50 replies to this topic

[Connor MacLeod]

I just recently found out that one of my nephews (almost 2 years old) may be showing signs of autism. He is, of course, going to be seeing a specialist. But I also want to look into supplements that might be helpful. If anyone has any recommendations, I really appreciate it. Thanks!

[niner]

I'm glad you asked about this, Connor. There are a surprising number of physiological correlates with autism spectrum disorders that can be addressed with supplements. For example, transmethylation metabolites and glutathione redox status may be messed up. There are characteristic GI tract disorders (constipation and "megarectum" (eek)). Here is a link to an NIH site that has a collection of papers that may be of interest. My 8 year old son has Aspergers; I'm giving him fish oil and have been attempting to give him P5P and magnesium. I'm also looking into methylcobalamin and folinic acid. The trouble with giving him anything is that he's not able to swallow pills, and like a lot of kids on the spectrum, gets really freaky about things that taste weird. I've been resorting to taste masking with melted chocolate and marshmallows. (P5P S'mores...)

[rwac]

I've always been curious about this.

Have either of you guys tried a gluten free casein free diet ?
What about cutting the sugar ?

Or even full paleo if possible.

[niner]

I've always been curious about this.

Have either of you guys tried a gluten free casein free diet ?
What about cutting the sugar ?

Or even full paleo if possible.

Yeah, I was going to start a thread, and was wondering why it had never come up. We're thinking about GF/CF. The evidence for it isn't spectacular, but it might be worth a try. These days, GF is not that tough to pull off. I've had a number of GF foods that actually taste good. CF is tougher mainly because of my son's issues with food. There's a limited number of things he'll eat. This is really common with kids on the spectrum. I'm succeeding at getting him to adopt my sugar == poison religion, which is quite an achievement, since he has a major sweet tooth. (Got that from me...) Paleo probably isn't in the cards for a while. He likes olive oil though, oddly enough. For any nutritional intervention, it can be hard to tell if it's doing anything, because he's maturing and continuing to develop, and he's getting a variety of ongoing therapies. He's getting better all the time, although it does come somewhat in fits and starts. With that sort of "baseline", it's hard to tell if something is really helping or not. If he has methylation or redox issues, we should be able to measure that, if we can find a place that can do it.

[Connor MacLeod]

I'm glad you asked about this, Connor. There are a surprising number of physiological correlates with autism spectrum disorders that can be addressed with supplements. For example, transmethylation metabolites and glutathione redox status may be messed up. There are characteristic GI tract disorders (constipation and "megarectum" (eek)). Here is a link to an NIH site that has a collection of papers that may be of interest. My 8 year old son has Aspergers; I'm giving him fish oil and have been attempting to give him P5P and magnesium. I'm also looking into methylcobalamin and folinic acid. The trouble with giving him anything is that he's not able to swallow pills, and like a lot of kids on the spectrum, gets really freaky about things that taste weird. I've been resorting to taste masking with melted chocolate and marshmallows. (P5P S'mores...)

Thanks for the info, niner.

[Connor MacLeod]

He's getting better all the time, although it does come somewhat in fits and starts.

I'm glad to hear that your son's condition is improving.

[k10]

You may want to look into the cutler protocol

[stephen_b]

Dr. Cannell of the vitamin D council achieving fairly high vitamin D levels in a recent newsletter:

For now, give him enough vitamin D to obtain a 25(OH)D of around 100 ng/mL. We may want to increase his dose high enough to obtain a level of 150 ng/mL in the future, which is perfectly safe in the short term, so as not to miss a treatment effect or to be sure we are seeing the full treatment effect. Six months after he fully responds, you can begin to slowly lower the dose to obtain levels of 70–80 ng/mL.
...
For reasons I do not yet understand, many autistic children first start responding to vitamin D only when their blood level reaches 90–100.

Note that the high levels are temporary. For a child under 2 years of age, there would seem to be a good window of opportunity to make a lifelong difference.

StephenB

[Logan]

Whatever you do, make sure the parents are involved in giving their son APA(applied behavioral analysis) therapy as much as the people they hire. Maybe the specialist will suggest this, maybe not. My cousin is autistic. His parents had him in therapy for up to 80 hours a week. They not only hired a few people to work with him, but they themselves worked with him as much as they possibly could. I think many parents of autistic children fall short in providing the right amount for therapy for their child. It may simply be that they are not very good parents in general and not willing to make the sacrifice. It also may be that they are simply not educated enough to know that they too need to be just as much a part of the therapeutic process as the people they hire. Just make sure the parents of your nephew realize how necessary it is for them to be involved in improving the development of their child.

