5-HTP (5 Hydroxytryptophan) is a naturally occurring amino acid. It can help promote the production of serotonin, often low in children with autism. It may help with sleep problems, especially for children who have problems staying asleep. As well as sleep, serotonin is implicated in mood, body temperature regulation, gut motility, and appetite. Serotonin levels are often abnormal in children with autism.

Adrenal Cortex (or Adrenal Cortex Extract) is a glandular supplement that can help support stressed adrenals, a problem highly common in children with autism. Adrenal stress can be debilitating and will likely only worsen over time if not addressed. Some signs of poor adrenal function are "anxiety with OCD, poor task switching, sensory integration problems" (per Andrew Hall Cutler, PhD), and avoidance of other activities by engaging in avoidance behaviours such as repetitive movie watching or other types of stimming. One trusted brand is Nutricology Adrenal Cortex Organic Glandular (also known as Allergy Research Group Adrenal Cortex Organic Glandular). It is important that your supplement is made from the outer portion of the adrenal gland (the cortex) and comes from a very safe source. Supporting the adrenals also involves supplementing the B vitamins, vitamin C and sometimes a blood sugar regulating supplement like chromium or vanadium.

Alpha Lipoic Acid (or Lipoic Acid) is a chelator and a strong antioxidant. Because it is a chelator it should not be taken as a supplement by anyone with amalgams or a metal toxicity problem. Be sure it is not a part of any multivitamin your child takes.

Amino Acids, crucial for proper neurological, gastrointestinal, and immune function, are often low in children with autism. This deficit is relatively complex in that there are a wide variety of possible deficiencies; therefore, some people get a custom blend based on test results (eg. ION test from Metametrix Labs). Some people simply use a broad spectrum amino acid support although there is some concern among people that glutamate (an amino acid generally found in broad spectrum blends) is not good for some of our children. An introduction to amino acids can befound here

Biotin (sometimes known as B7) is one of the B vitamins. No toxic effects of oral biotin have been reported in humans or animals, even at doses up to 10 mg/day. Used as a yeast fighter in that it seems to prevent candida from transforming into a more difficult to get rid of form (its fungal form). It is also important to note that because a major source of biotin is gut bacteria, most children with yeast overgrowth will actually be suffering from biotin deficiency.

Black Currant Oil is a source of GLA (see Essential Fatty Acids). Some children, especially those with eczema, may be deficient in GLA, an Omega 6 fatty acid.

Calcium supplementation can become important if your child is casein-free, and especially if your child is excreting lead through chelation; however, some children have very poor reactions to calcium supplementation. Calcium is best taken with meals. Some difference of opinion as to which is the best form, especially as one needs to consider lead levels in calcium supplements. Lead will be found in all calcium supplements--you need to research to ensure that your supplement has very low levels. It is thought that in general, sources like oyster shells, dolomite and animal bones generally contain the most lead. If you want to be sure, you must contact the company to ask for the assay on lead content.

Calcium chelates are the best absorbed (calcium citrate, calcium gluconate, for example). Taking magnesium with calcium will improve absorption (this is why many calcium supplements are already a calcium/magnesium blend). Some people find baking with the powder form an easy way to supplement. Good ARI rating.

Carnitine, an amino acid, is taken in the form of l-carnitine, and has shown promise for autistic children who tend to be low in this particular amino acid. It can help with energy by acting on the mitochondria and can help children with muscle tone problems. Mitochondrial dysfunction is common in children with ASD.

Carnosine has helped some ASD children with seizures, but seems to have adverse effects on many ASD children who do not suffer from seizures. Adverse effects will take a few days to subside after stopping the supplement.

Cholesterol has been shown to be low in some children with autism. Cholesterol plays an important role in brain function and proper myelin development. New Beginnings has a physician-referred cholesterol supplement; however, egg yolks are an excellent source of dietary cholesterol. For more information see http://www.greatplainslaboratory.com/cholesterol/web/

Choline is considered an essential nutrient, classifying it as a vitamin. Choline deficiency can cause liver problems. There are no known toxic effects from choline, though high doses may worsen epileptic conditions. Some people use choline alfoscerate (more commonly known as Alpha GPC) to target brain function. There is strong research to show its efficacy in stroke victims. Many parents supplement in the form of phosphatidylcholine, or lecithin (see phosphatidylcholine).

