Autism Spectrum Disorder (ASD) is a complex developmental condition that involves persistent challenges in social interaction, speech and nonverbal communication, and restricted/repetitive behaviors. The effects of ASD and the severity of symptoms are different in each person. Nutritional therapy and nutrient supplementation have been identified as potential helpful approaches for individuals with autism (1).
This article delves into some of the most crucial supplementation targets to consider: neuroimmune support, mitochondrial function, melatonin supplementation, and micronutrient support. It’s essential to understand that ASD exhibits a broad spectrum of presentations, and each individual will have unique needs.
Neuroimmune Support Nutrients
The immune system and the nervous system are intricately linked. In individuals with autism, this connection often requires additional support to function optimally.
Key nutrients that play a role in neuroimmune support include:
- Omega-3 Fatty Acids: These essential fatty acids, found abundantly in fish oil, are known for their inflammation modulating properties (2). Omega-3s are critical for brain health, cognitive function, brain development, and neuroimmune communication (3-5). Research shows that many children with autism consume less omega-3s in their diet than the rest of the population, suggesting that supplementation may be helpful (6).
- Vitamin A: Essential for immune function and maintaining the integrity of mucosal surfaces, Vitamin A plays a crucial role in neuroimmune interactions. It supports the development and function of the brain, supports optimal microbiome composition in the gut, and is involved in regulating the immune system’s response (7-10). Additionally, recent studies have shown a correlation between lower vitamin A levels and higher autism severity symptoms. This leads to the possibility that correcting vitamin A deficiencies or inadequacies is extra important for those with autism (11).
- Vitamin D: This vitamin plays a pivotal role in immune regulation, gut health, and neurological development (8-13). Many individuals with ASD have lower levels of vitamin D, suggesting a potential need for supplementation (14).
- Probiotics: Probiotics are well known to modulate the neuroimmune system, digestive system, and more. They are a safe supplement for children with autism and may improve quality of life (15,16). For more information about how probiotics affect the immune system, see: 12 Science-Backed Ways Probiotics Benefit The Immune System.
Mitochondrial Support Nutrients
Mitochondria are known as the powerhouses of the cell, generating the energy that our cells need to function. There is evidence suggesting that some individuals with autism may have mitochondrial dysfunction (17-19).
Nutrients that can support mitochondrial health include:
- Carnitine: This nutrient aids in the transport of fatty acids into mitochondria, where they are used for energy production (20). Carnitine supplementation has been shown to improve certain symptoms in some, but not all, types of autism. See the references below for more details including doses (21-23).
- Coenzyme Q10 (CoQ10): An antioxidant that helps with energy production in mitochondria (24). In one small study, supplementation with CoQ10 in the form of ubiquinol was associated with improvements for children with ASD in eating, sleeping, communicating, and playing (25).
- B Vitamins, Vitamin C, and Vitamin E: These vitamins aid in cellular energy production (26,27). For the most part, these vitamins haven’t been specifically examined in the research as stand alone treatments for autism, but they are included in multinutrient support studies (28,29). For these nutrients, correcting and preventing deficiency is important for optimal health as discussed in the micronutrient support section below.
Melatonin Supplementation
Melatonin is a hormone that regulates sleep-wake cycles. Many individuals with autism experience melatonin deficiency, circadian rhythm issues, and sleep disturbances (30,31). Melatonin supplementation can be beneficial in improving sleep quality and correcting deficiency (32-34). Beyond its role in sleep regulation, melatonin also possesses antioxidant properties that may support neurological health and improve behavior (34).
Many safety studies have been done regarding long term melatonin supplementation in kids with neurological issues like ASD and ADHD, and it is my opinion that this supplement is safe when used as directed (35-38).
Micronutrient Support
Individuals with ASD often have restricted diets due to sensory sensitivities, therapeutic diets, or other factors. This dietary restriction may lead to potential micronutrient deficiencies.
Ensuring adequate intake of essential vitamins and minerals is crucial for overall health and supports cognitive function, immune health, and more.
A comprehensive approach to overall micronutrient support for those with ASD (or those without) could involve multivitamins, nutrient-dense superfoods, and food-based nutrient supplements, like Nature’s Nutrients or Grass Fed & Finished Beef Liver Capsules. Advice from a nutritionist with experience helping those with ASD is ideal. This is especially true for children who are picky or who have sensory challenges or Avoidant Restrictive Food Intake Disorder (ARFID), which is present in approximately 20% of children with autism (39).
