By: Dr. David Berger, MD, FAAP
Wholistic Pediatrics and Family Care
One of the more frequent questions that I am asked about by parents of children with autism spectrum disorders is about the use of B vitamins. This is a family of vitamins that include Thiamine (B1), Riboflavin (B2), Niacin (B3) Pantothenic acid (B5), Pyridoxine (B6), Biotin (B7), folic acid/folate (B9,, “folic acid” and ” folate” are often used interchangeably) and cobalamin (B12). Each of these nutrients are vital to everyone’s health, but some of them take on a important role in the treatments that we do to help children on the spectrum optimize their development and behaviors. While textbooks can be written on each of these vitamins, I would like to share some of the newer research and how they can be applied to help our children.
Many families have heard about the use of “B-12 shots” and folic acid as a therapy for Autism. About 10 years ago, groundbreaking research was done at Arkansas Children’s Hospital by Dr. Jill James that documented low blood levels of chemicals such as methionine, cysteine and glutathione, which significantly improved when given certain forms of B vitamins. These chemicals are very important for detoxification and the body’s production of anti-oxidants. They keep the immune system strong and reduce allergies and inflammation. They are involved in the metabolism of neurotransmitters like dopamine and serotonin.
We have learned that there are alterations in genes that activate folic acid (MTHFR is needed to make methylfolate) and B12 (MTRR is needed to make Methyl B12). These DNA switches, which can now be tested for at commercial labs, can result in significant slowing of the enzymes that activate these B vitamins.
Especially if there is a double switch present (we all get 1 copy of these genes from our mom and 1 from our dad), a person may particularly benefit from taking the activated forms of these B vitamins.
Higher doses of activated folate (folinic acid and methylfolate) are also being used in patients that have been identified with having auto-antibodies that are blocking or binding the receptors for folate that are located in the brain. If these antibodies are present, the high doses are therapeutically used to try and bypass the receptor that is being blocked. Improvements in reducing seizures, improving behaviors, and improving communication skills have all been noted with treatment for those with the auto-antibodies. A great review article has been written on this by 2 colleagues, Dan Rossignol, MD and Richard Frye, MD (http://tinyurl.com/folate-receptor-antibodies)
There are many caveats with the use of B vitamins, in terms of the doses, the way they are taken (such as by injection or under the tongue) and how/when they are introduced. B vitamins can be a safe and effective way to treat children with neurodevelopmental disorders, but as with all medical treatments, it is best for these to be done under the supervision of a knowledgeable physician or nurse practitioner.