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Effect of Vitamin/Mineral Supplements on Children with Autism

Effect of Vitamin/Mineral Supplements on Children with Autism. James B. Adams parent of a child with autism President of Greater Phoenix Chapter of ASA engineering professor at Arizona State University. Research Team. Jim Adams: organizer;

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Effect of Vitamin/Mineral Supplements on Children with Autism

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  1. Effect of Vitamin/Mineral Supplements on Children with Autism James B. Adams parent of a child with autism President of Greater Phoenix Chapter of ASA engineering professor at Arizona State University

  2. Research Team • Jim Adams: organizer; • Richard Fabes: statistician; chair of Human Resources and Family Development at Arizona State Un. • Carol Johnston: professor of nutrition at Arizona State University; expert in vitamins and minerals • Raun Melmed, M.D.: developmental pediatrician; co-medical director of Southwest Autism Research Center • Cindy Schneider, M.D.: co-medical director of Southwest Autism Research Center • many volunteers from ASA and SARC

  3. Goal of our study: Determine if vitamin/mineral supplements can reduce some of the symptoms of autism

  4. Why consider vitamin/mineral supplements? Vitamins and minerals are essential for good health of everyone. The lack of essential vitamins and minerals results in disease - this is the definition of an “essential vitamin/mineral” Deficiency of Vitamin C: scurvy Deficiency of Vitamin D: rickets Deficiency of Iron: anemia High levels of vitamin/mineral intake have been shown to improve health in many cases Many typical Americans suffer from vitamin/mineral deficiencies: 30% of Americans are deficient in Vitamin C many women are deficient in calcium and iron 80% of Americans suffer from deficiencies in magnesium and chromium

  5. Why consider vitamin/mineral supplements for people with autism? 1) often restricted diets (“picky eaters”): limited vitamin/mineral intake 2) poor digestion (25% have chronic diarrhea, 25% have chronic constipation); Wakefield’s work shows intestinal problems limited absorption of vitamins/minerals 3) Shaw’s work suggests presence of yeast/bacterial infection in intestine: fewer “good” bacteria which actually produce several vitamins 4) 18 studies demonstrated benefits of vitamin B6/Mg 5) 1 study showed vitamin C was beneficial in autism 6) Prof. Megson: cod liver oil (with high levels of vitamin A, D, and essential fatty acids) helped with gaze aversion, behavior 7) Dr. Rimland’s set of parent-reported case studies on benefits of vitamins/minerals

  6. Dr. Rimland’s database: self-reported by parents Supplement # respondents % worse % same % better calcium 97 1 41 58 vitamin C 220 3 48 49 folic acid 226 3 53 44 vitamin B6 and Mg 2050 5 49 46 zinc 88 6 44 50 dimethylglycine 1467 7 52 41 niacin or niacinamide 49 8 47 45

  7. Vitamin/Mineral Testing by Dr. Emar Vogelaar Tested blood levels in 20 children with autism Found low levels of the following vitamins/minerals in over 50% of children A, B1, B3, B5, biotin, selenium, zinc, and magnesium. Also found that over 50% of the patients had low levels of essential amino acids and two essential fatty acids (EPA and DGLA).

  8. Why test a multi-vitamin/mineral supplement? 1) Over 20 essential vitamins and minerals, so very difficult to test every one individually 2) Many vitamins/minerals work together: Vitamin B6 and Mg Vitamin C and bioflavonoids Vitamin D, Calcium, and Magnesium 3) If individual vitamins/minerals help some, perhaps including all the essential vitamin/minerals would help more 4) Despite widespread use, no prior research on effect of multi-vitamin/mineral supplements on people with autism

  9. Thousands of supplements on market;Which to choose? Criteria: 1) want high level of B6 and Magnesium, with some/all B6 in P5P form (other forms may not be well absorbed if yeast infection) 2) no copper (too high in most children with autism) 3) no iron (not needed in most children) 4) high levels of all other vitamins/minerals within safe ranges (especially careful with A, D, K which are fat-soluble and can build up in body) 3 optimal choices, Kirkman’s Super Nu-Thera, Brainchild’s Spectrum Support, and DANplex (all developed for children with autism)

  10. Spectrum Support Developed by a father of a child with autism; New; previously used by about 100 children with autism; 3 levels (I, II, and III) all in liquid form with lemon/lime flavor contains high levels of all vitamins and minerals except: no vitamin A; (contains beta-carotene instead) moderate calcium (in case drinking milk) moderate D (so can take with cod liver oil) sweetened with vegetable glycerin; no artificial colors or flavors; GFCF

  11. Vitamins SSII SSIII %RDI A (as Carotenes) 6000 IU 7500 IU 200% B1 20 mg 25 mg 2778% B2 20 mg 25 mg 2272% B-3 Niacinamide 20 mg 25 mg 346% B-3 Inositol H. 15 mg 20 mg (above) B-5 60 mg 85 mg 1545% B-6 (as P5P) 20 mg 35 mg 25,600% B-12 600 mcg 800 mcg 6668% Folic Acid 500 mcg 700 mcg 467% Biotin 60 mcg 100 mcg 400* Choline 60 mg 90 mg * Inositol 60 mg 90 mg * Vitamin C 350 mg 450 mg 1000% Bioflavoinoids 250 mg 400 mg * D-3 200 IU 200 IU 50% E 125 IU 150 IU 750%

  12. Minerals SSII SSIII %RDI Calcium 280 mg 400 mg 48% Magnesium 325 mg 400 mg 329% Potassium 98 mg 99 mg * Zinc 20 mg 30 mg 400% Manganese 5 mg 8 mg * Chromium 75 mcg 100 mcg * Selenium 75 mcg 85 mcg * Molybdenum 50 mcg 75 mcg * Silica 0 10 mg * * values not set by US Food and Drug Administration

