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April 23, 2008
Whether it's due to keener diagnoses, wider public awareness of the condition, an actual increase in the occurrence of autism or, more likely, a combination of all three factors, there is no denying that the number of reported cases of autism is on the rise. In fact, the U.S. Centers for Disease Control reports that 5.7 children out of every thousand—one in 175—now have the condition. Despite the growing need for a cure, effective treatments for autism are still elusive.
In truth, nearly everything about autism is indefinable. For example, it displays no outward physical characteristics, and so doctors must diagnose it based on the occurrence of behavioral symptoms, including impairments in social interaction and communication, as well as restricted and repetitive behaviors. Similarly, its causes have been attributed to a wide variety of sources—from genetics to abnormal connections in the brain to environmental factors, such as vaccinations or pollution. Despite all of this uncertainty, one thing is clear: A number of natural therapies are showing promise for treating the condition.
Vitamin B6 and magnesium
Currently, vitamin B6 is making a solid name for itself in the treatment of autism symptoms, but researchers have been speculating about its benefits for decades. In fact, as early as 1968, administration of high doses of vitamin B6 (100 mg to 600 mg) was reported to significantly improve the behavior of 12 of 16 children with autism.1 Although the evidence from this small study was considered somewhat anecdotal, it gave rise to a number of similar trials in the late 1970s. These included a double-blind study that, while flawed in certain methodological aspects, revealed that the autistic participants' behavior deteriorated during the times when they were not given B6.2
The mechanism behind the effects of vitamin B6 is thought to be its role in neurotransmitter formation. Studies have suggested that individuals displaying autistic symptoms often suffer from disturbances in the metabolism of brain neurotransmitters, such as dopamine and serotonin.3 B6 supplementation appears to help normalize neurotransmitter processing and thereby ease some autism symptoms. The best effects occur when magnesium is added to vitamin B6 supplementation, because high doses of vitamin B6 can give rise to magnesium deficiency.
In 1995, a methodological review of the existing literature on supplementation with vitamin B6 and magnesium, consisting of 12 studies, was conducted and published in the Journal of Autism and Developmental Disorders.4 Despite certain procedural shortcomings in a number of studies, including small sample size and repeat use of subjects, the majority of studies reported a favorable response to administration of vitamin B6 and magnesium, and indicate B6-Mg supplementation may be a promising adjunct to autism treatment.
More recent science backs up this evidence. Although not a placebo-controlled study, a 2006 trial demonstrated fairly dramatic results.5 Thirty-three autistic children between the ages of 1 and 10 were given 0.6 mg of vitamin B6 per kilogram of body weight and 6 mg of magnesium per kilogram of body weight daily for an average of eight months. The results showed improvements in social inter?actions in 23 patients, communication in 24 patients, restricted behavior in 18, and abnormal functioning in 17. The percentage of overall improvement ranged from 49 percent to 53 percent. What's more, when treatment ceased, symptoms recurred within a few weeks.
Omega-3 fatty acids
Omega-3 fatty acids—such as those found in fish oils—are directly involved in the structure and activity of every cell of the body, and particularly in the brain. In children, the role of omega-3 essential fatty acids in the treatment of autism is being aggressively investigated, especially in light of the growing evidence that fatty-acid imbalances or deficiencies may contribute to autistic disorders.6
In a randomized, placebo-controlled study published in Biological Psychiatry in 2007, 13 children (age 5 to 17 years) with autistic disorders accompanied by severe tantrums, aggression or self-injurious behavior, were given 1.5 g of omega-3 fatty acids (providing .84 gm per day of eicosapentaenoic acid and .7 gm per day of docosahexa?enoic acid) or a placebo daily for six weeks. Results were measured on the Aberrant Behavior Checklist at six weeks.
Although this study had limitations, including a small sample size and failure to prove statistical significance, there was a noticeable tendency for greater remission of hyperactive symptoms in the experimental group versus the placebo group.7 Similarly, in a study published in 2004, parents of autistic children who received 2 gm to 4 gm per day of fish oils rich in omega-3s reported improvements in general health, sleeping patterns, cognitive and motor skills, concentration, and eye contact and sociability, as well as reductions in irritability, aggression and hyperactivity.8 However, this was not a blinded, placebo-controlled study.
