Approximately 2% of American children experience symptoms among the autism spectrum. Many of these children have difficulty interacting and communicating with others. Currently, the only approved medications for autism are antipsychotic medications that address some symptoms but many times lead to unwanted side effects. Many of these families seek integrative doctors to investigate food sensitivities, environmental toxins, nutritional deficiencies, and metabolic imbalances not seen on standard laboratory testing.
According to a study published three days ago in Nature’s Molecular Psychiatry, researchers demonstrated that therapeutic doses of folinic acid can help improve the language and communication skills of children with autism spectrum disorder (ASD).
Previous research has identified a link between autism and abnormalities in the metabolism of folate as well as genes involved in folate metabolism. In addition, other studies have demonstrated that children of mothers who took folate supplements before during pregnancy had a lower risk of having a child with ASD. Researchers have also described cerebral folate deficiency (CFD) in which the concentration of folate is below normal in the central nervous system but not in the blood. Many children with CFD have ASD symptoms and respond well to high-dose folinic acid. It had also been demonstrated that folate receptor autoantibodies were commonly found in children with ASD.
In this study, researchers found that children with folate receptor autoantibodies had a more favorable response to treatment with folate. Improvement in verbal communication was significantly greater in children who received folinic acid compared with those receiving the placebo.
Folate is not the only important nutrient for children with ASD. I shared a study earlier this year in January published in PLOS One which found that vitamin B12 levels in the brain are significantly lower in children with autism. In this study autistic children were found to have brain vitamin B12 levels three times lower then what is commonly seen in adults in their fifties. These differences were not seen in serum B12 levels. This large deficit of brain B12 in individuals with autism may provide insight as to why these patients experience neurological and neuropsychiatric symptoms.
Autism spectrum disorders are also associated with oxidative stress, which may play an underlying role in the decreased brain B12 levels observed in this study. These results suggest there may be a need for supplemental vitamin B12 and antioxidant support to help prevent or decrease oxidative stress. This may include using n-acetyl-l-cysteine, glutathione, and/or s-acetyl-glutathione.
Assessing other methylation cofactors such as folate are also important as a folate deficiency has been associated with developmental delay and autism, and is essential in treating these conditions as identified in the study above. An organic acid test is also a great test to assess nutrient deficiencies, oxidative stress, and detoxification impairment, as well as stool testing to assess the gut microbiome.
By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS
Source: R E Frye, J Slattery, L Delhey, B Furgerson, T Strickland, M Tippett, A Sailey, R Wynne, S Rose, S Melnyk, S Jill James, J M Sequeira, E V Quadros. Folinic acid improves verbal communication in children with autism and language impairment: a randomized double-blind placebo-controlled trial. Molecular Psychiatry, 2016; DOI:10.1038/mp.2016.168