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Head-to-head evidence comparison — which supplement is right for you?
Folic Acid vs L. crispatus CTV-05: L. crispatus CTV-05 has the stronger overall evidence (6 vs 8/10); the best pick depends on your goals. Take the 60-second quiz for a pick tailored to your goals.
L. crispatus CTV-05 wins 2 of 3 categories. Both are solid choices — the best pick depends on your specific goals.
Verdict
Too few graded studies
Top outcomes
Verdict
Mostly mechanism / observational
Top outcomes
Shared outcomes (1)
Outcomes where both Folic Acid and L. crispatus CTV-05 have evidence — compare verdict strength side-by-side.
400 mcg/day for anyone planning or capable of pregnancy (USPSTF: 400-800 mcg); adult RDA 400 mcg DFE/day, 600 mcg DFE in pregnancy, 500 mcg DFE in lactation (IOM)
Any time of day
Folic acid (pteroylmonoglutamic acid)
VAGINAL USE ONLY, by applicator: 2 x 10^9 CFU per dose. The phase 2b regimen was one dose daily for 5 days in week 1, then twice weekly for a further 10 weeks — always started after a completed course of vaginal metronidazole gel.
Any time of day
Vaginal applicator delivering L. crispatus CTV-05
Periconceptional
Weeks
Weeks to months
11-week dosing course, measured at 12 weeks
n/a
Days 10-28
Persisting to 24 weeks
Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation.
N Engl J Med (1992) · Rct
Randomised trial of periconceptional vitamin supplementation for prevention of a FIRST neural tube defect (PubMed publication types: Randomized Controlled Trial, Clinical Trial)
Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group.
Lancet (1991) · Rct
Randomised, multicentre trial of periconceptional folic acid for prevention of RECURRENT neural tube defects (PubMed publication types: Randomized Controlled Trial, Multicenter Study, Comparative Study)
Effects and safety of periconceptional oral folate supplementation for preventing birth defects.
Cochrane Database Syst Rev (2015) · Meta analysis
Cochrane Database of Systematic Reviews CD007950, third edition (PubMed publication types: Meta-Analysis, Systematic Review)
Randomized Trial of Lactin-V to Prevent Recurrence of Bacterial Vaginosis.
N Engl J Med (2020) · Rct · n=228
Recurrence of bacterial vaginosis by week 12: 30% (46/152) with Lactin-V vs 45% (34/76) with placebo; risk ratio 0.66 (95% CI 0.44-0.87), P=0.01
Response to Antibiotic Treatment of Bacterial Vaginosis Predicts the Effectiveness of LACTIN-V (Lactobacillus crispatus CTV-05) in the Prevention of Recurrent Disease.
Sex Transm Dis (2024) · Observational
This is a POST HOC analysis of the already-completed phase 2b LACTIN-V trial, not a new trial
Sustained effect of LACTIN-V (Lactobacillus crispatus CTV-05) on genital immunology following standard bacterial vaginosis treatment: results from a randomised, placebo-controlled trial.
Lancet Microbe (2022) · Rct · n=66
Vaginal IL-1α was significantly lower with LACTIN-V (β 0.310, SE 0.149; p=0.042)
L. crispatus CTV-05 has a higher evidence score (6/10 vs 8/10) and wins in 2 of 3 categories.
No documented interaction was found in the data searched. This does not establish that this exact combination is safe.
The right pick depends on your goals. Answer a few quick questions for a personalised recommendation — or dig into the full evidence on each.