Folate vs. Folic Acid (Which is better? +MTHFR)

Folate vs. folic acid: is folate the same as folic acid? Let’s talk about the difference between folic acid and folate, so you can make the best decision for your health.

Is folate the same as folic acid?

Short answer: NO.

The terms folic acid and folate are often used interchangeably as if they were the same thing which they are not.

Both folic acid and folate are forms of vitamin B9 which is a crucial nutrient for virtually all living cells within the human body regardless of age or gender. And, well, that’s pretty much the only commonality of the two.

Folate vs. folic acid

Folate is a naturally occurring vitamin B9. You can get folate from foods that are high in folate, or from dietary supplements containing natural folate. Folate exists in nature in several different forms.

Folic acid is a synthetic form of vitamin B9 that’s found in many supplements that are based on synthetic USP vitamins. There is only one form of folic acid (pteroylglutamic acid), and it’s one that doesn’t occur in nature in a free isolated form.

In the United States, a significant source of folic acid are also fortified foods. Following a mandate from 1996 (fully implemented in 1998), folic acid is added to conventional (as well as some organic) grain products (bread, rolls, pastries, pasta, breakfast cereal, etc.) with the intention to increase folate levels not so much in the general population but predominantly in the subgroup of females of childbearing age.

Why are our foods fortified with folic acid?

It’s because the wheat flour has changed.

The way commercial grain is milled has changed dramatically compared to the olden days, which consequently changed the composition and quality of the flour.

The wheat kernel is made up of 3 components:

• bran – the outer part of the kernel. It contains large amounts of B vitamins, some protein, phytonutrients, trace minerals, and dietary fiber.
• germ – the sprouting and central part of the kernel. It’s packed with healthy fats, fiber, folate and many other B vitamins, protein, and minerals.
• endosperm – the largest portion of the kernel and the least nutritious of the three. It contains high amounts of carbohydrates, and only small amounts of vitamins and minerals.

Originally, small-operation stone milling, typically powered by wind or water, was the only way to turn grain into flour. The flour milled in this way used all three vital parts of the kernel and therefore retained much of its nutritional value.

The problem was, as nutritious as the flour was back then, it had a relatively short shelf life. This was impractical, given that the flour had often spoiled before it even reached its destination or shortly after. The germ part of the kernel and its high fat content was the culprit behind such quick spoilage – oils speed up oxidation which leads to rancidity. Rancid flour will not kill you, but the cookies won’t be good.

Looking for means to mass produce and to improve the shelf life of commercially sold flour, automated flour mills were gradually introduced, with the roller mill invention in 1865 changing the flour forever – for better and for worse.

Roller milling separated all 3 parts of the wheat berry. With much of the bran and germ removed, only the starchy part – the endosperm – was processed into flour.

PRO: This resulted in a dramatically extended shelf life.

CON: The flour was stripped of much of its nutrients.

The results of modern industrial milling led to higher profits and increase in production but also to a surge in health issues including miscarriages and birth defects. The government was aware and had to do something.

In 1941, the U.S. federal government launched a flour enrichment program, calling for flour fortification with iron and some B vitamins (thiamin, riboflavin, and niacin) which were some of the nutrients lost in the milling process. In 1998, folic acid became the most recent addition to the mandate due to evidence showing that the incidence of neural tube defects in infants dropped when mothers took more folic acid/folate before getting pregnant.

Folate vs. folic acid – which form is better???

#1 Bioavailability of folic acid and folate

The medical consensus has long been that natural folates show underwhelming bioavailability when compared with synthetic folic acid. (Never mind that it makes zero sense.) It is believed that folic acid supplements confer 100% bioavailability, with fortified foods hovering somewhere around 85%. In contrast, the bioavailability of natural folate is believed to be limited and significantly subpar to that of folic acid, about half the numbers shown. [source, source]

Why is folic acid considered to be more bioavailable than natural folate?

1. Folic acid is more stable. It doesn’t degrade as quickly as natural folates do (similar to how fresh produce continuously loses nutritional value post-harvest).
2. Monoglutamate vs. polyglutamate form – while synthetic folic acid is a monoglutamate (containing only 1 glutamate), the majority of natural folates are polyglutamate chains (meaning they contain more than 1 glutamate) which is believed to hamper natural folate bioavailability.

