Folate for PCOS

by Nicole Holovach, RD – Dietitian at Pulling Down the Moon

Nicole Holovach, RD

For the majority of the population, folic acid and folate are the same thing – a nutrient found in food and prenatal vitamins that helps prevent neural tube defects in babies. While the terms are often used interchangeably, there is an important distinction between the two. Folate is a B vitamin found in foods like dark leafy greens, lentils, beans, eggs, sunflower seeds, and liver. Folic acid is the synthetic form of folate. It is only found in fortified foods and supplements and must be converted to the active form within the cell. Humans are unable to make their own folate, so we have to get it from food or supplements.

Most prenatal vitamins contain folic acid because it’s less expensive, more stable, and more of it is absorbed than folate. But there are several factors that affect conversion of folic acid to the active form. Under normal dietary conditions, absorbed folic acid is converted into an active form used by the body. Age, environmental factors, a defect in the converted gene, and certain drugs can all play a part in how effectively folic acid is converted.

Folate for PCOS Patients

In certain clients, I may have them switch to a prenatal with folate, or add a folate supplement, depending on their health issues. For my clients with polycystic ovary syndrome (PCOS), I now have a reason to potentially add a folate supplement.

A recent study showed that folate, the active form, has beneficial effects on metabolic profiles in women with PCOS. The study was a randomized controlled trial, considered the “gold standard” of research. In the study, 5 mg of folate supplementation, compared with 1 mg and a placebo, resulted in better glucose metabolism and better cholesterol lab values in women with PCOS.

The average prenatal vitamin has between 600-1000mcg (1 mg) of folic acid or folate, so to reach 5 mg another supplement may be needed. While folate is more difficult to find over-the-counter than folic acid, high-end vitamin stores and health food stores may sell folate supplements.

While there is little risk associated with folate supplementation, it is recommended to speak with your physician before taking folate for PCOS or any other supplement.


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This article was submitted as a guest writer. The opinions expressed in the article do not necessarily represent the opinions of Shady Grove Fertility Center.