[Notes from Autism Europe Biomedical]
This file consists of three parts: General information (tricks parents have learned, helpful sites you can connect to, etc.), Supplement Information (a listing of the most common supplements used in association with ASD, how they might help, problems parents have seen with them, etc.) and Supplementing for Chelation (based on, for the most part, how parents have implemented Andy Cutler’s recommendations for his protocol).
None of this is medical advice. This file is meant to be a time efficient way of doing what the list does—sharing information among people. It is suggested that you read the file in its entirety, particularly if you are new to this. Although there is plenty of information, it is just a starting point. Supplementing your child appropriately will require that you consult other, more detailed resources, a few of which are listed below, in order to get the information you will need.
If you want a great starting point for just about anything you need to know about autism you should go to http://www.danasview.net/index.htm. Dana has compiled a mind-boggling amount of information that will save you days of searching. If you want supplement specific information, go to http://www.danasview.net/parent3.htm#supps
Another site for detailed supplement information that is not ASD specific is http://www.Vitaminherbuniversity.com. Some of the general information provided here has been taken from this site. The site offers interesting articles and helpful ideas such as how to read a vitamin label, what toxicity looks like, and health implications for each supplement.
Autism: Effective Biomedical Treatments (2005) by Jon Pangborn and Sidney Baker has up-dated information, particularly for parents just starting out, and one entire section on supplements. Pangborn outlines a general protocol for introducing supplements. He admits that certainly not everyone would benefit from it, but he does explain in a lot of detail the background science and experience informing these recommendations. A lot of information from this file was taken from this resource. You can order this book direct from ARI (see below).
You will notice the comment “good ARI rating” in some of what follows. To find out more about what has worked for other parents, visit http://www.autismwebsite.com/ari/treatment/form34q.htm at the Autism Research Institute website. Some information in this file was also gleaned from DANWebCast presentations. Go to http://www.danwebcast.com/ for presentations on autism, particularly biomedical options.
Go to http://www.noamalgam.com/ if you need information on chelation and Andrew Cutler’s protocol, where you will see his books available for purchase. If you would like to find a bit of that same information, including Andy’s recommended dosing schedule (and a whole host of other informative and inspiring things) go to http://home.earthlink.net/~moriam/ (and send an email to thank Moria for all of her hard work).
Two books which discuss supplementation which Andy has recommended as good are Michael Murray's Encyclopedia of Nutritional Supplements and The Power of Herbs. One knowledgeable parent describes them as “very well-organized, well-written, in depth (but not so much depth it's impossible to follow).”
A good resource for people looking for more in-depth, technical information on certain classes of supplement is http://www.carbonbased.com/modules/sections/index.php?op=listarticles&secid=2. A quick introduction to supplements common use for biomedical approaches to autism can be found at the Kirkman’s site http://www.kirkmanlabs.com/roadmap_medium2.html
(be sure to roll over the supplements to get the information).
If you are looking for supplementation advice specific to viruses, please see the Viral Information and Resources file in the files section.
A good number of parents are using the Yasko protocol for their autistic children or simply using some of the supplements recommended by Amy Yasko. You can find out more information here http://www.ch3nutrigenomics.com/phpBB2/welcome.html Her supplement recommendations are for the most part quite different from the DAN! approach (this file reflects more of a DAN approach).
Knowing which are the fat soluble vitamins and which are the water soluble vitamins can help you organize your dosing schedule. The fat soluble vitamins are A, D, E, and K. The water soluble vitamins are B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), B7 (biotin), B9 (folic acid), B12 (cobalamin), and C (ascorbic acid).
Advice from parents:
1. Always start ONE supplement at a time. Start at a very low dose, increasing gradually. If you add more than one at a time, it's much harder to tease out what's causing the improvements or problems. If you see nothing, or some improvements, continue upping the dose, within safe limits, of course. If you see regression or intolerance cut back or stop. If you are just starting this process, you will likely want to give your child every supplement out there in hopes of helping. Don’t. It won’t help. You don’t want your child to regress, you don’t want your child to take supplements that are unnecessary, and lastly, supplements can add up financially.
