Vitamin D and Breastfeeding

 

breastfeed

A great article by Carole Baggerly
Director, GrassrootsHealth

Breastfeeding is one of the most perfect forms of food for a baby though it has long been “understood” to be an inadequate source of vitamin D.

How can that be?

If you know that most women of childbearing age are vitamin D deficient, it starts to make sense that they wouldn’t have the vitamin D available to pass on in their breast milk.

Is it really that simple – if you give women enough vitamin D will they pass it on to the baby?

Researchers at the Medical University of South Carolina (MUSC) tackled this question with the hypothesis that if a breastfeeding mom receives much more than the standard 400 IU/day of vitamin D, she will be able to pass on an adequate amount of vitamin D to her infant. After a double-blind randomized controlled trial they found that a daily vitamin D supplement of 6400 IU did indeed allow the mothers to pass enough vitamin D through breast milk so that their babies did not need a vitamin D supplement! The average 25(OH)D level of the women who received 6400 IU/day was about 60 ng/ml. The infants nutured this way had the equivalent of the 400 IU/day that is currently recommended by the American Academy of Pediatrics.

You can give babies a supplement, but only 2-19% of the infants are given a supplement. This suggests that over 80% of babies are not getting the recommended amount of vitamin D.

You can expose babies to sunshine, but your pediatrician has probably told you to keep your baby out of direct sunlight for at least the first 6 months and to make sure they are covered with clothing or sunscreen when they do go outside. (We don’t recommend this.)

This is a problem! Not enough D in breast milk, no supplementation, and no sun puts far too many babies at risk of vitamin D deficiency, and at increased risk of many future diseases that could be avoided.

We are now working at MUSC to change the standard of care for the pregnant women–getting the serum levels to at least 40-60 ng/ml. We need to take the next step: make sure that the breast fed baby ALSO has enough vitamin D. The easy way to do that is for the mom to take 6400 IU/day while she breast feeds the infant.

Onwards!

Carole Baggerly
Director, GrassrootsHealth
A Public Health Promotion & Research Organization
Moving Research into Practice NOW!

In the USA? find your D HERE!   

In the UK? find your D HERE!

Update on Vitamin D role in Autism by Dr John Cannell March 2016

Courtesy of Dr John Cannell

Latest research on Vitamin D and Autism Spectrum Disorder (ASD)

I first wrote about vitamin D and the developing brain in 2005.

Vitamin D and the developing brain

I first published my hypothesis in a peer-reviewed journal in 2007, and my paper was met with deafening silence. However, in the last two months confirmatory research is pouring out. Within this paper, I will present data regarding the role of vitamin D in autism, including results from animal studies, three case series and a randomized controlled trial (RCT) completed around the time of a dramatic Pediatrics case report. I will also tell parents how to safely use the high dose vitamin D treatment for ASD.

Autism Spectrum Disorder [ASD], is a common neurodevelopmental disorder characterized by impaired communication, repetitive behaviours and social impairment. For the last 35 years, a dramatically increased incidence has occurred, possibly reflecting increased surveillance, over-diagnosis, a true increase in incidence or some combination of these explanations. As of 2010, ASD is diagnosed in 1 of every 64 American children by the age of eight (8) years. Vitamin D deficiency has been hypothesized to contribute to ASD as far back as 2007.1 High doses of vitamin D were first proposed to have a significant treatment effect on the core symptoms of autism in 2013 based on vitamin D’s mechanisms of action, in particular in anti-inflammatory properties.2

Possible mechanisms of action that explain vitamin D helping attenuating ASD are well known, are related to the fact vitamin D is not a vitamin (it is a pro-hormone) and has been recently reviewed.3, 4 Besides reducing risk or severity through it’s steroid hormone anti-inflammatory effects in the brain, vitamin D regulates DNA repair mechanism genes, has autoimmune effects, raises seizure threshold, increases T-regulatory cells, protects neural mitochondria, and up-regulates glutathione, the master antioxidant, which scavenges oxidative by-products.5 Vitamin D’s anti-inflammatory and anti- autoimmune properties in ASD were evident in Mostafa et al’s study of 50 children with ASD, aged 5-12, which found 25(OH)D levels were very highly correlated with the presence of an anti-neural antibody (r = – 0.86;P < 0.001)) and that serum 25(OH)D levels in children were highly correlated with the severity of ASD symptoms on the Childhood Autism Rating Scale (r = – 0.81;P <0.001).6

Another one of vitamin D’s steroid hormone mechanism is through vitamin D’s effect on serotonin via direct genetic regulation of serotonin’s rate limiting enzymes; both the gene for peripheral tryptophan hydroxylase (TPH)1 and the gene for central TPH2 require vitamin D for transcription. Activated vitamin D (the steroid hormone) genetically down-regulates TPH1 while it up-regulates TPH2, thus explaining the serotonin paradox in ASD in which peripheral serotonin is increased but central serotonin is decreased.7 It is not known if any or all of these are possible mechanisms of action; steroid hormones effect multiple genes in multiple ways; it is possible there are different mechanisms at work in different individuals.

A recent meta-analysis [11 cross-sectional studies] reported vitamin D deficiency was much more common in children with ASD than in controls (P=0.0002).8 A study in the Faroe islands, where – due to

high latitude and cloud cover – most vitamin D is obtained from dietary fish, found that 40 young adults with ASD had much lower serum vitamin D levels (10 ng/ml) then did their 139 typically developing first degree relatives [17 ng/ml; P=0.003].9 Another family study found that 58 new-borns who later developed ASD had significantly lower vitamin D levels at birth than did their typically developing siblings (10 ng/ml vs. 13 ng/ml respectively, P=0.013), suggesting that infants who later develop ASD are born with genetically lower 25(OH)D levels and that vitamin D genetics is involved in ASD genetics.10 In support of the possibility that the genetics of vitamin D is playing a role in the genetics of ASD is the fact that several polymorphisms of vitamin D’s metabolic pathways are associated with ASD risk.11

A recent propionic acid induced toxic rat model of autism revealed vitamin D – in amounts comparative to high dose human vitamin D consumption – exerted both a protective and treatment effect with the protective effect more robust than the treatment effect.12 Also, an ecological study found that, in the United States, the prevalence of autism was almost three times as high in areas with low vitamin D – producing UVB ultraviolet light (p < 0.001).13

In the January 2016 issue of Pediatrics, Jia and colleagues presented a case report of a 32-month-old autistic child whose core symptoms of autism dramatically responded in two months to high doses of vitamin D (150,000 IU (3.75 mg) monthly given intramuscularly together with 400 IU/day (10 mcg) orally).14

A 3-month Egyptian study of 122 subjects with ASD, found serum 25(OH)D levels were inversely correlated with severity on the Childhood Autism Rating Scale (CARS) with (R=0.5 and p<0.001). 15 An open label trial of high-dose vitamin D (300 IU/kg/day up to a maximum of 5,000 IU/day) in 83 of those 122 ASD subjects found, on a per protocol analysis, significant clinical improvement (mean CARS went from 37 to 30, a change, if true, is not only statistically significant but also clinically meaningful. Approximately 75% of 83 supplemented ASD children improved (P<0.05) with no evidence of toxicity in any child. In fact, the highest 25(OH)D level in these children after 3 months of 300 IU/kg/day was 45 ng/ml. The subjects with ASD whose final 25(OH)D was > 40 ng/ml had the most robust improvement on the CARS.

Another open label study of 37 children aged 3-11 years with ASD were treated for 3 months with large bolus doses (150,000 IU/month given intramuscularly) together with 400 IU/day by mouth by the same research group that authored the Pediatrics case report referred to above. They found significant vitamin D treatment effects in ASD on standardized rating scales, again with no evidence of toxicity.16 The mean baseline level of the treatment group was 21 ng/ml and after three months of vitamin D their mean 25(OH)D was 41 ng/ml with the highest levels being 55 ng/ml. Significant improvement were found of the Autism Behaviour Checklist (P= 0.038) and the CARS (P=0.016).

