Folic Acid And Fertility – Doing More Harm Than Good?
The vitamin deserves its exalted status.
When women take it before and during pregnancy, it reduces the risk of devastating neural-tube defects in the fetus. It’s one of the only things we can do to improve fetal health that is supported by rigorous evidence.
But with levels of infertility, multiple miscarriages and failed IVF attempts on the rise, we need to take a closer look at our genetics – the MTHFR gene could be the key to conception.
The MTHFR gene directly dictates if folic acid, folinic acid or 5-MTHF is the best way to improve your folate levels for successful conception.
Let start With The Basics – What is Folate, Folic Acid, Folinic Acid & 5-MTHF?
The terms ‘Folate’ and ‘Folic acid’ are often used interchangeably, however they are not the same.
The term folate really encompasses a group of nutrients that are all different types of folates. They belong to the B vitamin family group, otherwise known as B9.
Dihydrofolate (DHF) is the form of folate that is found in food sources, such as green leafy vegetables. This food form of folate is then metabolised into tetrahydrofolate (THF), the main form of folate which can enter the folate metabolic cycle.
Finally, the body converts these forms down into methylfolate (5-MTHF) – the most active and potent form of folate.
On the other hand, Folic Acid is an oxidised, synthetic compound used in dietary supplements and food fortification that does not occur naturally.
Folate and MTHFR Mutations
If you have a genetic mutation of the MTHFR gene you may not be metabolising supplemental folic acid into the active form 5-MTHF.
The diagram below shows the steps in converting dietary folate and folic acid into the active folate, 5-MTHF.
You can see the MTHFR enzyme comes in at this last step of the process. This means, that if you have a mutation in your MTHFR gene, the ability for your body to create healthy levels of active folate will be affected or decreased.
This will result in less active folate available for your body to use in several very important processes, primarily methylation.
This is where the link between MTHFR and preconception and pregnancy arises.
Several of the vital processes that we need active folate for are highly active during times of preconception and pregnancy and need to be working well to support a healthy pregnancy.
In 2009, folic acid was introduced as a mandatory food fortification in Australia because of its ability to protect against neural tube defects in newborns.
Fortified foods include breads, cereals, rice, pasta and other grain products. 2-3mg of folic acid is added per kg of wheat flour.
Researchers now believe that long-term consumption of folic acid through supplements and food may relate to an increased risk of cancer and cognitive impairment.
Increased levels of unmetabolized folic acid (UMFA) in the blood is associated with decreased levels of natural killer cells. These natural killer cells play a vital role in tumour cell destruction, suggesting that excessive folic acid intake could promote existing premalignant and malignant tumours.
In IVF and fertility issues, doctors and specialists alike are still recommending a high dose 5mg folic acid as a standard treatment for infertility. This super dose of folic acid may be doing more harm than good in women with MTHFR mutations.
Those with the MTHFR gene mutations should be avoiding folic acid in supplemental form and fortified food sources. The reason is that folic acid has the potential to build up and inhibit our DHFR enzyme, which is crucial in our folate pathway.
Some research has also shown that unmetabolised folic acid builds up and affects our immune system negatively too.
Neural Tube Defects and MTHFR
Anencephaly, spina bifida and encephalocele are the most common types of Neural Tube Defects (NTD’s), and develop due to the failure of the neural tube to close between the 3rd and 4th week of embryonic development.
While science still debates the true cause of NTD’s, there can be no doubt that the introduction of mandatory fortification of breads with folic acid has reduced the prevalence of NTD’s.
One thing we can be sure of however, is folate’s crucial role in the production of healthy DNA in the rapidly growing embryo, with the demand for folate being the highest during this period than throughout the rest of a human’s lifetime.
Therefore, the ability of the mother to provide adequate levels of active folate to a growing child is critical for the growth and development of the fetuses brain and organs.
As a positive MTHFR mutation can have a large impact on the body’s ability to create adequate levels of active folate, and keep the level of homocysteine down, many scientific studies have been done looking at the association of the MTHFR gene, homocysteine and the development of NTD’s.
Research has discovered that if levels of folate are already low in the diet, homocysteine is elevated (because there is not enough folate) and a MTHFR mutation is present, the risk of NTD’s forming is increased by almost 40% and anencephaly by almost 80% if you are homozygous for the MTHFR C677T gene mutation.
If you are wanting to get pregnant, currently trying or are having some difficulties getting pregnant, a simple MTHFR test may be the key to conception.
Its quick and easy to do, a cheek swab sample can be taken in the comfort of your own home and have the results within 2-3 weeks.
To find out more and to order your MTHFR testing kit, simply click here.
If you already have been tested and are either A1298C heterozygous or homozygous switching your folic acid containing pregnancy formula to one that contains folinic acid or 5-MTHF is the best option. Eagle Tresos Natal contains 250mcg folinic acid per tablet.
If you are homozygous for C677T, your MTHFR enzyme function is reduced by about 70%. This means that the amounts of folic acid you can successfully convert to active folate is severely reduced.
You should start on a seperate 500mcg 5-MTHF supplement. Bioceuticals MTHF contains 500mcg 5-MTHF per capsule.
If this is a little too confusing, simply contact an Emed Practitioner for a consultation to see if MTHFR testing could benefit your chances of conceiving.
Or if you’ve already been tested and need some guidance, chat to one of our Emed Practitioners today.
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