Folate vs Folic Acid in Pregnancy: What You Need to Know

Photo of author

Published on

BabyFacts logo

Folate (or Folic Acid) is arguably one of the most important nutrients to consume during pregnancy. But what is the difference between Folate and Folic Acid? Is one better than the other? And what is the deal with the MTHFR gene and Folate?

The main difference between Folate and Folic Acid is that Folate is naturally occurring in food, while Folic Acid is the synthetic version that is added to food and supplements.

However, there’s more to it than that. Read on to learn more about the difference between Folate, Folic Acid, and Methylfolate, and why you should be supplementing during pregnancy.

What’s the Difference between Folate and Folic Acid?

Folate is part of the B vitamin family, which also includes Thiamine, Riboflavin, Niacin, Pantothenic Acid, Biotin, Pyridoxine, and Cobalamin. Folic Acid is the synthetic version of Folate.

Folate is naturally occurring in food, while Folic Acid is the synthetic version that is added to food and supplements. Folate can naturally be found in foods such as citrus fruits, eggs, and green leafy vegetables. We’ll give you some great natural food sources of folate later in this article.

Folic Acid is made in a lab, but interestingly enough, the terms “Folate” and “Folic Acid” are used interchangeably, even though they are not the same substance.

Also keep in mind that “Folate” can be used as a generic term for anything related to Folate, including Folic Acid. Other forms include methylfolate, dihydrofolate or tetrahydrofolate.

Folate/Folic Acid is arguably the most important supplement to take during pregnancy. Research has proven that supplementation during pregnancy helps to prevent neural tube defects (spina bifida) that can shorten or greatly reduce your baby’s quality of life (Source: Cambridge)

There is also research showing that adequate Folate intake could prevent dementia and some forms of cancer. (Source: Pubmed)

Sources of Folate During Pregnancy (Folate-Rich Foods)

Here are five awesome sources of folate; what’s even better is they are all suitable for EVERYONE; plant-based women and omnivores!

  • Lentils contain high levels of folate; one cup of cooked lentils provides 90% of the daily recommended intake of folate!
  • One cup of cooked asparagus contains 68% of the DRI of folate, while also providing fiber and high levels of antioxidants.
  • Broccoli provides 42% DRI of folate per every cup (cooked); it also provides lots of antioxidants, fiber, and Vitamin K.
  • Beets also contain folate, with one cup of raw beets providing 37% of the daily recommended intake.
  • One cup of cooked Kidney Beans contains 33% DRI of folate, while also providing lots of fiber, carbohydrates, and potassium.
foods that are sources of folic acid

Sources of Folic Acid During Pregnancy

Folic Acid is the synthetic version of Folate, and is added to many processed foods. Common food sources of folic acid include:

  • Fortified cereal
  • Fortified bread
  • Fortified pasta
  • Fortified rice
  • Fortified tortillas and other corn products,
  • Vitamins, including many prenatal vitamins (Source: Medical News)

Folate is found in food sources (See above for five awesome sources), including liver, asparagus, black-eyed peas, spinach (and other green leafy vegetables), dairy, eggs, seafood, fruits, nuts, and poultry.

Folic Acid vs Folate Absorption

Through a series of chemical reactions, Folic acid is reduced to Pteroylglutamic acid. It is absorbed in the intestines, after passing through the stomach, and blood levels of folate can quickly rise, with about 60-80% of the nutrient being absorbed into the blood.

To compare, folate is NOT absorbed in the intestines, and women who have intestinal issues may find that they are deficient in folate even before becoming pregnant (Source: Journal of Clinical Pathology)

Folate vs Folic Acid in Prenatal Vitamins; Which is Better?

This question is tricky. It’s tricky because Folic Acid and Folate both break down in the body, if the correct genes are in place.

The Food and Nutrition Board of the Institute of Medicine recommends a prenatal vitamin with Folate, instead of Folic Acid, during pregnancy. It states that folate is preferable over folic acid.

It appears that this recommendation might be because they are recommending methylfolate, or the form of folate that can be absorbed by the body (Source: APA).

This might be better for women who have genetic variations in their genes (more on this later).

However, the NIH discusses this further; folic acid is available in multiple forms, including supplements and prenatal vitamins. If a prenatal vitamin is taken without food, you can likely absorb almost 100% of the folic acid. If you take your vitamin with food, you can absorb about 85% of the folic acid from the vitamin (Source: NIH).

