A 32-month old boy with autism spectrum disorder showed significant improvement in behavioral problems after treatment with vitamin D3 (cholecaliferol), according to a study published Dec. 15 in Pediatrics, the journal of the American Academy of Pediatrics.
To our knowledge, this is the first case report of a case with ASD and vitamin D deficiency whose autism symptoms markedly improve after vitamin D supplementation, the authors, led by Feiyong Jia, PhD, MD, wrote in the study. Vitamin D deficiency is a common nutritional disorder, and one of the most common undiagnosed medical conditions in the world. Recent studies suggested that vitamin D deficiency is a common phenomenon in children with ASD, and vitamin D deficiency may be involved in the process of autoantibody production in patients with autism.
Vitamin D3 seems to play a significant role in the etiology of ASD because this vitamin is important for brain development, according to the authors. Vitamin D3 is converted into 25-hydroxyvitamin D3 in the liver. Higher serum concentrations of this steroid may reduce the risk of autism. Importantly, children with ASD are at an increased risk of vitamin D deficiency, possibly due to environmental factors. It also has been suggested that vitamin D3 deficiency may cause ASD symptoms.
The boy was referred to the department of pediatric neurology and rehabilitation of the First Hospital of Jilin University in Changchun, China, in 2014. He was diagnosed with ASD by a team of autism experts, using diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, according to the study.
The patients scores on assessments include 80 on the Autism Behavior Checklist, where normal is 54; 35 on the Childhood Autism Rating Scale, where normal is 35; and 6 on the Severity of Illness of Clinical Global Impression, where normal is 1. His serum 25-hydroxyvitamin D level was 12.5 ng/mL, as assessed by the high-performance liquid chromatography method. Serum vitamin D is considered adequate at greater than or equal to 30 ng/mL and deficient at less than or equal to 10 ng/mL.
Vitamin D3 then was intramuscularly administered at a dosage of 150,000 IU every month and orally administered at a dosage of 400 IU per day. Follow-up evaluation was performed at the end of the second month. According to the study, the patients parents reported a significant improvement in behavioral problems, including self-injury. Their child now responds when his name is called, plays with toys and seeks out physical contact with his parents. He is no longer incontinent.
Laboratory tests revealed that serum 25(OH)D had increased to 81.2 ng/mL. The marked improvement in the relatively brief period of treatment that was observed in this case appears to be related to vitamin D supplementation, the authors wrote. It seems unlikely that this improvement was caused by spontaneous natural development unrelated to serum vitamin D levels. Because no other medical abnormalities were found other than the vitamin D deficiency, it also appears unlikely that other diseases explain the improvements seen in this patient.