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Levomefolic acid (INN, also known as L-5-MTHF, L-methylfolate and L-5-methyltetrahydrofolate and (6S)-5-methyltetrahydrofolate, and (6S)-5-MTHF) is the primary biologically active form of folate used at the cellular level for DNA reproduction, the cysteine cycle and the regulation of homocysteine.
5,10-Methenyltetrahydrofolate (5,10-CH=THF) is a form of tetrahydrofolate that is an intermediate in metabolism.5,10-CH=THF is a coenzyme that accepts and donates methenyl (CH=) groups.
The 2013–2014 survey reported that for adults ages 20 years and older, men consumed an average of 249 μg/day folate from food plus 207 μg/day of folic acid from consumption of fortified foods, for a combined total of 601 μg/day of dietary folate equivalents (DFEs because each microgram of folic acid counts as 1.7 μg of food folate).
Metanx is a prescription medical food made by Alfasigma that contains L-methylfolate (as Metafolin, a calcium salt of vitamin B 9), methylcobalamin (vitamin B 12) and pyridoxal 5'-phosphate (vitamin B 6). It is a vitamin B supplement. Metanx is indicated for the dietary management of peripheral neuropathy (i.e. DPN). [1]
As an intermediate in one-carbon metabolism, 5,10-CH 2-THF converts to 5-methyltetrahydrofolate, 5-formyltetrahydrofolate, and methenyltetrahydrofolate. It is substrate for the enzyme methylenetetrahydrofolate reductase (MTHFR) [ 1 ] [ 2 ] It is mainly produced by the reaction of tetrahydrofolate with serine, catalyzed by the enzyme serine ...
Methylenetetrahydrofolate reductase (MTHFR) is the rate-limiting enzyme in the methyl cycle, and it is encoded by the MTHFR gene. [5] Methylenetetrahydrofolate reductase catalyzes the conversion of 5,10-methylenetetrahydrofolate to 5-methyltetrahydrofolate, a cosubstrate for homocysteine remethylation to methionine.
A different study corroborates these results and suggests a physiological dose (800 μg) of 5-methyltetrahydrofolate can bypass MTHFR C677T and A1298C isoforms in couples with fertility problems. [16] This treatment with 5-MTHF also avoids un-metabolized folic acid syndrome, which can occur with folic acid intakes of 5 mg per day. [16]
It is approved by the U.S. Food and Drug Administration for the treatment or prevention of vitamin deficiencies. [ 1 ] "Cerefolin NAC" contains L-methylfolate (as Metafolin) 5.6 mg, methylcobalamin 2 mg, N-acetylcysteine 600 mg. [ 2 ]