Why We Use Leucovorin

After reviewing compelling medical literature and clinical studies showing that Leucovorin may improve language, behavior, and social engagement in children with autism, we decided to take a closer look. Our team conducted an in-depth review of the research to determine whether this treatment could be used safely and effectively in our patient population.

In June 2025, we began prescribing Leucovorin to select patients—and we’re happy to report that we are already seeing positive improvements. This includes several nonverbal children who are now beginning to speak and interact more meaningfully with their families. While every child responds differently, these results have been incredibly encouraging.

We typically consider Leucovorin when:

• A child shows signs of folate-related metabolic issues

• There is suspected mitochondrial dysfunction

• Lab testing supports the need for enhanced folate support (e.g., elevated folate levels with poor CNS absorption or positive folate receptor antibodies)

• A child is plateauing in development despite consistent therapies

Important Considerations

Leucovorin is a prescription medication and should only be used under the guidance of a qualified provider. Most children tolerate it well, but some may experience side effects such as hyperactivity, irritability, or changes in sleep patterns, and rarely seizures. We carefully monitor each child's response and tailor the treatment to their individual needs.

If you're interested in whether Leucovorin—or any other biomedical support—may be appropriate for your child, please reach out. We're here to help you explore safe, research-informed options that support your child’s unique developmental journey.

Frequent Asked Questions

1. What is folate, folinic acid, and Leucovorin?

Folate is a type of B vitamin that plays a critical role in your child’s brain, nervous system, and overall health. It’s involved in growth, development, mood regulation, and even how the body makes and repairs DNA. Because it’s so important, understanding the different forms of folate can really help make sense of why Leucovorin is used.

Here’s a simple breakdown:

Folic Acid

• What it is: Folic acid is the synthetic form of folate. It’s the version commonly added to fortified foods (like breads and cereals) and found in many over-the-counter vitamins.

• The challenge: The body has to convert folic acid into the active form before it can be used. Many people, especially children with certain genetic differences (like MTHFR mutations), struggle to make this conversion. This means even if they’re eating fortified foods or taking vitamins, their bodies may not be getting the folate they truly need.

Leucovorin (Folinic Acid)

• What it is: Leucovorin, also called folinic acid, is a form of folate that is already active and ready for the body to use.

• Why it helps: Because it bypasses the tricky conversion step, Leucovorin can provide the brain and body with folate directly. This makes it especially helpful for children whose systems can’t efficiently convert folic acid into a usable form.

• What this means for families: Instead of just “adding more vitamins,” Leucovorin helps ensure that the folate is actually doing its job where it matters most—in supporting brain function, development, and overall health.

By understanding the difference, families can see why we often use Leucovorin in treatment. It’s not about taking more folate—it’s about taking the right form that the body can actually use.

2. Why is folate important?

Folate is one of those nutrients that touches almost every part of health and development—it’s so much more than “just a vitamin.”

• At the cellular level: Folate plays a critical role in how the body makes DNA and repairs cells. Every time your child grows, learns, or heals, folate is involved.

• For the brain and nervous system: Folate helps support healthy brain function, mood regulation, and communication between nerve cells. It’s especially important for children’s learning, focus, and emotional balance.

• For energy and growth: When folate is too low—or when the body struggles to use it properly—it can lead to fatigue, slower growth, or difficulties keeping up with developmental milestones.

• For behavior and daily life: Families sometimes notice that low folate function is connected with things like irritability, attention struggles, sleep challenges, or delays in language and social skills.

Because folate is so central to the body’s processes, even a small disruption in how it’s used can have a ripple effect across development, mood, and day-to-day functioning.

This is why treatments like Leucovorin can make such a difference—they help ensure the brain and body are actually getting the type of folate they can use, so children can thrive.3.

3. Do I need testing before starting Leucovorin?

The short answer is no, testing is not required before getting started. When you come in, we take a comprehensive health history and background to decide if your child is a good candidate for treatment. For many families, this is enough to move forward safely without any additional delays.

That said, testing can sometimes give us very helpful information. Labs may include things like:

• Folate – to check baseline levels.

• Vitamin B12 – since B12 works closely with folate in the body.

• Vitamin D – an important nutrient for overall health and immune support.

• Methylation/DNA panels – to see how your child’s body processes and uses nutrients at a genetic level.

Having this data can help us fine-tune and personalize a treatment plan, especially when we’re looking at supplements beyond Leucovorin. It’s a way of adding more clarity and customizing care even further.

Still, we want to make this process accessible, not overwhelming. That’s why we often encourage families to begin with treatment and consider testing later, once you’ve seen how your child responds. This allows you to start making progress right away while still keeping the option open to dig deeper when the time feels right.

