Folate vs Folic Acid: How They Affect Women with MTHFR

By Emily Carver, Recent ASU Nutrition Student

Folate is best known for its role in reducing the risk of a baby in utero from getting Spina Bifida. Spina Bifida comes in many different forms; however, it is due to neural tube defects while the baby is within the first four weeks of gestation. Oftentimes, this is due to the mother getting inadequate amounts of folate in her diet. With many foods being fortified with “folic acid”, it may seem rather odd to hear a mother isn’t getting enough to help support her growing baby’s brain, spine, and spinal cord. There’s one thing, however, many aren’t quite aware of, and that is folic acid is not folate. The two are considerably different and not to be confused with one another despite their names being used interchangeably.

Folic acid is a synthesized (man-made) version of folate and was created and used to fortify milk, flours, and cereals to ensure the American public was getting adequate amounts. Though overall seen as a benefit, the debate about whether folic acid is a benefit or hindrance to the human body is still being discussed and continuously researched.


One such discussion is how women with a genetic mutation called, methylenetetrahydrofolate reductase, or as it’s more conveniently called MTHFR can’t process the synthetic folic acid. This is because the mutation is linked to poor enzyme and methylation production. What does that mean, exactly? It means that the MTHFR gene that is designed to give the body directions on how to make certain enzymes isn’t doing its job fully.


When this happens, it changes how some bodies metabolize and convert essential nutrients like vitamins, minerals, and proteins within the diet up to 70%. Meaning the body has a 40-70% reduction in its ability to process these essential nutrients. That’s a huge percentage.


What’s more is if a woman with MTHFR is already having an up to 70% reduction in processing the natural folate, imagine how impossible it would be for her to process the synthetic folic acid. Not only will her body be unable to process folic acid, that folic acid will attach itself to the receptors that absorb natural folate, thus making the body have an even more difficult time absorbing the usable folate within the body (1).


There are two main MTHFR mutations: MTHFR C677T and MTHFR A1298C. Out of the more than fifty different mutations, these two, in particular, are what women get tested for. What’s worth noting is the medical field believers 30-50% of the population has this genetic mutation and most are completely unaware they do.


Many of the signs and symptoms can be confused with other conditions which can make it difficult to distinguish, but some are miscarriages, irritable bowel syndrome, blood clots, pre-eclampsia, spina bifida, depression, migraines, hypertension (high blood pressure), tongue tie, and asthma to name a few.


It’s important for women, whether they know they have this genetic mutation or not to consume folate in its natural form. This is especially important if they’re wanting to get pregnant. Simple ways would be to eat your greens: broccoli, avocados, asparagus, and spinach. All of these contain high amounts of natural folate along with other essential vitamins and minerals our bodies need. Beans, lentils, and oranges are other great sources of folate. If the need to supplement is in order, be sure to look for the bioavailable form of folate called L-methylfolate (labeled as 5 L-MTHF or 6(S)-L-MTHF) and take only as recommended by your doctor.


Supplemental vitamins and minerals can be a great tool in our diet. Provided you know you’re taking a quality product. But by focusing on getting the necessary nutrients through whole foods, you’ll have the guarantee that you’re consuming the natural form of each vitamin and mineral and nothing else. Being aware of what we consume is essential not only for our health but the health of all future babies. To learn more about MTHFR and ways to help manage it, feel free to read here, here, and here.


For more articles on nutrition and health check out the Fill Your Plate blog. New articles are posted every week.




Dr. Lynch. (2014). Folic Acid Awareness Week 2015: Want Awareness? Here You Go. MTHFR.Net. Retrieved from:

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