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Sunday, 8 December 2013

A Hypothesis: Vitamin D, Calcium, Milk, and the Autism Epidemic



by Seth Bittker

My name is Seth Bittker, and I am the father of a boy with ASD.  My son’s development was slow up until about 2 1/2 years of age.  Around this time, his milk consumption increased, and it began crowding out other sources of sustenance.  Within a few months he regressed, and we received an autism diagnosis soon after this.  Stopping his milk consumption was the first step in helping him get better.
Like some other parents of those with ASD children, I noticed that his behavior varies significantly with what he eats.  When he consumes large amounts of calcium fortified foods or beverages, his behavior gets worse: he becomes more autistic in a behavioral sense.  Since milk has a lot of calcium, and calcium fortified foods do as well, it seemed like there might be some connection to calcium and his symptoms.  Later based on a doctor’s recommendation we gave him supplemental vitamin D.  We did not notice much initially, but a few weeks later he developed hives, and he regressed.  Since supplementation with vitamin D increases absorption of calcium, it appeared that the bad reaction to calcium and vitamin D might be connected.  Based on these experiences and others, I eventually inferred that we should keep him on a relatively low-calcium diet and avoid vitamin D supplementation or fortification (milk as well as many other foods in the US are fortified with vitamin D).
I also concluded that my son was different from most others affected with autism as some have suggested that vitamin D deficiency is involved in inducing autism,[1] and he evidently did not have a deficiency based on the vitamin D trial even though vitamin D levels in his blood were relatively low.
But is he really different than others with autism?  If one examines the evidence from a number of genetic syndromes that are comorbid with autism, in many cases the cause is over-active calcium channels (effectively too much intra-cellular calcium).[2]  You can see this by looking at syndromes such as Timothy syndrome, Williams syndrome, and Sotos syndrome, which have high comorbidity with autism and seem to be caused by too much intra-cellular calcium.  In Williams syndrome the connection is through a gene which upregulates vitamin D.[3]  In some of these syndromes is it well known that supplementation with calcium and vitamin D are contraindicated.[4]
In addition there are certain biochemical markers that are typical in autism, and my son seems to have this same biochemical gestalt.  For example two types of immune system cells released by the thymus are called “Th1” cells and “Th2” cells, and Th2 cell levels relative to Th1 cells are much higher in the blood of those with autism than in controls.[5]  As Th2 is associated with extra-cellular immunity, this suggests that those with autism will be prone to allergies,[6] which fits with anecdotal observation.  In addition with autism we see elevated markers for oxidative stress and endothelial damage.[7]  Also those with autism typically have functional deficiencies of magnesium[8] and potassium.  By functional we mean the levels may not be low in the blood relative to controls, but there is a biochemical need for greater consumption.  To see the latter you can give somebody with autism a small dose of supplemental potassium, and the result is generally a reduction in autistic symptoms.  For more on this, see Peter’s work: http://epiphanyasd.blogspot.com/2013/08/potassium-may-play-important-role-in.html.
It turns out that vitamin D skews the immune system to produce elevated levels of Th2 cells.[9]  One can infer that it also produces functional deficiencies of potassium and magnesium as these minerals offset the effect of calcium on calcium channels and vitamin D increases the absorption of calcium.  In addition in high doses vitamin D causes oxidative stress and endothelial damage as we see in autism.[10]

Oral supplementation with vitamin D can cause other consequences as well.  Supplementation with significant doses of vitamin D early in life, results in more cases of allergies, asthma, and dermatitis later.[11]  Asthma, allergies, and dermatitis all feature high levels of Th2 cells like autism.[12]  Is it too much of a stretch to suggest that supplementation with vitamin D early in life, might result in more cases of autism later as well?

On looking at the data we can see that my son as well as most other babies in much of the civilized world received, and in many cases continue to receive, large oral doses of vitamin D starting from birth.  As a baby we gave him vitamin D drops, and he also occasionally received some formula.  Starting at one year of age he consumed increasing amounts of milk (fortified with vitamin D in many countries) as well as children’s multivitamins, which also contained vitamin D.   Here is a graph showing vitamin D content of various beverages:



 
We are giving babies today much more oral vitamin D than they would consume from human milk alone and also much more than they would have consumed in past decades through formula and food sources when vitamin D fortification was more restrained.  In fact based on nutrition data and caloric intake, a baby just out of the womb consuming Similac baby formula today will receive approximately 855 IU per day of vitamin D.[13]  I am 190 pounds.  If we assume that dose should be proportional to weight, which is a good baseline assumption for most vitamins, I should consume 16,245 IU per day of vitamin D.  This is a huge dose, and based on past experience I know it would have a devastating effect on my health.  Why should it not be the same for some subset of babies?
When and where vitamin D consumption by the young is high, is where autism rates are high.  For example, in the United States autism rates are high relative to much of the rest of the world and they rose gradually starting around 1980 as much of the population transitioned to lower fat milks, which increased consumption of vitamin D.[14]  Later rates rose again in the early 1990s as the amount of vitamin D in milk was increased significantly with no change in the label.[15]  Rates continued rising with the popularization of the Sippy Cup starting in the 1995.[16]  They rose further during the 2000s as the Institute of Medicine increased the supplementation recommendations for babies in 2003 and again in 2008.[17]

