Editor’s Note:  Cara has done extensive research on how nutrition relates to disability, has used the GAPS diet protocols successfully with her own family, and strives to break down healthy habits into easy-to-accomplish changes for the average busy family. She uncovered the overlooked difference between folic acid and natural folate while doing research on the MTHFR gene mutation, and is alarmed that this isn’t more widely discussed especially in prenatal consultations.
Today she shares how 20-40% of our population does not produce enough of the enzyme needed to break down the synthetic folic acid found in supplements and fortified foods like boxed breakfast cereal and how its presence in the modern diet is likely contributing to many of our modern diseases. Just about every pregnant woman is told to supplement with synthetic folic acid rather than the natural form folate. This is alarming and is impacting the health of the generation of children being born right now.
I would encourage you to read and consider this information very carefully!
….
As a mom of a child who has struggled with disability (see our story about GAPS and Autism here), I’ve made it a priority to be proactive when it comes to my children’s health, and I have seen their health blossom because of it. I carefully research nutrition in pregnancy, make it a priority to avoid genetically modified foods and the dirty dozen, insist that my children take cod liver oil, and even start my babies on liver as a first food.
One little nutrient slipped by me until recently, though, and I’m kicking myself now.
Folate
That nutrient was folate. Folate, vitamin B9, is a water-soluble vitamin used in just about every process in the body. It breaks down, builds, and uses proteins. It’s used in red blood cell production, DNA synthesis, and many more functions. Lack of it in pregnancy leads to neural tube defects including spina bifida and anencephaly. Lack of it in childhood and adulthood leads to growth problems, neurological problems, anemia, low white blood cell count, and more. (source)
Folate is naturally found in high amounts in leafy greens, seaweed, sunflower seeds, chicken liver, calf liver, leeks, and peppers. (source)
See, I thought I was safe because, in addition to eating food daily that contained natural folate, as listed above, I also was taking a prenatal vitamin to make sure I wasn’t missing any. But I was wrong.
But I’m taking Folic acid, so I don’t have to worry about this, right?
Folic acid is the synthetic version of folate. It is true that most of the medical community uses the terms folate and folic acid interchangeably, but they enter the metabolic cycle in different ways, and natural folate is easier for the body to access than the cheap synthetic version folic acid (source).
When people have the MTHFR gene mutation, they do not turn folic acid into folate. In addition, the folic acid plugs the receptor sites in cells with an unusable form for these people. With the unusable folic acid in the receptor sites, the body is prevented from being able to use the folate that they do consume through natural food.
What is MTHFR?
MTHFR (yes, I hear a curse word every time I read that too) is a gene mutation that is relatively common (source) and is common among people on the autistic spectrum (source). When people have this gene mutation, they do not produce the amount of the enzyme dihydrofolate reductase needed to adequately convert folic acid into the form of folate that can enter the main folate metabolic cycle.
Why is Folic acid bad?
So many people are taught that taking an excess of water-soluble vitamins isn’t a bad thing. This is because it will just be excreted in the urine if not needed. This is not the case with folic acid. If a person cannot process folic acid into usable folate, the folic acid ends up in the bloodstream where it hogs the receptor sites on cells where folate is needed (source).
When unusable folic acid is taking up the receptor sites where real folate is needed, a folate deficiency occurs and the following can happen:
- Neural tube defects
- Recurrent miscarriage
- Midline defects including tongue-tie
- Neurological problems
- Anxiety (many people don’t realize they have anxiety until starting folate and having it go way down)
- Growth problems
- Thyroid problems
- Anemia
- And more
In addition, this excess folic acid has been linked to:
Where is Folic acid found? How can I avoid it?
Good news! Since folic acid is synthetic and made in a lab, it is never found in natural, whole foods. The foods that are fortified are:
- processed cereals
- commercial flour
- other grain-based processed foods
- supplements including multivitamins
- prenatals
So if we are eating all homemade foods, only use home ground flour and oats that are not fortified, we can avoid it by also avoiding supplements that contain it.
But wait! Â My doctor says Folic acid is important to take
Doctors often use the terms ‘folic acid’ and ‘folate’ interchangeably. As discussed above, they are not interchangeable, just as margarine and butter are not interchangeable when studying the effect of saturated fat on heart disease.
If your doctor is open to it, I recommend starting a dialogue about the research you have been doing on how folic acid is not as easily absorbed by many people, and that you are switching to folate or discontinuing additional folic acid supplementation.
Who knows, maybe your doctor will be inspired to research and will change the standard recommendation.
In any case, it is very unlikely that your doctor will prefer you to take folic acid over folate, it is much more common that he or she will just insist that there is no difference.
