The active form of folic acid is very important for a successful pregnancy and healthy baby. 5-MTHF is considered part of the B family. It is an essential vitamin meaning the body cannot make it, but must take it in via food or supplementation. It has many very important roles in the body and is especially important for DNA replication (genetics) and many other metabolic processes.
Folic acid is a synthetic dietary supplement that is present in enriched foods like grains and cereals and in commercially prepared vitamins. Folate is a general term that refers to several chemical compounds based on the folic acid structure. Folate is naturally occurring folic acid found in leafy green vegetables, beans, egg yolks, liver and citrus. Neither folate nor folic acid is metabolically active in the body – both need to undergo chemical changes to be used by cells. The activated form of folate is called L-5-methyltetrahydrofolate or 5-MTHF for short. It can also be called L-methylfolate.
One of the best known indications for supplementing with folic acid is during prenatal care to prevent neural tube defects (birth defects) in babies. Studies have indicated adequate levels of folic acid not only prevent neural tube defects, but may also support blood volume expansion in pregnancy, decrease the risk of miscarriage and preeclampsia, and may decrease the risk of preterm labor.
Folate is also important beyond pregnancy for many other body systems with high cell turnover requiring frequent DNA synthesis, such as the immune system and large intestine health.
A large percentage of people are unable to effectively convert folic acid / folate to the metabolically active form 5-MTHF resulting in a relative folate deficiency even though there may be adequate dietary intake or supplementation through a multivitamin/prenatal. This is can be reflected by elevated homocysteine levels in blood work; however, the metabolic genetic defects can still be present even with normal homocysteine levels. Therefore, new research is looking at the importance of supplementing 5-MTHF rather than folic acid especially in prenatal care. Genetic testing is available at a moderate price to screen for defects in 5-MTHF reductase pathways.
Concerns have been raised in the past about supplementing with high levels of the synthetic folic acid as some evidence suggests high levels of the unmetabolized synthetic vitamin are associated with a greater risk of cancer, depression and cognitive impairment. Early evidence does not show the same risks with this natural, activated form of folate. Therefore, many doctors and educated consumers are choosing to supplement with the activated form, and are choosing multivitamins that contain the naturally occurring folate rather than synthetically derived folic acid.
http://www.nlm.nih.gov/medlineplus/folicacid.html
REFERENCES
Folic Acid supplementation and pregnancy: more than just neural Tube defect prevention. James A Greenberg MD, Stacey J Bell, Yong Guan MD, Yan-hong Yu, MD PhD. Rev Obset Gynecol. 2011; 4 (2): 52-59
The 5, 10 methylenetetrahydrofolate reductase C677T mutation and risk of fetal loss: a case series and review of the literature. Ivy Altomere, Alan Adler, Louis Aledort. Thrombosis Journal 2007, 5:17
Methylenetetrahydrofolate reductase C677T and A1298C polymorphism and changes in homocysteine concentrations in women with idiopathic recurrent pregnancy loss. N Mtiraoui, W Zammiti, L Ghazouani et al. Reproduction 2006 131: 395-401
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