Evidence supporting the use of: Vitamin B9 (5-Methyltetrahydrofolate)
For the health condition: Miscarriage (prevention)

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Synopsis

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

Vitamin B9, specifically in the form of 5-Methyltetrahydrofolate (5-MTHF), is used to support miscarriage prevention based on scientific rationale rather than tradition. Folate is essential for DNA synthesis, repair, and methylation—critical processes in embryonic development. Folate deficiency is a well-established risk factor for neural tube defects and may also be associated with increased risk of miscarriage. Some women possess genetic polymorphisms in the MTHFR gene, which impairs the conversion of folic acid to its active form (5-MTHF), potentially leading to suboptimal folate status even with standard supplementation. Several observational studies suggest that periconceptional folate supplementation may reduce the risk of miscarriage, though the evidence is inconsistent and often confounded by other maternal health factors. A 2016 meta-analysis (Czeizel et al.) found an association between multivitamin supplementation (including folic acid) and reduced miscarriage risk, but direct evidence specifically linking 5-MTHF supplementation to miscarriage prevention is limited. Clinical guidelines universally recommend folic acid supplementation before and during pregnancy to reduce birth defects, but recommendations for 5-MTHF are primarily for women with MTHFR mutations. In summary, while there is a plausible biological mechanism and some supporting evidence for folate's role in miscarriage prevention, high-quality randomized controlled trials are lacking, and the specific benefit of 5-MTHF over standard folic acid for this indication is not yet established.

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