Summary of Biomedical Treatments for Autism, by James B. Adams, Ph.D.
page 7High-Dose Vitamin B6 and Magnesium
Rationale:There are over 20 studies of vitamin B6 with Magnesium for autism, including 12 double-blind, placebo-controlled studies, making it one of most studied treatments for autism. Almost all of these studies found that 45-50% of children and adults with autism benefited from high-dose supplementation of vitamin B6 with magnesium. Vitamin B6 is required for over 100 enzymatic reactions, including the production of major neurotransmitters (serotonin, dopamine, and others) and glutathione (needed for detoxification). Magnesium is used to prevent the possibility of hyperactivity, which can occur if the vitamin B6 is taken by itself.
Most of the studies used dosages of about 8-15 mg/pound of B6 (maximum of 1000 mg). Only 1 study used a lower dosage (1.3 mg/pound), and that is one of the few studies that found no benefit.
A dosage study by T. Audhya steadily increased the dosage of vitamin B6 from 1 to 10 mg/pound. They found that at least 3 mg/pound was needed to begin to see benefits, and 6 mg/pound was enough for most children to see benefit.
The reason why many children and adults benefit from high-dose vitamin B6 is still unclear, but a possible explanation is that many children and adults with autism have both 1) a decreased ability to convert vitamin B6 to its active form, and 2) defective enzymes for making key neurotransmitters that require an unusually high amount of the active form of vitamin B6. (For more explanation see Adams et al, Abnormally high plasma levels of vitamin B6 in children with autism not taking supplements compared to controls not taking supplements. J Altern Complement Med. 2006 Jan-Feb;12(1):59-63).
Treatment: Based on a review of all the research, Dr. Bernard Rimland has recommended a dosage of about 8 mg/pound of vitamin B6 (maximum of 1000 mg) and half as much magnesium. However, he emphasized that some individuals with autism need somewhat more or less.
It should be noted that all the treatment studies involved children and adults who were generally not following DAN! interventions, and it is possible that the other DAN! interventions may reduce the need for high-dose vitamin B6 in some children and adults.
Test: There is not yet a lab test to determine who will benefit from high-dose vitamin B6, although measurements of low neurotransmitters might be a possible clue. The best test is simply a 2 month trial, slowly increasing the dose from 1 mg/pound bodyweight to 8 mg/pound bodyweight of B6, and half as much magnesium.
Safety: High dose supplementation of vitamin B6 in children and adults with autism appears to be very safe. One study by Audhya compared 6 months of treatment with high-dose vitamin B6 in two forms (PLP or pyridoxine HCl) in 184 children with autism, and found adverse side-effects (worsening of behaviors) in 10% of those children receiving PLP (half the group) vs. none in those receiving pyridoxine HCl. However, a few children can do better on PLP. So, we suggest first starting with pyridoxine HCL, and then consider adding some P5P (5-25 mg) to see if further improvement occurs.
There is a small possibility that high dose vitamin B6 could cause temporary peripheral neuropathy (loss of feeling in fingers and toes), but this is extremely rare, and stopping supplementation generally results in full recovery.
For more info: A summary of vitamin B6 studies in autism is available at http://www.autismwebsite.com/ari/treatment/b6studies.htm
Summary of Biomedical Treatments for Autism:
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