Folplex

Folplex is a dietary supplement that contains three B-vitamins: folic acid (B9) 2.2 mg; pyridoxine (B6) 25 mg; and cyanocobalamin (B12) 1 mg. Folplex is referred to as a ‘medical food’ because it is formulated to treat health conditions with specific nutritional requirements.

Each of the B vitamins in Folplex plays an important role in one-carbon metabolism, which is essential for nucleotide synthesis, homocysteine metabolism, neurotransmitter production, and many more processes.

• Folic acid is the synthetic form of folate that the body converts to tetrahydrofolate (THF), the active form required for DNA synthesis, homocysteine metabolism, and neurotransmitter production. 
• Pyridoxine is one of several forms of Vitamin B6 that is converted to pyridoxal 5′-phosphate (PLP), a cofactor involved in amino acid metabolism, neurotransmitter synthesis, hemoglobin production, and more. 
• Cyanocobalamin is the synthetic form of vitamin B12 (converted to methylcobalamin and adenosylcobalamin). B12 is required for homocysteine metabolism, cognitive function, red blood cell production, and myelin sheath maintenance.

Folplex is most often prescribed to treat or prevent deficiencies in B6, B12, or folate, or to treat conditions caused by these nutritional deficiencies such as hyperhomocysteinemia (elevated homocysteine), vascular conditions, and/or megaloblastic or macrocytic anemia.

These conditions are most common in pregnant women, children, or people with liver disease, alcoholic cirrhosis, intestinal strictures, and malabsorption syndromes, or those taking medications that interfere with folate absorption. It is often prescribed to those with end-stage renal disease, who are at high risk of hyperhomocysteinemia.

• Hyperhomocysteinemia
  Folate, B6, and B12 are all required for the conversion of homocysteine to methionine, and deficiency in any of these nutrients can lead to an accumulation of homocysteine in the blood. Excess homocysteine causes inflammation in the vascular system, increasing risk of coronary artery disease, thrombosis, stroke, and other vascular diseases. Folplex is designed to provide the three B vitamins involved in remethylation and transsulfuration pathways to assist in reducing homocysteine levels. Research shows that supplementation with these B vitamins can normalize homocysteine and reduce the risk of vascular conditions.¹
  
  
• Nutritional deficiencies
  People with malabsorption conditions due to digestive disorders (e.g., celiac disease, inflammatory bowel disease), genetic mutations, chronic alcoholism, the elderly, and/or taking medications that affect nutrient absorption or metabolism (e.g., methotrexate, certain antiepileptics) may be given Folplex to restore their levels of these B vitamins. However, their ability to absorb and utilize the forms of these vitamins within Folplex should be discussed beforehand.
  
  
• Anemia
  Folplex may be given to people with megaloblastic anemia resulting from B12 deficiency, which causes abnormally large red blood cells. This is usually an adjunct to B12 injections or other high-dose B12 supplementation.
  
  
• Diabetic neuropathy
  B vitamins play important roles in nervous system function, which are required for repair and maintenance of peripheral nerves.

Each Folplex tablet contains 2.2 mg folic acid, 25 mg Vitamin B6 and 1 mg Vitamin B12. Dosage for adults is usually 1 tablet per day.

Folic acid is a standard recommendation in pregnancy, usually as 400 mcg daily from pre‑conception through the first trimester. 

Folplex is a B-vitamin combination that contains 2.2 mg folic acid, which is significantly higher than the recommended daily intake during pregnancy, and should only be prescribed for women with specific deficiencies or health conditions.

Women are advised to consult their health professional regarding possible risks associated with high-dosage folic acid during pregnancy. As mentioned above, high intake of folic acid exposure has been associated with higher rates of gestational diabetes, hormone‑related cancers, and adverse neurodevelopmental outcomes.¹⁰