Autism Information and alternative treatment , herbs, supplements, and vitamins, Natural Treatment for autistic disorder by Ray Sahelian, M.D., and review of vaccine controversy

April 20 2014

Autistic disorder is a developmental disorder resulting in social, language, or sensorimotor deficits. Autism occurs in approximately one out of every 70 children. Early detection and intervention significantly improve outcome, with about one third of persons with autism achieving some degree of independent living. Indications for developmental evaluation include no babbling, pointing, or use of other gestures by 12 months of age, no single words by 16 months of age, no two-word spontaneous phrases by 24 months of age, and loss of previously learned language or social skills at any age. Autism is frequently associated with fragile X syndrome and tuberous sclerosis, and may be caused by lead poisoning and metabolic disorders. Children with autism often suffer form mental retardation, seizure disorder, and psychiatric disorders such as depression and anxiety. Symptoms have a tendency to lessen with age. One out of four toddlers born prematurely have early signs of autism.

Diet and autism
Research indicates that a gluten and casein-free diet may be helpful in some children with autism. Therefore, it would be a good idea to try a gluten free diet for a period of a few weeks to see if there is any response. Since fish oils have benefited some autistic children, it may be a good idea to include more cold water fish in the diet.

Gluten- and casein-free diets for autistic spectrum disorder.
Cochrane Database Syst Rev. 2004.
It has been suggested that peptides from gluten and casein may have a role in the origins of autism and that the physiology and psychology of autism might be explained by excessive opioid activity linked to these peptides. Research has reported abnormal levels of peptides in the urine and cerebrospinal fluid of persons with autism. If this is the case, diets free of gluten and /or casein should reduce the symptoms associated with autism. The one trial included reported results on four outcomes. Unsurprisingly in such a small-scale study, the results for three of these outcomes (cognitive skills, linguistic ability and motor ability) had wide confidence intervals that spanned the line of nil effect. However, the fourth outcome, reduction in autism traits, reported a significant beneficial treatment effect for the combined gluten- and casein- free diet.

Natural supplement for the treatment of autism - Vitamins and nutrients
There is a scattering of research that indicates nutrients may be of some benefit in treating autism, but  many more clinical trials are needed before we have a better understanding the role nutritional supplements in the treatment of autism. However, here are some possible options that I have come across that may or may not be helpful. Discuss with your child's doctor to see if they are appropriate for your child.

5-HTP
I don't know enough about autism and the biochemical abnormalities to know whether serotonin is found too much, too little, or serotonin levels in autism are affected only in certain areas of the brain and whether supplements would help.

Serotonergic disturbances in autistic disorder: L-5-hydroxytryptophan administration to autistic youngsters increases the blood concentrations of serotonin in patients but not in controls.
Life Sci. 2005.
Some studies have suggested that disorders in the peripheral and central metabolism of serotonin (5-HT) may play a role in the pathophysiology of autistic disorder. This study examines the whole blood concentrations of 5-HT and 5-hydroxy-indoleacetic acid (5-HIAA) in baseline conditions and during a challenge with L-5-OH-tryptophane (5-HTP; 4 mg/kg in non enteric-coated tablets), the precursor of 5-HT, in a study group of 18 male, post-pubertal, We found an increased synthesis of 5-HT from its precursor 5-HTP might be a one factor responsible for differences in the serotonergic system between autistic post-pubertal youngsters and normal controls.

Carnosine
Children with autism given carnosine showed statistically significant improvements on several tests including an improvement in vocabulary and recognizing a picture. The carnosine dose should be probably be low for kids, much less than the 500 mg adult dose.

Researchers at the Autism and Epilepsy Specialty Services in Lake Bluff, Illinois, investigated 31 children with autism in an 8-week, double-blinded study to determine if carnosine would result in changes. The children received 800 mg of carnosine a day and were compared with a group of children on placebo. After 8 weeks, children given carnosine showed statistically significant improvements on several tests including an improvement in vocabulary and recognizing a picture.

