This week on Instagram I talked about something I really wish I’d understood before I got pregnant.

Folic acid and folate. They sound like the same thing. They’re not quite. And the difference is one of those small things that’s reallllly worth knowing if you’re trying to conceive or sat in your first trimester right now.

Before anything else though: If your midwife or GP has told you to take folic acid, please keep taking it. Folic acid in early pregnancy does an important job and it’s recommended for very good reasons. Nothing here is a reason to stop or swap anything without speaking to them first. Okkkk? Good. Now let’s get into it.

So what’s the actual difference

Folate is the natural form of vitamin B9, the kind you get from food. Folic acid is the synthetic version, the one in most supplements and added to loads of fortified foods like cereal and bread.

But your body can’t use folic acid as it is. It has to convert it into the active form first before. For plenty of people that conversion happens absolutely fine. For some it’s slower and less efficient, so a chunk of that folic acid ends up floating around unused.

That’s where the active, methylated form comes in. It’s already in the form your body can use without the conversion step needed. 

What to look for on a label

If you’re buying a prenatal and you want the easier-to-use form, the words to look for in the ingredients list are methylfolate, 5-MTHF, L-5-MTHF or L-methylfolate. If it just says folic acid, that’s the synthetic one.

I’m not telling you to bin your current prenatal, my love. Plenty are perfectly good and folic acid is still the official recommendation here in the UK. I’m just handing you the words so you can read the label and make an informed choice, ideally alongside your midwife.

Where to get it from food, because you know me…food first always

This is one of the rare times I’ll say a supplement is actually a non-negotiable in early pregnancy. Of course, food is doing alot work alongside it, and folate-rich food is cheap and easy.

The big hitters:

• Lentils and beans (a bowl of dahl is a folate goldmine!!)
• Leafy greens like spinach, kale and romaine 
• Asparagus, broccoli, Brussels sprouts and beetroot
• Chickpeas, so hummus on everything
• Avocado, oranges and strawberries
• Liver if you’re into it, one of the richest sources going

Quick tip. Folate is delicate and gets wrecked by heat and water, so lightly steam your greens or eat them raw where you can rather than boiling them to death.

The MTHFR question

You might have seen MTHFR floating around online, usually in a fairly scary way. In plain English it’s a gene involved in that conversion I mentioned, turning folic acid into the form your body uses. Some people have a variation that makes them less efficient at it, and some estimates suggest it’s more common than you’d think.

My honest take: the internet has turned MTHFR into a absolute rabbit hole and I’m not about to send you down it at 11pm googling yourself into a spiral (you’ve probably done enough of that if you’re anything like me in pregnancy). But if you’re curious about it, especially if you’ve been through recurrent miscarriage or unexplained fertility struggles, it’s worth a conversation to with your GP or midwife who can tell you whether testing actually makes sense for you. It’s not something to self-diagnose or lose sleep over. For most people, enough folate from a good supplement and real food is the main event.

If this opened up more questions than it answered, that’s completely normal.

This stuff is so so confusing and you never have to work it out on your own.

If you want a calm starting point for eating well in pregnancy, my free pregnancy food guide walks you through it without the overwhelm. 

And if you’d like to talk through your own situation properly, my free 20 minute discovery call is there whenever you’re ready. 

You’ve got this, lovely.