Edited by morganator, 15 October 2010 - 09:06 PM.

[Connor MacLeod]

Thanks everyone.


Niner,

Have you looked into Dr. Cannel's work on vitamin D? Do you have any thoughts on it?

[someidiot]

I happen to be researching memantine. There is a clinical trial that is testing out this medication for the autism spectrum--including Asperger's

http://clinicaltrial...how/NCT01078844

[Rational Madman]

I just recently found out that one of my nephews (almost 2 years old) may be showing signs of autism. He is, of course, going to be seeing a specialist. But I also want to look into supplements that might be helpful. If anyone has any recommendations, I really appreciate it. Thanks!

The use of supplements for the treatment of disorders on the autism spectrum have thus far yielded largely disappointing and inconclusive results. Drug treatments may be somewhat more promising, but in all candor, nothing groundbreaking has been discovered. In my opinion, the most promising line of inquiry is through treatments that modulate or suppress an aberrant immune response, and in this regard, drugs like Rapamycin hold tremendous promise. But presently, drugs used for behavior modification--like antipsychotics, mood stabilizers, and antidepressants---have the most empirical evidence, and remain the mainstays of treatment. However, their treatment benefits leave much to be desired, and constitute only an incomplete remedy to such a systemically affecting disorder. Increasng oxytocin is another avenue worth considering, but the most effective delivery mechanism has yet to be determined, and is not without detrimental effects. In any case, I sincerely wish that the disorder could be resolved with biomedical modalities, but I haven't seen any compelling evidence to alter my assessment. For now, I suggest that you counsel patience, try the conventional methods, and steer clear from the NOW clinicians.

Edited by Rol82, 19 October 2010 - 11:16 PM.

[Guacamolium]

I stumbled onto this thread accidentally, but I believe beta-alanine supplementation would benefit the autism spectrum disorders. I haven't looked into it fully though.

http://www.ncbi.nlm....pubmed/12585724

[Ark]

Try large dosages of Fish Oil/Coconut oil/Mucuna Pruriens Extract & Bacopa. I'd t also recommended ashwagandha extract double dosages at first, give those a shot. Tell me if it helps?

[Ark]

Forgot to mention low dosage of stablon and lithum might be worth looking into.

[Delta Gamma]

Are there any signs of comorbid conditions (ADHD, depression, OCD, etc...)? If so, perhaps treating those could provide some sort of reduction in symptoms, similar to what Rol82 mentioned. Though I loath giving people anecdotal evidence, I have a friend with aspergers who (after paying for a VERY complete blood, fat, and hair analysis)found some success with a cocktail of supplements. I hope this provides some sort of help to you, and if you want PM me and I'll give you more specifics.

But, off the top of my head:
he addressed methylation issues, copper/zinc imbalances, a chronic low level bacterial infection, and anxiety/agitation. His stack included Bacopa for all its worth.

It seems to have had a rather significant effect on him, he's still a little "off", but he's far more in sync socially than before.

[kismet]

Watch out for pseudoscience. It is not like unnecessary overmedication and -supplementation does no damage.

[Delta Gamma]

I should add that my friend only supplements what his tests reveled he was lacking, to counteract what he had in excess, and what was found to be required for the treatment of a infection. I talked to him last night and it seems like the only things he takes that aren't directly related to "balancing his chemistry" is creatine for the gym and a bacopa + ginkgo supplement for school.

I wish you luck in improving your sons condition, and can only suggest that he get a full spectrum blood test so you can see if anything seems out of the ordinary. Your profile says you live in Philadelphia, and you mentioned that you were having a hard time finding a place to have the testing for things like methylation and redox done. Unless you've already looked around, I'd suggest looking for labs in Canada (particularly Southern Ontario).

[stephen_b]

Article about a JAMA study: Study Finds Children With Autism Have Mitochondrial Dysfunction (PMID 21119085).

This brings up the possibility that supplements targeting mitochondrial function could have a role in autism treatment.

[Delta Gamma]

Article about a JAMA study: Study Finds Children With Autism Have Mitochondrial Dysfunction (PMID 21119085).

This brings up the possibility that supplements targeting mitochondrial function could have a role in autism treatment.

Reminded me of this thread back on M&M
http://www.mindandmu...showtopic=42450

There's some indication that lactate metabolism may be altered in autistic children. I'd say its worth a read, even if it does mostly focus on ADHD, there's some interesting studies on autism mentioned.

