Effect of a vitamin/mineral supplement on children and adults with autism

BMC Pediatr. 2011; 11: 111.
Published online 2011 December 12. doi:  10.1186/1471-2431-11-111
PMCID: PMC3266205
Copyright©2011 Adams et al; licensee BioMed Central Ltd.
Effect of a vitamin/mineral supplement on children and adults with autism
James B Adams,1 Tapan Audhya,2 Sharon McDonough-Means,3 Robert A Rubin,4 David Quig,5 Elizabeth Geis,1 Eva Gehn,1 Melissa Loresto,1 Jessica Mitchell,6 Sharon Atwood,1 Suzanne Barnhouse,1 and  Wondra Lee1
1Autism/Asperger’s Research Program, Arizona State University, Tempe, AZ, USA
2Health Diagnostics and Research Institute, South Amboy, NJ, USA
3Integrative Developmental Pediatrics, Tucson AZ, USA
4Department of Mathematics, Whittier College, Whittier, CA, USA
5Doctor’s Data, St. Charles, IL, USA
6Southwest College of Naturopathic Medicine, Tempe, AZ, USA
corresponding authorCorresponding author.
James B Adams: jim.adams@asu.edu
; Tapan Audhya: audhyatk@optonline.net
; Sharon McDonough-Means: mcdosh@dakotacom.net
; Robert A Rubin: brubin698@earthlink.net
; David Quig: dquig@DoctorsData.com
; Elizabeth Geis: autismstudynurseasu@gmail.com
; Eva Gehn: egehn@asu.edu
; Melissa Loresto: melissaada@cox.net
; Jessica Mitchell: J.Mitchell@scnm.edu
; Sharon Atwood: sharon.atwood@asu.edu
; Suzanne Barnhouse: jsdbarnhouse@cox.net
; Wondra Lee: wonlijean@hotmail.com
Received February 8, 2011; Accepted December 12, 2011.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background
Vitamin/mineral supplements are among the most commonly used treatments for autism, but the research on their use for treating autism has been limited.
Method
This study is a randomized, double-blind, placebo-controlled three month vitamin/mineral treatment study. The study involved 141 children and adults with autism, and pre and post symptoms of autism were assessed. None of the participants had taken a vitamin/mineral supplement in the two months prior to the start of the study. For a subset of the participants (53 children ages 5-16) pre and post measurements of nutritional and metabolic status were also conducted.
Results
The vitamin/mineral supplement was generally well-tolerated, and individually titrated to optimum benefit. Levels of many vitamins, minerals, and biomarkers improved/increased showing good compliance and absorption. Statistically significant improvements in metabolic status were many including: total sulfate (+17%, p = 0.001), S-adenosylmethionine (SAM; +6%, p = 0.003), reduced glutathione (+17%, p = 0.0008), ratio of oxidized glutathione to reduced glutathione (GSSG:GSH; -27%, p = 0.002), nitrotyrosine (-29%, p = 0.004), ATP (+25%, p = 0.000001), NADH (+28%, p = 0.0002), and NADPH (+30%, p = 0.001). Most of these metabolic biomarkers improved to normal or near-normal levels.
The supplement group had significantly greater improvements than the placebo group on the Parental Global Impressions-Revised (PGI-R, Average Change, p = 0.008), and on the subscores for Hyperactivity (p = 0.003), Tantrumming (p = 0.009), Overall (p = 0.02), and Receptive Language (p = 0.03). For the other three assessment tools the difference between treatment group and placebo group was not statistically significant.
Regression analysis revealed that the degree of improvement on the Average Change of the PGI-R was strongly associated with several biomarkers (adj. R2 = 0.61, p < 0.0005) with the initial levels of biotin and vitamin K being the most significant (p < 0.05); both biotin and vitamin K are made by beneficial intestinal flora.
Conclusions
Oral vitamin/mineral supplementation is beneficial in improving the nutritional and metabolic status of children with autism, including improvements in methylation, glutathione, oxidative stress, sulfation, ATP, NADH, and NADPH. The supplement group had significantly greater improvements than did the placebo group on the PGI-R Average Change. This suggests that a vitamin/mineral supplement is a reasonable adjunct therapy to consider for most children and adults with autism.
Trial Registration
Clinical Trial Registration Number: NCT01225198
Vitamins and minerals (elements) are, by definition, essential for human health, primarily due to their critical function as enzymatic cofactors for numerous reactions in the body, such as the production of neurotransmitters and fatty acid metabolism Historically attention has focused on inadequate intake of vitamins and minerals due to poor diet as a major contributing factor to many child health problems in the US and around the world, including anemia (low iron), hypothyroid (low iodine), scurvy (vitamin C deficiency), and rickets (calcium and/or vitamin D deficiency). More recently the focus has shifted to the relationship between relative metabolic disturbances and developmental disorders, for example those associated with attention deficit disorder [15], learning disorders [6], and intellectual development [7]. Children with autism sometimes have limited, self-restricted diets, and in this paper we further investigate the hypothesis that nutritional insufficiency and metabolic imbalances may play a role in autism spectrum disorders (ASD) as well.
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