Methylfolate and depression

...or how to B undepressed.

Folate is a B vitamin that occurs naturally in green leafy vegetables. It plays a host of important roles in the human body, and is so essential to the proper construction of the nervous system of a developing human that the FDA mandated in 1996 that its synthetic form--folic acid--be added to breads, flours, and other grain foods.

The trouble with folic acid supplementation or even naturally occurring dihydrofolate from food sources is that the body must convert them into the active form which is L-methylfolate (known as MTHF--yes, I thought of that word too the first time I read it). Some people are better MTHF producers than others. For purposes of our discussion, we will focus on the effects of MTHF deficiency and the fully developed brain.

The brain is tightly guarded by the 'blood-brain barrier.' Certain molecules can't pass through the blood vessel walls into brain tissue, and folate is one of them. MTHF, on the other hand, slips right in, and a right good thing it does because it is an important co-factor in producing the three most important neurotransmitters involved in mood regulation. If you're low on MTHF, studies suggest that you may subsequently run low on dopamine, norepinephrine, and serotonin. We're talking transmitters with a capital T that rhymes with D that stands for depression.

A host of research shows that supplementing methylfolate--thus skipping the necessary internal steps to activate folic acid--improves depression under a host of circumstances. This being an older person's health blog, let me illustrate with one study which supplied sad, old people with MTHF.

Researchers coaxed 20 elderly people who were not only Italian but also depressed to take 50 mg daily of MTHF rather than antidepressants. Four said the Italian equivalent of 'what's the use' and quit. The remaining subjects showed significant improvement in their depressive symptoms.

But you don't have to be old to enjoy the potential mood elevation of MTHF. A product called Deplin is now available by prescription and specifically indicated for use in patients having a less than stellar response to antidepressants. Theoretically, it might also be useful for persons with mild mood disorders not on other medications.

The basic science literature supporting the theory that MTHF improves brain function is large, but clinical research, except for the random Italian or so, is sketchy. Thus Deplin has been designated a 'medical food' which apparently does not have the stringent proof requirements of prescription drugs. Nevertheless, no adverse effects of MTHF supplementation have occurred, and a downloadable coupon at deplin.com makes this an affordable gamble of a therapy.