Summary
The nutritional needs of individuals with autism are diverse and require a personalized approach. Supplementation with nutrients that support neuroimmune function, mitochondrial health, sleep regulation, and overall nutritional status can be an integral part of a comprehensive care plan.
It is essential to work closely with a healthcare professional to determine appropriate supplements and dosages, taking into account the unique needs and health status of each individual with autism. By adopting a targeted nutritional approach, it may be possible to support better health outcomes and quality of life for those on the autism spectrum.
References:
- Adams, J. B., Kirby, J., Audhya, T., Whiteley, P., & Bain, J. (2022). Vitamin/mineral/micronutrient supplement for autism spectrum disorders: a research survey. BMC pediatrics, 22(1), 590. https://doi.org/10.1186/s12887-022-03628-0
- Jalili, M., & Hekmatdoost, A. (2021). Dietary ω-3 fatty acids and their influence on inflammation via Toll-like receptor pathways. Nutrition (Burbank, Los Angeles County, Calif.), 85, 111070. https://doi.org/10.1016/j.nut.2020.111070
- Shahidi, F., & Ambigaipalan, P. (2018). Omega-3 Polyunsaturated Fatty Acids and Their Health Benefits. Annual review of food science and technology, 9, 345–381. https://doi.org/10.1146/annurev-food-111317-095850
- Luchtman, D. W., & Song, C. (2013). Cognitive enhancement by omega-3 fatty acids from child-hood to old age: findings from animal and clinical studies. Neuropharmacology, 64, 550–565. https://doi.org/10.1016/j.neuropharm.2012.07.019
- Gutiérrez, S., Svahn, S. L., & Johansson, M. E. (2019). Effects of Omega-3 Fatty Acids on Immune Cells. International journal of molecular sciences, 20(20), 5028. https://doi.org/10.3390/ijms20205028
- Esteban-Figuerola, P., Canals, J., Fernández-Cao, J. C., & Arija Val, V. (2019). Differences in food consumption and nutritional intake between children with autism spectrum disorders and typically developing children: A meta-analysis. Autism : the international journal of research and practice, 23(5), 1079–1095. https://doi.org/10.1177/1362361318794179
- Pham, V. T., Dold, S., Rehman, A., Bird, J. K., & Steinert, R. E. (2021). Vitamins, the gut microbiome and gastrointestinal health in humans. Nutrition research (New York, N.Y.), 95, 35–53. https://doi.org/10.1016/j.nutres.2021.09.001
- Cantorna, M. T., Snyder, L., & Arora, J. (2019). Vitamin A and vitamin D regulate the microbial complexity, barrier function, and the mucosal immune responses to ensure intestinal homeostasis. Critical reviews in biochemistry and molecular biology, 54(2), 184–192. https://doi.org/10.1080/10409238.2019.1611734
- de Medeiros, P. H. Q. S., Pinto, D. V., de Almeida, J. Z., Rêgo, J. M. C., Rodrigues, F. A. P., Lima, A. Â. M., Bolick, D. T., Guerrant, R. L., & Oriá, R. B. (2018). Modulation of Intestinal Immune and Barrier Functions by Vitamin A: Implications for Current Understanding of Malnutrition and Enteric Infections in Children. Nutrients, 10(9), 1128. https://doi.org/10.3390/nu10091128
- Olson, C. R., & Mello, C. V. (2010). Significance of vitamin A to brain function, behavior and learning. Molecular nutrition & food research, 54(4), 489–495. https://doi.org/10.1002/mnfr.200900246
- Liu Z, Wang J, Xu Q, Hong Q, Zhu J, Chi X. Research Progress in Vitamin A and Autism Spectrum Disorder. Behav Neurol. 2021 Dec 7;2021:5417497. doi: 10.1155/2021/5417497. PMID: 34917197; PMCID: PMC8670912.
