Anyone who has been in the conception space will have no doubt come across the importance of folate, or vitamin B9, in pregnancy. It’s promoted highly by health professionals, especially in the first trimester of pregnancy, and with good reason.

In pregnancy, folate is needed to reduce the risk of:

• Neural tube defects, including spina bifida

• Midline defects

• Cleft palate, cleft lip

• Tongue tie, lip tie

• Pre-eclampsia

• Placental abruption

So very important, right? And it’s equally important to understand that there are two forms of vitamin B9:

• Folate: the natural form of B9 found in foods

• Folic Acid: the fully oxidised mono-glutamate synthetic form of B9 that is found in most supplements and fortified foods

Foods that are naturally rich in folate are:

• Chicken, lamb and beef liver

• Lentils, beans and chickpeas

• Asparagus

• Strawberries

• Broccoli

• Beetroot

• Brussels sprouts

• Leafy greens, such as kale, spinach, lettuce, silverbeet

But here’s the thing.

For the body to use folic acid and dietary folate, it must be converted into the methylated form of active folate which is methyltetrahydrofolate (5-MTHF). And concerningly, folic acid has been shown to block the body’s receptors for the uptake of active folate.

Talking more about the methylation process, we can’t talk about that without talking about the MTHFR gene and the role it plays in this scenario too. The MTHFR gene produces the MTHFR enzyme, which is responsible for something known as methylation. One particularly important role of methylation is to “activate” (or methylate) B vitamins so that the body can properly use them. If inactivated forms of B vitamins are consumed and the body is unable to convert them, they can’t go on to perform their key functions in the body.

This conversion is especially poor in people who have a MTHFR gene mutation, and it’s estimated that as many as 60% of the population (told you it’s worth a mention!) have a variation of this mutation. And the vast majority of the population don’t know if they have a gene mutation or not.

Because of the pathway that both folic acid and dietary folate have to take to be converted into the methylated form of active folate, and given that we know that 60% of the population have poor methylation conversion due to the MTHFR gene, a prenatal supplement with methylated folate would be better utilised by the body.

However, expecting parents need to be really mindful of overdoing their folate or folic acid intake or swapping their supplements without guidance. Too much circulating folic acid in the system (that hasn’t been methylated) is known to pose several possible health consequences. I cannot emphasis enough the importance of working closely with your preferred health practitioner in pregnancy to find a supplement protocol for your pregnancy that works for you individually. I personally love practitioners who utilise blood tests for their supplement recommendations.

I am currently not taking on 1:1 clients outside of my programs, however, here are my recommendations for holistic practitioners who will be able to work with you in your pregnancy:

• Steph Lowe - The Natural Nutritionist

• Sheridan Austin - Well Embodied

• Gina Urlich

I also urge you to read this blog post here by Sheridan Austin which talks more about this topic.