1. Neufol
(L-Methylfolate)
LMF is highly bioavailable source of folic acid. It is the
natural, active form of folic acid which is an integral
component of prenatal care, homocysteine
management, depression treatment, dementia and
cardiovascular concerns. LMF is a vitamin essential for
reproductive health.

2. Folic Acid
• Folate is the natural (complex) form found in foods
such as dark-green leafy vegetables, broccoli,
asparagus, lentils, beans, peanuts, strawberries,
kiwi, orange juice, liver.
• Folate in foods can be lost through processing and
cooking, reducing the amount of available folate.
• A diet rich in folate is important, however the
average daily intake of folate from foods is about
200 micrograms.
• Efficacy of folate absorption is estimated at 50%.
• So, of the 200 micrograms that are eaten, only about
100 micrograms are actually used by the body

3. Recommended Daily Value
• Adults (14-years and older) 400 mcg/d
• Pregnancy (all ages) 800 mcg/d
• Breastfeeding (all ages) 400 mcg/d
• Previously affected pregnancy 4000 mcg/d

4. Institute of Medicine
• Recommends all women of reproductive age
(capable of becoming pregnant) consume
400 mcg/d of folic acid from supplements or
fortified foods, in addition to a diet rich in
food folate.
• For women who have had a previous
affected pregnancy, folic acid
supplementation of 4 mg/d is recommended
(under physician supervision).

5. Functions
L-Methylfolate contributes to
•Maternal tissue growth during pregnancy
•Normal amino acid synthesis
•Normal blood formation
•Normal homocysteine metabolism
•Normal psychological function
•Normal function of the immune system
•Reduction of tiredness and fatigue
•Process of cell division

6. Neural Tube Defects
 Estimated 4,000 affected pregnancies yearly.
 About 2,500 babies born yearly.
 1,500 babies born with spina bifida.
 1,000 babies born with anencephaly.
 About 1,500 fetuses are miscarried or
terminated after diagnosis.

7. • Neural Tube Defects (NTDs) are birth
defects of the brain and the spinal cord.
• They occur when the neural tube, which
later becomes the brain and the spine, fails to
close properly.
• This happens very early in pregnancy,
between the 17th and the 28th day after
conception.

8. After the egg and the
sperm unite, cells divide
and multiply to form an
elongated structure as
seen in day 22.
A “zippering” effect
closes the groove or
the tube beginning in
the center and going
both up and down as
seen in day 23.

9. • A defect may occur in the upper or lower
portion of the neural tube.
• If the tube fails to close properly on the
upper portion of the neural tube, a brain
defect called anencephaly or another called
encephalocele occurs.
• If it fails to close properly along the lower
portion of the neural tube, a spinal defect
called spina bifida occurs.

10. Anencephaly Encephalocele

11. Spina Bifida

12. Additional Birth Defects
• Researchers are studying other potential
benefits of multivitamins containing folic
acid.
• Heart Defects
• Cleft Lip/Cleft Palate
• Limb Defects
• Urinary Defects

14. Folic Acid Knowledge
2003 Folic Acid Knowledge (All women 18-45y)
79%
21%
10%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Aware of folic acid Know it prevents birth
defects
Know to take it before
pregnancy
March of Dimes Folic Acid Survey conducted by The Gallup Organization, August 2003

15. • L-Methylfolate is the biologically active form of folic acid
• L-Methylfolate is the natural, active form of folic acid used at the
cellular level
• It bypasses several metabolic steps in the body as it is already present in
the absorbable form
• L-methylfolate is a Novel form of Folate
• More effective than folic acid
• L-methylfolate is a high absorbable form of folic acid
• L-methylfolate is the bioactive form of folic acid ready to use at cellular
level.
• Unlike regular folic acid, L-methylfolate does not require enzymatic
conversion to L-methylfolate in the body
• L-methylfolate is 7 times more bioavailable than folic acid
• L-methylfolate is less likely to mask a vitamin B deficiency compared to
folic acid
• L-methylfolate increases RBC folate better than folic acid
Advantages of L-Methylfolate

16. Clinical Applications
The active form of folate, LMF has been linked to benefits of augmenting
anti-depressant effect, addressing early memory loss, improving sensation
with diabetic peripheral neuropathy and reducing the risks of neural tube
defects.
Infertility and conception support
•LMF Deficiency precipitates hyperhomocysteinemia, a pro-inflammatory
state that is linked with poor sperm and oocyte quality, thereby augmenting
male and female infertility
•Supplementation of LMF in periconceptional period has been
demonstrated to improve sperm concentration and pregnancy rates in
studies involving assisted contraception.
•Genetic polymorphism of MTHFR enzyme has been observed in infertile
couples.
•LMF assures the optimal folate levels for conception in infertile men and
women where failure rates are very high

17. Cardiovascular Health
Folate is involved in critical enzymatic reactions
throughout the body. Deficiency of folate in the
body systems can lead to development of a
substance called homocysteine, responsible for
cardiovascular decline. LMF benefits
cardiovascular health by reducing the levels of
homocysteine

18. Diabetic Neuropathy:
Diabetic peripheral neuropathy (DPN) has been
estimated to affect roughly half of all patients with type 2
diabetes mellitus. Elevated levels of homocysteine and
reduced bioactivity of nitricoxide induce endothelial
dysfunction, endothelial injury, and may impair
vasodilation in patients with diabetic neuropathy. LMF
has been shown to be more bioavailable and effective in
lowering homocysteine levels than naturally occurring
folic acid when combined with methylcobalamin and
pyridoxal 5 phosphate. In this combination, LMF has been
found to be effective for alleviating signs and symptoms
of DPN, including anaesthesia, motor neuropathy,and
autonomic neuropathy
.

19. Depressive disorders
Lower systemic levels of folate can result from
poor dietary intake, diabetes, various
gastrointestinal disorders, hypothyroidism,
renal failure, nicotine dependence,alcoholism,
and a particular genetic polymorphism
prevalent in 70% of depressed patients

20. Folic acid may prevent hypertension
• Researchers from Brigham and Women's
Hospital in Boston found that women who
consumed high levels of the B vitamin from
food and supplements significantly reduced
their risk of developing hypertension.
JAMA. 2005;293:320-329.

21. L-Methylfolate References
• Depressed patients with low RBC folate are 6 times more
likely not to respond to antidepressant therapy and less
likely to achieve remission.
Journal Clin Pharmacology 2003
PsychiatryResearch,2005;140(3):301-7
• Low serum or low red blood cell folate levels have been
reported in 15%-56% of depressed patients.
Nutrition Reviews, 1997
Journal of Psychopharm; 2005
• The severity of a depressive episode, length of an episode,
and later onset of clinical improvement are inversely
correlated with RBC folate levels. J of Affective Disorders, 1989

22. • Depressed patients with low RBC folate are associated with
impairment in the synthesis and release of monoamine
neurotransmitters: serotonin, norepinephrine, and dopamine
Bottiglieri T, Prog in Neuro-Psychopharm & Bio Psych, 2005
• Higher folate levels in patients taking SSRIs and TCAs
predicted a better response, but the trend was stronger with
SSRIs
Journal Clin Pharmacology 2003
• Methylfolate in depressed patients show significantMethylfolate in depressed patients show significant
improvementimprovement
((Guaraldi et al., 1993; Di Palma et al., 1994;
Glória et al., 1997; Passeri et al., 1993)