8 replies to this topic

[Juliee1]

Good morning,

I was told by friends to take folate instead of folic acid, as folic acid can increase the risk of some types of cancers and it may not be as effective in preventing neural tube defects.  I have seen many articles and posts discussing this, but most refer to the same article by Chris Kresser.  Is there scientific evidence to suggest it is preferable to take folate?

Thank you!

[amazing grace]

According to my RE, Folate is natural and folic acid is synthetic. Folate is harder to absorb, hence having to take more. 

[redacted]

Folic acid is the synthetic form of folate (also known as vitamin B9). Folate metabolism is somewhat complex - folates exist in various derivative forms (variations), interconverted by a number of enzymes. One of these enzymes, MTHFR, is responsible for producing 5-methyltetrahydrofolate, which is the bioactive form of folate. Some people (about 10% of the population) have a genetic variant in MTHFR that results in reduced enzymatic activity - i.e., inefficient production of 5-methyltetrahydrofolate from folic acid. In this case, taking a methyltetrahydrofolate supplement is helpful because you`re essentially bypassing MTHFR. In cases where there is no genetic variant of MTHFR, it certainly can`t hurt. 

 

There have been some scientific studies that too much folic acid can cause cancer or make it worse. And there have been many that show the opposite - the jury is still out. In North America, many of our foods have been fortified with folic acid since the late `90s and has resulted in a tremendous decrease in the number of neural tube defects. I am not familiar with the literature showing that folic acid is not as good as folate for the prevention of neural tube defects - it may be in a subset of the population.

 

If you can access to the supplements containing the natural form of folate, I would say go for it. If you can`t, then don`t avoid folic acid because it `may`cause cancer - it`s role in preventing neural tube defects is well-established. And to cover your bases, eat leafy greens, legumes, and citrus fruits - all provide the bioactive form of folate. 

 

Edited to add: The naturopathic physician and others may have additional or different comments to add - I spent 7 years in grad school researching MTHFR and folic acid, so I couldn`t resist replying!

[Juliee1]

Thanks redacted, much appreciated!

[Highest hopes]

Good question Julie, I wonder the exact same thing.

Redacted, I am so curious what your degree was in?

I've been told the same thing by my naturopath and online research but when I've brought it up with REs they act like its crazy talk.

[happy wishes]

I'm so glad that I saw this post. I was just told recently that I have a "genetic mutation " and cannot process folic acid and that I should take 5mg of folic acid. I have done a bit of research and keep reading that methylated folate is what I need, not an increase of folic acid.

[DrFionaMcCulloch]

Hello - great answer here by redacted! 

 

Yes, there is a gene called MTHFR  which is fairly common -  if a mutation is present, it will reduce your ability to convert synthetic folic acid (what is in most prenatals) to methylfolate - which is what your body uses to "methylate" (which includes one-carbon metabolism, critical for cell growth among many other functions - it goes without saying that it is very important for pregnancy). This mutation is also is linked to clotting, another issue when it comes to implantation and miscarriages.

 

There are different mutations in MTHFR, the most significant being the C677T mutation (the A1298C mutation is much milder). You can have either one copy (heterozygous) or two copies (homozygous). Being homozygous means that you can have a 50-60% reduction in ability to convert folic acid to methylfolate. Since there are a variety of mutations of this gene, it's estimated that a fairly large percentage of people (40-50%) may have some form of mutation -yet those who are homozygous for the stronger mutation C677T tend to be the most impacted. 

 

If you have this mutation, 5-MTHF (L-5 methylfolate) is the best form to use because it doesn't have to be converted. It's already bioavailable and is preferable for that reason.

 

Here's an article citing some evidence for you that you might find to be a good discussion of the topic! 

 

http://www.ncbi.nlm....les/PMC3250974/

 

hope this is helpful! 

[Juliee1]

Thank you for the information!

[happy wishes]

Could someone please give a recommendation on an appropriate dose of Folate? I am newly pregnant. I have MTHFR and have been taking 1mg of Folate (it was recommended I take Folgard but chose not to based on my MTHFR research). Thank you!