Updated: Jul 17, 2020
Have you been told to take folic acid in a prenatal supplement to improve your chances of having a healthy baby?
Most of my clients tell me that prenatal supplements are one of the first things they think about when preparing their body for pregnancy. As a matter of fact, this is also one of the first things a medical doctor will recommend when you tell them you are ready to start preparing for pregnancy.
While this is definitely a great way to start preparing the body for pregnancy, there are some things that you need to know to ensure you are nourishing your body with the best ingredients to grow a new life.
Firstly, a prenatal supplement is extremely important during preconception and even during pregnancy, but it is not the magic pill that’s going to get you pregnant. A prenatal supplement should be looked at as ”the icing on the cake.” The building blocks of your cake are a healthy diet and lifestyle, and the supplements add an extra flavor and texture to complete it. This is how I want you to think about prenatal supplements.
Now you may already know that all prenatal supplements are not created equal. There are some great ones on the market, but also some that are less desirable due to the quality of their ingredients and the extra fillers that can be found inside.
Spoiler Alert! I even find that prenatal vitamins recommended by doctors are not ideal, so make sure to read your labels!
So how can you make sure that what you are putting in your body will serve you rather than harm you?
Top 3 things to consider when choosing a prenatal:
What format does it come in?
It could be a capsule, tablet, liquid, powder, softgel or chewable. Tables are the most difficult form for the body to break down into nutrients that can be properly absorbed. Tables also contain a relatively large amount of fillers and binders, which may result in adverse effects in sensitive clients. Chewable and gummy products often contain many non therapeutic ingredients. Capsules, liquids and powders usually have good absorption as well as fewer fillers and non therapeutic ingredients.
Does it contain harmful ingredients?
All supplements should be free of potentially harmful ingredients. You want to keep the number of additives and excipients (aka, the laundry list of unpronounceable elements listed under ‘other ingredients’) to a minimum. These unnecessary, often toxic, ingredients arein many mainstream brands. They hinder absorption and put a toxic burden on your liver and GI system. So, please read your labels, even if it was given to you by your doctor. Here are some specific ingredients you should actively avoid:
FD&C Blue #2 Lake
FD&C Yellow #5 (Tartrazine) Lake
FD&C Yellow #6 Lake
Folic Acid vs. Folate, which one?
Folate is a term used for water-soluble B-vitamins, also called B9, and is found in foods such as chicken liver (not recommended when pregnant due to high vitamin A levels), peanuts, sunflower seeds, spinach, broccoli and more. This form is easily absorbed by the body and requires little processing to get used up by the body.
Folic acid (a type of folate) is usually a synthetic compound made in a lab that doesn’t naturally come from food. It is added to cereals and grain products, as you might notice on the labels "fortified with B9.." However, 'folic acid' needs to be activated by the body via an enzyme called MTHFR (no, this is not an acronym for the bad swear word it might sound like).
Natural folate is absorbed through your small intestines, while folic acid must be processed by the liver. The problems is that the liver doesn't contain a lot of enzymes (MTHFR) to process this folic acid. Too often the folic acid isn't metabolized and it circulates in the blood without a good way for it to actually be used or processed.
The problem, folic acid is really hard for our body to process and convert into the active form of folate that we need.
The main function of this vitamin is to helps prevent birth defects in the baby's brain and spinal cord. While fortifying foods with folic acid has been helpful for reducing birth defects in general, there is a small caveat.
If you have had more than one miscarriage or have had a history of depression, it is important to check for the MTHFR gene mutation to rule it out.
Stay with me as I briefly explain this genetic mutation.
Each cell of our bodies contains the MTHFR gene, which helps produce the nutrient methyfolate, the body's most active form of folate that initiates a long series of essential enzymatic reactions. About 15% of the population have two copies of this gene, making them unable to convert folate to its active form. In addition, approximately 50% of the population have a reduced ability to do this conversion sufficiently. (1)
A successful functioning MTHFR gene is vitally important to the proper functioning of many of our body's systems (neurotransmitter, DNA, immunity, cardiovascular), not just for the reproducitve system.
An improperly functioning MTHFR gene can create elevated homocysteine levels (a naturally occurring amino acid in the blood plasma, which when high is believed to increase the risk of heart disease and stroke), and can trigger higher rates of miscarriage and embryonic neural tube defects, as well as such conditions as depression, attention deficit hyperactivity disorder and autism for you and your baby. (2)
The Good News!
You can get tested for an MTHFR mutation, and if your test comes back positive, there are steps you can take to counteract its effects and have a healthy conception and pregnancy.
If you want to err on the side of caution, choose the right supplements (as recommended below), eat organic and non GMO food, reduce your intake of 'synthetic folic acid' and increase your intake of natural-folate foods.
You ideally want a prenatal to contain either 'L-5-methyltetrahydrofolate' (L-5-MTHF) or 'folate', aim for 800mcg or more.
If your supplement is made from whole foods, then any folic acid listed comes from folate and this will give you a greater chance of absorption to help your DNA and cells to stay healthy.
So, what prenatal supplement should you get?
When recommending a prenatal to my clients, I always recommend those that are sourced from real, whole food whenever possible, though I know that nonfood based elements are sometimes necessary for maximum absorption.
Here are four of my favorite prenatal vitamins:
Thorne Research’s Basic Prenatal
Ortho Molecular’s Prental Complete
New Chapter’s Perfect Prental
Garden of Life’s Vitamin Code Raw Prenatal