By Larry Newman
Chief Operating Officer
Kirkman Group, Inc.
Kirkman® is now offering the product 5-MTHF ([6S] 5-Methyltetrahydrofolate), a form of folic acid, which some physicians have reported to be more effective than folic or folinic acid for certain individuals. Based on doctors’ reports, Kirkman® has already added 5-MTHF to some of our preconception and prenatal formulas. This article explains the differences and benefits of folic acid, folinic acid and 5-MTHF.
Folic acid is a B vitamin that helps the body manufacture healthy new cells. Everyone needs folic acid to survive but getting enough folic acid is especially important for women intending to get pregnant or women already expecting. Inadequate levels of folic acid before and during pregnancy can lead to birth defects in a baby’s brain or spine. (1) Foods containing significant amounts of folic acid include leafy green vegetables, fruits, beans, peas and nuts. In addition, enriched breads and cereals are fortified with folic acid. Even with all the food fortification, it still is very difficult to get enough folic acid from one’s diet. Supplementation is generally required and recommended by physicians and health professionals. The suggested daily requirement is 400 mcg. for the normal population and 800 mcg. for pregnant or lactating women.
The form of folic acid generally used in food and nutritional supplement products is synthetic folic acid. This folic acid is not biologically active in the body until it is converted to biologically active forms in the liver and the gut. The biologically active forms that folic acid is converted to are 5-Methyltetrahydrofolate (5-MTHF) and 5-Formyltetrahydrofolate (folinic acid). In order for the folic acid to be converted to these biologically active forms in the body, a particular gene must be functioning normally. This gene is called the methyltetrahydrofolate reductase gene. (1) If this gene is functioning normally and sending the correct signals to the related body enzymes, the body will convert folic acid to the active forms. The conversion may not be complete, however, resulting in un-metabolized folic acid remaining in the body and incomplete utilization of the ingested folic acid. (2)
There are approximately 40 mutations of the 5-MTHF reductase gene in the body. Some of these mutations interfere with the proper conversion of folic acid to its active forms. This can lead to low folic acid (folate) levels, which can lead to health problems and birth defects in newborns. It is estimated that 10 to 25 percent of individuals have a genetic mutation resulting in a 40 to 60 percent decreased ability to convert folic acid to its biologically active forms. (3)
With high percentages of low folic acid levels, modern research is now indicating a possible change in how we supplement with folic acid. Rather than relying on the body’s natural processing of the folic acid conversion, supplementing with an active form of folic acid is gaining momentum. The active forms don’t require the conversion process because they are already biologically active.
The 5-MTHF product, which Kirkman® now offers, is one of those active forms of folate. It can be used safely as a folate supplement if a person is unsure of his/her 5-MTHR gene status or if his/her doctor has verified that the gene is mutated. Kirkman® already uses the other active form of folate, folinic acid, in some formulations geared toward individuals with special needs because patients with special needs often display similar folic acid conversion abnormalities. Since there is some question as to how much folinic acid the FDA will allow in dietary supplements because it is also used as a drug in certain situations, Kirkman® uses only low doses of folinic acid in these formulations. There are no restrictions on the dosage of 5-MTHF.
There is ample ongoing research on folate supplementation, much of which will be completed in the near future. Hopefully this research will lead to a clearer picture on how folate should be supplemented in the future. In the meantime, Kirkman’s 5-MTHF product can be utilized if someone has a concern about his/her folic acid metabolism. Women intending to become pregnant or who are currently pregnant need to be particularly concerned because of the potential for birth defects. For this reason, Kirkman® has begun to use this 5-MTHF active form of folate in its Prenatal Advanced Care Vitamin & Mineral Formulation and in its Before Baby™ Women’s Vitamin and Mineral Formulation.
- Ullis, Karlis, M.D. and Paul Cristiana M.S. Nutrition “Folate Newsletter” April 12, 2010 pp 1-7
- Kelly P. McPartlin, J Groggins, M. Weir, JM Scott. Unmetabolized folic acid in serum: acute studies in subjects consuming fortified food and supplements. Am J Clin Nutr. 1997:65: 1790-5.
- Bailey LB, Gregory JF, Polymorphisms of methyltetrahydrofolate reductase and other enzymes: metabolic significance, risks, and impact on folate requirement. J Nutr 1999: 129(5): 919-22.