Updated: Feb 2
*This blog is largely in regards to supplementation while trying to conceive or pre-natal care*
If you have a concern with this article, please email me.
Folate is often supplemented in pre-conception care to reduce the risk of neural tube defects (i.e. the spinal cord and brain) in the embryo development in the first trimester. This is basic pre-natal and natal care and should be continued throughout the period of trying to conceive and the first trimester. Folic acid and Folinic acid are both types of FOLATE, the term also including 5-methylfolate.
But, what do the different forms mean?
To keep things simple, folic acid is the synthetic version often found in supplements, fortified foods, and pre-natals. There is no natural occurance of folic acid, and so requires more effort for the body to convert this synthetic form to an active form once ingested.
The naturally occuring forms of folate are folinic acid and 5-methylfolate are already active. These are found in dark leafy green and cruciferous vegetables (for example). You can find supplements with this version, but it's not as common because it's more expensive to manufacture.
Studies within the last 10 years have shown that the 'active forms', i.e. 5-methylfolate, is more bioavailable and better absorbed. This is not hugely important for the majority of people, unless; they have the MTHFR gene which affects the enzyme that helps to activate folic acid and increases homocyestine; or there is an underlying B12 deficiency (due to inadequate intake* or absorption issue); or they have a history of miscarriage (keep reading). B12 deficiency haematology (blood) symptoms can be masked by excess folate - weird I know, but they both help form red blood cells.
If you have just found out you are pregnant and are not taking a pre-natal - 5-Methylfolate (as metfolin usually) is the best form to begin with to rapidly boost folate levels to support your pregnancy.
Both B12 deficiency and high homocysteine can be risk factors for miscarriage - that's why I recommend seeing a qualified professional if you have the MTHFR gene and are looking to have a baby soon, or have had reoccurant miscarriages and no further investigations yet.
To briefly summarise: 5-Methylfolate (as metafolin) is the superior form for absorption to bring up folate status. If you have MTHFR gene polymorphisms, folic acid and 5-methylfolate were shown to be equal, but an activated B complex may be more holistically supportive.
*If you are vegan or vegetarian, please begin B12 supplementation immediately .