L-methylfolate

L-methylfolate is the natural, active form of folate used at the cellular level for DNA reproduction, the cysteine cycle and the regulation of homocysteine among other functions. L-methylfolate is found in leafy green vegetables. Synthetic folic acid works to replicate the action of folate; but must be broken down in a series of metabolic steps in order to become L-methylfolate. Approximately 10% of the general population (homozygous TT) lack the enzymes needed to receive any benefit from folic acid. Another 40% of the population (heterozygous CT) appear to convert only a limited amount of folic acid into L-methylfolate. They cannot fully process supplemental folic acid at RDA or higher dose levels. The remaining population do not have an MTHFR polymorphism and can fully metabolize folic acid.

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Commercial use of L-methylfolate in pharmacuetical products began in Europe in the early part of this decade and have now appeared in the U.S. This approach to folate supplementation has potential to impact prenatal care, homocysteine management and the treatment of depression, dementia and cardiovascular concerns.

Prenatal Care - low folate status has been linked to neural tube defects, recurrent pregnancy loss, low birth weight and a variety of age-related high risk complications of pregnancy.

Depression - folate status has been linked to the performance of SSRI drugs. Many patients have required folate supplementation in order to adequateley respond to standard treatment protocol.

Homocysteine Management - elevated homocysteine is frequently linked to the presence of the MTHFR polymorphism.

Dementia - folate status has been linked to the efficacy of neural transmitters and the performance of the blood brain barrier.

Diabetic Neuropathy - folate status has been shown to have a substantial impact upon wound care.

Oral doses of L-methylfolate have been developed in Germany and are now marketed under the brand name Metafolin.