-IBIS-1.7.0-
tx
mental/emotional
autism
Nutrition
dietary guidelines
therapeutic foods:
foods that tonify the Heart
foods that tonify the Liver
foods that calm the Shen (Spirit)
foods that open channels
supplements
Magnesium, 10-15 mg per 2.2 pounds of body weight: Most
research on the use of nutrient supplementation with autistic children has
combined high doses of magnesium and vitamin B6 over periods lasting more
than three months. The dose levels of magnesium usually employed would
normally be expected to cause diarrhea in most people. The supervision of a
nutritionally-trained healthcare professional would be advisable in the
treatment of autism with these nutrients at the recommended levels.
(Findling RL, et al. J Autism Dev Disord 1997 Aug;27(4):467-478;
Kleijnen J, et al. Biol Psychiatry 1991 May 1;29(9):931-941;
Martineau J, et al. Biol Psychiatry 1985 May;20(5):467-478;
Martineau J, et al. Dev Med Child Neurol 1989
Dec;31(6):721-727; Pfeiffer SI, et al. J Autism Dev Disord 1995
Oct;25(5):481-493)
Vitamin B6, 30 mg/kg (toxic dose), usually combined with
Magnesium. Numerous studies have examined the apparent beneficial effects
of Vitamin B6 supplementation upon the nervous system in autistic children
but Pfeiffer and Findling have recently disputed these conclusions. In
the positive uncontrolled and double-blinded trials, children were
typically given doses of B6 ranging from 3.5 mg to nearly 100 mg for every
2.2 pounds of body weight; some researchers recommended threapeutic levels
of 30 mg per 2.2 pounds of body weight. It is generally assumed that such
levels will inevitably damage the nervous system even though such toxicity
was not reported. Clearly any use of vitamin B6 at these levels for
treatment of autism needs to be under the supervision of a
nutritionally-trained physician. (Findling RL, et al. J Autism Dev
Disord 1997 Aug;27(4):467-478; Kleijnen J, et al. Biol Psychiatry
1991 May 1;29(9):931-941; Martineau J, et al. Biol Psychiatry
1985 May;20(5):467-478; Martineau J, et al. Dev Med Child
Neurol 1989 Dec;31(6):721-727; Pfeiffer SI, et al. J Autism Dev
Disord 1995 Oct;25(5):481-493)
footnotes
Findling RL, Maxwell K, Scotese-Wojtila L, Huang J, Yamashita T,
Wiznitzer M. High-dose pyridoxine and magnesium administration in children
with autistic disorder: an absence of salutary effects in a double-blind,
placebo-controlled study. J Autism Dev Disord 1997 Aug;27(4):467-478.
Abstract: Several reports have described salutary effects such as
decreased physical aggression and improved social responsiveness being
associated with the administration of high doses of pyridoxine and
magnesium (HDPM) in open-labeled and controlled studies of patients with
autism. Despite this fact, this intervention remains controversial. A
10-week double-blind, placebo-controlled trial was undertaken to examine
both the efficacy and safety of HDPM in autism. Twelve patients were
enrolled, and 10 patients (mean age 6 years 3 months) were able to complete
the study. HDPM at an average dose of 638.9 mg of pyridoxine and 216.3 mg
of magnesium oxide was ineffective in ameliorating autistic behaviors as
assessed by the Children's Psychiatric Rating Scale (CPRS), the Clinical
Global Impression Scale, and the NIMH Global Obsessive Compulsive Scale.
Furthermore, no clinically significant side effects were noted during HDPM
administration. A trend for a transient change on the CPRS was found that
was possibly due to a placebo response. This study raises doubts about the
clinical effectiveness of HDPM in autistic disorder.
Jonas C, Etienne T, Barthelemy C, Jouve J, Mariotte N. [Clinical and
biochemical value of Magnesium + vitamin B6 combination in the treatment of
residual autism in adults]. Therapie 1984 Nov-Dec;39(6):661-669.
[Article in French]
Kleijnen J, Knipschild P. Niacin and vitamin B6 in mental functioning: a
review of controlled trials in humans. Biol Psychiatry 1991 May
1;29(9):931-941. (Review)
Abstract: Fifty-three controlled trials of the effects of niacin,
vitamin B6, and multivitamins on mental functions are reviewed. The results
are interpreted with emphasis on the methodological quality of the trials.