What can I do?
I did these simple steps for my family upon reading about MTHFR and folate.
- Toss any fortified food in your house. Now!
- Toss any supplement containing folic acid.
- If you feel that you need to supplement with folate, choose a supplement with real folate or methyl folate (I take this one and I give my kids this one – I see lowered anxiety in myself with it, as well as increase in focus and energy, it’s too soon for me to be able to tell if it’s helping the kids yet).
- Diligently watch labels of all supplements for folic acid and avoid.
- Consider getting tested for MTHFR gene mutation so that you know how toxic folic acid really is for you.
- Learn more about supplementing with bio-available folate (you can learn more here). Some people who have been consuming folic acid need to replenish their stores.
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I am curious if there is a better folate supplement out there? The one recommended in this article (the link to amazon) has Zylitol, natural cherry flavor, and a couple other things in it. Would love to know, as I am looking for a folate supplement. Thanks!!
Yes, seeking health has a whole line of them. I haven’t looked into other companies, but I”m sure there are others.
Hi Cara,
I am a dietitian and am not going to jump on the defensive bandwagon and tell you your wrong, I would just like to point out to you that you need to consider all of the evidence before you produce articles that can be very persuasive for people. The folic acid claim is based on 20 years of concrete research with a definitive meta-analysis of the direct link between folic acid and its prevention of neural tube defects in the first 28 days of conception. After the first 28 days the expecting mother does not need to continue taking the folic acid if they do not want to. Before you can start making claims like this, there needs to be randomised control trials with definitive results done to make this claim plausible. I am not saying that your wrong, for all we know you could be right. However the evidence your referring to does not produce the same recurring results in a variety of settings and therefore cannot be concluded that folic acid supplements are detrimental to health. To start telling pregnant women not to take the folic acid when their diets are lacking is very unethical if you do not have this conclusive evidence to support this. It is all good and well to encourage women to eat more foods high in folate, however from experience a lot of women will not do this and there isn’t enough time in the first 28 days to work with the mothers to produce results that fast. I know a mother who lost two babies to anencephaly and during those pregnancies she did not take any supplements. Her third baby she decided to take the supplements and the baby was born healthy. To this day mum and her child are still extremely healthy with no dramas. Again I would just like to point out that I’m not saying your wrong, I’m just saying please please consider all of the evidence and the ethics behind your claims before you write articles like these. This generally worries me especially for expecting mothers and their newborn baby’s health. I have counselled mothers who have lost babies before and its a horrible experience to go through, especially if its something they think they could’ve done differently.
Kind Regards,
Samantha
No one is saying don’t get enough natural folate … yes this is necessary to prevent neural tube defects. No one is arguing this point!
But, to suggest women take these prenatals loaded with synthetic folic acid and to fortify all manner of processed foods with folic acid which causes many more health problems than it solves? Stupidity.
Reading comprehension is your friend. She’s not saying don’t supplement, she’s saying supplement with FOLATE not folic acid. And the evidence is growing stronger and stronger against using folic acid in all populations, not just those with MTHFR because it does NOT work the same as folate. Yeah, if someone is severely deficient AND able to process it, it can help with deficiency, but not in a benign way. It’s also causing problems. Better to avoid both problems and deficiency and take folate supplements if needed.
Thank you! The reason I’m concerned about this is because I believe (this hasn’t been studied, I don’t have trials, and this isn’t medical advice) that things like sacral dimples, tongue/lip tie, and other midline defects are pointing to the idea that my family might be more susceptible to having a child with NTDs (also a midline defect) even with consuming folic acid.
Just because folic acid has reduced the amount of NTDs since it started being advised doesn’t mean that another form of folate isn’t *better*. Nobody is saying to avoid folate.
Pubmed has many trials on MTHFR and folic acid.
Or not.
I mean really.. from experience.. I know many people who would be dead right now if they waited for controlled studies to confirm that common sense makes sense. There is no case anyone could make about this that could say a synthetic form is better than the natural form. It violates everything logical and the only reason the studies were done on folic acid is because the studies come from a whole generation that believed synthetics were fine. A study on the effectiveness of a synthetic was never dual tested to show the percentage not absorbed in the test subject. Studies most commonly have a single agenda.
Our bodies were never designed for synthic anything.
Samantha,
Thank you; the ethics are a really good point. I was a midwife long ago, and when I trained in a school for midwifes, our instructor said to stay away from herbal treatments, unless we took extensive training. She said we had no right to experiment with someone’s baby. Adele Davis was talking about the need for folate/folic acid supplementation in the 1970’s, and the decrease in neural tube defects after fortification is well-documented.
