There are the essential vitamins and minerals we all know well; like iron, vitamin C and vitamin D. Then there are those that fly under the radar.
They're no less important, especially throughout pregnancy, but they can easily be missed. One example is vitamin B9 — also known as folate or folic acid.
To help you maintain a healthy pregnancy, we're breaking down folate vs. folic acid and its other counterparts. We'll help you understand what they are, why you need them and how you can get a healthy dose each and every day.
Is folate the same as folic acid?
Let's start with the basics; are folate and folic acid the same? Yes...and no. To put it simply, both folate and folic acid are scientific names for vitamin B9.
Folate is the naturally occurring form of the vitamin which you primarily get from food sources. Folic acid, on the other hand, is the synthetic form.
It's the kind that you find in supplements, fortified foods and medications. Both folic acid and folate are good for you, the difference is in how you take them.
There's one more name that you need to know in the folate family — methylfolate. You may also hear this one called levomefolic acid or 5-MTHF. Don't stress; those are all the same thing.
Methylfolate is special because it is the most easily absorbed type of folate for your body. When you eat foods rich in vitamin B9, or take folic acid supplements, your body breaks down the good stuff and absorbs it.
There are about four steps in this process, from folic acid to folinic acid and finally, methylfolate. As the final step on the journey, methylfolate is the most bioavailable form of folate for your body to absorb.
Some people have trouble breaking down folic acid and folate into methylfolate. For this reason, a lot of research and newer-generation supplements are exploring the use of methylfolate instead of folic acid.
Why? Because they can help your body to bypass the breaking down stages and head straight to absorbing nutrients.
Is folinic acid the same as folic acid?
The folate family is pretty large; there's folate, folic acid, folinic acid and a few more scientific names that are hard to pronounce. What they all have in common is they are forms of vitamin B9. The difference between them is whether they are ready to be used by your body.
As we mentioned, methylfolate is an active form of folate. It's the final step in a long journey of breaking down nutrients to the point where your body is ready to use them.
Folinic acid is simply another step along this chain. It's around step two or three; partially broken down from folic acid but not yet ready to be used by the body. If you're feeling scientific, you may also hear folinic acid called tetrahydrofolate (THF).
What is the role of folic acid and folate in pregnancy?
Since the 1960s, researchers have studied the effects of folate deficiency on pregnant women. The first studies were published in the 1980s, which is when the connection between folic acid supplementation and pregnancy health was fully realised.
By the 1990s, the medical community was in agreement that taking at least 0.4mg of folic acid per day was beneficial for both the mother's and the baby's health.
Thanks to all this fantastic research, we now know a few things for sure:
- Folate and folic acid supplements are good for pregnant women
- Folate deficiency can lead to health problems for both the mother and baby
Okay, but what makes folic acid beneficial for pregnancy? And how much should you take? Here are all the common questions, answered.
Why do you need folic acid supplementation?
From the moment your baby is conceived, your body starts rewiring itself to help grow that tiny foetus into a bouncing bub. This means the demands placed on your body to function well are much higher.
You need more of almost every essential nutrient in order to support yourself and your baby through pregnancy.
Folate is one such nutrient that protects women and their babies. Here are the most common benefits to getting enough folate during pregnancy:
- Folic acid helps prevent neural tube defects which have the highest risk in the first 28 days of pregnancy. This is why most sources say you should begin taking folic acid before you conceive.
- Folic acid assists women in maintaining healthy iron levels. Low iron levels and anaemia can increase the risks that your baby will have a low birth weight or will be born early.
- Folic acid may decrease the chances of preterm labour. Research is ongoing in this area, but early results are positive.
- Folic acid may decrease the risks of congenital heart disease.
How much folic acid should you take each day?
According to the Australian Dietary Guidelines, the recommended dietary allowance for women planning a pregnancy is at least 400 micrograms (0.4mg) of folic acid per day. This daily intake should also be continued throughout early pregnancy or the first three months.
Some sources suggest a little more than this depending on which stage of pregnancy you're in. For pre-conception, it stays at 0.4mg per day. Throughout pregnancy, it can be increased to 0.6mg per day and for postpartum, as long as you're lactating, it settles on 0.5mg per day.
