{"id":58155,"date":"2024-02-27T18:20:09","date_gmt":"2024-02-27T18:20:09","guid":{"rendered":"https:\/\/medsname.com\/tetrafol\/"},"modified":"2026-04-30T10:24:17","modified_gmt":"2026-04-30T10:24:17","slug":"tetrafol","status":"publish","type":"product","link":"https:\/\/medsbase.com\/nb\/product\/tetrafol\/","title":{"rendered":"Tetrafol"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div class=\"medsbase-tldr-answer\" style=\"background:#fff8d6;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<h3 style=\"margin-top:0;\">\u26a1 Raskt svar<\/h3>\n<p style=\"margin-bottom:0;\">Tetrafol (L-methylfolate 1 \/ 5 \/ 7.5 \/ 15 mg) is the bioactive form of folate (vitamin B9). Used as antidepressant augmentation in major depression, in MTHFR polymorphism carriers (~ 30% of population), and as a folate-deficiency replacement. Bypasses MTHFR enzyme \u2014 useful where folic acid (synthetic) is inadequately converted.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Hva du f\u00e5r med MedsBase:<\/strong> WHO-GMP-sertifisert produsent \u00b7 Diskret emballasje \u00b7 Verdensomspennende levering \u00b7 1 400+ verifiserte <a href=\"https:\/\/medsbase.com\/nb\/reviews\/\">kundeanmeldelser<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Hver ordre er dekket av v\u00e5r <a href=\"https:\/\/medsbase.com\/nb\/medsbase-re-shipment-assurance-policy\/\"><strong>Reshipment Assurance Policy<\/strong><\/a> \u2014 hvis pakken din ikke ankommer innen 20 virkedager, sender vi ny.<\/p>\n<h3>Hvorfor bestille fra MedsBase<\/h3>\n<p>Tetrafol at MedsBase is supplied directly from a WHO-GMP certified manufacturer in plain, discreet packaging. Every order is covered by our <a href=\"https:\/\/medsbase.com\/nb\/medsbase-re-shipment-assurance-policy\/\">Reshipment Assurance Policy<\/a> \u2014 20 virkedagers leveringsvindu eller vi sender p\u00e5 nytt uten ekstra kostnad \u2014 og kvalifiserer for v\u00e5rt <a href=\"https:\/\/medsbase.com\/nb\/loyalty-points\/\">kundelojalitetsprogram<\/a>. Verdensomspennende shipping er tilgjengelig til de fleste destinasjoner.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>Important \u2014 supplement, not a substitute for primary antidepressant therapy<\/strong><\/p>\n<p style=\"margin-bottom:0;\">L-methylfolate is augmentation therapy. It is <strong>not a substitute<\/strong> for an SSRI\/SNRI in major depression. The strongest evidence supports L-methylfolate as add-on to existing antidepressants in partial responders.<\/p>\n<\/div>\n<h2>What Tetrafol is and how it works<\/h2>\n<p>Tetrafol is an L-methylfolate (5-MTHF) tablet supplied by Sun Pharma. Available strengths: <strong>1 \/ 5 \/ 7.5 \/ 15 mg<\/strong>. L-methylfolate is the active form of folate that crosses the blood-brain barrier and serves as a methyl donor for the synthesis of serotonin, dopamine, and noradrenaline. Folic acid (the synthetic form found in most supplements) requires conversion by the methylenetetrahydrofolate reductase (MTHFR) enzyme \u2014 a polymorphism (C677T or A1298C) reduces enzymatic activity in approximately 30% of the population, producing functional intra-CNS folate deficiency despite normal serum folate.<\/p>\n<h2>Indikasjoner og dosering<\/h2>\n<table>\n<thead>\n<tr>\n<th>Indikasjon<\/th>\n<th>Typical dose<\/th>\n<th>Merknader<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>Antidepressant augmentation in MDD<\/td>\n<td>7.5\u201315 mg\/day<\/td>\n<td>Trivedi 2012, Papakostas 2012<\/td>\n<\/tr>\n<tr>\n<td>MTHFR-polymorphism carriers with depression<\/td>\n<td>7.5\u201315 mg\/day<\/td>\n<td>Higher doses sometimes used<\/td>\n<\/tr>\n<tr>\n<td>Folate deficiency (replacement)<\/td>\n<td>1 mg\/day<\/td>\n<td>For 3\u20136 months<\/td>\n<\/tr>\n<tr>\n<td>Cardiovascular health (homocysteine reduction)<\/td>\n<td>1\u20135 mg\/day<\/td>\n<td>\u2014<\/td>\n<\/tr>\n<tr>\n<td>Neural tube defect prevention (pregnancy)<\/td>\n<td>0.4\u20135 mg\/day<\/td>\n<td>Pre-conception and first trimester; folic acid generally preferred for cost<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>Viktige sikkerhetshensyn<\/h2>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>Mask vitamin B12 deficiency<\/strong><\/p>\n<p style=\"margin-bottom:0;\">High-dose folate (any form) can correct the megaloblastic anaemia of B12 deficiency without correcting the neurological deficit \u2014 masking the diagnosis and allowing irreversible neurological damage. <strong>Always check B12 status before high-dose folate.