March 24, 2025 • 28 mins
Synthetic folic acid has infiltrated our food supply and supplement industry, creating potential health havoc while masquerading as an essential nutrient. This deep dive into the critical differences between natural folate and its synthetic counterpart reveals why so many of us might be suffering unnecessarily from issues like fatigue, brain fog, anxiety, hormone imbalances, and even fertility challenges.
The FDA's 1998 mandate requiring folic acid fortification in enriched grains successfully reduced neural tube defects in newborns, but created an unintended consequence: massive population-wide exposure to a synthetic nutrient that up to 40% of people struggle to properly metabolize. For those with MTHFR gene variants, this synthetic form can build up in the bloodstream as unmetabolized folic acid (UMFA), blocking folate receptors and creating a functional deficiency—even when blood tests show normal or high folate levels.
From enriched bread and cereals to protein bars and conventional vitamins, I expose the hidden sources of folic acid lurking throughout the standard American diet. A typical day might include multiple fortified foods, creating a perfect storm for methylation disruption. The consequences extend beyond fatigue and brain fog to include increased homocysteine (raising cardiovascular risk), masked B12 deficiency leading to neurological damage, impaired detoxification, and hormone imbalances that manifest as PMS, PMDD, or estrogen dominance.
The solution lies in both avoiding synthetic folic acid and ensuring adequate methylation support through properly formulated supplements containing methylfolate (5-MTHF), methylcobalamin (B12), and other methylation cofactors. I provide practical guidance for navigating restaurants, grocery shopping, and supplement selection to support optimal methylation and folate status—without resorting to synthetic shortcuts that your body wasn't designed to process.
Ready to transform your health by addressing this often-overlooked nutritional factor? Test, don't guess, and give your cells the bioavailable nutrients they truly need to thrive.
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Episode Transcript
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Speaker 1 (00:01):
Welcome to Harmony Hub Health, where my mission is
to provide comprehensive,affordable, integrative care
that addresses the root cause ofhealth issues.
At the Hub, the focus is onindividual patient journeys.
I strive to optimize health,vitality and longevity,
fostering a community where eachperson can thrive in body, mind
and spirit.
(00:21):
Today we're going to talk aboutfolic acid, the synthetic
imposter hiding in your vitamins, and why your body is begging
for real folate.
If you've ever taken amultivitamin, a prenatal or
(00:45):
fortified cereal, thinkingyou're giving your body what it
needs, there's something thatyou should know that little
label that says folic acid.
It's not the same thing asfolate, the active, bioavailable
form your body actuallyrecognizes and uses.
In fact, if you have certaingenetic mutations, like MTHFR,
(01:05):
that synthetic version may notonly be useless, it might be
clogging your detox pathways,elevating homocysteine and
contributing to symptoms likefatigue, brain fog, anxiety,
hormone imbalance or eveninfertility.
And even for those that don'thave mutations like MTHFR, this
can cause some really bigproblems, you know so?
(01:28):
We've been told folic acid isessential, especially for
pregnancy and anemia, but thetruth is that's a
one-size-fits-all fix in a worldwhere personalized, functional
nutrition should really be thestandard.
So what's the differencebetween folic acid and folate.
Why do so many people havetrouble converting synthetic
(01:49):
folic acid and how do you knowif your body is silently
struggling?
Today I want to unpack thescience and why choosing the
right form of B9 could be a gamechanger for your mood, your
metabolism and your mitochondria.
So first we'll talk about theessential nutrient often
(02:10):
confused with folic acid, andyou know, folate.
Folate is benign.
It's crucial for various bodilyfunctions, including DNA
synthesis, cell division and theformation of red blood cells.
Dna synthesis, cell divisionand the formation of red blood
cells.
However, many people oftenconfuse folate with its
synthetic counterpart, folicacid.
(02:31):
This misunderstanding can leadto complications, especially
regarding health and nutrition.
So folate is naturally found infoods like leafy greens,
legumes and citrus fruits, whilefolic acid is a synthetic form
used in supplements andfortified foods.
When ingested, folic acid hasto be converted into the active
(02:52):
form of folate in the body.
This conversion is criticalbecause your body primarily
utilizes folate for itsbiological functions.
Folic acid is added to manyfoods in the standard American
diet, primarily due to mandatoryfortification policies aimed at
preventing neural tube defectsin newborns.
(03:13):
However, there are severalreasons why it's so widespread,
and they're not all beneficial.
So in 1988, the FDA mandatedfolic acid fortification in
enriched grains like flour,bread, cereals, pasta, rice to
reduce birth defects like spinabifida and anencephaly.
(03:35):
Luckily this public healtheffort was successful in
lowering neural tube defectrates.
But it really didn't considergenetic mutations like MTHFR
which affect folic acidmetabolism.
So folic acid is synthetic andmore stable than natural folate
found in whole foods.
(03:56):
It's cheap.
It's a very stable form offolate.
It extends shelf life so itmakes it ideal for processed and
packaged foods.
You know shelf life, so itmakes it ideal for processed and
packaged foods.
You know natural folate fromleafy greens, liver and legumes
degrades much faster.
The standard American diet isheavy in refined grains and
processed foods, which are oftenstripped of nutrients during
(04:16):
production.
And to compensate,manufacturers add synthetic
vitamins like folic acid toenrich the food.
Synthetic vitamins like folicacid to enrich the food.
This makes it seem healthier,even though these foods are
still ultra-processed andnutrient-depleted.
And many food companies marketfortified foods as healthy.
Pushing products with addedfolic acid, breakfast cereals,
(04:38):
snack bars and bread are theprime examples.
Consumers associatefortification with improved
nutrition, despite the risks ofoverconsumption, and those with
MTHFR mutation struggle toconvert folic acid into active
5-MTHF, leading to unmetabolizedfolic acid buildup, or UMFA.
But you don't have to have agenetic mutation like MTHFR.