In my area (see post above), we have excess nitrates in wells (20% of wells are in excess of Federal levels)and I found a lot of articles connecting nitrates and neural tube defects. It may be the nitrates degrade folate.
Mary
Dr Abram Hoffer is probably rolling is his grave with all this hype on Folic acid as well as all the important people that have not bought into all the hype about how one form of Vitamin or mineral is so superior than another. I have been in the Vitamin industry as a Nutritional consultant for many years,and have seen this hype over and over again. Victims are the consumer who waste there money when they could buy inexpensive effective regular Folic acid that works well. I myself take 15 mg of Folic acid and have for many years,prescribed by a well known Dr who also practices alternative medicine. One way to enhance absorption of Vitamins and minerals is to use Betaine Hydrochloride and pepsin which produces stomach acid for good digestion of nutrients from food and supplements.
I’ve been meaning to try Betaine HCL and pepsin for a while, I haven’t tried it yet but I’ve heard good things about it. I disagree that folic acid as is sold cheaply is the same. I would also argue that different kinds of iron and calcium are more effective than others as well.
Ok Keith. If you understand the article correctly, what is said is, MTHFR gene mutatios are in 30-40% of the population. So. The 60 70% who don’t have this gene mutation ‘can’ process ‘folic acid’ the rest cannot, causing much illness, like autism, Alzheimers, Parkinsons, ALS, cancer, MS, CFS, ADHD, diabetes, thyroid, spina bifada, cleft lip. SO, natural FOLATE supplementation is essential to many millions. FDA is being pressured by big Pharma to get Folate out of our hands and into theirs so they can control it. Folate is a big one, but if they control this what else will they control? Until 5 years ago. I had no clue. Then all hell broke loose and my mother became ill, in great pain, then dementia symptoms, her sister at the same time enveloping ALS and her brother dying from cancer and Parkinsons…. SO don’t tell me that ‘naturals’ are not needed. This story is just to detailed, but finding out my mother has MTHFR and her sister, (and probably their brother), now me and my sister are dealing with thyroid andmI’m also dealing w blood sugar issues. I pray it is not too late for us to avoid the illnesses of my family.
Can I please add this post to my website? Thank you for posting. This is awesome research!!
You may reprint a small excerpt of this article and link over to the original on this website for the remainder of the article.
This is total rubbish. I had trouble getting pregnant for 10 years after my first son was born. After 10 years the specialist said…take folic acid …so I did. I finally had a successful pregnancy….thanks to the addition of folic acid.
So it’s been scientifically proven that your successful pregnancy was due to synthetic folic acid? I doubt that!
Congratulations on your healthy pregnancy, but, your solution won’t work for everyone. It is a common logical fallacy to generalize from one’s own individual experience to everyone else. Your experience doesn’t say *anything* about the validity of the research cited. You may be among those that have enough of the enzyme to break down folic acid. That doesn’t mean that this isn’t a real issue for the 20-40% of the population that doesn’t. It may also be coincidental that you got pregnant after taking folic acid; you can’t rule out that it was another factor you haven’t isolated.
Good evening,
Actually, your story proves that the folate / methylation pathway is critical for fertility and healthy pregnancies. Further explanation could be that you are not someone who has difficulty converting folic acid, but were deficient in your diet. Or possibly, you do have difficulty processing it and the higher dose helped overcome that.
MTHFR and the problems with folic acid are real and have science to back them up. I would disagree with the statement that they are rubbish.
Blessings,
Eric Potter MD
Sanctuary Medical Care and Consulting
Wholistic healthcare for the glory of God (Col. 3:23)
None of this post is meant to be medical advice. Consult your medical provider for advice.
My doctor, a chronic fatigue specialist, just tested me for the MTHFR gene mutation. In my life I have had chronically low serotonin. I have read that folate helps with the production of serotonin. Low serotonin led in me to: Bipolar disorder and seasonal affective disorder. I also have an autism spectrum disorder called non-verbal learning disability. Also, I have chronic fatigue syndrome. Could it be I wonder, that if I have the gene mutation (there are a couple different mutations), that it could be a partial cause of all these problems I have had?? I found a B-complex by Douglas Labs with two forms of folate in it, methyl folate being one of them. I’m going to try it and see if it helps me. It could potentially help with mood, and cognitive issues like focus, also energy–folate is an important contributor to the methylation cycle, hence my doctor’s interest in it. I have spent the last 6 years studying natural health and am treating all my problems naturally with food and through treating nutritional deficiencies. Adding real folate in could be a major missing link for me. Thank you for your article, it was very informative.