Higher folate intake has also been linked to better iron levels, which is another common deficiency for women. Low iron can impact your fertility and have negative effects during pregnancy.
In a clinical trial, pregnant women taking a high dose of folic acid showed better iron levels than those taking the lower dose. Another study found that methylfolate was even better at supporting iron levels than folic acid.
How early should you start folic acid supplements?
Ideally, you'll start taking a folic acid supplement as soon as you start trying for a baby. The best time is around two to three months before conception. That's all well and good when you're planning for a baby; but what about when it's a surprise? Believe it or not, governments around the world have a plan for this.
As the connection between folic acid deficiency and neural tube defects became clearer, public health bodies decided they should do something to help. Knowing that a number of pregnancies were unplanned; they introduced mandatory folic acid fortification to subtly improve folate intake.
Since 1998, it has been mandatory for grain products to be folate-enriched in Canada and the US.
In 2009, Australia ruled that all bread-making flour (except for organic) must be enriched with folic acid. This initiative was meant to provide a safety net to help women avoid folate deficiency and, in turn, protect their babies from any adverse effects.
While fortified foods do help keep your folate levels up, they don't replace the need for supplements. These initiatives were designed to support folic acid supplementation, not replace it. To make these foods safe for everyone, the levels of folic acid are quite low.
What are the best prenatal vitamins to take?
There must be hundreds of prenatal vitamins out there for you to choose from and many of them carry the same ingredients, but not the same quality of ingredients.
While every formula features 100 per cent of your daily vitamins and minerals; they source them from different places. Some use an active form that is easily absorbed by the body, while others take a bit more effort to extract the key ingredients.
The Prenatal by Kin is a new generation of prenatal vitamins — one that is made from bioavailable ingredients that are easily absorbed by your body.
This means that each vitamin and mineral is ready to be used in your body, which helps you reap the benefits of a full dose. One of our hero ingredients is methylfolate; AKA the ideal form of folate for your body to absorb.
Each dose of The Prenatal features 625 micrograms (0.6mg) of methylfolate which is a safe, generous amount that can help avoid nutritional folate deficiency and may also improve your iron levels.
Is folate better than folic acid?
Let us be clear here: All forms of folate have benefits for your health. Whether that's the natural form from foods rich in vitamin B9, or the synthetic form of folic acid — you'll benefit from either.
If you forced us to answer, we'd have to say that the best type is the one with the highest bioavailability. The easier it is for your body to absorb nutrients, the easier it is for you to reap the benefits.
For this reason, the ideal form of folate is its most bioavailable form: Methylfolate. Methylfolate is a synthetic form, which means you need to take it via supplements.
Should you take folate or folic acid?
When it comes to our health, many of us focus on natural sources. Where possible, we want to absorb all our nutrients from foods. Unfortunately, with folate, this is difficult to do. Especially in pregnancy, it's almost impossible to get enough folate through diet alone as your needs have increased.
That doesn't mean you avoid folate-rich foods. They still form part of a balanced and varied diet.
But, you are unlikely to consume enough of them to meet your daily folate needs. The best option is typically to take a mix of both — including folate-rich foods in your diet while also taking folic acid supplements.
Examples of foods where folate occurs naturally include:
- Dark green leafy vegetables (brassica or cruciferous varieties)
- Citrus fruits and some fruit juices
- Egg yolks
Can you consume too much folate and folic acid?
Just as too little folate carries certain risks, consuming too much folate or folic acid can be detrimental too. The upper limit for daily folate intake is set at 1000 micrograms (1mg) per day. This includes both vitamin supplementation and where it naturally occurs through foods; whether they are fortified or not.
It is very rare to reach a toxic level of folic acid, though it is possible. If you're worried about getting too much folate, ask your doctor about safe dosages and how you can monitor for symptoms.
Why is too much folate a problem? The main reason is that it can hide a vitamin B12 deficiency. Vitamins B9, B12 and all the other B vitamins are equally essential to your health.
A common symptom of B12 deficiency is anaemia. As high folate intake can improve your iron levels, this can mask the side effects of not enough B12. If this goes unnoticed for a long time, you carry an increased risk for damage to the brain or nervous system.
Again, toxic levels of folate are quite rare. The best thing you can do is monitor your health with your doctor throughout pregnancy.