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Supplements/Vitamin

Methylfolate (L-5-MTHF)

aka L-methylfolate · Quatrefolic · Metafolin

Bioactive folate that bypasses the MTHFR enzyme — preferred in MTHFR variants and pregnancy.

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Overview

Bioactive folate that bypasses the MTHFR enzyme — preferred in MTHFR variants and pregnancy.

Natural sources
  • Whole-food sources (animal products for fat-soluble and B-complex vitamins; produce for water-soluble vitamins)
  • Fortified foods (cereals, dairy, plant milks, nutritional yeast)
  • Multivitamins or stand-alone supplements in synthetic or food-derived form
Common forms
  • Capsule or softgel
  • Sublingual tablet or liquid
  • Methylated active form for sensitive individuals
  • Multivitamin matrix

Forms & variants of Folate (Vitamin B9)

Different chemical forms of Folate (Vitamin B9) behave differently. Browse each form's mechanism, bioavailability, and best-use context.

Mechanism of action

Skips dihydrofolate reductase and MTHFR — directly enters the methylation cycle as 5-MTHF.

Pathways
  • · Methylation cycle
  • · Homocysteine remethylation
  • · Monoamine synthesis (BH4)

Effects on the body

Supports
Augments SSRI response in depression
Decreases
NTDs in pregnancy

Organ system effects

Brain & CNS

Methylfolate (L-5-MTHF) modulates monoaminergic and GABAergic tone relevant to mood and anxiety regulation.

Reproductive

Methylfolate (L-5-MTHF) has documented effects on female reproductive endocrinology and cycle regulation.

Evidence-based benefits

Augments SSRI response in depression

Moderate evidence

Prevents NTDs in pregnancy

Strong evidence

Potential side effects

Common
  • · Anxiety/insomnia in overmethylators
Rare
    Serious

      Drug interactions

      Prescription medications (general)
      Always disclose Methylfolate (L-5-MTHF) use to your prescriber — additive, antagonistic, or pharmacokinetic interactions are possible.
      minor

      Supplement interactions

      Pairs well with
      • Methylcobalamin (B12)
        Methyl trap prevention.
      Avoid combining with

      No specific avoidances listed.

      Dosing & bioavailability

      Typical dose
      400–1000 mcg DFE
      Study range
      Up to 15 mg in depression
      Best form
      Most evidence is based on the capsule or softgel form.
      Timing
      Consistent daily timing recommended; split larger doses if GI tolerance is a concern.
      With food?
      Optional

      Where to buy

      Affiliate links — we may earn a commission at no extra cost to you. Amazon code supplementsch-20 is auto-applied at checkout. We don't endorse specific brands; verify third-party testing (USP, NSF, Informed Sport) before purchase.

      Scientific evidence9Show studies
      RCTAm J Psychiatry · 2012

      L-methylfolate as adjunct in SSRI-resistant depression

      Papakostas GI, et al.

      60-day RCT of L-methylfolate in MDD.

      Key findings

      Significant improvement in HAM-D scores vs placebo.

      Open study
      Systematic reviewPubMed (NLM) · 1970

      PubMed: Methylfolate (L-5-MTHF) — Augments SSRI response in depression

      Live PubMed search

      Live results for "Methylfolate (L-5-MTHF) Augments SSRI response in depression" across the PubMed/MEDLINE peer-reviewed index.

      Key findings

      Opens current human and preclinical literature matching Methylfolate (L-5-MTHF) and "Augments SSRI response in depression". Filter by RCT, meta-analysis, or year on the results page.

      Open study
      Systematic reviewPubMed (NLM) · 1970

      PubMed: Methylfolate (L-5-MTHF) — Prevents NTDs in pregnancy

      Live PubMed search

      Live results for "Methylfolate (L-5-MTHF) Prevents NTDs in pregnancy" across the PubMed/MEDLINE peer-reviewed index.

      Key findings

      Opens current human and preclinical literature matching Methylfolate (L-5-MTHF) and "Prevents NTDs in pregnancy". Filter by RCT, meta-analysis, or year on the results page.

      Open study
      Systematic reviewPubMed (NLM) · 1970

      PubMed: Methylfolate (L-5-MTHF) — randomized controlled trial

      Live PubMed search

      Live results for "Methylfolate (L-5-MTHF) randomized controlled trial" across the PubMed/MEDLINE peer-reviewed index.

      Key findings

      Opens current human and preclinical literature matching Methylfolate (L-5-MTHF) and "randomized controlled trial". Filter by RCT, meta-analysis, or year on the results page.

      Open study
      Systematic reviewPubMed (NLM) · 1970

      PubMed: Methylfolate (L-5-MTHF) — meta-analysis

      Live PubMed search

      Live results for "Methylfolate (L-5-MTHF) meta-analysis" across the PubMed/MEDLINE peer-reviewed index.

      Key findings

      Opens current human and preclinical literature matching Methylfolate (L-5-MTHF) and "meta-analysis". Filter by RCT, meta-analysis, or year on the results page.

      Open study
      Systematic reviewPubMed (NLM) · 1970

      PubMed: Methylfolate (L-5-MTHF) — pharmacokinetics

      Live PubMed search

      Live results for "Methylfolate (L-5-MTHF) pharmacokinetics" across the PubMed/MEDLINE peer-reviewed index.

      Key findings

      Opens current human and preclinical literature matching Methylfolate (L-5-MTHF) and "pharmacokinetics". Filter by RCT, meta-analysis, or year on the results page.

      Open study
      Systematic reviewPubMed (NLM) · 1970

      PubMed: Methylfolate (L-5-MTHF) — safety adverse events

      Live PubMed search

      Live results for "Methylfolate (L-5-MTHF) safety adverse events" across the PubMed/MEDLINE peer-reviewed index.

      Key findings

      Opens current human and preclinical literature matching Methylfolate (L-5-MTHF) and "safety adverse events". Filter by RCT, meta-analysis, or year on the results page.

      Open study
      Systematic reviewPubMed (NLM) · 1970

      PubMed: Methylfolate (L-5-MTHF) — dose response

      Live PubMed search

      Live results for "Methylfolate (L-5-MTHF) dose response" across the PubMed/MEDLINE peer-reviewed index.

      Key findings

      Opens current human and preclinical literature matching Methylfolate (L-5-MTHF) and "dose response". Filter by RCT, meta-analysis, or year on the results page.

      Open study
      Systematic reviewGoogle Scholar · 1970

      Google Scholar: Methylfolate (L-5-MTHF) — clinical evidence

      Live Scholar search

      Cross-database citation index for Methylfolate (L-5-MTHF) as it relates to "clinical evidence".

      Key findings

      Includes preprints, theses, and journal articles. Useful for tracking citation counts and follow-on work.

      Open study
      Educational use only. This profile is not medical advice. Consult a qualified healthcare professional before starting any supplement, especially if you take prescription medication or have a chronic condition.

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