(05:03):
Umfa is linked to cancer risk,to immune dysfunction, to
neurological issues.
Overconsumption of folic acidcan also mask B12 deficiency,
which is very dangerous.
So let's go over some of thebiggest culprits for hidden
folic acid in the standardAmerican diet.
The number one, of course, isthe enriched grains and bread.
(05:24):
This is a major source.
So white bread, wheat breadunless labeled whole wheat, and
unfortified pasta unless it'sorganic or whole grain without
enrichment.
Flour tortillas, bagels,hamburger and hot dog buns and
crackers Some of that might justhave been everything you've
(05:45):
already eaten today.
Number two are the breakfastcereals.
They're a huge folic acid loadin these cereals.
Cheerios, which we all think isvery healthy, special K Raisin,
bran, corn Flakes, lucky Charmsone of my old favorites and I
used to think that that was okayto eat because it was
gluten-free and I couldn'tunderstand why sometimes I would
(06:07):
still get sick after eating abowl.
I blame the milk.
No, it's the folic acid.
Frosted flakes and many organiccereals are also fortified.
So you really have to check thelabels as you continue down
those processed food aisles.
We have the processed andpackaged foods, which are
granola bars, protein bars,instant oatmeal, boxed mac and
(06:30):
cheese, frozen waffles, pancakemix and instant noodles.
Again, you've probably alreadyeaten several of these today.
Then we have white rice.
Unless it's labeled asunfortified, instant rice is a
huge no-no.
And then there's pasta madefrom enriched flour.
Then we have the baked goodsand convenience foods.
(06:52):
So muffins, donuts, pastries,croissants, packaged cookies,
many gluten-free breads andbaked goods.
Ironically, they often addfolic acid for, quote, unquote
nutrition, um, even nutritiondrinks and meal replacement.
So ensure and boost carnation.
Breakfast essentials, which Iwas giving that to my son every
(07:14):
single morning, thinking thatthey had vitamins.
Um, slim fast.
And many protein powders arefortified, even multivitamins.
You want to look at the labels.
Many conventional prenatalvitamins contain synthetic folic
acid instead of methylfolate.
You want to look for 5-MTHF ormethylfolate in your
(07:35):
multivitamins.
Even canned and processed meats, like deli meats, a lot of
noodle-based soups are fortified.
You need to really read labels.
You want to avoid anything thatsays folic acid in the
ingredients.
You want to opt for organic andwhole grain versions of bread,
pasta and rice when you canchoose fresh whole foods and
(07:59):
make sure your supplement hasmethylfolate instead of folic
acid like that 5-MTHF If you'reeating out fast food.
There are some places that aremore folate friendly.
Chipotle is a big one.
They use whole ingredients.
There's no fortified greens.
You can get a bowl or saladwith rice, meat, veggies, guac,
(08:20):
salsa Just skip the tortilla.
Cava is a big one I keepreading about.
I personally have never been,but my husband eats there.
You can get a Mediterraneanbowl with fresh ingredients, no
fortified bread.
You can choose greens, lentils,hummus, tzatziki and grilled
protein.
There also is sweet green,which I've also never been to.
(08:44):
I don't really eat out verymuch for lunch, but all salads
and bowls are unprocessedingredients and it's great for
clean whole food meals.
Shake Shack is another good one.
Their fries are made with realpotatoes and cooked in non-seed
oils.
You can get that lettucewrapped.
Um, and and that is really good, um, I'm trying to think of
(09:06):
what, oh?
Five guys which I was surprisedto see when I did some research
.
You can get their lettucewrapped burger.
They do not use fortified breadthere, which is odd, right?
Um, and their fries are alsoonly potato salt and peanut oil.
Um, not like poor McDonald's,which I know tastes amazing, but
they even add chemicals to maketheir french fries look yellow,
(09:30):
which to me is very odd, andthat's why when you get Five
Guys, you ever get Five Guys andyour bag is like dripping with
grease.
But hey, at least all it is ispeanut oil, salt and potatoes.
Panera Bread does have someoptions.
I would avoid all of theirsandwiches and their their
pastries because it's allfortified flour.
(09:50):
But they do have good salads,they do have good broth bowls
and they do have steel cutoatmeal for people that like
that.
Even Starbucks, their egg bites, their protein box, which was
my favorite, that has like theeggs and the grape and the
cheese.
I just throw out the bread onlybecause I'm gluten free.
Um, they have a bacon andgruyere egg bites that are folic
(10:12):
acid free and their oatmealthere is also safe.
Even though people may preferother coffee shops Coffee, I
like Starbucks, so they havegood stuff.
If you're going to sit down at arestaurant, it's always best to
pick something that's a farm totable and organic restaurant.
One of my favorite places ishere in Columbia, maryland.
(10:34):
It is Seasons 52.
That is a farm to tablerestaurant, so you can check for
places that emphasize localwhole food ingredients.
Or what we usually do is pick asteakhouse stick with steak,
grilled chicken or seafood withveggies and avoid the bread and
enriched sauces.
And avoid the bread andenriched sauces.
Sushi is a good one.
Sushi rice is often fortified,though, so you want to opt for
(10:58):
sashimi or rolls wrapped incucumber Even Mexican
restaurants if you can get thecorn tortillas instead of flour,
because they're less likely tobe enriched, or you can get a
burrito bowl without tortillas,and if you're going to eat
Italian, you can use gluten freepasta or zoodles.
I tell many, many people thatI'm not surprised when, even
(11:20):
though they don't have celiac,when they eat gluten free
options, they feel better andthey're like oh, maybe I have
celiac too and it's like, no,you're just eating those
fortified pastas.
So you want to make sure, ifyou are eating Italian, you ask
for their gluten-free option,because they're usually
unfortified.
Some places also have thezucchini noodles or spaghetti
(11:43):
squash, and some of my favoritegrocery stores Sprouts.
That's number one on the list.
We actually emptied out ourpantry last week and went
shopping because we still had tobe careful and we still had to
read the ingredient labels,which was a great experience for
my son.
