Autism spectrum disorder (ASD) has an unclear cause but is associated with various genetic neurologic metabolic and immunologic factors. Although there is no definitive treatment there has been increasing use of dietary interventions and nutritional support in these patients. For example many children with ASD take nutritional supplements and follow specific diets such as a gluten-free and casein-free (GFCF) diet.
Pharmaceutical and behavioral therapies are often used but their success is limited. This can be due to the high variability of autism as well as adverse reactions to medications.
According to a review published seven days ago in Brain Development researchers demonstrated the clinical efficacy and safety of dietary supplements in children with autism.
In this review 17 studies were included evaluating the efficacy of amino acids fatty acids and specific vitamins and minerals. As a result n-acetylcysteine (NAC) was shown to have a beneficial effect on symptoms of irritability. Additional data demonstrated encouraging results with ascorbic acid and methylcobalamin supplementation.
Oxidative stress is a hypothesized mechanism in the pathogenesis of ASD. These patients have been found to have elevated oxidative stress markers as well as decreased levels of glutathione.
N-acetylcysteine provides antioxidant effects as well as cysteine to restore glutathione. According to the researchers NAC was shown to improve irritability in a clear dose dependent manner.
Previous research has demonstrated significantly lower vitamin and mineral concentrations in children with autism. This could be associated with the fact that children with autism tend to be picky eaters or may have an aversion to vegetables or certain foods; therefore they may not be getting sufficient amounts of vitamins and minerals.
Vitamin B6 B12 and magnesium demonstrated the greatest efficacy after NAC and ascorbic acid. Vitamin B6 and magnesium have been shown to be involved in serotonin dopamine and norepinephrine synthesis and a B12 deficiency has been associated with defects in myelin synthesis and neurotransmitter imbalances.
Children with ASD may obtain most of their required nutrients from their diet; however it is essential to determine the specific nutrient need of each child. The level of nutrient intake that maintains the best possible health is highly variable from person to person. Lifestyle choices and environmental exposures filtered through genetic predisposition are fundamental factors in ASD and a successful treatment approach must include investigation into these factors. It is important to assess the nutrient status of the child. This can include the status of antioxidants vitamins essential fatty acids vitamin D magnesium etc. Also it is critical to assess gut health including leaky gut and dysbiosis. Many of these children have a dysbiosis and opportunistic infections.
Children with ASD have significantly different concentrations of certain bacteria in their stool compared to children without ASD. Increasing evidence suggests that children with ASD have altered gut bacteria. It is suspected that gut microbes can alter the levels of neurotransmitter-related metabolites affecting the gut-to-brain communication and alter brain function.
By Michael Jurgelewicz DC DACBN DCBCN CNS
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