Chromium is a trace mineral (we require it in very small amounts, measured in micrograms, not milligrams) that seems to show efficacy in regulating blood sugar levels. Many children with ASD seem to struggle with regulating blood sugars, often manifested in tantrums or emotional collapses for no apparent reason.

Cod Liver Oil is often used for ASD children because of the vitamin A, vitamin D, and omega three fatty acids it provides. See Vitamin A , Vitamin D, and Essential Fatty Acids for further information.

Copper, a trace mineral, is very often high in children with autism. High copper is generally associated with low zinc levels. Imbalanced zinc-copper ratios can lead to things such as hyperactivity. Although the vast majority of children with ASD require zinc supplementation and should stay away from copper, there are some very few children who will react to zinc supplementation with bloody noses. These children may be copper deficient.

CoQ10 (co-enzyme Q10 or sometimes called ubiquinone, because it is ubiquitous in the body) is implicated in many body functions. It works best if given with essential fatty acids, and Vitamins C and/or E. Try to give with food, and is best given in the morning, as it has implications for the manufacture of melatonin. CoQ10 is one of the supplements used to address mitochondrial dysfunction, a widespread problem among children with ASD, and improvements in energy and attention are not uncommon. It is difficult to get dietary CoQ10, unless one eats a great deal of sardines or heart. Be sure to close bottle and keep out of sunlight.

Digestive enzymes have been used successfully by some parents to help improve their ASD child's health. Children with ASD can be deficient in enzyme production because of poor gut health. Many consider enzymes one of the best supplements to try first in order to improve digestion. Some parents use enzymes with a special diet, others replace the special diet. Enzymes are an exception to the rule of stopping supplementation if there is regression. Some "worse" behavior is not uncommon before it gets better. Houston's and Kirkman's both carry enzymes formulated for ASD children--each company has a different view of enzyme use. Some parents have been able to remove their children from a special diet using Houston enzymes, many of which are listed in this file.

See www.enzymestuff.com for complete information. Digestive enzymes have a good ARI rating.

DMG, or dimethylglycine is an amino acid which in some children can improve language, eye contact, and stamina. May cause hyperactivity. Try with folic or folinic acid to reduce hyperactivity. If hyperactivity is still observed, try TMG, which is DMG with one more methyl donor. Dosing in the morning is recommended. Because the body needs glycine for proper detoxification, DMG can be very helpful. DMG can help promote proper methylation, an important step in promoting glutathione production and health. See the ARI website for more information. See also TMG.

Epsom salts are often used for ASD children, although not ingested orally. Instead they are taking transdermally. Magnesium sulphate, the chemical name for Epsom salts, offers both magnesium and sulphur. Often taken in the form of a bath or as a skin cream. Many parents find that Epsom salt baths or cream can help deal with phenol problems and alleviate problems sometimes associated with swimming in chlorine pools. It can also calm some children and help them to sleep better. See http://www.enzymestuff.com/epsomsalts.htm for detailed information on this topic. Epsom salts can be purchased in large quantities very cheaply from companies like www.justasoap.co.uk

Essential Fatty Acids, are crucial to good health. Of the two most important essential fatty acids, Omega 3 and Omega 6, children with ASD are generally low in Omega 3s. Omega 3s include alpha linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). DHA is particularly abundant in brain cells and highly implicated in the proper function of the brain. It is thought that most Americans (on a Standard American Diet) have a 10 to 1 ratio of Omega 6s to Omega 3s in their diet, when the recommended ratio is 2 to 1, some of our children who have not had a typical American diet may need Omega 6 supplementation with something like evening primrose oil or black currant oil before they will tolerate the Omega 3's. Generally, if our children are deficient in the Omega 6 fatty acids, it is gamma-linolenic (GLA) that they require, found in the above mentioned supplements. Pangborn recommends having taurine, Vitamins C and E in place before starting fatty acid supplementation. Give with food for better absorption and to reduce possibility of any nausea. Some children seem to do better with high DHA levels, some better with high EPA levels. EPA can convert to DHA, but the reverse does not seem to be true. This may be an important consideration. General information on EFAs can be found here.

