Evidence supporting the use of: 5-methyltetrahydrofolate glucosamine
For the health condition: Miscarriage (prevention)

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

5-methyltetrahydrofolate glucosamine (5-MTHF) is the active, bioavailable form of folate, often used as a supplement, especially in individuals with genetic polymorphisms (such as MTHFR mutations) that impair the conversion of folic acid to active folate. Folate is critical in DNA synthesis, repair, and methylation, processes essential for embryonic development and placental function.

The prevention of miscarriage with folate supplementation is primarily supported by its proven ability to reduce the incidence of neural tube defects (NTDs) and some evidence that low folate status is associated with increased risk of pregnancy complications, including miscarriage. However, direct evidence that 5-MTHF (or any form of folate) supplementation specifically prevents miscarriage is limited and inconclusive. Some observational studies have suggested an association between low maternal folate and increased miscarriage risk, but randomized controlled trials focusing on miscarriage prevention as a primary outcome are lacking. The use of 5-MTHF rather than folic acid is based on its superior bioavailability in certain populations, not on direct evidence of miscarriage prevention.

Thus, while there is a scientific rationale for ensuring adequate folate status in early pregnancy, the evidence specifically supporting 5-MTHF supplementation for miscarriage prevention is weak. Current clinical guidelines universally recommend folic acid or folate supplementation for all women planning pregnancy, but the primary focus remains on NTD prevention rather than miscarriage.

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