2. Just because something works for others does NOT mean it will work for you. For example, calcium is considered an important initial supplement, yet some children are already too high in calcium. Some kids cannot tolerate certain supplements at certain times. What they cannot tolerate at one point, may be necessary at some other point. Conversely, what they need and progress with at one time may not be tolerated later. If your child regresses after doing well and you can't figure out why, it may be that a supplement is no longer needed or tolerated. Try dropping the ones you suspect, or even all of them, for a few days and adding them back one at a time, watching for any signs positive or negative (there is some concern that dropping all the supplements at once can cause its own problems, and you may only want to try this if the situation really warrants it).
3. Buy the brand with the least fillers and additives. Powders are generally better than liquids because they don't require preservatives or flavorings, which cause trouble for many kids. Some brands which contain few if any fillers are Allergy Research Group, Metabolic Maintenance, Pure Encapsulations and the NOW brand powders, with the last brand generally being the least expensive.
4. Source Naturals, Natural Factors, Nordic Naturals, and Jarrow, as well as the brands mentioned above, are recommended by many parents. Many people purchase supplements, particularly ones specialized for ASD children from Kirkman’s, Klaire Labs, and Brainchild Nutritionals as well, and from all reports, these last three companies are very helpful on the phone. Many people choose to order from http://www.vitacost.com/index.html and http://www.iherb.com/store/. If you are a Canadian, you may want to consider http://spectrumsupplements.com or http://feelgoodnatural.com as an easy way of procuring some American-based supplements.
5. If your child is phenol-intolerant, B vitamins are likely to be a problem, especially B2 and B6.
6. Some people buy a multivitamin mix only to find that their child does not do well on it, either because the vitamins and minerals ratios are not good (too little of one thing, too much of another) or because in such a large mixture something won't be tolerated. Consider getting trial sizes beforehand or mix your own so that the ratios/ingredients are always adaptable. Having said that, many people use a multivitamin/mineral powder or liquid (Life Extension, Brainchild Nutritionals, Kirkman, and New Beginnings are some recommended sources) as a starting base and then add whatever extra is necessary to make things more convenient.
7. If your child is soy-intolerant, make sure any oil based supplements are in something other than soy oil – vitamin E is usually in soy. Source Naturals Gamma E is sesame oil based. Also be aware that most fish oils with added vitamin E will have soy in them.
8. If your child is corn-intolerant, make sure your vitamin C isn't derived from corn. Twinlabs Allergy C is made from palm and Perque makes Vitamin C from potato, for example.
9. Sometimes a child doesn’t tolerate a supplement because of the carrier. For example, if magnesium seems to be a problem, it may be just the magnesium citrate that isn’t tolerated, but magnesium glycinate might work.
10. Getting a daily or weekly pillminder makes supplementing much easier. Keeping good records (supplements given, general comments on behavior etc.) can really help you spot problems and successes. To save time, consider making a chart that you print out each week. You will need to adapt the chart as your child requires different supplements over time.
11. Try to give the water soluble vitamins like B1, B2, B6, B12, biotin, niacin, panthothenic acid and folic acid and the minerals like magnesium, zinc, selenium, molybdenum three or four times a day (divided up into appropriate doses, of course). The fat soluble vitamins like A, D, E, and K can be given once a day. Calcium can block the absorption of other minerals (like zinc) and some people choose to give them separately.
12. ASD children commonly require 2 to 3 times RDA of a supplement. In some cases, need can be much higher. If uncertain of where to start, begin dosage at ¼ the RDA and work up. Ideally you want to give the minimum amount of supplement for the maximum benefit. Be sure to educate yourself regarding possible toxicity levels.