But a lot of their food isorganic.
(12:05):
It's unfortified there, and sois Whole Foods.
Whole Foods is another good one.
We just don't live as close toa Whole Foods like we do a
Sprouts.
My son's favorite is TraderJoe's.
He loves their salads.
He swears they taste betterthan everyone else's.
They also have a really goodcauliflower and gnocchi and they
have pre-made meals at TraderJoe's that are folic acid free,
(12:26):
and I think they label it thatway as well.
Or if you're looking for, youknow, bulk buying, costco is a
great choice because they havethe rotisserie chicken and they
have a lot of organic snackoptions.
And you know you can avoid a lotof those processed options.
And a lot of people ask me do Ihave to never eat anything?
(12:47):
I'm not saying that.
I do tell people.
You know it's that ultraprocessed foods.
You know, try to really limitit, because here's the danger of
too much folic acid and toolittle folate.
It's that UMFA buildup, orunmetabolized folic acid.
Because folic acid is synthetic.
It has to be converted by yourliver using the DHFR enzyme,
(13:11):
which is slow and easilyoverwhelmed.
So when folic acid intakeexceeds what the body can
process, especially insupplements and fortified foods,
it builds up as UMFA in thebloodstream.
Umfa equals biologicallyinactive, but it competes with
(13:32):
real folate and may block folatereceptors and it creates a
functional deficiency.
You can have high folic acidlevels and be very folate
deficient.
One example would be what myson used to eat for breakfast.
Um, let's see you wake up inthe morning.
Maybe you have your flintstonevitamin, then you have a
(13:54):
Pop-Tart okay, then you may havea cinnamon roll that right
there, insane.
And then you pack your lunchboxand you have an enriched bread
peanut butter sandwich.
You have your Cheetos which aresprayed with folic acid.
Then you come home to a nicespaghetti and meatball which is
(14:15):
enriched pasta, and then yourmeatballs with your sauce.
That is just crazy.
But that was a typical day andI wondered why my son had ADHD
and an attitude problem.
So the folate is required formethylation.
It's a critical process thatregulates your DNA repair, your
(14:35):
detoxification, yourneurotransmitter synthesis, your
hormone balance and your immunefunction.
Too much folic acid can clog upmethylation pathways,
especially if you have thatMTHFR gene but you don't have to
have that MTHFR gene, thatMTHFR gene, but you don't have
to have that MTHFR gene.
(14:56):
You could just have a dirtygene and it could lead to brain
fog, mood issues, infertility,estrogen dominance or even detox
issues.
So without active folate thatL5MTHF, your body can't recycle
homocysteine back to methionine,so this is all part of your
methylation process.
(15:17):
High homocysteine causes anincreased risk of heart disease,
stroke and inflammation.
Folic acid does not lowerhomocysteine effectively in
those with poor conversioncapacity.
Okay, folic acid does not lowerhomocysteine.
So Excess folic acid can alsomask low B12 by correcting
(15:41):
megaloblastic anemia on yourblood work.
But it can also causeneurological damage.
So you get these B12 deficiencysymptoms like neuropathy or
cognitive decline, and it goesvery unnoticed until it's too
late, because it can make yourblood work look like you have an
excess of B12 when you don'thave enough at all.
(16:04):
And there are some studies thatsuggest excess folic acid helps
promote tumor growth inindividuals with precancerous or
active cancer cells.
So real folate supports normalcell repair, but synthetic folic
acid in excess may pushabnormal cells to divide more
rapidly.
So here are some symptoms andhow it happens.
(16:27):
So you can have brain fog andfatigue because of that
methylation dysfunction.
You can have infertility, badPMS or estrogen issues because
of poor hormone detoxification.
You can have anxiety anddepression because of the
impaired neurotransmitterproduction, especially ADHD.
(16:49):
You can have cardiovasculardisease from that high
homocysteine, you can have thatnerve damage because of the
masked B12 deficiency.
You can also have potentialtumor growth from abnormal cell
proliferation and immunedysregulation because of the
poor DNA repair and detox.
So folate and vitamin B12, theywork closely together in the
(17:13):
body, particularly in thesynthesis of red blood cells and
DNA.
So a deficiency in eithernutrient can lead to macrocytic
anemia.
I say that word a lot when I'mgoing over blood work in my loom
videos.
It's a condition characterizedby the production of abnormally
large red blood cells that don'tfunction properly.
(17:33):
And if you have a low folate,here are some of the signs and
symptoms that you might have andwe'll break it down into
systems.
So the first one is yourhematologic.
This is all blood related.
This is when you're havingfatigue, weakness, you might
have pale skin, you might getshort of breath.
You may tell me you havedizziness or lightheadedness,
(17:54):
even heart palpitations.
You'll have that megaloblasticanemia that I mentioned on your
blood work.
You may have poor ironutilization or the inability to
absorb iron, even though youclaim that you've gotten iron
transfusions or you've takeniron supplements and your iron
level never budged.
Or we might find elevatedhomocysteine levels.
(18:18):
Next, if we're talking aboutneurological and cognitive a lot
of people.
I would say the biggestsymptoms that I face in my
practice is numbness andtingling in the hands and feet,
burning or pins and needlessensation, peripheral neuropathy
, poor balance or coordination,brain fog, memory issues,
(18:39):
difficulty concentrating,irritability, depression,
anxiety, insomnia or poor sleepand headaches.
These are all signs of lowfolate.
The next one is vascular andcirculatory.
This is when you have coldhands, cold feet.
You can have Raynaud's-likesymptoms where you have color
changes in your fingers and yourtoes.
(19:00):
You can have Raynaud's-likesymptoms where you have color
changes in your fingers and yourtoes.
You're at increased risk ofblood clots because of that
elevated homocysteine and youjust have poor circulation.
If you look at my legs, I havea lot of little spider veins, I
have the MTHFR and I have verypoor circulation.