However, part of the scientific community questions these findings and reports that the bioavailability of natural folates actually appears to be much higher (up to 98% –  so, way more than subpar…), and that consuming a diet rich in naturally occurring folate actually seems to be much more effective than previously thought. [1,2,3,4,5]

The truth is, things are not black and white, even when it comes to folate. A multitude of pre- and post-absorptive factors likely play a major role in folate bioavailability, such as:

• specific forms of natural folates (there are several common forms)
• the cellular matrix of the food consumed (a plate filled with the goodness of whole foods vs. deep fried Twinkies with a side of greens)
• genetic polymorphism (more on that in a bit)

#2 Folic acid vs. different folate forms

There is only one version of folic acid (pteroylglutamic acid) whereas folates exist in nature in various different forms. The chemical formula of folic acid is not like any of the naturally occurring folates, and it’s one that’s not readily usable, while some natural folates are.

When folic acid is consumed, either as a supplement or in fortified foods, it needs to be converted by the body into a biologically active form in order to be utilized. This happens through a process called methylation. The final cycle of the methylation pathway is methylated folate, AKA L-Methylfolate, the active and functional form of folate that the body can actually benefit from.

L-Methylfolate is also known as:

• Methylfolate
• 5-Methylfolate
• 5-Methyltetrahydrofolate
• L-5-Methyltetrahydrofolate
• 6(S)-5-Methyltetrahydrofolate
• L-MTHF
• 5-MTHF
• L-5-MTHF
• 6(S)-5-MTHF
• 5-CH3-H4folate
• 5-Methyl THF (as shown below)

When ingested, folic acid must be reduced – first to dihydrofolate (DHF), then to tetrahydrofolate (THF), before being methylated. Each step of the conversion is dependent on specific enzymes, with the last step of the conversion relying on the MTHFR enzyme (MTHFR being the acronym for methylenetetrahydrofolate reductase).

TECHNICALLY… Both natural folate and synthetic folic acid fall into the same loop of methylation cycle. The difference here is that folate occurs in nature in a wide range of already reduced forms, with many foods naturally containing high levels of L-Methylfolate (methylated, highly bioavailable, readily usable form of folate) which is where folate wins over folic acid hands down in the folic acid vs. folate debate.

The most abundant natural folate forms are:

• [reduced and methylated] 5-Methyltetrahydrofolate (5-Methyl THF; 5-CH3-H4folate)
• [reduced] 5- and 10-Formyltetrahydrofolate (5,10-Formyl THF)
• [reduced] tetrahydrofolate (THF)

[6,7]

Another slight difference between folic acid and folate is that while folate is absorbed in the small intestine, folic acid is converted into L-Methylfolate (methylated folate) in the liver. [8,9]

Folic acid vs. folate vs. methylfolate

To sum it up, you could say that there is folic acid that always needs to be fully reduced before being methylated, and various forms of natural folate that differ in the reduction extent from which some is already methylated (readily usable) and some unmethylated (reduced but still needing to go through the last and final MTHFR pathway). 

Virtually no natural folate is present in the form of unreduced folic acid.

Several processes and cofactors must play out in order to convert folic acid into L-Methylfolate, whether it’s folic acid from dietary supplements or folic acid from fortified foods.

For some of us, the conversion may not happen so easily.

In a significant portion of the population (the rough estimate is around one third to half the population), the MTHFR enzyme – the key player in the methylation pathway – may not be very efficient due to various genetic disorders of the MTHFR gene.

#3 Folic acid + MTHFR

We’re all born with the MTHFR gene. It’s passed down to us from our parents. This gene is responsible for producing the MTHFR enzyme that helps convert folic acid and some folate into L-Methylfolate, a biologically active form of folic acid/folate. Some of us carry a mutation in the MTHFR gene which can interfere with the process of methylation.

There are several known mutations of the MTHFR gene, and quite possibly more to be discovered.