Our goal is to balance science with practicality—making sure every step feels manageable for your family while still providing the best care possible.4. What about FRAT testing?

FRAT testing (Folate Receptor Antibody Test) measures the presence of autoantibodies that can block the body’s ability to use folate effectively. In some children, these antibodies may play a role in folate deficiency and related symptoms.

That said, FRAT testing is not required. It’s just one piece of the bigger puzzle, and it is not a definitive answer on whether or not Leucovorin will work for your child. In fact, many families choose to move forward with a Leucovorin trial without FRAT testing and still see positive results.

There are also some important challenges to be aware of:

• 💰 Cost-prohibitive – The test is $350.00 out-of-pocket and not covered by insurance.

• ⏳ Long turnaround time – Results currently take nearly three months to come back.

• 🧩 One piece of the puzzle – Even with results, it does not give us a clear “yes or no” answer about Leucovorin effectiveness.

Because of these limitations, in most cases we recommend starting with a Leucovorin trial rather than delaying treatment while waiting on the test. Still, if you would like the added data and reassurance, we do have access to the test and can help you order it.

Our priority is always to balance the science with what is practical for families—making sure care feels accessible, timely, and effective.

5. Will I have to take this long term?

This is a great question, and one we hear often. The truth is, it really depends on each individual child. For some, Leucovorin becomes an important part of their long-term support; for others, it may only be needed for a season.

Our typical approach looks like this:

1. Start with a titration phase – We begin slowly, carefully increasing the dose to find the amount that works best for your child without causing unnecessary side effects.

2. Move into a maintenance phase – Once we see progress and stability, we work on maintaining those results without continuing to push doses higher.

3. Reevaluate regularly – We don’t believe in “set it and forget it.” Over time, we’ll revisit whether the current dose is still appropriate, whether it can be lowered, or whether it’s time to consider tapering off.

The goal is always to avoid staying on higher doses longer than necessary. That said, some patients truly do benefit from long-term use, and in those cases we continue treatment with careful monitoring.

It’s important to know there is no one-size-fits-all answer. Some families see that after a period of treatment, their child maintains gains even after lowering the dose or stopping altogether. Others find that continued use provides ongoing stability and improvement.

Our role is to walk alongside you—making thoughtful adjustments, celebrating wins, and ensuring that your child gets the benefits of treatment without being on more than they truly need.

6. What are the side effects?

It’s important to be aware that, like with any treatment, some children may experience side effects. In my practice, I’ve seen about 40% of patients develop mild effects when first starting. These can include things like:

• Mild stomach upset

• Irritability or moodiness

• Changes in sleep patterns (either more restless or needing a little extra rest)

The good news is that these side effects are usually temporary and often improve as the body adjusts. Many families notice that within a few weeks, these symptoms either fade away or become much more manageable.

There is one side effect that is considered very rare but important to mention—seizures. While this happens only in a very small number of cases, we always keep it in mind and monitor closely.

Most importantly, you are not alone in this process. If you ever notice any changes that concern you—whether mild or more serious—please reach out right away. Our team is here to listen, support, and make adjustments if needed.

Our goal is always to maximize benefits while keeping your child safe and comfortable throughout treatment.

7. What improvements can I expect?

What Improvements Can I Expect?

One of the most common questions we hear is, “What changes will I see?” The honest answer is that every patient is different—but we want you to know that even small improvements can make a meaningful difference in daily life.

We also want to be completely honest and upfront: no results are ever guaranteed, and this is not a promise to cure. At the same time, we deeply understand that for many families, this treatment represents hope where there once was none—and walking that journey together is at the heart of what we do.

Families often share with us that after starting treatment, they notice things like:

• Better language and communication – children may begin using more words, expressing themselves more clearly, or initiating conversations more often.

• Improved focus and attention – the ability to sit through a task, finish an activity, or engage in learning can start to feel easier.

• More stable mood – fewer ups and downs throughout the day, with calmer, more predictable behavior.

• Reduced anxiety or irritability – children may seem less on edge, less reactive, and more comfortable in their own skin.

• More energy and less fatigue – you may see your child participating more fully in activities they used to avoid.

These improvements don’t usually happen overnight—sometimes they appear gradually, and sometimes families notice certain changes sooner than others. Progress can be subtle at first, but over time, those small shifts build into something much bigger.

Our goal is always to celebrate the wins, no matter how small, and to keep building step by step. Each improvement is a sign that we’re moving in the right direction together.