[Rational Madman]

Although there doesn't seem to be much energy devoted toward this avenue, I think it's somewhat worthy of inquiry. An Internet friend---that formerly maintained a pretty neurotic blog on food intolerances---claims that nearly all of her ostensible intolerances, and additionally, her symptoms of Asperger's Syndrome have been greatly attenuated by thyroid replacement therapy. Does that mean that there's a correlation between clear or cryptic hypothyroidism? Probably not. But I think thyroid replacement might be addressing some of the symptoms, and perhaps address problems with an etiology where there has been a burgeoning amount of interest---which is the mitochondria.

Edited by Rol82, 19 January 2011 - 03:19 AM.

[niner]

This study on carnosine is interesting, particularly considering what a benign compound it is.

J Child Neurol. 2002 Nov;17(11):833-7.
Double-blind, placebo-controlled study of L-carnosine supplementation in children with autistic spectrum disorders.

Chez MG, Buchanan CP, Aimonovitch MC, Becker M, Schaefer K, Black C, Komen J.

Research Division, Autism and Epilepsy Specialty Services of Illinois, Ltd, Lake Bluff, IL 60044, USA. mchezmd@interaccess.com
Abstract

L-Carnosine, a dipeptide, can enhance frontal lobe function or be neuroprotective. It can also correlate with gamma-aminobutyric acid (GABA)-homocarnosine interaction, with possible anticonvulsive effects. We investigated 31 children with autistic spectrum disorders in an 8-week, double-blinded study to determine if 800 mg L-carnosine daily would result in observable changes versus placebo. Outcome measures were the Childhood Autism Rating Scale, the Gilliam Autism Rating Scale, the Expressive and Receptive One-Word Picture Vocabulary tests, and Clinical Global Impressions of Change. Children on placebo did not show statistically significant changes. After 8 weeks on L-carnosine, children showed statistically significant improvements on the Gilliam Autism Rating Scale (total score and the Behavior, Socialization, and Communication subscales) and the Receptive One-Word Picture Vocabulary test (all P < .05). Improved trends were noted on other outcome measures. Although the mechanism of action of L-carnosine is not well understood, it may enhance neurologic function, perhaps in the enterorhinal or temporal cortex.

PMID: 12585724

[stephen_b]

Acetyl-l-carnitine arginate might be something to consider. It has been found to stimulate brain neurite growth in rat cells (PMID 7739750). From LEF:

Acetyl-L-carnitine arginate has several valuable properties. The attachment of an arginine molecule to acetyl-L-carnitine gives this compound a number of additional benefits for the aging brain. Acetyl-L-carnitine arginate appears to mimic the effects of a protein called nerve growth factor that supports the survival of neurons in areas of the brain associated with emotion, such as the hippocampus, and in the forebrain, which is associated with cognition, emotion, and important body functions.

[caruga]

The study on mitochondria was very interesting to me. I'm arguably on the spectrum (asperger's) and Piracetam is reported to improve mitochondrial dysfunction, and I've lately been taking it along with magnesium, malic acid and ALCAR among other things, and I've seen an improvement in my social intelligence even though I wan't taking it for that purpose (although admittedly i've also been doing a lot of introspection on such matters lately so it could also be that...).

[Rational Madman]

This study on carnosine is interesting, particularly considering what a benign compound it is.

J Child Neurol. 2002 Nov;17(11):833-7.
Double-blind, placebo-controlled study of L-carnosine supplementation in children with autistic spectrum disorders.

Chez MG, Buchanan CP, Aimonovitch MC, Becker M, Schaefer K, Black C, Komen J.

Research Division, Autism and Epilepsy Specialty Services of Illinois, Ltd, Lake Bluff, IL 60044, USA. mchezmd@interaccess.com
Abstract

L-Carnosine, a dipeptide, can enhance frontal lobe function or be neuroprotective. It can also correlate with gamma-aminobutyric acid (GABA)-homocarnosine interaction, with possible anticonvulsive effects. We investigated 31 children with autistic spectrum disorders in an 8-week, double-blinded study to determine if 800 mg L-carnosine daily would result in observable changes versus placebo. Outcome measures were the Childhood Autism Rating Scale, the Gilliam Autism Rating Scale, the Expressive and Receptive One-Word Picture Vocabulary tests, and Clinical Global Impressions of Change. Children on placebo did not show statistically significant changes. After 8 weeks on L-carnosine, children showed statistically significant improvements on the Gilliam Autism Rating Scale (total score and the Behavior, Socialization, and Communication subscales) and the Receptive One-Word Picture Vocabulary test (all P < .05). Improved trends were noted on other outcome measures. Although the mechanism of action of L-carnosine is not well understood, it may enhance neurologic function, perhaps in the enterorhinal or temporal cortex.

