The Real Deal on Methylfolate vs. Folic Acid from a Labor & Delivery Nurse

If you’ve been researching prenatal vitamins lately and found yourself spiraling down the internet rabbit hole of folic acid vs. folate vs. methylfolate, you are not alone, mama.

Maybe your OB provider told you to grab something with folic acid. Or maybe you read something about MTHFR and started wondering, hmmm, am I missing something major?

Let’s slow it down and walk through this together — what methylfolate actually is, how it compares to folic acid, and how to pick the best prenatal for you!

Follow @mommy.labornurse on Instagram to join our community of over 650k for education, tips, and solidarity on all things pregnancy, birth, and postpartum!

What is Methylfolate?

Methylfolate is the active, usable form of folate — also known as 5-MTHF or L-methylfolate. It's what your body naturally converts folate (from food) or folic acid (from supplements) into before it can actually do its job. Clear as mud?!

In other words: methylfolate is ready to go — no extra steps required by your body.

Folic Acid vs. Folate vs. Methylfolate (what’s the difference?)

This is where it gets a little science-y, but stick with me — it's worth understanding. If we’re being totally honest, it took me (more than) a hot second to fully grasp it myself.

• Folate is the general term for vitamin B9. It’s found naturally in foods like leafy greens, beans, and citrus.
• Folic acid is the synthetic form of folate, used in most traditional prenatal vitamins and fortified foods.
• Methylfolate is the already-converted active form of folate your body can use right away.
  
  

For many people, folic acid is fine — their bodies convert it into methylfolate just like they should. But up to 60% of people have a gene variant called MTHFR that makes this conversion less efficient.

If your body can’t easily convert folic acid, it may not get the full benefit — and that’s where taking methylated folate directly can really help.

Why It Matters During Pregnancy

No matter which form you take, folate is crucial during pregnancy — especially in the first trimester.

It helps prevent:

• Neural tube defects (like spina bifida)
• Brain and spinal cord abnormalities
• Complications related to red blood cell production
  
  

But here’s the big deal: If your body can’t process folic acid efficiently, you might not be absorbing enough of it — even if your prenatal label says you are.

That’s why many mamas (especially those with miscarriage history, fertility struggles, or MTHFR mutations) choose prenatal vitamins with methylfolate instead.

Prenatal vitamins with Methylfolate (that we actually recommend)

If you’re looking for a prenatal that skips folic acid altogether and gives you bioavailable methylfolate, here are two options that I highly recommend:

1.  Ritual Prenatal Multivitamin

• Uses 5-MTHF (methylated folate)
• Gentle delayed-release capsule (no nausea!)
• Includes DHA, choline, iron, and other must-haves
• Smells like mint or citrus — no fishy burps here!

💡 Great for mamas who want a once-daily, no-nonsense vitamin they can feel good about (it's me!) 

You can learn more about Ritual Prenatal Vitamins and purchase here!

2. CareNatal Prenatal Powder

• OB-formulated with bioavailable methylfolate
  
• Comes in a drinkable powder — mix with water or a smoothie
• Loaded with choline, calcium, magnesium, and iron
• Free from sugar, dyes, and artificial junk

💡 Perfect for mamas who hate pills or want something super absorbable.

You can learn more about CareNatal Prenatal Powder and purchase here!

FAQs about Methylfolate + pregnancy

1. Is methylfolate safer than folic acid?

Not necessarily safer, but it may be more effective for mamas who have trouble converting folic acid.

2. Can I get methylfolate from food?

You can get folate from food, but methylfolate in supplement form ensures you’re getting enough during pregnancy.

3. What if my prenatal has folic acid — should I switch?

Not always. If you tolerate it well and your provider approves, you may be fine. But if you’ve had issues or want peace of mind, a methylated option may be worth it.

4. Can I take too much folate?

Folate is water-soluble, so your body typically flushes out the excess — but always stick to your provider’s recommended dose (usually 400–800 mcg per day during pregnancy).

Final Thoughts: what’s best for YOU, mama?

Whether your prenatal contains folic acid or methylfolate, the most important thing is that you’re supporting your pregnancy with B9 in a form your body can actually use.

If you're unsure which is best for you, bring your prenatal to your next appointment and talk it over with your OB provider — especially if you have a family history of MTHFR or any pregnancy loss.

Knowledge is power, and you’re doing an amazing job digging into the details. You’ve got this, mama!