While treated interchangeably by numerous medical professionals, these substances are definitely not the same thing and they are treated very differently by the body

Folate is the active form and more readily utilised by the body, found in whole foods such as leafy green vegetables.  Folic acid, comparatively, is a synthetic compound, added to many packaged foods such as breads and cereals and dressed up with a “fortified with folic acid” slogan on food packaging. This was historically done in response to a surge in neural tube defects in babies due to a folate deficiency.  While this served its purpose and we saw a very welcome decline in these issues, we are now seeing “too much of a good thing” problems affecting, amongst other things, the ability to conceive itself which is where folic acid can start to be problematic and needs to be examined.

What does folate do?

Folate, in its active ‘methylfolate’ state, plays a role in something called methylation which very over simply put is a chemical relay with a vital role in DNA synthesis and quality, detoxification, neurotransmitter production, histamine metabolism (as in susceptibility to allergies), hormone – especially oestrogen – metabolism and clearance, eye health, cellular energy production and fat metabolism, explaining while it is such a crucial nutrient for our entire body though especially important for conception and healthy pregnancy.

The problem with folic acid is that multiple chemical processes or steps are required to convert it to its active form so it can then be utilised for methylation. An enzyme known as methylenetetrahydrofolate reductase (MTHFR) is one of the major players in this process, however, a huge proportion of the population have slight variances, known as a polymorphism, in the sequence of the gene that codes for this enzyme which can make it anywhere from 20-70% less effective depending on the variance.

Further to this potential issue, folic acid also preferentially binds to folate receptors meaning priority access and blocking any active folate that comes from our delicious whole foods like broccoli, brussel sprouts or spinach.

How does this relate to fertility?

The traditional medical model often sees very high doses of folic acid recommended for women trying to conceive and whilst effective in some, can be extremely counterproductive in others. Dihydrofolate reductase (DHFR) is another enzyme involved in the folic acid-to-active folate conversion and this can actually become clogged in the presence of high levels of folic acid, meaning even less of the good stuff is being made available to the body.

The average person consuming a standard Western diet and taking a multi-vitamin (“just to be healthy”), can be consuming up to 1000 mcg of folic acid a day. The DHFR enzyme, when functioning well, can only convert around 200-300 mcg to active usable methylfolate. This results in high levels of unmetabolized or unutilised folic acid floating around and continuing to block up the system, which can worsen a woman’s (or man’s) folate status effectively making an infertility problem worse.

Speaking of men, another incredibly important factor when it comes to folate and successful pregnancy is the male methylation status. Responsible for bringing half the DNA to the table, his folate utilisation is just as important and often overlooked even though research shows it as being the second highest factor behind unsuccessful versus successful conception.

Also worth mentioning is that the humble folate molecule, even when active cannot orchestrate methylation alone, it relies on the help of over essential nutrients such as B2, B6, B12, magnesium, vitamin D and betaine to make the whole operation work effectively.

Lifestyle factors such as exposure to heavy metals, toxins such as BPA in plastics, stress, medications, excessive exercise, alcohol, smoking, age and of course diet, will all affect this delicate and vital process. Unfortunately, it is a little more complicated than simply adding methylfolate to your regime. If you suspect you have issues, get tested and work with a knowledgeable practitioner and take the opportunity to really optimise and fine tune this delicate system.