My husband and I have a son who is a high-functioning autistic. He also developed type 1 diabetes as an adult. You mentioned a nutrient, L-Carnosine to help type 1 diabetics and said it also helped brain function in autistics. We decided to try it and told our son we had something we thought might help his diabetes. Within a couple of weeks, he became much more talkative (he's a very quiet person and usually keeps his opinions to himself) and began voicing his political opinions. It was obvious he had put quite a bit of thought in them. Friends began noticing how much more he was talking with them and not immediately retreating to his room when they came to visit. And to prove it wasn't all in our heads, his endocrinologist has lowered his insulin twice since he began taking the L-Carnosine. So, thanks for pointing us in that direction.

What would be the appropriate dosage for the various supplements that are suggested for autism? The child is just 2 years old.
   Research in the area of supplement use for children at various ages with autism is quite recent and little is known about the benefits, risks, or effectiveness of these natural supplements. Please consult with your pediatrician. My best guess would be about a tenth of 500 mg capsule although I have no studies to support this dosage recommendation.

Fish oils
Children with autism may be deficient in fish oils, hence a role for diet. Childhood autism may be linked to a deficiency of fatty acids found in oily fish. A pilot study at the University of Stirling found that children with autism had cells that broke down fatty acids more rapidly than normal cells. Autism rates in Scotland have risen dramatically in the past ten years, a trend mirrored across the developed world. In Scotland, an estimated 50,000 people, nearly 7,000 of them children, suffer from autism. Brain cell membranes are composed primarily of omega-3 and omega-6 fatty acids, substances found in oily fish such as mackerel and salmon. A study of about 20 autistic children last year revealed that cell membranes in their blood metabolized, or processed, fatty acids at a faster rate than other children. The discovery led to speculation that a fatty acid deficiency may be partially responsible for the onset of autism. "We have already seen a connection between omega levels and schizophrenia and dyslexia," said Dr Gordon Bell of the university. If cell function in the brain is changed, the behavior of the brain will change as well. Dr Bell compared cell membranes to a "brick wall" of fatty acids. Bricks fall out, but as long as they are replaced, then the wall holds strong. Problems occur when bricks fall out faster than they can be replaced. If the scientists confirm this is what causes autism, they may conclude that the answer is to replenish "bricks" of fatty acids at a greater rate; in short, eat more fish.

Behavioral effects of omega-3 Fatty Acid supplementation in young adults with severe autism: an open label study.
Arch Med Res. 2008.
Nineteen young adults with severe autism, aged 18-40 years, received two fish oil capsules per day [0.93g of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) plus 5mg of vitamin E to avoid lipid peroxidation] for 6 weeks. Subjects were assessed with an ad hoc caregiver questionnaire, the Rossago Behavioral Checklist, for the assessment of behavioral anomalies. No significant improvements were observed with regard to the severity and frequency of problematic behaviors either during the active treatment period or during the post-treatment 6-week observation period. Our negative findings do not point toward a major effect of omega-3 FA supplementation on behavioral abnormalities in adults with severe autism.

Omega-3 fatty acids supplementation in children with autism: a double-blind randomized, placebo-controlled pilot study.
Biol Psychiatry. 2007.
We conducted a randomized, double-blind, placebo-controlled 6-week pilot trial investigating the effects of 1.5 g/d of omega-3 fatty acids (.84 g/d eicosapentaenoic acid, .7 g/d docosahexaenoic acid) supplementation in 13 children (aged 5 to 17 years) with autism disorders accompanied by severe tantrums, aggression, or self-injurious behavior. We observed an advantage of omega-3 fatty acids compared with placebo for hyperactivity and stereotypy, each with a large effect size.

Plasma fatty acid levels in children with autism.
Prostaglandins Leukot Essent Fatty Acids. 2001.
Phospholipid fatty acids are major structural components of neuronal cell membranes, which modulate membrane fluidity and hence function. Evidence from clinical and biochemical sources have indicated changes in the metabolism of fatty acids in several psychiatric disorders. We examined the phospholipid fatty acids in the plasma of a population of autism subjects compared to mentally retarded controls. Our results showed a marked reduction in the levels of 22: 6n-3 (23%) in the autism subjects, resulting in significantly lower levels of total (n-3) polyunsaturated fatty acids (PUFA) (20%), without significant reduction in the (n-6) PUFA series, and consequently a significant increase in the (n-6)/(n-3) ratio (25%).

