8 December 2025
You’ve probably heard that folic acid is important when preparing for pregnancy and it absolutely is, but what many people don’t realise is that not everyone processes folic acid the same way, and the form you take can make a big difference, especially when it comes to fertility, hormone balance, and early pregnancy health.
As a naturopath and acupuncturist working in fertility care, this is something I often see in clinic and it’s a simple shift that can be really empowering.
What Is Folic Acid, and Why Do We Need It?
Folic acid is a synthetic form of vitamin B9, often found in supplements and fortified foods. It plays a critical role in:
Supporting healthy ovulation and egg quality
Preventing neural tube defects in early pregnancy
Aiding DNA synthesis and repair
Supporting methylation pathways, which are involved in detoxification, hormone processing, and mental health
But here’s where it gets interesting…
The MTHFR Gene and Why It Matters
Some people have a common genetic variation in an enzyme called MTHFR (short for methylenetetrahydrofolate reductase). This enzyme is responsible for converting folic acid into its active form called 5-MTHF or methyl folate, which your body can actually use.
If you have an MTHFR variant, your ability to make this conversion may be reduced. This means that even if you’re taking folic acid, your body might not be getting the full benefit.
It’s estimated that 30–40% of people carry a form of this gene variation, and while it doesn’t always cause problems, it can become more important when you’re:
Trying to conceive (TTC)
Preparing for IVF
Managing hormonal imbalances
Recovering from miscarriage or pregnancy loss
Supporting mood and energy naturally
The Alternative. Methyl folate
Instead of taking synthetic folic acid, many practitioners recommend using the active form, methyl folate (5-MTHF), especially if there’s a family history of fertility issues, neural tube defects, miscarriage, or if you’ve tested positive for an MTHFR variant.
Methyl folate is already in its usable form, so your body can absorb and apply it more efficiently, regardless of your genetics.
My Clinical Approach
When I work with clients in preconception care or fertility treatment, I often review their supplements to make sure they’re getting the right form of folate, especially if we’re supporting methylation, hormone metabolism, or egg and sperm health.
In many cases, a practitioner grade B-complex that includes methyl folate (rather than folic acid) can offer better support, and may be gentler on digestion, too.
Should You Get Tested for MTHFR?
MTHFR testing is available through private pathology, and while it can offer useful insight, it’s not always essential to make a change. If you’re concerned about folate absorption, or you’ve had issues with fertility or hormone health in the past, using a supplement with activated B vitamins may still be a smart, low-risk step.
Folate is absolutely essential when you’re trying to conceive but the form you take matters. If you’re unsure whether your current supplement is right for you, or if you’d like to review your nutrition, testing, or fertility support plan, I’d love to help.
You can book a consultation in person (Melbourne) or online from anywhere in Australia.