Essential fatty acids can help with dyspraxia, skin problems (bumps on skin, dry skin, "jock itch"). To supplement essential fatty acids, most parents choose to give cod liver oil or fish oil, the main difference being that cod liver oil will contain vitamin A and vitamin D. Some parents choose non-animal sources, but there is some concern that some children cannot utilize these sources of essential fatty acids properly. Ensure that your fish oil supplements are not rancid by keeping them refrigerated and in the dark. Nordic Naturals and Carlson's carry CLO and other fish oils that are very highly recommended. Signs of fatty acid deficiency (especially omega 3 deficiency) include chicken skin, especially on the back of the arms; dry hair or skin; excessive ear wax; excessive thirst; frequent urination; sleep disturbances; problems with inflammation; visual and auditory processing problems. Good ARI rating. See also flax seed oil.

Evening Primrose Oil is a source of GLA (see Essential Fatty Acids). Some children, especially those with eczema, may be deficient in GLA, an Omega 6 fatty acid.

Fibre is found naturally in our diet, but for children who may have poor eating habits, dietary fibre can be supplemented in two forms, soluble and insoluble. It is thought that a 50/50 ratio is best. Fibre can be helpful for some children who suffer from constipation, but it is not good for all children. See "Constipation" in Useful Documents for more information.

Flax seed that is ground is a source of fatty acids (although see comments under flax seed oil) and is of great benefit for fibre in that it is a balanced source of soluble and insoluble fibre. More than 4 tablespoons a day is excessive and can cause problems. It is important to grind the flax seed each day, as it can become rancid quite easily. See also the useful document called "Constipation". Flax Seed Oil is a source of essential fatty acids; however, it seems that some people are unable to convert the omega 3 in flax to the long chain form, necessary for it to be of use to our bodies. Also, flax is not a good source of EPA. For these reasons, some people believe that it may be more beneficial to children with digestion problems to use the fish oil fatty acids.

Folic acid or folate is one of the B vitamins. If a child cannot tolerate folic acid (becomes hyper or aggressive) try folinic acid. Some parents use Folapro, which is in the form of L-5-methyl tetrahydrofolate , the most asorbable from of folic acid. Folic acid at high doses of 5 to 30 mg may cause an increase in frequency of seizures in epileptics. Folic acid is implicated in preventing anemia.

GABA (Gamma-aminobutyric acid) is the chief inhibitory neurostransmitter in humans and is thought to be deficient in many children with autism. GABA can be helpful for behaviour, language, anxiety, and perhaps seizures.

Garlic Oil is used as an antifungal. Note that garlic is high in sulfur and some will not tolerate it. Cooked garlic will not have the same anti-fungal effect.

Glutathione or reduced, active glutathione (GSH) is a powerful antioxidant. Many ASD children are low in glutathione--a normal occurrence when the body is sick. Three main forms of glutathione seem to have some positive effect on some children: lipoceutical, transdermal, or nebulized. If using the lipoceutical glutathione it is best not to shake it. There have been some adverse reactions to glutathione supplementation and some people choose instead to spare glutathione by supplementing with antioxidants. Glutathione is also available through diet in many raw foods. Jim Adams, PhD, found that glutathione levels normalized in children using oral DMSA as a chelator.

HN-Zyme Prime is an all purpose digestive enzyme. Made by Houston's. If bromelain (pineapple) and papain (papaya) are a problem, use Zyme Prime (no HN) instead. Inositol, sometimes referred to as vitamin B8, plays an important role in the health of cell membranes and although it is readily available in the diet, this may not be true for our children. It can be helpful for OCD, although will worsen children with temporal lobe problems because it increases the strength of the signal serotonin sends.

Inositol hexaphosphate (IP-6), a derivative of inositol, can also be used to boost the immune system, but it is also an efficient chelator of most minerals, and that should be taken into account when using it. Some people use IP-6 if their children are iron toxic, or have some other similar condition.

