Is it bad do supplement folate while taking malarone?

I got low folate from malarone despite taking folate supplements. So I just stopped using malarone. I've taken mepron with no problems.

I described my experience with malarone here:

https://www.healingwell.com/community/default.aspx?f=30&m=4149533

it looks like the picture is complex and nuanced

the full study is here
https://journals.sagepub.com/doi/10.1177/15648265070284s407 ( click PDF)

it shows a rather mixed picture - with conflicting findings in many trials

it does seem that the degree of parasitology remained higher for longer in the blood of those who were given folate and iron - vs those who were not - but, significantly, clinical outcomes were no different in the end

it seems likely therefore that while there is an effect on the parasite - overall its not a very large one in terms of patient outcomes

the effect was also present in one species malaria (P. vivax) but not in the other(P. falciparum)

therefore if you are not treating malaria at all - but Babesia or other species - one has to be cautious in applying the above findings - as although they are related, these organisms are all considerably different to malaria - much more different to malaria than different species of malaria are to each other - and therefore its somewhat unlikely that the conclusions will hold true for Babesia.

since clinical outcomes were largely the same - i am not sure its worth worrying about

Garzie said...
it looks like the picture is complex and nuanced

the full study is here
https://journals.sagepub.com/doi/10.1177/15648265070284s407 ( click PDF)

it shows a rather mixed picture - with conflicting findings in many trials

it does seem that the degree of parasitology remained higher for longer in the blood of those who were given folate and iron - vs those who were not - but, significantly, clinical outcomes were no different in the end

it seems likely therefore that while there is an effect on the parasite - overall its not a very large one in terms of patient outcomes

the effect was also present in one species malaria (P. vivax) but not in the other(P. falciparum)

therefore if you are not treating malaria at all - but Babesia or other species - one has to be cautious in applying the above findings - as although they are related, these organisms are all considerably different to malaria - much more different to malaria than different species of malaria are to each other - and therefore its somewhat unlikely that the conclusions will hold true for Babesia.

since clinical outcomes were largely the same - i am not sure its worth worrying about

Thank you, that was really good information that I didn't found myself! I will read the full report you linked!

Do you think that folate can be negative when it comes to how proguanil works... I mean because it is an antifolate drug if folate supplementation can interact with how proguanil works?

Post Edited (MariaS74) : 3/21/2024 10:32:41 PM (GMT-8)

MariaS74 said...


Do you think that folate can be negative when it comes to how proguanil works... I mean because it is an antifolate drug if folate supplementation can interact with how proguanil works?

isn't that the same question that we have just discussed Maria?

OK - i think i understand

both are kind of the same thing Maria.

the parasite needs folate to survive - it gets this from its host

by interfering with its folate metabolism - say blocking its ability to absorb it from its environment - you slow growth or even kill it

by adding additional folate - levels in its environment rise - and this helps it absorb more - even though the drug is still blocking most of it

the net result is more parasites do tend to survive at least a bit longer into treatment - but in the trials described in the papers above - the treatments are still effective - so the overall effect is a minor one - and the antifolate drugs are still generally strong enough to successfully treat the disease - even when folate is given

and again - even this minor effect was only the case for one species of malaria and not the other common malaria species - so given this effect varies by species within a genus - its not safe to extrapolate it to other organisms in different genus all together - like Babesia.