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Folate or Folic Acid?

February 2024


This is often a big question with my fertility clients. Are they the same? Which one is better? Should we supplement when trying to conceive or rely on food sources only?


Let me break this down for you as it can be confusing.


Both folate and folic acid are a form of vitamin B9, their names are often used interchangeably but they are different.


Why is it important?


Folate plays a pivotal role in DNA synthesis, repair, and cell division. In the context of fertility, these functions are of paramount importance as they influence the development of the foetal neural tube during the early stages of pregnancy. Sufficient folate intake is associated with a reduced risk of neural tube defects such as spina bifida, making it a vital nutrient for those planning to conceive.


Folate is also involved in the production and maturation of eggs and sperm. In women, it supports the formation of a healthy uterine lining, enhancing the chances of successful implantation. In men, folate contributes to the integrity and health of sperm DNA, potentially impacting fertility.


What are the differences between Folate and Folic Acid?


Folic acid is the synthetic form of B9, meaning it is man-made in a lab. Our body can’t use folic acid in this form and must convert folic acid to methylfolate in order to utilise it. However, 40% of the population carry a gene mutation that affects their ability to do this conversion. The genetic variation known as MTHFR (methylenetetrahydrofolate reductase), affects the body's ability to convert folic acid into the active form, methylfolate, therefore reducing their ability to absorb and use it.


This can lead to higher concentrations of folic acid in the blood stream which raises concerns about potential health risks.


Folate however is the natural form of vitamin B9. Our body doesn’t need to do any conversions and knows exactly what to do with it.


Folate gets into the cells and does the job!


Food Sources:


There are of course food sources of folate which we shouldn’t ignore and should incorporate into our daily diets daily. These food sources are:


Legumes (beans, peas and lentils), asparagus, eggs, leafy greens, beetroot, broccoli, citrus fruits, bananas, avocado and nuts and seeds.


So my advice on the decision whether to supplement with folic acid or folate is folate every time!


But you must include food sources too which are jam-packed with a whole host of other essential nutrients as well as that all important folate.


But how long should you take it for?


It is recommended to take folate before trying to conceive and for the first 12 weeks of pregnancy to protect the baby from neural defects. However, folate is important throughout pregnancy and beyond and I recommend supplementing for far longer than this.


Why supplement for longer?

Optimal folate can reduce pregnancy complications as it contributes to a myriad of processes crucial for a healthy pregnancy. It aids in the formation of genetic material, supports cell division, and helps in the synthesis of DNA and RNA. These processes are not only pivotal for the developing foetus but also for the overall health and well-being of the mother.

Folate deficiency anaemia can be common as both the growing baby and the mother need it. Folate deficiency symptoms include fatigue; tongue swelling; headaches; irritability; mouth sores; weakness; pallor of the skin; shortness of breath; palpitations and lethargy.

In addition to the prevention of neural tube defects and anaemia, folate supplementation also has other beneficial effects, including the prevention of congenital heart disease, oral clefts and possibly preterm birth.

Is folate needed after birth?

Yes. The importance of folate doesn't diminish after childbirth, folate supports the production of red blood cells, which is particularly crucial during the post-natal period when blood volume increases, and therefore aids in childbirth recovery.

For breastfeeding mothers folate remains a key player. Folate is secreted into breast milk and levels can be reduced when there is a maternal deficiency. Adequate folate levels in the mother contribute to the nutritional quality of the breast milk and promotes the healthy growth and development of the newborn. This is highly important during the early months when the infant’s nutritional needs are only met through breastfeeding.

Pregnancy and breastfeeding can place considerable demands on the mother's body. Folate, with its involvement in energy metabolism and the production of neurotransmitters, contributes to overall maternal well-being. It helps combat fatigue, supports mental health and aids in the management of stress—all factors that can significantly impact the experience of pregnancy and breastfeeding.


Carboni, L. (2022). Active Folate Versus Folic Acid: The Role of 5-MTHF (Methylfolate) in Human Health. Integrative Medicine (Encinitas, Calif.), 21(3), 36–41.


Gaskins, A. J., Afeiche, M., Wright, D. L., Toth, T. L., Williams, P. L., Gillman, M. W., Hauser, R., & Chavarro, J. E. (2014). Dietary Folate and Reproductive Success Among Women Undergoing Assisted Reproduction. Obstetrics and Gynecology, 124(4), 801–809.


Gaskins, A. J., & Chavarro, J. E. (2018). Diet and fertility: a review. American Journal of Obstetrics and Gynecology, 218(4), 379–389.


Greenberg, J. A., Bell, S. J., Guan, Y., & Yu, Y.-H. (2011). Folic Acid Supplementation and pregnancy: More than Just Neural Tube Defect Prevention. Reviews in Obstetrics & Gynecology, 4(2), 52–59.


Hoek, J., Steegers‐Theunissen, R. P. M., Willemsen, S. P., & Schoenmakers, S. (2020). Paternal Folate Status and Sperm Quality, Pregnancy Outcomes, and Epigenetics: A Systematic Review and Meta‐Analysis. Molecular Nutrition & Food Research, 64(9), 1900696.


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Miraglia, N., & Dehay, E. (2022). Folate Supplementation in Fertility and Pregnancy: The Advantages of (6S)5-Methyltetrahydrofolate. Alternative Therapies in Health and Medicine, 28(4), 12–17.

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