It turns out that virtually all trials show serious short-comings: in the
number of participants, the presentation of baseline characteristics and
outcomes, and the description of changes in concomitant treatments. Only in
autistic children are some positive results are found with very high
dosages of vitamin B6 combined with magnesium, but further evidence is
needed before more definitive conclusions can be drawn. For many other
indications (hyperactive children, children with Down's syndrome, IQ
changes in healthy schoolchildren, schizophrenia, psychological functions
in healthy adults and geriatric patients) there is no adequate support from
controlled trials in favor of vitamin supplementation.
Lelord G, Callaway E, Muh JP. Clinical and biological effects of high
doses of vitamin B6 and magnesium on autistic children. Acta Vitaminol
Enzymol 1982;4(1-2):27-44.
Abstract: In 1973 Rimland reported that some autistic children responded
favorably to high doses of vitamin B6. Since this finding, different
studies were performed to identify apparently B6 responsive subjects and to
critically evaluate clinical and biological B6 responsiveness. Magnesium
was included because large doses of B6 might increase irritability. 44
patients (mean age 9.3 years) were examined. All selected children had
marked autistic symptoms. The children received a complete diagnostic
work-up, including psychiatric, psychological, neurological and medical
evaluation. Clinical data were scored using an estimate of global clinical
state and numerical rating on a 18 item scale (Behavior Summarized
Evaluation). In a first open trial 15 out of 44 children exhibited moderate
clinical improvement with worsening on termination of the trial. Thirteen
responders and 8 non responders were re-tested in a 2-week crossover,
double-blind trial and the responses to the open trial were confirmed.
Biochemical data analysis revealed that a significant decrease in urinary
homovanillic acid (HVA) levels was observed during B6-Mg administration.
During B6-Mg treatment, middle latency evoked potentials exhibited a
significant increase of amplitude.
Lelord G, Muh JP, Barthelemy C, Martineau J, Garreau B, Callaway E.
Effects of pyridoxine and magnesium on autistic symptoms--initial
observations. J Autism Dev Disord 1981 Jun;11(2):219-230.
Abstract: In an open trial, a heterogeneous group of 44 children with
autistic symptoms were treated with large doses of vitamin B6 and
magnesium. Clinical improvement with worsening on termination of the trial
was observed in 15 children. Thirteen responders and 8 nonresponders were
retested in a 2-week, crossover, double-blind trial, and the responses to
the open trial were confirmed.
Martineau J, Barthelemy C, Cheliakine C, Lelord G. Brief report: an open
middle-term study of combined vitamin B6-magnesium in a subgroup of
autistic children selected on their sensitivity to this treatment. J
Autism Dev Disord 1988 Sep;18(3):435-447.
Martineau J, Garreau B, Barthelemy C, Callaway E, Lelord G. Effects of
vitamin B6 on averaged evoked potentials in infantile autism. Biol
Psychiatry 1981 Jul;16(7):627-641.
Abstract: In autistic children, averaged evoked potentials have been
reported to have lower amplitudes and shorter latencies than those of
normal children. Also, moderate clinical improvement has been observed in
some autistic children after treatment with vitamin B6 and magnesium. We
have studied biochemical and electrophysiological effects of vitamin B6 and
magnesium in 12 autistic children and in 11 normal children. During
treatment of the autistic children with B6, an increase of amplitude of
middle-latency evoked potentials and a decrease of urinary homovanillic
acid were found. The reverse was noted in the normal subjects.
Martineau J, Barthelemy C, Roux S, Garreau B, Lelord G.
Electrophysiological effects of fenfluramine or combined vitamin B6 and
magnesium on children with autistic behaviour. Dev Med Child
Neurol 1989 Dec;31(6):721-727.
Abstract: The authors compared the effects of fenfluramine or combined
vitamin B6 and magnesium treatment on the evoked potential conditioning of
12 children whose autistic behaviour had improved clinically following
treatment. The children who were clinically sensitive to combined vitamin
B6 and magnesium developed a conditioning phenomenon and the
fenfluramine-sensitive children showed an enhancement of the Cz evoked
response amplitude. Results are discussed with reference to behaviour
modifications observed during treatment.
