Volume 6, Issue 12 March 21, 2013
Why folic acid supplements
may not cure your depression
The risk of depression increases dramatically with age. But why? Is it because older people have more stress and tragedy? There's no evidence to support that. I have seen many of my older patients become depressed even when there is absolutely nothing depressing going on in their lives.

The majority of the time, the cause of depression in the over 55 group is biochemical. And one of the major biochemical imbalances stems from a deficiency of the B vitamins. Now a new study points to what may be the main B-vitamin culprit. And the surprising thing is that the blood levels of this vitamin can be well into the normal range – and yet they're still not enough.

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Researchers at the Gerontological Research Program at the National University of Singapore wanted to find out more about depression. In particular, they wanted to see if older adults with depression also had low levels of vitamins B12 and the B-vitamin folic acid.

They rounded up 669 men and women over the age of 55. Then they measured their blood levels of B12, folic acid, and homocysteine. The reason they looked at homocysteine is because high homocysteine levels are an indicator of low B12 and folic acid levels.

Then they gave them a questionnaire called the Geriatric Depression Scale. You can find a copy of this questionnaire at http://www.chcr.brown.edu/GDS_SHORT
. Any score over 5 points indicates the likelihood of depression. Here's what they found.

Out of the 669 people, 178 (26%) of them scored over 5 points! I told you depression increased with age. The average blood folic acid level in this group was 21.5 nmol/L. The average blood level in the folks with scores less than 5 was 11% higher (24.0 nmol/L). But there's more to the story. And here's where it really gets interesting.

As the levels of folic acid became lower than 21.5, the chances of being depressed consistently increased. In fact, those with the lowest levels (less than 14.6) were 72% more likely to have the symptoms of depression then those with the higher levels. And the researchers found this to be true regardless of psychosocial issues, alcohol and smoking, sickness, nutritional status, depression-inducing medications, use of antidepressants, and even vitamin supplements! But here's the thing:

Any level of folic acid greater than 4.5 nmol/L is considered normal. So these changes were happening even in people with completely normal levels! How can that be?

In all likelihood it's because the people who were depressed were not able to convert their folic acid to the form that the body uses. The form your body uses is l-methyl folate. Unless your body converts your folic acid into methyl folate, it's the same as being folic acid deficient. Somewhere between 20-30% of people cannot make this conversion well. You can find out if you are in this group by asking your doctor to check a simple blood test called MTHFR.

If this test is positive and you are depressed, you should try taking some l-methyl folate. You can find this online. A good starting dose is 10 mg, twice a day. I would suggest at least a three month course. If your depression is not significantly improved by that time, look for other causes. And remember that regular folic acid supplements did not work in this study and may not for you either.

What about B12 and homocysteine levels? Were they helpful in the study? Homocysteine was not helpful at all. And B12 was associated only with depression when the blood levels were in the deficient range (less than 180 pmol/L). In that case, there was almost a three times higher risk of depression.

One last thought. All of the B vitamins work together. So if you are going to try taking some l-methyl folate for your depression symptoms, make sure to take an additional source of all the other B-vitamins at the same time. My best advice for that would be to take two scoops per day of my Super Immune QuickStart. I have loaded it up with very substantial doses of all the B-vitamins.

Finding your Real Cures,

Frank Shallenberger, MD

REF: Ng TP, Feng L, Niti M, Folate, vitamin B12, homocysteine, and depressive symptoms in a population sample of older Chinese adults. J Am Geriatr Soc. 2009 May;57(5):871-6.

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