Iron should not be supplemented unless you know from testing that your child is very deficient; it can be toxic. Many people get constipated with iron supplementation. If your child shows low ferritin levels on tests, you may want to consider Energizing Iron by PhytoPharmica which is an absorbable and natural form of iron (but messy if your child cannot swallow capsules). The best way to approach low iron is to give your child the drippings from cooking meet. Increasing vitamin C can help also.

Lecithin--see phosphatidylcholine.

Lithium has traditionally been used as a prescription medicine for bipolar. Some parents have found that lithium orotate has helped their children with ASD especially in terms of mood. This form of lithium at low doses has been found to be very safe. You can read more here

Magnesium is an essential mineral. Supplementing magnesium can improve constipation, mood, appetite, muscle relaxation, and sleep. It may also decrease tics and phenol intolerance. Citrate, malate, or glycinate forms are recommended. Too much magnesium will cause diarrhea (although you should consider the form--not all forms will cause loose stool). Some children who have the "jack-in-the-box" or "flopping fish" syndrome as they try to fall asleep may be lacking magnesium and potassium. Often works best when used in conjunction with Vitamin B6. Some people supplement in a cream form or through magnesium sulfate baths (Epsom salts baths) if oral supplementation is not tolerated, although this method will offer very small amounts of magnesium. Children who wet the bed at night are often low in magnesium and supplementation can often help this situation.

Melatonin is considered an antioxidant particularly helpful for the brain. Most ASD children do not make enough. Melatonin helps to improve sleep by allowing kids to fall asleep, but can actually disrupt sleep in some, particularly if too much is used. Only 1-2 mg/day is generally used; some parents see better results with time-released, although your child must be able to swallow pills to benefit from these. Good ARI rating.

Molybdenum is a trace mineral that can be used to lower copper levels, often high in ASD children (85% of them) and sometimes made worse during chelation.

Mullein and garlic oil ear drops are a very effective way of fighting ear infections, a common problem among ASD children. These drops can be found at most health food stores. It is important that the ear drops not be used if the ear drum as already been perforated. Many parents use these drops prophylactically to prevent the return of chronic ear infections.

NAC (N-Acetylcysteine) is an antioxidant contraindicated for anyone with high plasma cysteine. It can also worsen yeast problems. It can be used to increase glutathione levels but will not detoxify the body on its own.

NAG (N-acetyl glucosamine) is thought to help heal the gut by promoting mucus production in the gut and perhaps by dealing with dietary lectins. It has been shown to help with diarrhea and gut distention in children with constipation.

Niacin is one of the B vitamins, also known as B3. It is a term which means both nicotinic acid and nicotinamide. High doses of nicotinic acid can cause a flush, resulting in vasodilation of surface blood vessels. This will increase blood flow, principally in the face, neck and chest. Nicotinamide is not associated with this condition. B3 is highly implicated in many enzymatic reactions.

No-Fenol is a digestive enzyme for highly phenolic foods. May be helpful for those with phenol intolerance. Some people also give it away from food to help control yeast. Houston product.

Pantothenic acid or pantethine is vitamin B5, very good for adrenal problems and allergies, which many ASD children have. There are no known reports of pantothenic acid toxicity. Large doses (10 grams or more) may cause diarrhea.

Peptizyde is a protein digesting enzyme that works for gluten, casein, and soy protein. Contains bromelain (pineapple) and papain (papaya). If these are a problem, use the AFP Peptizyde instead. Will not allow you to leave GF diet if you have celiac disease. A Houston's product.

Phosphatidylcholine can be helpful to the liver, brain (particularly in protecting the myelin sheaths), and digestive health. Powdered form or pure liquid forms are recommended. Generally a soy product; however, egg-based forms are available. Some people choose to use glycerylphosphorylcholine (alpha-GPC) instead, as it is very similar but easier to dose because it comes in a powder that tastes better. Phosphatidylcholine is the active component of lecithin.

Phosphatidylserine can be used to improve concentration, focus, and mood. Can also reduce "brain fog". A soy product

Probiotics are supplements to replace the "good" bacteria in the intestinal tract destroyed from antibiotic use, stress, pesticides, malnutrition, and toxins. Some people use them alone to control yeast overgrowth; many people use them in conjunction with an anti-fungal. They come in capsule, loose powder, and chewable forms. If your child is casein-free, be sure to buy non-dairy. Try to use probiotics long before the expiration date. Some need to be refrigerated. There are a wide variety of probiotics, both in type and quality. What works for individuals seems to vary. Some people rotate their probiotics to ensure a wide variety of good bacteria. Most children require far more than the amounts recommended on the bottles. Many people use cultured foods as a more economical and efficacious way of promoting the growth of good bacteria. See Cultured Foods document in the Useful Documents section.

