Multiple sclerosis (MS) currently has no cure, but treatments are available to help stop the progression of this central nervous system disease and manage symptoms.

As part of your MS treatment plan, you may have heard about supplements, like folate and vitamin B12, that may complement your medications and offer benefits.

Both folate (also called vitamin B9) and vitamin B12 are essential nutrients that some people may be able to get enough of from the foods they eat.

But if you have a deficiency or an underlying condition that interferes with the absorption of these nutrients, a doctor may recommend supplementation.

Read on to learn what the science says about folate and vitamin B12 for MS.

While experts caution there’s not enough evidence to suggest any supplement can necessarily treat MS, emerging research shows that folate and vitamin B12 supplements could offer some benefits.

In one 2019 study, both folate and vitamin B12 were found to reduce levels of homocysteine while improving anemia status in a group of participants with relapsing-remitting multiple sclerosis (RRMS).

Researchers noted that such effects significantly improved both the physical and mental well-being of study participants.

It’s thought that these benefits and subsequent improved quality of life could be related to the effects of folate and B12 on homocysteine levels. While this amino acid is naturally present in the body, B vitamins can help break it down.

Additionally, vitamin B12 deficiency may lead to anemia, balance issues, and problems with the nervous system. Such symptoms are also seen in MS.

High homocysteine levels may worsen MS

In general, high homocysteine levels in the body can damage blood vessels and increase the risk of cardiovascular disease. Researchers also believe that high homocysteine levels may worsen MS and damage the nervous system more generally.

Animal studies have shown that folic acid (the synthetic form of folate) may help promote nerve growth factors while also repairing peripheral nerve injuries.

More research is needed to determine how such effects may play a role in humans with MS.

Let’s first take a look at what food groups naturally have these vitamins, as well as oral supplements you can take and their recommended dosages.

Natural food sources of folate

Folate is naturally present in a variety of foods, such as:

  • dark leafy greens
  • Brussels sprouts
  • asparagus
  • oranges
  • orange juice
  • nuts
  • beans
  • beef liver

Folate supplements

Adults need about 400 micrograms (mcg) of folate per day. If you don’t get this amount through diet, you may be able to take a folate or folic acid supplement. Folate is also available in multivitamins and B-complex supplements.

Natural food sources of vitamin B12

Food sources of vitamin B12 include:

  • meat
  • fish
  • poultry
  • beef liver
  • dairy products
  • eggs

Vitamin B12 supplements

B-complex supplements and multivitamins also contain vitamin B12. However, you may also take this supplement on its own, too, especially if you don’t get the daily recommended amount of 2.4 mcg.

As a supplement, cyanocobalamin is the most common form of vitamin B12. It may also be available as:

  • adenosylcobalamin
  • hydroxocobalamin
  • methylcobalamin

When first starting a folate or vitamin B12 supplement, keep in mind that the full effects may not be seen for a few weeks. Until then, you may start experiencing slightly better energy and other improved symptoms.

In the previously mentioned 2019 study of folate and vitamin B12 in people with MS, researchers believed there may be some benefit in eating more folate-rich foods along with taking 1 milligram (mg) of vitamin B12 monthly.

However, the exact dosage depends on your own needs, the course of your MS, and what any lab results show in terms of deficiency.

Always talk with your doctor before starting any supplements

It’s important to talk with a doctor before trying any supplements on your own. That’s particularly true for people with chronic conditions such as MS.

You’ll want to check in about the proper dosage and make sure there are no potential interactions with the medications you’re taking.

In addition to folate and vitamin B12 supplementation, you can discuss the potential of other underlying nutritional deficiencies you may have with a doctor to see whether you need to take other supplements.

One other common deficiency is vitamin D, but more studies are needed to determine whether vitamin D supplements may help MS more specifically.

However, current research does suggest that low levels of this fat-soluble nutrient may worsen MS symptoms and progression.

Complementary practices for MS

The following complementary practices may help manage MS symptoms, but only when you work with a healthcare professional:

  • Acupuncture may help reduce pain and discomfort throughout the body.
  • Reflexology may help reduce burning sensations caused by nerve damage in MS.
  • Yoga may increase energy and boost your mood.

It’s important to talk with a doctor before starting any new supplements. They can help determine whether there’s a risk of interactions with your current MS medications and help provide correct dosing guidance.

Before you take folate supplements for MS, it’s also important that a doctor checks your vitamin B12 levels with a blood test. Folate may mask an underlying vitamin B12 deficiency, and possibly make related symptoms worse.

There’s not enough evidence to support any of the following herbs and supplements for MS:

Research is starting to explore the possible links between certain nutritional deficiencies and related supplementation to see whether these may play a role in helping alleviate MS symptoms.

Folate and vitamin B12 supplements may help reduce homocysteine levels in the blood while increasing energy and overall well-being.

Before trying any supplements, be sure to discuss their potential benefits and risks with a doctor. They can help determine possible nutritional deficiencies and recommend supplementation as appropriate.