Folic acid is a nutrient every woman trying to conceive has heard of and for good reason.
Inadequate levels of folate is one of the principal reasons behind unsuccessful pregnancies. This nutrient is involved in cell division and the production of DNA- which are both vital functions in the early development of the foetus. In addition, there is strong research to support the premise that supplementing with folic acid pre and during pregnancy significantly helps in reducing the risk of neural tube defects (NTD); this is a structure which is formed early on in pregnancy and later goes on to form the brain and the spinal cord. Folic acid is the synthetic form of folate. This form is used in supplements which is then required to be converted to the activated form: 5-MTHFR. Although most of the research around folic acid is in regards to NTDS, there have been suggestions that it can influence fertility and how soon you get pregnant.
One of the enzymes involved in converting folic acid to its activated form is called MTHFR. The gene that codes for this enzyme is changed in approximately 30-50% of people and is known as an MTHFR polymorphism. Some studies have indicated that having a polymorphism can lead to women not being able to effectively absorb folate, thus having the potential to cause health problems surrounding pregnancy. It may result in your baby developing a neural tube defect or can cause problems with the cells dividing properly, which can lead to unsuccessful pregnancies. Additionally, having a mutated MTHFR gene can also be the cause behind infertility
Studies have shown that supplementing 5-MTHFR, rather than folic acid is more effective at improving long term folate status BUT there have not been studies in regards to the prevention of neural tube defects with 5-MTHFR and this is where the contention arises; some doctors will say that testing for MTHFR will not change their practice, will continue to advise on folic acid and that since taking activated folate has not been shown to reduce the risk of NTDs, then they would not recommend its use.
It is important to note that there will never be studies looking at whether supplementing with the activated form of folate will prevent NTDs since it would be unethical to do so as we already know that folic acid works. So, should all pregnant women that folic acid or activated folate? This is an area that needs to be considered on a case-by-case basis but if you have had repeated miscarriages or have been struggling with fertility for quite some time and no known cause has been identified, then it may be worth getting tested for the the MTHFR gene to see if you have a mutation and if so, then it may be worth taking an activated form of folate.
In some women, continuous low folate levels (despite folic acid supplementation), low B12 levels (despite adequate dietary intake) and high homocysteine are all suggestive that you may have a mutation in the gene that codes for the MTHFR enzyme. When I work with my 1:1 clients, these are some of tests that i request from the GP in order to help guide the nutritional and supplement plan going forward.
If you have been struggling to conceive, are feeling overwhelmed and not sure if your diet is supporting or hindering your fertility journey, feel free to reply to this email in order to request a FREE discovery call. The aim of this call is to get to know a bit more about you and your situation, an opportunity for you to ask me any questions you may have and to see whether I would be best suited to help you on your nutrition and fertility journey.