Protein Powder can be used to add protein to diet. Many children, particularly those who are GFCF, may need more protein. Undenatured whey protein is a good way to boost glutathione levels but is not CF.

Rice protein powder is a complete protein as well. Pea protein powder is also available. Some children, particularly those who may have problems with glutamate, may not do well on protein powders.

Riboflavin is vitamin B2 (see below).

SAMe does not have a good ARI rating. It seems to help only 1 in 5 ASD children.

Selenium is an antioxidant trace mineral. Use the selenomethionine form. If you're avoiding yeast, make sure to get "yeast free" selenium. Selenium supports delivery of zinc to cells and the sequestering of mercury and other heavy metals. Some children with ASD are low in selenium, although exact percentages are controversial; however, most soil is depleted of selenium and the general population is low. The National Academies of Science established an UL of 400 mcg/day for selenium. Selenium can be toxic at high levels. Some people choose to supplement with organic Brazil nuts (non-organic may not contain selenium because of soil depletion).

Taurine is an amino acid and powerful antioxidant and is needed to form bile salts (necessary to properly use vitamins and fats). It will also make your poop brown as it should be. Pangborn considers taurine an important supplement that should be in place before a number of others (unlike the rest of the amino acids). Can also counter chlorine intolerance, from swimming pools. Taurine given at bedtime can also help for calmness and sleep. Some parents have used taurine successfully to reduce or eliminate seizures.

Thiamin is vitamin B1 (see below).

Trimethylglycine or TMG, like DMG has a good ARI rating. Pangborn recommends that you have taurine in place first. May cause hyperactivity. Suggested morning dosing. See ARI website for more information. See also DMG.

Vanadium is a trace mineral that may help in controlling blood sugar levels. See Chromium for more information.

Vitamin A is often thought to help with visual problems and language. Vitamin A plays an important role in healing leaky gut; this may be of particular relevance to children who have suffered an adverse reaction to the MMR or who believe that chicken pox may have played a role in their child's autism. Vitamin A is also highly implicated in the proper function of the immune system. Vitamin A is not the same as beta carotene. Beta carotene is the pre-vitamin A found in plants (a precursor to Vitamin A which healthy bodies convert--our children may not be able to do this). Many people use cod liver oil to supplement Vitamin A, thereby supplementing Vitamin D and the fatty acids as well (see essential fatty acids). The vitamin A in CLO is in the natural cis- form, which is best for the body. If your child doesn't tolerate CLO, you may consider a different form of Vitamin A (eg. Klaire Lab micellized Vitamin A). Good ARI rating.

Vitamin B is actually a group of many vitamins. Some parents choose to supplement their children with Vitamin B50 or B100 (the second being twice the dose as the first) which are B complexes containing standardized amounts of the various B vitamins. Other parents choose to supplement the different B vitamins separately, especially if their child seems to have a bad reaction to the B vitamins. Some children react badly to vitamin B because of phenol issues. Children with ASD are often low in one or more of the B vitamins.

Vitamin B1 is called thiamin. Thiamin is highly implicated in many metabolic processes. Children with lead toxicity may benefit from higher levels of thiamin. Thiamin deficiency can starve the brain of fuel. There is little danger of thiamin toxicity when it is taken orally.

Vitamin B2 or riboflavin, is highly implicated in a wide variety of cellular processes. Children with MTHFR dysfunction may be struggling with a riboflavin deficiency. B2 is readily excreted in the urine and absorption by the digestive tract may be less than 20 mg for one dose. There appears to be no danger of oral toxicity.

Vitamin B6 is also known as pyridoxine or pyridoxine-HCI. It becomes the P5P active co-enzyme form in the body, which is why some supplements recommended for children with ASD are in the P5P form already. Shows best results when given with magnesium. (See ARI website, where B6 is highly recommended, for details). Adequate zinc is required for proper utilization and it is best given with food. May also require amino acid supplements to work best--testing can show. Many phenol intolerant children have problems with B6; sufficient magnesium may address this problem.

