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Folic acid and folate are two terms that are often used interchangeably, but they refer to two different forms of vitamin B9. While they have similar functions in the body, there are some important differences between the two that may affect their effectiveness as a nutritional source. The unfortunate truth, particularly in the UK, is that many doctors and midwives are not fully aware of these differences.
Zita West has been an advocate for folate for many years, which is why we use folate in our products and why we always encourage others who care for conception and pregnancy to use folate rather than folic acid. Read on to find out why this distinction matters.
All Zita West fertility supplements use Quatrefolic, a bioavailable form of folate approved by the European Food Safety Authority. If you are looking for a standalone folate supplement or a combined folate and vitamin D product covering two of the nutrients the NHS recommends for women trying to conceive, both are available below.
Shop Zita West Folate Shop Folate and Vitamin DFolic acid is the synthetic form of vitamin B9 found in most fortified foods and many dietary supplements. It is commonly used to fortify grains and cereals and is added to most generic prenatal and preconception vitamins because it is inexpensive and has well-documented population-level benefits for reducing neural tube defects. Many of the best-selling and doctor-recommended preconception vitamins globally contain folic acid rather than folate, largely because folic acid is a cheaper ingredient.
Folate, on the other hand, is the naturally occurring form of vitamin B9 found in foods such as leafy green vegetables, beans and citrus fruits. Unlike folic acid, folate does not need to be converted by the body before it can be used, making it a more efficient and bioavailable source of the vitamin.
Some people do not convert folic acid into active B9 folate in the expected way, and there is no reliable way to determine on a population basis who is and is not converting effectively without genetic testing. Put simply, it is a bit of a lottery.
Folate is more easily absorbed and utilised by the body because it is already in its active form and is metabolised in the small intestine. Folic acid must be converted in the liver before it can be used, and this conversion process may be inefficient in some individuals. Unmetabolised folic acid may circulate in the bloodstream when conversion capacity is exceeded, which some researchers have flagged as a potential concern, though the evidence is still developing.
Some individuals have variations in the MTHFR gene, which encodes the enzyme responsible for converting folic acid into its active form, L-methylfolate. These variations can reduce enzyme activity significantly, making it more difficult for the body to metabolise folic acid effectively. For these individuals, supplementing with bioavailable folate rather than folic acid may make a meaningful difference to their actual folate status.
MTHFR gene variations are more common than is widely appreciated — estimates suggest up to 40% of the population carry at least one variant. For women trying to conceive, this is a relevant consideration when choosing a preconception supplement.
Excessive folic acid intake may mask a vitamin B12 deficiency, which may lead to neurological problems over time. Folate does not have this effect as it does not interfere with vitamin B12 metabolism in the same way.
As with many nutritional issues, those with the least access to a varied, high-quality diet are most affected by folate deficiency. Those who eat a wide variety of good quality fruits and vegetables will rarely be deficient. This makes the choice of supplement form particularly important for women who rely on supplementation rather than dietary sources to meet their folate needs.
Quatrefolic is a specific, patented form of bioavailable folate that delivers 5-methyltetrahydrofolate (5-MTHF), the active form of folate that the body uses directly. It outperforms folic acid on oral absorption and is approved by the European Food Safety Authority (EFSA). Because it is already in its active form, it bypasses the conversion step that can be inefficient in women with MTHFR gene variants.
All Zita West fertility supplements use Quatrefolic rather than synthetic folic acid, which is one of the reasons we are confident that every woman taking our products is receiving folate in the form most likely to be effectively utilised by their body.
A standalone folate supplement using Quatrefolic, the bioavailable form of folate that does not require conversion by the body. Suitable for women trying to conceive who want to ensure they are getting the most effective form of vitamin B9, particularly those with MTHFR gene variants.
Shop Zita West Folate
Combines Quatrefolic with vitamin D3 — two of the nutrients the NHS recommends for women trying to conceive and during early pregnancy. A practical option for those looking to cover both in a single supplement alongside their main preconception multivitamin.
Shop Folate and Vitamin DFor women looking for a comprehensive preconception multivitamin that includes Quatrefolic alongside a full range of fertility-relevant nutrients, Vitafem is our fertility multivitamin for women. For men, Vitamen includes Quatrefolic alongside zinc, selenium, CoQ10 and other key nutrients for sperm health. For women with PCOS (PMOS) or irregular cycles, Inositol and Folate combines myo-inositol with Quatrefolic in a powder format.
If you are unsure which products are right for your situation, book a free 1:1 fertility product consultation with our team.
No. Both are forms of vitamin B9, but they are chemically different. Folate is the naturally occurring form found in food and is already in its active state. Folic acid is a synthetic form used in supplements and fortified foods that must be converted by the body before it can be used. For most people the difference is modest, but for those with MTHFR gene variants the distinction may be significant.
Folate, particularly in bioavailable forms such as Quatrefolic, does not require conversion by the body before use, making it more reliably effective across the whole population. Folic acid requires conversion in the liver, which may be inefficient in women with MTHFR gene variants. For women trying to conceive, ensuring effective folate status is important for egg quality, DNA synthesis and early embryo development.
The MTHFR gene encodes an enzyme that converts folic acid into its active form. Variants in this gene reduce enzyme activity, meaning some people are less able to convert folic acid effectively. Estimates suggest up to 40% of the population carry at least one MTHFR variant. Women with known MTHFR variants are generally advised to use bioavailable folate such as Quatrefolic rather than synthetic folic acid.
Quatrefolic is a patented form of bioavailable folate that delivers 5-methyltetrahydrofolate (5-MTHF), the active form the body uses directly. It is approved by the European Food Safety Authority and outperforms folic acid on oral absorption. It is the form used in all Zita West fertility supplements including Zita West Folate, Vitafem, Vitamen and Inositol and Folate.
The NHS recommends 400mcg of folic acid or folate daily for women trying to conceive and during the first 12 weeks of pregnancy. Some women, including those with MTHFR variants or a family history of neural tube defects, may be advised to take a higher dose. Always discuss with your GP or healthcare provider for guidance specific to your situation.
Yes. The NHS recommends both folate and vitamin D for women trying to conceive and during pregnancy. The Zita West Folate and Vitamin D supplement covers both in a single product using Quatrefolic rather than synthetic folic acid. Note that while these are the two supplements the NHS recommends, this product is not itself endorsed by the NHS.
Yes. Folate plays a role in DNA synthesis and contributes to the genetic quality of sperm. Men trying to conceive should ensure adequate folate intake alongside other key nutrients for sperm health. Zita West Vitamen contains Quatrefolic alongside a broader male fertility nutrient profile.
External references: NHS: Vitamins, supplements and nutrition in pregnancy | EFSA: Dietary Reference Values for folate
This content is for educational purposes only and is not intended to diagnose, treat, or replace medical advice. Always consult your healthcare provider before starting any new supplement.
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