Most people know that folic acid is one of the most important nutrients to take in the preconception period, and it is found in most prenatal vitamins. But did you know that over 50% of the population cannot absorb and utilize regular folic acid? The best folate for prenatal vitamins is actually methyl-folate, but only a few prenatals contain that form.
The reason this is so important is because of problems with methylation. Methylation refers to a series of biochemical pathways in the body that impact a number of functions – these include one’s ability to detoxify, the ability to produce neurotransmitters properly, immune function and many others. In the context of preconception, folic acid is crucial for preventing neural tube defects, most of which happen in the first six weeks of embryonic development.
Because of defects in the genes that control methylation, many people do not methylate nutrients properly. In very simple terms, their body does not have enough “methyl groups” to adequately turn nutrients into the methylated form that the body needs to carry out its functions.
Thousands of biochemical pathways in the body depend on methylated folate to act as a cofactor ie help the reactions to happen. Therefore without methyl-folate, the wheels slow down and in some cases stop turning.
If 50% of the population cannot use regular folic acid and turn it into it’s methylated form, then the basic prenatals are not serving women in the best way. 5-methyltetrahydrafolate comes into the body in the form that’s readily usable for everyone.
So why isn’t it found in more prenatals? Well, it’s more expensive, for one. Therefore it is more frequently found in higher-end products. Many practitioner lines of supplements contain 5MTH-folate, but the general population might not have access to them or know which ones they are, unless they are working with a nutritionist or naturopath. Many people simply are not aware that there is anything other than folic acid.
I’m not saying that regular folic acid won’t always get the job done. If 50% of the population does not convert it well, then 50% of the population does. I still feel that taking folic acid in the 5MTH form optimizes the absorption. There may also be a small group of “overmethylators” for whom adding methyl groups is counterproductive, but the majority of people will be “undermethylators”.
How do you find out if you have methylation defects? You can do a basic test through big labs such as Labcorp that will show two of the major genes, and whether there are heterozygous (one copy of the gene) or homozygous (both copies of the gene) defects. This can be a good initial guide. For those who want to get detailed information about their genetic status, the 23 & Me test is very detailed and comprehensive. They can no longer provide any interpretation, however, so most people would want to run their results through a website such as Genetic Genie, which does provide some interpretation. Even with this service, it can be quite confusing and it might be smart to recruit a naturopathic doctor or other integrative doctor or nutritionist who has a good grasp on genetics.
Back to the prenatals, I would suggest getting a methylated folate, even if you have not done any labs. There are two products that I have taken myself and recommend to others:-
Wellness Essentials For Pregnancy – this is a complete prenatal that comes with 5MTH-folate, plus extra calcium/ magnesium, essential fatty acids and choline (important for the neurological development of the baby). It comes in individual packets so it’s really convenient to take.
FolaPro – this is just methylated folate by itself, but this can be good to take along with other prenatals that have unmethylated folic acid in them.
Methylation is a growing area of interest, especially in integrative medical circles. It ties into epigenetics, which is the area that looks at how we can influence how our genes are expressed using environmental changes including nutrition. It’s all fascinating stuff.
If you’re trying to get pregnant or are pregnant, have a look at your prenatal and see what type of folic acid it has in it. If it just says “folic acid” then it’s not the methylated form, and you might consider supplementing with the good type of methyl-folate, or switching your prenatal all-together to one that contains methyl-folate.