5 Helpful Supplements for Autism Spectrum Disorder
“Many kids on the autism spectrum have nutrient deficiency related to selective eating, poor absorption in the gut, or depletion of nutrients from chronic stress. Repleting nutrients with diet and nutrition supplements can often be a missing piece of the puzzle and help kids feel their best & thrive.”
Studies show that individuals with autism spectrum disorder (ASD) consume inadequate levels of certain vitamins and minerals including:
Vitamin B12 [2,10,11,12,16]
Vitamin D [4,5,6,7,8,16]
Vitamin A [3,5,6,9]
Iron [1,6,7,8]
Vitamin C [13,14,15]
Calcium [5,6,7,16]
Zinc [1,7]
Folate [7]
Magnesium [7]
Omega-3s [16]
Low intake of vitamins and minerals is mainly caused by a restrictive diet. Many children with ASD also have Sensory Processing Disorder (SPD) which is defined as “a condition in which the brain has trouble receiving and responding to information that comes in through the senses” [17]. The five senses are sight, hearing, taste, smell, and touch, though it’s important to also take into account texture, temperature, and consistency. Eating is a very sensory-rich activity, which includes all of the senses at once (smelling the food, hearing the crunch, feeling the texture, seeing the color and shape, etc) and can be very overwhelming for an individual with SPD.
When children have a restrictive diet, it is usually comprised of foods with few nutrients like chicken nuggets, french fries, crackers, chips, candy, and other processed foods. Over time, this can lead to nutrient deficiency and cause additional cognitive and behavioral issues. When a child is selective and changing the diet to become nutrient-rich is not an option immediately, supplements are a great option to replete nutrients quickly and effectively. In this article, we will review nutrition supplements that are helpful for children with ASD.
Note: if you’re worried about getting your child to take supplements, see my blog on 5 Tips To Get Your Child To Take Supplements.
Methylated Multivitamin
As you can imagine, not all multivitamins are created equal. It’s important that we choose a multivitamin that is methylated, or active, so that it can be metabolized and absorbed easily and effectively. Recent research has been showing a link in autism and a genetic mutation called the MTHFR (methylenetetrahydrofolate reductase) gene [18]. This gene produces an enzyme that essentially turns inactive folate (folic acid) into the active form (5-methylfolate) that the body can use. If an individual has full or partial mutations of one or both of the MTHFR mutations, folic acid can build up in the blood without being able to get into the cell. This creates a “functional” deficiency of folate, meaning the body cannot use the inactive, synthesized form. Other B vitamins are involved in this as well, namely vitamin B12 and B6. Even if an individual doesn’t have either of these mutations or abnormalities of the methylation cycle, taking the methyl (active) forms of B vitamins is only helpful, so if you are unsure if your child has the mutation, it is always the better option to take the methyl forms of B vitamins.
Folic Acid → Folinic Acid → L-5 MTHF
(inactive → more active → most active)
Some of my favorite methylated multivitamins include:
Capsules
Kid’s Optimal Multivitamin by Seeking Health
Junior Nutrients by Pure Encapsulations
VitaSpectrum Capsules by Klaire Labs
Children’s Multivitamin with MTHF by Kirkman Labs
Powder
Multivitamin Mineral Plus Powder by My Spectrum Heroes
VitaSpectrum Powder by Klaire Labs
All of the capsules above can be broken and used as powder!
Gummies
PureNutrients Gummies by Pure Encapsulations
Kid’s Complete with Fiber by Smarty Pants
>> See my full blog on multivitamins for autism! <<
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Fish Oil
Fish oil is highly anti-inflammatory. It is high in Essential Fatty Acids, mainly omega-3s, which are vital for cognitive function and brain health. Research shows that individuals with ASD have low intake of omega-3s [16]. In my practice, I would guess that 95% of my clients don’t consume adequate omega-3 amounts with diet alone. Low levels of omega-3s can cause brain fog, lack of concentration, slow language development, developmental delay, skin issues, and other cognitive issues.
The established Dietary Reference Intake (DRI) for omega-3s is:
700 mg for children ages 1-3
900 mg for children ages 4-8
1200 mg for males ages 9-13
1000 mg for females ages 9-13
1600 mg for males ages 14-18
1100 mg for females ages 14-18
A dose of double the DRI is usually an adequate dosage for children with ASD, though higher levels are commonly used. It’s important to not use too high of a dose, as fish oil can be a blood thinner. It’s recommended to discontinue use of fish oil 7 days prior to any medical or dental procedure, as it can cause additional bleeding.
