Did you know that it is best to avoid synthetic folic acid supplements? Here's why: roughly half of the population has a variant on their MTHFR gene that causes a reduced ability to convert folic acid into it's usable form: folate (5-MTHF). For these people unmetabolized folic acid, called 'UMFAs', can stay in the body and do harm.
Using 23andme I learned that I myself have two variants on this gene that reduce my ability to convert folic acid into methylfolate (aka 5-MTFH) by 50% (read how I went about discovering this here). Several studies have linked unmetabolized folic acid (UMFAs) to cancer (1). Folate, in contrast and even in excess, is perfectly safe.
Most prenatal vitamins on the market contain 'Folic acid' that can cause a build up of UMFAs. Avoid these. Instead, look for products that contain folate directly from whole foods or folate that is manufactured to be in it's final bioavailable state (5-MTHF) without the risk of UMFAs. Here are the best options:
The healthiest prenatal supplements with folate
This is my top choice for a multivitamin with natural folate because it is made from a vegan and organic food blend. It is also gluten free, non-GMO verified, with no synthetic binders or fillers. The makers have also included organic ginger and lemon peel to help fight nausea. One tablet per day offers 600 mcg of natural folate which is 100% of what you need if you are pregnant. If you have a MTHFR variant, you will have a reduced ability to absorb all 600 mcg in which case I suggest that you use the Wholesome app to ensure you are also getting folate from your diet.
Cost: For $69.82 you get a 3 month supply (That's $23.27 for a 1 month supply)
This multivitamin contains 800 mcg natural folate directly from broccoli. The downside is that you have to swallow 4 tablets per day. While it is made with all whole foods, only some of them appear to be organic. It contains organic ginger and to help with nausea. If you have a MTHFR variant, you will have a reduced ability to absorb all 800 mcg of folate in which case I suggest that you use the Wholesome app to ensure you are also getting folate from your diet.
Cost: $30.75 for a 1 month supply
Thorne research has a a complete nutritional supplement for pregnant and lactating women. It is a vegetarian pill (not vegan). It comes with 90 tablets and you must take 3 tablets per day to get 1,000 mcg folate in the form of L-5-Methyltetrahydrofolate. This form is well-absorbed by the body and is not affected by variants in the MTHFR gene. Thorne specializes in reducing the risk of stomach upset by offering nutrients such as iron and folate in the form that is tissue-ready and more easily digestible. It includes 45mg of iron which is higher than the recommended amount of 27mg per day for pregnant women. If you struggle with anemia, and you have low folate levels, or are affected by a MTHFR variant, this is a great option for you.
Cost: $39.34 for a 1 month supply
Zahler offers an easy to swallow softgel prenatal multivitamin. It contains 1,000 mcg folate in the ideal activated form for absorption. It also contains DHA which is a plus. The serving size is 2 tablets per day and 60 tablets are provided. It has 27mg of the bioavailable form of iron which is 100% of your daily requirement for pregnancy. It also the only option that contains Lutein Zexanthin for vision health. There are no herbal additives and no artificial color or preservatives. It is not vegetarian/vegan but it is certified kosher. This is a great option for those that aren't yet taking DHA and are low on folate or have a MTFHR variant.
Cost: $32.47 for 1 month supply tablets.
Pink stork offers folate on it's own. That means it isn't a multivitamin, its simply 1,000 mcg of folate in the bioavailable form for easy absorption. It is the same folate substance that's in Thorne and Zahler's products. All three of these companies source their folate from the company Quatrefolic. You only have to take 1 tablet and it is all vegetarian free from all the common allergens: free from milk, gluten, eggs, fish, shellfish, tree nuts, peanuts, wheat, soy, GMOs, and preservatives. This is a good option for those that already have a multivitamin and that only wish to get added folate.
Cost $18.03 for 60 days of tablets (That's $9.15 for a 1 month supply)
Which folate supplement is better for you?
Personally, I use the organic food blend option 'Garden of Life - myKind Organics' because I would rather ingest organic whole foods whenever possible.
WHAT TO DO IF YOU HAVE THE MTHFR GENETIC VARIANT(s)
If you have a genetic variant on your MTFHR gene, you will have a reduced ability to convert all of the folate from food (or a food based supplement like Garden of Life). To mitigate this, I recommend that you also get lots of folate from your diet. There is no need to worry about getting too much folate, its not dangerous in excess like it is with folic acid.
Another thing you can do is to take a supplement that has folate in the methylfolate form '5-MTHF'. I recommend: Thorne Basic Prenatal, Zahler Prenatal DHA, or Pink Stork Folate. They all have the benefit that they use 5-MTHF that bypasses the MTHFR enzyme such that folate is already converted to it's 'final' state. These three companies all source their folate as 'Quatrefolic' from the company GNOSIS S.P.A, so they are all basically the same. By taking Quatrefolic, there won't be any wasted folate should you have a MTHFR variant.
DOn't JUST SUPPLEMENT - EAT A FOLATE RICH DIET
While I recommend taking a folate supplement if you are trying to conceive or pregnant, it should be in combination with a plant based diet high in folate from whole foods.
I designed the Wholesome app to help me monitor and track toward my daily goals of nutrients, like folate. This is especially useful while pregnant when your nutritional needs increase. If you're pregnant, simply tell Wholesome what trimester you are in and it will help you track toward your specific goals. Wholesome sets your daily goals to what the National Institute of health recommends for your age, gender, and pregnancy stage, so you can rest assured that you will get what you need from your diet. If you want to adjust your goals further, you can customize them in the app.
Besides folate, the app tracks 90 nutrients in your diet, including omega 3's like DHA, protein, lutein, and a variety vitamins and antioxidants. It also allows you to save your recipes for easy tracking. I hope it's helpful for you!
RELATED ARTICLES ABOUT FOLATE AND FOLIC ACID
About the author
Jessica Glago is the CoFounder of the Wholesome App. After having two different cancers in her childhood she developed the app with the help of her husband to get more healthfulness out of her diet. To date, Wholesome for iOS has had over 250,000 downloads and over 1.5 million whole foods tracked. The app has been featured on BuzzFeed, LikeHacker, CultofMac, and The Seattle Times.