Folate is a B vitamin that’s essential for healthy cell growth and DNA production. While folate occurs naturally in foods like leafy greens and legumes, folic acid is the synthetic form used in supplements and fortified foods. Your body can use both forms, but folic acid is specially designed to be more easily absorbed by your body.
Why Folic Acid is Important
Folic acid plays a crucial role in preventing serious birth defects of the baby’s brain and spine called neural tube defects (NTDs), including spina bifida. These defects occur very early in pregnancy – between days 21-28 after conception, often before many people know they’re pregnant. This is why starting folic acid before pregnancy is so important.
Recommendations for Folic Acid Supplementation
The Centers for Disease Control and Prevention (CDC) and other major medical organizations recommend:
- Take 400 micrograms (mcg) of folic acid daily for all people who could become pregnant
- Start at least one month before conception and continue through pregnancy
- Continue taking folic acid throughout pregnancy and while breastfeeding
- Some people may need higher doses (up to 4000 mcg) if they have certain risk factors – such as having a previous child with a NTD or if you or your partner has a NTD. Ask your healthcare provider if you would benefit from a higher dose of folic acid.
Folic Acid vs. Other Forms of Folate such as 5-MTHF
You may have seen supplements containing a form called 5-MTHF (methylfolate) marketed as a “more natural” alternative to folic acid, especially for people with MTHFR gene variants. However, folic acid remains the recommended form because:
- It’s the only form proven in large clinical trials to prevent neural tube defects
- It’s stable and well-absorbed by the body
- Research shows it effectively raises folate levels even in people with MTHFR variants
- It’s regulated for quality and purity as a medication
While 5-MTHF may seem promising, there isn’t enough research proving it prevents birth defects. Until more studies are done, folic acid remains the safest, most evidence-based choice for pregnancy.
Getting Enough Folic Acid
You can get folic acid through:
- Prenatal vitamins or folic acid supplements
- Fortified foods like breads, cereals, and pasta
- A combination of both supplements and fortified foods
Remember that while many foods contain natural folate, it’s harder for your body to absorb than folic acid. This is why supplementation is recommended even with a healthy diet.
Talk to your healthcare provider about the right folic acid dose for you based on your individual risk factors. They can help ensure you’re getting enough of this crucial nutrient to support a healthy pregnancy.
Sources
Goetzl, L. M. (May 1 2024). Preconception and prenatal folic acid supplementation. In Uptodate, Wolters Kluwer. Retrieved November 14, 2024, from uptodate.com.
Samaniego-Vaesken, María de Lourdes et al. “Supplementation with Folic Acid or 5-Methyltetrahydrofolate and Prevention of Neural Tube Defects: An Evidence-Based Narrative Review.” Nutrients vol. 16,18 3154. 18 Sep. 2024, doi:10.3390/nu16183154
U.S. Department of Health and Human Services, National Institutes of Health (Nov 30 2022) “Folate Fact Sheet for Health Professionals” Retrieved Nov 14, 2024, https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
Berry RJ, Li Z, Erickson JD, et al. Prevention of neural-tube defects with folic acid in China. China-U.S. Collaborative Project for Neural Tube Defect Prevention. N Engl J Med. 1999;341:1485-90.
Crider KS, Zhu JH, Hao L, et al. MTHFR 677C->T genotype is associated with folate and homocysteine concentrations in a large population-based, double-blind trial of folic acid supplementation. Am J Clin Nutr. 2011;93:1365-72.