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Folate supplementation during pregnancy can prevent serious birth defects. Women planning pregnancy should start supplementation before conception. This calculator is for education only—consult your healthcare provider for personalized advice.
Calculate your optimal folate intake for pregnancy, MTHFR, and general health
| Form | What It Is | Found In | Notes |
|---|---|---|---|
| Folate | Natural form of vitamin B9 | Leafy greens, legumes, liver | Well-absorbed from food, no toxicity concern |
| Folic Acid | Synthetic form for supplements/fortification | Supplements, fortified grains | Requires conversion by MTHFR enzyme; most studied for NTD prevention |
| Methylfolate (5-MTHF) | Active, bioavailable form | Higher-end supplements | Bypasses MTHFR enzyme; may be better for those with variants |
| Folinic Acid | Another active form | Supplements, medical settings | Used in some protocols; converts readily to 5-MTHF |
DFE (Dietary Folate Equivalents): Because synthetic folic acid is absorbed better than food folate, 1mcg folic acid = 1.7mcg food folate. A 400mcg folic acid supplement provides 680mcg DFE.
MTHFR (methylenetetrahydrofolate reductase) is an enzyme that converts folic acid into its active form, methylfolate. Some people have gene variants that reduce this enzyme's efficiency.
~30-40% of people. Enzyme activity reduced by ~35%.
~10-15% of people. Enzyme activity reduced by ~70%.
MTHFR testing is controversial. Many experts say it's usually unnecessary because:
Note: Having MTHFR variants doesn't mean you can't use folic acid. Studies show folic acid still prevents neural tube defects in women with MTHFR variants.
| Food | Serving | Folate (mcg DFE) | % Daily Value |
|---|---|---|---|
| Beef liver | 3 oz (85g) | 215 mcg | 54% |
| Spinach (cooked) | ½ cup | 131 mcg | 33% |
| Black-eyed peas | ½ cup | 105 mcg | 26% |
| Fortified breakfast cereal | 1 serving | 100-400 mcg | 25-100% |
| Asparagus | 4 spears | 89 mcg | 22% |
| Brussels sprouts | ½ cup | 78 mcg | 20% |
| Avocado | ½ fruit | 59 mcg | 15% |
| Orange | 1 medium | 40 mcg | 10% |
Cooking note: Folate is sensitive to heat. Raw leafy greens have more folate than cooked ones. Steaming preserves more folate than boiling.
Key fact: Adequate folate before and during early pregnancy reduces neural tube defects (spina bifida, anencephaly) by 50-70%. This is one of the most successful public health interventions in history.
400mcg folic acid daily from 1+ month before conception through first trimester
4mg (4000mcg) folic acid daily—prescription required. For women with previous NTD pregnancy, diabetes, obesity, or on anticonvulsants.
Note: Folate deficiency can look like B12 deficiency. Both should be checked together.
Both work for most people. Methylfolate is the active form that bypasses the MTHFR enzyme, making it potentially better for those with MTHFR variants. However, folic acid has decades of research proving it prevents neural tube defects. If unsure, methylfolate is a reasonable choice that works for everyone.
Natural food folate has no known toxicity. Synthetic folic acid above 1000mcg daily may mask B12 deficiency (preventing anemia while allowing nerve damage to progress). This is especially concerning in older adults. Some research suggests very high folic acid may have other risks, so stay within recommended ranges unless medically supervised.
L-methylfolate at high doses (7.5-15mg) has shown benefit as an add-on treatment for depression that doesn't fully respond to antidepressants. This is a prescription dose (Deplin) and should only be used under psychiatric supervision. Standard folate supplements haven't shown the same effect.
In 1998, the US mandated folic acid fortification of enriched grain products to prevent neural tube defects. This has been hugely successful—NTD rates dropped 25-30%. This is why many Americans get adequate folate even without supplementation, though women planning pregnancy should still supplement.
Yes, folate (along with B12 and B6) lowers homocysteine levels. High homocysteine was thought to increase cardiovascular risk, but supplementation trials haven't shown reduced heart attacks or strokes. Lowering homocysteine may still have benefits for other conditions, but it's not a proven heart disease treatment.
No. The levels in fortified foods (typically 100-200mcg per serving) are fine and beneficial. Some internet sources promote "folic acid avoidance" for MTHFR variants, but this isn't supported by mainstream science. Even with MTHFR variants, some folic acid is converted to active folate—just less efficiently. Concerns are primarily about high supplemental doses, not food-level fortification.