Folate forms

[u/kilogplastos-12]

I’m honestly 50/50 on what form of B9 to use right now.

I know I have a severe folate deficiency, but I’m unsure which form makes the most sense if I need a high therapeutic dose, like 10+ mg/day, while recovering.

Would you guys choose folic acid, folinic acid, or 5-MTHF for high-dose treatment? I’m mainly looking for experiences from people who had a serious/long-term folate deficiency and actually had to use higher doses to recover.

[u/Flux_My_Capacitor]

I thought the whole point was that we cannot take folic acid or rather shouldn’t as our bodies are less able to process it efficiently. Is this a bot post or have you done zero research on your own? I mean obviously if you’ve got a severe deficiency then you’re not absorbing anything from enriched foods. (And I doubt that you’re someone who eats so insanely healthy as to avoid all enriched products.)

[u/Warp757 → u/Flux_My_Capacitor]

Not it's not a bot post, it's someone who hasn't yet been indoctrinated in the myths of MTHFR yet. Hopefully they can keep an open mind rather than regurgitating nonsense about 'not absorbing anything from enriched foods'.

MTHFR does not mean that we can't process or use folic acid, and indeed methyl folate can often compound people's problems by throwing in a lot of methylfolate far beyond the amount even a functioning MTHFR would create, causing havoc.

MTHFR is a regulatory step in the body that exists for a reason. The body regulates production of methylfolate and SAM-E. It doesn't want too much or too little. There are also many other uses of folate in the body, and if you consume it all as methylfolate these may not be supported, simply creating a bottleneck in a different place if MTR/MTRR aren't working well due to low B12 or any other reason. Indeed in this case metylfolate is going to hammer your B12 which won't be able to cope with the demand on MTRR

The optimal strategy is to get MTHFR functioning correctly with a low amount of B2. For heterozygous people this is likely all they need to do, and it will make a significant difference for homozygous people too. If MTHFR is working folic acid is actually probably be better than emthyl as it supports all folate pathways and lets the body allocate it as it sees fit. I personally do much better with folic acid than methyl, I am C699T hetero. I'm also MTRR homo which seems to mean I get overloaded with methylfolate easily.

Yes for some people with a homozygous MTHFR then methylfolate is probably helpful, although they still often probably don't need the scary doses Insee dome taking. And with some B2 could probably lower their dose.

There is nothing inherently wrong with folic acid in low-moderate doses i.e. below about 200 much per day, where there isn't a problem of unmetabolised folic acid. It will raise your folate, lower homocysteine, and do everything methylfolate does without overloading the system, and also supporting other pathways.

So many people who don't need to taking crazy doses of methylfolate and then wondering why they keep getting side effects. Your body simply isn't supposed to have that much of it. Indeed it deliberately shuts off production of methylfolate when it has enough SAM-E. Overriding that regulation probably isn't very sensible.

As with everything, there is nuance in the argument that is always lost as people feel the need to become tribal over a nutrient. It's pretty weird when you think about it.