Yet another open label trial of 11 children with ASD studied changes in neurotropic factors as well as changes in the autism behaviour checklist after administration of varying amounts of vitamin D. Only small doses of vitamin D were given and 25(OH)D >20 ng/ml was considered adequate, but a significant treatment effect on standardized scales was found nonetheless.17

The first and only RCT of 109 ASD children ages 3-10 by an Egyptian group using 300 IU/kg/day up to max of 5,000 IU/day has been submitted for publication to the Journal of Child Psychology and Psychiatry. In this study, all autistic children with 25(OH)D < 20 ng/ml were excluded from the study for ethical reasons and treated with vitamin D. Baseline 25(OH)D of the 109 study children (mean age 5.4 years) was around 27 ng/ml in both arms of the study. After the 4-month study duration, mean 25(OH)D in the treatment group was 47 ng/ml and unchanged in the placebo arm. The highest 25(OH)D obtained during this “high dose” treatment was 55 ng/ml. In a per protocol analysis, the total CARS scores significantly improved in the vitamin D group while the placebo group remained unchanged (Mean final CARS ± SD; 30.3 ± 6.1 versus 36.4 ± 6.0; p=<0.001 respectively), again with no evidence of toxicity.18 Younger children responded better than older children.

In terms of prevention, an open label study of infants born to mothers who already had one child with ASD, found 5,000 IU/day of vitamin D given to the pregnant mothers and 1,000 IU/day to the resultant child up to the age of 3 years reduced subsequent ASD incidence to 5% instead of the 20% rate consistently reported in the literature for mothers who already had one or more autistic children.19

A limited number of studies of varying quality appear to show that “high-dose” vitamin D administration has a preventative and a treatment effect in ASD, probably through steroid actions of vitamin D on the central nervous system.20, 21, 22, 23 Regardless of the cause of the autoimmune inflammatory pathogenesis of autism, vitamin D supplementation of the infants and children is likely to help, because vitamin D up-regulates the genes that produce dendritic (peacemaker) lymphocytes that reduce the intensity of autoimmune attack by up-regulating interleukin 10, an anti-inflammatory cytokine.24

Future RCTs of vitamin D in ASD children are urgently needed, but such studies may fail for the following reasons: 1) if conventional and not pharmacological vitamin D doses are used, 2) if study subjects are sufficient at baseline, 3) if deficient placebo controls are treated with vitamin D (as may be required by the ethics committee), 4) if pre and post 25(OH)D levels are not measured, and 5) if reliable pre and post ASD rating scales are not used.

Therefore, we recommend pregnant and lactating women take at least 4,000 (100 mcg)25 or, better yet, 6,000 IU (150 mcg)/day. 26 One of the problems with clinicians using adequate supplementation is the antiquated use of IU (International Units) to measure mass; vitamin D is very potent; 1 mg of vitamin D is 40,000 IU. The other problem with vitamin D is that it is not a vitamin; it was never meant to be consumed in the diet; it’s a seco-steroid pro-hormone made in the bare un-sun-blocked skin upon exposure to some sunlight, at certain times during the day, at certain latitudes and in certain seasons.

In lactating women, a 2,000 IU (50 mcg)/day arm was stopped for ethical reasons as inadequate as that dose did not result in suckling infants obtaining adequate 25(OH)D levels.27 The 4,000 IU (100 mcg)/day arm was safe in pregnancy and appears to help prevent complication of pregnancy.28 4,000 IU (100 mcg)/day will result in breast milk having some vitamin D (It usually contains almost none, a normal suckling infant gets about 77 IU/day.29) but 6,000 IU (150 mcg)/day safely raised suckling infants 25(OH)D to normal.30 A recent review concluded pregnant women who maintain 25(OH)D levels of 40

ng/ml have significantly reduced preterm births.31 It takes at least 6,000 IU/day (150 mcg) to maintain a level of 40 ng/ml in most women.32, 33

Which brings us to the question of what are normal 25(OH)D levels? PTH is frequently cited as the most obvious 25(OH)D biological cut-off marker, as PTH does not dramatically decline as much when 25(OH)D levels rise above 20 ng/ml. However, there is controversial evidence that different diseases have different biological cut-offs, such as 30 ng/ml for cognitive decline 34 and multiple sclerosis 35 and cut- offs of 40 ng/ml for depression 36 and systemic lupus erythematosus.37 In fact “normal” implies the clustering of levels possessed by “normal” people, almost all of whom have an indoor sun-deprived lifestyle. When one looks at 25(OH)D levels of traditional hunter-gatherers who live close to the equator (where human evolved), their mean level is 46 ng/ml, which requires an input of 5,000 (125 mcg) to 10,000 IU/day (250 mcg).38 So doses that result in 25(OH)D levels of 40 – 50 ng/ml (300-500 IU/kg/day) should be considered physiological, not pharmacological.

Studies show that fewer and fewer American infants over the age of one year are weaned on vitamin D enriched cow’s milk, as used to be the case, and more and more are weaned onto unfortified fruit juice. In fact, a 2006 study found that only 14% of mothers thought cow’s milk should be used at weaning while 84% thought fruit juice the best.39 As mentioned above, “normal” modern day human breast milk contains almost no vitamin D unless mothers sunbath or take about 5,000 IU (125 mcg)/day. The other source of vitamin D during toddlerhood, sun exposure, has also been dramatically curtailed over the last 30 years.40 If toddlers don’t get vitamin D from milk, or from sun exposure, then supplements are the only other source available as vitamin D is not present in significant quantities in most foods, other than fortified milk in the USA and Canada. (Other milk products such as yogurt, ice cream and cheese are usually not fortified with vitamin D but easily could be.) A recent study of 652 Belgian children found 46% had 25(OH)D levels below 20 ng/ml.41

The American Academy of Pediatrics (AAP) recommends all healthy infants up to the age of one year take 400 IU/day (10 mcg) of vitamin D and 600 IU/day (15 mcg) after their first birthday. However, research has shown that about 70% of American toddlers do not take any vitamin D at all, in spite of the AAP recommendation.42 Also, only 20% of American infants take the 400 IU/day (10 mcg) the AAP recommends.43 It is unknown if parents simply ignore the pediatricians advice or if pediatricians are forgetting to recommend vitamin D supplements for their infants and toddlers.

The optimal vitamin D dose for treating ASD is unknown but may exceed the 300 IU/kg/day used in two of the studies discussed above, none of which showed any evidence of toxicity; indeed, most final 25(OH)D levels were still on the low side of the normal range (30-100 ng/ml). Should pedicatricans choose to treat their autistic patients with higher doses, periodic spot urine CA/Cr ratios can easily be obtained along with finger prick blood spot 25(OH)D levels to prevent benign hypervitaminosis D [25(OH)D 100-150 ng/ml] or, as stated by the Pediatrics Endocrine Society, the very rare occurrence of symptomatic vitamin D toxicity.44 In fact, from 2000 to 2014 there were 25,397 calls to poison control centers concerning overdoses of vitamin D, but hypercalcemia was rare, clinical toxicity was extremely rare and there were no deaths.45

Well-designed, well-conducted RCTs using high dose vitamin D [at least 400 IU/kg/day (10 mcg/kg/day) up to 10,000 IU (250 mcg)/day] to treat ASD with careful monitoring are desperately needed. However, meanwhile, as a case report, three open label trials and one RCT all showed an apparent treatment effect and all of the interventional studies show the safety of “high dose” vitamin D in children with ASD, we believe paediatricians should start such treatment for their ASD patients now (300 IU/kg/day), before the autistic child ages and brain damage becomes permanent, being careful to measure a blood spot or venepuncture 25(OH)D and urine CA/CR ratios every few months and adjust the dose until 25(OH)D levels are stabilized above 40 ng/ml. 46 It is unknown if final 25(OH)D levels higher that 40 ng/ml would result in a more robust treatment effect.

Citation

Cannell, JJ. Latest research on Vitamin D and Autism Spectrum Disorder (ASD). The Vitamin D Council Blog & Newsletter, March 2016.

References

1 Cannell JJ. Autism and vitamin D. Med Hypotheses. 2008;70(4):750-9.
2 Cannell JJ. Autism, will vitamin D treat core symptoms? Med Hypotheses. 2013;81(2):195-8.
3 Cannell JJ, Grant WB. What is the role of vitamin D in autism? Dermatoendocrinol. 2013;5(1):199-204.

