Folate (methylfolate vs folic acid) and blood folate levels
What 3 graded rows on folate (methylfolate vs folic acid) agree on for blood folate levels, and where they differ. Counted side by side, never averaged.
Consensus finder Rows from the Folate (methylfolate vs folic acid) page, reviewed Oct 21, 2026 How it decides
What the rows agree on
Each block and row is one graded row from the Folate (methylfolate vs folic acid) page, with its PubMed record.
Your question
Folate (methylfolate vs folic acid) and blood folate levels
3 rows · 784 peopleMostly an improvement: 2 of 3 rows, and most of the people. 1 found no difference.
- CGrade C× 3
- Rows
- 3
- Trials
- 9
- People
- 784
- Pooled reviews may count some twice
Where they differ
From the rowsThe best-graded row, grade C, is a meta-analysis of 536 people (2025) and found an improvement.
The 2 rows that found an improvement were larger: a median of 340 people, against 104 people for the row that found no difference.
Only the 2 rows that found an improvement include pooled reviews of several trials (1 of 2); the row that found no difference is a single study.
The 2 rows that found an improvement are newer (2006 to 2025) than the row that found no difference (2002).
The rows
2 improved · 1 no difference- CGrade CBlood folate: active folate vs folic acid (meta-analysis) · Improved
Meta-analysis, 7 studies · n 536 · 2025 · Women of childbearing age in 11 randomized trials; red-cell folate pooled from 7 trials
Varied across trials · Varied across trials
Active folate raised red-cell folate (SMD 0.42; 95% CI 0.09 to 0.76) and plasma folate (SMD 0.67; 711 participants) more than folic acid, and lowered unmetabolized folic acid. Homocysteine did not differ.
Row on the Folate (methylfolate vs folic acid) page · PubMed 41398893 (opens PubMed)
- CGrade CRed blood cell folate: methylfolate vs folic acid · Improved
RCT · n 144 · 2006 · Healthy women aged 19-33
416 mcg/day 5-MTHF (equimolar to 400 mcg folic acid), 208 mcg/day 5-MTHF, or 400 mcg/day folic acid · 24 weeks
Red blood cell folate rose significantly more with 416 mcg 5-MTHF than with 400 mcg folic acid or 208 mcg 5-MTHF. Plasma folate plateaued after 12 weeks.
Row on the Folate (methylfolate vs folic acid) page · PubMed 16825690 (opens PubMed)
- CGrade CBlood folate: methylfolate vs folic acid at low doses · No difference
RCT · n 104 · 2002 · Women of childbearing age (18-49)
113 mcg/day 5-MTHF or 100 mcg/day folic acid · 24 weeks
Plasma and red-cell folate rose at similar rates with both forms (no significant difference in slopes).
Row on the Folate (methylfolate vs folic acid) page · PubMed 12421850 (opens PubMed)