Evidence supporting the use of: Vitamin B9 (methyltetrahydrofolate)
For the health condition: Dementia

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Vitamin B9, particularly in its active form as L-methyltetrahydrofolate (L-MTHF), has been investigated for its potential role in supporting or treating dementia, especially Alzheimer's disease. The primary rationale comes from the observation that folate deficiency is associated with elevated homocysteine levels, which are linked to cognitive decline and increased dementia risk. Some studies have shown that supplementation with folic acid or L-MTHF can lower homocysteine and, in some cases, modestly improve cognitive function in elderly individuals with mild cognitive impairment or early dementia. However, randomized controlled trials and meta-analyses have reported mixed results, with some failing to show significant cognitive benefits in established dementia.

The evidence for L-methyltetrahydrofolate specifically is limited, as most studies use folic acid. L-MTHF, being the bioactive form, may be more effective in people with genetic polymorphisms (such as MTHFR mutations) that reduce folic acid conversion. Despite plausible biochemical mechanisms and some positive findings, the overall body of evidence does not robustly support the use of Vitamin B9/L-MTHF as a standalone treatment for dementia. It may be beneficial in those with documented deficiency or elevated homocysteine, but not as a universal therapy.

In summary, while there is a scientific rationale and some supporting data, the evidence is inconsistent and generally weak (2/5), suggesting that B9 supplementation should be targeted rather than routine in dementia care.

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