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WTFolate...?!!

So you've made the decision to have a baby. The first thing you hear is - take folic acid (or MegaFol, or a Multi vitamin containing approximately 500mcg folic acid)....


It is the most commonly known vitamin to take during preconception phase and for some, the moment they've fallen pregnant they quickly rush to the Pharmacy to get on to it ASAP.


First of all - what IS folic acid and what is folate?


Folate AKA Vitamin B9 is a water soluble vitamin. Found in many foods such as leafy veggies, legumes, barley, lentils, eggs, offal, sprouts, oranges and fruits.


Folic acid is the synthetic form of folate which is often found in fortified foods like breads, pastas, cereals etc and in MANY multivitamins/prenatals.


You can get your folate in active forms in supplements as well, which is arguably the "better form" to take to optimise absorption and utilisation of folate as well as other nutrients as it is a cofactor for other bodily processes.

The activated forms to look out for on your multi's are:

- folinic acid

- 5-methyltetrahydrofolate (5MTHFR), which is often labelled as levomefolate calcium or calcium follinate.


Why folic acid might not be the best form for you:


We all have a gene called the MTHFR, which we need in order to process folate from our diets.

Folate is absorbed in the digestive tract in to its active form 5-MTHFR. This active form is important for our mental health and oestrogen metabolism!

For those who have a polymorphism with this gene, they can have issues with folic acid (the synthetic form), and this can have a negative impact on the MTHFR gene - affecting both mum and bub.


Whilst for the most of us, we are able to absorb folic acid, we can still result with a build up - having excess which binds to receptors in our bodies, leaving no opportunity for the natural (easy to absorb) source to bind.


When we have optimal absorption of folate and it becomes activated it is able to be readily absorbed in to our cells for all it's wonderful work in DNA repair, growth, Nitric Oxide production (hello libido), maturation of cells, synthesis of choline (crucial in pregnancy/conception) and serotonin + more.


It is so important we do take the correct form for us, as the role folate has in cellular division and cellular growth.


These 2 polymorphisms in the MTHFR gene reduce our dopamine, serotonin and norepinephrine. So it can have a HUGE impact on our mental health, mood and energy.


HOWEVER...

What we need to consider is, there is a MOUNTAIN of evidence suggesting the BENEFITS of taking folic acid, as it helps to prevent neural tube defects in the developing foetus.

If you're concerned this might not be the right form for you - and you have had issues in the past with B12 levels or folate levels - you could get a MTHFR gene test or opt for the activated forms as mentioned above.


Why it is SO important we take folic acid / folate:


  1. For the mother:

- helps reduce risk of preeclampsia

- helps to prevent anaemia

- reduces pregnancy induced hypertension


2. For the foetus:

- blood formation

- cell building

- helps prevent birth defects

- reduces the risk of cleft palate/oral clefts

- bone development

- helps prevent early miscarriage

- reduces risk of premature birth

- reduces risk of neural tube defects

- reduces low birth weight

- suggestive to reduce Autism



When is the IDEAL time to start taking a folic acid or folinic acid supplement?


Ideally, 3 months prior to conception. (This is why preconception nutrition and healthcare is really important, as conception is not guaranteed the moment we begin trying).


The RDI for preconception is 400mcg.


400mcg is considered minimum consumed daily in preconception and during the first trimester reduces the chances of neural tube defects by half.


The RDI increases to 500-600mcg during first trimester.


And unless there is a history of spina bifida, neural tube defects in other children or diabetes - 5mg daily! But this should be something you work on with your healthcare provider.





references:

PMCID: PMC1852617

PMID: 25010374

PMCID: PMC4933077

Mayo Clinic

The Royal Womens Hospital

Mahan et. al 2012


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