I’ve been thinking a lot about paleo, nutrition, and pregnancy as my wife and I get ready to go full TTC in just over a month. My doctor and the internet recommends overall good nutrition, but with a heavy focus on folate, iron, and calcium. Well, it turns out the Autoimmune Protocol might just be ideal for that, with its heavy focus on organ meats, broth, and lots and lots of leafy green veggies.
What with the liver in my meatballs, the daily bone broth and heaping servings of greens, and the dark green veggies, I’m fairly certain I get way over the recommended amount of calcium and iron. Folate is a little more difficult, but I’m pretty close. Even with all that, I went back and forth for a while towards the end of last year about whether or not I should start taking a full on prenatal vitamin.
After a bit of research, I decided to forgo the full vitamin for a small folate supplement. Folate is just so important to get enough of, especially in those first few weeks. It helps the brain and spine of the fetus to develop correctly. Considering I don’t eat liver every day and the amount of folate can be wildly variable in greens, I decided to take it – if only for peace of mind.
But why not a full prenatal vitamin? Well, I might change my mind if food aversions come to play in a big way, but at this time it just doesn’t seem necessary. Most prenatals include:
Folate is a B vitamin (B9 specifically) and is essential for tissue growth and functioning cells. Basically, folate works with vitamin B12 and vitamin C to help your body break down, use, and create new proteins. The vitamin helps form red blood cells – it can reduce anemia – and produce DNA. Suffice to say, it’s essential.
Folate occurs naturally in leafy green veggies, legumes, citrus, cauliflower, broccoli, beets, eggs, and liver.
Folic acid is the synthetic form of folate – they’re similar chemically, but not identical. There are several variations of folate found naturally and only one form of folic acid, but the synthetic folic acid is the most stable. Studies have also shown that folic acid is more readily absorbed by the body – where natural folate has a 50-75% absorption rate, folic acid is closer to 85%.
This has largely to do with the structure and metabolization of folic acid. Natural folate is joined up with non-essential amino acids that have to first be stripped away in your intestine before the folate can be absorbed. This process is sometimes not completed, which leads to the lower absorption rate. Synthetic folic acid lacks those amino acids, so it can be absorbed more completely.
That’s the jist, at least. If you want the full chemical run down, read this.
Folic acid and folate are also metabolized into tetrahydrofolate (THF) – the form that your body can actually use – in different places. Where folate is absorbed in the intestines, folic acid ends up in the liver. The liver then uses a reductase enzyme to turn the folic acid into THF. The enzyme, though, doesn’t work very fast on folic acid, and if you’re supplementing with a lot of it, that means some of the folic acid ends up unprocessed in your circulation. Studies have shown elevated levels of unmetabolized folic acid following consumption of supplements of fortified foods.
Is this a problem? That’s yet to be decided, but the evidence is starting to point that way. There have been numerous links made between high folic acid intake and cancer, for one. But there have also been some studies to the contrary. We don’t yet know for sure, but it’s starting to look like high folic acid intake is not always a good thing.
On the surface, folic acid initially looks superior to natural folate, but, although absorption rates are important, they are only one aspect of the nutrient’s use and cycle through the body. I, personally, would rather get sufficient folate from my diet, supplementing with natural folate as I feel necessary, then take folic acid. There haven’t been any links (as far as I can find, trolling through pubmed) between natural folate and cancer.
I’ll be writing a little more about paleo, AIP, and the primary prenatal nutrients over the next few days, so watch out. 🙂