Those who take ordinary folic acid supplements, however, may not be experiencing its full spectrum of effects. This is because once ingested, not everyone converts folate to its biologically active form called 5-methyltetrahydrofolate (5-MTHF). Research shows that in a large proportion of the population, genetic enzyme deficiencies prevent the conversion of folate to 5-MTHF, leaving many vulnerable to low blood folate levels (and higher than desired homocysteine).

A more useful approach is to take the bioactive folate 5-MTHF directly, which has been declassified as a drug and is now available as a dietary supplement. 5-MTHF has been shown to dramatically raise blood serum folate levels compared with folic acid supplementation. This bioactive folate is up to seven times more bioavailable than folic acid. This greater bioavailability is especially important in people who have a genetic enzyme deficiency since it requires no conversion to become metabolically active.

A study of 10 patients with endothelial dysfunction showed complete reversal of endothelial impairment after 5-MTHF supplementation compared with healthy control patients.

People with elevated homocysteine levels have a greater risk of cognitive decline. Unlike folic acid, 5-MTHF is able to cross the blood-brain barrier to enhance brain synthesis of acetylcholine—the neurotransmitter associated with memory, which is especially important for people with cognitive difficulties. Studies also show that the effectiveness of 5-MTHF can be further enhanced by co-supplementing with methylcobalamin (the active form of vitamin B₁₂), vitamin B6, and riboflavin.

Suggested Use: Take one capsule daily with meals, or as recommended by a healthcare practitioner.