Kava root
I just wanted to let you know that kava has saved our family. We have a 17 year old son with autism. With puberty and the teenage years presenting challenges of size, rages and inability to control some emotional behaviors we were desperate. When we see our son beginning to become agitated we give him kava kava and he completely calms down and is able to focus and maintain at school, home and in the community. Not wanting to medicate our son, we are thankful for the discovery of the effects of kava kava on the behaviors of autism.
   Kava should not be used more than 3 days a week due to potential liver harm.

Multi vitamin and mineral
A multivitamin supplement may  be considered.

Melatonin could be helpful for occasional use in case there is a sleep disorder.

The serotonin system could be involved in autism, since there is a different metabolic response to 5HTP administration in children with autism compared to controls (see study below).

Ribose?
Email November 2011 - A study came out last June which suggested that d-Ribose could be helpful for autism. My son tried it, and the results were remarkable: increased sociability, increased social cognition, mood stabilization, etc.

Vitamin B6 and multivitamins
Pilot study of a moderate dose multivitamin / mineral supplement for children with autistic spectrum disorder.
J Altern Complement Med. 2004. Arizona State University, Tempe, AZ, USA.
Determine the effect of a moderate dose multivitamin / mineral supplement on children with autistic spectrum disorder. Twenty children with autistic spectrum disorder, ages 3-8 years. A Global Impressions parental questionnaire found that the supplement group reported statistically significant improvements in sleep and gastrointestinal problems compared to the placebo group. An evaluation of vitamin B(6) levels prior to the study found that the autistic children had substantially elevated levels of B6 compared to a control group of typical children. Vitamin C levels were measured at the end of the study, and the placebo group had levels that were significantly below average for typical children, whereas the supplement group had near-average levels. The finding of high vitamin B6 levels is consistent with recent reports of low levels of pyridoxal-5-phosphate and low activity of pyridoxal kinase (i.e., pyridoxal is only poorly converted to pyridoxal-5-phosphate, the enzymatically active form). This may explain the functional need for high-dose vitamin B6 supplementation in many children and adults with autism.

Melatonin for sleep
Dr. Beth L. Goodlin-Jones, of the Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute at the University of California Davis Health System in Sacramento, and her team report, "Melatonin can be considered a safe and effective pharmacologic treatment in addition to behavior therapies and sleep hygiene practices for the management of sleep problems in children with autistic spectrum disorder and fragile X syndrome." In a 4-week study, 18 children, ranging in age from 2 to 15 years, with autistic spectrum disorder and/or fragile X syndrome were given either 3 mg melatonin or placebo each night for 2 weeks. The children then "crossed over" to the other treatment group for 2 weeks. Reports from 12 children who completed the study showed that use of this natural hormone led to improvements in total night sleep durations, sleep latency times and sleep-onset times. Journal of Clinical Sleep Medicine, 2009.
   Comments: For long term use, I suggest no more than 1 mg of melatonin a few nights a week. I am concerned that if parents give 3 mg nightly for many weeks or months tolerance could develop or side effects could occur. It is possible that even a third of a mg or half a mg could also be effective.

Symptom
The main feature of autism is impaired social interaction. Children with autism may fail to respond to their names and often avoid looking at other people. They often have difficulty interpreting tone of voice or facial expressions and do not respond to others' emotions or watch other people's faces for cues about appropriate behavior. Another autism symptom is being unaware of others' feelings toward them and of the negative impact of their behavior on other people.
   Sleep problems are reported in the vast majority of children with autism and fragile X syndrome. Fragile X syndrome is an inherited form of mental impairment resulting from a "fragile," or broken site, on the X chromosome. The syndrome affects 2 to 4 percent of those with autism spectrum disorder, and symptoms of autism are common in children with fragile X. Some people consider autism to be part of the obsessive compulsive disorder spectrum.

Sign
Many children with autism engage in repetitive movements such as rocking and hair twirling, or in self-injurious behavior such as biting or head-banging. They also tend to start speaking later than other children and may refer to themselves by name instead of "I" or "me." Some speak in a sing-song voice about a narrow range of favorite topics, with little regard for the interests of the person to whom they are speaking.