PMID: 12585724

I like Carnosine, but I think a more powerful agent like Rasagiline or Donepezil have the potential to lead to more clinically significant improvements.

[niner]

This study on carnosine is interesting, particularly considering what a benign compound it is.

J Child Neurol. 2002 Nov;17(11):833-7.
Double-blind, placebo-controlled study of L-carnosine supplementation in children with autistic spectrum disorders.

Chez MG, Buchanan CP, Aimonovitch MC, Becker M, Schaefer K, Black C, Komen J.

Research Division, Autism and Epilepsy Specialty Services of Illinois, Ltd, Lake Bluff, IL 60044, USA. mchezmd@interaccess.com
Abstract

L-Carnosine, a dipeptide, can enhance frontal lobe function or be neuroprotective. It can also correlate with gamma-aminobutyric acid (GABA)-homocarnosine interaction, with possible anticonvulsive effects. We investigated 31 children with autistic spectrum disorders in an 8-week, double-blinded study to determine if 800 mg L-carnosine daily would result in observable changes versus placebo. Outcome measures were the Childhood Autism Rating Scale, the Gilliam Autism Rating Scale, the Expressive and Receptive One-Word Picture Vocabulary tests, and Clinical Global Impressions of Change. Children on placebo did not show statistically significant changes. After 8 weeks on L-carnosine, children showed statistically significant improvements on the Gilliam Autism Rating Scale (total score and the Behavior, Socialization, and Communication subscales) and the Receptive One-Word Picture Vocabulary test (all P < .05). Improved trends were noted on other outcome measures. Although the mechanism of action of L-carnosine is not well understood, it may enhance neurologic function, perhaps in the enterorhinal or temporal cortex.

PMID: 12585724

I like Carnosine, but I think a more powerful agent like Rasagiline or Donepezil have the potential to lead to more clinically significant improvements.

I'd be a little hesitant to use a MAOI (and can't find much on its use in autism), but Donepezil (Aricept) is another compound that Michael Chez, the lead author on the carnosine paper, has used to good effect in autistic kids. Here's a paper on it. More recently, Chez has seen positive results with Memantine:

J Child Neurol. 2007 May;22(5):574-9.
Memantine as adjunctive therapy in children diagnosed with autistic spectrum disorders: an observation of initial clinical response and maintenance tolerability.

Chez MG, Burton Q, Dowling T, Chang M, Khanna P, Kramer C.

Department of Neurology, Rosalind Franklin University/The Chicago Medical School, Chicago, Illinois, USA. mchezmd@yahoo.net
Abstract

Autism and Pervasive Developmental Disorder Not Otherwise Specified are common developmental problems often seen by child neurologists. There are currently no cures for these lifelong and socially impairing conditions that affect core domains of human behavior such as language, social interaction, and social awareness. The etiology may be multifactorial and may include autoimmune, genetic, neuroanatomic, and possibly excessive glutaminergic mechanisms. Because memantine is a moderate affinity antagonist of the N-methylD-aspartic acid (NMDA) glutamate receptor, this drug was hypothesized to potentially modulate learning, block excessive glutamate effects that can include neuroinflammatory activity, and influence neuroglial activity in autism and Pervasive Developmental Disorder Not Otherwise Specified. Open-label add-on therapy was offered to 151 patients with prior diagnoses of autism or Pervasive Developmental Disorder Not Otherwise Specified over a 21-month period. To generate a clinician-derived Clinical Global Impression Improvement score for language, behavior, and self-stimulatory behaviors, the primary author observed the subjects and questioned their caretakers within 4 to 8 weeks of the initiation of therapy. Chronic maintenance therapy with the drug was continued if there were no negative side effects. Results showed significant improvements in open-label use for language function, social behavior, and self-stimulatory behaviors, although self-stimulatory behaviors comparatively improved to a lesser degree. Chronic use so far appears to have no serious side effects.

PMID: 17690064

[niner]

This is a pretty good paper, with free full text. Two things jumped out at me that I hadn't seen before; The first is that children on the spectrum are quite low in whole blood lithium, which suggests an easy experiment: Supplement with low dose lithium orotate. Another thing that I wanted to bring up was the unusually high level of uridine in autistic children, probably due to poor methylation. There's been a lot of interest in uridine around here of late, but this suggests that it would be a bad idea for people with Aspergers. Also of note was a low level of iodine in a significant subset of the autism group. Go here for a quick look at the figures from the paper, and here for full text.

