From the Research
The recommended daily dose of 5-MTHF for peripheral neuropathy is 3 mg, as it has been shown to improve cutaneous sensitivity in diabetic peripheral neuropathy when combined with methylcobalamin and pyridoxal 5'-phosphate 1.
Key Considerations
- 5-MTHF is the active form of folate, which plays a crucial role in methylation processes and nerve function.
- Individuals with MTHFR gene mutations may benefit from 5-MTHF supplementation, as they cannot efficiently convert folic acid to its active form.
- When taking 5-MTHF, it is best absorbed when taken with vitamin B12 (methylcobalamin form, 1000-5000 mcg daily), as these nutrients work synergistically.
- The bioavailability of 5-MTHF is higher compared to folic acid, with peak concentrations almost seven times higher after administration of 5-MTHF 2.
- A study on Malaysian women found that l-5-MTHF supplementation increased blood folate concentrations to a greater extent than folic acid supplementation 3.
Monitoring and Adjustments
- Start with a lower dose (1-3 mg) and increase gradually if needed, monitoring for improvement in neuropathic pain, tingling, or numbness.
- Some people may experience side effects like sleep disturbances or irritability at higher doses.
- 5-MTHF supplementation works best as part of a comprehensive approach that addresses underlying causes of nerve damage, and should be discussed with a healthcare provider before starting, especially if taking medications that affect folate metabolism.
Supporting Evidence
- A study on diabetic peripheral neuropathy found that combination therapy with L-methylfolate, methylcobalamin, and pyridoxal 5'-phosphate improved cutaneous sensitivity and reduced symptoms 1.
- A real-world patient experience trial found that patients with diabetic peripheral neuropathy treated with L-methylfolate-methylcobalamin-pyridoxal-5-phosphate achieved significant improvements in total symptom score and quality of life 4.