Folate, Folic Acid, or B9: What’s the Difference?

Folate and folic acid both provide vitamin B9, an essential nutrient involved in cell division, DNA synthesis, normal blood formation and homocysteine metabolism.

The terms are often used interchangeably, but they do not describe exactly the same thing.

Folate refers to a family of vitamin B9 compounds.

Folic acid is a synthetic form, widely used in supplements and fortified foods. 

5-MTHF, or 5-methyltetrahydrofolate, is another form of folate and is the main form found in circulation in the body. 

The key difference is the form of vitamin B9 being supplied and how it is processed by the body.

Folic acid

Folic acid has been used successfully in supplementation and food fortification for decades. However, before it can be used by the body, folic acid must be converted through several metabolic steps into 5-MTHF, the main form of folate circulating in the bloodstream. How efficiently this conversion occurs can vary between individuals and may be influenced by factors such as genetics and nutritional status.

5-MTHF

5-MTHF is a biologically active form of folate and the main form found in the bloodstream.

Supplementing directly with 5-MTHF bypasses the need to be converted from folic acid. Studies have shown that 5-MTHF is an effective source of folate and can increase blood folate concentrations.[2]

Why Supplement Folate?

Folate intake is particularly important for people with increased nutritional requirements or a low intake of folate-rich foods. It is especially important before and during pregnancy because of its role in cell division and maternal tissue growth. In the UK, people who are pregnant or trying to conceive are specifically advised to take folic acid, so pregnancy supplementation should follow current NHS guidance or advice from a healthcare professional.[1]

What is Quatrefolic®?

Quatrefolic® provides 5-MTHF, a biomimetic source of folate; meaning it is identical to the main form naturally used by the body. 

The 5-MTHF in Quatrefolic® is delivered as a glucosamine salt, a formulation designed to deliver a stable and bioavailable source of folate. The European Food Safety Authority has assessed this form and concluded that it is a bioavailable and safe source of folate.[3]

Advantages of 5-MTHF

Research comparing 5-MTHF with folic acid has identified several differences.

Direct provision of 5-MTHF. 5-MTHF is supplied directly rather than produced through the series of metabolic reactions required to convert folic acid.

Effective support for folate status. Clinical studies have shown that 5-MTHF can effectively raise blood and red-blood-cell folate concentrations. Some studies have reported greater increases than with equivalent amounts of folic acid, although results vary according to dose, population and outcome measured. [2]

Less dependence on conversion pathways. Providing 5-MTHF directly bypasses several metabolic steps involved in converting folic acid into active folate forms. [4]

References and further reading

1. NHS. Vitamins, supplements and nutrition in pregnancy.
https://www.nhs.uk/pregnancy/keeping-well/pregnancy-vitamins-and-supplements/

2. Lamers Y, et al. Red blood cell folate concentrations increase more after supplementation with [6S]-5-MTHF than with folic acid in women of childbearing age. American Journal of Clinical Nutrition. 2006.
https://pubmed.ncbi.nlm.nih.gov/16825690/

3. EFSA. Scientific Opinion on (6S)-5-methyltetrahydrofolic acid, glucosamine salt as a source of folate added for nutritional purposes to food supplements. EFSA Journal. 2013.
https://efsa.onlinelibrary.wiley.com/doi/10.2903/j.efsa.2013.3358

4. Henderson AM, et al. Comparison of 5-MTHF and folic acid supplementation during pregnancy, including maternal folate status and unmetabolised folic acid. British Journal of Nutrition. 2023.
https://pubmed.ncbi.nlm.nih.gov/37649241/

5. NIH Office of Dietary Supplements. Folate: Health Professional Fact Sheet.
https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/

Disclaimer: This article is for general information only and is not intended as medical advice. Always consult a qualified healthcare professional before starting or changing any supplement, particularly if you are pregnant, trying to conceive, breastfeeding, taking medication, or have an existing medical condition.