I've already had my saphenousveins in my legs burnt out by
(19:20):
lasers because my circulationwas so poor and I didn't even
know at that time that I hadthat mutation.
Next is hormonal andreproductive.
So PMS or PMDD-like symptomshappen when you are low in
folate.
You have fertility challenges.
You have irregular menstrualcycles.
You have a very high increasedmiscarriage risk.
(19:41):
You have a high risk of neuraltube defects in pregnancy and
you have these estrogen-dominantsymptoms due to your impaired
detox.
Next, you know, especially ifyou do have MTHFR and you have
methylation-related issues, youcan have detox issues.
You'll have, you know,sensitivity to chemicals, smells
(20:03):
, medications.
You can have poor stresstolerance and you might have
histamine intolerance symptomsand mood swings, more so if you
have MTHFR.
But you don't have to have thatvariant to have these
methylation related symptoms,especially if you are just so
depleted in folate.
(20:24):
Next, for your oral andgastrointestinal, it's very
common to see mouth ulcers ormouth sores, sore or swollen
tongue, known as glossitis.
I can usually tell becausepeople have cracks at the
corners of the mouth.
That's that angular chilitisand nausea, diarrhea, poor
(20:44):
appetite and I'm like, yep, youare low in folate.
Other things I might see when Ilook at your blood work.
Besides, low serum folate is anelevated homocysteine.
And remember, when I say lowserum folate, I don't even want
you to look at the referencerange on your labs because you
know conventional medicine andfunctional medicine have
different standards of where youshould be to be healthy.
(21:06):
We might find a low red bloodcell folate which is more
accurate than a serum folate inmost chronic cases.
Usually it's the enlarged redblood cell, so the high MCV on
your complete blood cell count,and then you might have either a
(21:26):
low B12, ferritin or othersynergistic nutrient.
There are other causes of lowfolate as well.
Usually they are inadequatedietary intake, so insufficient
consumption of folate-rich foods.
You can have a malabsorptiondisorder like celiac disease or
Crohn's disease.
They can hinder folateabsorption.
Sometimes you just haveincreased demand.
(21:48):
That would be usually pregnantor lactating women.
They have a significantlyincreased requirement for folate
.
And then if you're takingcertain medications like
methotrexate, anticonvulsants,they all interfere with folate
metabolism.
There are some people also thatcan have just really high
(22:10):
folate and high levels of folatecan happen because of excess
supplementation.
If you're taking high doses offolic acid, it can lead to
elevated folate levels in yourblood.
If you do have liver disease,an impaired liver function can
affect how you metabolize folateand how you clear it.
Okay, so methylated folate isthe bioactive form of folate
(22:34):
that the body can utilizedirectly without the need for
conversion, and this isimportant for individuals with
the MTHFR gene, as they maystruggle to convert folic acid
to active folate efficiently.
So supplementing withmethylated folate can help
bypass this metabolic block andensure adequate folate levels in
the body.
(22:55):
And Orthomolecular's methyl CPGis such an excellent choice and
a functional medicine favoritefor comprehensive methylation
support.
And let me break down what's inthat for you.
So it does have thequatropholic, that's L5, mthf
400 micrograms.
It's all active folate, nofolic acid.
(23:17):
So it supports DNA synthesis,neurotransmitters and
homocysteine regulation.
It does have themethylcobalamin B12.
It has a full gram milligramI'm sorry, that's a lot An
active form of B12 for nervoussystem and methylation.
The methylcobalamin it'sessential if folate is being
(23:37):
supplemented because it preventsmasking of B12 deficiency.
A lot of the supplements you'llfind over the counter.
It has cyanocobalamin, which isnot the same.
It also has riboflavin B2, andthat's required for folate cycle
and MTHFR enzyme function.
It also has the B6, and it'sthe active B6 to support
(24:01):
homocysteine clearance by thetranssulfuration pathway.
And it has TMG and betaine.
This is the trimethylglycine.
This supports the BHMT pathway,providing backup methylation
support for homocysteinerecycling.
So this is my absolute favoritesupplement because it has all
(24:22):
of the methylated Bs.
So this is great for anybodythat does have the MTHFR gene
variant.
It's good for anyone with highhomocysteine levels, even if
they don't have the MTHFR genevariant.
It's good for people with mooddisorders like focus, anxiety
and depression.
It's good for detox support,it's good for fertility, it's
(24:43):
good for hormone imbalances,especially if you have estrogen
dominance, and it's good fornervous system issues, including
neuropathy.
You want to start low and slow,especially if you're sensitive
to methyl donors.
If you're sensitive to methyldonors, it can cause anxiety,
irritability or somesleeplessness in some people,
(25:05):
but it can also be combined withglutathione or an antioxidant
support for deeper detoxprotocols.
It works beautiful incombination with lifestyle and
dietary folate from leafy greens, liver, avocado, all of those
really high folate foods.
So methylcpg is morecomprehensive than standalone
(25:26):
folate because it supports theentire methylation cycle, not
just one part.
So it is ideal if you want toaddress systemic issues fatigue,
detox, overload, moodinflammation at a root level and
I do carry this in the officeand you can come and pick that
up if you would like to try it.
(25:46):
We have been told for decadesthat folic acid is essential,
but now we know better.
Your body deserves more than asynthetic shortcut.
If you're dealing with fatiguethat won't budge, mood swings
that feel hormonal andneurological, or symptoms like
(26:06):
cold hands, brain fog orfertility struggles, it may be
time to look beneath the surfaceand support your methylation
pathways the way nature intended, with active folate, not a
counterfeit.
So in functional medicine, wedon't guess, we assess.
And when it comes to folate,the difference between synthetic
and bioavailable isn't justtechnical, it's transformational
(26:29):
.
If any of this podcast hit home,or any of this sounds like it
could be you, I would love tosee you for a functional
medicine consultation.
You can find me atHarmonyHubHealthcom.
