The difference between folate, folic acid and folinic acid
Folate, folic acid and folinic acid - and does it matter when choosing a natal multi-vitamin?
Well, yes, it does matter. It may seem confusing especially as ‘folate’ is the name given to the water-soluble B9 vitamin which is naturally found in leafy greens and other vegetables, the livers of calves and chicken and some pulses like lentils. ‘Folate’ and ‘folic acid’ are also used to name the synthetic compound Vitamin B9 which is used in many natal multivitamin supplements as well as in fortified foods.
The naturally occurring folate is absorbed in the digestive tract and assimilated well in the body as long as there is no MTHFR gene defect. Synthetic folate has difficulty being metabolised in the liver, especially in approximately 60% of the population with MTHFR gene defects impacting its conversion to being an activated nutrient. Several studies have shown the presence of unmetabolized folic acid in the blood following the consumption of folic acid supplements or fortified foods and implicate it in the inadequate uptake of activated folinic acid.
Since the 1990’s fortification of foods with synthetic folate was to prevent NTDs – neural tube defects in newborns, most commonly known as Spina Bifida. There was overwhelming evidence of the protective effect of folic acid supplementation before conception and during early pregnancy especially as it supports rapid cell division and supports the growth of the placenta and fetus. Now there is concern that synthetic folic acid is not providing protection against NTDs and is a health risk.
So, the best advice is to eat abundant quantities of leafy greens… always. The reality is that frequently we don’t have our ‘A’ eating regimen in action. With 50% of pregnancies unplanned, making an extra effort to consume more vegetables would seem like a worthy plan.
For those anticipating a pregnancy, or with the MTHFR gene mutation, taking an activated folic acid supplement as well as increasing green vege is recommended.
Women planning a pregnancy should consume between 800-1200mcg of folate a day, starting several months before conception. This is quite a substantial amount of leafy greens, so unless you are consuming liver as well, the recommended daily supplementary dose is 600-800mcg. If you are one of many with an MTHFR gene defect it is important to be supplementing with activated folinic acid.
Read the labels well on natal multivitamin supplements. Look for names like - folinic acid, leucovorin, and 5MTHF (5 methyltetrahydrofolate). Avoid supplements that state ‘folic acid’.