Folate (also known as vitamin B9) plays an essential role in many chemical reactions in your body, including DNA synthesis and amino acid metabolism.

One important folate-dependent chemical reaction is clearing the body of homocysteine by converting it to methionine.  If it doesn’t get broken down properly, homocysteine can build up in your artery walls and contribute to atherosclerosis.

Spinach is a power-packed source of folate, with other dark green leafy vegetables not far behind (hooray kale!)  Folate is also found in a wide variety of other foods, including fruits, beans, meats, and more.

Despite its broad availability in the American diet, public health authorities have determined that many people are at risk of folate deficiency, and have required that fortified grains include extra folate.

But natural sources of folate, even with fortified grains added in, may not be enough.

One reason you might benefit from supplementation is that you can’t make direct use of the folate found in food.  First, your body has to convert it to usable form – 5 methyl-tetrahydro-folate.  (We can call it by its nickname:  5-MTHF.  Catchy, isn’t it?)

If you have a deficiency of the enzymes needed to make the conversion into 5-MTHF, you can consume bountiful amounts of folate from food but still be deficient where it counts – the amount of folate circulating in your blood stream.

That’s why you should select a supplement that provides folate that’s already in the form of 5-MTHF.  That way you’re sure to have plenty of the active form available to catalyze your internal chemical reactions and clear your body of excess homocysteine.

Pregnant women, and even women who could potentially become pregnant, are urged to take extra folate because it helps prevent birth defects.

In addition to its proven role in supporting your overall health, folate may have the potential to improve the outcomes of several specific medical conditions.  That’s why everyone should consider using folate – particularly in its most bioactive form — as a supplement.

Cardiovascular disease and stroke

Folate supplements have shown some promise in helping to prevent stroke.  And in theory extra 5-MTHF should help with other cardiovascular problems, like coronary heart disease.

Cancers

Some scientists have speculated that folate supplementation might be useful in the prevention of certain cancers, particularly colon cancer.  Though there is some research to support this hypothesis, the results are unclear.  And in some situations, it seems that adding folate supplements to your diet could actually raise your risk of certain cancers.

Depression

Using folate supplementation in the treatment of depression has also been studied.  Here is some of what we know:

There’s a subgroup of people with depression who are folate-deficient.  For that subgroup, supplementation with extra folate boosts the response to standard SSRI anti-depressant drugs.  At the same time, if you have normal levels of folate in your blood to begin with, you won’t get an extra boost from supplementation.

Unfortunately, since most of this research has been performed by pharmaceutical companies, we don’t know what would happen if patients took folate supplements by themselves, leaving out the SSRI’s altogether.

How much folate should I take and what kind?

If you choose to use a folate supplement, I recommend a product that comes in the 5-MTHF form that’s most usable by your body.  Begin with a dose of about 800 micrograms per day. You can sign up for my online nutrition dispensary Fullscript using this link to find a high quality version of 5-MTHF.

Dr. Lavine has been an innovator in the use of movement and touch to promote health since 1981. He practices in New York City and Princeton, NJ.

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