To Your Health

What are the benefits of taking the 'fancy' form of folic acid, 5-methyl tetrahydrofolate, and how would I know if it is better for me if I decide to try it?

Q. What are the benefits of taking the "fancy" form of folic acid, 5-methyl tetrahydrofolate, and how would I know if it is better for me if I decide to try it?

A. For well over half a century folic acid has been classified as an essential B-vitamin. Until the 1980s folic acid deficiency was mainly associated with anemia, because folic acid is needed to form new red blood cells. More recent research shows that folic acid deficiency during pregnancy increases the risk of a mother giving birth to a baby affected with a neural tube defect such as spina bifida, probably due to the involvement of folic acid in DNA synthesis. Now folic acid is also considered the most important nutrient deficiency that leads to elevated homocysteine, the amino acid connected to increased risk of cardiovascular disease, cancer, and mental illness.

Actually, "folic acid" is not the naturally occurring form that is found in food or in our bodies. Mostly folic acid circulates in our bodies in the form called 5-methyltetrahydrofolate, an activated form of folic acid. When we take folic acid as a food supplement, it is slowly converted to 5-MTHF or another of folic acid's active forms. Taking a folic acid supplement as 5-MTHF has several advantages such as more rapid absorption, and several disadvantages such as increased cost.

Most of us will do fine taking folic acid in the form that is easily and inexpensively available, but with new information from the Human Genome Project, we are now aware that some people would benefit from using folic acid in the 5-MTHF form. To date, mutations have been found at two locations on the gene needed to convert folic acid into 5-MTHF and that roughly a quarter of the population has one or both of the mutations. The conversion of folic acid to 5-MTHF still takes place in these people but even more slowly than normal, and there is a tendency for homocysteine to become elevated.

The test that reveals the mutations is expensive, and relatively few health care providers are comfortable interpreting the results, but an alternative is to check your blood homocysteine level before and after taking 5-MTHF for about three months. Assuming this is the only change in your diet and supplement program, a sharp drop in blood homocysteine level would indicate that you are probably one of the minority of people who would benefit from using 5-MTHF as your folic acid supplement.

Imbalance in B-vitamin intake does not develop rapidly, so during the three-month test period you can simply continue the same supplements you have been using, in order to make it easier to decide whether you need to use 5-MTHF. If you decide to continue using 5-MTHF, be sure your supplements include a complete B-complex, one that provides at least 5 micrograms per day or more of vitamin B12, to make certain you can safely use 5-MTHF for the rest of your life.

Bear in mind that blood homocysteine levels can conceivably drop too low, and that folic acid insufficiency is not the only factor in elevated blood homocysteine level, so it would be prudent to seek the advice of a nutrition-oriented practitioner to assist you both in obtaining and interpreting these tests.

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