Evidence supporting the use of: Folinic Acid
For the health condition: Birth Defects (prevention)

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Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Folinic acid (also known as leucovorin) is a form of reduced folate. Its use in the prevention of birth defects, specifically neural tube defects (NTDs) such as spina bifida and anencephaly, is based on its biological similarity to folic acid. Folic acid supplementation before conception and during early pregnancy is strongly supported by robust evidence to prevent NTDs. However, most scientific guidelines and studies specifically recommend folic acid, not folinic acid, for this purpose. Folinic acid is sometimes used in rare medical conditions where there is impaired folic acid metabolism (such as certain inborn errors of metabolism or after antifolate chemotherapy) and may be considered in women who cannot metabolize folic acid due to specific genetic variants (e.g., MTHFR mutations). A few studies have explored folinic acid supplementation in these special populations, suggesting it can also raise folate levels and potentially confer similar protective effects as folic acid, though large-scale trials for NTD prevention using folinic acid exclusively are lacking. Thus, while folinic acid is scientifically reasonable and used in specific circumstances, the bulk of direct evidence for NTD prevention involves folic acid. For the general population, folic acid remains the standard. The evidence rating reflects some support for folinic acid in niche situations, but less direct data than for folic acid.

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