Effect of a vitamin/mineral supplement on children and adults with autism

BackgroundVitamin/mineral supplements are among the most commonly used treatments for autism, but the research on their use for treating autism has been limited.MethodThis study is a randomized, double-blind, placebo-controlled three month vitamin/mineral treatment study. The study involved 141 children and adults with autism, and pre and post symptoms of autism were assessed. None of the participants had taken a vitamin/mineral supplement in the two months prior to the start of the study. For a subset of the participants (53 children ages 5-16) pre and post measurements of nutritional and metabolic status were also conducted.ResultsThe vitamin/mineral supplement was generally well-tolerated, and individually titrated to optimum benefit. Levels of many vitamins, minerals, and biomarkers improved/increased showing good compliance and absorption. Statistically significant improvements in metabolic status were many including: total sulfate (+17%, p = 0.001), S-adenosylmethionine (SAM; +6%, p = 0.003), reduced glutathione (+17%, p = 0.0008), ratio of oxidized glutathione to reduced glutathione (GSSG:GSH; -27%, p = 0.002), nitrotyrosine (-29%, p = 0.004), ATP (+25%, p = 0.000001), NADH (+28%, p = 0.0002), and NADPH (+30%, p = 0.001). Most of these metabolic biomarkers improved to normal or near-normal levels.The supplement group had significantly greater improvements than the placebo group on the Parental Global Impressions-Revised (PGI-R, Average Change, p = 0.008), and on the subscores for Hyperactivity (p = 0.003), Tantrumming (p = 0.009), Overall (p = 0.02), and Receptive Language (p = 0.03). For the other three assessment tools the difference between treatment group and placebo group was not statistically significant.Regression analysis revealed that the degree of improvement on the Average Change of the PGI-R was strongly associated with several biomarkers (adj. R2 = 0.61, p < 0.0005) with the initial levels of biotin and vitamin K being the most significant (p < 0.05); both biotin and vitamin K are made by beneficial intestinal flora.ConclusionsOral vitamin/mineral supplementation is beneficial in improving the nutritional and metabolic status of children with autism, including improvements in methylation, glutathione, oxidative stress, sulfation, ATP, NADH, and NADPH. The supplement group had significantly greater improvements than did the placebo group on the PGI-R Average Change. This suggests that a vitamin/mineral supplement is a reasonable adjunct therapy to consider for most children and adults with autism.Trial RegistrationClinical Trial Registration Number:NCT01225198

[1]  David W Gaylor,et al.  Efficacy of methylcobalamin and folinic acid treatment on glutathione redox status in children with autism. , 2009, The American journal of clinical nutrition.

[2]  Maurizio Elia,et al.  Sulphation deficit in “low-functioning” autistic children: a pilot study , 1999, Biological Psychiatry.

[3]  E. Geis,et al.  The Severity of Autism Is Associated with Toxic Metal Body Burden and Red Blood Cell Glutathione Levels , 2009, Journal of toxicology.

[4]  M. Thomson,et al.  Focal-Enhanced Gastritis in Regressive Autism with Features Distinct from Crohn's and Helicobacter Pylori Gastritis , 2004, American Journal of Gastroenterology.

[5]  Charles Gant,et al.  Outcome-based comparison of Ritalin versus food-supplement treated children with AD/HD. , 2003, Alternative medicine review : a journal of clinical therapeutic.

[6]  P. Ashwood,et al.  Intestinal Lymphocyte Populations in Children with Regressive Autism: Evidence for Extensive Mucosal Immunopathology , 2003, Journal of Clinical Immunology.

[7]  M. Ireland,et al.  Complementary Alternative Medicine for Children with Autism: A Physician Survey , 2009, Journal of autism and developmental disorders.

[8]  Stepan Melnyk,et al.  Metabolic endophenotype and related genotypes are associated with oxidative stress in children with autism , 2006, American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics.

[9]  E. McCabe,et al.  Perinatal hypophosphatasia: tissue levels of vitamin B6 are unremarkable despite markedly increased circulating concentrations of pyridoxal-5'-phosphate. Evidence for an ectoenzyme role for tissue-nonspecific alkaline phosphatase. , 1988, The Journal of clinical investigation.

[10]  J. B. Adams,et al.  Mercury in first-cut baby hair of children with autism versus typically-developing children , 2008 .

[11]  Janet K. Kern,et al.  A Prospective Study of Transsulfuration Biomarkers in Autistic Disorders , 2009, Neurochemical Research.

[12]  F. George,et al.  Abnormally high plasma levels of vitamin B6 in children with autism not taking supplements compared to controls not taking supplements. , 2006, Journal of alternative and complementary medicine.

