Understanding "Folate" – What’s in a Name?
When it comes to folate, a lot is in the name! Often misunderstood, “folate” (or Vitamin B9) is really just an umbrella term for a bunch of structurally related compounds.Folate is primarily involved in amino acid metabolism, methylation, and the repair and synthesis of DNA (hence its importance in preconception / pregnancy and reducing the risk of neural tube defects).There are many medications which may require co-administration of folate due to absorption and metabolism interference; such as antacids, methotrexate, protein pump inhibitors and the oral contraceptive pill. Keep in mind that alcohol also depletes the body's folate reserves.Folate is found in many foods, and is especially high in green leafy vegetables and liver. Cooking and processing readily destroys natural folate, so a diet that's loaded with processed foods will almost certainly be low in folate.
If you’re going to be supplementing with folate at some stage in your life, whatever the reason, it’s important to understand the terminology. So let’s break it down.FOLATE is what you find in nature, and it occurs naturally in several different forms, including 5-MTHF. Depending on our needs and digestive capacity, we absorb about half of the collective “folate” that we eat.FOLIC ACID is the oxidised, synthetic form of folate. It’s not found in nature. Despite it having high bioavailability (closer to 100%), it requires conversion to the active form after absorption, and not everyone is great at this! Please note this is also the form that’s added to foods such as wheat flour (for bread/bakery goods).
*With synthetic folic acid, a portion of it will remain un-metabolised, especially when it’s taken at high doses. The jury’s out on what this means for our health, but until we know more, we should of course err on the side of caution with big whopping doses of folic acid.
5-MTHF (5-methyltetrahydrofolate) is the main form of folate found in plant foods. It’s often referred to as the ‘active’ form. It constitutes 98% of folate in human plasma, and this is what’s being mostly detected on blood tests. Increasingly so, this form can be found in practitioner-prescribed supplements as a more natural alternative to synthetic folic acid.
*For those with severe MTHFR polymorphisms (e.g. those that are homozygous to the C677T variant), 5-MTHF is the preferred form because it by-passes the conversion steps that are compromised in these people.
FOLINIC ACID has almost 100% bioavailability and is a naturally occurring folate derivative. It’s generally found in supplements as calcium folinate. Like folic acid however, it’s not in its active state yet, so requires conversion in the body.If you've been advised to take high doses of folate/folic acid, please keep an eye on your B12 levels as supplementation can mask B12 deficiency (potentially leading to permanent cognitive decline and nerve damage!).Finally, if you don't need folic acid/ folate supplements for any specific reason, then please just carry on eating those greens!