5 Kočovská E, Fernell E, Billstedt E, et al. Vitamin D and autism: clinical review. Res Dev Disabil. 2012;33(5):1541-50.

7 Patrick RP, Ames BN. Vitamin D hormone regulates serotonin synthesis. Part 1: relevance for autism. FASEB J. 2014;28(6):2398-413.

9 Kočovská E, Andorsdóttir G, Weihe P et al. Vitamin d in the general population of young adults with autism in the faroe islands. J Autism Dev Disord. 2014;44(12):2996-3005.

10 Fernell E, Bejerot S, Westerlund J, et al. Autism spectrum disorder and low vitamin D at birth: a sibling control study. Mol Autism. 2015;6:3.

4 DeLuca GC, Kimball SM, Kolasinski J, et al. Review: the role of vitamin D in nervous system health and disease. Neuropathol Appl Neurobiol. 2013;39(5):458-84.

6 Mostafa GA, Al-Ayadhi LY. Reduced serum concentrations of 25-hydroxy vitamin D in children with autism: relation to autoimmunity. J Neuroinflammation. 2012 Aug 17;9:201.

8 Wang T, Shan L, Du L, et al. Serum concentration of 25-hydroxyvitamin D in autism spectrum disorder: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry. 2015 Oct 29

11 Schmidt RJ, et al. Selected vitamin D metabolic gene variants and risk for autism spectrum disorder in the CHARGE Study.Early Hum Dev. 2015 Aug;91(8):483-9.

12 Alfawaz HA, Bhat RS, Al-Ayadhi L, et al. Protective and restorative potency of Vitamin D on persistent biochemical autistic features induced in propionic acid-intoxicated rat pups. BMC Complement Altern Med. 2014;14:416.

13 Grant WB, Cannell JJ. Autism prevalence in the United States with respect to solar UV-B doses: An ecological study. Dermatoendocrinol. 2013;5(1):159-64.

15 Saad K, Abdel-Rahman AA, Elserogy YM, et al. Vitamin D status in autism spectrum disorders and the efficacy of vitamin D supplementation in autistic children. Nutr Neurosci. 2015 Apr 15.

16 Feng J, Shan L, Du L. et al. Clinical improvement following vitamin D3 supplementation in Autism Spectrum Disorder. Nutr Neurosci. 2016 Jan 18.

17 İlknur İbili Ucuz II, Dursun OB, Esin IS, et al. The relationship between Vitamin D, autistic spectrum disorders, and cognitive development: do glial cell line-derived neurotrophic factor and nerve growth factor play a role in this relationship? Journal: Int. J. Dev. Disab.2015: 61(4):222-230.

18 Saad K, Abdel-Rahman AA, Elserogy YM, et al. Randomized-Controlled Trial of Vitamin D Supplementation in Children with Autism Spectrum Disorder: 2016 (Submitted, J Child Psych Psych) Clinical Trial. Trial registration number: UMIN-CTR Study Design: trial Number: UMIN000020281.

19 Stubbs G, Henley K, Green J. Autism: Will vitamin D supplementation during pregnancy and early childhood reduce the recurrence rate of autism in newborn siblings? Med Hypotheses. 2016;88:74-8.

20 Lardner AL. Vitamin D and hippocampal development-the story so far. Front Mol Neurosci. 2015;8:58.

23 Eyles D, Burne T, McGrath J. Vitamin D in fetal brain development. Semin Cell Dev Biol. 2011;22(6):629-36.

21 Hawes JE, Tesic D, Whitehouse AJ, et al. Maternal vitamin D deficiency alters fetal brain development in the BALB/c mouse. Behav Brain Res. 2015;286:192-200.

22 Eyles DW, Burne TH, McGrath JJ. Vitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease. Front Neuroendocrinol. 2013;34(1):47-64.

24 Bakdash G, van Capel TM, Mason LM, et al. Vitamin D3 metabolite calcidiol primes human dendritic cells to promote the development of immunomodulatory IL-10-producing T cells. Vaccine. 2014;32(47):6294-302.

25 Wagner CL, McNeil RB, Johnson DD, et al. Health characteristics and outcomes of two randomized vitamin D supplementation trials during pregnancy: a combined analysis. J Steroid Biochem Mol Biol. 2013;136:313-20.

26 Wagner CL, McNeil RB, Johnson DD, et al. Health characteristics and outcomes of two randomized vitamin D supplementation trials during pregnancy: a combined analysis. J Steroid Biochem Mol Biol. 2013;136:313-20. Review.

27 Hollis, B. W. and C. L. Wagner et al. Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant. Am J Clin Nutr 2004; 80(6 Suppl): 1752s-1758s.

28 Hollis BW, Wagner CL. Vitamin D and pregnancy: skeletal effects, nonskeletal effects, and birth outcomes. Calcif Tissue Int. 2013;92(2):128-39.

29 Við Streym S, et al. Vitamin D content in human breast milk: a 9-mo follow-up study. Am J Clin Nutr. 2016 Jan;103(1):107-14.

30 Hollis BW, et al. Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial. Pediatrics. 2015 Oct;136(4):625-34.

31 Wagner CL, Baggerly C, McDonnell SL et al.Post-hoc comparison of vitamin D status at three timepoints during pregnancy demonstrates lower risk of preterm birth with higher vitamin D closer to delivery. J Steroid Biochem Mol Biol. 2015;148:256-60.

33 Heaney R, Garland C, Baggerly C, et al. A statistical error in the estimation of the recommended dietary allowance for vitamin D. Nutrients. 2015;7(3):1688-90.

34 Slinin Y, et al. Study of Osteoporotic Fractures Research Group. Association between serum 25(OH) vitamin D and the risk of cognitive decline in older women. J Gerontol A Biol Sci Med Sci. 2012;67(10):1092-8.

35 Holmøy T, Kampman MT, Smolders J. Vitamin D in multiple sclerosis: implications for assessment and

treatment. Expert Rev Neurother. 2012 Sep;12(9):1101-12.

36 Jaddou HY, Batieha AM, Khader YS, Kanaan SH, El-Khateeb MS, Ajlouni KM. Depression is associated with low levels of 25-hydroxyvitamin D among Jordanian adults: results from a national population survey. Eur Arch Psychiatry Clin Neurosci. 2012 Jun;262(4):321-7.

37 Petri M, Bello KJ, Fang H, Magder LS. Vitamin D in Systemic Lupus Erythematosus: Modest Association With Disease Activity and the Urine Protein-to-Creatinine Ratio. Arthritis Rheum. 2013 Jul;65(7):1865-71.

39 Walker RB, Conn JA, Davies MJ, et al. Mothers’ views on feeding infants around the time of weaning. Public Health Nutr 2006;9(6):707–13.

40 Hall HI, Jorgensen CM, McDavid K, et al. Protection from sun exposure in US white children ages 6 months to 11 years. Public Health Rep 2001;116(4):353–61.

42 Briefel R, Hanson C, Fox MK, et al. Feeding infants and toddlers study: do vitamin and mineral supplements contribute to nutrient adequacy or excess among US infants and toddlers? J Am Diet Assoc 2006;106(1 Suppl. 1):S52–65.

32 Veugelers PJ, Pham TM, Ekwaru JP. Optimal Vitamin D Supplementation Doses that Minimize the Risk for Both Low and High Serum 25-Hydroxyvitamin D Concentrations in the General Population. Nutrients. 2015;7(12):10189- 208.

38 Luxwolda MF, et al. Traditionally living populations in East Africa have a mean serum 25- hydroxyvitamin D concentration of 115 nmol/l.Br J Nutr. 2012 Nov 14;108(9):1557-61.

41 Sioen I, Mouratidou T, Kaufman JM, Bammann K, Michels N, Pigeot I, Vanaelst B, Vyncke K, De Henauw S; IDEFICS consortium. Determinants of vitamin D status in young children: results from the Belgian arm of the IDEFICS (Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants) Study. Public Health Nutr. 2012 Jun;15(6):1093-9.

43 Perrine CG, Sharma AJ, Jefferds ME, et al. Adherence to vitamin D recommendations among US infants. Pediatrics. 2010;125(4):627-32.

