Summer is slowly coming to a close, and if you are a parent, this means a new school year is just around the corner. This may be a relief for some, but for others, it may be a source of serious stress. How will my child adjust to a new year, new teacher(s), or a new school? This type of stress is often amplified for parents of children with autism spectrum disorders (ASDs). 

All of our children are unique, but there are some natural approaches to supporting positive behavior that have shown significant success in children with behavior and learning challenges. One such approach is to make sure children are getting more than just adequate levels of some very powerful nutrients with research-based, carefully designed natural supplements.

Why might my child benefit from specialized nutritional supplements for calm and focus?

Dr. Jared M. Skowron has been working with children with ASDs and attention deficit and hyperactivity disorder (ADHD) for over fifteen years. Dr. Skowron has collaborated with Metabolic Maintenance to develop a multivitamin/ mineral supplement called “Spectrum Awakening”. It is all-natural and non-pharmaceutical, and it supports healthy language development, calm behavior, normal sensory function, regular sleep patterns, emotional stability, and improved memory.

Sometimes, language delays and problematic behavior (such as tantrums, unhealthy fixations, and inattention) in children can stem from chemical imbalances in the brain. Brain chemicals such as serotonin, dopamine, and adrenaline are made from certain vitamins, minerals, and amino acids [1]. Combined with the fact that many children are picky or selective eaters due to sensory sensitivities, it is easy to see that these imbalances can be exaggerated by a diet lacking certain important nutrients [1,2].

Specific to healthy neurological development and function is the relationship between B vitamins and methylation. Methylation has become an increasingly publicized cellular pathway, as research has progressed showing its central role in our health. Not only is methylation key to many biochemical reactions regulating the cardiovascular, reproductive, and detoxification systems, it is also necessary for the production of and effective signaling of neurotransmitters. 

What is the link between methylation and the autism spectrum?

Doctors and scientists are working hard to uncover the unknown causes and mechanisms of ASDs, and there have been some studies that have revealed biochemical differences between people with and without ASDs [3]. The autism spectrum is composed of several subgroups or endophenotypes. There are several lines of evidence to show that a certain subcategory or endophenotype of ASD is associated with abnormal methylation [3]. Specifically, these individuals are likely to have trouble producing the precursors for methylation and glutathione synthesis. Glutathione is essential for normal immune function, detoxification capacity, redox-sensitive enzyme activity, and membrane redox signaling. There is also evidence to show redox imbalance and oxidative stress may contribute to autism pathophysiology [3].

Again, it is critical that all people consume adequate B-vitamins to allow these processes to run smoothly, but those with developmental or neurological differences are at an even greater disadvantage, which can be made worse by consuming an imbalanced diet.

Studies have shown that supplementation with certain vitamins and minerals has been associated with improved behavior in some children, indicated by fewer tantrums, reduced hyperactivity, and more receptive language [4]. Aside from behavioral benefits, oral vitamin/mineral supplementation has, time and again, been demonstrated to promote improvement in the nutritional and metabolic status of some children, including improvements in methylation, glutathione use, oxidative stress reduction, sulfation, and the production of ATP, NADH, and NADPH [4].

What nutrients does Spectrum Awakening contain?

Designed to support methylation, neurotransmitter synthesis, and calm the brain, Spectrum Awakening contains a blend of activated B vitamins, minerals, and amino acids to support optimal nervous system functioning, normal mood, and emotional well-being. The formula has had a recent update, and now contains higher levels of GABA (750 mg/2 scoops), an inhibitory neurotransmitter researched for its role in normal neurodevelopment, and methylcobalamin (1000 mcg/2 scoops), the active, methylated form of B-12. Vitamin E has been removed to result in a soy-free formula so that the product is suitable for people with allergies.

Vitamin B-6 and Magnesium. Magnesium and vitamin B-6 are a synergistic combination. Magnesium appears to increase intracellular uptake of B-6 and vice versa [5]. There is evidence to suggest that many conditions that respond to B-6 also respond to magnesium, and in some of those cases, the effect of the two nutrients in combination is greater than the sum of each nutrient alone [5]. At least 11 double-blind, placebo-controlled studies have tested high dose vitamin B-6 with magnesium, repeatedly showing positive behavioral improvements [4]. 

Taking a magnesium supplement, with B-6 for improved uptake, can help to regulate the central and parasympathetic nervous systems, calming the body and relaxing muscles, in part by improving the efficiency of the neurotransmitter, GABA, and the sleep hormone, melatonin [6,7]. Studies have shown that magnesium has a protective effect from ischemic damage of the brain and an inhibitory effect on the release of the stress hormone, norepinephrine [8]. Magnesium also helps to balance cellular calcium levels, thereby regulating cell signaling pathways and neurotransmission [8]. Vitamin B-6 is also involved in the synthesis of neurotransmitters, and has been linked to increased serotonin levels and decreased anxiety [7].

