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Folate deficiency can lead to a variety of serious conditions, particularly for pregnant women and their babies. Despite our best efforts, some of us may have genetic conditions that prevent our bodies from using folate properly. What are the differences between folate, folic acid, and methylfolate? And can methylfolate help us address folate deficiency?

What is Folate?

Also known as vitamin B9, folate is an essential nutrient for the proper function of our body. It helps to form DNA and RNA, and is vital for red blood cell production, especially during periods of intense growth like pregnancy. Folate also helps the body to metabolize amino acids like homocysteine, which can be harmful to our health if accumulated in large amounts.

Humans cannot produce our own folate. It is a water-soluble vitamin that must be replenished daily. Hence, we need to get our folate from dietary sources. Food that is rich in folate includes whole grains and dark leafy vegetables such as spinach, kale, and broccoli. With the abundance of processed food in our modern diets, it can be difficult to get enough folate.

Symptoms of Folate Deficiency

Certain types of people are more likely to be deficient in folate. Pregnant and lactating women need more folate as it is required for fetal cell development. People with gastrointestinal disorders and those with a specific gene variant may not be able to absorb and use folate efficiently. Alcoholism and dietary restrictions can also impact folate intake and absorption.

Because folate is critical for red blood cell creation, folate deficiency often results in anemia. Some signs of folate deficiency include shortness of breath, fatigue, muscle weakness, irregular heartbeat, hair loss, poor appetite, difficulty concentrating, mouth sores, and pale skin. Low folate is also linked to higher risks of health disease, cancer, and dementia.

What is the MTHFR mutation?

Methylenetetrahydrofolate reductase (MTHFR) is a naturally-occurring enzyme in our body. This enzyme is central to the metabolism of homocysteine. The specific gene that influences how this enzyme functions is known as the MTHFR gene. Some people have an MTHFR gene mutation or variant that deactivates the enzyme or causes it to malfunction.

Despite being somewhat unknown to the public, MTHFR mutations are relatively widespread. Gene variation is a part of evolution and there are two common variants of the MTHFR gene: C677T and A1298C. In the United States, 25 percent of Hispanic people and 10-15 percent of Caucasian people have two copies of the C677T MTHFR variant—one from each parent.

MTHFR gene mutations can result in high levels of homocysteine accumulating in the blood. This can lead to severe health conditions such as anemia, neurological conditions like ataxia and peripheral neuropathy, birth anomalies like microcephaly, mental health conditions like depression, and a higher risk of cardiovascular diseases and cancer.

Folic Acid vs. Methylfolate

Folic acid is the synthetic form of folate. It is usually prescribed as a supplement for folate deficiencies and is frequently added to processed food to increase its nutritional value. Unfortunately, it is not always helpful for the 40 percent of the population who have MTHFR variants.

For it to be useable by the body, folic acid must first be converted into its active form, methylfolate or L-methylfolate. This conversion relies on the MTHFR enzyme and gene. Therefore, people with digestive issues or MTHFR genes variants are sometimes unable to effectively convert folic acid to methylfolate.

Methylfolate supplements, on the other hand, provide folate in its biologically active form. This means that the body can absorb and use it easily without having to undergo any additional metabolic processes. Hence, it is the most effective way to add folate to your diet.

Additionally, consuming high levels of folic acid without the ability to metabolize it can lead to health problems. Excessive folic acid in the body can impair immune function and worsen the symptoms of vitamin B12 deficiency. Therefore, methylfolate is sometimes considered a safer option than folic acid.

Who Should Take Methylfolate?

Not everyone with the MTHFR variant needs to take a folate supplement. However, pregnant women are strongly advised to increase their folate intake. If you have elevated homocysteine levels (above 8), you may need to start taking a methylfolate supplement too. The same applies if you have a poor diet lacking in whole foods and dark leafy greens.

When choosing a source, look for a reputable L-methylfolate supplement shop. The supplement should be pure, with as few filler ingredients as possible. It can also be beneficial to choose a supplement that comes with complimentary nutrients such as B12. Unless instructed otherwise by your doctor, always start with a mild dose of methylfolate.

Just like with any supplement, careful consideration is due before deciding to take methylfolate. Despite its potential benefits, taking the wrong dose of methylfolate can cause unwanted side effects like anxiety and irritability. It is generally recommended that you speak to a medical practitioner to assess your health before you start any supplement regime.