44 Vogiatzi MG, Jacobson-Dickman E, DeBoer MD; Drugs, and Therapeutics Committee of the Pediatric Endocrine Society Vitamin D supplementation and risk of toxicity in pediatrics: a review of current literature. J Clin Endocrinol

Metab. 2014;99(4):1132-41.

45 Spiller HA, Good TF, Spiller NE, Aleguas A. Vitamin D exposures reported to US poison centers 2000-2014: Temporal trends and outcomes. Hum Exp Toxicol. 2015 Oct 30.

46 Cannell JJ. Autism Causes Prevention and Treatment; Vitamin D Deficiency and the Explosive Rise of Autism Spectrum Disorder. 2015, Sunrise River Press, North Branch, MN, USA. ISBN: 978-I-934716-46-5

Vitamin D supplements beneficial for breastfed children says new study

FEBUARY 2016

Some thing we have read and studied for some time, and primarily why we brought out our Zoomavit D Drops in 400I.U.

A Canadian study recommends giving Vitamin D supplements to children who are still breastfeeding after their first birthday in order to prevent health problems such as rickets.

The study, conducted by Dr. Jonathon Maguire at St. Michael’s Hospital, Toronto, Canada, measured the levels of Vitamin D in the blood of 2,500 Canadian children aged one to five.

The children were all participating in TARGet Kids!, a study by researchers from St. Michael’s Hospital and The Hospital for Sick Children in Toronto looking into the health of Canadian children.

The test results from the children showed that for every month that a child was breastfed after his or her first birthday, the risk of being vitamin D deficient rose by 6%.

By the time the child was two their risk of being Vitamin D deficient had reached 16%, and by the time they were three it had reached 29%.

The researchers found that the results were the same even if the children were eating solid food in addition to being breastfed.

Breast milk is an excellent source of many nutrients needed by children in the early stages of life, however it does not contain sufficient amounts of vitamin D. Breastfeeding exclusively in the first year of life is known to increase the risk of the bone disease rickets, with the Canadian Paediatric Society and the American Academy of Pediatrics already both recommending that breastfed children be supplemented with 400 International Units (IU) of vitamin D every day for the first year of life.

Dr Maguire believes that these new findings could be significant not only for Canadian children but also those from other northern countries who may struggle to get enough exposure to the sun’s ultraviolet rays, which the body uses to produce vitamin D.

The World Health Organization (WHO) recommends breastfeeding exclusively for the first 6 months of life. From six months of age WHO recommends introducing nutritionally-adequate solid foods to meet the child’s increasing energy demands, as well as continued breastfeeding up to 2 years of age or beyond.

The findings were published in the American Journal of Public Health.

Vitamin D & Autism

Turmeric Curcumin2What interaction does Vitamin D have with Autism?  I thank Dr John Cannell for his work on this.

 

 

Risk factors for autism include:

▪ Environmental toxins (exposure to chemicals and heavy metals)
▪ Environmental conditions leading to vitamin D deficiency
▪ Genetics
Environmental risk factors may lead to DNA mutations and increased risk for autism. Vitamin D protects against DNA damage. Vitamin D also repairs the damage once it occurs

Dr. John Cannell of the Vitamin D Council has studied the link between autism and lower levels of sunlight. There is increased prevalence of autism in regions of greater cloud cover and rainfall.
According to many studies, more children with autism are born during the spring. March is the time of lowest vitamin D levels in northern mid-latitudes. These areas are further from the sun and get less light. This corresponds to brain damage around the sixth month of pregnancy.

How vitamin D works
Every cell in the brain has vitamin D receptors. The receptors control gene expression or how genetic material is used. Therefore, vitamin D may have many beneficial effects for the brain.
Dr. Cannell pointed out that infection during pregnancy could increase the risk of autism. Some adverse birth outcomes, such as schizophrenia, are associated with maternal influenza during pregnancy. Influenza during pregnancy raises the maternal body temperature. This can have adverse effects on the developing fetus. High levels of vitamin D may lower the risk for influenza.
One of the hallmarks of autism is oxidative stress. This leads to early cell death. There are many papers in the literature reporting that vitamin D reduces oxidative stress.

one parent said:
In April 2006 a few weeks after my 3-year-old, profoundly autistic daughter began refusing her daily PediaSure drink, she began having excruciating foot spasms lasting from 10–30 minutes at a time, several times a week. She would throw herself on the floor, curl her toes, slam her heels against the floor, and rub the tops of her feet against the carpet, all while screaming the entire time. These were horrible for her to endure, and horrible for my wife and myself to watch. This went on for a year.
From what I read, the symptom was perhaps like foot spasms associated with carpopedal syndrome or tetany. But her blood work did not support that at all. Calcium level was normal (10.2 mg/dL); vitamin D, 25-Hydroxy low (23.5 ng/ml); activated vitamin D 1,25 Dihydroxy normal (24.7). Despite some vitamin D deficiency, I was assured by medical professionals that nothing supported a vitamin D cause of these particular spasms, so vitamin D was dismissed. Because her calcium level was normal, she did not have tetany, and vitamin D could not be the cause of the pain.
All medical consultants were stymied. I made another research effort and found a 2003 article on WebMD that stated vitamin D has been found to have some link to basic, unexplained muscle and bone pain. By chance, vitamin D was the next supplement we had at home to begin giving my daughter to treat her autism. So, in April 2007 we began giving my 4 year-old profoundly-autistic daughter Vitamin D supplements. Her foot spasms which had plagued her for a year diminished within days and disappeared within three weeks. She has not had a spasm in over two months.
In addition, we noted clear improvements in her autistic condition which appear to be from the vitamin D supplements (although obviously we are less certain of this benefit than we are of the disappearance of her foot pain). Eye contact went from zero to fantastic. Her vocalizations increased markedly (still only babbling; she remains completely nonverbal). She appears even happier than previously (she has always been a somewhat happy child). (Please note that my wife and I have tried many dietary supplements over the past 1.5 years guided by a doctor and dietician who both specialize in autism. We honestly state that this is the only thing that has ever had a positive effect on my daughter. We have seen nothing else work.)
My daughter and vitamin D have a complicated relationship. By all counts, looking at her lab work and general condition, vitamin D should have played no role in those excruciating foot fits. And yet it is apparently exactly what is involved in them. And, my wife and I believe at the same time her autistic condition has improved from the vitamin D. The foot fits and her autism appear linked; it was not just a coincidence that this autistic child has those mysterious foot spasms, and the link appears to be vitamin D.
And so I wonder if this is just the tip of the iceberg, if perhaps there is more to know about my child’s relationship with vitamin D and what that might mean for her autism. Does she have a specific vitamin D-related disorder? If so, might direct treatment of it also improve her autism further? These are the questions I would like to pose to a vitamin D specialist who could perform a medical work up on my daughter. Please let me know if you know of anyone in the Northern Virginia/Washington DC area. Also, where is the best place to get vitamin D? Thank you for your time. Paul Washington, D.C.