[13]  James B. Adams,et al.  Gastrointestinal flora and gastrointestinal status in children with autism -- comparisons to typical children and correlation with autism severity , 2011, BMC gastroenterology.

[14]  F. George,et al.  Analyses of toxic metals and essential minerals in the hair of arizona children with autism and associated conditions, and their mothers , 2006, Biological Trace Element Research.

[15]  James B. Adams,et al.  Pilot study of a moderate dose multivitamin/mineral supplement for children with autistic spectrum disorder. , 2004, Journal of alternative and complementary medicine.

[16]  J. Spollen,et al.  A preliminary trial of ascorbic acid as supplemental therapy for autism , 1993, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[17]  S. Schoenthaler,et al.  The effect of vitamin-mineral supplementation on the intelligence of American schoolchildren: a randomized, double-blind placebo-controlled trial. , 2000, Journal of alternative and complementary medicine.

[18]  H. J. Mcclung,et al.  Treatment of vitamin E deficiency during chronic childhood cholestasis with oral d-alpha-tocopheryl polyethylene glycol-1000 succinate. , 1987, Gastroenterology.

[19]  M. Stipanuk,et al.  Dealing with methionine/homocysteine sulfur: cysteine metabolism to taurine and inorganic sulfur , 2011, Journal of Inherited Metabolic Disease.

[20]  T. Schiano,et al.  Efficacy of water-soluble vitamin E in the treatment of vitamin E malabsorption in short-bowel syndrome. , 1994, The American journal of clinical nutrition.

[21]  J. Breakey,et al.  The role of diet and behaviour in childhood , 1997, Journal of paediatrics and child health.

[22]  B. Hollis,et al.  d-α-Tocopheryl Polyethylene Glycol-1000 Succinate Enhances the Absorption of Vitamin D in Chronic Cholestatic Liver Disease of Infancy and Childhood , 1992, Pediatric Research.

[23]  Karoly Horvath,et al.  Autistic disorder and gastrointestinal disease , 2002, Current opinion in pediatrics.

[24]  L. Mehl-Madrona,et al.  Micronutrients versus standard medication management in autism: a naturalistic case-control study. , 2010, Journal of child and adolescent psychopharmacology.

[25]  J. Bali,et al.  Magnesium VitB6 Intake Reduces Central Nervous System Hyperexcitability in Children , 2004, Journal of the American College of Nutrition.

[26]  M M Konstantareas,et al.  Ear infections in autistic and normal children. , 1987, Journal of autism and developmental disorders.

[27]  David Quig,et al.  Nutritional and metabolic status of children with autism vs. neurotypical children, and the association with autism severity , 2011, Nutrition & metabolism.

[28]  R. Waring,et al.  Sulphur metabolism in autism. , 2000 .

[29]  T. Audhya,et al.  Biochemical Effects of Ribose and NADH Therapy in Children with Autism , 2011 .

[30]  Pat Levitt,et al.  Evaluation, Diagnosis, and Treatment of Gastrointestinal Disorders in Individuals With ASDs: A Consensus Report , 2010, Pediatrics.

[31]  David W Gaylor,et al.  Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism. , 2004, The American journal of clinical nutrition.

[32]  I. Cohen,et al.  The PDD Behavior Inventory: A Rating Scale for Assessing Response to Intervention in Children with Pervasive Developmental Disorder , 2003, Journal of autism and developmental disorders.

[33]  J. García-Erce,et al.  An update on iron physiology. , 2009, World journal of gastroenterology.

[34]  James B. Adams,et al.  Mercury, Lead, and Zinc in Baby Teeth of Children with Autism Versus Controls , 2007, Journal of toxicology and environmental health. Part A.

[35]  A. Brotherton,et al.  Principles of nutritional assessment , 2006 .

[36]  BMC Pediatrics , 2005 .

[37]  L. J. V. van Oudheusden,et al.  Efficacy of carnitine in the treatment of children with attention-deficit hyperactivity disorder. , 2002, Prostaglandins, leukotrienes, and essential fatty acids.

[38]  J. Hubbard,et al.  Sleep Disturbances and Correlates of Children with Autism Spectrum Disorders , 2006, Child psychiatry and human development.

[39]  G. Schrauzer Lithium: Occurrence, Dietary Intakes, Nutritional Essentiality , 2002, Journal of the American College of Nutrition.

[40]  A. Bender Nutritional Biochemistry , 1968, Nature.

[41]  J. Kalbfleisch,et al.  Bioavailability of a Novel, Water-Soluble Vitamin E Formulation in Malabsorbing Patients , 2007, Digestive Diseases and Sciences.