Folic Acid and Neurotransmitters
Folic acid is required for the production of many neurotransmitters, including serotonin. Folic acid deficiency is common among people with depression and people with low folate status or low dietary intake of folate have a higher risk of depression.
Folic acid must be converted to its active form to be used by the body. This is a multi-step biochemical process that occurs in the intestines and liver. Any dysfunction in the intestines or the liver may impeded the conversion of folic acid into its active form. In addition, up to 60% of the U.S. population may have a genetic enzyme defect that makes it difficult for them to convert folic acid into its active form (called 5-methyltetrahydrofolate or 5-MTHF). Therefore, it is best to use the active form – 5-MTHF – for folate repletion.
Research indicates that taking 500 mcg/day of folic acid may reduce depression, especially in women taking conventional antidepressants. Folic acid depletion is common with many medications, including:
- Carbamazepine (Tegretol)
- Metformin (Glucophage)
- Phenobarbital (Luminal)
- Sulfasalazine (Azulfidine)
- Triamterene (Dyrenium)
- Valproic acid (Depakote)
Note, folic acid therapy can mask vitamin B12 deficiency; you should have your B12 levels checked before starting folic acid therapy.