The Differences Between Folic Acid, Folate, L-Methylfolate, etc.

Folate is absolutely essential for a healthy brain and body. Most people I talk to have heard about folic acid. A few know that it is an important vitamin for pregnancy because it reduces neural tube defects in newborns. Primarily for this reason, the US government started mandating the addition of folic acid in cereal products in order to reduce the number of neural tube defects. The plan worked, because the incidence of neural tube defects apparently went down from 3.5% to about 1% after folic acid fortification.

However, despite the success in lowering neural tube defects, scientists started noticing negative effects from the fortification of folic acid in food products. Increased colon cancer and the masking of anemia were the primary concerns, and evidence of increased autism and epilepsy were other concerns.

Additionally, people have started noticing a myriad of health problems can be remedied by taking supplements of functional folate (not folic acid). I’ll explain the difference between functional folate and folic acid below.

Folic acid is just one specific form of a class of molecules collectively called “folates”. Folates are essential to health and life, and are an essential vitamin. It is important to remember that folate is a generic term for many types of compounds similar to folic acid. Folic acid is an artificial folate chemically pieced together in the lab using smaller chemicals. Strictly speaking, folic acid is synthetic and virtually nonexistent in nature. Folic acid is a bare-bones vitamin that needs several “upgrades” or “additions” in order for it to actually function in your body. Think of folic acid as a car without wheels or gasoline. Even though it has potential, when the rubber meets the road (pun intended) folic acid just doesn’t work in your body until it gets “fixed up”. Even though folic acid isn’t fully assembled, your liver has some limited capacity to “correct” the folic acid by attaching the wheels and filling the gas tank, so to speak. In contrast with folic acid, however, methylated folate (known as L-methylfolate, 5-methylfolate, 5-MTHF, prescription Deplin, 5-CH3-H4folate, or simply methylfolate) is primed and ready to function in your body. It has all four wheels and gasoline and is ready to work in your body.

The Major Types of Folate

	Front Wheels	Back Wheels	Gasoline
Folic Acid	No	No	No
Dihydrofolate	Yes	No	No
Tetrahydrofolate	Yes	Yes	No
5-formyltetrahydrofolate (Folinic Acid)	Yes	Yes	Not quite
5,10-methylenetetrahydrofolate	Yes	Yes	Not quite
5-methyltetrahydrofolate (L-methylfolate or 5-MTHF)	Yes	Yes	Yes

The problem with folic acid (and it’s a major problem), especially if you have particular MTHFR genetic mutations, is that the liver can have a very hard time upgrading folic acid into functional L-methylfolate. Thus, even if someone has enough “folate” they may not have enough methylated folate (folate with wheels and gasoline) so the folate is doing them no good. They don’t produce enough neurotransmitters (they’re depressed), they aren’t protected against cancer, Alzheimer’s, fatigue, and more.

It’s extremely important to get folate in the most reduced (with wheels) and methylated (with gasoline) form you can.

The good news is that L-Methylfolate is the primary form of folate found in nature and, naturally, in most fresh, unprocessed food. The L-methylfolate in food is fully built with all four wheels and the gas tank is full.

References

Powers HJ. Folic acid under scrutiny. Br J Nutr. 2007 Oct;98(4):665-6. Epub 2007 Aug 13. PubMed PMID: 17697404.

Choi JH, Yates Z, Veysey M, Heo YR, Lucock M. Contemporary issues surrounding folic Acid fortification initiatives. Prev Nutr Food Sci. 2014 Dec;19(4):247-60. doi: 10.3746/pnf.2014.19.4.247. Epub 2014 Dec 31. Review. PubMed PMID: 25580388; PubMed Central PMCID: PMC4287316.