When looking internationally, the evidence also points to a role for oral consumption of vitamin D in inducing autism.  Cuba for example has extraordinarily low rates of autism.[18]  The Cuban Health Service does not supply vitamin D drops to babies.  Nor do they fortify milk or other foods with vitamin D in Cuba.[19]  The Amish also have very low rates of autism as well.  They do not provide vitamin D drops to babies, and the milk they consume comes straight from cows: no vitamin D is added.[20]  In the United Kingdom rates of autism are lower than in the United States.[21]  Fortification and supplementation are common in the United Kingdom, but at somewhat lower levels than in the United States.[22]
Vitamin D is also used as a rodenticide, and experiments in rats show that it is more deadly to male rats than female rats.[23]  Is it any coincidence that autism strikes many more males than females?  Babies who get most of their sustenance from formula also receive more vitamin D than those who receive vitamin D from human milk.  Not surprisingly autism rates are higher among those who are formula fed.[24]
Vitamin D’s involvement also explains why some with autism benefit from a “casein” free diet as such diets avoid milk, which has high calcium content and is fortified with vitamin D in many countries.  It also explains why low-oxalate diets are beneficial as well as ketogenic diets.  Oxalates cause excess calcium salts to precipitate in the body and ketones effectively remove excess calcium due to acidity.[25]  Both lower the calcium load.  Oral supplementation with vitamin D also explains why some with autism have a favorable reaction to chelation.  Chelation agents remove excess calcium at the same time as they remove other metals.[26]  So they also lower the calcium load.
So the evidence suggests that over-consumption of vitamin D by babies and toddlers may induce autism in a genetically susceptible subset of the population.  This explains the biochemistry of autism as well as the nature of the autism epidemic.  There are a number of other data points that fit with this hypothesis.  If you are interested in this topic, here is an ebook with a lot more detail: http://www.amazon.com/dp/B00GVB46ES.

I want to thank Peter for allowing me to be a guest blogger here, and I also want to thank you for reading this. How do you view this hypothesis?  Do you have observations that are relevant to it?  Are you aware of existing data that would help confirm it or refute it?




[2] For more on calcium channels and autism, please see http://www.autismcalciumchannelopathy.com/Genetic_Factors.html.
[10] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3052582/ and Gross, David Ross, Animal Models in Cardiovascular Research, p. 316.
[15] FDA, M-I-92-13.

11 comments:

  1. Well written and thought provoking! Thanks for sharing this.

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  2. This hypothesis has now been written up as a paper in an open access journal and is available here: http://www.omicsgroup.org/journals/infant-exposure-to-excessive-vitamin-d-a-risk-factor-for-autism-2165-7890.1000125.pdf.

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  3. For some reason the link did not work. But a couple of comments. The Mother's Milk data for D- is not this level very low because mothers are also very low in D? When their levels increase, the breast milk level increases. We can't manufacture it. Secondly, in Cuba, it is tropical. Vit D levels in the blood seem to level off at 50 ng/l in tropical areas. This is much higher than typical N. Amer. levels. And low blood D is linked to many illnesses. See vitamindcouncil.org- there are several stories of mothers giving high D to autistic children with good results. Dr Cannell says blood levels need to get up to over 100ng, then good results start to happen. I do agree however that mg is important, and again, mg levels are also too low in general. One more point- the skin makes huge amounts of D when in the sun with UV (summer, midday) around 10000 IU in 30 min to average light skin body. Do this daily and your D levels will rise to 50ng. And note that Autism etc also trended up when the sun scare started. Sunscreen, hats, etc. probably caused low D. Now kids don't go outside much- they are on videogames. You must also consider the vaccine toxins. And mercury from white tuna for example. I read a story from a parent whose child became somewhat autistic after a year of eating white tuna for lunch every day, and the child's mercury levels were very high. Stopping the tuna reversed the symptoms. Vit D is important for detox as well I believe.

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    1. http://www.omicsgroup.org/journals/infant-exposure-to-excessive-vitamin-d-a-risk-factor-for-autism-2165-7890.1000125.pdf

      Try the link again, it works for me.