13. Many parents who have children who cannot swallow pills hide supplements in things like smoothies, jam, ketchup, nutbutter balls, favorite drinks, peanut butter or pudding. Consider the flavor of the supplement (for example, selenium has virtually no flavor, milk thistle tastes a bit like dirt, vitamin C powder can be quite bitter) when you are choosing a hiding place. If you need some more ideas on how to get your children to take their supplements, you might try here: http://www.kirkmanlabs.com/about/buttons/taking_supplements.html
14. If you’d like to teach your child to swallow pills, this may prove to be a helpful resource: http://www.dbpeds.org/media/2004AutumnSODBPNews.pdf
15. If you have spilled your supplements and cannot tell which capsules are which, see post # 156734 at autism-mercury for excellent advice on how to solve your problem.
16. If you are unsure of your child’s nutritional status (as most of us are with ASD children) you may want to run tests like the Metametrix Labs ION panel http://www.metametrix.com/TestServ/default.asp?PageID=1&TabID=1 which you can interpret yourself by using the information found here http://www.iwdl.net/Practitioners/Organix%20Pract%20Interpretation.pdf
Supplement Information (in alphabetical order).
Please note that supplements that are generally considered as those which should be in place first are marked with an asterisk (*). Consult Pangborn’s chapter on supplements for this view on supplementing priorities.
5-HTP can help promote the production of serotonin, often low in children with autism. It may help with sleep problems.
Activated charcoal is used to absorb toxins released by die-off (Herxheimer reaction). Do not use at the same time as other supplements, as it will absorb those as well—you should wait 2 hours.
Adrenal Cortex Glandular is a supplement that can help support stressed adrenals, a problem quite common in autistic children. Adrenal stress can be debilitating and will likely only worsen over time if not addressed. Some signs of poor adrenal function are “anxiety with OCD, poor task switching, sensory integration problems” (per Andy Cutler), and avoidance of other activities by engaging in things such as repetitive movie watching. One trusted brand is Nutricology Organic Adrenal Cortex Glandular.
Aloe vera liquid is sometimes used to help deal with constipation and aid in gut healing. George’s brand is tasteless and highly recommended.
Alpha Lipoic Acid (or Lipoic Acid) is a chelator and should not be taken as just a supplement by anyone with amalgams or a metal toxicity problem. Be sure it is not a part of any multivitamin your child takes.
Amino Acids are relatively complex in that there are a wide variety of possible deficiencies among autistics; therefore, some people get a custom blend based on tests (eg. ION test from Metametrix Labs). Some people simply use a broad spectrum amino acid support although there is some concern among people that glutamate is not good for some of our children. Most autistic children will have an amino acid deficiency and this deficiency will have far-reaching repercussions on health and therefore behaviour.
Antifungals are used to fight yeast overgrowth, a common condition in ASD, especially among children who have used antibiotics. Antifungals can be over the counter (OTC) such as garlic, caprylic acid, oregano, grapefruit seed extract (GSE), and oil of oregano. Or they can be prescription, such as Nystatin or Diflucan. If you use a prescription, be sure to consider whether your child tolerates artificial flavor or color—if not, a compounding pharmacy can help you avoid those. Always use probiotics in conjunction with an antifungal otherwise you risk the overgrowth of bad bacteria, a problem equally serious.
Biotin is one of the B vitamins. No toxic effects of oral biotin have been reported in humans or animals, even at doses up to 10 mg/day. Used as a yeast fighter in that it seems to prevent candida from transforming into a more difficult to fight form.
*Calcium supplementation can become very important if your child is casein-free. Best taken with meals. Some difference of opinion as to which is the best form. Some people find baking with the powder form an easy way to supplement. Can be constipating. Should be taken away from other minerals like zinc. Good ARI rating; however, some children definitely have problems with calcium. Information can be found on the Vitamin K yahoo group.
Carnitine, taken in the form of l-carnitine, has shown promise for autistic children who tend to be low in this particular amino acid. It can help with energy by acting on the mitochondria and can help children with muscle tone problems.
Carnosine has helped some ASD children with seizures, but has had adverse effects on ASD children who do not suffer from seizures. Adverse effects will take a few days to subside after stopping the supplement.