You can email me at MichelleM-I-C-H-E-L-E at
HarmonyHubHealthcom, or you cancome see me in person at Monarch
(26:52):
Beauty and Spa in Manchester,maryland, and I would love to
help guide you through yourmethylation process and get you
feeling much better.
So remember, when it comes tofolate, it's not just about what
you take, it's about what yourbody can actually use.
So test, don't guess, and giveyour cells the fuel they need to
thrive.
(27:13):
Until next time, stay curiousand stay well.
This content is for educationalpurposes only and it's not
intended to diagnose, treat orreplace medical advice from your
health care provider.
Always consult with a licensedmedical professional before
starting any new supplements,especially if you are pregnant,
nursing, have a medicalcondition or you're taking
(27:34):
medications.
Lab testing and personalizedcare plans are strongly
recommended for optimal results.
I am not your nursepractitioner yet, but I would
love to be, so make sure youreach out to HarmonyHubHealthcom
.
Welcome to Harmony Hub Health, where my mission is
to provide comprehensive,affordable, integrative care
that addresses the root cause ofhealth issues.
At the Hub, the focus is onindividual patient journeys.
I strive to optimize health,vitality and longevity,
fostering a community where eachperson can thrive in body, mind
and spirit.
(00:21):
Today we're going to talk aboutfolic acid, the synthetic
imposter hiding in your vitamins, and why your body is begging
for real folate.
If you've ever taken amultivitamin, a prenatal or
(00:45):
fortified cereal, thinkingyou're giving your body what it
needs, there's something thatyou should know that little
label that says folic acid.
It's not the same thing asfolate, the active, bioavailable
form your body actuallyrecognizes and uses.
In fact, if you have certaingenetic mutations, like MTHFR,
(01:05):
that synthetic version may notonly be useless, it might be
clogging your detox pathways,elevating homocysteine and
contributing to symptoms likefatigue, brain fog, anxiety,
hormone imbalance or eveninfertility.
And even for those that don'thave mutations like MTHFR, this
can cause some really bigproblems, you know so?
(01:28):
We've been told folic acid isessential, especially for
pregnancy and anemia, but thetruth is that's a
one-size-fits-all fix in a worldwhere personalized, functional
nutrition should really be thestandard.
So what's the differencebetween folic acid and folate.
Why do so many people havetrouble converting synthetic
(01:49):
folic acid and how do you knowif your body is silently
struggling?
Today I want to unpack thescience and why choosing the
right form of B9 could be a gamechanger for your mood, your
metabolism and your mitochondria.
So first we'll talk about theessential nutrient often
(02:10):
confused with folic acid, andyou know, folate.
Folate is benign.
It's crucial for various bodilyfunctions, including DNA
synthesis, cell division and theformation of red blood cells.
Dna synthesis, cell divisionand the formation of red blood
cells.
However, many people oftenconfuse folate with its
synthetic counterpart, folicacid.
(02:31):
This misunderstanding can leadto complications, especially
regarding health and nutrition.
So folate is naturally found infoods like leafy greens,
legumes and citrus fruits, whilefolic acid is a synthetic form
used in supplements andfortified foods.
When ingested, folic acid hasto be converted into the active
(02:52):
form of folate in the body.
This conversion is criticalbecause your body primarily
utilizes folate for itsbiological functions.
Folic acid is added to manyfoods in the standard American
diet, primarily due to mandatoryfortification policies aimed at
preventing neural tube defectsin newborns.
(03:13):
However, there are severalreasons why it's so widespread,
and they're not all beneficial.
So in 1988, the FDA mandatedfolic acid fortification in
enriched grains like flour,bread, cereals, pasta, rice to
reduce birth defects like spinabifida and anencephaly.
(03:35):
Luckily this public healtheffort was successful in
lowering neural tube defectrates.
But it really didn't considergenetic mutations like MTHFR
which affect folic acidmetabolism.
So folic acid is synthetic andmore stable than natural folate
found in whole foods.
(03:56):
It's cheap.
It's a very stable form offolate.
It extends shelf life so itmakes it ideal for processed and
packaged foods.
You know shelf life, so itmakes it ideal for processed and
packaged foods.
You know natural folate fromleafy greens, liver and legumes
degrades much faster.
The standard American diet isheavy in refined grains and
processed foods, which are oftenstripped of nutrients during
(04:16):
production.
And to compensate,manufacturers add synthetic
vitamins like folic acid toenrich the food.
Synthetic vitamins like folicacid to enrich the food.
This makes it seem healthier,even though these foods are
still ultra-processed andnutrient-depleted.
And many food companies marketfortified foods as healthy.
Pushing products with addedfolic acid, breakfast cereals,
(04:38):
snack bars and bread are theprime examples.
Consumers associatefortification with improved
nutrition, despite the risks ofoverconsumption, and those with
MTHFR mutation struggle toconvert folic acid into active
5-MTHF, leading to unmetabolizedfolic acid buildup, or UMFA.
But you don't have to have agenetic mutation like MTHFR.
(05:03):
Umfa is linked to cancer risk,to immune dysfunction, to
neurological issues.
Overconsumption of folic acidcan also mask B12 deficiency,
which is very dangerous.
So let's go over some of thebiggest culprits for hidden
folic acid in the standardAmerican diet.
The number one, of course, isthe enriched grains and bread.
(05:24):
This is a major source.
So white bread, wheat breadunless labeled whole wheat, and
unfortified pasta unless it'sorganic or whole grain without
enrichment.
Flour tortillas, bagels,hamburger and hot dog buns and
crackers Some of that might justhave been everything you've
(05:45):
already eaten today.
Number two are the breakfastcereals.
They're a huge folic acid loadin these cereals.
Cheerios, which we all think isvery healthy, special K Raisin,
bran, corn Flakes, lucky Charmsone of my old favorites and I
used to think that that was okayto eat because it was
gluten-free and I couldn'tunderstand why sometimes I would
(06:07):
still get sick after eating abowl.
