ivf day 23 - let's talk folate

Folate has nothing to do with snow-covered firewood, but I wanted to post a photo anyway.

I would assume that most people have heard about folic acid for years and its importance in preventing birth defects, specifically, neural tube defects. Folic acid has been so well-marketed that it is added to so many foods. Even flour is fortified with folic acid these days.

What I would assume you haven't heard is that folic acid is a synthetic substance. 100% man-made. When you eat a green vegetable (good for you!), you aren't eating folic acid, you're consuming folate.

So, you might think, to-MAY-toes ta-MAH-toes, what's the big deal.

Let's start with a little lesson in basic pharmaceuticals. And, like all good lessons, it comes with a cool acronym which is why I can remember it: DAM.

• Dissolution: For a drug or vitamin to be used by our bodies, it must dissolve, otherwise, it would just go straight through our disgestive tract and out the other end and not do us any good. To see if your vitamin or drug dissolves, simply place it in a cup of water and watch it for an hour or so. With folate, it's important that the vitamin dissolves within 1 hour because by that point it's reached the small intestine and it's absorbed in the first section (in layman's terms), which brings us to the next letter of our acronym.
• Absorption: All drugs or vitamins are absorbed in the small intestine. That's where they enter the bloodstream and get exchanged with waste. Each drug is different in where it is absorbed along the small intestine, and as mentioned previously, folate is absorbed first along that pathway, so it needs to dissolve relatively quickly.
• Metabolism: The last portion of this pathway is metabolism and it's a bit more complicated. Once the drug or vitamin is absorbed into the bloodstream, it has to be broken down and changed a bit to be usable by the body. Different enzymes act during this process and this is why folate versus folic acid is so important.

Since folic acid is synthethic, it has to go through lots of steps to be broken down. That normally wouldn't be a problem, except that up to 50% of some ethnicities (Italian, Hispanic, Caucasian) have a genetic mutation and don't have the necessary enzyme to break down folic acid. You can read more about this mutation here. If you're concerned you might have this mutation, there is a genetic test for it, but it costs about $300. Otherwise, you could just take a prenatal vitamin that contains folate instead of folic acid, which is a lot less expensive.

The only prenatal that I'm aware of that contains folate has it patented as "Metafolin" short for 5-methytetrahydrofolate (although I used to say it the long way when talking to physicians just because I liked to sound like I knew what I was talking about). Metafolin is sold as part of Prenate DHA or Prenate Elite and also over the counter as "Folate", but it will likely have the word "Metafolin" underneath it.

Yes, I used to sell this drug, and while I was selling it, I wouldn't be allowed to talk about it on my blog due to regulations of the pharma industry. But now, I think it's important information for ladies to know, so there you have it.

Let me know if you have any questions and I'll do my best to answer them or refer you to someone who can.

Last, as an update on my IVF process, I just took my last birth control pill today, so another milestone has been reached.