Nutrition for Autism: How Multivitamins and Folic Acid Can Lower Autism rates

(Updated June 30, 2020)

In March of 2018, a report by the Public Health Agency of Canada estimated that one in every 66 Canadian children and youth aged five to 17 has autism spectrum disorder (ASD). This is in line with similar estimates in the U.S. According to Autism Ontario, “While we don’t know why, we do know that the rate of ASD is increasing and it is placing huge demands on the education, healthcare, and social service systems and highlighting glaring gaps in the supports available.”

As a naturopathic doctor, I have become very interested in possible preventive strategies that can help to reduce the alarming rise of autism, and restore the health of our kids. While investigating the nutritional medicine aspect of prevention, I came across a research study which found that children of mothers who take multivitamins and/or folic acid supplements have a 60% lower risk of autism, even if their moms only take the supplements before getting pregnant.[1] And the risk appears to be lowered even in those who used the supplements before becoming pregnant but discontinued their use while pregnant.

In 2017, Dr. Stephen Z. Levine and his colleagues conducted a case-control cohort study in which they surveyed 45,300 children born between January 1, 2003 and December 31, 2007 for a diagnosis of autism spectrum disorder (ASD). The children were followed from birth to January 26, 2015, for the risk of ASD. The cases were all children diagnosed with ASD and the controls were a random sample of 33% of all live-born children.

Then Dr. Levine and his colleagues compared ASD incidence with patterns of maternal vitamin and folic acid usage. What’s notable is that the participants were Israeli women who were prescribed the vitamins by their doctors.

What the researchers found is striking: multivitamin and/or folic acid use lowered the risk for autism spectrum disorder by 61% in those who used the supplements before becoming pregnant (i.e. not within nine months of pregnancy). Even more striking was the finding that women who used the vitamins during pregnancy lowered their children’s risk for autism spectrum disorder by 73%!

This study by Levine et al., confirms earlier findings by a Norwegian group, who also found that folic acid supplementation in mothers reduced ASD risk in their children.[2] The latter study showed a reduction in risk of 39% in mothers who used the vitamin for only a short period, from four weeks before, to eight weeks after, becoming pregnant.

Levine and his fellow researchers concluded that, although “causality cannot be inferred,” the use of the observational type of study that they conducted is “more pragmatic and ethical” than a randomized, controlled clinical trial (RCT). A RCT where, for example, women would be prescribed the supplements and others denied it by giving placebo would be considered unethical, since it is already known that folic acid supplementation prevents neural tube defects that lead to spina bifida in children.[3]

Are Autistic Kids More Affected by Pollutants and Nutrient Deficiencies?

We now know that mutations, which occurred in our ancestors’ genes, have led to many individuals requiring higher levels of certain nutrients.[4] For example, all humans must derive vitamin C from their diet, because we, along with guinea pigs and some other primates, have a genetic mutation in the synthetic pathway for ascorbate, whereas most other mammals produce their own.[5]

Similarly, variations in genetics between individuals, often called single-nucleotide polymorphisms (or SNPs), may contribute to the root of the autism epidemic.[6] The science behind these genetic influences is known as epigenetics and has much to contribute to our understanding of the autism epidemic occurring today.[7]

Epigenetics is the science of how our genes, which are unalterable, can be modulated by changing the cellular biochemical environment in which those genes are expressed.[8,9] In other words, diet, nutritional supplements, and lifestyle factors (such as exposure to toxins in the environment) can modify the expression of existing genes, so that mutations or other genetic differences can be either expressed or repressed.

Folate, and other vitamins and nutrients are important in the biochemical pathways, which methylate DNA base sequences that comprise genes. This can modulate how the DNA for a gene gets expressed into proteins. This epigenetic mechanism is not permanent but can be passed from one generation to the next.