A product I’m taking under the guidance of my doctor is a topical cream called ‘Neuro-immune stabilizer’ by the company Neuro Biologix. I have the heterozygous mutation of the MTHFR gene. This article is absolutely correct! If a person doesn’t have the ability to produce the enzyme their bodies cannot convert homocysteine back into methionine leading to an increase in the blood which can cause inflammation.
My mother was deficient in folic acid and had Alzheimer. When it was supplemented her Alzheimer disease improved dramatically. Please be careful when publishing such articles. You even note that only 20-40% of the population could have this problem. Folic acid is a valuable nutrient that many have a deficiency of and in that population it can save minds and prevent birth defects and other health issues.
Folic acid is the synthetic version of folate, which is advised in this article. Nobody is advocating avoiding b9 (folate), just the synthetic version which is less bio-available than other forms.
Good evening,
“Folate” is important. I agree totally. However, scientific studies indicate that excessive folate (especially in persons genetically susceptible to higher buildup) can cause other problems (white blood cell dysfunction) and interfere with transport of folate to breast milk. Science also shows that methyl-folate is a more potent and more active form which allows the nutrient to enter the methylation cycle downstream, nearer to the action.
Not everyone “needs” methylfolate as much as the other, but if you don’t know your genetics, taking methylfolate is a safer bet.
Blessings,
Eric Potter MD
Sanctuary Medical Care and Consulting
Wholistic healthcare for the glory of God (Col. 3:23)
None of this post is meant to be medical advice. Consult your medical provider for advice.
I take Fola Pro from Metagenics. It is L-5 Methyltetrahydrofolate. 800 mcg and I take two per day.
I just wanted to point out that the article that you linked to this about a connection to breast cancer seems to be a bit of a stretch. The author of the study concluded that the link to breast cancer was attributed to alcohol consumption rather than folic acid.
It is – there is a link, but correlation does not equal causation for sure. It’s interesting to note that a high level of synthetic folic acid in the diet may not be as benign as previously thought though. Most people have been under the impression that since folic acid is a water soluble vitamin, it would just get flushed out in the urine if taken too much (as in people who consume a lot of processed food, which is fortified), but that might not be the case.
I had a radical mastectomy and have never consumed alcohol in my life. When I read through this post, I see many health issues that I have had or continue to struggle with and tend to believe that it’s certainly something to look at. Thank You, for opening my eyes to a potential problem!
I wish you would answer the questions about why the supplements you suggest are with b12. is this just specific to your family’s needs? Because our recent blood work shows plenty of b12 and I would not want to supplement b12 at all. Why the two together? What about folate on its own?
Also, I believe a number of multi vitamins that are whole foods based are now using folate instead of folic acid. I have known for several years not to use folic acid and have watched out for it. What do you think about a whole foods based prenatal or multi with folate?
Of course food is best. But knowing that not every child or even adult is eating just right… sometimes nature based supplementation can be of great value.
The problem with blood testing is that it measures what vitamins are in the blood. What we want to know is how much is getting absorbed into the cells. It can be that there is an excess amount of a certain vitamin (for example, b12 or b9) in the blood stream because it isn’t a usable form, so the metabolic process of actually getting it where it needs to go isn’t happening fast enough, and there’s an excess amount in the blood stream.
I’m not saying that’s the case for you, I don’t know about your family, but it’s just one of the down sides of blood testing. People can make false assumptions from it.
In our family, I tried the kids on the b12/folate because I didn’t see a difference from the regular folate and I was wondering if the combo would work better. I tend to supplement my family based on symptoms, not blood work.
Cara,
I agree with that approach.
Blessings,
Eric Potter MD
Sanctuary Medical Care and Consulting
Wholistic healthcare for the glory of God (Col. 3:23)
None of this post is meant to be medical advice. Consult your medical provider for advice.
When measuring for B12 and folate check these:
Serum vit B12
RBC (red blood cell) Folate
MMA methylmalonic acid
Homocystine
Intrinsic Factor antibody
The combination of these measurements will help you or your Dr truly decide if you are deficient in B12 and Folate. Check out book ‘Could It Be B12?’ Any kind of antacid can produce deficiencies especially B12 and Magnesium. MTHFR mutation doesn’t allow B12/folate to process in body and can build up., especially ‘folic acid’ to toxic levels.
I answered below, comments are moderated to prevent spam from coming through.
In addition, many multis and prenatals claim to be food based, but they also contain additional (cheaper) synthetic vitamins. I was taking a ‘whole food’ prenatal unknowing that the folic acid in it didn’t come from food. I know to check into specifics more now.
B-12 and folate work together in methylation (their chemical job). An excess of folate can lead to a relative deficiency of B-12, which can have consequences such as neuropathy.