L-5-Methyltetrahydrofolate (L-5-MTHF)

Vitaminwater-solubleModerate dose evidence

Also known as: L-methylfolate, 5-MTHF, levomefolic acid, methylfolate, L-5-methyltetrahydrofolate calcium, 5-MTHF glucosamine salt, (6S)-5-MTHF, Quatrefolic, Metafolin

Add to a formula

L-5-methyltetrahydrofolate is the main circulating form of folate and the form cells use directly for homocysteine remethylation, so it bypasses the MTHFR enzyme step that is less active in people carrying the common 677C>T variant. NIH ODS reports its bioavailability is equal to or greater than folic acid's. Supplements supply it as a calcium salt or a glucosamine salt (branded examples include Metafolin and Quatrefolic), and it is the folate of choice in methylation, prenatal, and mood-support formulas that want to avoid unmetabolized folic acid.

Research summary

Donates its methyl group to homocysteine via methionine synthase (B12-dependent) to regenerate methionine and tetrahydrofolate, feeding the SAMe methylation cycle.

Dosage

Daily amounts, of compound.

Lowest studiedTypical rangeHighest studiedUpper limit
400 mcg400–1,000 mcg1,000 mcg1,000 mcg

NIH ODS — UL of 1,000 mcg/day is set for folic acid from supplements and fortified foods; applied to this synthetic folate form as a conservative ceiling

Doses are mcg of L-5-MTHF salt as labeled; the folate content of the salt differs by form (calcium salt about 91 percent 5-MTHF by mass, glucosamine salt about 72 percent), so confirm the supplier's declared folate equivalence. FDA allows a 1.7 conversion factor to mcg DFE for 5-MTHF (or a supplier-established factor not above 1.7), so 400 mcg can be labeled up to 680 mcg DFE. Prescription L-methylfolate at 7.5 to 15 mg is a medical food regimen outside supplement dosing. Pair with vitamin B12.

Standardization: ≥98% (6S)-5-MTHF calcium or glucosamine salt; supplied neat or as 1% to 2% dilutions

Source material: synthetic

As supplied: Commonly supplied as a 1% to 2% dilution on a carrier for premixes (0.1 mg powder per mcg at 1%); neat salt is used at mg doses. Supplier dependent.

Forms of Folate

FormTypical doseElement %FormatsPrice
L-5-Methyltetrahydrofolate (L-5-MTHF)400–1,000 mcgCapsule, Tablet, Powder, Gummy, Liquid, Softgelhigh
Folic Acid400–800 mcgCapsule, Tablet, Powder, Gummy, Liquid, Softgellow
Folinic Acid (Calcium Folinate)400–800 mcgCapsule, Tablet, Powder, Liquidhigh

Format suitability

  • Capsule
  • Powder
  • Tablet
  • Softgel
  • Gummy
  • Liquid

The glucosamine salt is more water-soluble and stable than the calcium salt, which helps in liquids and gummies. Light- and oxygen-sensitive; protect and consider overage.

Formulation notes

Pair with methylcobalamin or cyanocobalamin. Same methotrexate and antiepileptic interactions as folic acid. Glucosamine-salt grades are typically shellfish-free (fermentation derived) but confirm allergen status.

  • Has an upper limit
  • Notable drug interactions

Sources

  1. Folate — Health Professional Fact SheetNIH ODS
  2. Folic acid and L-5-methyltetrahydrofolate: comparison of clinical pharmacokinetics and pharmacodynamics. (Pietrzik K, 2010)PubMed
  3. Folate, folic acid and 5-methyltetrahydrofolate are not the same thing. (Scaglione F, 2014)PubMed

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