Composition 
Active ingredient:1 tablet contains 400 mcg of L-5-methyltetrahydrofolate (in the form of L-methylfolate calcium salt). 
Auxiliary substances:microcrystalline cellulose, colloidal silicon, magnesium stearate.

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Product information
L-5-MTHF (L-methylfolate) contained in Metifol tablets is the natural and biologically active form of folic acid that is the predominant (98% folate) found in human blood. Folate or vitamin B9 is one of the 13 essential vitamins - it is not produced in the human body and can only be obtained from the outside. L-methylfolate, unlike folic acid, does not undergo the action of enzymes for activation and is directly involved in the folate cycle after ingestion. Tetrahydrofolate is a precursor of tetrahydrofolic acid, which is a coenzyme of various metabolic processes, ensures the physiological division and normal growth of all cells in the human body, participates in metabolism, performs many functions, and is also important for neutralization of toxic products of metabolism. It participates in the synthesis of amino acids (including methionine, serine, glycine and histidine), nucleic acids, purines, pyrimidines, choline metabolism in the liver, prevents fat infiltration.
The body's demand for folates increases especially during pregnancy. Folates protect the body from the effects of teratogenic factors during pregnancy, ensure the normal growth and functioning of the couple, play an important role in the normal formation of the nervous system of the embryo, and prevent the development of neural tube defects. Folate levels are very important for all women planning pregnancy, and its intake is recommended several months before conception. It plays a major role in the development of the neural tube, which is involved in the formation of the spine and brain of the fetus, and also stimulates cell division and contributes to the proper development of other organs of the embryo. The foundation of the neural tube is laid from the first days of fertilization. Folate deficiency during pregnancy primarily affects the nervous system of the fetus. As a result, neural tube defects in the fetus and hydrocephalus, anencephaly (absence of the brain), brain herniation, spina bifida, etc. in the future. serious defects may develop. Also, folate deficiency causes retardation of mental and physical development. In addition, the lack of vitamin B9 during pregnancy causes hestosis of pregnancy in women, premature (frozen) pregnancy, miscarriage (miscarriage), lack and rupture of twins, premature birth, anemia,   and "rabbit lip" in babies "worm mouth" is dangerous due to the occurrence of cardiovascular defects. Folates play an important role in protecting women's health: they regulate the hormonal background in women, reduce the symptoms of premenstrual syndrome, such as high irritability, crying, sleep disorders, apathy, and also delay the onset of menopause. L-methylfolate is involved in the normalization of the level of homocysteine in the blood (an increase in the amount of homocysteine causes damage to the vessel walls and the development of atherosclerosis). Folic acid deficiency in adults can cause heart attack, stroke, oncological diseases, and anemia. Folic acid is also necessary for the balance of the neurotransmitters noradrenaline and serotonin in the nervous system (noradrenaline promotes alertness and serotonin helps maintain healthy sleep and high mood). Folate, together with vitamin B12, participates in the process of hematopoiesis, stimulates erythropoiesis, is important for the normal maturation of megaloblasts and the formation of normoblasts. Folate deficiency negatively affects the bone marrow, which is the main blood-forming organ, and leads to the development of megaloblastic (macrocytic) anemia. 
Folate deficiency can cause ulcers on the mucous membranes, indigestion and intestinal infections. The calcium salt of L-5-MTHF (L-methylfolate) is the most biologically active form of folate. In the body, calcium is broken down into L-methylfolate calcium ions and 5-MTHF. Because it is a metabolically active substance, unlike folic acid, it is absorbed better, accumulates in a higher concentration in the blood plasma and has a faster effect. No additional enzymatic reactions are needed for complete absorption. The absorption of L-methylfolate is almost 100%. 
It is absorbed into the blood without the participation of intestinal enzyme systems, is directly absorbed by cells, participates in metabolic processes and significantly reduces the risk of cardiovascular, malignant diseases, cognitive disorders, pregnancy complications and fetal developmental defects.  

Instructions for use  
It is recommended as an additional source of folic acid in the following situations: 
- Treatment and prevention of macrocytic anemias, including in pregnant women 
- Preparation stage for pregnancy
- Prevention of defective development of the fetus, disruption of pregnancy during pregnancy 
- Treatment and prevention of folic acid deficiency and anemia during lactation
- Prevention and complex treatment of cardiovascular diseases 
- Malabsorption syndrome, celiac disease, metabolic disorders fol 
  acid deficiency
- Chronic hemorrhages (gastrointestinal, bladder, hemorrhoidal, etc.)
- In the complex treatment of liver diseases
- Certain medicines (anti-epileptics, combined oral contraceptives,
  cytostatics) disturbance of folate metabolism
- When the excretion of folic acid from the body is high (for example, against the background of alcohol addiction,
  during hemolytic anemia)
- Anemias caused by ionizing radiation, chemicals, including drugs 
  and leukopenias
- Megaloblastic anemias due to resection of a part of the stomach or intestine, intestinal tuberculosis and chronic gastroenteritis       (without anemia in these diseases) is also recommended for use)

Contraindications
Individual hypersensitivity to any component of the preparation, vitamin В12 deficiency,   malignant neoplasms, malignant anemia, severe megaloblast or
macrocytic anemia. 

Method of use and dosage 
Use the following doses unless otherwise prescribed by a doctor.
Children and adults over 14 years old: 1 tablet 1 time a day with water during meals.
In severe cases, the dose can be increased 2-3 times with the doctor's advice. 
The preparation should be taken for a long time (at least 2-3 months). 
Metifol tablets can be prescribed to children under 14 years of age on the advice of a doctor.
Dose, administration and duration of treatment can be adjusted individually by the doctor.

Release form: Tablet No. 30 in a blister, packed in a cardboard box with an insert.
 
Producer: ValueMed Pharma Srl, San Marino (Italy).