Vitamin B-12 is also known as cobalamin. It is thought that toxins such as thimerosal can damage the body process of making methylcobalamin. Some ASD children respond very well to injections of methylcobalamin because these injections bypass the damaged gut and are therefore well absorbed, contributing to the proper function of the methylation system. Injections are done after consulting with a doctor as they require a prescription. For supplementing with Vitamin B12 as methylcobalamin, Pangborn recommends that you deal with gut and food intolerance issues first, and that you have taurine in place before supplementing. Some children have adverse reactions (violence, extreme emotion) to the injections, but many children benefit (See Dr. Neubrander's site for information ) Parents may want to start with oral methyl B12 to see if it is tolerated well; however, a lack of improvement on oral mb12 does not mean shots will not help. Some people have also used the nasal spray effectively and there are some who have found that the transdermal is effective as well (Cenaverde provides a transdermal B12). Vitamin B12 plays a key role in crucial body functions such as methylation.

Vitamin C is a powerful antioxidant and is implicated in many bodily functions. Most children with ASD suffer from excessive oxidative stress. Vitamin C works to enhance the efficacy of Vitamin C and spare glutathione. It also boosts immune function. Be aware that most vitamin C is corn based and that hypoallergenic vitamin C may be a good idea. Twinlabs Allergy C is made from palm for those avoiding corn. Perque makes Vitamin C from potato. Allergy Research Group has cassava-based C. Some people choose buffered Vitamin C for better absorption and better bowel tolerance. Others choose the unbuffered--plain ascorbic acid--because it can help raise stomach acid and low stomach acid is a problem for some autistic children (see Constipation document for more information). Good ARI rating.

Vitamin D is a fat soluble vitamin naturally produced by our bodies in response to certain types of sunlight; however, many children are deficient as large amounts of exposure to sunlight are required for sufficient levels of D. If you are supplementing with CLO, you are also giving vitamin D. Many parents find that increasing levels of D increases the happiness of their child. There is growing evidence that vitamin D deficiency plays a role in autism. Vitamin D is one of the key vitamins in the Fat Soluble Vitamin protocol (see Vitamin K yahoo group in our Links section). See Vitamin D in the useful documents section.

Vitamin E is an antioxidant also known as d-alpha-tocopherols. If a label says "dl" instead of just "d", it means the vitamin E is synthetic and most people want to avoid that. Since vitamin E is fat soluble, any condition affecting fat digestion, absorption, or transport can lead to vitamin E deficiency with associated symptoms such as greasy stools or chronic diarrhea. This population may need a water-soluble form of vitamin E. The general health risk of too much vitamin E is low. Most vitamin E is soy-based and if your child is highly intolerant of soy you may need to find another source. Note that most fish oils will contain vitamin E that is soy-based.

Vitamin K is thought by some to be an antioxidant. It plays an important role in making sure that calcium ends up where it belongs and some children have shown great improvement in tooth health with the use of Vitamin K, generally K2. Natural forms of vitamin K have caused no symptoms of toxicity, even when supplemented in large amounts. Vitamin K plays a key role in the Fat Soluble Vitamin protocol. (see Vitamin K yahoo group in our Links section).

Zinc, an essential mineral, often needs to be supplemented in ASD children. Zinc is highly implicated in brain function, adrenal glands, gastrointestinal health and immune system function. It can help to lower copper levels (85% of ASD people have high copper-zinc ratios). Some suggest giving zinc separately from calcium, iron, or folate. Best absorbed if given away from meals in smaller doses; however, zinc on a empty stomach can cause nausea, in which case, give with food. Citrate form is the same form as found in breastmilk and generally well tolerated but other forms such as picolinate or methionine are considered by some to be better absorbed. Zinc should be given away from enzymes that contain DPP-IV as it may inactivate these enzymes. Zinc deficiency can cause mouthing and chewing of objects as well as a lack of appetite. Pica (eating non food items) can be a sign of zinc deficiency. Good ARI rating.