Very briefly, my situation is that I am supplementing daily with 5000 mcg of oral methylcobalamin for a demyelinating condition. My blood tests showed I was low in B12 but high in folate.

I’ve been reading about the MTHFR mutation that you’ve mentioned on other threads. I haven’t been tested genetically for it, as my neurologist didn’t think it was necessary, but I’m thinking it may be safer to assume I have it and begin with methylfolate supplementation.

Right now I am taking 400 mcg of folic acid daily which is included in my multivitamin. I’ve read elsewhere that 400 mcg is the maximum dosage a person should take because of the possibility that high doses of folic acid may lead to cancer. I’m assuming that there is no such 400 mcg limitation on the amount of methylfolate that can be consumed safely, is this correct?

Would you have a recommendation on how much methylfolate is reasonable for me to take daily along with my 5000 mcg of methylcobalamin and 400 mcg of folic acid? I’m thinking of buying the Solgar brand of methylfolate, and iHerb now carries it in doses of 400, 800, or 1000 mcg.

My concern with dosages is that I want to take enough methylfolate to make the methylcobalamin effective, but not so much that I could develop a folate overdose.

Thank you!!

Folic acid itself is not active.... it has to be methylated in the body.

But there are some papers suggesting that folic acid floating around in the blood will compete for methylfolate at the blood brain barrier (BBB). This has not been 100% verified, but the MTHFR experts suggest avoiding folic acid. This is discussed at MTHFR.net.

It is quite common for folate to test high when B12 is low. This is called the methyl trap... which is complex to understand.
The biggest danger is having extra folate supplements when B12 is low because they mask the nerve damage because of the B12 lack. This is why 1mg or more of folic acid is RX. Deplin is RX and methylfolate approved by the FDA for depression...so that is certainly higher than any supplemental need.
Metanx -- the RX neuropathy formula has 3mg of methylfolate in each tablet/capsule.

I usually suggest 800mcg of Methylfolate tops to go with the methylcobalamin. We have seen on the PN forum people who come here have failed to get adequate help from doctors, and those who decided to do the 23andme DNA testing have all come back with various mutations in COMT and MTHFR.

If you continue with your multivit... space it away from any methylfolate. This might reduce competition at the BBB. That is all I can offer. Our food in the US is also fortified...so you get folic acid that way too. At this time, it is unclear just how important this competition is.

The methylfolate (MetaFolin by Solgar) doesn't have any food restrictions like the B12 does...so you can take it any time of the day.

I find myself highly stimulated by methylfolate...so I cannot take it every day... or I do NOT sleep! I take it once or twice a week. But I have not seen others complain about this.

Hi mrsD, thanks so much for your very quick response!

Well, I probably have more research to do before deciding on a beginning methylfolate dosage. I read through some of the articles on mthfr.net, and one of particular interest to me was an article on methylfolate side effects:

http://mthfr.net/methylfolate-side-effects/2012/03/01/

From what was said, it seems that it may be a good idea to start at a low dose, monitor results, then gradually increase to the 800 mcg level.

I would be interested in hearing the experiences of other people on the board who have supplemented with both methylfolate and methylcobalamin – dosages, benefits, side effects? Thanks in advance to anyone who responds!

You might think about every other day or every 3rd day dosing too. IF you are a MTHFR candidate, it will take time to build up with supplements.

You know that Deplin 7.5mg (methylfolate) -- such a high dose--- never really worked for the reasons it was approved...for depression.
I read many depression forums where the patients just hated it.
Called it useless.

I'd do the B12 daily however, as it is much more critical.

I do know that I just cannot take methylfolate every day.
I also use B-right by Jarrow, though, and it 3 times a week.
I've never confirmed MTHFR for myself. My B12 has been high without vitamins... 849. With 5mg of methylB12 daily for 3 months it went up to 1999!. I don't think I have the polymorphism myself.

For a while Merck refused to sell methylfolate OTC anymore and so it was not available. But about 5 yrs ago they changed their minds when Deplin failed, and now it is back OTC by several makers. Merck make all the raw vitamin and licenses it out to various makers.(including some RX ones)

Thanks for all of the additional information. I particularly like your suggestion of not dosing every day, so if I go forward with this, I may start with a 400 mcg dosage every other day and see how it works out.

Is there no one else here that is taking methylfolate with methylcobalamin (B12)?

mrsD, there is a multivitamin from Natural Factors that lists under its ingredients “Folate (folic acid) .... 1000 mcg”. You get the 1000 mcg dosage if you take three capsules: http://www.iherb.com/Natural-Factors...&sr=null&ic=44

Would you interpret this terminology as being synonymous with just folic acid, or do you think it is a blend of the two? In your experience, if it is a blend is it likely to be an equal blend, or weighted more toward the folic acid side? Thank you!!

I think this is old folic acid only.

For a while Methylfolate was not available to OTC makers.

So most mixes are the old folic acid. They would have a huge batch made, and to change that would be expensive for them.
Also the cost of methylfolate is pretty steep... Single content methylfolate OTC tabs now, are rather pricey.

Makers of mixtures of vitamins do two things in general.
1) try to keep the size of the tablet/capsule as small as possible.
2) keep the costs down.

Usually when a mixture occurs, the nice active part of it is the smallest in size. The cheapest (and usually the older form in the mix) is usually the main ingredient.

Thus when you see magnesium (from magnesium oxide, citrate and glycinate) you can count on the majority to be Oxide.

I have called makers on this, and they cannot answer how much of each is in their product typically when a mix is on the label (like with magnesiums).

Thanks for all of the information! I kind of suspected that the content was probably all folic acid.

I’ve been doing some searching for multivitamins that contain folate instead of folic acid, and they are apparently few and far between. Life Extension does carry a product containing folate which is described as” folate from lemon extract (peel)”: http://www.iherb.com/Life-Extension-...3&sr=null&ic=1

Hi again mrsD,

I’m thinking about postponing the addition of folate to my regimen. Although it would probably make my B12 supplementation more effective, it would probably also make my low potassium situation even worse than it already is (muscle spasms and skipped heartbeats).

From your experience, is it possible from food sources alone to elevate potassium levels to the point where the side effects become negligible?

Also, with my demyelination condition, what risk am I taking if I never supplement with folate?

Thank you!!

Just because you take B12 does not mean you will have lowered potassium.

If your MCV was high normal or out of range, or you had anemia, then yes, potassium becomes an issue.

If you have easy access to doctors, you can get tested for potassium levels. Then you would know more.