One of the most important nutrients found in prenatal vitamins is folic acid. If you look at one vitamin brand and compare it to the next, you might be surprised to see folate listed instead. So, what’s the difference between folic acid and folate, and does it matter what you take?
What is folate and folic acid?
Both folate and folic acid are forms of vitamin B9. However, folate is naturally occurring and found in foods. Folic acid is the synthetic form, and when broken down in the body it converts into methylfolate.
“Folate is a natural form of vitamin B9, but it’s sensitive to heat and light, so that can actually reduce how much your body absorbs,” said Jill Shea, RPh, a pharmacist and manager of Yale New Haven Health Pharmacy at Bridgeport Hospital. “Being synthetic, folic acid is more stable and therefore the body can absorb it more readily. That’s why you get higher levels of folate when it’s taken through folic acid.”
What are the benefits of folic acid?
The American College of Obstetricians and Gynecologists currently recommend all pregnant women take a prenatal vitamin with at least 400 micrograms of folic acid because it’s been shown to help prevent neural tube defects.
“Folic acid is really important for the neural development, which is the development of the spinal column and the brain of the baby in very early pregnancy,” said Northeast Medical Group Certified Nurse Midwife Meghan Sperry, APRN. “It’s important to assure good folic acid use even prior to getting pregnant because those are some of the earliest structures that start to be built within the pregnancy right after conception.”
Those thinking about conception should take a prenatal vitamin with adequate folic acid at least 30 days before conceiving, and up to a year prior.
Do some people need folate instead of folic acid?
Folic acid is recommended in pregnancy because it is the most studied form of vitamin B9. However, the broken-down form of folic acid, methylfolate, is beneficial for those who have the MTHFR gene mutation, a variant that makes it difficult for people to break down folic acid.
“Between 30 and 50% of the population have a variant of the MTHFR gene. The problem is a lot of people are asymptomatic, so there are no signs that they are not absorbing folic acid within their body in the same way,” said Sperry.
Since so many people may not know whether they have the MTHFR variant, Sperry says patients can take a prenatal vitamin with folic acid, as well as an extra 400 micrograms of methylfolate. Those who are unclear about what they should take can speak with their healthcare provider to discuss their health history and make an informed decision.
How to pick a good prenatal vitamin
In addition to folic acid, patients should also look for other nutrients in their prenatal vitamin including:
- Vitamin D, especially for those who live in the Northeast where many are Vitamin D deficient
- Probiotics, which help with healthy gut bacteria
- Fish oil, which is important for healthy brain development
- Choline for brain health
Shea says patients can also consult their healthcare provider, because often they can get a prescription prenatal vitamin that may have higher levels of key nutrients than what’s available over the counter.
However, both Shea and Sperry stress that if patients are taking a prenatal and eating a healthy, balanced diet, they are most likely covering their bases.
“There’s no perfect prenatal vitamin. There’s nobody who eats a perfect diet,” said Sperry. “Prenatal vitamins aren’t meant to be the answer to preventing all major complications. But we know from research that when we eat a healthy diet and take a prenatal vitamin, it does reduce our risk of having a baby with certain complications, especially neural tube defects.”
