Why don’t we care about folate?

The Little Vitamin With a Big Impact on Mental Health

If you’ve ever felt like you’re doing all the right things for your mental health — therapy, medication, good sleep, exercise — but you’re still stuck, the missing link might be something your provider hasn’t checked closely: folate.

Most people know folate (vitamin B9) as “that prenatal vitamin you take to prevent birth defects.”
But that’s only part of the story. Folate is actually one of the most important brain nutrients you’ll ever hear about — and most people, including many clinicians, don’t realize just how connected it is to mood, focus, resilience to stress, and even how well your medications work.

Folate’s Job in Your Brain: The Mental Health Connection

Think of your brain like a high-tech factory. Folate is the power source and toolkit the factory uses to:

• Make neurotransmitters like serotonin, dopamine, and norepinephrine — your “feel good,” “focus,” and “motivation” chemicals.

• Repair brain cells and keep your brain’s wiring in good shape.

• Help your brain adapt to stress by producing glutathione, your body’s “master antioxidant” that protects against inflammation and toxins.

• Support memory and learning by keeping DNA healthy and helping new brain connections form.

• Protect blood vessels in your brain and heart by lowering homocysteine, a harmful byproduct that damages vessel walls.

If your brain doesn’t have enough folate — or can’t use it properly — these systems slow down. You might feel more irritable, foggy, tired, unmotivated, or stuck in low mood.

Why a “Normal” Blood Folate Test Can Be Misleading

Here’s the part most people never hear:
You can have plenty of folate in your blood and still have too little in your brain.

That’s because folate has to pass through the blood-brain barrier — your brain’s security checkpoint. The main “door” is something called the folate receptor alpha (FRα). For folate to get in, it has to be in the right form (5-MTHF) and the “door” has to be working properly.

Things that can block or slow this process include:

• Folate receptor antibodies — immune proteins that block the receptor. These are found in up to 75% of children with autism, but can also occur in adults with autoimmune issues.

• MTHFR gene variants — these slow down your body’s ability to make the active form of folate your brain needs.

• Chronic inflammation — can damage the receptor and make transport less efficient.

So while your serum folate blood test might look normal, your brain folate could be running low — a condition called cerebral folate deficiency.

The MTHFR Gene: The Folate “Conversion Switch”

You don’t have to memorize “methylenetetrahydrofolate reductase” — that’s a mouthful. Just remember:
MTHFR is the enzyme that turns folate into its active form (5-MTHF).

If you have a common MTHFR variant (like C677T or A1298C), your body might make up to 70% less active folate. That means less fuel for making neurotransmitters, repairing brain cells, and producing glutathione.

The result can be:

• Higher homocysteine (increasing heart, stroke, and dementia risk)

• Lower neurotransmitter levels (affecting mood, focus, sleep)

• More oxidative stress (less protection against toxins and inflammation)

For some people, taking folate in its already-active form (L-methylfolate) or as folinic acid can make a huge difference.

Folate and Glutathione: Your Brain’s Antioxidant Shield

Glutathione is like your brain’s clean-up crew. It sweeps up damaging free radicals, protects your brain from toxins, and helps reduce inflammation.
Your body can only make glutathione if it has enough building blocks — and one of those key steps depends on folate.

When folate is low or can’t be activated:

• Homocysteine builds up instead of being recycled

• Cysteine production drops

• Glutathione levels fall

• Your brain is left more vulnerable to oxidative stress

Low glutathione has been linked to depression, bipolar disorder, autism, schizophrenia, and Alzheimer’s.

Who Should Care the Most About Folate

While everyone needs healthy folate metabolism, these groups should especially pay attention:

1. Women of Childbearing Age

   • Needed before and during pregnancy to protect the baby’s brain and spinal cord.

   • Supports mom’s mood and brain function during and after pregnancy.

2. Perimenopausal & Post-Menopausal Women

   • Hormone changes raise homocysteine and inflammation.

   • Folate can help protect memory, focus, and heart health during the transition.

3. Children & Adults with Autism

   • High rates of folate receptor antibodies.

   • Certain folate forms can improve language, behavior, and daily functioning in some people.

4. Those Concerned About Dementia

   • Low folate and high homocysteine speed up memory loss.

   • Folate supports blood flow and brain cell repair.

5. People with Depression or Anxiety

   • Low brain folate means fewer raw materials for neurotransmitters.

   • Medications may work better when folate status is optimized.

How We Look at Folate at Open Road Psych

If you’re struggling with mood, focus, or energy despite doing everything “right,” we look deeper than a basic folate test. We may:

• Check homocysteine — a better measure of folate function

• Look for MTHFR gene variants

• Test for folate receptor antibodies when indicated

• Recommend the right form of folate for your body

• Integrate folate support into a personalized mental health plan

The Bottom Line

Folate isn’t just for pregnancy — it’s for mental clarity, balanced mood, and brain protection at every stage of life.
If your brain isn’t getting enough, you might feel it in ways that look like “psychiatric symptoms” — but the root cause is biochemical.

At Open Road Psych, we treat mental health from the ground up — starting at the cellular level. Because when your brain gets what it needs, everything else works better.

Wondering if folate is the missing piece in your mental health puzzle?
Let’s find out together. Call us or book online to schedule your personalized evaluation.