Effect of Vitamin/Mineral Supplements on Children with Autism

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)
• Wakefields work shows intestinal problems
• limited absorption of vitamins/minerals
• 3) Shaws 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. Rimlands set of parent-reported case
  studies on benefits of vitamins/minerals

6
Dr. Rimlands 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 marketWhich 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, Kirkmans Super Nu-Thera,
  Brainchilds 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 childrens 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 dont
  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 average1.3
• 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
• 1much worse
• 2worse
• 3slightly better
• 4same
• 5slightly better
• 6better
• 7much 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 dont 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

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
• 1never
• 2rarely
• 3sometimes
• 4frequently
• 5always

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 [phone]
• Note Researchers have no financial link with
  Brainchild Nutritionals