If you are trying to conceive in the UK, start with the NHS, not with a forum thread about MTHFR. Take 400 micrograms of folic acid every day from before you get pregnant through the first 12 weeks of pregnancy. That dose reduces the chance of neural tube defects such as spina bifida. It is difficult to get enough from food alone. Some people need a prescribed 5 mg dose. Methylfolate versus folic acid is a secondary conversation about form, not a reason to ignore that advice.
What the NHS actually says
Some people need a prescribed 5 mg dose — the BMJ paper on who should take high-dose folic acid is the overlay for that group.
- 400 µg folic acid daily when you are trying — ideally from three months before — and through the first 12 weeks.
- A higher dose of 5 mg folic acid if you or the baby’s father has a neural tube defect, a close family history, a previous NTD-affected pregnancy, diabetes, some blood conditions, or you take certain epilepsy or HIV medicines. That 5 mg is prescribed.
- Vitamin D: 10 µg (400 IU) as the routine figure, and do not take more than 100 µg a day from supplements.
- Avoid extra vitamin A / retinol and liver when pregnant.
Flour fortification in the UK does not replace the supplement.
Folic acid and 5-MTHF are related, not rivals
Folate is the vitamin. Folic acid is the stable synthetic form used in most tablets and in the trials that cut neural tube defects. 5-MTHF (levomefolic acid, L-methylfolate) is a form your body can use without the same conversion steps. Some people — including those interested in MTHFR gene variants — prefer 5-MTHF because they have read that conversion can be less efficient. That is a reasonable nutritional preference. It is not a reason to call folic acid toxic or outdated.
Supplemental folic acid increases maternal folate status. Low maternal folate status is a risk factor for neural tube defects. Folate also contributes to maternal tissue growth during pregnancy.
How Her Fertility fits
Her Fertility uses folate as 5-MTHF at 400 µg — the same 400 µg figure the NHS talks about, in the methylfolate form — alongside CoQ10 300 mg, NAC 400 mg, zinc 20 mg and selenium 200 µg. If you have been prescribed 5 mg folic acid, keep taking that. Stop Her Fertility at a positive test and move to a pregnancy vitamin a midwife accepts.
FAQ
If I take 5-MTHF, do I still need folic acid?
The NHS specifies folic acid. If a clinician is happy that 400 µg of 5-MTHF is your TTC folate, that is their call. Do not drop a prescribed 5 mg folic acid because a blog prefers methylfolate.
Does methylfolate get you pregnant faster?
It is a folate form. The public-health job is covering 400 µg of folate before and in early pregnancy.
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