can you substitute folic acid for folate 1-1?

[harrycat]

Hi,

My mum has rheumatoid arthritis and I'm trying to help her get on the methylation protocol. She takes methotrexate with which they prescribe folic acid (not folate), in 5 mg daily doses as methotrexate can deplete folate. I have the MTHFR polymorphism (+/-) so I want to assume my mum has that too and get her to switch to folate. My question is whether you are pretty much able to substitute methylfolate / folinic acid for folic acid at a similar dosage level, eg 5mg? She spoke to her doctor about this who (surprise, surprise) didn't know anything about it, but did agree to getting her homocysteine level checked.

I don't know if there are any other alternatives to methotrexate that she could look into, since depleting folate doesn't sound like a good idea. Hope this question is ok since I know it doesn't specifically relate to CFS, but I thought this would be the best place to ask.

Hope someone can help, thank you.

 

[Freddd]

Hi,

My mum has rheumatoid arthritis and I'm trying to help her get on the methylation protocol. She takes methotrexate with which they prescribe folic acid (not folate), in 5 mg daily doses as methotrexate can deplete folate. I have the MTHFR polymorphism (+/-) so I want to assume my mum has that too and get her to switch to folate. My question is whether you are pretty much able to substitute methylfolate / folinic acid for folic acid at a similar dosage level, eg 5mg? She spoke to her doctor about this who (surprise, surprise) didn't know anything about it, but did agree to getting her homocysteine level checked.

I don't know if there are any other alternatives to methotrexate that she could look into, since depleting folate doesn't sound like a good idea. Hope this question is ok since I know it doesn't specifically relate to CFS, but I thought this would be the best place to ask.

Hope someone can help, thank you.

Hi Harrycat,

Acccording to the Deplin (Metafolin 7.5mg or 15mg) research serum levels of folate are 7 timers higher with 7.5mg of Metafolin compared to folic acid of the same dose. The problem with folic acid is that it is not converted at all to methylfolate at all in 20% of people so for those people the folate level is infinitely higher. In 30% of people there is some conversion so in those people the range is thousands of times as much to perhaps 7 times as much and in 50% of the people the folic acid is converted to methyfolate at approximately the 800mcg to 1000mcg or a little more, which is the general biological limit of the enzymes present. The 7x is the most frequent typical result. Does she exhibit the methylfolate deficiency specific symptoms?

 

[harrycat]

Thanks Freddd. That sounds rather more complicated than I imagined... Not sure what I should suggest to my mum in terms of replacing her 5mg folic acid if her doctor won't help.

My mum's main symptoms are swelling of her knuckle and ankle joints and severe pain at times limiting movement but her symptoms are not constant, she has much better periods (which she struggles to link to anything) at times. She also gets periods of depression correlating with worsening symptoms.

I thought of the methylation protocol since she must share some of my (Cfs) genetics, and she also has asthma and allergies in common with me. Her mother is still alive and has severe asthma and recently had a stent fitted for heart disease.

 

[Freddd]

Thanks Freddd. That sounds rather more complicated than I imagined... Not sure what I should suggest to my mum in terms of replacing her 5mg folic acid if her doctor won't help.

My mum's main symptoms are swelling of her knuckle and ankle joints and severe pain at times limiting movement but her symptoms are not constant, she has much better periods (which she struggles to link to anything) at times. She also gets periods of depression correlating with worsening symptoms.

I thought of the methylation protocol since she must share some of my (Cfs) genetics, and she also has asthma and allergies in common with me. Her mother is still alive and has severe asthma and recently had a stent fitted for heart disease.

Hi Harrycat,

The metafolin may be far more effective for your mother. The folic acid itself migh be casuing a lot of the inflammation and depression. With multi mg dses of mb12 and Metafolin, inflammation and CRP (C reactive protein, an inflmmation marker) plummets.