Natural Folate vs Folic Acid for Pregnancy

Natural Folate vs Folic Acid, MTHFR, and Why I Regret My Prenatal Vitamin

When I was pregnant with my first child, I didn't give much thought to the type of prenatal vitamin I took. I just assumed that all prenatal vitamins were created equal and would give my growing baby and me the essential nutrients we needed. However, after experiencing pregnancy complications and learning more about the different forms of folate, I regret not thoroughly researching my prenatal vitamin ingredients.

In this article, I want to share what I wish I had known back then about the differences between natural folate and folic acid, the MTHFR gene mutation, and why the type of prenatal vitamin you take really matters. My goal is to help other moms-to-be learn from my mistakes and make the most informed choice for their own prenatal health.

Many women don't realize that not all prenatal vitamins are created equal.

Prenatal Vitamin Regrets - What I Wish I Knew

When I became pregnant with my first child, I immediately started taking a popular drugstore prenatal vitamin that my doctor recommended. It contained the standard 800 mcg of folic acid found in most traditional prenatal multivitamins. At the time, I didn't realize the significant difference between folic acid and natural folate.

I've heard stories of other moms who experienced extreme fatigue, anxiety, and depression in their second and third trimesters. These can all be symptoms of a folate deficiency

Since then, there has been increasing research and awareness around the MTHFR gene mutation. This genetic variant makes it difficult for some individuals to properly process synthetic folic acid found in many common prenatal vitamins.

By sharing this information, I can help you make the most informed decision about your personal prenatal vitamin and avoid potential issues. Let's take a deeper look at why natural folate matters.

Folate is critical for proper fetal development and growth.

Why Do You Need Folic Acid or Folate During Pregnancy?

Folate is crucial in cell growth and development, DNA and RNA synthesis, and red blood cell formation. You need extra folate to support your developing baby and avoid deficiencies when you're expecting.

Folate is especially critical in the first month of pregnancy when the baby's neural tube is forming and closing (this will later form the brain and spinal cord). Getting adequate folate reduces the risk of neural tube defects like spina bifida.

Later in pregnancy, folate continues to support the baby's growth and development. It helps form a healthy placenta and normal umbilical cord blood flow.

Folate deficiency during pregnancy can also lead to some unwanted health effects for mama. Signs and symptoms may include anemia, tongue pain, digestive problems, higher rates of infections, poor mental health, and even miscarriage.

Bottom line: Folic acid or folate is vital for both you and your baby!

Though similar, the body absorbs and utilizes natural folate more readily than synthetic folic acid.

Folate vs Folic Acid - What's the Difference?

The human body can use both folate and folic acid, but they are not interchangeable. The two have several significant differences, including absorption, bioavailability, and metabolism.

Folate is absorbed directly into the bloodstream, while folic acid must first be converted into the active form of folate. This conversion may be less efficient for some individuals, leading to a buildup of unmetabolized folic acid in the bloodstream.

  • Folate - the natural form of vitamin B9 found in foods like leafy greens, liver, and legumes. It's readily used by the body.

  • Folic acid - This synthetic form is added to supplements and fortified foods but requires conversion before your body can use it.

While similar, folate is preferred for optimal health, especially during pregnancy. Some key differences:

  • Bioavailability: Natural folate is more easily absorbed and utilized than folic acid.

  • Processing: Around 30-40% of the population cannot fully metabolize folic acid due to genetic mutations.

  • Excess: Unmetabolized folic acid can build up in your blood and may have unintended effects long-term.

Now, let's look at how common gene mutations further impact folic acid absorption.

The MTHFR mutation can reduce conversion of folic acid into usable folate by up to 70%.

The Role of MTHFR Gene Mutations

The MTHFR gene helps create an enzyme crucial to metabolizing folate and folic acid. Specific mutations of this gene can severely impact how well your body processes folic acid.

It's estimated that around 40% of the population has an MTHFR mutation, often without even realizing it. Even minor mutations can reduce folic acid conversion by 30-50%.

Major MTHFR mutations lead to up to 70% less conversion of folic acid into a usable form your body can benefit from. This mutation also causes unmetabolized folic acid to build up in the bloodstream.

If you have the MTHFR mutation, taking large amounts of folic acid may be ineffective and potentially harmful, as we'll explore next.

Problems with High Folic Acid Intake

While adequate natural folate is highly beneficial, getting too much folic acid can cause issues if your body cannot process it properly, including:

  • Masking vitamin B12 deficiency: High folic acid intake can hide a lack of B12, allowing neurological damage to progress.