Methylcobalamin and L-methylfolate (the activated and most bioavailable forms of the vitamins B-12 and B-9/folate) are essential for maintaining the integrity of the nervous system and participate in key methylation reactions. As previously described, B vitamins (folate, B-6, and B-12) are all involved in methylation, which is necessary for the production of monoamine neurotransmitters, phospholipids, and nucleotides in the brain [9]. Multiple studies have shown that folate and vitamin B-6 levels in plasma and red blood cells are significantly, positively correlated with test scores for several domains of cognitive and neurophysiological function and B-6 is also known to catalyze the reaction that produces serotonin from its precursor 5-HTP (another component included in this blend) [9,10]. Serotonin levels have been shown to increase in response to an increase in blood plasma levels of 5-HTP and vitamin B-6 [11]. Regular supplementation with activated vitamin B-12 (methylcobalamin) and activated folate (l-methylfolate) can result in significant improvements in daily living, social, and communication skills [3].

A recent placebo-controlled, double-blind study partially funded by Autism Speaks, noted that methionine levels increased and homocysteine levels decreased in patients given a high dose of methylcobalamin, which is consistent with effective methylation [12].

Gamma Aminobutyric acid (GABA) is a unique neurotransmitter in that it calms, rather than excites, the brain [13]. By binding its receptor, GABA inhibits the “fight-or-flight’ mechanisms of the neuromuscular system in response to environmental stressors, thereby promoting calm and a reduced stress level [13]. GABA also plays a role in the development of healthy, normal neurons and synapse formations in the immature, developing brain [14]. Studies show that GABA release in the brain is enhanced with an increase in zinc availability [15]. This is why a healthy dose of zinc has been included in the formula as well. Zinc is also a regulator of dopamine.

Taurine, a sulfur-containing semi-essential amino acid, is required in a certain abundance for the normal development of the central nervous system (CNS), calcium modulation, membrane stabilization, reproduction, and immunity [16]. Taurine has been added for its neuroprotective properties.

L-Theanine, an amino acid found in green tea, has been shown in double-blind placebo studies to reduce neuronal overstimulation, attenuating the sympathetic nervous system’s response to stressors (i.e. reduced heart rate and salivary production of immunoglobulin A) [17]. 

5-hydroxytryptophan, better known as 5-HTP, plays a role in both mood and sleep. 5-HTP is naturally produced by the body as a precursor to serotonin and is therefore indirectly converted into melatonin, the body clock regulating sleep hormone. Because 5-HTP increases serotonin, it has a calming, relaxing effect on brain chemistry, and may help to ease any anxiety. Serotonin also plays an important role in many other bodily functions, including digestion, appetite, and pain perception. Studies have shown that 5-HTP supplementation can help patients fall asleep faster and sleep more deeply than a placebo [18]. 

Can my child take Spectrum Awakening on a gluten-free, casein-free (GF/CF) diet?

Yes. Spectrum Awakening is free of the eight major allergens as identified by the Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA): Wheat (gluten), eggs, milk (casein), soybeans, shellfish, fish, peanuts, tree nuts. All ingredients are vegan and non-GMO. Additionally, as children sometimes struggle with swallowing capsules or dislike chalky chewables, Spectrum Awakening comes in a convenient powder to be dissolved in water or juice. This way the dose can also be adjusted according to your physician’s recommendations.

Just before the turn of the millennium, the gluten-free, casein-free diet began to gain in popularity, as parents began to see a beneficial change in the symptoms and behaviors of children with ASDs [19]. Gluten is a protein found in many types of grain (wheat, rye, barley, and more) and casein is a protein found in milk, and therefore most dairy products. While the research confirming this trend has been somewhat spotty, if you feel this diet is working well for your child, then that’s all the research you need! 

One drawback to giving up gluten and casein, however, is the loss of opportunity for the vitamins and minerals often found specifically in foods that also contain gluten or casein. You may find that your child’s diet is low in calcium, fiber, and vitamins A, D, and B. Please be sure to discuss with a physician the best ways to keep your child’s diet nutritionally balanced, whether through food or dietary supplement.

Is this supplement beneficial for children without an ASD?

Most likely! The American diet is typically lacking in magnesium and some B-vitamins, and zinc, B-vitamins, and magnesium are all essential to normal brain development and function. Although designed around the likely nutritional needs of those with learning and behavior challenges, this supplement may aid in promoting a sense of calm alertness for whoever should take it. 

