Our Schools, Autism, and Vitamin D

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Our Schools, Autism, and Vitamin D
 
On Sunday, July 13, 2008, the San Francisco Chronicle published an article
titled:
State’s Schools Lack Cohesive Plan For Autism:Autism a “Public Health Crisis”

Using the Autism Society of America, the Autism Clinic of the University of
California, San Francisco, and the California Department of Education as
sources, this article shows disturbing statistical trends concerning autism,
mental retardation, speech and language disability, and learning disabilities in
the state of California. Specifically, between 2000 and 2007 autism incidences
increased 229%, mental retardation increased 6%, and speech and language
disability increased 7%. In 2007, the number of children with autism was
officially recorded as 46,196; the number of children with mental retardation
was 43,113; the number with speech and language disability was 176,265; and the
number with learning disabilities was 297,933.

A major concern is not only the sheer number of cases and their statistical
escalation, but also their public cost. As an example, the article notes that
the average annual cost per pupil with autism is $36,000 per year. The cost for
autism alone (in California) is about $1.7 billion in 2007. With the realization
that cases of speech and language disabilities and learning disabilities dwarf
the number of autism cases, the costs are staggering.
•••••
In November 2008, researchers from Cornell University, Indiana University,
Purdue University, and from the Children’s Hospital of Philadelphia, published a
study in the journal Archives of Pediatric and Adolescent Medicine titled:

Autism Prevalence and Precipitation Rates in California, Oregon, and Washington
Counties
The objective of their study was to investigate the possibility of an
environmental trigger for autism. They note that 30 years ago, one (1) in 2500
children had autism; today the number is one (1) in 150 children. They found
that “autism prevalence rates and counts among school-aged children were
positively associated with a county’s mean annual precipitation.” In other
words, bad weather is associated with increased autism rates.
The authors offer three possible explanations for their findings:
1) When the weather is bad, children stay indoors and watch more television and
video. They state “television and video viewing by very young children has
previously been associated with psychopathological characteristics in the
pediatric literature, including problems concerning language development,
cognitive development, and the development of later behaviors consistent with
attention-deficit hyperactivity disorder.”
2) When children stay indoors, they have greater exposure to household chemical
cleaners, or other types of chemical pollutants or pesticides.
3) When children stay indoors, there is a vitamin D deficiency. They state:
“Vitamin D deficiency can lead to reduced levels in the developing brain of
calcitriol, a critical neurosteroid involved in brain development. Of interest,
while health care providers have exhorted patients during the last 20 years to
reduce sunshine exposure, autism prevalence has been increasing. It is also of
interest to note that evidence indicates a substantial incidence of vitamin D
deficiency in the United States and elsewhere among infants and toddlers.”
•••••
In a supportive article from 2008, John Jacob Cannell published a study in the
journal Medical Hypotheses titled:

