Levomefolic acid

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Levomefolic Acid

Diagram of MTHFR metabolism

Levomefolic acid, also known as 5-methyltetrahydrofolate (5-MTHF), is the biologically active form of folate in the human body. It is the predominant form of folate in circulation and is involved in numerous critical biochemical processes.

Biochemical Role

Levomefolic acid plays a crucial role in the one-carbon metabolism pathway, which is essential for the synthesis of nucleic acids and the methylation of homocysteine to form methionine. This process is vital for DNA synthesis and repair, as well as for the regulation of gene expression through epigenetic mechanisms.

MTHFR Enzyme

The conversion of dietary folate to levomefolic acid involves the enzyme methylenetetrahydrofolate reductase (MTHFR). MTHFR catalyzes the reduction of 5,10-methylenetetrahydrofolate to 5-methyltetrahydrofolate. Mutations in the MTHFR gene can lead to reduced activity of this enzyme, affecting folate metabolism and increasing the risk of hyperhomocysteinemia and related health issues.

Clinical Significance

Levomefolic acid is often used in supplementation and fortification strategies to prevent folate deficiency and its associated complications, such as neural tube defects in newborns. It is also used in the treatment of hyperhomocysteinemia and certain types of anemia.

Folate Deficiency

Folate deficiency can lead to megaloblastic anemia, characterized by the production of abnormally large and immature red blood cells. Supplementation with levomefolic acid can help correct this deficiency and restore normal hematopoiesis.

Cardiovascular Health

Elevated levels of homocysteine, a condition known as hyperhomocysteinemia, have been associated with an increased risk of cardiovascular disease. Levomefolic acid helps lower homocysteine levels, thereby potentially reducing cardiovascular risk.

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Contributors: Prab R. Tumpati, MD