Folic Acid vs. 5-MTHF: What Every Woman Trying to Conceive Needs to Know

If you’re trying to conceive, chances are you’ve been told to take folic acid. It’s become the go-to prenatal nutrient for decades to reduce the risk of neural tube defects. But new research is challenging whether folic acid is actually the best option—especially for women with MTHFR gene variants or a history of pregnancy loss.

Folic acid is a synthetic version of vitamin B9. While it’s absorbed well, the problem lies in how it’s metabolised. Folic acid must be converted into its active form—5-MTHF (5-methyltetrahydrofolate)—before your body can use it.

But here's the catch: this conversion relies on an enzyme called DHFR (dihydrofolate reductase), which works slowly in most people and even less efficiently in those with MTHFR polymorphisms.

This leads to unmetabolized folic acid (UMFA) floating around in the blood—a form your body can’t use, and one that may interfere with DNA methylation, increase inflammation, and even negatively affect fertility outcomes.

Research now shows that supplementing with 5-MTHF instead of folic acid is not only safe but significantly more effective at increasing folate levels and supporting fertility—especially for those with recurrent pregnancy loss or known gene mutations.

It’s time we stop treating all folate the same. If you’re planning a pregnancy, talk to your practitioner about using activated folate like 5-MTHF to support both your fertility and future baby’s development.

Much Love,

Megan