ARI Publication 40 – 2013 Version

• Either folinic acid or methyl-tetra-hydrofolate should be used for supplying vitamin B – folic acid
  is not sufficient for children with autism, according to one research study.
  James SJ, Cutler et al., Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in
  children with autism. Am J Clin Nutr. 2004, 80(6):1611-7.
• Calcium supplements are especially important if a person is on a dairy-free diet.
• Iron supplements are needed by some typical children as well as children with autism, but
  should only be given if a test indicates a need, as too much iron can also be a problem.
• In general, nutritional supplements are a good way to boost key nutrients lacking in the diet,
  and to provide extra amounts that may be needed to overcome metabolic problems.

Testing:
Most vitamin and mineral levels can be tested using blood samples taken while fasting. Health
Diagnostics is one of very few companies that can measure the level of all vitamins. Many
commercial labs can measure the level of most minerals, most of which can be measured reliably in
Red Blood Cells (RBC). Calcium is best measured in the urine, preferably with a 24-hour urine
collection. Some laboratories also offer functional assessments of the need for vitamins and
minerals based on blood and/or urine testing. Measure iron with serum ferritin.

Recommended Dosages:
We recommend the following dosages for people with autism as a reasonable level to start with.
However, some individuals may need more or less depending on their diet and metabolic needs,
and testing can help determine optimal supplement levels.
Note that vitamins and minerals can have a potent effect on body function and behavior, so start at
a low dose (1/10 of that below) and then gradually increasing over 3-4 weeks.

Iron should be added only if a test indicates a need for iron – this is a common problem in children
under 5 years. Low iron is a leading cause of mental retardation in the US, and 40% of infants
under the age of 2 have low iron (and so do 40% of women of child-bearing age). Most
girls/women who are menstruating should take supplemental iron. However, too much iron can be
harmful, so testing is important.

The dosage below should be adjusted up or down by bodyweight; ie, half for a 30-lb child, and
double for 120 pounds and above.

The following recommendations are based on the results of a published study that
measured the effect of a multi-vitamin/mineral supplement on children with autism.
Adams JB et al., Effect ofa Vitamin/Mineral Supplement on Children with Autism, BMCPediatrics 2011,
11:111
The recommendations are similar to what was used in the Adams et al 2011 study, but slightly
modified based on the results of that study. We recommend starting at a low dose, and gradually
increasing over several weeks – some individuals may be better with half or¾ dose.

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