Conclusion

As a naturopathic doctor, I have found that autism in young children does indeed respond to naturopathic therapies, especially if treated as quickly as possible after diagnosis. The longer someone waits to be treated, the less likely that complete recovery is possible, though many cases even of long standing do improve.

Nutritional deficiencies are common in the modern diet, and because of genetic differences some individuals may need higher levels of essential nutrients. Nutritional therapies that comprise an excellent diet including fruits and vegetables along with specific vitamin and mineral supplements, as well as herbal medicines, are all indispensable to the recovery of children with autism.

Especially helpful are supplements in adequate doses of the B vitamins including folate and biotin, vitamins C, D, E, essential omega-3 fatty acids found in walnuts, flax seeds, and fish oil, along with probiotics and essential minerals including magnesium.[10,11] In conclusion, the cost of preventing autism may be merely to give nature a gentle boost.

References

[1] Levine SZ, Kodesh A, Viktorin A, Smith L, Uher R, Reichenberg A, and Sandin S. “Association of Maternal Use of Folic Acid and Multivitamin Supplements in the Periods Before and During Pregnancy With the Risk of Autism Spectrum Disorder in Offspring.” JAMA Psychiatry; Published online January 3, 2018. doi: 10.1001/jamapsychiatry.2017.4050. https://www.ncbi.nlm.nih.gov/pubmed/?term=29299606

[2] Surén P, Roth C, Bresnahan M, et al. “Association between maternal use of folic acid supplements and risk of autism spectrum disorders in children.” JAMA. 2013;309(6):570-577. https://www.ncbi.nlm.nih.gov/pubmed/23403681

[3] De Wals P, Tairou F, Van Allen MI, et al. “Reduction in neural-tube defects after folic acid fortification in Canada.” N Engl J Med. 2007;357(2): 135-142.   http://tinyurl.com/y6944wke

[4] Williams RJ. Biochemical Individuality McGraw-Hill; (1998) ISBN-13: 978-0879838935

[5] Saul AW. Ascorbic Acid Vitamin C: What’s the Real Story? http://orthomolecular.org/resources/omns/v09n27.shtml

[6] Schmidt RJ, Hansen RL, Hartiala J et al. “Prenatal vitamins, one-carbon metabolism gene variants, and risk for autism.” Epidemiology. 2011 Jul; 22(4): 476-485. https://www.ncbi.nlm.nih.gov/pubmed/21610500

[7] Miyake K, Hirasawa T, Koide T, and Kubota T. “Epigenetics in Autism and Other Neurodevelopmental Diseases.” In: Neurodegenerative Diseases, edited by Shamim Ahmad. Austin, Texas: Landes Bioscience and Springer Science+Business Media, 2012. Adv Exp Med Biol. 2012;724:91-8. doi: 10.1007/978-1-4614-0653-2_7 https://www.ncbi.nlm.nih.gov/pubmed/22411236

[8] Abdul QA, Yu BP, Chung HY, Jung HA, Choi JS. Epigenetic modifications of gene expression by lifestyle and environment.. Arch Pharm Res. 2017, 40:1219-1237.   http://tinyurl.com/yxub23jo

[9] Friso S, Udali S, De Santis D, Choi SW. One-carbon metabolism and epigenetics. Mol Aspects Med. 2017;54:28-36. https://www.ncbi.nlm.nih.gov/pubmed/27876555

[10] Case HS. Vitamins & Pregnancy: The Real Story: Your Orthomolecular Guide for Healthy Babies & Happy Moms. Basic Health Pub. (2016) ISBN-13: 978-1591203131

[11] Saul AW. Vitamins and Autism: The Real Story. http://orthomolecular.org/resources/omns/v13n13.shtml

The above article was adapted from an article originally published by the Orthomolecular News Service. For more information: http://www.orthomolecular.org To find a naturopathic doctor in Canada: https://www.cand.ca

Orthomolecular medicine uses safe, effective nutritional therapy to fight illness. Visit: http://www.orthomolecular.org