New findings suggest 5-MTHF is a viable alternative to folic acid during second and third trimester, supporting folate status while reducing excess folic acid in circulation

Clinical trial results published in Frontiers in Nutrition, a leading, open-access, peer-reviewed journal

LOS ANGELES, May 7, 2026 /PRNewswire/ -- Women's health supplement brand Ritual in partnership with Brooklyn College (CUNY) announced the publication of the folate results from their clinical trial on their top-selling Essential Prenatal in the journal Frontiers in Nutrition. The randomized, controlled clinical trial found that prenatal multivitamins containing 5-methyltetrahydrofolate (5-MTHF) instead of folic acid may help minimize levels of unmetabolized folic acid (UMFA) in pregnant individuals while maintaining adequate folate status in both mother and baby.

"This study allows us to directly compare how different supplemental forms of folate are processed during pregnancy," said Dr. Xinyin Jiang, a professor of health and nutrition sciences at Brooklyn College (CUNY) and the study's principal investigator. "We found that 5-MTHF can maintain folate status just as effectively as folic acid, but with significantly less unmetabolized folic acid circulating in the body."

The randomized, double-blind, controlled study, widely acknowledged as the gold standard in human research, spanned 24 weeks. Participants in their second trimester were assigned to receive a prenatal multivitamin containing either 5-MTHF or synthetic folic acid and continued taking the supplements as directed until delivery. Key results at the end of the trial included:

• No difference in total folate levels between groups, indicating that 5-MTHF is effective at maintaining folate status.^†*
• Significantly fewer individuals with detectable blood UMFA in the 5-MTHF group (7%) compared with the folic acid group (31%).^†*
• Lower UMFA concentrations in maternal blood and in the placenta, among those taking 5-MTHF.^†*

†Based on a 24-week, randomized, double-blind, controlled clinical trial on 62 second and third trimester pregnant women.

Folate helps the body produce and maintain DNA, which is essential for the growth and development of the fetus. While folic acid is a commonly used form of folate in supplements and fortified in foods, the body must convert this into an active form (5-MTHF) before it can be used by your cells. When intake is too high, the body can't process all of it, leading to a buildup of unmetabolized folic acid (UMFA) in the bloodstream, which is becoming more commonly seen in people with high supplement use.

The study was funded by Ritual in collaboration with its clinical affairs team, as part of their commitment to evaluating dietary supplement efficacy through rigorous clinical research. Working with independent research partners like universities or research organizations helps ensure studies are objective and trustworthy, even when funded by the product's manufacturer. It also allows collaboration with leading experts in the field to ensure the research meets the highest scientific standards.

"Our goal is to support rigorous, well-controlled research during pregnancy, a critical life stage when many individuals rely on supplements and place significant trust in their safety and efficacy," said Dr. Mastaneh Sharafi, PhD, RD and Senior Vice President of Science & Innovation at Ritual. "There are still major gaps in prenatal nutrition research, and we see a responsibility to help build that evidence base, particularly in diverse study populations."

The study cohort reflected a broad range of participants, with an average age of 32 years, varied educational and marital backgrounds, and racial and ethnic diversity: 33.9% identified as White, 29.0% as Black, 22.6% as Asian and 14.5% as another race; 34% identified as Hispanic or Latino.

"As a founder and a mother, I am deeply aware that women's health, and specifically pregnancy, has long been underrepresented in clinical research," said Katerina Schneider, Founder and CEO of Ritual. "By intentionally funding research in these often-excluded populations, we aim to not only evaluate our own products but also to proactively raise the bar for the entire industry and contribute to a deeper understanding of maternal and fetal nutrition."

Underscoring this dedication to transparency, Ritual has committed $5 million dollars to complete clinical trials for its entire product portfolio by 2030. The brand has completed five clinical studies, having published the results of three in peer-reviewed journals already.

The study, "Using 6S-5-methyltetrahydrofolate instead of folic acid in prenatal multivitamin reduces unmetabolized folic acid concentrations in the mother-fetus dyad: a 24-week randomized controlled trial," is published in Frontiers in Nutrition. The clinical trial is registered at ClinicalTrials.gov (NCT05673070).

About Ritual
Ritual is one of the largest privately held women's health platforms pioneering traceable, evidence-based supplements and driving systemic change toward transparency and accountability across the supplement industry. A Certified B Corporation, they have pioneered a new standard of high-quality multivitamins and supplements that are backed by science and Made Traceable® with the first visible supply chain of its kind. Together with leading scientists, researchers and advisors, Ritual has developed products based on thousands of independent research studies, and now has one of the leading prenatal multivitamins backed by its own human clinical trial in the U.S. Learn more at Ritual.com and follow the brand @Ritual on Instagram.

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SOURCE Ritual