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Crossfire

Should pregnant women avoid folic acid in favour of methylfolate?

What the experts say

Dr Idrees Hamid MughalMBBS · MRes (nutritional research) · DipIBLM · nutrition myth correction

No. The study behind the fear did not test folic acid supplementation.

What it rests onA study-design critique in four moves: wrong exposure measured, unvalidated intermediate endpoint, no maternal measurement to connect the cord finding to the mother, and confounding by preterm birth.

Source: foodfacts.org ↗
Paul Gregory SaladinoMD · physician and animal-based nutrition creator

Reported as: avoid folic-acid-containing prenatals in favour of L-5-methylfolate.

What it rests onReported as resting on a Boston Birth Cohort paper linking cord unmetabolised folic acid to autism risk, and on a preference for the 'natural' form.

Overview

Pregnant and pre-conception women. This is the one disagreement here where acting on the wrong side has a named, quantified harm (neural tube defects), which is why it should be settled rather than dropped.

Where they agree

Not established, because one side is unsourced.

What would settle it

Trials with clinical endpoints rather than unmetabolised folic acid concentrations, comparing folic acid and 5-MTHF prenatals.

Practice does not pick a winner here

You do, and your call is dated, kept, and yours to change. Follow the people you already trust and what they publish turns into a short daily practice.

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