Abstract. In order to increase the tissue level of tetrahydrobiopterin (BH 4 ), supplementation with 6R-tetrahydrobiopterin (6RBH 4 ) has been widely employed. In this work, the effectiveness of 6RBH 4 was compared with 7,8-dihydrobiopterin (7,8BH 2 ) and sepiapterin by administration to mice. Administration of 6RBH 4 was the least effective in elevating tissue BH 4 levels in mice while sepiapterin was the best. In all three cases, a dihydrobiopterin surge appeared in the blood. The appearance of the dihydrobiopterin surge after BH 4 treatment suggested that systemic oxidation of the administered BH 4 had occurred before accumulation of BH 4 in the tissues. This idea was supported by the following evidences: 1) An increase in tissue BH 4 was effectively inhibited by methotrexate, an inhibitor of dihydrofolate reductase which reduces 7,8BH 2 to BH 4 . 2) When the unnatural diastereomer 6SBH 4 was administered to mice, a large proportion of the recovered BH 4 was in the form of the 6R-diastereomer, suggesting that this BH 4 was the product of a dihydrofolate reductase process by which 7,8BH 2 converts to 6RBH 4 . These results indicated that the exogenous BH 4 was oxidized and the resultant 7,8BH 2 circulated through the tissues, and then it was incorporated by various other tissues and organs through a pathway shared by the exogenous sepiapterin and 7,8BH 2 in their uptake. It was demonstrated that maintaining endogenous tetrahydrobiopterin in tissues under ordinary conditions was also largely dependent on an methotrexate-sensitive process, suggesting that cellular tetrahydrobiopterin was maintained both by de novo synthesis and by salvage of extracellular dihydrobiopterin.