The benefits of folic acid are often communicated to the public by health authorities. Folic acid is the synthetic form of folate (vitamin b9) which means it is cheaper to produce. However, it is not fully metabolised by the body. Folic acid must be converted to tetrahydrofolate before it can be used in the body.This activity requires a methyl group to be added to the molecule. In the diet, this requires several co- factors to make the conversion which can include the following:
When folate that is already methylated (methyltetrahydrafolate-MTHF) is ingested, it provides the body with a more readily available source and requires fewer cofactors for the body to be able to use it.
Numerous studies have reported unmetabolised folic acid in the blood after consumption of folic acid supplements. Other research shows that unabsorbed folic acid in blood may increase risk of disease conditions.
It is common advice that women should take folic acid during pre-conception and pregnancy to prevent birth defects. What is not explained however is that folic acid is the synthetic form, and that only a small percentage of folic acid converts to the active form, which is called L- Methylfolate (sometimes marketed as tetrahydrofolate or 5-MTHFR).
The problem with folic acid is that 50-60% of people have genes that reduce their ability to convert folic acid into the active form (methylfolate). We need the active form of folate to synthesise, repair and express DNA. In these cases patients should use methylfolate (MTHF).
Methylfolate is the active,natural form of folate that the body uses. The body cannot produce folate so it must be obtained through your diet. Folate provided by food is not biologically active,therefore must be processed by the liver into methylfolate, which is the form your body can use.
Folate is used to form red blood cells in bone marrow, where it also helps to make antibodies by using sugars and amino acids. Folate works with vitamin B12 in the formation of haemoglobin and is essential for zinc metabolism. It’s a fundamental ingredient to good health and plays a crucial role in pregnancy because the mother’s body needs a lot of it to share with her baby.
A deficiency is common during pregnancy. A mother’s deficiency in folate can lead to fetal abnormalities like cleft palate, harelip, deformed limbs, neural tube defects like spinal bifida, skeleton deformities, lung and kidney underdevelopment, brain deformities and anaemia. Studies suggest that women who supplement with folate during the month of conception and the first 8-10 weeks after conception are less likely to have a malformed baby.
Good sources of the active form of folate are green leafy vegetables (kale, collards, chard and spinach), organ meats and root vegetables and nuts. In addition to this, supplementation with methyl folate prior to pregnancy with appropriate amounts is recommended.