The idea behind treating autism with a gluten- and casein-free diet is based on the opioid hypothesis of what causes autism. (An opioid is a chemical substance that has a morphine-like action in the body.) This theory says defective enzymes in an autistic child's intestines allow incompletely digested molecules of gluten and casein—from gluten-containing grains and dairy products, respectively—to pass through the gut, causing opioid-like effects such as irritability, lack of social awareness, self-stimulation and issues with attention. Eliminating these foods as well as soy (another top allergen) for one month is usually sufficient to determine if a dietary approach will help ease autistic symptoms.
In one study, 270 individuals, including 149 with autism, were fed the GFCF diet for one year. Each of the study participants was assessed for behavioral and physiological measures by parents, physicians and some teachers. Results showed an improvement in 81 percent of autistic children on the GFCF diet within three months.9 Moreover, in a recent trial published in International Journal of Immunopathology and Pharmacology, blood samples of 50 autistic children showed that a significant number developed antibodies to casein and gliadin (a component of gluten), and these same molecules, as well as ethyl mercury, were shown to bind to lymphocyte and tissue enzymes, likely triggering inflammatory and immune responses in autistic children.10
Recent research into the effectiveness of the GFCF diet in treating autism led to a randomized, double-blind study in which 13 children ate either a regular diet or the GFCF diet for 12 weeks. Autism symptoms were measured in terms of social initiation, social response, intelligible words spoken and nonspeech vocalizations. Results showed no significant differences. However, anecdotal reports from parents of seven of the children reported marked improvements in the child's use of language, decreased hyperactivity and fewer tantrums. Further, parents of nine children decided to keep the children on the GFCF diet even though there was no empirical support for continuing.11
The future of autism
For parents of autistic children, natural approaches to treating the condition are a great source of hope and promise. The number of anecdotal reports of improve?ments from nutrient supplementation, dietary changes and other natural treatments is growing, and so is the science to back them up. Because autism is still a mysterious condition in many regards, it is best for consumers to work with a trained health practitioner who understands a child's specific symptoms and the remedies that may help.
Linda Knittel, M.A., is a Portland, Ore.-based freelance writer. She is the author of User's Guide to Natural Remedies for Depression (Basic Health Publications, 2003).
1. Bonisch V. Experience with pyrithioxinine brain damaged children with autistic syndrome. Praxis der Kinderpsychologie 1968;8:308-10.
2. Rimland B, et al. The effects of high doses of vitamin B6 on autistic children. Am J Psychiatry 1978;135:472-5.
3. Werbach, MR. Nutritional treatments for autism. Townsend Letter for Doctors and Patients 2003;243:176.
4. Pfeiffer SI, et al. Efficacy of vitamin B6 and magnesium in the treatment of autism: a methodology review and summary of outcomes. J Autism Dev Disord 1995;25(5):481-93.
5. Mousain-Bosc M, et al. Improvement of neurobehavioral disorders in children supplemented with magnesium-vitamin B6. II. Pervasive developmental disorder?autism. Magnes Res 2006;19:53-62.
6. Vancassel S, et al. Plasma fatty acid levels in autistic children. Prostaglandins Leukot Essent Fatty Acids 2001;65:1-7.
7. Amminger GP, et al. Omega-3 fatty acid supplementation in children with autism: a double-blind randomized, placebo-controlled pilot study. Biol Psychiatry 2007;61:551-3.
8. Bell JG, et al. Essential fatty acids and phospholipase A2 in autistic spectrum disorders. Prostaglandins Leukot Essent Fatty Acids 2004;71:201-4.
9. Cade R, et al., Autism and schizophrenia: intestinal disorders. Nutr Neurosci 1999;3:57-72.
10. Vojdani A, et al. Infections, toxic chemicals and dietary peptides binding to lymphocyte receptors and tissue enzymes are major instigators of autoimmunity in autism. Int J Immunopathol Pharmacol 2003;16(3):189-99.
11. Elder JH, et al. The gluten-free diet in autism: results of a preliminary double-blind clinical trial. J Autism Dev Disord 2006;36(3):413-20.
12. Danczak E. Glucosamine and plant lectins in autistic spectrum disorders: an initial report on 6 children with uncontrolled diarrhoea. J Nutr Environ Med 2004;14:327-30.
13. Dolske MC, et al. A preliminary trial of ascorbic acid as supplemental therapy for autism. Prog Neuropsycholpharmacol Biol Psychiatry 1993;17:765-74.
14. Dosman CF, et al. Children with autism: effect of iron supplementation on sleep and ferritin. Pediatr Neurol 2007;36(3):152-8.
Natural Foods Merchandiser volume XXVIII/number 9/p. 102, 104
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