Understanding Alternatives: What Should I Take Instead of Folic Acid?

October 14, 2025 •

2 min read

Over 40% of the population may have genetic variations that impair the body's ability to convert synthetic folic acid into its active form. For these individuals and others seeking alternatives, understanding what should I take instead of folic acid is a critical health consideration.

Quick Summary

This guide differentiates between natural folate, synthetic folic acid, and active methylfolate, detailing food sources and supplementation options. It examines the role of genetic factors like the MTHFR variant on folate metabolism and helps inform personalized nutritional decisions for optimal health.

Key Points

Methylfolate (5-MTHF): The active, highly bioavailable form of folate, a key alternative to folic acid.
MTHFR Gene Variation: Can impair folic acid conversion, making methylfolate a better choice for some individuals.
Natural Food Folate: Found in foods like leafy greens and legumes, providing folate in its natural state.
Higher Bioavailability: Methylfolate is directly absorbed, unlike natural folate which is less stable and can be lost in cooking.
Risk of Unmetabolized Folate: Methylfolate reduces this risk associated with high-dose folic acid intake, particularly with impaired conversion.
Dietary Considerations: Optimize food folate intake by consuming raw or lightly cooked vegetables.

What is the Difference: Folate vs. Folic Acid vs. Methylfolate?

Folate is a B vitamin naturally found in foods, while folic acid is its synthetic form used in supplements and fortified foods. Both require conversion to the active form, methylfolate (5-MTHF), for the body to use them. This conversion can be less efficient in individuals with certain MTHFR gene variations, potentially leading to unmetabolized folic acid accumulation.

The Rise of Methylfolate

Methylfolate (5-MTHF) is the active, readily usable form of folate. It bypasses the conversion process, making it a good option for those with MTHFR variants or concerns about folic acid metabolism. Methylfolate has been shown to raise folate levels effectively and is increasingly used in prenatal supplements due to its direct role in fetal development.

Natural Food Sources of Folate

Increasing natural folate intake through diet is a valuable approach. Cooking methods can impact folate content, so steaming or microwaving may be preferable to boiling.

Excellent food sources of folate include:

Dark Green Leafy Vegetables: Spinach, kale, turnip greens, and romaine lettuce.
Legumes: Lentils, chickpeas, and various beans.
Asparagus.
Avocado.
Citrus Fruits: Oranges and grapefruit.
Eggs.
Liver: A concentrated source (avoid during pregnancy).

Comparison: Folic Acid, Methylfolate, and Natural Folate


Feature	Folic Acid	Methylfolate (5-MTHF)	Natural Food Folate
Source	Synthetic (man-made)	Bioactive form, supplements	Naturally in foods
Activation	Requires enzymatic conversion	Ready for immediate use	Converted to 5-MTHF
Absorption Rate	Higher bioavailability than food folate	Highly bioavailable and directly utilized	Less bioavailable, affected by cooking
MTHFR Impact	Conversion can be inefficient with variations	Bypasses conversion, unaffected by MTHFR variations	Requires MTHFR enzyme in final step
Cost	Generally inexpensive	Typically more expensive	Varies based on food choices
Risk of Unmetabolized Folate	Possible with high doses/impaired conversion	Low risk	None
Pregnancy	Standard recommendation, widely studied	Considered an alternative for some; research growing	Good foundation, often needs supplementation

MTHFR: Understanding the Genetic Factor

The MTHFR gene is vital for converting folate into its active form. A common variant can reduce the enzyme's efficiency. For individuals with significant MTHFR variations, relying solely on folic acid may not maintain optimal folate levels. Methylfolate supplements can be a beneficial alternative as they bypass the need for the MTHFR enzyme. Discuss MTHFR testing with a healthcare provider to understand your needs.

Conclusion: Making an Informed Choice

Choosing an alternative to folic acid depends on individual factors like genetics, diet, and health status. Methylfolate is a highly bioavailable option for those with MTHFR variants or concerns about unmetabolized folic acid. A diet rich in natural folate is beneficial for everyone. Always consult with a healthcare professional to determine the best approach for your specific needs, especially during pregnancy or with existing health conditions. Making informed decisions about nutrition and supplements supports optimal health.

To learn more about folate and folic acid, refer to the National Institutes of Health fact sheet.

Frequently Asked Questions

Methylfolate is a superior option for those with MTHFR variations affecting folic acid conversion. For individuals with normal MTHFR function, folic acid is generally effective.

A diet rich in folate-rich foods can contribute significantly, but supplementation is often recommended, especially for women of reproductive age or during pregnancy, to ensure adequate levels.

Top sources include beef liver, spinach, asparagus, Brussels sprouts, broccoli, and legumes.

An MTHFR mutation can decrease the efficiency of the enzyme needed to convert folate into its active form, particularly impacting the metabolism of synthetic folic acid.

Methylfolate may be a better option for pregnant women with MTHFR variations due to direct absorption. However, folic acid is proven to reduce neural tube defects, and the CDC recommends it even with MTHFR variants. Consult a healthcare provider for personalized advice.

Yes, combining a diet with natural folate and a methylfolate supplement is generally safe and beneficial for ensuring adequate levels, while minimizing the risk associated with high synthetic folic acid intake.

Methylfolate can interact with some medications, especially those affecting folate metabolism like methotrexate. Always inform your doctor about any supplements you are taking.