Autism and Vitamin D

The abstract from this article makes the following points:
Any theory of autism’s etiology must take into account its strong genetic basis
while explaining its striking epidemiology.
Animal data has repeatedly shown that severe vitamin D deficiency during
gestation dysregulates dozens of proteins involved in brain development and
leads to rat pups with increased brain size and enlarged ventricles,
abnormalities similar to those found in autistic children.
Children with vitamin D deficient rickets have several autistic markers that
apparently disappear with high-dose vitamin D treatment.
Estrogen and testosterone have very different effects on vitamin D’s metabolism,
differences that may explain the striking male/female sex ratios in autism.
Vitamin D down-regulates production of inflammatory cytokines in the brain,
cytokines that have been associated with autism.
Key points from this article include:
1) “The apparent increase in the prevalence of autism over the last 20 years
corresponds with increasing medical advice to avoid the sun, advice that has
probably lowered vitamin D levels and would theoretically greatly lower
activated vitamin D (calcitriol) levels in developing brains.”
2) “Consumption of vitamin D containing fish during pregnancy reduces autistic
symptoms in offspring.”
3) “Autism is more common in areas of impaired UVB penetration such as poleward
latitudes, urban areas, areas with high air pollution, and areas of high
precipitation.”
4) “Autism is more common in dark-skinned persons and severe maternal vitamin D
deficiency is exceptionally common in the dark-skinned.”
5) “Widespread gestational and/or early childhood vitamin D deficiency may
explain both the genetics and epidemiology of autism. If so, much of the disease
is iatrogenic, brought on by medical advice to avoid the sun.”
6) The male:female ratio for autism is 4:1.
7) Hypovitaminosis D is a candidate risk factor for neurodevelopmental
disorders, because vitamin D:
A)) Functions as a neurosteroid
B)) Is a potent up-regulator of nerve growth factor
C)) Is found in a wide variety of brain tissue very early in embryogenesis
D)) Offers neuroprotection, antiepileptic effects, and immunomodulation
8) Prenatal, neonatal, and postnatal vitamin D supplementation is important for
normal brain functioning.
9) Vitamin D affects al least 200 human genes.
10) “Ninety percent of human vitamin D stores come from skin production, not
oral intake.”
11) “Large populations of pregnant women putting small amounts [of vitamin D] in
their mouths – in the form of prenatal vitamins – instead of generating large
amounts in their skins, is novel to human brain development.”
12) “The skin’s production of vitamin D is remarkably rapid and extraordinarily
robust, easily exceeding recognized dietary sources by an order of magnitude.”
13) When fair-skinned adults sunbathe in the summer (full-body) for 20 min, they
input about 20,000 units of vitamin D to their systemic circulation within 24 h.
14) “In 1989 the American Medical Association’s Council on Scientific Affairs
warned about the dangers of sun-exposure and advised mothers to, ‘keep infants
out of the sun as much as possible.’ The increase in autism appears to have
begun at the same time. Indeed, most of the graphs showing rising prevalence
rates of autism over the last 20 years would be strikingly similar to graphs
showing the rising rates of programs promulgating sun-avoidance.”
15) “Human behavior, be it the step into the sun, the step to the supplements,
the step into the shade, or the step to the sunscreen, determine brain [vitamin
D] levels.”
16) “Both the brain and the blood of autistic individuals show evidence of
ongoing chronic inflammation and oxidative stress. Vitamin D has powerful
anti-inflammatory properties.”
17) Vitamin D is remarkably neuroprotective by “increasing brain glutathione.”
“This may explain the purported link between heavy metals, oxidative stress, and
autism.”
18) “The primary route for the neurotoxicity of most heavy metals is through
depletion of glutathione and subsequent generation of reactive oxygen and
nitrogen species. Besides its function as a master antioxidant, glutathione acts
as a chelating agent to remove heavy metals, including mercury.”
19) Estrogen increases neural vitamin D levels, but testosterone does not. This
may explain the higher incidence of autism in males.
20) Vitamin D supplementation in autistic children improves a number of brain
function markers.
21) “The vitamin D theory of autism predicts that consumption of vitamin D-rich
fish during pregnancy would improve the offspring’s mentation.”
22) Higher fish consumption during pregnancy is associated with better infant
cognition with the greatest effect for infants whose mothers consumed the most
fish.
23) Low maternal seafood consumption is associated with infants who have lower
verbal IQs and suboptimal outcomes for fine motor, communication, and social
development.
24) Autism appears to escalate when children wean from formula and begin
drinking juice instead of vitamin D enriched formula.
25) Autism rates go up when children watch more television or when it rains
more. Both issues reduce vitamin D production.
26) Amish children of Pennsylvania spend much more time outdoors, and have very
low rates of autism.
27) If childhood vitamin D deficiency is involved in autism, symptoms should
improve in the summer, and studies show dramatic improvements in both sleep and
behavioral problems in the summer.
28) Dark skinned people are poor at making vitamin D and they also have higher
incidences of autism. Ninety-six (96) percent of pregnant black women and 63
percent of pregnant white women do not have adequate vitamin D blood levels.
29) To achieve and maintain ideal vitamin D levels “requires the daily ingestion
of thousands – not hundreds” – units of vitamin D per day. Natural levels found
in humans who live or work in the sun, are around 50 ng/ml – “levels obtained by
a tiny fraction of modern humans.”
30) A 2006 article published in Lancet reported the prevalence of autism
spectrum disorder in 56,000 British children was one (1) in 86 children. [WOW!]
31) “The lifetime additive societal cost of autism is $3.2 million per case.”
32) “Autism may be caused by gestational and early childhood vitamin D
deficiency, an iatrogenic deficiency brought on by medical advice to avoid the
sun, advice that tragically failed to compensate for the consequent ‘epidemic of
vitamin D deficiency’.”

FINAL COMMENTS:
There is no doubt that there is no single cause, no single prevention strategy,
and no single treatment for autism. However, these articles present both
academics and evidence that low levels of vitamin D might be an important cause
of autism. Maternal, infant, and pediatric Vitamin D supplementation could be an
extremely low cost approach to reduce the incidence of this expensive,
debilitation, life-long neurological disorder.
References:
Nanette Asimov, State’s Schools Lack Cohesive Plan For Autism; Autism a “Public
Health Crisis” San Francisco Chronicle, July 13, 2008.
Michael Waldman, PhD; Sean Nicholson, PhD; Nodir Adilov, PhD; John Williams, MD,
MBA; Autism Prevalence and Precipitation Rates in California, Oregon, and
Washington Counties; Archives of Pediatric and Adolescent Medicine;
2008;162(11):1026-1034.
John Jacob Cannell; Autism and Vitamin D; Medical Hypotheses; Volume 70, Issue
4, 2008, Pages 750-759.

Dan Murphy graduated magna cum laude from Western States Chiropractic College in
1978, and has more than 26 years of practice experience. He received his
Diplomat in Chiropractic Orthopedics in 1986. Since 1982, Dr. Murphy has served
as part-time undergraduate faculty at
Life Chiropractic College West, where he is currently teaching classes to
seniors in the Management of Spinal Disorders.