Autism Spectrum Disorder (ASD) is a fast-growing developmental disability in many countries, characterised by impaired social interaction and communication, as well as restricted and repetitive behaviour. Research into the background of autism, the etiology and associated biomedical interventions is ongoing. Treatment is often limited to targeting the behavioural challenges.

Recently, however, mitochondrial dysfunction has been found to be distinctly prevalent in this particular group of children and adults. The disorder means that the brain and muscles require a tremendous amount of energy to function normally – therefore possibly leading to some of the symptoms of autism.

What is mitochondrial disorder?

Mitochondria are the energy producers of the body and produce 90 percent of the energy our body needs to function. Thousands of mitochondria are present in nearly every cell in the body. Their function is to process oxygen and convert the food we eat into energy.

A mitochondrial disease is usually a chronic, inherited genetic disorder that arises when the mitochondria fail to produce enough energy for the body to function properly. It’s a condition that can affect all parts of the body – particularly nerves, muscles, kidneys, heart, liver, eyes, brain cells, ears or pancreas. Mitochondrial diseases are reflected in Parkinson’s, Alzheimer’s, Muscular Dystrophy, cancer – and autism.

What can be done to alleviate mitochondrial disorder as much as possible?

While there is no real cure in sight, there are various treatments that can help to reduce the symptoms and give patients some relief. But there are points to consider:

• there is no way to predict an individual’s response to treatment, either initially or long term, because no two people will respond to the same treatment in the same way, even if they have the same disease ;
• because individuals respond differently to treatments even if their conditions are very similar, treatment will vary from patient to patient and will also depend on the specific mitochondrial disease and its severity;
• as a general rule, those with mild disorders tend to respond to treatment better than those with severe disorders;
• treatment cannot reverse the damage already sustained, such as brain malformations;
• treatment can include vitamins and supplements, exercises, speech therapy, respiratory therapy and occupational therapy.

What support is needed for the autistic child with mitochondrial disorder?

There are several ways to support the mitochondrial function such as eating smaller meals more frequently, avoiding canned vegetables and processed meat, and increasing hydration. Also avoiding mitochondrial toxins such as: valproic acid, aminoglycoside antibiotics, acetaminophen, metformin, etc.

Most importantly, it is advisable to use recommended vitamins and supplements under the guidance of a health practitioner. These would include:

Vitamin B1: (thiamine) – a B-complex vitamin that must be consumed in the diet. Vitamin B1 is involved in numerous metabolic processes. Deficiency can cause severe neurological symptoms including delirium, neuropathy, and sleep disturbance.

Vitamin B2: (riboflavin) – a B-complex vitamin essential to many enzymatic reactions that take place in the mitochondria. Sources include milk, cheese, leafy vegetables, mushrooms, and almonds.

Vitamin B3: (niacin or niacinamide) – deficiency can lead to symptoms such as nausea, anemia, headaches, and fatigue.

Vitamin B5: (pantothenate) – a B-complex vitamin needed to synthesize coenzyme-A which is important in the synthesis and oxidation of fatty acids and in the Krebs cycle.

Vitamin B7: (biotin) – a water-soluble vitamin necessary for cell growth and the metabolism of fats and amino acids.

Vitamin B9: (folate) – a water-soluble vitamin essential for many bodily functions that must be supplied through the diet. Folate is important in the synthesis, repair, and methylation of DNA and is a cofactor in many biological reactions.

Vitamin B12: (cobalamin) – a water-soluble vitamin which plays a key role in the normal functioning of the brain and entire nervous system. Vitamin B12 has an important role in DNA synthesis and regulation as well as fatty acid metabolism and amino acid metabolism.

Vitamin C: a water-soluble vitamin naturally present in many foods. Vitamin C is an important physiological antioxidant and has been shown to regenerate other antioxidants in the body, including vitamin E. It helps to counter the damaging effects of free radicals on cellular and mitochondrial function.

Vitamin E: a fat-soluble vitamin that comes in many different chemical forms. Alpha-tocopherol is the form of vitamin E that is most widely recognised to meet human requirements and is the form most commonly found in supplements. Vitamin E is a potent antioxidant and helps to protect cells from the damaging effects of free radicals.

L-Creatine: an organic acid that facilitates the formation of adenosine triophosphate (ATP) and thereby helps to supply energy to all of the cells of the body, and in particular to muscles. Creatine is made in the body and is also consumed in the diet (mainly from meat products).

Alpha lipoic acid: a compound that is important in many different aspects of aerobic metabolism including the Krebs cycle.

L-arginine: an amino acid that is produced in the body but also needs to be consumed through the diet to achieve sufficient amounts. L-arginine plays an important role in cell division, wound healing, detoxification, immune function, and hormone release.

Selenium: a chemical element necessary for cellular function and a component of several antioxidant enzymes.

Make sure you work with your child’s health practitioner to ensure that the treatment is tailored to the child’s specific symptoms. Supplements should be managed by a professional in conjunction with your child’s condition. Types of supplement, dosage and duration are all important. If not used correctly some vitamins and supplements can have adverse effects.

Dr Louise Lindenberg

Dr Louise Lindenberg runs an integrated medical practice in Durbanville, Cape Town. She incorporates dietary intervention, supplementation, nutrition, phytotherapy/herbal medicine, and allopathic medicine in a holistic health care environment.

Her passion is working with children on the Autistic Spectrum, including Autism, PDD, ADD, ADHD and behavioural problems. She follows a biomedical approach in treating children to improve their outcome in the Autistic Spectrum. Due to her specialised knowledge she is a sought after speaker and frequently addresses other medical professionals, teachers and parents on various topics relating to autism.

Find more information at: www.drlindenberg.co.za