Dietary Supplements for Core Symptoms of Autism Spectrum Disorder

Autism Spectrum Disorder is a neurodevelopmental condition characterized by difficulty in social functioning, of which the ‘core symptoms’ are said to be impairment in social interaction and the presence of repetitive behavior. Lack of approved medication compounds an increasing prevalence of ASD. Currently, dietary supplements offer a therapeutic solution in this area. Feeding problems and consequent nutritional deficiency as well as the neurologic, genetic, metabolic and immune basis for the condition are the presumed targets of such dietary therapy.

As supplementary treatment is a safe, affordable, time-saving option already widely used by parents, it is important to qualify its potential effectiveness and safety in treating core symptoms. A qualitative analysis of 22 trials detailing 8 supplements for core symptom treatment in ASD was undertaken to elucidate, for clinicians and caretakers alike, exactly how benefits of daily vitamins may help in alleviating symptoms.

Essential Vitamins

Vitamin B12: Vitamin B12 is vital to the functioning of enzymes involved in some key metabolic pathways that maintain the antioxidation capacity of the body. Metabolic derangements mirroring B12 deficiency have been noticed in children with ASD. Vitamin B12 additionally inhibits nitrous oxide (N20), a potential risk factor for ASD. Supplementation may help reverse these unfavorable biochemical changes, as suggested in trials showing behavioral improvement that was clinically observable and correlated with normalized lab parameters. Vitamin B12 is given through subcutaneous injection, which, although safe, might pose a barrier to patient compliance.

Vitamin D: A steroid-like neuroprotective vitamin, it is essential for myelination and affects neural transmission and synaptic remodeling. ASD patients have been reported to have low levels of vitamin D, a vitamin that has an anti-inflammatory effect on the brain and increases the central production of serotonin. A clinical trial showed that Vitamin D supplementation improves core symptoms in children significantly enough to alter clinical assessment scores. Hence, oral supplementation with vitamin D is a safe and recommended option for treating core symptoms of ASD.

Folinic Acid: Folinic acid is important for the metabolism of homocysteine and glutathione (antioxidant), abnormalities of which are implicated in ASD. Prenatal folate supplementation reduces ASD risk, indicating that this supplement may be useful in addressing the underlying metabolic causes of ASD. Folinic acid can easily cross into the nervous system and cerebrospinal fluid even when a person has autoantibodies against the transport receptor, leading to improvement in neurological symptoms. A recent trial showed that giving kids supplements improves the core symptoms of ASD, especially in children with folate receptor auto-antibodies. It is well-tolerated but safety as a treatment should be further studied. Care needs to be taken when prescribing it in conjunction with vitamin B12 as the two are metabolically interlinked.

Camel Milk: Camel milk is low in allergens compared to cow milk and is a good choice for children with milk allergies. Its constituent proteins have antibacterial and immunological properties that may enhance the immune system and reduce gut inflammation specific to ASD. Findings from a trial showed that raw camel milk therapy leads to significant clinical improvement in children. It is well tolerated and low-risk.

Gluten and Casein: Free and Supplement: This refers to a diet free of cereal and dairy products like bread, flour, milk and yogurt. Theories suggest that certain peptides in a gluten and casein diet can cross the gut and be transported to the central nervous system, altering brain functioning and exerting effects that mimic the core symptoms of ASD. Moreover, evidence exists that ASD patients may suffer from increased gut leakiness. Only one study out of the 6 undertaken has shown significant reduction in autistic behaviour with this dietary therapy. Earlier, this option was expensive and could further alienate children with ASD from social integration but with Vegan, Gluten-free products becoming popular due to their benefits there are many companies adapting and creating Gluten free-Non GMO and Vegan supplements for children.

Omega-3 Fatty Acids: These are fatty acids essential for the proper development of the nervous system. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are of special interest in treating ASD. The body depends on external supplementation for these and ASD patients are often deficient. This supplementary therapy has also been studied for treatment of other neurodevelopmental disorders like ADHD, schizophrenia and mood disorders. Out of 6 trials testing this supplement for ASD, only one has shown significant improvement in core symptoms. Omega 3 Fatty acids supplements, however, are generally safe and may still be of help in improving the overall neurodevelopment in children.

Probiotics and Digestive Enzymes: Probiotics are microorganisms that help promote the mucosal barrier and intestinal immunity as well as overall digestive health. Gastrointestinal disturbances are common in patients with ASD. As such, digestions supplements for kids may improve behavioural symptoms by reducing ASD-related GI symptoms.

However, findings from trials are inconclusive. Behavioral improvement notwithstanding, supplementation is very effective in improving overall GI health in ASD patients. Further research on this method is underway.

Sulforaphane (SFN): It is a substance found in cruciferous vegetables like broccoli, cauliflower and cabbage. It works like a fever response in dramatically improving ASD symptoms and may offer protection against inflammation and cellular damage.

In a trial on older ASD patients (aged 13-17 years) with reported improvement in core symptoms with febrile illness, sulforaphane showed improvement in all behavioral measures. It is considered safe and effective for daily supplementation. Ongoing research on SFN promises further scope for the treatment of core symptoms.

All above-mentioned dietary therapies, excluding the GFCF diet and omega-3 fatty acids, are effective to some degree in treating core symptoms of ASD. Vitamin D is the most effective and recommendable, with folinic acid and SFN being close seconds. All supplements for kids are safe and mostly affordable. With further research, some may still be used to improve symptoms other than the core ones, like probiotics for kids- supplements for gastrointestinal symptoms of ASD. However, further, scientific study is needed to establish optimum dosages and mechanisms before any of these supplements can be recommended as a safe alternative treatment for ASD.