Folic Acid: More Than Just a Prenatal Vitamin

When you think of folic acid, you might picture a vitamin that is pregnancy centric—after all, it’s often touted as a must-have for preventing birth defects. But did you know that folic acid offers a whole lot more than just that? 

Folic Acid: More Than Just a Prenatal Vitamin

When you think of folic acid, you might picture a vitamin that is pregnancy centric—after all, it’s often touted as a must-have for preventing birth defects. But did you know that folic acid offers a whole lot more than just that? This unassuming B vitamin is a powerhouse for maintaining overall health, supporting everything from hormonal balance to heart health and mental clarity. Yet, many people struggle to absorb folic acid effectively, which can limit its benefits. Join us as we explore why folic acid is so crucial for women at every stage of life, uncover the hidden challenges of absorbing standard supplements, and reveal why the form known as 5-MTHF might be your best bet for maximising its benefits.

The Hidden Challenge: Folic Acid Absorption

Folic acid is a common ingredient in fortified foods and supplements, but many people absorb this form well. Let’s dive into why this happens and what you can do about it.

Genetic Variations

Our bodies rely on a series of biochemical processes to convert folic acid into its active form, which is crucial for various functions. However, some individuals are born with genetic variations that can make this conversion more challenging. One such variation is the MTHFR (methylenetetrahydrofolate reductase—can you see why we use the acronym?) mutation. Approximately 10-15% of individuals carry the common MTHFR C677T variant, which can affect folic acid metabolism. Overall, around 20-30% may have some genetic variation in the MTHFR gene that influences folate processing, with prevalence varying among different ethnic groups.

The MTHFR gene provides instructions for producing an enzyme that helps convert folic acid into 5-MTHF (5-methyltetrahydrofolate), the active form of the vitamin. If you have this mutation, particularly in its more severe forms (like MTHFR C677T), your enzyme activity may be reduced. As a result, your body may struggle to convert synthetic folic acid into its usable form. This can lead to lower levels of active folate in your system, despite adequate folic acid intake from supplements or food. 

People with MTHFR mutations might experience symptoms of folate deficiency even if they’re consuming enough folic acid. Therefore, those affected by this genetic variation may benefit from taking supplements that contain 5-MTHF directly, bypassing the need for conversion - we’ll dive deeper into this later.

Digestive Issues

Digestive health is a critical factor in nutrient absorption, and issues such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD) can significantly impact how well your body absorbs folic acid. These conditions often involve chronic inflammation or disruption in the gut lining, which can interfere with the absorption of various nutrients.

For individuals with IBS (Irritable bowel syndrome) or IBD (Inflammatory bowel disease), the lining of the intestines may be compromised, reducing the surface area available for nutrient absorption. This can result in suboptimal folic acid absorption. Symptoms like diarrhoea, bloating, and abdominal pain can further exacerbate nutrient loss, making it even more challenging to maintain adequate folate levels.

Medication Interactions

Many commonly used medications can affect folic acid absorption, often by altering the digestive system’s environment or interfering with nutrient processing. For instance, antacids and proton pump inhibitors (PPIs) are frequently prescribed to manage conditions like acid reflux and stomach ulcers.

These medications work by reducing stomach acid, which can affect the absorption of various nutrients, including folic acid. Stomach acid plays a role in breaking down nutrients and facilitating their absorption in the intestines. When acid levels are reduced, it can impair the absorption of folic acid, potentially leading to deficiencies.

Other medications, such as certain anti-seizure drugs can also impact folic acid metabolism. If you are on such medications, it’s important to discuss your folic acid levels with your healthcare provider. They may suggest monitoring your levels more closely or taking a different form of folate that is less affected by medication interactions.

Dietary Factors

Last but definitely not least, your diet significantly influences how well your body absorbs folic acid. Low levels of other essential nutrients, particularly vitamin B12 and iron, can hinder folic acid absorption and utilisation. Vitamin B12 and folate work closely together in various bodily functions, including DNA synthesis and red blood cell production.

A deficiency in vitamin B12 can lead to problems in metabolising folic acid, resulting in a functional deficiency even if folic acid intake is adequate. Similarly, iron is necessary for the optimal function of red blood cells, and a lack of iron can affect the absorption of folate and other nutrients. Potential nutrient deficiencies are important to take if you’re trying to conceive. In case you’re on the lookout for tasty and nutritious recipes, check out SABI’s Conscious Collective (shameless plug).

Beyond Pregnancy 

Folic acid is often recognized for its role in pregnancy, but its benefits extend far beyond that. This essential B vitamin supports numerous aspects of women’s health, making it crucial to include in your wellness regimen. Let’s explore why folic acid should be a staple in your day-to-day life and how it contributes to overall well-being.