Cause
Current research links autism to biological or neurological differences in the brain. MRI ( Magnetic Resonance Imaging) and PET (Positron Emission Tomography) scans show abnormalities in the structure of the brain, with significant differences within the cerebellum, including the size and number of Purkinje cells. In some families there appears to be a pattern of autism or related disabilities, which suggests there may be a genetic basis to the disorder, although at this time no one gene has been directly linked to autism. Men who become fathers in their 40s or older are much more likely to have autistic children than younger dads, bolstering evidence that genetics contributes to autism.
   Disturbances in the serotonin system is another cause of autism, see study below.
   Having a parent or a mother with psychiatric problems such as schizophrenia increases a child's risk of having autism.
   Low birth weight and preterm delivery are a cause. These children are more likely to exhibit autistic symptoms.
   Advanced parental age appears to increase  autism risk in children, and the risk is seen with both mothers and fathers.
   Newborn babies who develop jaundice, a common liver problem that turns their skin and eyes yellow, are at greater risk. Pediatrics, 2010.
   Expectant mothers suffering from asthma, allergies or a type of skin disease have a higher risk of giving birth to an autistic child. Asthma, allergies and psoriasis symptoms during pregnancy especially if diagnosed in the second trimester doubled the risk of autism in children compared to children who were not afflicted. Obese mothers are more likely to have autistic children.
   Having a mother who lived within 1,000 feet of a freeway while pregnant doubles a child's odds, according to Southern California researcher Heather E. Volk, PhD, MPH.
   Women who used prescription antidepressants of the SSRI type before or during pregnancy have an increased risk of having a child with this condition.
   Women who have the flu while pregnant or have a fever lasting several days are more likely to have a child later diagnosed with this condition.
   Children exposed to higher levels of traffic-related pollutants during pregnancy or during the first year of life are more likely.
   Environmental pollutants, in addition to genetics, play a role in autism development.

Vaccine controversy
Is it possible that children given too many vaccines could develop signs of autism?
   There is a debate in the medical community regarding the role of vaccines in causing or precipitating autism. I am not sure at this time but I am not ruling out the possibility that there could be a link. Over the past two decades so many new vaccines have been added to a child's vaccination list that the medical community has little idea how all of these interact with each other and how they influence the immune system and neural tissue.

A study of specially bred mice suggests that a mercury preservative in vaccines could potentially cause some of the brain changes in autism. Mercury released primarily from coal-fired power plants may be contributing to an increase in the number of cases. However, a 2013 study indicates children exposed to low levels of mercury in the womb because their mothers ate large amounts of fish during pregnancy don't appear to be at increased risk. University of Rochester Medical Center, news release, July 23, 2013

What does not cause it
There does not appear to be a link between the season or month a child is born and the subsequent risk. There does not seem to be a link between mercury levels (as determined by analyzing hair samples for mercury) and the risk. I have not seen any evidence that autism is a result of toxins or toxic metals.

Autism treatment
There are three large categories of autism treatment: Behavioral modification and communication approaches, dietary and nutritional approaches, complementary approaches. Despite anecdotal evidence suggesting that secretin is a useful treatment, the results of a new review do not support a therapeutic role for this gastrointestinal hormone.

Growth hormone
Boys with autism have higher levels of growth hormones than other boys, which may explain why children with the condition often have larger heads. Boys with autism spectrum disorders are also heavier than boys without these conditions.

Research study
Tests on the brain tissue of 11 patients with autism who had died and spinal fluid from six living children with autism showed the activation of immune system responses. In a study published in the online edition of the Annals of Neurology, researchers said they found abnormal activity by immune system signaling chemicals called chemokines in the autistic patients. This ongoing inflammatory process was present in different areas of the brain and produced by cells known as microglia and astroglia.

Emails
We have an 8-year old son that has autism and we've been working with him for the last 4-years with therapy. We didn't see as big of a change in him until the last 3 months when we put him on a GFCF diet ( flucose free casein free ) and had a local allergy doctor, Dr. Baptist recommend a bunch of supplements and B-12 injections. He still has some behavior issues but his vocabulary has increased. Any opinions about chelation therapy? Does it work for Asperger syndrome?
   We are glad your child has improved. I am not familiar with the use of chelation therapy for autism but I would be cautious.