8. Do I need to change my diet?

Dairy is just one of several possible contributors to folate deficiency. In autistic children, the relationship between food, absorption, and overall wellness can be complex. We see children on the spectrum every single day, and we understand how overwhelming it can feel to make immediate food changes on top of everything else you’re already managing.

Because of this, we typically recommend starting with Leucovorin first and focusing on dietary adjustments later in the plan. Trying to avoid dairy within a few hours of taking Leucovorin may improve absorption and increase the chances of seeing positive results, even before any major food changes are made.

While a gluten-free, casein-free, and dairy-free diet is often considered the most beneficial approach for children who may have folate deficiencies, we recognize that not all families can implement such significant changes right away. Our approach is to support you step by step—we usually encourage these conversations a few months into treatment, once you’ve already seen stability and progress with Leucovorin, rather than pushing for an immediate dietary overhaul.

9. What supplements do I need to add?

Our Approach to Supplements

We know how overwhelming it can feel when you see protocols that push 30, 40, or even 50 different supplements at once. That’s not our philosophy. We don’t believe in “one-size-fits-all” or blanket protocols. Every child and every family is different, and your care should reflect that.

Instead, we take a personalized approach. We almost always recommend starting with a high-quality multivitamin as a strong foundation—this helps cover the basics without overcomplicating things. From there, we only add additional supplements if there’s a clear reason to do so. Sometimes that means supporting methylation pathways, sometimes it’s gut health, sometimes it’s calming the nervous system—it all depends on your child’s unique needs.

This is where lab results and testing can make such a difference. Having real data in front of us allows us to be thoughtful and intentional, creating a plan that’s not just “throwing supplements at symptoms,” but carefully designed to help your child feel better, function better, and thrive.

Our goal is simple: to make the process manageable, sustainable, and truly helpful for your family—never overwhelming.

10. Pharmacy Information

Even though Leucovorin is technically a vitamin, it is only available in prescription strength doses. Most local pharmacies carry it or can order it. When we prescribe it, you’ll receive detailed instructions on how to start with small doses and increase slowly.

11. Over-the-Counter Folinic Acid vs. Prescription Leucovorin

Over-the-counter folinic acid supplements are chemically the same as prescription Leucovorin, but most of them come in doses that are far too low to correct a true folate deficiency. To reach the therapeutic levels needed, you would have to take nearly half a bottle each day, which isn’t realistic.

For this reason, prescription Leucovorin is typically necessary to achieve effective treatment levels. The only over-the-counter brand we are aware of that provides a true high-dose option is Spectrum Awakening’s High-Dose Folinic Acid.

Out-of-State Telehealth Services

We are expanding our services to patients outside of Kentucky through telehealth.

We are actively hiring providers in many states. If you live in one of the states below and are interested in care, please let us know so we can add you to our priority list. As soon as we have a provider licensed in your state, we will contact you.

States We Are Currently Focusing On

Florida

Illinois

Alaska

Arizona

Colorado

Connecticut

Delaware

Hawaii

Idaho

Iowa

Kansas

Maine

Maryland

Massachusetts

Minnesota

Montana

Nebraska

Nevada

New Hampshire

New Mexico

New York

North Dakota

Oregon

Rhode Island

South Dakota

Utah

Vermont

Washington

Wyoming

Washington, D.C.

Telehealth Pricing (Cash-Pay)

Because insurance credentialing takes several months, we are initially offering cash-pay telehealth services in these states:

• Initial Visit: $150

• Follow-Up Visits: $50

Appointments are done by telehealth, so you can meet with us from the comfort of your own home.

Interested?

If you are an out-of-state patient, please submit our interest form with your state and contact information. We will reach out as soon as a provider is available where you live.

Worldwide Coaching Services

Not in one of our telehealth states? No matter where you live, our coaching services are available to you. These sessions provide personalized guidance on supplementation, helping you feel confident and supported in your wellness journey.

✨ With coaching, you’ll receive education, recommendations, and step-by-step support tailored to your needs.

⚠️ Please note: prescriptions cannot be provided through coaching appointments.

This is not our typical process — we’re simply doing our best to keep things running smoothly during these extremely busy times while training new staff who can give each family the personal attention they deserve on the phone.

If you’re comfortable sharing your child’s information (name, date of birth, and a valid email address), we can send the new patient paperwork right away. Completing this paperwork early helps us streamline your experience, reduce waiting times, and get your appointment scheduled faster.

Once your paperwork is complete, just call or email us — we’ll be happy to finalize your appointment and answer any questions you may have.

Begin your journey toward personalized, compassionate care with our book now above or completing the form below. Our team will review your information and contact you to confirm your appointment.