The Importance of Micronutrients in Autism: Part 1

Did you know that within Canada, there are an estimated 190,000 Autistic children? Recent epidemiological studies suggest that the rate of Autism has increased from 40 cases per 10,000 to 60 cases per 10,000! Autistm is considered to be a neurological disorder that results in developmental disability.  The causes of Autism are not certain; according to a September 2010 report conducted by CBC News, current research is focused on genetics, differences in brain function, environmental factors, viral infections and immune responses and deficiencies.

Nutritional Deficiencies and Autism Spectrum Disorders:

While most conventional research does not emphasize nutritional deficiencies, Orthomolecular Medicine practitioners approach Autism from a different perspective.  Here is the short of it all:

Vitamin B12 (Cobalamin):

Vitamin B12 has been used since the 1960’s as a first-line therapy in the treatment of many neurological and psychiatric disorders.  B12 is found in meat products and requires an optimal environment in order to be absorbed by the body.    Optimal levels of B12 are necessary in both the blood and cerebral spinal fluid (CSF) and while often blood levels are within the normal range, CSF levels are very low. In children B12 levels are essential to the integrity of the myelin sheath which wraps around nerve cells and an early onset infantile deficiency is associated with insufficient myelination, impaired neurological development and on occasion, death.  If B12 deficiency is not diagnosed it later becomes associated with a vast array of neurological symptoms, many of which overlap with the development, neurological and behavioural symptoms associated with the Autism Spectrum Disorders.  One 2001 study found that early onset of B12 deficiency was characterized by feeding difficulties, failure to thrive, hypotonia, seizures, microcephaly and developmental delay.  Another study found that psychomotor status may improve after years of treatment with B12 – likely due to an eventual myelination – and that hypotonia, lethargy and impaired responsiveness positively reacts to methyl cobalamin (a specific form of B12) within 24-48 hours.

The cause of B12 deficiency is multifactorial but one contributing factor can be related to a maternal B12 deficiency.  One 2001 study looked at the status of B12 in mothers and found deficiencies to be related to psychomotor retardation, apathy, muscular hypotonia, abnormal movements and failure to thrive and microcephaly.  It is recommended that every woman gets her B12 levels tested prior to pregnancy with B12 levels being >300ng/l.

The Folate Factor

Folic Acid was once considered to be a highly deficient nutrient among the Canadian population resulting in a high incidence of Neural Tube Defects.  It is also a member of the water-soluble B Vitamin family and must be in equilibrium with B12.  Folate over-fortification and supplementation has led to a disruption in the balance between folic acid and B12.  Very high levels of folate can mask a B12 deficiency.  Folic Acid intake, as with B12, should come from whole foods such as meat and eggs.

The Gut-Link:

As mentioned, B12 requires an optimally acidic environment in order for absorption.  If that environment doesn’t exist, no matter the amount of B12 ingested, none will be absorbed or utilized.  Believe it or not (especially you heartburn sufferers) most people suffer from low stomach acid leading to impaired B12 absorption (and heartburn!).  To worsen the matter, B12 deficiency results in the destruction of the gastric lining leading to further impaired digestion and absorption… See the cycle? low B12 = bad mucosa = impaired digestion and absorption = even lower B12!

Iron Irony:

Iron is required for the proper delivery of oxygen to the brain.  In the pediatric brain, the neurological consequences of low iron status may only be partially reversible.  This means that iron deficiency in early life is associated with delayed development which persists after iron therapy has corrected iron status.  One 2008 study found that infants lacking iron in their first 6-12 months of life are likely to experience persistent effects.  The optimal combination of laboratory measurements for detecting iron deficiency anemia is: hemoglobin, serum ferritin and serum transferritin. Please keep this in mind: similar to B12, one comprehensive assessment found that with or without anemia, low iron status was correlated with moor motor functioning.  A last thought on the subject: low maternal iron stores during pregnancy will predispose a developing fetus to suboptimal iron status at birth and thereafter.  This is important since many people avoid red meat and eggs as a means of reducing cholesterol levels and improving overall health.

Stay Tuned:

Interested in learning more? Stay tuned for part 2 of this blog where I will be exploring key nutrients such as Zinc, Selenium, Essential Fatty Acids and Proteins.

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