Caprylic Acid is used as a yeast fighter. Caprylic acid is a fatty acid. It can be taken as tablets (often coated) or as an oil (generally tasteless). It can only deal with yeast it comes in contact with and should probably be taken a few times a day.
Choline is now considered an essential nutrient, classifying it as a vitamin. There are no known toxic effects from choline, though high doses may worsen epileptic conditions. Some people use choline alfoscerate starting three to four months after chelation to target the hippocampus (part of the brain thought to be most affected by mercury) and its connectors. Choline bitatrate does not survive the environment of the stomach, phosphatidylcholine, or lecithin does (see phosphatidylcholine).
*Cod Liver Oil is often used for ASD children because of the vitamin A, vitamin D, and omega three fatty acids it provides. See Vitamin A and Essential Fatty Acids.
Colostrum is used to bolster immune system. Be sure to verify with the manufacturer if it is casein-free if this is an issue for your child. Kirkman’s does guarantee their colostrum to be casein-free. Also, be sure to buy organic.
CoQ-10 may help some ASD children as it is implicated in many body functions. Works best if given with EFA and Vitamins C and/or E. Implicated in mitochondrial function. ry to give with food, and is best given in the morning, as it has implications for the manufacture of melatonin. Be sure to close bottle and keep out of sunlight.
Culturelle is a single strain probiotic. Works well against clostridia. Made by Vitamin Research Products. Some children very sensitive to casein may have problems with this product.
*Digestive enzymes have been used successfully by some parents to help improve their ASD child’s health. (Good ARI rating) Many consider enzymes one of the best supplements to try first in order to improve digestion. Some parents use enzymes with a special diet, others replace the special diet. Enzymes are the exception to the rule of stopping supplementation if there is regression. Some “worse” behavior is not uncommon before it gets better. Houston’s and Kirkman’s both carry enzymes formulated for ASD children—each company has a different view of enzyme use. Some parents have been able to remove their children from a special diet using Houston enzymes, many of which are listed in this file.
DMG, or dimethylglycine can improve language, eye contact and stamina. May cause hyperactivity. Try with folic acid to reduce hyperactivity. If hyperactivity is still observed, try TMG, which is DMG with one more methyl donor. Dosing in the morning is recommended. See the ARI website for more information. See also TMG.
Epsom salts are often used for ASD children. Magnesium sulphate, the chemical name for Epsom salts, offers both magnesium and sulphur. Often taken in the form of a bath or as a skin cream. Many parents find that Epsom salt baths or cream can help deal with phenol problems and alleviate problems sometimes associated with swimming in chlorine pools. It can also calm some children and help them to sleep better. See http://www.enzymestuff.com/epsomsalts.htm for detailed information on this topic.
*Essential Fatty Acids, most particularly the Omega 3’s, are commonly at low levels in ASD children. Although it is thought that most Americans have a 10 to 1 ratio of Omega 6’s to Omega 3’s in their diet, when the recommended ratio is 2 to 1, some of our children who have not had a typical American diet may need Omega 6 supplementation with something like evening primrose oil or black currant oil before they will tolerate the Omega 3’s. Pangborn recommends having taurine, Vitamins C and E in place before starting. Give with food for better absorption and to reduce possibility of any nausea. Some children seem to do better with high DHA levels, some better with high EPA levels. EPA can convert to DHA, but the reverse is not true. This is an important consideration, particularly for older children who may not need as much DHA as very young children. Also it is important to understand that if a child seems to do better on the high EPA, that child will still be able to create as much DHA as needed . Also, best earlier in the day because the oil might be energizing. General information on EFAs can be found here: http://www.equazen.com Can help with dyspraxia, skin problems (bumps on skin, dry skin, “jock itch”). Fish oils should not smell fishy. Carlson’s is a recommended brand of fish oil that is vitamin A and D free. Nordic Naturals carries a CLO (containing vitamin A and D) that is very highly recommended. See Vitamin A. Good ARI rating. See also flax seed oil.
