Folate vs Folic Acid - Does it matter for fertility and pregnancy?

What's the difference?

Maybe you haven't heard of the difference between folate & folic acid.

Maybe you have heard of the difference but don't really understand why it's such a big deal.

Or maybe you don't quite get why your health practitioner may be recommending vitamin brands with activated folate instead.

We are here to help.

Don't you need folic acid for fertility & pregnancy?

No, your body needs folate.

Unfortunately not all health practitioners are up to date on the research, differences & implications.

Folic acid is the cheap synthetic version put in lower quality vitamins.

To be extra confusing, folate has lots of names & variations including: vitamin B9, or folinic acid, dihydrofolate (DHF), tetrahydrofolate (THF), 5, 10-methylenetetrahydrofolate (5, 10-MTHF), and 5-methyltetrahydrofolate (5-MTHF).

Folate is needed by everyone, but in higher doses of 600ug per day for pregnancy.

Folate is needed for

• Making new cells (crucial in pregnancy!)
  

• Protecting against gene mutations such as neural tube defects
  

• Methylation (detoxifying your body)
  

• Keeping Homocysteine levels down (more on this later)
  

• Avoiding Macrocytic Anaemia

Why have activated folate instead?

Good question! :)

1. Folic acid isn't as bioavailable and isn't used as well by the body. This can mean you may be supplementing but you still have low folate levels
   

2. MANY people have a MTHFR gene mutation. It means you really struggle to use folic acid but the activated forms of folate work great (see below)
   

3. Having low folate levels can lead to a whole host of general health, fertility & pregnancy problems (see below)
   

(We dont recommend folic acid for anyone, much less for those who don't know if they have this gene mutation or not)

How does this affect fertility & pregnancy?

Folic acid is poorly utilized by the body (especially by those with MTHFR gene mutations), leading to:
low folate levels & high homocysteine levels.

The implications for fertility are:

• Folate is needed to make cells. This includes good quality eggs, egg maturation & fetal development
  

• Regulated homocysteine "is associated with a better embryo quality and chance of pregnancy"
  

• Activated folate (rather than high dose folic acid) helps lower high homocysteine in people with MTHFR mutations
  

• Higher homocysteine is associated with lower oestrogen, higher FSH, lower progesterone in the luteal phase & a 33% increased risk of sporadic anovulation
  

  The implications for pregnancy are:

• This study found lower folate was associated with preterm babies & higher homocysteine with pre- eclampsia
  

• This study found the same + low birth weights in the low folate & high homocysteine group
  

Like to see even more research?

• This explains the difference between the types of folate vs folic acid
  

• This is a good general explainer on avoiding folic acid with pregnancy
  

• This has info on folic acid and placenta implications
  

• This is another general explainer
  

• This explains some risks in women with MTHFR gene mutations
  

• This shows non folic acid forms of folate being better absorbed
  

• Activated folate helps lower raised homocysteine. Here's more info on that here too
  

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What to do next

• Ditch any multi thats got folic acid in it.
  We love Naturobest for awesome Aussie made multis for men & women (and get zero for singing their praises!).
  

• Get folate & homocysteine tested as part of your general or fertility testing.
  

• Especially if you're a vegetarian (typically a low folate & b12 diet) or have a family history of MTHFR gene mutations.
  

• Chat to your doctor, or get folate and homocysteine tested privately

Hope this explains things a lot more!
Click for more women's health & fertility research.

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Take care, and see you in the clinic.