Folate (B9) and CFS Dosages and Results

After discovering some new facts on B12, I noticed that folate was often cited in the same articles. As with B12 — there are two versions, just like B12:

  • methylfolate
  • folate

There is no harm in taking methylfolate, but if you have the TT MTHFR genotype then plain folate will have little impact.

B12 / Folate Balance

The issue arises when B12 levels are low… from [2007] review: “Simply put, if your vitamin B-12 status is good, folate supplementation is good for you!

  • “Those with a low vitamin B-12 status (serum cobalamin <148 pmol/L) and high serum folate (>59 nmol/L) had an odds ratio for cognitive impairment of 5  [times higher] compared with those whose vitamin B-12 status and folate status were both normal. “
  • ” In agreement with current knowledge, they found that a low vitamin B-12 status is associated with macrocytosis, anemia, and cognitive impairment. “
  • “The “good news” is that, in subjects with a normal vitamin B-12 status, high serum folate (>59 nmol/L) was associated with protection from cognitive impairment. This finding is remarkable in a population with a much higher mean folate concentration (39 nmol/L) than that seen in countries where there is no mandatory folate fortification. “

Bottom Line

For methylfolate, a dosage between 6,000 mcg and 13,000 mcg have been tried with good results. Unlike Vitamin B12 (cost around $.06/day), looking at Amazon we are looking at a cost of $130+/day. With some brands, the capsules are just 400 mcg which means 15 –> 30 capsules per day. There is one brand that sells in 15mg (15,000 mcg) at $39.00 for a 30 day supply – that’s just one capsule per day.

  • A remarkable 81% of CFS patients experienced subjective improvement of their symptoms after treatment with folinic acid” [2006] [Full Text] “Folinic acid should be distinguished from folic acid (vitamin B9). However, folinic acid is a vitamer for folic acid, and has the full vitamin activity of this vitamin. ” [wikipedia]
  • NOTE: folinic acid dosage is much smaller that folate (folic acid) because it is bioactive.

Additionally, adequate Vitamin D3 supplementation (likely 15,000 IU/day for many) may be needed to restore natural B-vitamin production

My gut feeling is that 95% of CFS patients are taking less than the level required for a mild responder.

WARNING: Some people can respond with severe anxiety, see this external post.