Flax seed that is ground is a source of fatty acids (although see comments under flax seed oil) and is of great benefit for fibre. More than 4 tablespoons a day is excessive and can cause problems. See also constipation file.
Flax Seed Oil is a source of essential fatty acids; however, some people are unable to convert the omega 3’s in flax to the long chain form. Also, flax is not a good source of EPA. For these reasons, some people believe that it may be more beneficial to children with digestion problems to use the fish oil fatty acids.
Folic acid or folate is one of the B vitamins. Give away from zinc. If a child cannot tolerate folic acid (becomes hyper or aggressive) try folinic acid. Folic acid at high doses of 5 to 30 mg may cause an increase in frequency of seizures in epileptics.
GABA can be helpful for language, anxiety, and perhaps seizures.
Garlic Oil is used as an antifungal. Note that garlic is high in sulfur and some will not tolerate it. Cooked garlic will not have the same anti-fungal effect.
Glutathione or reduced, active glutathione (GSH) is somewhat controversial. Many ASD children are low in glutathione—a normal occurence when the body is sick. Some believe supplementation is warranted only if plasma cysteine testing is low. Others believe there are benefits for a wider range of individuals. Three main forms of glutathione seem to have some positive effect on some children: lipoceutical, transdermal, or nebulized. If using the lipoceutical glutathione it is best not to shake it. There have been some adverse reactions to glutathione supplementation.
Grapefruit Seed Extract (GSE) is used as an antifungal. Will kill everything, including good bacteria; therefore, must be used with probiotics but spaced apart by a few hours. See Dana’s website for more information. Trusted brand: Nutribiotics GSE liquid.
HN-Zyme Prime is an all purpose digestive enzyme. Made by Houston's. If
bromelain (pineapple) and papain (papaya) are a problem, use Zyme Prime (no HN) instead.
Immune boosters and immune modulators include thymic protein, colostrum, astragalus root, Echinacea, vitamin C, larch arabinogalactan, inositol, Epicor, beta glucan, elderberry, zinc, Transfer Factor. For more complete information on these and a list of antivirals, please see the Virus Information and Resources file.
Inositol plays an important role in the health of cell membranes and although it is readily available in the diet, this may not be true for our children. It can be helpful for OCD. Inositol hexaphosphate (IP-6) can also be used to boost the immune system, but it is also an efficient chelator of most minerals, and that should be taken into account when using it. Some people use IP-6 if their children are iron toxic, or have some other similar condition.
Iron should not be supplemented unless you know from testing that your child is very deficient; it can be toxic. Many people get constipated with iron supplementation. If your child shows low ferritin levels on tests, you may want to consider Energizing Iron by PhytoPharmica which is an absorbable and natural form of iron (but messy if your child cannot swallow capsules).
*Magnesium can improve constipation, mood, appetite, muscle relaxation, and sleep. It may also decrease tics and phenol intolerance. Citrate, malate, or glycinate forms recommended. Too much magnesium will cause diarrhea (although you should consider the form—not all forms will cause loose stool). Some children who have the “jack-in-the-box” or “flopping fish” syndrome as they try to fall asleep may be lacking magnesium and potassium. Often works best when used in conjunction with Vitamin B6. Some people supplement in a cream form or through magnesium sulfate baths (Epsom salts baths) if oral supplementation is not tolerated, although this method will offer very small amounts of magnesium. Children who wet the bed at night are often low in magnesium and supplement can often help this situation.
*Melatonin is considered an antioxidant particularly helpful for the brain. Most ASD children do not make enough. Helps to improve sleep by allowing kids to fall asleep, but can actually disrupt sleep in some, particularly if too much is used. Only 1-2 mg/day is generally used; some parents see better results with time-released, although your child must be able to swallow pills to benefit from these. Good ARI rating.
*Milk Thistle Extract can help support liver function, especially important during chelation.
*Molybdenum can be used to lower copper levels, often high in ASD children (85% of them) and sometimes made worse during chelation.
