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Don't Make This Mistake When Picking Out A Folate Supplement

Molly Knudsen, M.S., RDN
Author:
September 22, 2023
Molly Knudsen, M.S., RDN
Registered Dietitian Nutritionist
By Molly Knudsen, M.S., RDN
Registered Dietitian Nutritionist
Molly Knudsen, M.S., RDN is a Registered Dietician Nutritionist with a bachelor’s degree in nutrition from Texas Christian University and a master’s in nutrition interventions, communication, and behavior change from Tufts University. She lives in Newport Beach, California, and enjoys connecting people to the food they eat and how it influences health and wellbeing.
September 22, 2023
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Fluency in vitamin B9 talk is not intuitive. There's folate, folic acid, and methylfolate (oh my!). It's hard to decipher what the difference is—let alone figure out what name to look for on the back of a supplement bottle. 

Folate is added to a lot of supplements: multivitamins to support nutritional sufficiency1; prenatal vitamins to support mom and baby2; B complex vitamins for cellular energy3; and methylation support supplements to aid healthy homocysteine levels4.*

It's likely that at some point during your life you have (or will) take a folate-containing supplement. So literacy in what to look for on a label is crucial.

And we're here to break it down for you.

Folate, folic acid & methylfolate

Folate, which is synonymous with vitamin B9, is the naturally occurring form of the vitamin that's found in foods like leafy greens (spinach & kale), Brussels sprouts, cauliflower, and broccoli. 

Only about half of the folate in foods1 is able to be used by the body, so many foods are now fortified to contain more of this vitamin. Folate supplementation is often encouraged in certain scenarios, like pregnancy.

"Folate" is also used as an umbrella term for all forms of the nutrient—including those used in supplements. 

Types of folate you'll find in supplements:

  • Folic acid: This is the most common form of folate found in fortified foods (like breads and cereals) and most supplements.  
  • Methylfolate: Also referred to as 5-MTHF, methylfolate is the fully bioactive form of the vitamin, which can be more easily metabolized in the body. It's also in some supplements but is less common than folic acid. 

The main difference5 between these two supplemental forms is how far along the activation process they are. 

Not all folate is bioactive

Methylfolate is fully activated6 and ready to be used as a carbon donor for methylation processes.

So, why is this important? Methylation refers to the transfer of carbon methyl groups from one biochemical compound to another to produce amino acids, hormones, red blood cells, and neurotransmitters. 

On the other hand, folic acid isn't very far along in the activation journey. When it's ingested from fortified foods or supplements, it's still multiple steps away from being fully activated. It must first be converted to dihydrofolate, then to tetrahydrofolate, and then—finally—to 5-MTHF. 5-MTHF is the biologically active form of the vitamin. In this form, it can carry out its role as a methyl donor to turn homocysteine into methionine (more on that later).

But this conversion process7 doesn't always run smoothly.

What happens when folic acid can't be activated?

Prenatal nutrition specialist Amy Burkholder, CNS, LDN, previously told mindbodygreen that "synthetic folic acid isn't [always] well metabolized once it's in the blood, especially for anyone with a MTHFR gene variant."

The MTHFR enzyme is the last pivotal player needed to turn tetrahydrofolate into 5-MTHF. However, people with an MTHFR gene variant (estimated to be more than 50% of the population8) have an impaired capacity to make that final conversion happen. 

If that's the case, it means there isn't a lot of available bioactive folate to methylate homocysteine to methionine, and homocysteine can build up in the blood.

High homocysteine levels are a surefire sign of subpar methylation (or low intake of vitamin B9). And if left unchecked, high levels of homocysteine are linked to cardiovascular implications9 down the road. 

Therefore, enough activated folate in your system is essential for overall health.*

So, which one do you choose when looking for a supplement? 

In case the answer isn't yet clear, it's best to look for supplements with methylfolate or 5-MTHF as the folate ingredient. It's added peace of mind that the folate you're supplementing with is the form of folate your body is actually able to use to make sure methylation processes run smoothly.* 

But it's not yet standard practice for supplements to provide this form of folate. So to fill that gap (and ensure sure methylation processes run smoothly) mindbodygreen formulated methylation support+.* 

This unique formula features Quatrefolic® methylfolate that's fully optimized for absorption.* Other bioactive B vitamins (like B12, B6, and riboflavin) and betaine are weaved in to help you absorb and utilize these methylation-essential nutrients most efficiently.* 

Overall, methylation support+ may help promote synthesis of DNA, red blood cells, neurotransmitters, as well as energy production and heart and brain health.*

The takeaway

There's no doubt that folate is a key player in essential methylation pathways that impact everything from cardiovascular to neurological and reproductive health as well as energy production and detoxification.* But the vitamin must be activated in the body to be effective. 

mindbodygreen's methylation support+ not only features methylfolate but additional bioactive B vitamins and the methyl donor betaine to support healthy homocysteine levels (some of our favorite multivitamins also have these activated B vitamins).* 

Whether you have a known MTHFR gene variation or not, methylfolate is the smart choice for targeted folate supplementation.*   

If you are pregnant, breastfeeding, or taking medications, consult with your doctor before starting a supplement routine. It is always optimal to consult with a health care provider when considering what supplements are right for you.

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