  13. Other Ingredients SSII SSIII Betaine 100 mg 200 mg MSM 200 mg 275 mg DMAE 80 mg 90 mg N-Acetyl Cysteine 15 mg 25 mg trace amounts of many herbs: Ashwaganda Root, Burdock root, Chinese Astralagus Root, Ginkgo Bilboba Leaf, , Gotu Kola Leaf, Gymnema Sylvestre Leaf, Schisandra Fruit, Milk Thistle Seed, Siberian Ginseng, Slippery Elm

  14. Finding Participants 1) Mass mailing to 1000 families with autism in AZ 2) Eligibility criteria: • age 2.5 to 7 yrs • diagnosed with autistic spectrum disorder • not taking any other vitamins/minerals (except regular children’s vitamin allowed) • no changes in any treatments in last 2 months • willing to keep other treatments constant during study

  15. Research Protocol • 3 month study • Half of subjects receive placebo • Half of subjects receive vitamin/mineral supplement • Dosage is slowly increased to maximum over first 2 months, then held constant • Double-blind: participants and examiners don’t know who is getting what until study ends

  16. Eliminated from study: placebo group Case 1) developed diarrhea 2 weeks into study (had history of frequent bouts of diarrhea); parent stopped “supplement”, but diarrhea continued for another week; Case 2) started risperdal 2 weeks into study; one week later child frequently lost control of bladder and bowels; parent stopped “supplement”; problems continued

  17. Eliminated from study: supplement group Case 1) Family went on vacation and stopped giving supplement; Cases 2 and 3) Twins reported occasional vomiting only in evening; supplements given at 9 pm on empty stomach \ Case 4) Child did not take supplement consistently

  18. Final Group of Participants • Placebo: 7 boys, 1 girl; • Supplement: 7 boys, 1 girl; • Same average age in each group (5.5 years) • Save average severity of autism (moderate)

  19. Testing/Evaluation • Testing at 0 and 12 weeks, including: • physical exam by medical doctor • blood sample to measure vitamin/mineral level • urine sample to measure vitamin/mineral level • SARC medical history (150 questions) • Parent reports (100 questions) at weeks 0, 2, 4, 6, 8, 10, and 12 • Diet analysis based on 11 daily food logs

  20. Vitamin C results (at end of study) range average Placebo: 0.9-1.4 1.03 Suppl. 1.0-2.0 1.33 The difference of 0.3 is statistically significant to 95% confidence Typical children age 3-17 average=1.3; Below 0.5 is marginal, and below 0.2 is deficient Data suggests control group had slightly low levels of C, and suggests that supplement did improve level of C in blood

  21. Vitamin B6 levels Pre-study: placebo: 54 ng/ml supplement: 57 Post study: placebo: 65 supplement: 97 Typical controls: 35 (22-47 range) Conclusion: children with autism have significantly elevated B6 levels, and supplement increases them Explanation: recent study by Dr. Tapan Audhya found that enzyme for conversion of B6 is defective in autism, such that conversion rate is 1/10 of normal

  22. Overall Results Based on parent evaluations on final day of study 7 point scale 1=much worse 2=worse 3=slightly better 4=same 5=slightly better 6=better 7=much better

  23. Alpha Lipoic Acid Levels • Autism: average 3.8, range 2.8-6.1 • Typical Adult: range 2.3-5 • Thus, children with autism don’t seem to have abnormal alpha lipoic acid levels, although values for typical children (not adults) are needed to be sure

  24. Overall Results Category Placebo Supplement Difference Sociability 5.1 5.3 +0.1 Expr. Language 5.6 5.9 +0.3 Rec. Language 4.9 5.8 +0.9 Eye Contact 4.9 5.5 +0.6 General Behavior 4.3 5.1 +0.8 Sleep 3.9 5.4 +1.5 Stools/Gastrointest. 3.9 5.4 +1.5 Overall 5.1 5.5 +0.4 Sleep and Stool results are statistically significant to 99.5% confidence; Receptive Language and General Behavior are significant at 80% level Expressive Language Placebo Supplement

  25. Some children improve much more than others Nobody worse Supplement seems to help children independent of age

  26. 100 Questions Filled out every 2 weeks by same parent Scale of 1 to 5 1=never 2=rarely 3=sometimes 4=frequently 5=always

  27. Major Results from Survey by Category Category: placebo change supplement change difference Sleep +0.08 +1.23 +1.18 Aggression +0.09 +0.69 +0.60 Communication +0.06 +0.52 +0.46 Motor Skills +0.02 +0.44 +0.42 Cognitive +0.13 +0.55 +0.42 Rep. Behav. +0.24 +0.60 +0.36 Daily Living +0.14 +0.46 +0.32 Sensory +0.16 +0.45 +0.29 Diet +0.12 +0.26 +0.14 Social Inter. +0.30 +0.42 +0.12 Inappr. Behav. +0.38 +0.43 +0.05 Hyperactivity +0.40 +0.39 -0.01 Conclusion: Supplement especially helped sleep, and also general improvement in many other areas

  28. Summary • Children with autism are low in vitamin C, high in B6 (but need even more B6) • Multi-vitamin/mineral supplement led to many improvements in the symptoms of autism, especially regarding sleep and GI problems • Larger study needed, with pre- and post-testing of all vitamin/mineral levels • See http://www.eas.asu.edu/~autism/ for copy of handout and other information

  29. Acknowledgements Financial support from the ASA Foundation, Arizona State University, ASA-Phoenix and FEAT-Tucson SARC for use of facilities and staff The families who participated in the study Brainchild Nutritionals for providing product and placebo at cost (831) 465-0104 Note: Researchers have no financial link with Brainchild Nutritionals

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