Folate, also known as vitamin B9, is one of the most important nutrients to get enough of during pregnancy. However, the type of folate that you take is even more important. Folate helps form the neural tube when a baby is developing during the first trimester of pregnancy.

Since the neural tube forms early in the baby’s brain and spine, if the mother does not get enough folate during pregnancy, there is a greater risk of birth defects to the baby’s brain (anencephaly) and spine (spina bifida).


What is folate good for?

Beyond pregnancy, folate is essential for many processes in children and adults, including amino acid metabolism, brain development health and function, DNA, and maintaining healthy glutathione levels. Glutathione is the body’s master antioxidant.

Folate also aids in methylation reactions, which is a chemical reaction in the body whereby a small molecule called a methyl group gets added to DNA, proteins, or other molecules for brain, cellular, metabolic, and cardiovascular health.

What foods have folate?

Folate is naturally found in many plant-based foods, including asparagus, avocado, banana, broccoli, green leafy vegetables, kidney beans, and wheat germ. But only about 50% of folate in foods is bioavailable to the human body, according to the NIH.

And there is more than one type of folate used in supplements and to fortify foods. Often the various types of folate are used interchangeably; however, for your health, your partner’s health, and your baby’s health, it is important to learn the differences.

The two main types of folate supplements

1. Folic acid is a synthetic form of folate used in some dietary supplements and in fortified foods such as rice, pasta, bread, and breakfast cereals because folic acid is cheap and stable. Though this is the type of folate recommended by government agencies, many doctors consider this to be the least bioavailable form of folate.

2. Methylfolate is the active form found in our bodies. When you take methylfolate, your body can use it immediately because it doesn’t have to convert it to anything else. Methylfolate is recommended for women of childbearing age and pregnant women. This form of folate is also 1.7 times more bioavailable than food folate. 


Metabolism of folate - is it the same for everyone?

No. Anywhere from 40% to 60% of the population has a variant in how they metabolize folate. A mutation in the methylenetetrahydrofolate reductase (better known as MTHFR) gene causes a problem with the conversion of folate to its active form, called 5-MTHF. People with this MTHFR genetic variant do not efficiently convert folic acid to its active form (L-methyl folate) because the enzyme activity to make this reaction occur is reduced by up to 70%.

The variant can occur in both women and men, reducing the chances of a viable pregnancy and increasing the risk of neural tube defects and miscarriages. About half of U.S. pregnancies are unplanned, and 3-4 weeks is the usual time that abnormalities to the brain or spine occur – often before a woman knows if she is pregnant. This is why taking a prenatal vitamin with L-methylfolate at least 3 months before getting pregnant is important.