methyltetrahydrofolate. This form of folic acid is considered active because it is the form that is directly incorporated into the methylation cycle that converts homocysteine to methionine. It is also 7 times more bioavailable than regular folic acid. Without adequate 5 MTHF, the inflammatory compound homocysteine can build up in the blood vessels. Also, this methyl-group donation is vital to many bodily processes, including the synthesis of serotonin, melatonin and DNA.†
There are many reasons why folate deficiency is considered one of the most common nutritional deficiencies. These include deficiency in the food supply, defects in utilization as in alcoholics or those with liver disease, malabsorption, increased needs in pregnant and nursing women, metabolic interference by drugs, and deficiencies in enzymes or cofactors needed for the generation of active folic acid.
In order for folate to be converted to its active form in the body, several enzymes, adequate liver and intestinal function and sufficient amounts of riboflavin (B2), niacin (B3), pyridoxine (B6), zinc, vitamin C and serine need to be present. Significantly greater amounts of folate were found in the serum after 24 weeks of supplementation with 5 MTHF than with folic acid and placebo. This may be because at least 25% of the population may have an enzyme defect, or single nucleotide polymorphism (SNP), that leads to a decrease in the function of the methylenetetrahydrofolate reductase (5 MTHFR) enzyme, which is needed to convert folic acid into its active form, 5 MTHF.
Signs and symptoms of folate deficiency include elevated homocysteine, macrocytic anemia, fatigue, irritability, peripheral neuropathy, hyper-reflexivity, restless legs syndrome, diarrhea, weight loss, insomnia, depression, dementia cognitive disturbances, and psychiatric disorders.
CARDIOVASCULAR DISEASE: High levels of homocysteine have been implicated in many different disorders of the cardiovascular system, including thrombosis, stroke, atherosclerosis, and myocardial infarction. As well as decreasing homocysteine levels in the blood, 5 MTHF also improves peripheral blood flow in the arteries by increasing nitric oxide (NO) production in the vascular endothelium. Most of the risk factors for atherosclerosis are associated with poor vasodilation due to insufficient NO production. In a six-week, randomized, crossover study of 52 individuals with coronary artery disease, folic acid at a dose of 5 mg/day significantly improved flow-mediated dilation, a measurement of endothelial function. This was independent of the homocysteine level in the blood.