Folic Acid vs Methylfolate: Which Should You Take Before Pregnancy?

October, 2026By Allove

You’ve probably been told to take folic acid if you’re planning a baby. Then you go online and someone says folic acid is “useless” and you need methylfolate instead. Then a third person mentions MTHFR, and now you’re wondering whether you need a genetic test before you can take a vitamin.

Let me untangle this, because the honest answer is simpler and less scary than the internet makes it.

Why folate matters so much before pregnancy

Folate is a B vitamin your body needs to make DNA and new cells. In early pregnancy, it’s essential for the baby’s neural tube, which becomes the brain and spinal cord.

Here’s the part people miss. The neural tube forms and closes within roughly the first four weeks of pregnancy, often before you’ve even taken a pregnancy test. That’s why the advice is to start folate before you conceive, not after the positive test.

The standard recommendation is 400 micrograms (mcg) of folic acid a day, starting at least one month before trying to conceive. Your doctor may prescribe a much higher dose if you have a higher risk, for example a previous pregnancy affected by a neural tube defect, diabetes, or certain epilepsy medicines. If they’ve prescribed one, follow it.

So what’s the difference?

Folic acid is the synthetic form found in most supplements and fortified foods. Your body has to convert it, through a few steps, into the active form it actually uses.

Methylfolate, labelled L-5-MTHF or 5-methyltetrahydrofolate, is that active form. Your body can use it straight away, without the conversion.

	Folic acid	Methylfolate (L-5-MTHF)
Form	Synthetic	Active, body-ready
Needs conversion	Yes	No
Research on neural tube defect prevention	Decades of large studies	Much less direct
Raises blood folate	Yes	Yes
Cost	Low	Higher

The MTHFR question

The conversion from folic acid to active folate depends on an enzyme called MTHFR. Many people carry a common gene variant that makes this enzyme work less efficiently.

This is where the internet goes off the rails. A slower enzyme doesn’t mean folic acid “doesn’t work” for you. Public health bodies like the US CDC note that people with common MTHFR variants can still process folic acid, and the standard recommendation applies to them too.

What methylfolate does is skip the conversion step entirely. So it’s a reasonable choice if you know you carry an MTHFR variant, if you’d simply rather take the active form, or if your doctor suggests it. Most people don’t need a genetic test before taking folate.

So which should you take?

My honest take:

The most important thing is starting early, at least a month before you start trying, ideally three. Whichever form you’ll take every day beats the “perfect” form you forget.
Folic acid has the deepest research behind it and is cheap. It’s a perfectly good choice for most women.
Methylfolate is a sensible alternative if you know you have an MTHFR variant, prefer the active form, or your doctor recommends it.
Don’t double up blindly. If you already take a prescribed folic acid tablet, check with your doctor before adding a supplement that also contains folate.

Why Her Genesis uses methylfolate

We chose the active form for Her Genesis because it removes the conversion question entirely, whatever your genetics. It sits alongside branded Kaneka CoQ10 in one daily pre-conception formula. Each serving has 220 mcg DFE of folate (440 mcg of L-5-MTHF).

If your doctor has prescribed a specific folic acid dose, show them the label before combining the two.

FAQ

Is methylfolate better than folic acid?

Methylfolate is the active form and doesn’t need conversion, which some people prefer. Folic acid has more research behind neural tube defect prevention. Both raise folate levels, and either is a reasonable choice for most women.