  • Unmetabolized folic acid buildup: Excess circulating folic acid may increase health risks, including certain cancers and immune problems.

  • Competitive binding: Unused folic acid competes for absorption sites with natural folate your body needs.

  • Potential epigenetic changes: Some research indicates excess folic acid in utero may impact gene expression linked to diabetes and obesity.

The problems posed by high folic acid intake are amplified for those with the MTHFR mutation. Let's look at how to avoid this by seeking natural folate sources instead.

Leafy greens, liver, and legumes provide natural folate.

Seeking Out Natural Folate Sources

If you're looking to prevent folic acid absorption issues, it's recommended to consume folate through natural sources:

If you're looking for something in pill form, look for:

  • Active methylfolate - Bioavailable form in supplements that bypasses metabolic steps needed for folic acid.

  • Plant-based prenatal vitamins - Some brands contain folate instead of folic acid. A simple look at the label will let you know which one it contains.

A folate-focused diet and an active methylfolate supplement is the ideal way to get this essential nutrient, especially if you have an MTHFR mutation.

Begin folic acid or folate supplements at least one month before conception.

When to Start Taking a Folate Supplement

Here's when you should start supplementing with folic acid or folate:

  • Before pregnancy - Take 400 mcg daily at least 1 month before trying to conceive. Since neural tube development happens in the first few weeks, getting enough folate pre-conception is critical.

  • Early pregnancy - Increase to 600 mcg of folic acid or folate, ideally before week 4 of your pregnancy. Continue taking this amount (or more if your doctor recommends) throughout pregnancy and breastfeeding.

Don't wait until you get a positive pregnancy test. Neural tube defects can occur before you even know you're pregnant! Take folic acid or folate as a precautionary measure.

Additional Tips for Absorption

To maximize absorption of natural folate sources:

  • Take folate supplements on an empty stomach when possible. Avoid taking with antacids.

  • If taking a calcium supplement, dose it separately from folate to prevent interference.

  • Add vitamin C foods to meals to boost folate absorption - citrus fruits, bell peppers, and broccoli are good sources.

  • Avoid excessive alcohol intake, which can deplete folate levels long-term.

  • If dealing with a health condition, nutrient deficiency, or digestive issues, check serum vitamin levels routinely.

With the proper dietary habits and supplement strategy, your body will get the precious folate it needs for you and your baby!

Look for prenatal vitamins with natural methylfolate instead of folic acid.

The Bottom Line

Knowing what I do now, I hope this information helps other moms-to-be from making the same prenatal vitamin mistakes I did. The takeaway points are:

  • Choose natural folate over folic acid whenever possible, especially if you have MTHFR mutations.

  • Get folate from natural food sources and supplements with methylfolate, not synthetic folic acid.

  • Research any prenatal vitamins thoroughly before taking them to ensure optimal absorption.

  • Work with a knowledgeable practitioner to determine the ideal folate sources and amounts for your health needs during pregnancy and beyond.

The right form of this vital B vitamin will make a big difference in your health and your baby's development!


Do you still have questions about the differences between natural folate and folic acid? Here are answers to some frequently asked questions:

Should I take a specific prenatal vitamin if I have MTHFR?

Yes. Choose one with methylfolate instead of folic acid, and avoid formulas with excessive folic acid.

How can I find out if I have an MTHFR gene mutation?

Ask your doctor for an MTHFR gene test. Many functional medicine practitioners offer this.

Is folate just for pregnant women?

No, folate is vital for anyone's health, especially the brain and heart. Get adequate folate from natural food sources daily.

Can I get too much natural folate?

It's rare but possible. Doses up to 1000 mcg daily are considered safe during pregnancy. Stay within what your doctor recommends.

When should I start taking folate supplements?

Start folate supplements 400 mcg daily at least one month before pregnancy. Boost to 600-800 mcg once pregnant.

I hope these tips help you make informed decisions about meeting your increased folate needs during your pregnancy journey! Please reach out if you have any other questions.

Katie Croslow

Katie Croslow, RN, CLC

Katie Croslow is a Registered Nurse, Holistic Health Coach, Certified Lactation Counselor and mother of five. She has worked in many different areas of nursing but her true passion is helping mothers and their babies. As a lactation counselor, she has helped countless women achieve their breastfeeding goals. Katie also enjoys working with pregnant women and new mothers to help them maintain their health and well-being during this important time in their lives.