I know of no such specialist in the Washington area. As far as a specific “vitamin D disorder” linking her spasms, autism, and vitamin D, I know of none. It sounds as if PediaSure was her only regular source of vitamin D? If so, her spasms began two weeks after stopping the small amount of vitamin D in PediaSure. They continued for a year, ending a few days after you started giving her vitamin D again—this time in the form of a supplement. Several weeks after restarting vitamin D, both you and your wife noticed an improvement in her autism.
As no medical literature has yet been published on any of this, all you can do is give her enough vitamin D to get her 25-hydroxyvitamin D, known as 25(OH)D or calcidiol, into high normal ranges and then wait and hope. Vitamin D’s extraordinary mass-action pharmacology implies that simply providing more substrate 25(OH)D will help children with low enzyme activity produce more activated vitamin D (calcitriol) in their brains. The vitamin D theory of autism is not simply that vitamin D deficiency in gestation or early childhood causes the disorder. Instead, the theory holds that a quantitative or qualitative abnormality exists in the enzyme system that activates vitamin D.
It could be as simple as the normal variation in the enzyme, an enzyme whose activity would vary in a normal or Gaussian distribution, much like height. Some people are tall, some are short, most are in the middle. The same may be true of the enzyme that forms activated vitamin D (calcitriol), some children have a lot and some only a little; most are in the middle. As 25(OH)D (the raw material the enzyme metabolizes) levels have fallen over the last 20 years with sun-avoidance, more and more children on the low end of the enzyme curve are effected by marginally-low 25(OH)D levels, explaining both its genetic basis and exploding incidence.
At this point, all you need is a physician willing to periodically measure your daughter’s 25(OH)D level. Once you have that, you can safely supplement your daughter with higher than the current upper limit for children (2,000 IU/day). You did not tell me your daughter’s weight but, assuming she weighs about 30 pounds, even without blood tests of 25(OH)D, you can safely give her 50 mcg (2,000 IU) a day. In fact, the U.S. government says this dose is safe for children over the age of one. Beware of cod liver oil—do not use it because vitamin A inhibits the actions of activated vitamin D and there is a potential for low-grade vitamin A toxicity.
Remember, more and more researchers now believe autism is a progressive, inflammatory disorder. That is, the inflammation probably progressively destroys brain tissue as the child ages. As I said in my recent paper on vitamin D and autism, I think there is a chance that vitamin D may have a treatment effect in young autistic children if given in adequate doses. Mainly due to its anti-inflammatory properties and its ability to upregulate glutathione, the master antioxidant that also chelates (binds) and excretes heavy metals like mercury. Unfortunately, I see no way—even if the vitamin D/autism connection turns out to be correct—that vitamin D can regenerate brain tissue. But, if vitamin D stops the inflammation and cell death, the brain could then begin to develop and learn. These are big “ifs”. However, you have nothing to lose by trying, the worst that will happen is that it will not help and vitamin D will be added to the long list of false-hope treatments.
Actually, there is a worse possibility. Say the parents of a three-year-old autistic child decide today that vitamin D is nonsense—another false hope—and that I am a quack. They decide not to give vitamin D supplements to their autistic child, who is probably—like your child—vitamin D deficient. Then, 5 years from now, scientific evidence shows vitamin D does indeed help. By that time, the child will be 8 years-old and will have suffered additional, irreparable brain damage. In my mind, that is more tragic than another false hope.

Dr. Cannell: After that article appeared in the Toronto paper, I started my 4-year-old son on 1,000 IU of vitamin D two weeks ago. So far the only thing I noticed is that after about 10 days, he didn’t seem so miserable. The thing that has always broken my heart is that look of sadness and suffering on his face. I wouldn’t say he looks happy now but that look of misery seems to be gone. Will it come back? I’m not sure I can take it if it comes back. What else might happen? Also, last summer we noticed he seemed to get better, but then he got worse in the fall. We never thought about it until we read about vitamin D. Susan Toronto, Canada

I don’t know. I think all parents have had their heart pierced by that look at one time or another. I would advise increasing the dose to 2,000 IU/day—make sure it is cholecalciferol and not ergocalciferol—and having your doctor order a 25(OH)D test every 2–3 months to see if higher doses are needed. You want to get his blood level up to between 50–80 ng/ml and keep it there, summer and winter. To do so may take more than 2,000 IU/day in the winter. (In many countries outside of the USA, that would be reported as between 125–200 nmol/L.) If vitamin D has a treatment effect, it will take many months to see its full effect. If the theory is correct, autistic children who spend time outdoors in the summer should show some seasonal improvements—if they don’t wear sunblock and if they expose enough skin to generate significant amounts of vitamin D.
Dr. Cannell: I resent you calling autism a tragedy. My son is not a tragedy and I’m glad he was born and is in our lives. He is our joy. Autism is not a tragedy. Emma London, England

I have no doubt that he is your joy and that you love him. I am new to the autism field and was not aware how much thought and speech control exists in the discussion of the disease. Nevertheless, I have a few politically incorrect questions. If autism is a joy, I assume you would like other parents to have an autistic child? If autism is such a joy, why is there a huge industry forming to prevent and treat it? At the risk of sounding insensitive—apparently one of the most serious charges leveled in the autism debate—autism is a tragedy. As I pointed out in my paper, research shows that having an autistic child puts the family under more stress than having a child with a fatal illness.
Dr. Cannell: Who are you to write an article on autism? You didn’t even publish it in a medical journal. You are not with a university. You have not published very much. You have no expertise on autism. No autism experts support your theory. There is no evidence to support the theory. Shouldn’t you leave this to experts before you give parents more false hopes? Mary Trenton, New Jersey

You are right, I am a nobody—just ask my ex-wife. I explained why I have not yet submitted the paper to the Toronto Globe. As far as giving false hopes, I’ve thought about that charge. Right now, regardless of what advocacy groups say, autism is rather hopeless. That is, no known treatment has been shown to materially affect the clinical course of autism. As a psychiatrist, my observation is that most people would rather live with a false hope than with no hope.
If autistic children began taking vitamin D, the worst that can happen is that a period of false hope will be followed by dashed hopes, then the parents will be back to the hopelessness with which they began. In the meantime, they will have at least made sure their child was vitamin D sufficient. Childhood vitamin D deficiency is a serious problem.
Cashman KD. Vitamin D in childhood and adolescence. Postgrad Med J. 2007 Apr;83(978):230–5.
Gillie O. Why vitamin D is so vital The Telegraph. 2007.07.16
As far as the theory having no support from experts, Dr. Richard Mills, research director of the National Autistic Society in England, was quoted in the Telegraph article on the autism/vitamin D theory:
“There has been speculation in the past about autism being more common in high-latitude countries that get less sunlight and a tie-up with rickets has been suggested—observations which support the theory.”
Finally, you said there is no evidence to support the theory. I assume you meant there is no proof. The first statement is absolutely false, the second absolutely true. As I detailed in my paper, there is a lot of evidence to support the theory. In fact, if anyone can come up with an autism fact that the theory cannot explain, I’d like to know about it. Even the announcement of a link between television viewing and autism supports the theory. Furthermore, the TV/autism link is actually evidence of a treatment effect. That is, if autistic children who play outside in the sunshine more—and therefore watch less TV—have less-severe illness, it may be due to the Sun-God, who bestows her precious gift of calcitriol into the brains of children playing outside in her sunlight, but not into the brains of children watching TV inside in the dark.
As far as proof the theory is true, there is, of course, none. In medicine, proof means randomized controlled trials, the gold standard for proof. However, proof is the last step, not the first. First comes evidence, then a theory, then come researchers disproving those theories. It works that way. Sometimes we never get to the last step, proof. For example, please point me to a single randomized, controlled trial that proves cigarette smoking is dangerous—there isn’t one. Instead, the convincing evidence of smoking’s dangerousness lies in thousands of epidemiological studies, but no randomized controlled trials. Proof, or disproof, of the autism vitamin D theory will take years—during which young autistic brains will continue to suffer irreparable damage. Perhaps vitamin D’s powerful anti-inflammatory actions will help prevent that damage, perhaps not?
It’s something of a Pascal’s wager, betting on vitamin D instead of the existence of God, risking your child’s brain instead of eternal damnation. “If you believe vitamin D helps autism and turn out to be incorrect, you have lost nothing—but if you don’t believe in vitamin D and turn out to be incorrect, your child may suffer irreparable brain damage that could have been prevented.”

