More on the cancer risk and folic acid:

http://coloncancer.about.com/b/2009/...ancer-risk.htm

The data is piling up about this connection of high folate intake and risk.

Metanx can be useful for people with the MTHFR DNA mutation that prevents the body from properly methylating (activating) B12 and Folate. It is estimated that 1 in 10 people have this difficulty. However, when doctors give a FIXED combination of these 3 vitamins, the folate level becomes really high. Some doctors are telling patients to use 2 Metanx a day... and that puts people into 5.6 milligrams of methylfolate.

I can see a short period of time of use of this in MTHFR patients to relieve a deficiency. However, this dose has not been studied in depth as safe for long term use.

It is possible still that the connection of folate to colon cancer will not be cemented into fact. But young women with low risk have turned up with this cancer from taking regular folic acid in high amounts to prevent spina bifida in their babies. I have personally seen expectant mothers with high risk of this taking 5mg of folic acid daily in the recent past.

I searched alot this morning and cannot find out what the recall of Metanx in July 09 consisted of. This troubles me also.

This is why I think patients who need these nutrients in their active form, can find them themselves and taylor their doses accordingly.
Methylcobalamin is now appearing in some stores locally. And yesterday, a Puritan's Pride catalog came to my home, offering it as a new item! The reason I continually insist on taking this B12 ON AN EMPTY STOMACH is because studies of drugs used in microgram amounts orally have found that they can be lost in the fiber found in the digestive tract. This then causes them to not be optimally absorbed. Levothyroxine and digoxin now have recommendation to take on an empty stomach.
Hence, B12, which is also in microgram amounts, and needful of passive absorption in the intestine, should not be taken with food either, for best results. In people with intact normal acidic stomachs, who do not have failure of intrinsic factor, this is less critical. But I think that patients with neuro problems have them because something is not working right. So therefore, taking the B12 so it CAN be absorbed is best == empty stomach.

I have a B12 thread with medical links given on this thread. It has a link to a new B12 formulation coming out soon, with better absorption tested in studies. Please take a look at that thread.

The other two ingredients of Metanx, are available by NOW and
Solgar. Locally you may find them, in large health stores that carry a complete line of these two manufacturers. However, locally you can expect to pay more. Many of us here use iherb.com because they are fast, very much less in cost than local stores, and offer a vast array of quality products and don't charge high shipping rates. In fact for a long time they were the only place I could find methylcobalamin. But now this is becoming more common, and that feature is less dominant. I still purchase many unusual items from them today.
There are other discount vitamin suppliers now on the net. You could use them too, if you stick with the reputable brands I've suggested.
NOW's P5P is enteric coated, because P5P is not stable in stomach acid. I don't know if Metanx is enteric coated or not, so that is why I suggest NOW brand for it.