Deficiencies in B-vitamins, and B-6 in particular, have been shown to cause irritability and fatigue in children and adults with ADHD [20]. When B-6 levels are adequate, alertness tends to increase and anxiety-like symptoms tend to decrease [20]. These effects are most likely seen as a benefit to all, not just those with ASDs or ADHD. There is a powerful dose of B-vitamins in Spectrum Awakening, and because B-vitamins are water-soluble, the body absorbs as much as it needs and can flush the rest through the urine. There is very little risk of overdose.

When the neurotransmitter dopamine is lacking in the brain, zinc, as a regulator of dopamine may help to combat that lack. Studies have shown that taking zinc supplements can help to reduce hyperactivity and impulsivity [20].

Magnesium is also used to make the neurotransmitters involved in attention, which is a benefit to all children going back to school. It tends to have a calming effect on the brain, which again is universal, and not specific to people with certain disorders or learning challenges [20]. 

Of course, as always, it is recommended that you speak to your pediatrician or family physician before changing your child’s diet, or your own, by adding any supplement. 

References:

1. Spectrum Awakening website. https://spectrumawakening.com/pages/about-us © 2019 Spectrum Awakening All rights reserved.
2. Cermak, Sharon A., Carol Curtin, and Linda G. Bandini. “Food selectivity and sensory sensitivity in children with autism spectrum disorders.” Journal of the American Dietetic Association 110.2 (2010): 238-246.
3. Frye, Richard E., et al. “Effectiveness of methylcobalamin and folinic acid treatment on adaptive behavior in children with autistic disorder is related to glutathione redox status.” Autism research and treatment 2013 (2013).
4. Adams, James B., et al. “Effect of a vitamin/mineral supplement on children and adults with autism.” BMC pediatrics 11.1 (2011): 111.
5. Gaby, Alan. Nutritional medicine. Vol. 265. Concord: Fritz Perlberg Publishing, 2011.
6. Durlach, J., et al. “Biorhythms and possible central regulation of magnesium status, phototherapy, darkness therapy and chronopathological forms of magnesium depletion.” Magnesium research 15.1-2 (2002): 49-66.
7. Poleszak, Ewa. “Benzodiazepine/GABAA receptors are involved in magnesium-induced anxiolytic-like behavior in mice.” Pharmacological Reports 60.4 (2008): 483.
8. Tatsuo Shimosawa, Koji Takano, Katsuyuki Ando, Toshiro Fujita, Magnesium Inhibits Norepinephrine Release by Blocking N-Type Calcium Channels at Peripheral Sympathetic Nerve Endings, Hypertension. 2004;44:897-902
9. Kim H, Kim G, Jang W, Kim SY, Chang N. Association between intake of B vitamins and cognitive function in elderly Koreans with cognitive impairment.Nutrition Journal. 2014;13:118. 
10. Dakshinamurti K, Sharma SK, Bonke D. Influence of B vitamins on binding properties of serotonin receptors in the CNS of rats. Klin Wochenschr 1990;68:142-145.
11. Hartvig P, Lindner KJ, Bjurling P, Langstrom B, Tedroff J. Pyridoxine effect on synthesis rate of serotonin in the monkey brain measured with positron emission tomography. J Neural Trans 1995;102:91-97.
12. Hendren, Robert L., et al. “Randomized, placebo-controlled trial of methyl B12 for children with autism.” Journal of child and adolescent psychopharmacology 26.9 (2016): 774-783.
13. Alan M. Kinnersley & Frank J. Turano, Gamma Aminobutyric Acid (GABA) and Plant Responses to Stress, Critical Reviews in Plant Sciences Vol. 19 , Iss. 6, 2000
14. Ben-Ari, Excitatory Actions of Gaba during Development: The Nature of the Nurture, Nature Reviews Neuroscience 3, 728–739 (2002)
15. Takeda, A., Minami, A., Seki, Y. and Oku, N. (2004), Differential effects of zinc on glutamatergic and GABAergic neurotransmitter systems in the hippocampus. J. Neurosci. Res., 75: 225–229.
16. Georgia B. Schuller-Levis, Eunkyue Park; Taurine: new implications for an old amino acid, FEMS Microbiology Letters, Volume 226, Issue 2, 1 September 2003, Pages 195–202
17. Kimura et al., L-Theanine Reduces Psychological and Physiological Stress Responses. Biological Psychology. 2007; 74:1, 39-45
18. Cauffield, Jacintha S., and Hiroko Jm Forbes. “Dietary supplements used in the treatment of depression, anxiety, and sleep disorders.” Lippincott’s primary care practice 3.3 (1999): 290-304
19. The GFCF Diet Intervention – Autism. Accessed Aug. 7, 2019. http://gfcfdiet.com/index.html
20. Frye, Devon. “Vitamins and Supplements” ADDitude. Accessed Aug. 8, 2019. https://www.additudemag.com/treatment/vitamins-and-supplements/