Hormonal Balance

Folic acid plays a crucial role in maintaining hormonal harmony, which is vital for overall health. Hormones like oestrogen and progesterone are fundamental for regulating various bodily functions, including mood, menstrual cycle, and reproductive health.

  1. Hormone Synthesis: Folic acid is involved in the synthesis of oestrogen and progesterone, two key hormones in the female body. Adequate levels of these hormones are necessary for a well-regulated menstrual cycle. Imbalances in these hormones can lead to irregular periods, mood swings, and even conditions like polycystic ovary syndrome (PCOS).

Cardiovascular Health

According to the British Heart Foundation, more than 3.6 million women in the UK are living with heart disease. This issue is particularly concerning given that some cardiovascular diseases (CVDs) are specific to women, such as preeclampsia and gestational diabetes. In this context, folic acid emerges as a key player in cardiovascular health, influencing several factors that contribute to heart wellness.

  1. Homocysteine Regulation: One of the major roles of folic acid is to help regulate homocysteine, an amino acid in the blood. Elevated levels of homocysteine are associated with an increased risk of cardiovascular diseases, including heart disease and stroke. Folic acid helps convert homocysteine into other beneficial substances, thereby lowering its levels in the blood. Specifically, 5-MTHF is involved in a reaction that converts homocysteine into methionine, an essential amino acid that the body uses to make proteins and other important molecules.
  2. Blood Vessel Health: Folic acid supports the health of blood vessels by reducing inflammation and promoting proper blood flow. Healthy blood vessels are crucial for preventing hypertension and other cardiovascular conditions.

Mental Health

The relationship between folic acid and mental health is gaining recognition for its significance in cognitive function and emotional well-being.

  1. Cognitive Function: Folic acid is involved in the production of neurotransmitters and the maintenance of brain health. Low levels of folate have been associated with cognitive decline and an increased risk of neurodegenerative conditions. Adequate folic acid helps support memory, concentration, and overall cognitive function.
  2. Mood Disorders: Folic acid deficiency has been linked to mood disorders. This is partly due to its role in neurotransmitter synthesis, which affects brain chemistry and mood regulation. Supplementing with folic acid can be beneficial for those struggling with depressive symptoms.
  3. Mental Clarity: Ensuring sufficient folic acid levels can enhance mental clarity and focus. It supports brain health by contributing to optimal neurotransmitter function and reducing the risk of mental fatigue and cognitive impairment.

Blood Cell Production

Folic acid is vital for the production and maintenance of healthy blood cells, which is crucial for overall health and energy levels. Folic acid is essential for the production of red blood cells, which carry oxygen throughout the body. Without sufficient folic acid, the body cannot produce enough red blood cells, leading to anaemia.

Cell Growth and Repair

The role of folic acid extends to cellular health, where it supports growth and repair throughout the body.

  1. Cellular Regeneration: Folic acid is involved in the synthesis of DNA and RNA, which are critical for cell division and regeneration. This means it plays a key role in maintaining healthy tissues and organs.
  2. Wound Healing: Adequate folic acid levels support faster wound healing by promoting cell repair and regeneration. This is particularly important for recovering from injuries or surgical procedures.

5-MTHF: A More Bioavailable Form of Folic Acid

While folic acid is a staple in many supplements and fortified foods, it’s not always a smooth ride when it comes to absorption. For approximately 30% of the population, the conventional form of folic acid can be a bit of a puzzle, especially if the body struggles to convert it into its usable form. Enter 5-MTHF (5-methyltetrahydrofolate)—the superhero of folate! It bypasses the usual hurdles and ensures your body gets what it needs more efficiently. Here’s why it may be beneficial for you 

Direct Utilisation

  1. Immediate Availability:
    • Active Form: 5-MTHF is the active, bioavailable form of folate that your body can use directly without any additional conversion. Unlike folic acid, which requires conversion into 5-MTHF before it can be utilised, 5-MTHF is already in its usable state.
    • Genetic Variations: For individuals with genetic variations such as the MTHFR mutation, the conversion of folic acid into its active form is impaired. This mutation affects the enzyme responsible for this conversion, leading to reduced effectiveness of standard folic acid supplements. 5-MTHF bypasses this conversion step, making it a more reliable source of folate for those affected by these genetic issues.
  2. Efficient Utilisation:
    • Enhanced Effectiveness: Because 5-MTHF is ready for immediate use, it ensures that your body can efficiently utilise the folate without the need for additional metabolic steps. This can be particularly beneficial for those with compromised folate metabolism.

