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Folate monoglutamates, including synthetic folic acid, are absorbed in the duodenum and upper part of the jejunum by the highaffinity protoncoupled folate transporter PCFT1, encoded by SLC46A1, where folic acid requires a further reduction reaction by dihydrofolate reductase (DHFR) and the riboflavin dependent enzyme, methylene tetrahydrofolate reductase (MTHFR), to form 5-methyl-tetrahydrofolate (5-MTHF)
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In these cases, a lower-dose approach may allow partial receptor engagement while clinicians monitor symptoms and metabolic markers
doi: 10.1001/jamaneurol.2019.4421 245 TiraboschiP.HansenL
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