Folic Acid, Folate, Methylfolate

Names can oftentimes confuse. And such is the case for many with respect to Folate and Vitamin B9 and the names of particular folates. Let’s try and sort this out.

Folate and vitamin B9 are essentially the same nutrient, though “folate” refers to its natural form found in foods, while “vitamin B9” is the broader term used to encompass both natural and synthetic forms (like folic acid). Here’s a breakdown of both:

• Vitamin B9 is the general term for a group of related compounds that includes both folate (natural) and folic acid (synthetic).
• It is a water-soluble vitamin, meaning it dissolves in water and is not stored in large amounts in the body, so it needs to be replenished regularly through diet.
• Vitamin B9 is essential for numerous biological functions, primarily linked to cell growth, DNA synthesis, and the production of red blood cells.

• Folate is the naturally occurring form of vitamin B9 found in foods.
• It is crucial for healthy cell division and helps in the formation of DNA, RNA, and amino acids.
• Folate plays a significant role in pregnancy by helping to prevent neural tube defects (like spina bifida) in the developing fetus.

1. DNA and RNA Synthesis: Necessary for the creation and repair of genetic material, which is especially important during periods of rapid cell division and growth, such as during pregnancy or childhood.
2. Red Blood Cell Formation: Vitamin B9 helps in the production of healthy red blood cells, preventing certain types of anemia (megaloblastic anemia).
3. Protein Metabolism: It helps convert homocysteine, an amino acid, into methionine. This reduces homocysteine levels, which, when elevated, can increase the risk of cardiovascular diseases.
4. Neural Development: Folate is critical during pregnancy for proper fetal brain and spinal cord development.

• Folate: Found naturally in foods like leafy greens, legumes, citrus fruits, and whole grains.
• Folic Acid: The synthetic form used in supplements and added to fortified foods (e.g., breakfast cereals, bread, pasta). It is more stable than natural folate but must be converted to its active form (5-MTHF) by the body for use.

• Adequate levels of vitamin B9 are crucial for maintaining healthy brain function, supporting mental and emotional health, and preventing birth defects during pregnancy.
• Deficiency in folate can lead to issues such as anemia, fatigue, irritability, heart disease (due to high homocysteine levels), and in pregnant women, an increased risk of birth defects.

In short, folate is the natural dietary form of vitamin B9, while the term vitamin B9 encompasses both the natural and synthetic forms of this essential nutrient.

Now we know that Folate (vitamin B9) exists in several forms, both natural and synthetic, each differing in its biochemical structure and how it functions or is absorbed in the body.

Folic acid, folinic acid, and 5-methyltetrahydrofolate (5-MTHF), which are the most common, are all forms of folate (vitamin B9), but they differ in their biochemical structure and how they function in the body. Here’s a breakdown of each:

• Synthetic form of folate found in supplements and fortified foods.
• Inactive when ingested and needs to be converted into its active form (5-MTHF) in the body through several enzymatic steps.
• Conversion: Requires the enzyme methylenetetrahydrofolate reductase (MTHFR) for the final step to convert it into 5-MTHF, the active form of folate.
• Use: Commonly used to prevent neural tube defects in pregnancy and is often added to foods like cereals and breads.

• A naturally occurring derivative of folate.
• It does not require the MTHFR enzyme for conversion to 5-MTHF, making it a more bioavailable form than folic acid.
• Often used in medical settings (such as during chemotherapy) to protect healthy cells from the effects of drugs like methotrexate.
• Also used as a supplement for individuals with the MTHFR gene mutation, who may have difficulty converting folic acid to its active form.

• The active form of folate that the body can directly use.
• It bypasses the need for conversion by the MTHFR enzyme, making it the most bioavailable form of folate.
• Found naturally in foods and available as a supplement.
• Often preferred for individuals with MTHFR mutations, as it is already in its usable form.

• Folic Acid: Synthetic, needs to be converted to 5-MTHF via MTHFR.
• Folinic Acid: Active, bypasses MTHFR, used medically.
• 5-MTHF: Active, bioavailable, bypasses conversion steps, commonly used for MTHFR-related issues.