“Let’s take a look at your supplements…” I say to a friend who struggles with leaky gut, autoimmune problems, and attention deficit.  “Can you text me pictures of the ingredient list and nutrition facts of them all?”

Despite only using ‘good’ brands of supplements from the health food store, we found synthetic folic acid in her B-complex, multivitamin, and the green juice she was drinking daily.  When someone has multiple unexplained health problems, and is going through the trouble of dietary intervention switching to a methylated form of folate and eliminating all the synthetic folic acid can be the missing piece of the puzzle. 

We are Folic Acid Blind

We are all so used to seeing folic acid on the ingredient list in so many foods and supplements that we’ve become blind to it.  Added to grains, cereals, juice, vitamins, and other supplements with the goal of reducing birth defects including spina bifida, the intention behind adding it to food was good.

But the synthetic (less expensive) form that is added to most vitamins, processed food, flour, and cereals is causing problems in those with MTHFR gene mutation who don’t produce enough of the enzyme needed to absorb it (source), and may even cause enzyme deficiencies in those without the MTHFR gene mutation (source).

Folate and Mythyl Folate For Those With Health Problems

As we’ve talked about before, some people will be able to better tolerate folic acid (and other synthetic food additives) better than others.  It has to do with the state of your gut, your gene type, and even how genes express themselves.

Most of my readers are interested in natural food and supplements because the status quo is not working for them. And this may be one piece of the puzzle.

Read: Folate, Autism, and Tongue Tie: Why I regret Taking My Prenatal Vitamin

Why is it in our food?

Again, let me remind you that the intention behind adding folic acid to most food in the supermarket and most multivitamins was good- we wanted to decrease the incidence of neural tube defects, and for those eating mostly processed food without any B vitamins added back in, the diet is low in natural folate and the risk of neural tube defects is higher.

But for those who have been consuming too much folic acid and have had the enzymes needed to process it suppressed (source), or are unable to process even small amounts due to fairly common gene mutations (source), this attempt at helping our health is causing similar symptoms to the deficiency that we’re trying to prevent (source).

Where is synthetic folic acid found?

In 1996 the FDA started requiring that folate/folic acid be added to all grain and cereal products.

In its naturally occurring form folate lacks stability in food storage and preparation; however, folic acid is stable and used for supplements and food fortification. – The History of Folic Acid Supplementation

• • Multi vitamins

• • B vitamin complexes

• • Prenatal vitamins

• • Supplements, especially supplements for energy

• • Fortified Juice

• • Fortified almond, soy, rice, or coconut milk

• • Bread and baked goods from the store

• • Flour from the store (freshly ground at home is okay)

• • Products made with flour such as crackers, chips, bread crumbs, pasta.

• Anything labeled ‘fortified’ or ‘enriched’

What should I take instead?

Through gene testing, lab testing, and trial and error, people are finding the correct form and dose of folate for them.

Before you let labs be your final say read: When The Labs Say There is Too Much Folate In Your Blood

Labs and Genetic Testing

Testing for the MTHFR gene mutation can be done through genetic testing.  They are also beginning to find that even those without the MTHFR gene mutation can have the enzyme needed to process folic acid into usable folate supressed (source) so the actual gene mutation may not tell the whole story about whether folic acid is good to consume or not.

Labs can measure the amount of folate/folic acid circulating in the blood.

Trial and error

It’s not sexy or expensive, and it doesn’t come with a computer-generated printout for reassurance, but to find the correct form of folate in my own family I use the trial and error approach. This is how we approach supplements, there are too many times that I have tried to adjust supplements based on lab work without noticing any improvement.

This is what our approach looked like: 

1. • Remove sources of folic acid for our diet for 1 week (see list above)
   • Add in high folate foods and note any improvements over 1 week. (see list below)

• • Add in 1 capsule of Methyl folate and see if symptoms improve.

• • If they do not improve or you feel worse, try a different form.  Some people can’t do the methyl.

• • Record symptoms on a simple wall calendar. In our family we note sleep hours, irritability, vocabulary, fatigue, eye contact, skin rashes, fogginess.

• • Increase by one capsule every few days until we get to the recommended dose of 3/day.

• • Continue to record symptoms.

• • Stay on recommended dose for 2 weeks, then use the opposite approach to go down on the dose.

• • Continue to record symptoms. If symptoms return that were gone, stop going down.

• • Every 2 weeks try going down on the dose, while continuing to record symptoms.  We have found that we only need one capsule every other day and we lose undesirable symptoms (kids not sleeping well, tiredness and fogginess for adults).
  • If you feel there is still another piece missing, you can repeat the process with the b12/methyl folate combination.

Foods that are high naturally in natural folate:

Amount of folate per 100 g as per nutritiondata.self.com

• Seaweed, agar – 1010 mcg
• Leeks – 366 mcg
• Sweet green peppers – 229 mcg
• Spinach, raw, 194 mcg
• Sunflower seed kernals, toasted, 238 mcg
• Duck liver – 738 mcg
• Chicken liver – 588 mcg
• Beef liver – 290 mcg

Supplements made with methyl folate, not folic acid:

• Chewables
• Prenatals
• Vitamin B12/folate combination
• Methyl folate

Quick reminder: I am not a medical professional, this is not medical advice. I am just a mom who is trying to figure out what’s going on in my own family with the information I have available to me.  And I want to share, in case it is helpful for you.  

Read more:

See all MTHFR/Folic Acid Articles