Nutr Metab (Lond). 2011 Jun 8;8(1):34.
Nutritional and metabolic status of children with autism vs. neurotypical children, and the association with autism severity.
Adams JB, Audhya T, McDonough-Means S, Rubin RA, Quig D, Geis E, Gehn E, Loresto M, Mitchell J, Atwood S, Barnhouse S, Lee W.

Arizona State University, Tempe, AZ, USA. jim.adams@asu.edu.

BACKGROUND:

The relationship between relative metabolic disturbances and developmental disorders is an emerging research focus. This study compares the nutritional and metabolic status of children with autism with that of neurotypical children and investigates the possible association of autism severity with biomarkers.
METHOD:

Participants were children ages 5-16 years in Arizona with Autistic Spectrum Disorder (n = 55) compared with non-sibling, neurotypical controls (n = 44) of similar age, gender and geographical distribution. Neither group had taken any vitamin/mineral supplements in the two months prior to sample collection. Autism severity was assessed using the Pervasive Development Disorder Behavior Inventory (PDD-BI), Autism Treatment Evaluation Checklist (ATEC), and Severity of Autism Scale (SAS). Study measurements included: vitamins, biomarkers of vitamin status, minerals, plasma amino acids, plasma glutathione, and biomarkers of oxidative stress, methylation, sulfation and energy production.
RESULTS:

Biomarkers of children with autism compared to those of controls using a t-test or Wilcoxon test found the following statistically significant differences (p < 0.001): Low levels of biotin, plasma glutathione, RBC SAM, plasma uridine, plasma ATP, RBC NADH, RBC NADPH, plasma sulfate (free and total), and plasma tryptophan; also high levels of oxidative stress markers and plasma glutamate. Levels of biomarkers for the neurotypical controls were in good agreement with accessed published reference ranges. In the Autism group, mean levels of vitamins, minerals, and most amino acids commonly measured in clinical care were within published reference ranges.A stepwise, multiple linear regression analysis demonstrated significant associations between several groups of biomarkers with all three autism severity scales, including vitamins (adjusted R2 of 0.25-0.57), minerals (adj. R2 of 0.22-0.38), and plasma amino acids (adj. R2 of 0.22-0.39).
CONCLUSION:

The autism group had many statistically significant differences in their nutritional and metabolic status, including biomarkers indicative of vitamin insufficiency, increased oxidative stress, reduced capacity for energy transport, sulfation and detoxification. Several of the biomarker groups were significantly associated with variations in the severity of autism. These nutritional and metabolic differences are generally in agreement with other published results and are likely amenable to nutritional supplementation. Research investigating treatment and its relationship to the co-morbidities and etiology of autism is warranted.

PMID: 21651783 PMCID: PMC3135510 Free PMC Article

From the full text:

Overall, the problems with SAM, glutathione, and oxidative stress suggest that children with autism need increased anti-oxidant support, folinic acid (not folic) and vitamin B12 to support the methionine cycle. (Folic acid is not sufficient in most cases. In the James et al 2004 [8] study 16 of the 20 children with autism were taking a multivitamin and mineral supplement containing 400 ug folic acid and 3 ug vitamin B-12 but still had abnormal methylation; folinic acid, not folic acid, was needed to normalize methylation).

Our results suggest that some children with autism (those with low tryptophan and phenylalanine) would benefit from either increased protein intake, use of digestive enzymes containing proteases, and/or supplements of tryptophan (or 5-HTP) and phenylalanine.

If you're interested in this, I'd recommend a look at the full text; there is more there.

[Now]

Thanks niner, you are a hero!

Unfortunately they don't test nutritional and metabolic status and just suggest Risperidone. Lithium is interesting, but is it not dangerous to take without monitoring plasma concentrations? I have my B12 level (commercially) tested a year ago and that level was normal.

[niner]

Lithium is interesting, but is it not dangerous to take without monitoring plasma concentrations?

It's safe if you are just trying to normalize blood levels. You would probably only need a milligram or two, which is hundreds of times less than the amounts that are used therapeutically in bipolar conditions. There's a milligram of lithium in Vimmortal. I take a quarter of a Doctor's Best 5mg Lithium Orotate tablet daily.

[Logan]

How about Luteolin or LDN?