I blame the milk.
No, it's the folic acid.
Frosted flakes and many organiccereals are also fortified.
So you really have to check thelabels as you continue down
those processed food aisles.
We have the processed andpackaged foods, which are
granola bars, protein bars,instant oatmeal, boxed mac and
(06:30):
cheese, frozen waffles, pancakemix and instant noodles.
Again, you've probably alreadyeaten several of these today.
Then we have white rice.
Unless it's labeled asunfortified, instant rice is a
huge no-no.
And then there's pasta madefrom enriched flour.
Then we have the baked goodsand convenience foods.
(06:52):
So muffins, donuts, pastries,croissants, packaged cookies,
many gluten-free breads andbaked goods.
Ironically, they often addfolic acid for, quote, unquote
nutrition, um, even nutritiondrinks and meal replacement.
So ensure and boost carnation.
Breakfast essentials, which Iwas giving that to my son every
(07:14):
single morning, thinking thatthey had vitamins.
Um, slim fast.
And many protein powders arefortified, even multivitamins.
You want to look at the labels.
Many conventional prenatalvitamins contain synthetic folic
acid instead of methylfolate.
You want to look for 5-MTHF ormethylfolate in your
(07:35):
multivitamins.
Even canned and processed meats, like deli meats, a lot of
noodle-based soups are fortified.
You need to really read labels.
You want to avoid anything thatsays folic acid in the
ingredients.
You want to opt for organic andwhole grain versions of bread,
pasta and rice when you canchoose fresh whole foods and
(07:59):
make sure your supplement hasmethylfolate instead of folic
acid like that 5-MTHF If you'reeating out fast food.
There are some places that aremore folate friendly.
Chipotle is a big one.
They use whole ingredients.
There's no fortified greens.
You can get a bowl or saladwith rice, meat, veggies, guac,
(08:20):
salsa Just skip the tortilla.
Cava is a big one I keepreading about.
I personally have never been,but my husband eats there.
You can get a Mediterraneanbowl with fresh ingredients, no
fortified bread.
You can choose greens, lentils,hummus, tzatziki and grilled
protein.
There also is sweet green,which I've also never been to.
(08:44):
I don't really eat out verymuch for lunch, but all salads
and bowls are unprocessedingredients and it's great for
clean whole food meals.
Shake Shack is another good one.
Their fries are made with realpotatoes and cooked in non-seed
oils.
You can get that lettucewrapped.
Um, and and that is really good, um, I'm trying to think of
(09:06):
what, oh?
Five guys which I was surprisedto see when I did some research
.
You can get their lettucewrapped burger.
They do not use fortified breadthere, which is odd, right?
Um, and their fries are alsoonly potato salt and peanut oil.
Um, not like poor McDonald's,which I know tastes amazing, but
they even add chemicals to maketheir french fries look yellow,
(09:30):
which to me is very odd, andthat's why when you get Five
Guys, you ever get Five Guys andyour bag is like dripping with
grease.
But hey, at least all it is ispeanut oil, salt and potatoes.
Panera Bread does have someoptions.
I would avoid all of theirsandwiches and their their
pastries because it's allfortified flour.
(09:50):
But they do have good salads,they do have good broth bowls
and they do have steel cutoatmeal for people that like
that.
Even Starbucks, their egg bites, their protein box, which was
my favorite, that has like theeggs and the grape and the
cheese.
I just throw out the bread onlybecause I'm gluten free.
Um, they have a bacon andgruyere egg bites that are folic
(10:12):
acid free and their oatmealthere is also safe.
Even though people may preferother coffee shops Coffee, I
like Starbucks, so they havegood stuff.
If you're going to sit down at arestaurant, it's always best to
pick something that's a farm totable and organic restaurant.
One of my favorite places ishere in Columbia, maryland.
(10:34):
It is Seasons 52.
That is a farm to tablerestaurant, so you can check for
places that emphasize localwhole food ingredients.
Or what we usually do is pick asteakhouse stick with steak,
grilled chicken or seafood withveggies and avoid the bread and
enriched sauces.
And avoid the bread andenriched sauces.
Sushi is a good one.
Sushi rice is often fortified,though, so you want to opt for
(10:58):
sashimi or rolls wrapped incucumber Even Mexican
restaurants if you can get thecorn tortillas instead of flour,
because they're less likely tobe enriched, or you can get a
burrito bowl without tortillas,and if you're going to eat
Italian, you can use gluten freepasta or zoodles.
I tell many, many people thatI'm not surprised when, even
(11:20):
though they don't have celiac,when they eat gluten free
options, they feel better andthey're like oh, maybe I have
celiac too and it's like, no,you're just eating those
fortified pastas.
So you want to make sure, ifyou are eating Italian, you ask
for their gluten-free option,because they're usually
unfortified.
Some places also have thezucchini noodles or spaghetti
(11:43):
squash, and some of my favoritegrocery stores Sprouts.
That's number one on the list.
We actually emptied out ourpantry last week and went
shopping because we still had tobe careful and we still had to
read the ingredient labels,which was a great experience for
my son.
But a lot of their food isorganic.
(12:05):
It's unfortified there, and sois Whole Foods.
Whole Foods is another good one.
We just don't live as close toa Whole Foods like we do a
Sprouts.
My son's favorite is TraderJoe's.
He loves their salads.
He swears they taste betterthan everyone else's.
They also have a really goodcauliflower and gnocchi and they
have pre-made meals at TraderJoe's that are folic acid free,
(12:26):
and I think they label it thatway as well.
Or if you're looking for, youknow, bulk buying, costco is a
great choice because they havethe rotisserie chicken and they
have a lot of organic snackoptions.
And you know you can avoid a lotof those processed options.
And a lot of people ask me do Ihave to never eat anything?
(12:47):
I'm not saying that.
I do tell people.
You know it's that ultraprocessed foods.
You know, try to really limitit, because here's the danger of
too much folic acid and toolittle folate.
