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Folinic acid for chronic fatigue syndrome and fibromyalgia.

Forty-two patients (aged 19-64 years) with chronic fatigue syndrome, with or without fibromyalgia, received 25 mg of folinic acid three to four times per day for one to two months. Thirty-four patients (81%) reported a significant increase in energy level and a reduction in pain within two months. No adverse effects were reported. Responses were seen both in patients with primary fibromyalgia and fatigue and in those whose condition was associated with other diseases such as rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, or multiple sclerosis.

Comment: Folinic acid (5-formyl tetrahydrofolate) is an activated form of folic acid. In certain circumstances, when the conversion of folic acid to its active forms is blocked, folinic acid is an effective treatment even though folic acid is not. In addition, some people have a defect in the transport of folic acid across the blood-brain barrier into the brain, because they make antibodies that block the folate receptors in the choroid plexus. In those people, treatment with folinic acid corrects cerebral folate deficiency by bypassing the folic acid transport mechanism. There is no clear evidence that people with fibromyalgia or chronic fatigue syndrome have a defect in folic acid absorption, transport, or utilization. However, considering the apparent effectiveness of folinic acid in the treatment of these conditions, such a possibility should be investigated. Controlled trials are needed to confirm the efficacy of folinic acid.

Lundell K, et al. Clinical activity of folinic acid in patients with chronic fatigue syndrome. Arzneimittelforschung. 2006;56:399-404.
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Title Annotation:Literature Review & Commentary
Author:Gaby, Alan R.
Publication:Townsend Letter
Article Type:Brief article
Geographic Code:1USA
Date:Feb 1, 2008
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