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Pernicious Anaemia Society
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Folic acid and methylfolate

What amount of methyl folate (in mcg’s) should I take if I’ve been taking 5 mg of folic acid and I want to swap to methylfolate? Start with smaller amounts?

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5mg is dosage for treating a folate deficiency that has caused anaemia. Generally 400mcg of folic acid is okay as a treatment to maintain levels if you have an absorption problem. Unless you have had problems with folic acid I'd stick with it as it is generally just as effective and much cheaper than methylated forms. However, best source of folate is food - so worth checking that you are getting enough folate rich foods.


Thank you. I’m on B12 injections three times a week so taking folic acid 5 mg as well. Want to try methylfolate instead incase it works any better for me. If not will go back to folic acid. Do you know how much 5 mg FA is equivalent to in methylfolate mcg’s?


if you want the equivalent dose it will be 5mg. However I don't think it is advisable just to supplement at that level. Please speak to your doctor - or at the very least a pharmacist

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I use methylfolate to good effect as folic acid didn't work once I stopped taking methylcobalamin sublinguals to boost my hydroxocobalamin jabs (when I increased the hydroxocobalamin from 1mg to 1.5mg per day), suggesting my body wasn't methylating properly.

There are two parts to the product - the methyl bit which you only need if your body won't methylate properly and the folate bit which you can get from folic acid which is required by your body for many things, including making the B12 work.

If you have too much methyl you can get side effects and I get a headache that will not go for anything until I have apparently used up the excess methyl in my body... but if I stop taking the tablets altogether I get folate deficiency symptoms retuning, so if I get a headache from too much methyl I just take folic acid instead.

So the folate bit seems to work on a mgs of folate basis whether it is from methylfolate or folic acid. How much methylfolate as a percentage of this depends on how much methly group you need, if at all.

When I started taking it a couple of years ago when my system was horribly depleted I needed 4.8mg of methylfolate and got a further 0.8mg folic acid from my multivitamin and mineral supplement. As time has gone on and I have improved I only need about 3mg methylfolate (plus the 0.8 mg folic acid from the multivitamin and mineral supplement) and only sometimes need to top up my folic acid if I don't eat as much fruit and veg.

If it was me I would swap like for like in small amounts, see how I was for a few days and then swap some more. That way if it didn't agree with me it wouldn't take too long before it was out of my system and I was OK again.

Whenever you change something you should change it back at some point to see if you get a return of your old symptoms. If you don't get worse again then it probably was something else or you have effected a cure and don't need to do whatever the change you made.

Good luck with it!

PS Are you getting plenty of potassium, magnesium and iron? These are also needed in greater than normal quantity to make the extra B12 work, as are many vitamins and minerals which is why taking a broad spectrum multivitamin and mineral supplement can be beneficial.

Sorry this is badly written - I was sick and then had a folate depleting antibiotic a few weeks ago and I'm struggling to get my levels balanced again so I'm not on form. Please ask me again if you can't understand me!! 😁


There are not 'two parts'.

Methylfolate is produced in the body from methylenetetrahydrofolate by the enzyme methylenetetrahydrofolatereductase (MTHFR). Methylenetetrahydrofolate is made from tetrahydrofolate, which is absorbed from food or made from dihydrofolate. Dihydrofolate can be absorbed from food or made from folic acid.

Whether you start from folic acid or from tetrahydrofolate makes no difference whatsoever, all forms will need to be converted to tetrahydrofolate and then methylated.

Methylfolate is important for the conversion of homocysteine to methionine. To do this conversion requires both methylfolate and B12. The methyl group of methylfolate is transferred to the B12 and, from that, to homocysteine.

Some people have a problem with the MTHFR enzyme (a homozygous - two copies - mutation at the C677T nucleotide in the gene that makes the enzyme) that makes it less efficient at doing the conversion reaction. The reaction still happens, but the enzyme breaks down more easily. Most people can compensate just by making more of the enzyme. For them folic acid works just fine.

Others may find that supplementing with methylfolate instead of folic acid works better for them. I have the mutation (as do around 9% of the population) and I took methylfolate for a couple of years. Then I switched to folic acid for a few months.

At first I didn't notice any difference, but I switched back to methylfolate anyhow. Since then I've noticed various things that seem to be better. It's too soon to be sure, but I'm getting more and more convinced that I do better with methylfolate.

So suck it and see. Methylfolate is a little more expensive (so I go for the cheapest 400 mcg pills at Amazon) but other than that there's no reason why you shouldn't try it.


Thank you. I think i’ll Try a small amount and see how I go. Getting my head round the science of it is a bit of a challenge. ;)


Thank you,. Yes eating potassium and taking magnesium, b complex , prebiotic and iron(prescribed by gp). I appreciate your thorough answer.


I forgot to say I have tried several brands of methylfolate and do best with Solgar but it's more expensive. Folic acid doesn't seem to matter.


I try and use viridian or solgar but I bought harrows this time.


As I understand it you need folic acid to activate the B12, else it won’t work and that the folate should be on the top quarter of the range. I think i’ll Try a small amount and see how I go. Thank you.


Interesting thank you.


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