Home Remedies For Autism

Experts now estimate that one in 68 children in the United States— and 1 percent of children globally—have autism. I think we can do better here in terms of research, especially when it comes to diet, lifestyle, and supplement studies (not just drug interventions). 

I wasn’t sure there was enough research out there to warrant writing a full section on autism, but I hear from so many parents who are frustrated and looking for anything that might help their situation (or looking to identify anything that could potentially aggravate it). After a little digging, I realized there was enough preliminary evidence for parents right now in the areas of prevention and dietary supplement treatment combined with conventional therapies.

What is Autism?

Autism is one of a group of pervasive developmental disorders. It’s characterized by impairments in communication and social skills and by repetitive behaviors (often referred to as stereotypy). This group of disorders also includes Asperger’s syndrome, Rett’s syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (that is, PDD-NOS or atypical autism). Autism, Asperger’s, and PDD-NOS are frequently referred to as autism spectrum disorders (ASDs). Autism is the most serious ASD because it can involve an intellectual disability and a range of behavioral, medical, and psychiatric issues.

Risk factors for autism are unknown, but there are many theories as to what’s causing the increased prevalence, including environmental factors, older parents at conception, a shrinking supportive family unit, an expanded medical definition of ASD, and better diagnosing.

In my experience, more children with ASD should be taking supplements. Doctors often put these kids on restrictive (gluten- or casein-free) or elimination diets, which could increase the need for a multivitamin. It’s also important to get periodic (every few years) nutrition checkups. There have been some reported cases of vision loss and other serious health issues due to deficiencies of vitamin A and other nutrients.

Home Remedies For Autism

1. (tie) Folic acid 400 micrograms a day for all women of reproductive age for prevention; 800 micrograms a day if you’re trying to conceive

Folic acid is an essential vitamin, especially in the first trimester of pregnancy, because it’s involved in the formation of major organ systems, including the brain and spinal cord. Fifty percent of pregnancies are unplanned, which is why folic acid should be on every woman’s nutrient list if she’s of childbearing age. Preliminary research from Norway (published in the Journal of the American Medical Association) suggests that taking folic acid during pregnancy may reduce the risk of autism by as much as 40 percent.

Clinical research should test higher doses—such as the 4 milligrams (or 4,000 micrograms) that has been shown to dramatically reduce the risk of neural tube defects in high-risk pregnancies—in couples believed to be at higher risk of having an autistic child. There is preliminary evidence from several studies that a dose of 800 micrograms of folic acid could be more effective than 400 micrograms because lifestyle behaviors—drinking, weight gain, certain medications, and exposure to pollutants (such as secondhand smoke)—can reduce B-vitamin levels.

There is no concrete evidence that folic acid can really prevent autism, but the research is interesting enough to keep investigating. Although there are some authoritative voices out there suggesting overexposure to folic acid might contribute to autism—and you know I am a firm believer that some of us are being overex-posed to antioxidants and other nutrients—the opposite (underexposure) appears to have more data. Men might also want to supplement if they’re trying to conceive (ask your doctor about this).

1. (tie) BH4 (tetrahydrobiopterin) 1 to 20 milligrams per kilogram of body weight for treatment

BH4 is involved in the degradation of the amino acid phenylalanine (too much phenylalanine can cause mental problems and seizures). But it turns out that BH4 may operate in other human pathways, including metabolizing cellular by- products that might be harmful to neural connections in the brain and producing certain neurotransmitters and even nitric oxide. 

Abnormal changes in all of these pathways may increase the risk of ASD, and low concentrations of BH4 in the central nervous system have been found in individuals with ASD.

There has been a minimal amount of preliminary research with BH4 in children with autism at a dosage of 1 to 3 milligrams per kilogram of body weight, and a hint of improvement in social interaction and IQ over 3 to 6 months was seen. I initially had trouble jumping on this bandwagon until a better, but small, randomized trial from Emory School of Medicine came out. 

In it, children with ASD (ages 3 to 7) were given 20 milligrams per kilogram of body weight of BH4 per day or a placebo for 16 weeks. Although there was no difference in overall improvement between the groups by the end, the investigators did find significant improvements in the BH4 group in the areas of social awareness, autism mannerisms, hyperactivity, and inappropriate speech. Best of all, the side effects were similar to the placebo. Another small study from the Arkansas Children’s Hospital Research Institute using sapropterin (a synthetic form of BH4) also found benefits at 20 milligrams per kilogram a day.

2. NAC (N-acetylcysteine) 1,200 milligrams a day in two divided doses titrated up over 2 weeks for treatment, or 900 to 2,700 milligrams in divided doses titrated up over 12 weeks

NAC works on multiple pathways that impact mental health disorders. It increases levels of the antioxidant glutathione, reduces inflammation, and normalizes glutamate concentration and transmission, which in combination improves nerve cell health and cellular energy function. This is exemplified by some evidence showing it can help with drug addiction, schizophrenia, and bipolar disorder, and it’s also being tested for Alzheimer’s and Parkinson’s.