It's that UMFA buildup, orunmetabolized folic acid.
Because folic acid is synthetic.
It has to be converted by yourliver using the DHFR enzyme,
(13:11):
which is slow and easilyoverwhelmed.
So when folic acid intakeexceeds what the body can
process, especially insupplements and fortified foods,
it builds up as UMFA in thebloodstream.
Umfa equals biologicallyinactive, but it competes with
(13:32):
real folate and may block folatereceptors and it creates a
functional deficiency.
You can have high folic acidlevels and be very folate
deficient.
One example would be what myson used to eat for breakfast.
Um, let's see you wake up inthe morning.
Maybe you have your flintstonevitamin, then you have a
(13:54):
Pop-Tart okay, then you may havea cinnamon roll that right
there, insane.
And then you pack your lunchboxand you have an enriched bread
peanut butter sandwich.
You have your Cheetos which aresprayed with folic acid.
Then you come home to a nicespaghetti and meatball which is
(14:15):
enriched pasta, and then yourmeatballs with your sauce.
That is just crazy.
But that was a typical day andI wondered why my son had ADHD
and an attitude problem.
So the folate is required formethylation.
It's a critical process thatregulates your DNA repair, your
(14:35):
detoxification, yourneurotransmitter synthesis, your
hormone balance and your immunefunction.
Too much folic acid can clog upmethylation pathways,
especially if you have thatMTHFR gene but you don't have to
have that MTHFR gene, thatMTHFR gene, but you don't have
to have that MTHFR gene.
(14:56):
You could just have a dirtygene and it could lead to brain
fog, mood issues, infertility,estrogen dominance or even detox
issues.
So without active folate thatL5MTHF, your body can't recycle
homocysteine back to methionine,so this is all part of your
methylation process.
(15:17):
High homocysteine causes anincreased risk of heart disease,
stroke and inflammation.
Folic acid does not lowerhomocysteine effectively in
those with poor conversioncapacity.
Okay, folic acid does not lowerhomocysteine.
So Excess folic acid can alsomask low B12 by correcting
(15:41):
megaloblastic anemia on yourblood work.
But it can also causeneurological damage.
So you get these B12 deficiencysymptoms like neuropathy or
cognitive decline, and it goesvery unnoticed until it's too
late, because it can make yourblood work look like you have an
excess of B12 when you don'thave enough at all.
(16:04):
And there are some studies thatsuggest excess folic acid helps
promote tumor growth inindividuals with precancerous or
active cancer cells.
So real folate supports normalcell repair, but synthetic folic
acid in excess may pushabnormal cells to divide more
rapidly.
So here are some symptoms andhow it happens.
(16:27):
So you can have brain fog andfatigue because of that
methylation dysfunction.
You can have infertility, badPMS or estrogen issues because
of poor hormone detoxification.
You can have anxiety anddepression because of the
impaired neurotransmitterproduction, especially ADHD.
(16:49):
You can have cardiovasculardisease from that high
homocysteine, you can have thatnerve damage because of the
masked B12 deficiency.
You can also have potentialtumor growth from abnormal cell
proliferation and immunedysregulation because of the
poor DNA repair and detox.
So folate and vitamin B12, theywork closely together in the
(17:13):
body, particularly in thesynthesis of red blood cells and
DNA.
So a deficiency in eithernutrient can lead to macrocytic
anemia.
I say that word a lot when I'mgoing over blood work in my loom
videos.
It's a condition characterizedby the production of abnormally
large red blood cells that don'tfunction properly.
(17:33):
And if you have a low folate,here are some of the signs and
symptoms that you might have andwe'll break it down into
systems.
So the first one is yourhematologic.
This is all blood related.
This is when you're havingfatigue, weakness, you might
have pale skin, you might getshort of breath.
You may tell me you havedizziness or lightheadedness,
(17:54):
even heart palpitations.
You'll have that megaloblasticanemia that I mentioned on your
blood work.
You may have poor ironutilization or the inability to
absorb iron, even though youclaim that you've gotten iron
transfusions or you've takeniron supplements and your iron
level never budged.
Or we might find elevatedhomocysteine levels.
(18:18):
Next, if we're talking aboutneurological and cognitive a lot
of people.
I would say the biggestsymptoms that I face in my
practice is numbness andtingling in the hands and feet,
burning or pins and needlessensation, peripheral neuropathy
, poor balance or coordination,brain fog, memory issues,
(18:39):
difficulty concentrating,irritability, depression,
anxiety, insomnia or poor sleepand headaches.
These are all signs of lowfolate.
The next one is vascular andcirculatory.
This is when you have coldhands, cold feet.
You can have Raynaud's-likesymptoms where you have color
changes in your fingers and yourtoes.
(19:00):
You can have Raynaud's-likesymptoms where you have color
changes in your fingers and yourtoes.
You're at increased risk ofblood clots because of that
elevated homocysteine and youjust have poor circulation.
If you look at my legs, I havea lot of little spider veins, I
have the MTHFR and I have verypoor circulation.
I've already had my saphenousveins in my legs burnt out by
(19:20):
lasers because my circulationwas so poor and I didn't even
know at that time that I hadthat mutation.
Next is hormonal andreproductive.
So PMS or PMDD-like symptomshappen when you are low in
folate.
You have fertility challenges.
You have irregular menstrualcycles.
You have a very high increasedmiscarriage risk.
(19:41):
You have a high risk of neuraltube defects in pregnancy and
you have these estrogen-dominantsymptoms due to your impaired
detox.
Next, you know, especially ifyou do have MTHFR and you have
methylation-related issues, youcan have detox issues.
You'll have, you know,sensitivity to chemicals, smells
(20:03):
, medications.
You can have poor stresstolerance and you might have
histamine intolerance symptomsand mood swings, more so if you
have MTHFR.
But you don't have to have thatvariant to have these
methylation related symptoms,especially if you are just so
depleted in folate.