Mullein and garlic oil ear drops are a very effective way of fighting ear infections, a common problem among ASD children. These drops can be found at most health food stores.
NAC (N-Acetylcysteine) is an antioxidant contraindicated for anyone with high plasma cysteine. It can also worsen yeast problems. It can be used to increase glutathione levels but will not detoxify the body on its own.
NAG (N-acetyl glucosamine) is thought to help heal the gut by promoting mucus production in the gut. It has been shown to help with diarrhea and gut distention in children with constipation.
Niacin is one of the B vitamins. It is a term which means both nicotinic acid and nicotinamide. High doses of nicotinic acid can cause a flush, resulting in vasodilation of surface blood vessels. This will increase blood flow, principally in the face, neck and chest. Nicotinamide is not associated with this condition.
No-Fenol is a digestive enzyme for highly phenolic foods. May be helpful for those with phenol intolerance. Some people also give it away from food to help control yeast. Houston product.
Olive Leaf Extract is an antiviral. Comes in liquid (strong taste, like green tea) and capsules. Some amino acids (glycine, lysine, histadine and cysteine—including NAC) might cause OLE to be ineffective. Do note that OLE will kill soil based bacteria found in some probiotics. See Dana’s site and Viral Information and Resources file for more information on OLE.
Oregano (oil of oregano) can be used as an anti-fungal. There is evidence that it also has antiviral and antibacterial properties and is therefore a good all round product for many of our kids.
Oxypowder is a popular constipation remedy. For more on this product, constipation causes, and other treatments, see Constipation file.
Pantothenic acid or pantethine is the coenzyme form of B5, very good for adrenal problems and allergies, which many ASD children have. There are no known reports of pantothenic acid toxicity. Large doses (10 grams or more) may cause diarrhea.
Peptizyde is a protein digesting enzyme that works for gluten, casein, and soy protein. Contains bromelain (pineapple) and papain (papaya). If these are a problem, use the AFP Peptizyde instead. Will not allow you to leave GF diet if you have celiac disease. A Houston's product.
Phosphatidylcholine or lecithin can be helpful to the liver, brain (particularly in protecting the myelin sheaths), and digestive health. Powdered form is recommended or there are very pure liquid forms. Generally a soy product; however, egg-based forms are available. Some people choose to use glycerylphosphorylcholine (alpha-GPC) instead, as it is very similar but easier to dose because it comes in a powder that tastes better.
Phosphatidylserine can be used to improve concentration, focus, and mood. Can also reduce “brain fog”. A soy product
*Probiotics are supplements to replace the “good” bacteria in the intestinal tract destroyed from antibiotic use, stress, pesticides, malnutrition, and toxins. Some people use them alone to control yeast overgrowth; many people use them in conjunction with an anti-fungal. Come in capsule, loose powder, and chewable forms. If your child is casein-free, be sure to buy non-dairy. Try to use probiotics long before the expiration date. Some need to be refrigerated. There are a wide variety of probiotics, both in type and quality. What works for individuals seems to vary. Some people rotate their probiotics to ensure a wide variety of good bacteria. Most children require far more than the amounts recommended on the bottles.
Protein Powder can be used to add protein to diet. Many children, particularly those who are GFCF may need more protein. Undenatured whey protein is an excellent way to boost glutathione levels but is not CF. Rice protein powder is a complete protein as well. Pea protein powder is also available. Some children, particularly those who may have problems with glutamate, may not do well on protein powders.
SAMe does not have a good ARI rating. It seems to help only 1 in 5 ASD children.
Selenium is an antioxidant mineral. If you're avoiding yeast, make sure to get "yeast free" selenium. Not all is. Selenium supports delivery of zinc to cells and the sequestering of mercury and other heavy metals. Use the selenomethionine form. Some ASD children are low in selenium, although exact percentages are controversial. The National Academies of Science established an UL of 400 mcg/day for selenium.
