Target intelligence / Profile preview

Levomefolic acid (5-MTHF) (5-MTHF)

Target
5-MTHF
Molecular classification
Folate vitamer (PubChem CID 135398501), Methyl donor (DrugBank DB06695), Metabolite (PubChem CID 135398501), Other
01

Overview

Levomefolic acid, also known as 5-methyltetrahydrofolate (5-MTHF), is the primary biologically active form of folate found in the human body and circulation (PubChem CID 135398501). It is a critical component of the one-carbon metabolism cycle, serving as the primary methyl donor for the conversion of homocysteine to methionine via the enzyme methionine synthase (DrugBank DB06695). Unlike synthetic folic acid, levomefolic acid does not require enzymatic reduction by dihydrofolate reductase or methylenetetrahydrofolate reductase (MTHFR), making it particularly effective in individuals with MTHFR genetic polymorphisms (StatPearls NBK554487). It is essential for DNA synthesis, repair, and methylation, as well as the synthesis of key neurotransmitters like serotonin, dopamine, and norepinephrine (PubMed PMID 24351014). Clinically, it is utilized as a medical food or supplement to manage folate deficiency, hyperhomocysteinemia, and as an adjunct therapy for major depressive disorder to enhance the efficacy of antidepressants (NIH Folate Fact Sheet). Its ability to cross the blood-brain barrier allows it to directly influence central nervous system function, distinguishing it from other folate forms (PubMed PMID 24351014).

Other names
5-MethyltetrahydrofolateL-methylfolate5-methyl-5,6,7,8-tetrahydrofolic acidMetafolinDeplinQuatrefolic
02

Mechanism of action

Levomefolic acid acts as a methyl donor in the conversion of homocysteine to methionine and serves as a precursor for tetrahydrobiopterin (BH4) synthesis, which is a necessary cofactor for the production of monoamine neurotransmitters (DrugBank DB06695, PubMed PMID 24351014).

03

Biological functions

One-carbon metabolism (PubMed PMID 24351014)DNA synthesis and repair (StatPearls NBK554487)Homocysteine regulation (DrugBank DB06695)Neurotransmitter synthesis (PubMed PMID 24351014)Methylation (PubMed PMID 24351014)
04

Disease associations

Folate deficiency (NIH Folate Fact Sheet)Hyperhomocysteinemia (StatPearls NBK554487)Major depressive disorder (PubMed PMID 24351014)Neural tube defects (NIH Folate Fact Sheet)Cardiovascular disease (StatPearls NBK554487)
05

Safety considerations

Masking of Vitamin B12 deficiency (cobalamin deficiency), which can lead to irreversible neurological damage (NIH Folate Fact Sheet)Potential reduction in the efficacy of anticonvulsant medications like phenytoin (DrugBank DB06695)Hypersensitivity reactions (DrugBank DB06695)
06

Interacting drugs

Methotrexate (DrugBank DB00563)

5 more in the full profile.

07

Biomarkers

Serum folate levels (StatPearls NBK554487)Red blood cell (RBC) folate (StatPearls NBK554487)Plasma homocysteine levels (StatPearls NBK554487)MTHFR C677T polymorphism (PubMed PMID 24351014)MTHFR A1298C polymorphism (PubMed PMID 24351014)

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