Some of my favorite fish oil supplements include:
Capsules
Liquid
Probiotics
It is extremely common for children with ASD to have gut issues - most commonly constipation, though also including diarrhea, bloating, and stomach pains. Many times, this can be cause by dysbiosis (imbalance of gut bacteria) and yeast overgrowth. If you suspect this, you can get these tested by doing a GI-MAP Panel. It’s highly recommended that individuals with ASD be on lifetime probiotics. A general recommendation for young children (<4 years old) is to be on around 10 billion CFU, children ages 6-13 to be on 10-30 billion, and children older than 13 to be on 25-50 billion CFU. Of course, this number changes with each individual, so it’s important to verify dosage with your healthcare provider.
Some of my favorite probiotics include:
Capsules:
Powder:
>> See my full blog on Probiotics for autism! <<
Prebiotics & Other Gut Support
Because gut issues are so prominent in ASD, I recommend adding in additional prebiotics (fiber) and gut support supplements, like herbals. Magnesium can be a great natural supplement to use for constipation (it’s a natural laxative if used in the correct amounts). Other herbal ingredients such as oregano, olive leaf, black walnut, berberine, and curcumin. Other beneficial, strengthening, and soothing ingredients for the GI tract include L-Glutamine, inulin, aloe vera extract, slippery elm, psyllium, and flax.
My favorite herbal supplements include:
My favorite prebiotic/GI fortifying supplements include:
Digestive Enzymes
Individuals with ASD can struggle with producing sufficient enzymes to break down carbohydrates, protein, and fat. Using a broad-spectrum digestive enzyme can be helpful to break down food to make it easily absorbable.
My favorite digestive enzyme supplements include:
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References
[1] Wu LL, Mao SS, Lin X, Yang RW, Zhu ZW. Evaluation of Whole Blood Trace Element Levels in Chinese Children with Autism Spectrum Disorder. Biol Trace Elem Res. 2019;
[2] Zhang Y, Hodgson NW, Trivedi MS, et al. Decreased Brain Levels of Vitamin B12 in Aging, Autism and Schizophrenia. PLoS ONE. 2016;11(1):e0146797.
[3] Guo M, Zhu J, Yang T, et al. Vitamin A improves the symptoms of autism spectrum disorders and decreases 5-hydroxytryptamine (5-HT): A pilot study. Brain Res Bull. 2018;137:35-40.
[4] Arastoo AA, Khojastehkia H, Rahimi Z, et al. Evaluation of serum 25-Hydroxy vitamin D levels in children with autism Spectrum disorder. Ital J Pediatr. 2018;44(1):150.
[5] Bandini, L.G., et al., Food selectivity in children with autism spectrum disorders and typically developing children. J Pediatr, 2010. 157(2): p. 259-64.
[6] Attlee, A., et al., Physical Status and Feeding Behavior of Children with Autism. Indian Journal of Pediatrics, 2015. 82(8): p. 682-7.
[7] Guo M, Li L, Zhang Q, et al. Vitamin and mineral status of children with autism spectrum disorder in Hainan Province of China: associations with symptoms. Nutr Neurosci. 2018;:1-8.
[8] Bener A, Khattab AO, Bhugra D, Hoffmann GF. Iron and vitamin D levels among autism spectrum disorders children. Ann Afr Med. 2017;16(4):186-191.
[9] Liu, X., et al., Correlation between Nutrition and Symptoms: Nutritional Survey of Children with Autism Spectrum Disorder in Chongqing, China. Nutrients, 2016. 8(5).
[10] Zimmer, M.H., et al., Food variety as a predictor of nutritional status among children with autism. Journal of Autism & Developmental Disorders, 2012. 42(4): p. 549-56.
[11] Shmaya, Y., et al., Nutritional deficiencies and overweight prevalence among children with autism spectrum disorder. Res Dev Disabil, 2015. 38: p. 1-6.
[12] Pineles, S.L., R.A. Avery, and G.T. Liu, Vitamin B12 optic neuropathy in autism. Pediatrics, 2010. 126(4): p. e967-70.
[13] Xia, W., et al., A preliminary study on nutritional status and intake in Chinese children with autism. Eur J Pediatr, 2010. 169(10): p. 1201-6.
[14] Hyman, S.L., et al., Nutrient intake from food in children with autism. Pediatrics, 2012. 130 Suppl 2: p. S145-53.
[15] Emond, A., et al., Feeding symptoms, dietary patterns, and growth in young children with autism spectrum disorders. Pediatrics, 2010. 126(2): p. e337-42.
[16] Esteban-figuerola P, Canals J, Fernández-cao JC, Arija val V. Differences in food consumption and nutritional intake between children with autism spectrum disorders and typically developing children: A meta-analysis. Autism. 2018;:1362361318794179.
[17] Sensory Processing Disorder. WebMD Website. Accessed 23 Jan 19. https://www.webmd.com/children/sensory-processing-disorder
[18] Rai V. Association of methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism with autism: evidence of genetic susceptibility. Metab Brain Dis. 2016;31(4):727-35.
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