<\/strong><\/p>\n<\/div>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>Possible cancer signal at very high doses<\/strong><\/p>\n<p style=\"margin-bottom:0;\">Some observational data suggest very high folate intake may promote progression of pre-existing colorectal adenomas. Clinical translation: standard antidepressant-augmentation doses (7.5\u201315 mg) appear safe; mega-doses (&gt; 30 mg\/day) without indication are not recommended.<\/p>\n<\/div>\n<h2>Vanlige bivirkninger<\/h2>\n<ul>\n<li>Generally very well tolerated \u2014 placebo-like in most antidepressant-augmentation trials.<\/li>\n<li>Mild GI upset (nausea, bloating) \u2014 uncommon.<\/li>\n<li>Insomnia, irritability \u2014 rare; usually at high doses.<\/li>\n<li>Mood elevation in patients with bipolar tendency \u2014 rare but described.<\/li>\n<\/ul>\n<h2>Legemiddelinteraksjoner<\/h2>\n<ul>\n<li><strong>Metotrexat<\/strong> \u2014 folate antagonism is the basis for methotrexate&rsquo;s effect; high-dose folate can reduce methotrexate efficacy in oncology (less concerning in low-dose RA\/psoriasis use).<\/li>\n<li><strong>Antiepileptics<\/strong> (phenytoin, carbamazepine, phenobarbital) \u2014 these reduce folate; supplementation often warranted but high-dose folate can also reduce phenytoin levels.<\/li>\n<li><strong>Sulfasalazine, trimethoprim<\/strong> \u2014 folate antagonists; supplementation often warranted.<\/li>\n<\/ul>\n<h2>Graviditet, amming, pediatri<\/h2>\n<p>Pregnancy: folate supplementation is universally recommended pre-conception and through the first trimester. L-methylfolate is acceptable but folic acid is generally preferred for cost. Breastfeeding: compatible. Paediatric: weight-based dosing for deficiency.<\/p>\n<h2>Oppbevaring<\/h2>\n<p>Oppbevar ved 15\u201330 \u00b0C i originalemballasje.<\/p>\n<h2 id=\"faqs\">Vanlige sp\u00f8rsm\u00e5l<\/h2>\n<h3>How is L-methylfolate different from folic acid?<\/h3>\n<p>Folic acid is the synthetic form of folate found in most multivitamins. It requires conversion by the MTHFR enzyme to the active L-methylfolate form. Approximately 30% of people carry MTHFR polymorphisms (C677T or A1298C) that reduce enzymatic activity by 30\u201370%, producing functional CNS folate deficiency despite normal serum folate. L-methylfolate bypasses MTHFR \u2014 directly available for serotonin\/dopamine\/noradrenaline synthesis.<\/p>\n<h3>Will L-methylfolate help my depression?<\/h3>\n<p>The strongest evidence is for L-methylfolate as <strong>add-on to an existing antidepressant in partial responders<\/strong> \u2014 Trivedi 2012 and Papakostas 2012 both showed modest improvement at 15 mg\/day added to SSRIs. As monotherapy for depression, evidence is much weaker; do not stop your SSRI and replace with L-methylfolate.<\/p>\n<h3>Should I get tested for MTHFR?<\/h3>\n<p>MTHFR testing is widely available but the clinical utility is debated. The polymorphism is common (~30% of people are heterozygous, 10% homozygous), and L-methylfolate is safe \u2014 many clinicians simply give a trial of L-methylfolate to depressed patients with partial SSRI response without testing. Insurance coverage of MTHFR testing varies.<\/p>\n<h3>How long until L-methylfolate works?<\/h3>\n<p>Antidepressant augmentation effect typically appears at 4\u20138 weeks. Folate deficiency replacement: blood markers normalise over 3\u20136 months.<\/p>\n<h3>Is high-dose folate safe?<\/h3>\n<p>Standard antidepressant-augmentation doses (7.5\u201315 mg) appear safe in trials. Very high doses (&gt; 30 mg\/day) without specific indication are not recommended because of weak signals around cancer-progression risk in pre-existing adenomas.