By Thomas L. Schwartz, MD
Dr. Keith Ablow reported this week on FoxNews about “A Vitamin That Fights Depression.” I’d like to comment on vitamins or neutraceuticals being used to treat depression. There are many complementary and alternative medicine (CAM) products advertised to treat depression, but only a few have actually begun the steps to prove that they actually work.
First, food sources in the USA are not held accountable like FDA approved drugs where they need to be shown to be safe and effective against a sugar pill. As a consumer of prescription and over the counter medications, food supplements, and nutraceuticals I really would like some proof that the things I take to treat my medical problems are both effective and safe. In this blog, I want to comment on one vitamin-type product that seems to be turning the corner from a good idea to a reasonable, almost proven treatment for depression.
Folate and L-Methylfolate (LMF)
1) Folate is an essential nutrient in our diet. It can be found in spinach, lentils, liver, asparagus, beans, and collard greens. Some research studies have shown that folate tablets can help treat depression, but these are small and poorly regulated studies. Hardly definitive proof…
2) Your liver takes the folate you eat in your diet and converts it to a special form of brain folate called L-methylfolate (LMF). However, your liver has the ability to only convert a little bit of regular folate into brain LMF at a time. Therefore you can eat all the spinach in the world but still only get little bits of LMF into your brain at a time.
3) Once in the brain, LMF has the theoretical ability to provide nerves with the ability to make more neurotransmitters such as serotonin. This boost in serotonin allows antidepressants that work by manipulating serotonin to have a greater chance to work their antidepressant mechanisms. LMF tablets are available by prescription now as they are considered a medical food, similar to prenatal vitamin classifications.
4) More stringent research studies that compare LMF to placebo sugar pills are being published and scrutinized, and it appears that adding LMF products to antidepressants may improve depression symptoms. These studies are preliminary in nature but are clearly better regulated and supportive in that LMF may be safe and help in the treatment of depression. Larger, 400 patient studies are needed to prove definitive antidepressant effects, but these current medium sized studies are promising.