this is amaizing stuff and relates to the situation you are in right now.
read this:
Dr. Cannell: I have a three and half year old child who was diagnosed with autism spectrum disorder, verbal apraxia of speech, and hypotonia. I knew something was wrong very early on in that he was extremely late in gross motor skills, such as sitting independently and walking.
Although he eventually was able to sit and walk, his speech was severely delayed. Despite months of speech therapy, he was still unable to complete words. His speech though is very infrequent and is monotone and robotic like when he does speak. He has trouble with social language (engaging in conversations, asking questions and initiating communication). He also engages in stimming behaviors, like hand flapping, vocalizing, and throwing himself on the floor.
I have read your website about autism and vitamin D deficiency, and I am desperately trying to find a doctor in the NY metro area who is knowledgeable about treating children like this with vitamin D. I have been to so many doctors who keep telling me if he takes 400 IU’s per day in his vitamin and drinks milk, then he is not deficient. I would be so grateful for a recommendation.
Please help me. Thank you so much for your time, Amanda Smith, New York
I know of no such doctor in the NYC area but print out this article in Acta Paediatrica and take it to him; your pediatrician will know this journal, as it is the largest pediatric journal in the world.
The belief that a good diet, together with a standard multivitamin and milk three times a day, will prevent vitamin D deficiency in older children, teens, and adults is common in the medical profession.
In reality, two ways exist to obtain enough vitamin D, the sun or a pill containing thousands of units. In the complete absence of both, vitamin D deficiency will occur 100% of the time — unless cold water fish is consumed eight times a day. Next time you hear someone say that all vitamins can be obtained from a good diet, know that person to be misinformed on the subject.
His self-stimulation (stimming), how often does he do it or how many hours per day?
By the way, you can easily treat him yourself. How much does he weigh?
Dr. Cannell: Thank you so much for responding to my email. I am desperate. This autism is not what I had in mind for my child’s life or my family’s life. He spends about 1–2 hours a day stimming, mostly hand-flapping.
Does he need routine monitoring while on the vitamin D to check his 25-hydroxyvitamin D levels?
I am willing to travel if you know of a doctor affiliated with Boston’s Children’s Hospital, or anywhere else on the east coast.
He weighs about 30 pounds. He is currently taking: 3200 mg of fish oil, 400 IU’s of vitamin E, 3,000 mg of phosphatidycholine, and a standard daily dose of a Poly Visol vitamin (with 400 IU’s of vitamin D).
If he starts vitamin D, should he continue with his current regimen of E, fish oil and choline? I am not sure which combination of supplements and vitamins would be appropriate. I do not want to give anything that is contra-indicated or toxic.
This is why I was looking for a doctor who is knowledgeable, but cannot seem to find one. My pediatrician just sneered and returned your autism and vitamin D paper to me without reading it.
Thank you so much for your help. Amanda
I do not believe that all these supplements are needed, but I doubt they do any harm, except the Poly-Vi-Sol, which contains retinol. Stop it.
Go to the health food store and get some Ddrops, 1,000 IU per drop, not 400 IU per drop. They are marketed in the United States by Carlson.
Dr. Cannell: The dosage then would be 1,000 IU’s for him? I already bought capsules with 2,500 IU per capsule.
Does he also need the magnesium, zinc and vitamin K as cofactors? What about the vitamin E, B6, amino acids and fish oil?
Thanks so much for your help. Amanda
No, his dose is not 1,000 IU/day; his dose is 4,000 IU/day. Thus, as each capsule contains 2,500 IU, one day give him two capsules and the next day one capsule, and keep repeating. This is close enough to 4,000 IU/day. You want his 25(OH)D around 100 ng/mL to start.
Yes, those are the cofactors he needs, along with iron as he is a child. If he regularly eats red meat, he can get his iron from his diet. He needs seeds and nuts (like a nut butter) for magnesium and zinc, milk for calcium, and a vitamin K2 supplement, about 100 micrograms. Forget the vitamin E, amino acids, and fish oil pills. Feed him salmon several times a week.
Dr. Cannell: Thanks very much.
The problem is that I don’t have a doctor to check his blood.
If I told my pediatrician that he was taking 4,000 IU’s per day of vitamin D, he’d start screaming. He told me not to give him anything beyond the 400 IU’s in his multi- vitamin.
Are there medical doctors using vitamin D to treat autism? I have checked with several major children’s’ hospitals and cannot find any. Amanda
No, I know of no pediatrician in the NYC area who knows anything about autism and vitamin D, in spite of the fact that I first thought about this in 2006 and first published it in May of 2007 on the website and in a medical journal on October 24, 2007. I now believe that many autism researchers think my theory is true but they also know they may be out of work if it is shown to be so. If you Google autism and vitamin D, you will get almost half a million hits. Someone is reading about it, apparently not the pediatricians.
Within the Google results you will find a Scientific American article, written by Gabrielle Glaser. I worked with Gabrielle on the story, supplying her with all the evidence and the citations. After Gabrielle was finished, the editors at Scientific American told her to remove all references to me as the one who first proposed the theory and to credit someone else, anyone else.
I have since learned that one of the Scientific American editors has a child with autism, believes vaccinations caused the autism, and was angry with me for ridiculing the vaccination theory. If you want to know how it really happened, read:
Julius Goepp, MD. The Link Between Autism and Low Levels of Vitamin D. Life Extension Magazine April 2009.
If his pediatrician will not check his 25(OH)D, simply buy an in-home vitamin D test and have a neighbor or relative, who is a nurse, do a heel stick to obtain the little bit of blood needed to complete the test. Or, you can join Life Extension Foundation and get the vitamin D blood test through them.
Dr. Cannell: I would greatly appreciate it if you could please let me know what the optimal blood level 25(OH)D should be for him, (he’s three and a half).
Thanks so much Amanda
For now, give him enough vitamin D to obtain a 25(OH)D of around 100 ng/mL. We may want to increase his dose high enough to obtain a level of 150 ng/mL in the future, which is perfectly safe in the short term, so as not to miss a treatment effect or to be sure we are seeing the full treatment effect. Six months after he fully responds, you can begin to slowly lower the dose to obtain levels of 70–80 ng/mL.
The reason to seek the very upper limits of normal in your child is simple, your child has a serious — very serious — illness. A brain disease, one that may destroy his life, and yours. For reasons I do not yet understand, many autistic children first start responding to vitamin D only when their blood level reaches 90–100. In fact, I know of a case where the mother made a mistake and gave ten times the suggested dose and the autistic child had a miraculous and rapid response. How could that be? I do not know.
Nor do I know how a genetic disease could be cured with vitamin D. That makes no sense to me but enough mothers have written to me that I believe that it will routinely happen if retinol is stopped and enough vitamin D is given. It reminds me of Thomas Huxley who said, “Sit down before fact as a little child, be prepared to give up every preconceived notion, follow humbly wherever and to whatever abysses nature leads, or you will learn nothing.”
Dr. Cannell: Thanks so much.
At this level is there any risk of premature closure of the epiphyses? My son is only three and a half.
Thanks again, I really appreciate all of your help. How do you have the time to help me for nothing? Amanda
No, no risk of premature epiphyseal closure. Here is my cell phone number, give me a call on a Monday; I have Mondays off from work at the hospital. You are too worried and your anxiety may upset your child.
While I have proposed a number of vitamin D theories, my heart is with these children. If I didn’t have to work at the hospital four days a week, I would see autistic children five days a week. I daydream that a rich guy makes that happen and the autism clinic he sponsors is free for the families. For now, I do what I can with the limited time I have available.
Dr. Cannell: Thank you so much for speaking with me this past Monday regarding my son with autism.
I had his 25-hydroxyvitamin D level checked this week as a baseline and to my surprise his level was 51.7 ng/mL. I had been taking him out in the sun with no sunscreen about a week and a half prior to the test, and I am wondering if this could have impacted his levels that quickly if he was initially deficient.
I had also started the 4,000 IU’s two days prior to the test, but this should not have had an impact.
My question is at this point whether I should continue the 4,000 IU’s of vitamin D or if I should reduce the amount to 2,500 IU’s per day.
His metabolic panel also showed a high BUN/creatinine ratio of 55, and lower levels of protein (4.8 g/dL) and albumin (3.2 g/dL). We have to take him back next week to have his amino acids checked. I am wondering if the D affects these levels as well.
Thank you so much for all of your help, Amanda
Keep him on 4,000 IU/day together with the sunshine and plenty of fluids. Make sure he eats dairy three times a day (calcium), salmon (omega-3), red meat (iron), and vegetables (multiple vitamins), nut-butter (magnesium) with an otherwise varied diet. If he had trouble in the past with dairy, he may not have such trouble on the vitamin D. Don’t worry about these other blood tests, they did not need to have been obtained and these mild abnormalities will correct themselves in time.
