Critical Care A Day
Friday April 16, 2021
Friday April 16, 2021
Q: What is the difference between folate, folic acid, folinic acid, and 5-methyltetrahydrofolate (5-MTHF)?
Answer: Although folate and folic acid are used interchangeably, technically they are different terms.
- Folate in actuality is vitamin B-9 and comes naturally from plant-based foods and fortified grains.
- Folic acid is the synthetic oxidized, water-soluble form.
- Folinic acid and 5-MTHF are also naturally occurring, and are reduced form of folate.
Clinical implications:
1. Folic acid, folinic acid, and 5-MTHF are all effective in treating folate deficiency.
2. Folinic acid has a special clinical advantage in preventing toxicities of methotrexate but potentiating the cytotoxicity of fluorouracil (a chemotherapeutic agent).
#pharmacology
References:
1. Scaglione F, Panzavolta G. Folate, folic acid and 5-methyltetrahydrofolate are not the same thing. Xenobiotica 2014; 44:480.
2. Kelly GS. Folates: supplemental forms and therapeutic applications. Altern Med Rev 1998; 3:208.