*Taurine is an amino acid and powerful antioxidant and is needed to form bile salts (necessary to properly use vitamins and fats). It will also make your poop brown as it should be. Pangborn considers taurine an important supplement that should be in place before a number of others (unlike the rest of the amino acids). Can also counter chlorine intolerance, from swimming pools. Taurine given at bedtime can also help for calmness and sleep. Some parents have used taurine successfully to reduce or eliminate seizures.
Trimethylglycine or TMG, like DMG has a good ARI rating. Pangborn recommends that you have taurine in place first. May cause hyperactivity. Suggested morning dosing. See ARI website for more information. See also DMG.
*Vitamin A is often thought to help with visual stims and language. It is not the same as beta carotene. Beta carotene is the pre-vitamin A found in plants (a precursor to Vitamin A which healthy bodies convert—our children may not be able to do this). Many people use cod liver oil to supplement Vitamin A, thereby supplementing Vitamin D and the fatty acids as well (see essential fatty acids). Most recommended brand by far is Nordic Naturals. Must be refrigerated after opening and used within a couple months. Fish oil should not smell fishy. If your child doesn’t tolerate, you may consider a different form of Vitamin A (eg. Klaire Lab micellized Vitamin A). Vitamin A plays an important role in healing leaky gut; this may be of particular relevance to children who have suffered an adverse reaction to the MMR. Good ARI rating.
Vitamin B1 is called thiamin. There is little danger of thiamin toxicity when it is taken orally.
Vitamin B2 or riboflavin, is readily excreted in the urine and absorption by the digestive tract may be less than 20 mg for one dose. There appears to be no danger of oral toxicity.
Vitamin B6 is also known as pyridoxine or pyridoxine-HCI. It becomes the P5P active co-enzyme form in the body, which is why some supplements recommended for ASD people are in the P5P form already. Shows best results when given with magnesium. (See ARI site, where B6 is highly recommended, for details). Adequate zinc is required. Give with food. May require amino acid supplements to work best—testing can show. Many phenol intolerant children have problems with B6; sufficient Magnesium may address this problem.
Vitamin B-12 is also known as cobalamin. It is thought that toxins such as thimerosal can damage the body process of making methylcobalamin. Some ASD children respond very well to injections of methylcobalamin because they bypass the damaged gut and are therefore well absorbed. Injections are done after consulting with a doctor as they require a prescription. For supplementing with Vitamin B12 as methylcobalamin, Pangborn recommends that you deal with gut and food intolerance issues first, and that you have taurine in place before supplementing. Some children have adverse reactions (violence, extreme emotion) to the injections, but many children benefit (See Dr. Neubrander’s site for information http://www.drneubrander.com/page1.html) Parents may want to start with oral methyl B12 to see if it is tolerated well; however, a lack of improvement on oral mb12 does not mean shots will not help. Some people have also used the nasal spray effectively and there are some who have found that the transdermal is effective as well. Vitamin B12 plays a key role in crucial body functions such as methylation.
*Vitamin B complex is a convenient way to supplement the B vitamins if a child tolerates each vitamin at the same level (eg. 50 mg, 100 mg). The B vitamins, particularly B6 with magnesium, are considered an important initial supplement. Sometimes B vitamins can be in the aspartate form: some people believe that as an excitotoxin it should be avoided, just like glutamate.
*Vitamin C is a powerful antioxidant. Be aware that most vitamin C is corn based and that hypoallergenic vitamin C may be a good idea. Twinlabs Allergy C is made from palm for those avoiding corn. Perque makes Vitamin C from potato. Some people choose buffered Vitamin C for better absorption and better bowel tolerance. Others choose the unbuffered—plain ascorbic acid—because it can help raise stomach acid and low stomach acid is a problem for some autistic children (see constipation file for more information). Good ARI rating.
Vitamin D is naturally produced by our bodies in response to sunlight; however, many children are deficient as great amounts of exposure to sunlight are required for sufficient levels of D. If you are supplementing with CLO, you are also giving vitamin D. There is recent research implicating the crucial role vitamin D plays in health (autism rates for Somali children living outside of Somalia in countries with little sunshine are astronomical).
