by Dr. Wally Schmitt

At Least 1 in 5 People Have This Deficiency

At Least 20% of Your Patients Have This

At least one out of five of your patients has a decreased ability to convert folic acid to its most important active form! Like all B vitamins, folic acid must be activated from dietary forms to its active, 5-methyltetrahydrofolate (5-MTHF) form. 

Recent genetic advances have revealed that 20% to 35% of the population does not make this conversion properly. This leaves the person vulnerable to any of the myriad effects of folate insufficiency unless the diet is supplemented with a 5-MTHF form of folate. We now have available folic acid in its active 5-MTHF form.

Folic acid is necessary in the synthesis of DNA, hence for the growth and repair of all tissues. It is necessary for the production of red blood cells and white blood cells, the synthesis of a number of amino acids, the synthesis of various neurotransmitters, the breakdown of histamine, and so on.

Folic acid, in its activated 5-MTHF form is also necessary for the conversion of homocysteine in the major methylation pathway of the body. Faulty methylation and elevated homocysteine are implicated in the development of heart disease, cancer, and neurodegenerative diseases including Alzheimer’s Disease and Parkinson’s Disease.

Deficiency of 5-MTHF folic acid is also implicated in birth defects such as neural tube defects (spina bifida, anencephaly) and orofacial defects (cleft lip and cleft palate). We have had patients respond to 5-MTHF with such diverse symptoms as chemical sensitivities, irritable bowel syndrome, mental and physical fatigue, autoimmune problems, recurrent infections, and so on. Patients with mental or emotional problems including depression often show a need for 5-MTHF. In fact, 5-MTHR is one of the first nutrients we test in any difficult patient, especially those who have seen other doctors with little results.

Laboratory Genetic Testing

It is possible, but expensive to perform laboratory analysis for the genes that encode for the production of the enzyme 5,10-methylenetetrahydrofolate reductase (MTHFR) that converts precursors into 5-MTHF. Single nucleotide polymorphisms (SNPs) of this gene exist in around 30% of the population and these patients will be candidates for 5-MTHF supplementation. 

Some of these patients can get by without 5-MTHF supplementation, and others cannot. About 10% of the population has homozygous (double allele) SNPs for MTHFR which means that they cannot product any 5-MTHF. By ethnicity, the patients with no MTHFR genes are 7.2% white, 18.2% Hispanic, and 3.8% Asian. These patients must take 5-MTHF supplements.

AK Testing For 5-MTHF

Using applied kinesiology manual muscle testing (AK MMT) procedures, we can readily identify patients who qualify for a trial with 5-MTHF. Identify a weak (inhibited) muscle using AK MMT testing. When the patient who needs 5-MTHF tastes a source of dietary folic acid, there will be no response in the muscle strength response. 

However, when tasting the 5-MTHF form, the muscle will strengthen. This suggests an inability to convert the dietary form of folic acid into its active 5-MTHF form. We also measure symptoms such as pain and limited ranges of motion with the patient chewing and tasting a 5-MTHF pill and holding it in the mouth. Positive changes in the pain or ROM indicator confirm the clinical need.

An Interesting Folic Acid Case

I have observed 5-MTHF make changes in about 30% of my patients, many of whom had never achieved this level of symptom improvement at any other time in their lives. The variety of symptoms that have been improved by 5-MTHF supplementation is extraordinary and it is worth checking in any patient who does not immediately respond or who presents with chronic health issues.

One of the most interesting responses we have seen with 5-MTHF was a 30 year old male patient with a history of chronic post nasal drip and frequent (minimum 4 times per minute) throat clearing. He had been a patient for about five years and nothing had helped this problem. He responded to oral 5-MTHF (we tried it just because nothing else was working) and his congestion and throat clearing problem was almost totally alleviated. He ran out of his supplement for five days and the symptoms returned full force. When he re-started the 5-MTHF, the symptoms resolved once again.


Methyl B-12 works hand-in-hand with 5-MTHF. Methyl B-12 and 5-MTHF are necessary in the pathway for the conversion of homocysteine (Hcy) back into methionine (MET) in the body’s major methyl donor pathway. Just as CoA moves two-carbon (and three-carbon) groups around the body, folate and B-12 move one-carbon groups around. 

A build up of Hcy is implicated in heart disease, cancer, and neurodegenerative diseases including Alzheimer’s (AD) and Parkinson’s (PD) diseases. When Hcy is not converted to MET, it is converted to homocysteic acid which is a neurotoxin contributing to damage and death of neurons. 

My experience is that this is an issue not only in AD and PD, but also in other neurological problems, both named and unnamed.
In another pathway, Hcy can be converted on to cysteine (CYS) and taurine (TAU) requiring P5P. TAU is an essential substance to protect the body from the free radical hypochlorite, and CYS is part of the most important molecule, glutathione. So when Hcy is not being metabolized properly, the body is jeopardized in many different ways: neurological, cardiovascular, and immune.

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