Source: Autism Dietitian by Brittyn Coleman

“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
• Vitamin D
• Vitamin A
• Iron
• Vitamin C
• Calcium
• Zinc
• Folate
• Magnesium
• Omega-3s

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.

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

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
• Nordic Naturals ProOmega 2000 Jr.
• Nordic Naturals ProOmega Lemon
• OmegaGenics EPA-DHA 720

Liquid
• Nordic Naturals Arctic Cod Liver Oil (Orange)
• Nordic Naturals Arctic Omega (Lemon)
• DHA Junior Liquid (Strawberry)

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:
• Kirkman Labs Pro-Bio Gold
• Pure Encapsulations Probiotic 50B
• Klaire Labs Ther-Biotic Complete

Powder:
• Klaire Labs Ther-Biotic Complete Powder
• Klaire Labs Vital-10 Powder
• Kirkman Labs Acidophilus Powder

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:
• Designs for Health GI Microb-X
• Designs for Health Oil of Oregano
• Kirkman Labs CD-Herbal

My favorite prebiotic/GI fortifying supplements include:
• Pure Encapsulations GI Fortify (in capsules and powder)
• Klaire Labs Biotagen (in capsules and powder)

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:
• Pure Encapsulations Digestive Enzymes Ultra (capsules)
• Klaire Labs Vital-Zymes Chewable

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