Proper
folate supplementation is required in order to ensure proper
folate concentration in the organism, and consequently to prevent the development of numerous complications in general population and pregnant women.
Metafolin (stable
calcium salt of L-5-methyltetrahydrofolate
acid, L-5-
MTHF) is the most active form of reduced
folate circulating in plasma, which directly enters the metabolic process of
folate. After administration
metafolin shows optimum absorption, comparable or higher bioavailability as well as physiological activity when compared to
folic acid.
Metafolin supplementation is effective in decreasing plasma
homocysteine, as well as increasing
folate in plasma and erythrocytes, in pregnant and breastfeeding women or those who wish to conceive. In addition,
metafolin administration omits the multistage process of reduction before entering the
folate cell cycle, as well as a possible deficiency of activity of
enzymes participating in the reduction of
folate process in the intestine epithelium (DHFR and MTHFR
enzymes). So far no potential adverse and toxic effects of
metafolin management have been reported. The published findings require confirmation in larger groups of patients and an additional analysis of the presence of particular genotypes of 677C > T polymorphism of the MTHFR gene. Analysis of the recent literature reposts suggests that
metafolin could be an effective and safe alternative to
folic acid supplementation and could effectively prevent complications in pregnancy and series
birth defects in fetuses and newborns.