*Vitamin E is an antioxidant also known as d-alpha-tocopherols. If a label says "dl" instead of just "d", it means the vitamin E is synthetic and most people want to avoid that. Since vitamin E is fat soluble, any condition affecting fat digestion, absorption or transport can lead to vitamin E deficiency with associated symptoms such as greasy stools or chronic diarrhea. This population may need a water-soluble form of vitamin E. The general health risk of too much vitamin E is low.
Vitamin K is thought by some to be an antioxidant. It plays an important role in making sure that calcium ends up where it belongs and some children have shown great improvement in tooth health with the use of Vitamin K, generally K2. Natural forms of vitamin K have caused no symptoms of toxicity, even when supplemented in large amounts. There is a yahoo group devoted to Vitamin K and the other fat soluble vitamins.
Zeolites are a newer supplement that some people believe work against viruses, regulate pH, and help to chelate. Often known by a popular brand name Natural Cellular Defense (NCD) this supplement is somewhat controversial, but some people have seen impressive results. See the listserve http://health.groups.yahoo.com/group/autismNCD for more information.
*Zinc often needs to be supplemented in ASD children. It can help to lower copper levels (85% of ASD people have high copper-zinc ratios). Also used to reduce visual stims and "mouthing" of objects. Give separately from calcium, iron, or folate. Best given away from meals in smaller doses. Citrate form is the same form as found in breastmilk and generally well tolerated but other forms such as picolinate or methionine are considered by some to be better absorbed. Can be found in liquid form also—please note that Kirkman’s liquid zinc contains propylene glycol, a chemical many parents would rather not to give their children. Some recommended brands are OptiZinc, Solgar’s zinc, and E-Lyte. Some people use a cream. Zinc should be given away from enzymes that contain DPP-IV as it may inactivate these enzymes. Good ARI rating.
Supplementing for Chelation
When supplementing for chelation, you are not looking for improvement, instead, you are looking to support the body during the chelation process. However, you must introduce new supplements just as you would for more general supplementation. Start low and slow, watch carefully, keep track.
It is highly recommended that you supplement four times a day—the body can only absorb water-soluble vitamins and minerals in limited doses, and giving them all at once is a waste and may be harmful to your chelating child. Giving vitamins in the citrate form can raise pH levels and make the urine more alkaline, which prevents the chelators from dropping the metals into the kidneys, a problem you would want to avoid. It can also be helpful to give Vitamin C in the Ester form, as this also can raise pH levels.
Continue supplementing the same way every day, regardless of whether you are chelating or not. Supplements should be in place for a week or two before you begin chelation.
Remember, this is not medical advice, just one recommendation. You will find different ones elsewhere. You must make the decision as to what is best for your child.
Note that some supplements call for milligrams (mg) and some for micrograms (mcg).
Calcium: 5-20 mg/pound divided into four doses over the day
Essential Fatty Acid (fish oil or flax, see notes above) 1 to 3 tbsp/day
Magnesium: 10 mg/pound divided into four doses over the day
Milk Thistle: ¼-1 cap (20-80 mg) per dose/ 4 times a day
Molybdenum: 5-20 mcg/pound divided into four doses over the day
Selenium: 1-2 mcg/pound/divided into four doses over the day
Vitamin A: 5 RDA’s/day. Be sure to consider if your EFA is a source
Vitamin B: 12.5-25 mg/4 times a day
Vitamin C: 5 to 20 mg/pound per dose/4 times a day
Vitamin E: 500 IU/day
Zinc: 1 mg per pound + 20 mgs divided into four doses over the day.
Andy Cutler also suggests in some cases that glycine, taurine, lecithin, carotenes and lypocenes be considered as supplements. Note that Pangborn suggests that taurine be in place before a number of these recommended supplements are taken.
For information regarding chelators and chelation protocols, see Moira’s page http://home.earthlink.net/~moriam/. There you will find the basics of Andy Cutler’s protocol and many other valuable pieces of information.