Is calcium levofolinate pentahydrate more effective than folic acid in young healthy women before conception?

Purpose of investigation: To assess whether l,5-formyl-tetrahydrofolic (levofolinic acid, LV) is better than folic acid (FA) to increase serum folate and to reduce homocysteine in healthy young women during reproductive age. Materials and Methods: Folate deficiency is related to a number of pregnancy complications. FA is a synthetic compound that has no biological functions unless it is reduced to tetrahydrofolate. Supplementation of an active form such as LV, could be a better alternative. The authors performed an 8-week 1:1 randomized, open label clinical trial in 40 healthy women aged between 18-40 years, with daily 4 mg LV or 400 mcg FA supplementation. Results: Serum folate were increased after LV or FA supplementation, as compared to baseline, without any significant differences within the two groups (p = 0.8). Homocysteine levels were reduced in both groups, by 31.6% (p < 0.001) and 26.3% (p < 0.001) respectively, however the reduction was much relevant in the LV group (p < 0.001). Conclusions: Supplementation with LV seems to be more effective to reduce homocysteine levels.