Over the last few years there has been considerable controversy around the form and amount of folic acid that women trying to conceive should be consuming. In North America our grain products are fortified with a synthetic form of folate called folic acid (this is also the form found in several prenatal vitamins). The purpose behind food fortification was to help decrease the incidence of neural tube defects in new born babies.
There is a gene that makes up part of a detoxification pathway in your body called methylation that assists in your ability to convert folic acid into the active form of folate called 5-methyltetrahydrofolate or 5-MTHFR for short. Your body needs 5-MTHFR for the detoxification pathway to work properly and it is essential not just in preventing neural tube defects but also in several aspects of being able to maintain a pregnancy and general health. Having enough active folate is essential to produce children with healthy mental health parameters and to aid in the prevention of conditions such as ADHD, depression, cancer and autism. Approximately 10% of the population have a genetic variant or SNP that prevents them from being able to convert to the active form 5-MTHFR. About 60% of the population has a reduced ability for the conversion to function and the remaining 30% of the population are able to actively convert folic acid in the body to the active form 5-MTHFR.
Why is this relevant to patients concerned about fertility? If you are in the 70% of the population who either have a reduced ability or no ability to convert folic acid, unless you add an activated form of folate into your supplement regime your body will be deficient in 5-MTHFR and this will result in an impairment in your methylation cycle. Eating a diet with fortified grains with synthetic folic acid can also have a negative impact on this methylation cycle. Not having enough active 5-MTHFR can lead to infertility, miscarriage, neural tube defects as well as to anxiety, depression, cardiovascular concerns and cancer.
If you don’t know whether or not you are a proper methylator, make sure you minimize or eliminate fortified grains and ensure your prenatal vitamin contains the active form of folate 5-MTHFR. If you want to know for certain, then you can complete a simple saliva test through a company called 23andme.
If you’d like further information, please feel free to contact me at firstname.lastname@example.org
Dr. Jodie Peacock ND