Several variables predict whether or not you are at risk for depression: genes (SNP in your MTHFR enzyme), ELA (early life adversity), obesity, and inflammation. These same factors predict that you will not respond well to antidepressants. What to do, what to do. First, consider whether you may have low central nervous system (CNS) folate levels (you likely do). Why this matters: L-methylfolate is a critical vitamin needed by your brain to transform amino acids (from dietary protein) into key brain chemicals (neurotransmitters) such as serotonin, dopamine, norepinephrine, and acetylcholine. If your brain folate levels are low, you cannot make sufficient neurotransmitters. If so, not even the best antidepressant will work optimally. You may get better, but will you get well?
Find out what the signs (fatigue, inflammation, pain, being overweight, and other sickness behaviors), causes (diet, inflammation, environmental toxins, lifestyle, genetic mutations), and risk factors (age, depression, medications, other medical conditions) for low folate.
Won’t the folic acid in your current multi-vitamin or B vitamin complex take care of this? Probably not. For many people with depression, they cannot convert this synthetic form of folate (or for that matter, they cannot convert dietary folate from green leafy vegetables) into the only form of folate – L-methylfolate - that can get through the blood-brain-barrier (BBB) and into their brains. You may be one of those.
For that reason, I (Dr. Dave) only use that specific form of folate: L-methylfolate. But be careful, not all L- methyfolate is the same. The two that I trust and use the most often, depending on your insurance coverage and whether I’m your personal physician or your health consultant, are Deplin and our own IP Formula’s Methyl Esssentials.
Deplin, a medical food, requires a prescription from your clinician, and if not covered by your insurance may make it unaffordable. It is of high quality made by a superb company supported by topnotch sales and marketing team. You cannot buy it directly, however.
I also trust our over-the-counter form of L-methyfolate: Methyl Essentials. It too is of very high quality, is competitively priced, is ideally dosed, and combines with it the most bio-active form of Vitamin B12 (methylcobalamin). This is particularly important in our elder patients and clients. Here are the specs on Methyl Essentials:
IP Formulas Methyl Essentials L 5 MTHF 6.5 mg & B12 2mg contains the most bio active form of L 5-Methyl folate and methylcobalamin-vitamin B12 and is the only form that crosses the blood brain barrier.
Increases production of dopamine, melatonin, serotonin, and DNA
It can be ordered online here: http://www.integrativepsychiatry.net/ip-formulas-methyl-essentials-l-five-mthf-btwelve.html