Also, remember, if the healthiest person in the world repeatedly had 100 different blood tests, some would eventually be abnormal. That’s simple math. I have little patience for the “autism doctors” who find well-insured or wealthy parents, draw 100s of blood tests on the child, find the few that are abnormal, do something (anything will work) and then repeat the blood test next month and say to the mother, “look, the test is better, your son is improving under my care.” One of the few things worse are the academics who say, “Nothing can be done. It is a genetic disease. Here is a prescription for an antipsychotic if he starts beating on his sister.”
Dr. Cannell: My son has started on 4,000 IU’s of D and over the last several days we have noticed and increase in hitting, biting, and temper tantrums. I was wondering if other parents have reported this kind of behavior during the initial days of vitamin D supplementation, and whether it means we should stop the vitamin D?
Thank you so much for your help, Amanda
This too shall pass; just keep giving him 2 capsules one day (5,000 IU) and one capsule (2,500 IU) the next. Is he still going into the sun?
Dr. Cannell: My son’s 25 (OH) D level was only 64.8 ng/mL, (this was after 2 weeks of being in the sun without sunblock and supplementing him with 4,000 IU’s of vitamin D/day). I try to take him out 20–30 minutes on sunny days without sunblock. He may be a little better.
Also, how often should the blood work be done to check his 25(OH)D level? As the autumn is coming, his sun exposure will probably be decreasing.
Thank you so much for all of your help. Amanda
Yes, the sun and 4,000 IU/day together is fine for now.
Check his 25(OH)D every month.
Dr. Cannell: My son has been on Vitamin D for a month now and I wanted to report back to you that we have seen repeated bursts of spontaneous language. He has also started asking questions, and is initiating conversation with us. It has been truly remarkable; the teachers at school cannot believe it.
Additionally he is pedaling on his tricycle, just like a regular kid, whereas before, he was struggling just trying to pedal. We are very impressed with his progress and I do not know how to thank you so much for all of your help. I’d give the Vitamin D Council a million dollars if I had it.
About a month ago, we had a metabolic panel done on him and his protein, calcium and albumin levels were a little low. We followed up two weeks later with an amino acids plasma test (this was done when he was on the D for only two weeks). I just received the results and several of these levels are high-in umol/L: proline (396) alanine (605), valine (337), methionine (51), tyrosine (119), lysine (299), and histidine (136).
The high alanine level was of most concern because the lab added the following footnote: “In this sample, the concentration of alanine was elevated. This finding could be indicative of secondary lactic acidemia, acute illness, and reduced caloric intake”.
My son’s height is in the 75% percentile and his weight is in the 50th, he has never been failure to thrive. Also, his copper, carnitine, and B vitamin levels, (B1, B6 and B12) were normal-I know these are generally deficient in autistics, Actually his B12 level was high 1029 pg/mL. Given these levels should I continue giving him the vitamin D? Could the other supplements he is taking cause these abnormalities in the amino acids?
Thanks so much for your help. My mother can’t believe it; neither can my husband, neither can I. How long will this improvement last? Amanda
I am so glad to hear of your son’s improvement. I woke up last night with a nightmare that I had told you to stop the vitamin D when he seemed worse.
This improvement in his autism should be permanent, if you continue the vitamin D with the cofactors and avoid the retinol. This improvement will include his coordination and physical ability, not just his autism.
You still need to measure his 25(OH)D every month as you may have to adjust the dose (either up or down). For example, say his next vitamin D level is 90 ng/mL. My immediate question is “would his autism improve even more rapidly if his level was 100 ng/mL?”
You want to keep increasing his level (by increasing his dose) up to 150 ng/mL, until it is clear that the extra dose had no additional effect. Then back down until he seems a little worse, then go up until he is better again and then you will know the correct vitamin D dose for him.
Stop having all this other stuff measured and stop worrying about it. Someone, whoever is ordering all these blood tests, is defrauding you and your insurance company. Stop all these supplements except the vitamin D, vitamin K2, and maybe a little pediatric iron.
As an aside, one of the special masters in the autism/vaccine court recently ruled for the child’s family, awarding the child an initial sum of $1.5 million, with an additional $500,000 per year. However, the judge acted on the child’s petition because the petition filed by the other side, the Justice Department, agreed completely with the child’s lawyer. In other words, when this case came in front of the judge (special master), both sides had already agreed on the award:
Sharyl Attkisson, CBS News, September 9, 2010. Family to Receive $1.5M+ in First-Ever Vaccine-Autism Court Award.
If you are waiting in the vaccine/autism court, now is the time to change the diagnosis of your child from autism to “mitochondrial disorder and encephalopathy” and hope you are next in line.1 However, I worry this award will result in another ten year delay in accepting that maternal vitamin D deficiency causes autism, like the bogus vaccine research did.
Unlike autism, encephalopathy has long been recognized as a rare but dreaded result of vaccination. Such encephalopathy is an immune phenomenon, undoubtedly caused by the most common cause of acquired immune deficiency syndrome: vitamin D deficiency.
If you think the vaccination/anti-vaccination debate is a new one, read the article Mr. Pomeroy on vaccination in the British Medical Journal, published 100 years ago on 22 January 1910!
Getting back to your son, what he needs now is time, time for the vitamin D to do whatever it is doing, time for his brain to repair itself, time for the inflammation to stop, time for his brain to learn, time to make up what he has missed so far in life. Keep obtaining a 25(OH)D every month and keep adjusting the dose. You will be surprised how quickly he progresses. The key is high doses of vitamin D and no retinol.
If you do as I say, I predict that in one year you will deny that your son ever had autism.
Swedish Researchers on the Right Trail
I continue to get encouraging emails—like the one at the end of this newsletter—from parents of autistic children. At the same time, some researchers in the USA continue to deride my theory while scientists in Sweden are starting to piece it together. Three Swedish papers were published this month that support the Vitamin D Theory of Autism.
In the patients.
Mothers of autistic children have very low 25(OH)D levels
The second paper, by Dr. Elisbeth Fernell and colleagues—from various institutions in Sweden— measured vitamin D levels in mothers about six years after they had given birth to a child now diagnosed with autism. The Somali mothers had very low vitamin D levels, less than 10 ng/mL (25 nmol/L). The trend was in the direction of lower vitamin D levels for Somali mothers with autistic children, compared to Somali mothers without an autistic child.
Another scientist endorses the vitamin D theory of autism
The third paper, an invited editorial in Acta Paediatrica by Dr. Darryl Eyles of the University of Queensland was more interesting, at least to me. He issued an outright endorsement of my autism theory, not that it is proven, but that it is parsimonious, a word and concept I love.
Darryl is a prolific researcher and was involved in many of the rat studies that showed gestational vitamin D deficiency damages the brains of the infant rat pups. It was the work of Dr. Eyles, together with that of Dr. John McGrath, which helped me formulate my vitamin D theory of autism. I wrote about their research in 2005, before I realized that the human brain damage I wrote about was manifesitng itself as the autism epidemic. Shortly after I wrote the July 2005 Vitamin D Newsletter, I saw an autistic child at the shopping mall and started my research into autism and vitamin D.
Anyway, this month Dr. Eyles said, “Low maternal vitamin D remains a highly parsimonious explanation for certain prominent features of autism,” explaining how well their animal data fits with human data on autism. Perfect parsimony is when one theory explains all the known facts, and if there is one major autism fact the vitamin D theory of autism cannot explain, I have yet to locate it.
Pregnant women need 5,000 IU/day
Dr. Eyles discussed the crucial importance of all pregnant women having adequate amounts of vitamin D and said he was eagerly awaiting the results of the clinical trial Bruce Hollis and Carol Wagner of the Medical University of South Carolina have conducted. They have given 4,000 IU/day to pregnant women, comparing that to 400 IU/day (the amount in prenatal vitamins) and to 2,000 IU/day.
However, several months ago in Brugge, Belgium, Dr. Hollis presented some of the data from his clinical trial, reporting that 4,000 IU/day in pregnancy is not only safe, but significantly reduces complications of pregnancy more than 2,000 IU/day does and a lot more than 400 IU/day does. All pregnant women should be on at least 5,000 IU of vitamin D3 per day and take neither cod liver oil nor any retinyl acetate or retinyl palmitate (vitamin A).
Letters From A Mother of an Autistic Child