(20:24):
Next, for your oral andgastrointestinal, it's very
common to see mouth ulcers ormouth sores, sore or swollen
tongue, known as glossitis.
I can usually tell becausepeople have cracks at the
corners of the mouth.
That's that angular chilitisand nausea, diarrhea, poor
(20:44):
appetite and I'm like, yep, youare low in folate.
Other things I might see when Ilook at your blood work.
Besides, low serum folate is anelevated homocysteine.
And remember, when I say lowserum folate, I don't even want
you to look at the referencerange on your labs because you
know conventional medicine andfunctional medicine have
different standards of where youshould be to be healthy.
(21:06):
We might find a low red bloodcell folate which is more
accurate than a serum folate inmost chronic cases.
Usually it's the enlarged redblood cell, so the high MCV on
your complete blood cell count,and then you might have either a
(21:26):
low B12, ferritin or othersynergistic nutrient.
There are other causes of lowfolate as well.
Usually they are inadequatedietary intake, so insufficient
consumption of folate-rich foods.
You can have a malabsorptiondisorder like celiac disease or
Crohn's disease.
They can hinder folateabsorption.
Sometimes you just haveincreased demand.
(21:48):
That would be usually pregnantor lactating women.
They have a significantlyincreased requirement for folate
.
And then if you're takingcertain medications like
methotrexate, anticonvulsants,they all interfere with folate
metabolism.
There are some people also thatcan have just really high
(22:10):
folate and high levels of folatecan happen because of excess
supplementation.
If you're taking high doses offolic acid, it can lead to
elevated folate levels in yourblood.
If you do have liver disease,an impaired liver function can
affect how you metabolize folateand how you clear it.
Okay, so methylated folate isthe bioactive form of folate
(22:34):
that the body can utilizedirectly without the need for
conversion, and this isimportant for individuals with
the MTHFR gene, as they maystruggle to convert folic acid
to active folate efficiently.
So supplementing withmethylated folate can help
bypass this metabolic block andensure adequate folate levels in
the body.
(22:55):
And Orthomolecular's methyl CPGis such an excellent choice and
a functional medicine favoritefor comprehensive methylation
support.
And let me break down what's inthat for you.
So it does have thequatropholic, that's L5, mthf
400 micrograms.
It's all active folate, nofolic acid.
(23:17):
So it supports DNA synthesis,neurotransmitters and
homocysteine regulation.
It does have themethylcobalamin B12.
It has a full gram milligramI'm sorry, that's a lot An
active form of B12 for nervoussystem and methylation.
The methylcobalamin it'sessential if folate is being
(23:37):
supplemented because it preventsmasking of B12 deficiency.
A lot of the supplements you'llfind over the counter.
It has cyanocobalamin, which isnot the same.
It also has riboflavin B2, andthat's required for folate cycle
and MTHFR enzyme function.
It also has the B6, and it'sthe active B6 to support
(24:01):
homocysteine clearance by thetranssulfuration pathway.
And it has TMG and betaine.
This is the trimethylglycine.
This supports the BHMT pathway,providing backup methylation
support for homocysteinerecycling.
So this is my absolute favoritesupplement because it has all
(24:22):
of the methylated Bs.
So this is great for anybodythat does have the MTHFR gene
variant.
It's good for anyone with highhomocysteine levels, even if
they don't have the MTHFR genevariant.
It's good for people with mooddisorders like focus, anxiety
and depression.
It's good for detox support,it's good for fertility, it's
(24:43):
good for hormone imbalances,especially if you have estrogen
dominance, and it's good fornervous system issues, including
neuropathy.
You want to start low and slow,especially if you're sensitive
to methyl donors.
If you're sensitive to methyldonors, it can cause anxiety,
irritability or somesleeplessness in some people,
(25:05):
but it can also be combined withglutathione or an antioxidant
support for deeper detoxprotocols.
It works beautiful incombination with lifestyle and
dietary folate from leafy greens, liver, avocado, all of those
really high folate foods.
So methylcpg is morecomprehensive than standalone
(25:26):
folate because it supports theentire methylation cycle, not
just one part.
So it is ideal if you want toaddress systemic issues fatigue,
detox, overload, moodinflammation at a root level and
I do carry this in the officeand you can come and pick that
up if you would like to try it.
(25:46):
We have been told for decadesthat folic acid is essential,
but now we know better.
Your body deserves more than asynthetic shortcut.
If you're dealing with fatiguethat won't budge, mood swings
that feel hormonal andneurological, or symptoms like
(26:06):
cold hands, brain fog orfertility struggles, it may be
time to look beneath the surfaceand support your methylation
pathways the way nature intended, with active folate, not a
counterfeit.
So in functional medicine, wedon't guess, we assess.
And when it comes to folate,the difference between synthetic
and bioavailable isn't justtechnical, it's transformational
(26:29):
.
If any of this podcast hit home,or any of this sounds like it
could be you, I would love tosee you for a functional
medicine consultation.
You can find me atHarmonyHubHealthcom.
You can email me at MichelleM-I-C-H-E-L-E at
HarmonyHubHealthcom, or you cancome see me in person at Monarch
(26:52):
Beauty and Spa in Manchester,maryland, and I would love to
help guide you through yourmethylation process and get you
feeling much better.
So remember, when it comes tofolate, it's not just about what
you take, it's about what yourbody can actually use.
So test, don't guess, and giveyour cells the fuel they need to
thrive.
(27:13):
Until next time, stay curiousand stay well.
This content is for educationalpurposes only and it's not
intended to diagnose, treat orreplace medical advice from your
health care provider.
Always consult with a licensedmedical professional before
starting any new supplements,especially if you are pregnant,
nursing, have a medicalcondition or you're taking
(27:34):
medications.
Lab testing and personalizedcare plans are strongly
recommended for optimal results.
I am not your nursepractitioner yet, but I would
love to be, so make sure youreach out to HarmonyHubHealthcom
.
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