Martineau J, Barthelemy C, Lelord G. Long-term effects of combined
vitamin B6-magnesium administration in an autistic child. Biol
Psychiatry 1986 May;21(5-6):511-518.
Martineau J, Barthelemy C, Garreau B, Lelord G. Vitamin B6, magnesium,
and combined B6-Mg: therapeutic effects in childhood autism. Biol
Psychiatry 1985 May;20(5):467-478.
Abstract: This article reports the behavioral, biochemical, and
electrophysiological effects of four therapeutic crossed-sequential
double-blind trials with 60 autistic children: Trial A--vitamin B6 plus
magnesium/magnesium; Trial B--vitamin B6 plus magnesium; Trial
C--magnesium; and Trial D--vitamin B6. Therapeutic effects were controlled
using behavior rating scales, urinary excretion of homovanillic acid (HVA),
and evoked potential (EP) recordings. The behavioral improvementobserved
with the combination vitamin B6-magnesium was associated with significant
modifications of both biochemical and electrophysiological parameters: the
urinary HVA excretion decreased, and EP amplitude and morphology seemed to
be normalized. These changes were not observed when either vitamin B6 or
magnesium was administered alone.
Pfeiffer SI, Norton J, Nelson L, Shott S. Efficacy of vitamin B6 and
magnesium in the treatment of autism: a methodology review and summary of
outcomes. J Autism Dev Disord 1995 Oct;25(5):481-493. (Review)
Abstract: Pauling's orthomolecular hypothesis appeared in 1968, stating
that some forms of mental illness and disease are related to biochemical
errors in the body. Vitamin therapy is believed to be a means of
compensating for such errors. There have been few empirical studies on
vitamin therapy in individuals with autism. This article presents a
critical analysis of the 12 published studies located through an extensive
computerized search. Studies were systematically evaluated to provide an
objective assessment of empirical evidence supporting the efficacy of
vitamin treatment. The majority of studies report a favorable response to
vitamin treatment. However, interpretation of these positive findings needs
to be tempered because of methodological shortcomings inherent in many of
the studies. For example, a number of studies employed imprecise outcome
measures, were based on small samples and possible repeat use of the same
subjects in more than one study, did not adjust for regression effects in
measuring improvement, and omitted collecting long-term follow-up data.
Recommendations are offered to assist researchers in designing future
investigations.
Rimland B. Controversies in the treatment of autistic children: vitamin
and drug therapy. J Child Neurol 1988;3 Suppl:S68-72. (Review)
Abstract: A survey of approximately 4,000 questionnaires completed by
parents of autistic children provided ratings on a variety of treatments
and interventions. Among the biomedical treatments, the use of high-dosage
vitamin B6 and magnesium (n = 318) received the highest ratings, with 8.5
parents reporting behavioral improvement to every one reporting behavioral
worsening. Deanol (n = 121) was next most highly rated, with 1.8 parents
reporting improvement to each one reporting worsening. Fenfluramine (n =
104) was third, with a ratio of 1.5:1. Thioridazine hydrochloride
(Mellaril), by far the most often used drug on the list (n = 724), was
fourth with a helped-worsened ratio of 1.4:1. The research literature on
the use of vitamin B6-magnesium is briefly reviewed, and mention is made of
recent findings regarding high-dosage folic acid in autism and biotin in
Rett syndrome.
Rimland B. High dose vitamin B6 and magnesium in treating autism:
response to study by Findling et al. J Autism Dev Disord 1998
Dec;28(6):581-582.
Rimland B, Callaway E, Dreyfus P. The effect of high doses of vitamin B6
on autistic children: a double-blind crossover study. Am J
Psychiatry 1978 Apr;135(4):472-475.
Abstract: The authors used data from an earlier nonblind study to
identify 16 autistic-type child outpatients who had apparently improved
when given vitamin B6 (pyridoxine). In a double-blind study each child's B6
supplement was replaced during two separate experimental trial periods with
either a B6 supplement or a matched placebo. Behavior was rated as
deteriorating significantly during the B6 withdrawal.