100
and eat highly fortified foods, which risks excessive consumption of folate. But folate is
non-toxic, so the effect should be the same as eating too many leafy green vegetables.
Weil recommends 400 mcg per day.
In contrast, one of the cited studies used 15-30 mg per day – 15,000 to 30,000 mcg. This
discrepancy is disturbing, and Berkeley Wellness’s concerns caution that the lower
dosages are more appropriate. Commenting on the discrepancy, Lake and Spiegel state
that there is evidence that people with affective disorders or schizophrenia may have
higher requirements. They recommend 1 mg (1000 mcg) per day and recommend that
folate be coupled with 2.4 mcg of B12 per day to avoid masking a B12 deficiency.- RESEARCH: More rigorous, randomized studies are needed to address important clinical
questions regarding the magnitude of the effect of folate compared with standard therapies
as compared across different oral folate doses and folate forms, including folic acid,
methylfolate, and folinic acid. Further investigation of possible predictors of response would
help identify the people most likely to benefit from folate supplementation. Genetic
variations require additional study, following up on the MTHFR gene studies. Gender
differences and the effect of folate supplementation in the absence of baseline folate
deficiency require concerted research. Long-term outcomes -- benefits and liabilities from
continuing treatment with folate, measuring precise folate levels through the treatment
cycle and comparative assessment with other drugs -- require further investigation, as do
the systematic tracking, reporting and quantification of adverse effects.
1
How to Use Herbs, Nutrients & Yoga in Mental Health Care, by Richard P. Brown, M.D. (of Columbia University
College of Physicians and Surgeons), Patricia L. Gerbarg, M.D. (of New York Medical College), and Philip R. Muskin,
M.D. (of Columbia as well) (W. W. Norton & Company, New York 2009), at 38.
(^2) Fava, M., Borus, J.S., Alpert, J.E., Nierenberg, A.A., Rosenbaum, J.F. & Bottiglieri, T., “Folate, Vitamin B12, and
Homocysteine in Major Depressive Disorder,” Am. J. Psychiatry 154(3):426-8 (1997).
(^3)
Bottiglieri, T., “Folate, Vitamin B-12 and Neuropsychiatric Disorders,” Nutrition Review 54(12):382-390 (1996).
See also the more comprehensive discussion in Bottiglieri, T., “Homocysteine and Folate Metabolism in
Depression,” Progress in Neuropsychopharmacology and Biological Psychiatry 29(7):1103-1112 (2005).