Treatment Options - L-methylfolate

Folate is the natural form of vitamin B9 found in dark green leafy vegetables, legumes, and cruciferous vegetables. It is also referred to as folic acid. 

L-methylfolate is the primary active form of folate in your body, and it can be taken as a supplement to treat low levels of folate in your body. It can be used to treat individuals with low folate levels who are already taking mental health medications. What makes L-methylfolate unique is that it can more easily travel into the brain compared to other versions of folate. 

Scientific studies have shown that the use of L-methylfolate can help decrease depression symptoms when used alongside an antidepressant. 

Having a balanced diet that includes all the necessary nutrients is important for your mental health. However, since most foods do not contain the active L-methylfolate, dietary supplementation with folate alone may not be adequate. 

Folic Acid vs. L-methylfolate

The main difference between L-methylfolate and folic acid is that L-methylfolate is primarily the biologically active form of folate, whereas folic acid is a synthetic form. Folate is the natural form of vitamin B9 in food, while folic acid is the synthetic form of vitamin B9 found in many multivitamins, fortified foods, and certain pharmaceuticals. 

High intake of folic acid may lead to increased blood levels of unmetabolized folic acid, whereas L-methylfolate is more readily absorbed and metabolized by the body, and in particular, it can more easily travel to the brain.

Sometimes, certain genetic mutations can further inhibit the body's ability to convert folic acid into the active form, L-methylfolate. In cases like this, taking a supplement  with L-methylfolate may be more beneficial than taking one with folic acid.

Does L-methylfolate improve depression?

Various researchers are currently studying the impact of L-methylfolate on depression

In one study where two parallel investigations were conducted, the researchers found that when 15 mg/day of L-methylfolate was given to patients, there was a significant improvement in the depressive symptoms of patients who received L-methylfolate compared to those who received a placebo.

These parallel investigations support that when given in the proper dosage, L-methylfolate may improve depression symptoms. In particular, patients who have experienced minimal improvement with antidepressants, have folate deficiencies, or have risk factors for inflammation may benefit the most from adding L-methylfolate to their treatment plan. 

Additional studies have shown that the supplemental use of L-methyfolate can help improve outcomes in individuals with treatment-resistant depression. Patients with MDD who used L-methylfolate alongside another medication for depression reported significant improvement in their functioning in social situations, at home, and at work. 

Although the use of L-methylfolate to assist with reducing depression symptoms needs additional study, the results so far are promising.

Folate Deficiency Symptoms

Folate deficiencies usually happen alongside other nutritional deficiencies, such as iron deficiency or vitamin B-12 deficiency. 

You are more at risk of a folate deficiency if you have the following: 

  • An alcohol use disorder
  • Eating disorders
  • Conditions that interfere with nutrient absorption, such as celiac disease or inflammatory bowel disease
  • Mutation of the MTHFR gene, which impacts the body’s natural ability to convert folate into its active form that your body needs

Folate deficiencies are also more common among females than males. It is also more common among non-Hispanic Black females. 

Benefits of Folate

Folate is a necessary vitamin for many different bodily functions. It has many health benefits:

  • Lowers the risk of stroke by reducing levels of amino acid homocysteine, which is linked to cardiovascular disease and stroke
  • Reduces the risk of cognitive decline by lowering homocysteine in the body
  • Protects against certain cancers, such as lung, breast, cervical, and stomach cancer
  • Lowers the risk of neural tube defects in pregnancy
  • Eases depression symptoms

Foods with Folate

There are many food sources where you can access folate or folic acid: 

  1. Legumes such as beans, peas, and lentils
  2. Asparagus, cooked or raw
  3. Eggs
  4. Leafy greens, such as spinach, kale, and arugula.
  5. Beets
  6. Citrus fruits, like limes, lemons, grapefruit, and oranges
  7. Brussels sprouts
  8. Broccoli
  9. Nuts and seeds
  10. Beef liver
  11. Papaya
  12. Wheat germ
  13. Bananas
  14. Avocado
  15. Fortified grain 

Folate Risks

Taking folate in moderate amounts is not dangerous for most individuals. Compared to other medications for depression, L-methylfolate is well tolerated. However, taking large quantities of folates could pose health risks, which is why you don’t want to take too much. 

A few risks include: 

  • Masking vitamin B-12 deficiencies 
  • Unmetabolized folic acid 
  • Medication interactions with methotrexate, sulfasalazine, and epilepsy medication
  • Preneoplastic lesions

Always check with your doctor before taking any dietary supplements. 

Supplements are not regulated by the FDA like medications, so you should only purchase supplements from brands that have been evaluated for quality. Supplements are not FDA-approved to treat depression. 

L-methylfolate for Treating Depression

Finding the proper treatment when you have treatment-resistant depression can be challenging. L-methylfolate supplements can be used alongside other depression treatment options to boost their effect.

At Options MD, natural supplements, such as folate and L-methylfolate, are one of the 200 treatment options our expert team will consider when putting together a custom plan for your treatment-resistant depression. 

Do you have questions?

Options MD is here to help. Text us to start treatment now. Join our Facebook community to connect with other individuals with treatment-resistant depression. 

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