An interesting article has been just released by the South African General Practitioner (SAGP), a peer-reviewed journal that publishes the contributions of local key opinion leaders and researchers. 

In a short flyover, the KOL Dr. Paulo de Valdoleiros has considered the role of elevated homocysteine levels in the pathogenesis of depression then reviewing the simple strategy to lower elevated homocysteine levels and benefit from improved molecular functioning and subsequent increased mental health.

Dr. Valdoleiros is a medical doctor with a passion for addressing the causes of physical and emotional dysfunctions, preventing the development of disease, and even reverse the course of the disease, wherever possible, by regaining or improving function.

As described by the article, homocysteine pathways have received considerable attention in recent decades regarding their association with psychiatric disorders. Dysfunctional clearance of homocysteine leads to hyperhomocysteinemia, which is both a marker for pathogenic processes as well as a cause of pathology the role of elevated homocysteine levels in the pathogenesis of depression.

In the Framingham Heart Study, homocysteine levels were correlated with age and correlated inversely with folate and vitamins B6 and B12 levels. Supplementation with folate, B6, and B12 normalizes homocysteine levels, in spite of mixed clinical outcomes. Nevertheless, as highlighted by the author, the main reasons for a poor clinical outcome upon supplementation are:

– the presence of genetic polymorphisms (estimated at about 50% of the population in the USA), 

– the intake of prescription drugs that either affect the methylation cycle directly or cause the increased consumption of the vitamins mentioned above by diverse mechanisms,

– more importantly, the supplementing of poorly bioavailable forms of the above vitamins.

Activated forms of vitamins do not only possess greater bioavailability but spare the body’s energy consumption in having to transform a form of the vitamin to the required chemical structure. 

About vitamin B9-folate, the author suggests the use of Quatrefolic®, since on the contrary of folic acid that cannot cross the blood-brain barrier unless it is converted to methyltetrahydrofolate (5-MTHF), Quatrefolic® is already the 5-MTHF, the biologically active form that is required for its activity in the methylation cycle. 

Commenting on the article Silvia Pisoni, Market Manager of Gnosis by Lesaffre, a said: “The genetic polymorphism of MTHFR is associated with decreased enzyme activity, and with less availability of active folate 5-MTHF. We are happy that people are becoming aware of the importance of active folate and talking about our Quatrefolic®.”

The South African General Practitioner (SAGP) journal circulates to general practitioners and family physicians in South Africa via Medicross and Intercare. 

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