Folic acid or Folate?

Friday June 21, 2013

Do you feel really good most days? Energetic? Happy? Easy in your body?

If you eat well and exercise, and have created a life that nourishes you emotionally and spiritually, the answer to that question should be "Yes!"

Sometimes, though, it’s not. A person who makes wise choices in self-care, for whom all standard labs and medical tests are normal, may still experience symptoms of a lack of energy, or chronic recurring joint and muscle pain, or long-term mild depression. One potential cause is genetic. It’s worth checking for an anomaly on the gene that regulates the production of the enzyme, methylenetetrahydrofolate reductase (MTHFR).

MTHFR is the enzyme that changes the synthetic form of vitamin B9 (folic acid) into its bio-usable form (folate). Vitamin B9 helps the body make healthy new cells and is essential for red blood cell production. It plays an important role in cardiovascular health, in resolving inflammation and in eliminating toxins.

Like other B vitamins, B9 is water soluble, which means our bodies doesn’t store it and we need daily intake, either in the food we eat or in the form of a supplement. The supplement form, in capsules or in fortified foods, is folic acid. The food form is methyl-folate, and it is found especially in leafy green vegetables, legumes and egg yolk. This is the form that our bodies can make direct use of. In order to use folic acid, our bodies need to be able to convert it to methyl folate.

Data suggests that 25 to 40 percent of the population may have a genetic mutation that affects production of MTHFR. One third of those people are likely to have variants on more than one site on the gene. Depending on the extent of the effect, a person will produce less of the enzyme or produce an enzyme that is less functional. Consequently, levels of functional MTHFR will be less than optimal, folic acid will not be effectively converted to methyl folate, and the body will experience a deficiency of folate.

Folate deficiency can cause poor growth, diarrhea and other colon complications, gingivitis and mouth sores, peripheral neuropathy, forgetfulness, depression, mental sluggishness, behavioral disorders and other symptoms. Deficiencies in pregnant woman can cause neural tube defects in the developing fetus, creating cleft palates and spina bifida. In fact, it was to decrease the prevalence of these birth defects that the United States, in the mid-1990s, required folic acid fortification of cereal grains and flours.

Fortification did successfully decrease the rate of neural tube birth defects. The obvious problem though, is that those of us who cannot produce enough of the enzyme for conversion develop high levels of folic acid, and still have a deficiency of folate. Folic acid excess is being found to have a link to cancer, both because of a direct effect on neoplasm growth and because of an inhibition of natural killer cells.

What’s the solution? Discuss with your health care provider whether you are a candidate for the genetic testing that indicates whether you have a mutation on the gene that regulates production of MTHFR. If you do, avoid both supplemental folic acid and foods that are enriched with folic acid. Eat a diet high in folate-rich foods. Your health care provider will likely recommend supplementation with methyl folate, too. It is important to start slowly with a supplement regimen because too much folate in an initial daily dose is likely to cause a reaction while your body begins to make corrections and to detoxify at a healthy pace.

Dr. Linda Haltinner is a chiropractic physician at Sojourns Community Clinic. For more information, please contact Sojourns at (802)722-4023, 4923 US Route 5, Westminster, VT 05158,, find us on facebook, and visit


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