Folic acid versus 5-MTHF supplementation during pregnancy
What it found
Folic acid must be converted by the liver before the body can use it, while 5-MTHF is ready immediately.
Using 5-MTHF instead of folic acid may avoid certain risks for mothers and babies.
What they found
Studies in people
How the body uses folate
Folic acid is not active on its own. The liver must change it into 5-MTHF before the body can use it for growth and other tasks.
Risks of folic acid
Folic acid can hide signs of vitamin B12 shortage in the blood. It can also build up in the blood if the liver cannot process it well, due to genes or certain medicines.
Benefits of 5-MTHF
Because 5-MTHF is already active, it does not need liver processing. It is available right away to the mother and baby and does not build up in the blood.
Why folate matters in pregnancy
Folate helps make DNA building blocks and supports growth. It is especially important during early development to protect against brain and spine defects in the baby.
What the authors conclude
- They suggest that using 5-MTHF instead of folic acid can avoid some health risks during pregnancy.
- The authors note that 5-MTHF is immediately useful to both mother and fetus without needing liver activation.
How it was done
Folate protects against birth defects of the brain and spine, so pregnant women are often told to take it. The authors wanted to compare two forms of folate because folic acid needs liver processing and can cause problems in some people.
The authors compared the pros and cons of taking folic acid versus 5-MTHF. They focused on the health of mothers and their developing babies.
What it can’t tell you
- We summarised it from the abstract only.
- This is a summary of existing knowledge rather than a new trial. It cannot measure exactly how often these risks happen in everyday life.
Who paid
- Conflicts
- Declaration of Competing Interest This above unconditional support was funded by Zambon Italia Srl.
The paper
- Title
- Folic acid versus 5- methyl tetrahydrofolate supplementation in pregnancy
- Type
- ReviewThe authors read earlier studies and describe what they found. It isn’t a new study.
- Evidence
- Studies in people
- Summarised from
- Abstract only
- Cite
- Ferrazzi E, Tiso G, Di Martino D (2020). Folic acid versus 5- methyl tetrahydrofolate supplementation in pregnancy. European journal of obstetrics, gynecology, and reproductive biology. doi:10.1016/j.ejogrb.2020.06.012PubMed 32868164DOI
Summary written 30 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error