MTHFR and folate and folic acid which one if either will help you

When you think of folate, what comes to mind? If you’re like most folks, the nutrient probably sparks thoughts of pregnancy and prenatal vitamins. And hey, you’re not wrong; adequate folate intake is super important when you’re pregnant or trying to conceive (TTC). However, even if you’re in neither boat, it’s still crucial to get enough for optimal health. 

The world of folate can be confusing, though. Folate is often used interchangeably with “folic acid”, even though they’re different forms. Furthermore, a common genetic variant—called the MTHFR gene mutation—may determine the best choice for achieving optimal intake.


Folate (vitamin B9) is a water-soluble vitamin that’s essential for making red blood cells, DNA, and neurotransmitters, including serotonin and dopamine. Without enough folate, you’re more likely to feel tired, weak, and down in the dumps. Plus, our bodies can’t synthesize the nutrient, so it’s important to include it in the diet. Adult men and women both need 400 micrograms (mcg) of folate each day.

You can find folate in dietary sources like leafy greens, citrus fruits, and beef liver. But here’s the catch: Folate is destroyed through preparation methods like cooking, canning, and freezing. The bioavailability of food folate is also 50%, which means only half is absorbed and metabolized by the body.

Folate can also be synthesized for use in supplements and fortified foods, including enriched cereals and grains. The most common synthetic form is folic acid, which has a higher bioavailability (85%) than food folate. (Folic acid is more stable, so it’s less likely to be destroyed by the intestinal tract.) That rate jumps up to 100% if you take it with water on an empty stomach. 

Needless to say, it may be worth taking folate supplements. The only problem? Not all supplements are equal. Specifically, folic acid—the common synthesized format—may not be the best option due to a common gene mutation. This mutation, which involves the methylenetetrahydrofolate reductase (MTHFR) gene, makes it difficult for your body to properly use folic acid. In this case, you’ll want to be extra mindful of the folate supplements you consume.


The MTHFR gene codes for methylenetetrahydrofolate reductase, an enzyme. When you take a folic acid supplement, MTHFR converts the folic acid into L-methylfolate, also called 5-methyltetrahydrofolate (5-MTHF). This is the biologically active form of folate; in other words, it’s the type of folate our cells can use.

However, if you have an MTHFR gene mutation, your body might have a hard time making this conversion. The most common genetic variant is the MTHFR C677T mutation, which is found in 20 to 40% of white and Hispanic individuals and 1 to 2% of black individuals in the United States. 

Another variant, called the MTHFR A1298C mutation, is the second most common type. According to the journal Circulation, it’s found in 7 to 12% of people in North America, Europe, and Australia. It’s also found in 4 to 5% of Hispanic individuals, 1 to 4% of Chinese individuals, and 1 to 4% of Asian individuals.

Having a MTHFR gene mutation means your body is unable to efficiently code for MTHFR enzymes. This decreases normal enzyme function, or in some cases, totally turns it off. The result? Folic acid gets “stuck” and isn’t converted into a usable form. 

With high doses, unmetabolized folic acid can accumulate in the blood. (Generally, this isn’t a cause for concern—except for the fact that your cells aren’t getting the folate they need.) Single doses, on the other hand, are quickly cleared by the kidneys, resulting in some very expensive pee for women supplementing with folic acid.


Typically, doctors don’t test for MTHFR mutations unless you have high levels of homocysteine, an amino acid. (The MTHFR enzyme works to break it down, so low MTHFR function would increase homocysteine levels.) It involves a test that checks for different variants of the MTHFR gene. 

Talk to your doctor if you’re curious about your MTHFR status. They might recommend the test, depending on your overall health and family history.


Most traditional supplements contain folate as folic acid. But if you have a gene variation, your ability to convert folic acid into L-methylfolate is compromised—making it harder to reap the intended benefits of those supplements.

Luckily, it’s possible to take folate supplements as L-methylfolate. By using the form that’s already biologically active, you can bypass the need for enzyme conversions. In turn, this can help you achieve ideal folate concentrations (and avoid buildup of unmetabolized folic acid) if your body is unable to convert folic acid.

The takeaway? When possible, look for a supplement with L-methylfolate, rather than folic acid. For example, in one serving of these vitamins you’ll find 340% of the daily value of L-methylfolate. They are my favorite vitamins because it helps with your mood, energy, aids in weight management, and blood formation, which can help with that time of the month. But they are the only vitamins clinically proven to improve your health markers within first hour of taking them.

If you’re wondering how folate or the MTHFR gene plays a role in your health, reach out to your doctor. They can offer guidance based on your personal health, needs, and family history.

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