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l-methylfolate + methylcobalamin (brand name: Methyl Folate) is a combination nutritional and pharmaceutical supplement containing the active, bioavailable forms of Vitamin B9 and Vitamin B12. Developed and studied by Alexandria University, this combination is designed to target the homocysteine metabolic pathway. L-methylfolate and methylcobalamin serve as essential cofactors for the enzyme methionine synthase, which facilitates the conversion of homocysteine to methionine. By reducing elevated serum homocysteine levels (hyperhomocysteinemia), the supplement aims to mitigate cardiovascular risk factors and improve blood pressure control. It has been specifically investigated in Phase 4 clinical trials for the treatment of resistant hypertension (specifically 'H-type hypertension') in patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis.
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