- Cui, X., & Eyles, D. W. (2022). Vitamin D and the Central Nervous System: Causative and Preventative Mechanisms in Brain Disorders. Nutrients, 14(20), 4353. https://doi.org/10.3390/nu14204353
- Zhang, S., Miller, D. D., & Li, W. (2021). Non-Musculoskeletal Benefits of Vitamin D beyond the Musculoskeletal System. International journal of molecular sciences, 22(4), 2128. https://doi.org/10.3390/ijms22042128
- Siracusano, M., Riccioni, A., Abate, R., Benvenuto, A., Curatolo, P., & Mazzone, L. (2020). Vitamin D Deficiency and Autism Spectrum Disorder. Current pharmaceutical design, 26(21), 2460–2474. https://doi.org/10.2174/1381612826666200415174311
- Arnold, L. E., Luna, R. A., Williams, K., Chan, J., Parker, R. A., Wu, Q., Hollway, J. A., Jeffs, A., Lu, F., Coury, D. L., Hayes, C., & Savidge, T. (2019). Probiotics for Gastrointestinal Symptoms and Quality of Life in Autism: A Placebo-Controlled Pilot Trial. Journal of child and adolescent psychopharmacology, 29(9), 659–669. https://doi.org/10.1089/cap.2018.0156
- Srikantha, P., & Mohajeri, M. H. (2019). The Possible Role of the Microbiota-Gut-Brain-Axis in Autism Spectrum Disorder. International journal of molecular sciences, 20(9), 2115. https://doi.org/10.3390/ijms20092115
- Wang, Y. M., Qiu, M. Y., Liu, Q., Tang, H., & Gu, H. F. (2021). Critical role of dysfunctional mitochondria and defective mitophagy in autism spectrum disorders. Brain research bulletin, 168, 138–145. https://doi.org/10.1016/j.brainresbull.2020.12.022
- Rojas-Charry, L., Nardi, L., Methner, A., & Schmeisser, M. J. (2021). Abnormalities of synaptic mitochondria in autism spectrum disorder and related neurodevelopmental disorders. Journal of molecular medicine (Berlin, Germany), 99(2), 161–178. https://doi.org/10.1007/s00109-020-02018-2
- Wen, Y., & Yao, Y. (2021). Autism Spectrum Disorders: The Mitochondria Connection. In A. M. Grabrucker (Ed.), Autism Spectrum Disorders. Exon Publications.
- Adeva-Andany, M. M., Calvo-Castro, I., Fernández-Fernández, C., Donapetry-García, C., & Pedre-Piñeiro, A. M. (2017). Significance of l-carnitine for human health. IUBMB life, 69(8), 578–594. https://doi.org/10.1002/iub.1646
- Demarquoy, C., & Demarquoy, J. (2019). Autism and carnitine: A possible link. World journal of biological chemistry, 10(1), 7–16. https://doi.org/10.4331/wjbc.v10.i1.7
- Kępka, A., Ochocińska, A., Chojnowska, S., Borzym-Kluczyk, M., Skorupa, E., Knaś, M., & Waszkiewicz, N. (2021). Potential Role of L-Carnitine in Autism Spectrum Disorder. Journal of clinical medicine, 10(6), 1202. https://doi.org/10.3390/jcm10061202
- Malaguarnera, M., & Cauli, O. (2019). Effects of l-Carnitine in Patients with Autism Spectrum Disorders: Review of Clinical Studies. Molecules (Basel, Switzerland), 24(23), 4262. https://doi.org/10.3390/molecules24234262
- Pradhan, N., Singh, C., & Singh, A. (2021). Coenzyme Q10 a mitochondrial restorer for various brain disorders. Naunyn-Schmiedeberg’s archives of pharmacology, 394(11), 2197–2222. https://doi.org/10.1007/s00210-021-02161-8
- Gvozdjáková, A., Kucharská, J., Ostatníková, D., Babinská, K., Nakládal, D., & Crane, F. L. (2014). Ubiquinol improves symptoms in children with autism. Oxidative medicine and cellular longevity, 2014, 798957. https://doi.org/10.1155/2014/798957
- Wesselink, E., Koekkoek, W. A. C., Grefte, S., Witkamp, R. F., & van Zanten, A. R. H. (2019). Feeding mitochondria: Potential role of nutritional components to improve critical illness convalescence. Clinical nutrition (Edinburgh, Scotland), 38(3), 982–995. https://doi.org/10.1016/j.clnu.2018.08.032
- Pangrazzi, L., Balasco, L., & Bozzi, Y. (2020). Natural Antioxidants: A Novel Therapeutic Approach to Autism Spectrum Disorders?. Antioxidants (Basel, Switzerland), 9(12), 1186. https://doi.org/10.3390/antiox9121186
- Karhu, E., Zukerman, R., Eshraghi, R. S., Mittal, J., Deth, R. C., Castejon, A. M., Trivedi, M., Mittal, R., & Eshraghi, A. A. (2020). Nutritional interventions for autism spectrum disorder. Nutrition reviews, 78(7), 515–531. https://doi.org/10.1093/nutrit/nuz092
- Morris, C. R., & Agin, M. C. (2009). Syndrome of allergy, apraxia, and malabsorption: characterization of a neurodevelopmental phenotype that responds to omega 3 and vitamin E supplementation. Alternative therapies in health and medicine, 15(4), 34–43.