<\/p>\n<h3>Can L-methylfolate mask vitamin B12 deficiency?<\/h3>\n<p>Yes \u2014 like any high-dose folate, it can correct the megaloblastic anaemia of B12 deficiency without correcting the neurological deficit (peripheral neuropathy, subacute combined degeneration of the cord). Always check B12 status before starting high-dose folate. Older adults, vegans, and post-bariatric-surgery patients are at higher risk.<\/p>\n<h3>Can I take L-methylfolate with my SSRI?<\/h3>\n<p>Yes \u2014 this is the most-studied use. Standard combination is L-methylfolate 7.5\u201315 mg\/day added to an existing SSRI\/SNRI.<\/p>\n<h3>Is L-methylfolate the same as a B-complex vitamin?<\/h3>\n<p>L-methylfolate is the active form of vitamin B9 (folate). A standard B-complex contains folic acid (synthetic), not L-methylfolate. The two are different in patients with MTHFR polymorphisms.<\/p>\n<h3>Can L-methylfolate be used in pregnancy?<\/h3>\n<p>Yes \u2014 L-methylfolate is one acceptable folate form for pre-conception and pregnancy. Folic acid is generally preferred for cost in routine pregnancy supplementation; L-methylfolate is sometimes preferred where MTHFR polymorphism is known.<\/p>\n<h3>Are there side effects?<\/h3>\n<p>Generally placebo-like in trials. Rare reports of insomnia or irritability at high doses. Mild GI upset uncommon.<\/p>\n<h2>Andre psykofarmaka<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/nb\/lexaheal\/\">Lexaheal (Escitalopram SSRI \u2014 primary therapy)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nb\/flunil\/\">Flunil (Fluoxetine SSRI)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nb\/duvanta\/\">Duvanta (Duloxetine SNRI)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nb\/bupron-xl\/\">Bupron XL (Bupropion XL \u2014 NDRI)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nb\/mirtaz\/\">Mirtaz (Mirtazapine NaSSA)<\/a><\/li>\n<\/ul>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:18px 0;border-radius:4px;font-size:0.9em;\">\n<strong>Medisinsk ansvarsfraskrivelse.<\/strong> Denne siden er kun til informasjon og er ikke erstatning for individuell medisinsk r\u00e5dgivning. Behandling med psykofarmaka b\u00f8r startes, overv\u00e5kes og justeres av en kvalifisert lege. Hvis du eller noen du kjenner er i selvmordskrise, kontakt lokal akuttmedisinsk tjeneste umiddelbart, eller ring landets selvmordsforebyggende hjelpelinje (USA\/Canada: 988; Storbritannia: Samaritans 116 123; internasjonal liste: <a href=\"https:\/\/findahelpline.com\/\" rel=\"nofollow noopener\" target=\"_blank\">findahelpline.com<\/a>).\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Tetrafol (L-methylfolate 1\u201315 mg) \u2014 bioactive folate (vitamin B9) for antidepressant augmentation in MDD. bypasses MTHFR enzyme \u2014 useful in C677T\/A1298C carriers.<\/p>","protected":false},"featured_media":58156,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3342,3906],"product_tag":[4431,4432],"class_list":{"0":"post-58155","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-general-health","8":"product_cat-mental-health-and-psychiatric-medications","9":"product_tag-l-methylfolate","10":"product_tag-tetrafol","12":"first","13":"instock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/nb\/wp-json\/wp\/v2\/product\/58155","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/nb\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/nb\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/nb\/wp-json\/wp\/v2\/comments?post=58155"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/nb\/wp-json\/wp\/v2\/media\/58156"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/nb\/wp-json\/wp\/v2\/media?parent=58155"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/nb\/wp-json\/wp\/v2\/product_brand?post=58155"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/nb\/wp-json\/wp\/v2\/product_cat?post=58155"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/nb\/wp-json\/wp\/v2\/product_tag?post=58155"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}