In these instances, which is “best” depends on your diet, plus genetic factors – which we’ll discuss next.

How is Methylfolate Different from Folic Acid or regular Folate?

Methylfolate is the only form of folate that can be used in the body. This is the active form of the vitamin that can cross into cells and over the blood-brain barrier. Both folate and Folic Acid MUST be converted to methylfolate in order for them to be used in the body.

There is a specific enzyme called “Methylenetetrahydrofolate reductase” (MTHFR) that is required to convert Folate or Folic Acid to methylfolate. We will refer to this as MTHFR for the remainder of the article for clarity.

Surprisingly, many women have a defect in the genes that code for this enzyme. To make it even more confusing, there are several gene defects that have been discovered. This just means that the DNA sequence used to make the enzyme has little changes along the chain.

It is so common for women to have this gene variation that more women have it than don’t (at least in the United States); so, if you do, do not be alarmed! Up to 60% of American women have an MTHFR genetic variation.

Across the world, rates of gene variation differ. Studies show common populations include China (specifically northern China, with about 20%),  Mexico (32%), and southern Italy (26%).

Interestingly, rates of women and babies with the genetic variations increased when moving from north to south across the country (for example, rates increased from 4% to 7% from the north to the south of Finland). (BMJ)

So; what does that all mean? Well, this research could help to determine areas of the world that might need additional Folate supplementation, either through food or synthetic supplementations, which could help to lower the risk for birth defects, dementia, and cancer.

What does this mean for you? Long story short, daily supplementation of at least 400 mcg of Folate before pregnancy. The NIH recommends increasing to 600 mcg during pregnancy to 500 mcg per day through breastfeeding. (NIH)

One important thing to note about methyfolate; in the body it is responsible for breaking down some amino acids from protein, including homocysteine into methionine. If you do have an MTHFR gene variation and insufficient levels of methylfolate, there is a risk for elevated levels of homocysteine.

Homocysteine is an amino acid that may play a role in miscarriage, partly due to its blood clotting characteristics. (APA) This may suggest that having this gene variation could lead to pregnancy loss, but check with your medical professional to find out more about what this could mean for you and your pregnancy.

folic acid in capsules

Is it OK to take Folate instead of Folic Acid?

You might already be familiar with the MTHFR gene variation, and maybe have already been informed that you have the variation.

Just because you have a variation in your genes does not mean that taking one form over the other is better. It just means that your body might have difficulty converting Folate or Folic Acid to Methylfolate, meaning that you might need to adjust your supplementation or take a few tests to determine your levels.

Some people think that taking Folate instead of Folic Acid is better, but this is not necessarily true. The CDC has determined that Folic Acid supplementation is necessary during pregnancy, as it is the only form of Folate that can prevent neural tube defects in your baby. (CDC)

There are two factors to consider when determining whether or not you have enough folate to prevent neural tube defects; one is the amount of folic acid that you consume each day, and the other is the amount of time that you have been consuming it prior to becoming pregnant. (CDC)

The CDC recommends all women that could become pregnant should consume 400 micrograms of Folic Acid each day, even if you are not currently pregnant. Interestingly, even if you DO have an MTHFR gene variation, they still recommend the 400 micrograms, unless otherwise instructed by your medical professional.

However; if you have already had a baby born with a neural tube defect, the CDC recommends increasing your folic acid intake to 4,000 micrograms per day, starting one month before becoming pregnant and until three months post-partum. (CDC)

You might think that taking more is better, but that is not necessarily the case. Folate toxicity is not common, as it is a water-soluble vitamin; this means the body will not store excess amounts; instead, it will get broken down and excreted through urine.

However, very high amounts could cause seizures, irritability, insomnia, and intestinal issues. (Heart Healthy)

Final Thoughts

There are foods that are rich in Folate that can be consumed during pregnancy, along with supplementation. If you have an MTHFR gene variation, it might be more difficult for you to absorb Folic Acid, so taking the methylated form might be better.

If you have already had a baby with a neural tube defect, increased daily supplementation of Folic Acid is likely necessary, but talk with your medical professional can help you to determine what supplements you need.

Blood levels of folate must be adequate to ensure a healthy pregnancy for you and your baby. Folic acid supplementation is likely needed to maintain levels, increased to 600mcg per day during pregnancy and 500mcg during breastfeeding.