A recent well-done but small trial with 40 children and adolescents with ASD found that 1,200 milligrams of effervescent NAC per day along with the drug risperidone resulted in decreased levels of irritability after 8 weeks. Side effects were low and similar between the two groups tested, but the risperidone-plus- NAC cohort had more incidences of constipation, increased appetite, nervousness, and daytime drowsiness than the risperidone-plus-placebo group.

This study backed up an earlier 12-week study from Stanford University where 31 children (ages 3 to 11) with autism were given 900 milligrams of NAC or placebo once daily for 4 weeks, then 900 milligrams twice a day for 4 weeks, and then 900 milligrams three times a day for 4 more weeks. The researchers found significant improvements in irritability in the NAC group with no significant side effect difference compared to the placebo (nausea, vomiting, diarrhea, and increased appetite occurred in just two or three more cases in the NAC group).

3. Melatonin starting dosage of 1 to 3 milligrams a day (with weekly increases of 1 to 2 milligrams if not effective) for treatment of sleep issues

The research with melatonin is exciting because up to 80 percent of children with ASD have problems with sleep (difficulty falling asleep, frequent waking, and restless sleep), compared to just 20 percent of children without ASD. Researchers speculate that problems with internal melatonin production or use could be triggering the sleep issues.

Melatonin usually works quickly— within a week—and may improve both the duration of sleep and the ability to fall asleep by as much as 60 minutes; additionally it may reduce the number of night awakenings, behavioral problems (such as hyperactivity), and parent stress. 

Controlled-release melatonin may be an option for children who have trouble staying asleep as well. In my experience, most kids respond to 1 to 3 milligrams, which is also reflected in the research, but the ultimate optimal dose does not appear to be related to weight or age, so you may have to experiment.

Dosages of 0.5 to 15 milligrams a day have been used in clinical studies, with 3 to 6 milligrams (30 to 60 minutes before bedtime) being the most common. One of the largest Phase 3–like multicenter trials of melatonin involving children (ages 3 to 16) with ASD and other neurodevelopmental disorders who have sleep issues showed that more than half of the subjects responded to doses of 6 milligrams or less. Clinical studies have tested melatonin from 14 days to 4 years, so it appears safe to use long term.

Side effects were similar to placebo in most studies, but melatonin can rarely cause morning sleepiness, enuresis (involuntary urination), diarrhea, headache, dizziness, hypothermia, and rash. When it comes to ASD, drug interactions need to be considered. Drugs like cimetidine, tricyclic antidepressants, fluvoxamine, and ciprofloxacin can increase blood concentrations of melatonin; likewise, melatonin may lead to increased concentrations of certain drugs. In addition, melatonin may reduce blood pressure or glucose levels, so children taking drugs for these conditions should be monitored closely.

What Are Useless For Treating Autism?

Other supplements for ASD really have weak data: L-carnitine (50 milligrams per kilogram of body weight a day) may improve cellular (mitochondrial) dysfunction in ASD; vitamin C in high doses (8 grams per 70 kilograms of weight a day) showed some reduction in symptom severity, but nothing further has been published in more than 20 years (which makes me nervous); omega-3 supplements (1,000 to 1,500 milligrams a day) have some weak—and overhyped —data on reducing hyperactivity, but I think this is more applicable to ADHD, and I think it’s smarter to get plant or marine sources of omega-3s from diet first. 

Overall the studies have not been well done and have not found benefits in social interaction, communication, stereotypy (repetitive behaviors), or hyperactivity. Some so-called experts recommend omega-6s, including evening primrose oil (EPO), but EPO can lower the seizure threshold and also cause lipoid pneumonia. Until the benefit outweighs the risk in ASD, I cannot recommend these products.

Other Natural Remedies For Autism

Adjust diet

Gluten- or casein-free diets provided a mild benefit in a small study, but keep in mind that restrictive diets can be difficult and expensive for families— who are already burdened—so there needs to be more evidence. 

That said, I think the benefit of trying a variety of diets outweighs the risk here. For example, a high-fat, or ketogenic, diet might be beneficial. Seizures are commonly associated with ASD, and following a ketogenic diet (90 percent fat) or modified Atkins diet (70 percent fat) can help control seizures, especially for kids who aren’t responding to standard antiseizure medications.

You can use medium-chain triglycerides (coconut oil and palm kernel oil) instead of butter and cream as the main source of fat if necessary. I think there should be more research to determine this diet’s impact on other ASD symptoms. 

There was a wonderful case study done at Massachusetts General Hospital in Boston where the patient became almost seizure free and saw other ASD symptoms reduced to non-autistic levels (this was only a single published case study, but the ketogenic approach has had well-documented success for epilepsy).

What Else To Know About Treating Autism?

The drug methylphenidate can reduce hyperactivity and impulsive behavior better than any dietary supplement right now, but it has some minor side effects that require monitoring. It can inhibit growth, raise blood pressure, increase social withdrawal and irritability, reduce appetite, and cause difficulty sleeping and abdominal discomfort. Still, for many children with ASD, the benefits greatly outweigh the drawbacks.

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