- Yenen, A. S., & Çak, H. T. (2020). Melatonin and Circadian Rhythm in Autism Spectrum Disorders. Otizm Spektrum Bozukluklarında Melatonin ve Sirkadiyen Ritim. Turk psikiyatri dergisi = Turkish journal of psychiatry, 31(3), 201–211. https://doi.org/10.5080/u25160
- da Silveira Cruz-Machado, S., Guissoni Campos, L. M., Fadini, C. C., Anderson, G., Markus, R. P., & Pinato, L. (2021). Disrupted nocturnal melatonin in autism: Association with tumor necrosis factor and sleep disturbances. Journal of pineal research, 70(3), e12715. https://doi.org/10.1111/jpi.12715
- Xiong, M., Li, F., Liu, Z., Xie, X., Shen, H., Li, W., Wei, L., & He, R. (2023). Efficacy of Melatonin for Insomnia in Children with Autism Spectrum Disorder: A Meta-analysis. Neuropediatrics, 54(3), 167–173. https://doi.org/10.1055/s-0043-1761437
- Yan, T., & Goldman, R. D. (2020). Melatonin for children with autism spectrum disorder. Canadian family physician Medecin de famille canadien, 66(3), 183–185.
- Lalanne, S., Fougerou-Leurent, C., Anderson, G. M., Schroder, C. M., Nir, T., Chokron, S., Delorme, R., Claustrat, B., Bellissant, E., Kermarrec, S., Franco, P., Denis, L., & Tordjman, S. (2021). Melatonin: From Pharmacokinetics to Clinical Use in Autism Spectrum Disorder. International journal of molecular sciences, 22(3), 1490. https://doi.org/10.3390/ijms22031490
- Rzepka-Migut, B., & Paprocka, J. (2020). Efficacy and Safety of Melatonin Treatment in Children with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder-A Review of the Literature. Brain sciences, 10(4), 219. https://doi.org/10.3390/brainsci10040219
- Malow, B. A., Findling, R. L., Schroder, C. M., Maras, A., Breddy, J., Nir, T., Zisapel, N., & Gringras, P. (2021). Sleep, Growth, and Puberty After 2 Years of Prolonged-Release Melatonin in Children With Autism Spectrum Disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 60(2), 252–261.e3. https://doi.org/10.1016/j.jaac.2019.12.007
- Maras, A., Schroder, C. M., Malow, B. A., Findling, R. L., Breddy, J., Nir, T., Shahmoon, S., Zisapel, N., & Gringras, P. (2018). Long-Term Efficacy and Safety of Pediatric Prolonged-Release Melatonin for Insomnia in Children with Autism Spectrum Disorder. Journal of child and adolescent psychopharmacology, 28(10), 699–710. https://doi.org/10.1089/cap.2018.0020
- Gringras, P., Nir, T., Breddy, J., Frydman-Marom, A., & Findling, R. L. (2017). Efficacy and Safety of Pediatric Prolonged-Release Melatonin for Insomnia in Children With Autism Spectrum Disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 56(11), 948–957.e4. https://doi.org/10.1016/j.jaac.2017.09.414
- Keski-Rahkonen, A., & Ruusunen, A. (2023). Avoidant-restrictive food intake disorder and autism: epidemiology, etiology, complications, treatment, and outcome. Current opinion in psychiatry, 36(6), 438–442. https://doi.org/10.1097/YCO.0000000000000896