It’s possible to have more than a single mutation of the MTHFR gene, with some being more problematic than others. Generally speaking, the more variations in the MTHFR gene, the more difficult the process of methylation might be.

Furthermore, if methylation is impaired, unmetabolized folic acid may build up in the bloodstream. The effects of unmetabolized folic acid in the blood are not yet fully understood.

Can you get tested for MTHFR gene mutations?

Having a genetic test done is a personal choice, though certainly an option. This test can be done through your healthcare provider (your insurance may cover the cost) or independently through a private lab, typically with a non-invasive mouth swab. 23andMe is probably the most popular company for private genetic testing, but you’d need to run your raw data file through a genetic reporting service like Genetic Genie, NutraHacker, or something similar to access your methylation profile.

If you’re interested in having a DNA test done, keep in mind that just having an MTHFR mutation alone doesn’t necessarily mean that your MTHFR enzyme isn’t functioning well enough (to the point of causing health issues).

Also, it’s worth considering how you feel about having your DNA stored in a centralized genetic database, and what the future implications of sharing your DNA may be. In this world, once it’s out there, it’s out there. Even if you didn’t give consent to share.

If you really wanted to know your MTHFR status, you could talk to your physician about having your levels of homocysteine tested by a simple blood test. If they seem fine, nothing needs to be done (even if you have a variation in the MTHFR gene). If the levels are elevated, you may need to take supplements that will address your needs. (Many doctors like to prescribe high doses of folic acid to remedy this problem (while it was folic acid that wasn’t working in the first place). If that’s your case, I suggest you take the time to research MTHFR in depth and seek the help of a professional that truly understands methylation deficiency including upstream and downstream folate metabolism – the majority of allopathic healthcare providers do not).

#4 Folic acid and health concerns

The tolerable upper limit for folic acid intake is set at 1,000 mcg/day for all adults (and 300 – 800 mcg for kids through teens) [source].

It’s actually incredibly easy to go over this threshold if you take a multivitamin containing folic acid or a stand-alone folic acid supplement, and eat lots of processed, fortified foods.

Given that the vast majority of the foods of convenience are fortified these day (made with fortified flour), it has become increasingly difficult to avoid foods containing folic acid. I myself avoid folic acid in the ingredient lists as much as I can, and it’s HARD.

Furthermore, though controversial, folic acid supplementation and food fortification may be a risk factor for some types of cancers. [10,11,12,13,14,15]

Also, scientists are increasingly wondering if the scale of folic acid fortification and supplementation we see today is really necessary, and if it could be causing more harm than good. [16,17,18,19] There is growing concern that folic acid intake can result in detrimental effects, particularly in susceptible individuals that are having a hard time converting folic acid.

To summarize…

• Folic acid = synthetic. Folate = natural.
• There is only one form of folic acid, and various forms of natural folates.
• Folic acid and folate must be converted into a form that the body can utilize.
• Folic acid isn’t the readily bioavailable form, but many natural folates are.
• Those that are affected by imbalanced methylation (MTHFR mutations) may have a much harder time converting folic acid and some natural folate into the usable, active form (methylated folate).

The best way to boost folate levels?

If you want to boost folate levels (and, realistically, we all should…), your best bet is through folate-rich foods. Put more leafy greens and legumes on your plate, eat more avocados, oranges, beets, nuts, and other foods high in folate.

If you need a super boost or can’t (or don’t want to) eat many foods naturally high in folate, you might be better off taking a folate supplement (rather than folic acid) due to its variability and presence of natural co-factors. However, make sure it’s indeed folate as some brands put misleading information on the labels and market synthetic folic acid as natural folate (look for whole food supplements; not just food-based). Or purchase supplements that contain methylated folate.

I hope this article has shed some light on the topic of food fortification and folic acid conversion, and the difference between folic acid and folate.

DISCLAIMER: The information contained on this website is not considered to be a substitute for any type of professional medical advice or treatment. Some of the statements made here on WholesomeChildren.com have not been approved by the Food and Drug Administration including, but not limited to, nutrition-related advice, products, health conditions, ingredients, supplements, or a lifestyle practice. No information on this website should be used to diagnose, treat, prevent, or cure any disease or a health condition.

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References:

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