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Orthomolecular Medicine News Service, January 15, 2018

Multivitamin and folic acid use lowers autism rates

by Terry Vanderheyden, ND, RH

(OMNS Jan 15, 2018) Children of mothers who take multivitamins and/or folic acid supplements have a 60% lower autism risk, even if their moms take the supplements before getting pregnant. [1] The risk is lowered even in those who used the supplements before becoming pregnant but discontinued their use while pregnant.

Dr. Stephen Z. Levine and his colleagues conducted a case-control cohort study in which they surveyed 45,300 children born between January 1, 2003 and December 31, 2007 for a diagnosis of autism spectrum disorder (ASD). Then they compared ASD incidence with patterns of maternal vitamin and folic acid usage. Notable is that the participants were Israeli women who were prescribed the vitamins by their doctors.

What they found is striking: multivitamin and/or folic acid use lowered the risk for ASD by 61% in those who used the supplements before becoming pregnant (i.e. not within 9 months of pregnancy), while women who used them during pregnancy lowered their children's risk for ASD by 73%!

The study by Levine et al. confirms earlier findings by a Norwegian group, who also found that folic acid supplementation in mothers reduced ASD risk in their children.[2] The latter study showed a reduction in risk of 39% in mothers who used the vitamin for only a short period, from four weeks before to eight weeks after becoming pregnant.

Levine and his fellow researchers concluded that, although "causality cannot be inferred," the use of the observational type of study that they conducted is "more pragmatic and ethical" than a randomized, controlled clinical trial (RCT). A RCT where, for example, women would be prescribed the supplements and others denied it by giving placebo would be considered unethical, since it is already known that folic acid supplementation prevents neural tube defects that lead to spina bifida in children. [3]

We now know that mutations that occurred in our ancestors' genes have led to many individuals requiring higher levels of certain nutrients.[4] For example, all humans must derive vitamin C from their diet, because we and most other primates have a genetic mutation in the synthetic pathway for ascorbate, whereas most other mammals produce their own.[5] Similarly, genetic mutations may contribute to the root of the autism epidemic[6], even though the science of epigenetics apparently can explain the huge explosion in autism occurring today.[7]

Epigenetics is the science of how our genes, which are unalterable, can be modulated by changing the cellular biochemical environment in which those genes are expressed.[8,9] In other words, diet, nutritional supplements, and lifestyle factors can modify the expression of existing genes, so that mutations or other genetic differences can be either expressed or repressed. Folate and other vitamins and nutrients are important in the biochemical pathways that methylate DNA base sequences that comprise genes. This can modulate how the DNA for a gene gets expressed into proteins. This epigenetic mechanism is not permanent but can be passed from one generation to the next.


As a naturopathic doctor, I have found autism in young children does indeed respond to naturopathic therapies, especially if treated as quickly as possible after diagnosis. The longer someone waits to be treated, the less likely that complete recovery is possible, though many cases even of long standing do improve. Nutritional deficiencies are common in the modern diet, and because of genetic differences, some individuals may need higher levels of essential nutrients. Nutritional therapies that comprise an excellent diet including fruits and vegetables along with vitamin and mineral supplements, as well as herbal medicines, are all indispensable to the recovery of these children. Especially helpful are supplements in adequate doses of the B vitamins including folate and biotin, vitamins C, D, E, essential omega-3 fatty acids found in walnuts, flax seeds, and fish oil, probiotics, and essential minerals including magnesium. [10,11] In conclusion, the cost of preventing autism is merely to give nature a gentle boost.

(Terry Vanderheyden is a naturopathic physician in Barry's Bay, Ontario.)


1. Levine SZ, Kodesh A, Viktorin A, Smith L, Uher R, Reichenberg A, and Sandin S. "Association of Maternal Use of Folic Acid and Multivitamin Supplements in the Periods Before and During Pregnancy With the Risk of Autism Spectrum Disorder in Offspring." JAMA Psychiatry; Published online January 3, 2018. doi: 10.1001/jamapsychiatry.2017.4050.

2. Surén P, Roth C, Bresnahan M, et al. "Association between maternal use of folic acid supplements and risk of autism spectrum disorders in children." JAMA. 2013;309(6):570-577.

3. De Wals P, Tairou F, Van Allen MI, et al. "Reduction in neural-tube defects after folic acid fortification in Canada." N Engl J Med. 2007;357(2): 135-142.

4. Williams RJ. Biochemical Individuality McGraw-Hill; (1998) ISBN-13: 978-0879838935

5. Saul AW. Ascorbic Acid Vitamin C: What's the Real Story?

6. Schmidt RJ, Hansen RL, Hartiala J et al. "Prenatal vitamins, one-carbon metabolism gene variants, and risk for autism." Epidemiology. 2011 Jul; 22(4): 476-485.

7. Miyake K, Hirasawa T, Koide T, and Kubota T. "Epigenetics in Autism and Other Neurodevelopmental Diseases." In: Neurodegenerative Diseases, edited by Shamim Ahmad. Austin, Texas: Landes Bioscience and Springer Science+Business Media, 2012. Adv Exp Med Biol. 2012;724:91-8. doi: 10.1007/978-1-4614-0653-2_7

8. Abdul QA, Yu BP, Chung HY, Jung HA, Choi JS. Epigenetic modifications of gene expression by lifestyle and environment.. Arch Pharm Res. 2017, 40:1219-1237.

9. Friso S, Udali S, De Santis D, Choi SW. One-carbon metabolism and epigenetics. Mol Aspects Med. 2017;54:28-36.

10. Case HS. Vitamins & Pregnancy: The Real Story: Your Orthomolecular Guide for Healthy Babies & Happy Moms. Basic Health Pub. (2016) ISBN-13: 978-1591203131

11. Saul AW. Vitamins and Autism: The Real Story.

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