Dr. Cannell: (email received 5 weeks ago) I have just recently learned about the Vitamin D link with autism. I am starting to supplement my 12- year old on because it is such a cheap and easy thing to do, with low risk. I want so much to be able to help him!! I am hoping very much that this will help, yet I am afraid to hope! He has Asperger’s type autism, and he was recently diagnosed with oppositional defiant disorder, which is no surprise to me considering his very oppositional behavior. So, my question is: has Vitamin D supplementation helped children like my son? Is it too late??
He really is an indoor kid. He is a red-head and burns easily and I’ve always protected him from the sun, thinking he must get enough vitamin D from the milk we drink. Well, I was probably wrong, I feel so guilty—is it to late? I am starting him on 5000 IU of D3; considering he is starting puberty now and weighs almost 110 pounds; does this sound reasonable? Has anyone out there seen help for high functioning kids? He has so much social dysfunction, self-stimulatory behavior (belly-smacking and hair pulling, nail biting, etc.), paranoia, attention problems, and real difficulty with group dynamics, and of course, obsession with computers.
He is really smart (yet can barely use this because of his behavior), and wonderful with small children, animals, severely disabled children, and the elderly. Isn’t that interesting?? I am hoping that this helps. Please reply to me email. My husband and I are discouraged and depressed about it all, and concerned for my son’s future. His doctors imply there is no hope and think vitamin D is nonsense. I can barely get my husband to interact with my son anymore—he is so discouraged by our son’s negativity and defiant behavior. I realize there is no “magic” pill, but please let me know if there is any hope. Terry, Nebraska
There is always hope. As I wrote in my autism paper, I think a treatment effect is likely, especially with younger children. The fact that your son is 12 years old makes it less likely that vitamin D will have a treatment effect but it is certainly worth trying. I think it likely that there are two reasons why some parents do not see a treatment effect in their autistic children. Again, a treatment effect is quite different than a cure.
The first reason is that many of these children have been overdosed with vitamin A, either as bolus doses (large one-time doses) some DAN practitioners use or from the 3,500 IU of preformed retinol in the powdered multivitamin commonly used for autistic children. Be sure to stop any cod liver oil or any vitamin A that he may be taking in his multivitamins or other supplements. No one knows how long it takes for excess vitamin A to get out of the body but, as no known mechanism exists for its degradation, it may take years.
This is very different than vitamin D. Vitamin D is transformed in the cells of the body to a steroid hormone named calcitriol. It functions by turning genes on and off; more than 1,000 such genes have been discovered. As soon as it functions to turn on or off the genes in question, perhaps a matter of seconds, the calcitriol is rapidly degraded to calcitroic acid and then removed from the body. Thus, unlike vitamin A, which is used again and again, vitamin D is rapidly catabolized (degraded), removed from the body, and must be replenished.
The second reason for a poor response in autism is dose. Autistic children need aggressive doses of vitamin D, not maintenance doses. Think of it like treating rickets. My advice is to give enough vitamin D to get him to at least a 100 ng/mL (250 nmol/L) and if that does not work increase the dose until his 25(OH)D level is 150 ng/mL (375 nmol/L). This will require 2,000–5,000 IU/day for every 25 pounds of body weight, and occasionally more than that.
However, he will need frequent monitoring of his 25(OH)D levels as these are pharmacological doses, not physiological doses, meaning these doses should only be given, and monitored, in the hope of a treatment effect in the serious disease that has been linked to vitamin D deficiency. It is best done under the care of a knowledgeable physician. I know that is not always possible and time is of the essence in autism as it is a progressive, inflammatory brain disease.
Good luck, my prayers are with you.
Dr. Cannell: My 12-year-old autistic son is doing better on 5,000 IU of Vit. D3 every day, after only one month! I explained to him why he needs to take it, and he is fine with it. So, it has been over 1 month now. I was planning to get a 25 (OH)D test at the 3 month mark; should I stick to that? Is it a hard test?
His behavior has improved in almost all areas. He is still obsessive about his favorite computer games of course, and still smacks his belly when he really feels like it, but it overall is better. He has been doing much better in school behavior wise and has earned his privileges back in several areas. I don’t feel so desperate about everything anymore. He does still throw fits, but everything has been a little more manageable. I have also been bringing him to the YMCA for swimming, hoping more exercise is good for him. He is still very self-focused. I don’t know if that will ever change, after all, that is what autism is.
I have reduced his meds a little, esp. on non-school days. I have reduced his Adderall by eliminating his third dose in the afternoon, and reduced his second daily dose of Risperdal and Zoloft. (He was not ever on large doses, quite moderate or small ones). One of my friends told me his meds were making him worse but all these meds helped when we started them but now I cannot tell the difference on these lower doses, so I am very happy about that.
I haven’t talked to his doctors about it all yet. I am waiting for our next appointment. I have asked them many times about what would be good supplements for him, and all they have ever said is for him to take a multivitamin daily. I don’t think that ever helped at all. I stopped his multivitamin because I don’t want the vitamin A to antagonize the Vit. D. He does eat fruit well, and some veggies.
Both my husband and I are daring to hope and my husband is starting to interact with him again.
Thanks again for helping people and writing to me. My blessings to you! Terry, Nebraska
This is very hopeful, especially the improvement in face of the reductions in his medications. My advice is to continue his vitamin D at 5,000 IU per day for now and continue taking him to the YMCA for swimming and make sure it is an outdoor pool during the middle of the day. His sun exposure should occur when the sun is high enough up in the sky so his shadow is shorter than he is, the shorter the better, the more skin the better. If he is outdoors in these conditions frequently enough, his 5,000 IU/day supplement and the sun should raise his 25(OH)D to about 100 ng/mL (250 nmol/L).
As he is red-headed and fair-skinned, use no sunblock for the first 10 minutes, or the time it takes for his skin to begin to turn slightly pink, and then put it on. I recommend sunblock that contains zinc oxide, titanium oxide, or both. In spite of his fair skin, I predict that as his vitamin D level goes up, you will notice he tans with sun exposure; and then he will need less sunblock.
Obtain a 25-hydroxy-vitamin D (not a 1,25-dihydroxy-vitamin D) every month. You want his 25(OH)D to be high, as high as a lifeguard in Miami in August, so at least 100 ng/mL (250 nmol/L). Then, even if he is responding to 100 ng/mL, the question arises, “Would he respond even better at 150 ng/mL (375 nmol/L)? From what we know, this is perfectly safe as long as you get regular 25(OH)D tests and keep his 25(OH)D under 150 ng/mL. Documented toxicity (almost always asymptomatic hypercalcemia) has never been reported with 25(OH)D levels less than 200 ng/mL (500 nmol/L).
On our website, you can order in-home vitamin D testing. After you pay $65.00, ZRT will send you a test kit. You will need to stick his finger or his heel to get a small amount of blood on the blotter paper in the ZRT test kit. Maybe a nurse or a paramedic who you know will stick his finger or heel if you can’t stand to do it. If you mess up the first time, just contact ZRT, they will send you another test kit for free.
As far as reducing his psychiatric medication, be sure to do it very slowly, as an abrupt discontinuation may worsen his condition. His Adderall is an amphetamine stimulant, his Risperdal is an antipsychotic and his Zoloft is an antidepressant, but all can be helpful in autism. Also, be sure his psychiatrist is okay with slow reductions in his medication. Ignore anyone who tells you his psychiatric medications made him worse; they have their own agenda and it is not to help your son.
Also, make sure your son has a source of magnesium, zinc, boron, and vitamin K. Vitamin D has many co-factors, but these are the four Americans are the most likely to be deficient in. A large handful of seeds and nuts, together with whole grains, will help with the first three and green leafy vegetables with the vitamin K. Trader Joe’s sells sunflower and almond butter, both excellent sources of magnesium, zinc, and boron.
Finally, expect anger and defensiveness from many in the medical profession. Remember, if I’m right, it was not the evil power plants, or the mercury polluters, or the vaccine industry that caused your son’s autism. It was the CDC, the NIH, the AMA, and all the other committees and organizations that fell for the dermatologists’ calculations (the cosmetic industry will give me a larger grant if I warn about sunlight) and who then blasphemed the Sun God. That is, the worst charge you can level against medicine, “You have violated your primary duty; you have caused harm.” If I am right, the current autism epidemic is the worst iatrogenic disease in human history.
I am so glad your husband is starting to interact with his son more. As far as hope goes, Emily Dickenson once wrote:
Hope is the thing with feathers,
That perches in the soul.
And sings the tune
Without the words,
and never stops at all.