Clinical trials and research studies have demonstrated that 5-MTHF supplementation can lead to higher blood levels of active folate compared to folic acid. This improved absorption translates into more reliable health benefits and a reduced risk of folate deficiency..

Maximising Folic Acid Intake

To fully benefit from folic acid and ensure you’re meeting your nutritional needs, consider these strategies:

Prioritise Dietary Sources 

  1. Folate-Rich Foods: 
    • Incorporate Nutrient-Dense Foods: Focus on including a variety of folate-rich foods in your diet. Grass fed beef liver (highest and most bioavailable), Leafy greens (like spinach and kale), beans, Asparagus, Avocado and lentils (in that order of highest to lowest folate content and bioavailability).
       
  2. Food Preparation:

Consider a Supplement

  1. Choosing the Right Supplement:
    • Opt for 5-MTHF: If dietary sources are insufficient or if you have absorption issues, consider taking a folate supplement that contains 5-MTHF. As we discussed, this form is more bioavailable and effective for most people, especially those with genetic or metabolic challenges.Consult with a healthcare provider to determine the appropriate dosage based on your individual needs and health status.

Regular Health Checkups

  1. Routine Monitoring:
    • Professional Guidance: If you have concerns about your folic acid levels, genetic variations, or interactions with medications, it’s important to consult with a healthcare provider or registered dietitian. They can provide personalised advice and help you develop a plan to address any potential deficiencies or absorption issues.
    • Track Nutrient Levels: Regular health checkups and blood tests can help track your folate levels and overall health. This proactive approach allows for early detection and management of any deficiencies or health concerns.

Folic acid is a vital nutrient with far-reaching benefits for women’s health, extending beyond its role in pregnancy. By understanding the challenges associated with folic acid absorption and opting for 5-MTHF, you can enhance your body’s ability to utilise this essential vitamin. Prioritise folate-rich foods, consider high-quality supplements, and stay proactive with health checkups to support your hormonal balance, cardiovascular health, mental wellness, and overall vitality. Embrace the full potential of folic acid and ensure you’re getting the best possible support for your health, regardless of your life stage.


References

https://www.cdc.gov/folic-acid/data-research/mthfr/index.html

https://ada.com/conditions/folate-deficiency/ 

https://www.mdpi.com/2072-6643/9/4/382 

https://link.springer.com/article/10.1007/s10309-023-00602-3 

https://www.ncbi.nlm.nih.gov/books/NBK535377/ 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3458830/ 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7497502/ 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10490031/

https://pubmed.ncbi.nlm.nih.gov/15831124/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380836/ 

https://www.racgp.org.au/afp/2016/april/mthfr-genetic-testing-controversy-and-clinical-imp#:~:text=There%20are%20two%20predominant%20MTHFR,2.25%25%20will%20be%20 compound%20 heterozygous.

https://www.bhf.org.uk/informationsupport/conditions/heart-attack/signs-and-symptoms-of-heart-attacks-in-women

ABOUT HILARY

Hilary is the Co-Founder of the SABI, a Holistic Nutritionist, natural, whole foods Chef, product developer and advocate for women getting to know their bodies, cycles and selves better. Born in Los Angeles, California and raised in Baja California, Mexico, she now lives in Amsterdam, The Netherlands with her partner Kees, a curly-tailed rescue dog from Curacao, Flint and her rainbow baby, Paloma. 

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HORMONAL & PROUD

Created as a brand to help women navigate the toughest moments in pregnancy, childbirth, postpartum — and practically every stage of life –– The SABI aims to change the narrative around our hormones from one of taboo, embarrassment, and loneliness to awareness and pride. As more than a wellness brand, The SABI offers a carefully-crafted line of products to carry you through your hormonal journey, including rituals, supportive tools, and ancient herbal remedies that have been tested time and time again by women and now come backed by medicine. The SABI is a blend of science and nature conceived by women who have experienced the joys and deep struggles of bringing a child into the world, the pains of a heavy, difficult period, miscarriage, and difficulty conceiving.

We offer you an invitation to get to know your body and its cycles better –– an invitation to really understand what is going on inside. Learn to use your hormonal cycle to your advantage no matter your stage of life, and know that you can support and balance your hormone levels. Look for the right sources of information. Know that there is help, and know that you’re supported.

DISCLAIMER

The SABI blog and articles are not meant to instruct or advise on medical or health conditions, but to inform. The information and opinions presented here do not substitute professional medical advice or consultations with healthcare professionals for your unique situation. 

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