It’s drummed into us all that pregnant women need to take 400mcg of folic acid during pregnancy to prevent birth defects. Folic acid is actually the synthetic form of folate which is only found in our supplements and fortified foods.
Folic acid doesn’t occur naturally, and doesn’t cross the placental barrier like folate (also called Vitamin B9) does.
Folic Acid or Folate?
More and more research is now available showing that some people can benefit from taking folate, rather than folic acid.
Folic acid needs to go through a series of changes driven by enzymes to be used in the body. If there isn’t enough of the enzymes around to convert it then folic acid circulates around the body in a toxic form (i.e. not good for us).[i]
About 40% to 60% of us have a genetic trait (called a SNP or polymorphism) that means we don’t convert folic acid to its active form as well as we should (or at all) [ii]. High doses of unmetablolized folic acid can also contribute to certain cancers and depress the immune system.
So, if that means around half of us cannot convert folic acid and use it effectively, and it’s not good to have too much folic acid, what can you do?
Take folate instead.
Why we need folate in pregnancy
Folate is so important for making new DNA, and to grow another person inside you we need a lot of DNA as it’s in every cell. As the baby grows in the womb, cells are rapidly and constantly dividing which means we need a lot of folate to support this process.
Folate also promotes healthy neural tube formation, helps your baby gain an adequate birth weight and other development.
Folate pregnancy supplementation
In the UK The NHS recommend we get 400mcg folate during pregnancy; this is the minimum to prevent birth defects during pregnancy.
Unfortunately, most pregnancy multivitamins use folic acid instead of folate because it’s cheaper. However, if you can shop around for a higher quality pregnancy vitamin look for one with a methylated form of folate, which will be called folate or methylfolate. Companies like Biocare or Cytoplan include folate in their prenatal supplement which can be ordered online, or ask in a health food shop for more help.
Folic acid does prevent neural tube defects, so if you’re pregnant or trying to conceive don’t stop taking it unless you are replacing it with a folate substitute. Folic acid doesn’t have the same health benefits as folate, and too much of this version of the vitamin can have negative health impacts.
The highest sources of naturally occurring folates are beef liver (always choose organic liver), legumes like lentils and pinto beans, dark leafy greens like spinach, kale and collards, and asparagus so you can add these to your diet to increase folate levels.
If you’d like some specific support with your diet during pregnancy, or for pre-conception advice please get in touch and Anna, our qualified Naturopathic Nutritional Therapist can set up an appointment to review your health and diet. Contact us or email firstname.lastname@example.org for more info.
[i] Bailey, S. W., & Ayling, J. E. (2009). The extremely slow and variable activity of dihydrofolate reductase in human liver and its implications for high folic acid intake. Proceedings of the National Academy of Sciences of the United States of America, 106(36), 15424–15429. http://doi.org/10.1073/pnas.0902072106
[ii] Greenberg, J. A., & Bell, S. J. (2011). Multivitamin Supplementation During Pregnancy: Emphasis on Folic Acid and l-Methylfolate. Reviews in Obstetrics and Gynecology, 4(3-4), 126–127. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250974/