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    2. Hi RK Cannon,
      Sorry about the link. To find the paper, you can go on google scholar and type in "Bittker autism vitamin D".
      Regarding mother's milk vitamin D content I got the estimate from this study (http://www.ncbi.nlm.nih.gov/pubmed/7091022) published in 1982. My understanding is the mothers were healthy, and I don't have any reason to assume they were deficient in vitamin D. My understanding from other research is if you give the mothers massive doses of vitamin D, they will have somewhat higher vitamin D levels in their breast milk, but we are talking about a doubling or tripling of the base level with huge oral doses of vitamin D (which seems dangerous to me). So if one does this you are still comparing human milk which is spiked with vitamin D via the mother at around 100 IU per liter to Similac which has 1200 IU per liter. Similac (and cows milk) are still grossly overfortified.
      With respect to Cuba, it is indeed in the tropics but so are Hawaii and Puerto Rico. Both have autism rates that are orders of magnitude higher than Cuba's rate and Puerto Rico is significantly south of Cuba.
      With respect to low vitamin D levels there is indeed an assoication with many illnesses. Vitamin D blood levels if unmanipulated are good markers of endothelial damage and many illnesses feature endothelial damage. It does not follow that raising vitamin D levels artificially via supplementation is desireable. It seems to me raising vitamin D levels in autism may be particularly dangerous given the Th2 skew and hyperneuronal connectivity which are often present in autism.

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    3. Continued...
      With respect to stories of mothers giving vitamin D and having good results in autism, there do appear to be some stories. I also have heard stories about people giving vitamin D with autism and having terrible results including seizures, regression, and subsequent allergic reactions.
      With respect to Dr. Cannell's views on vitamin D, I do not trust them. There are studies that indicate vitamin D given early in life induces asthma, atopic dermatis, and allergy later (I cited one above). Yet nowhere in Dr. Cannell's writing on vitamin D do I see him mention such studies. He also seems to advocate very high levels of supplemenation, which I know from personal experience can be dangerous.
      With respect to the sun and vitamin D, I agree it is the appropriate and natural to get some sun exposure. However, oral supplementation with a certain goal blood level in mind seems to be misguided to me. Vitamin is a seco-steroid. Would you encourage somebody to take predisone if they seemed to have lower steroid levels than somebody else's fairly arbitrary "ideal" blood levels which are in fact above the average level of the current population? You could get half the population to supplement with prednisone, but this would be a dangerous idea. There is metabolic variability between people, and while one may feel marginally better on a steroid short term, it has all kinds of undesireable effects long term including inducing dependence. My guess is something like this maybe happening with oral supplementation with vitamin D.
      With respect to the sun hypothesis for autism, I do not find it to be persuasive. Babies in tenaments spent a lot of time in the dark during the first half of the last century. Probably much more time in the dark than most children do today. Yet it would seem the number of cases of autism were extraordinarily low in the first half of the last century. One may object that Kanner only did his paper describing autism in 1943 but that is precisely the point. Doctors in the first half of the last century were not idiots and if autism rates were anything like they are today, somebody would have noted it and there would be a huge number of older people with autism. In addition autism has risen significantly since the 1980s and Cannell among others has been pushing for people to get more sunlight since the late 1990s. We have seen no letup in the increase in autism rates despite people trying to get more sun (and increasingly supplementing with vitamin D). I suggest that autism rates seem to go up exponentially with oral consumption of vitamin D by the young, and I feel this supports the vitamin D excess hypothesis.

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  4. Not buying the vitamin D but calcium...that is an interesting direction. Calcium is notorious for being easily contaminated with lead. Almost all sources of calcium have some lead in them. The one with the least, I think, is Calcium Carbonate. Things fortified with calcium...I wounder if they are being very particular. It also might be possible that if exposed in the womb or as an infant to calcium with high lead content the body may react and inappropriately react later to calcium that has very low lead. If it is the case, they could still react to vitamin D even though it is harmless.

    And even milk that nothing has been done to could have lead. If the calcium the cows got was higher in lead the milk would be too.

    In your favor though white kids are getting autism at higher rates and they would be making more vitamin D in their skin.

    Still, the reason calcium so easily contains lead is that it has an affinity for it and eating things with calcium often helps to remove lead pulling from the body. But they are growing...the bone building could certainly put some lead in there.

    Of course there are 100 other explanations. The fact is that there was something wrong with the placenta of many of these kids. How would vitamin D cause problems their during development? Nah, it is something pregnant mothers are exposed to or something about those mothers. Overweight? Not enough iodine? Lead exposure? Fumes from cleaners, chemicals in fabrics such as flame retardants, experimentation with drugs earlier in life (perhaps even alcohol), nail polish, hair dye, antibacterial soaps, fertilizers, antidepressants, BBQ, plastic water bottles, diesel exhaust, 2-stroke engine exhaust (leaf blowers, weed whackers, mowers, edgers, chain saws, watercraft, snowmobiles, motorcycles), attached garages (fumes from arriving, departing, or cooling vehicles leaking into the house), not enough sleep, apatite suppressants, sitting too much, nicotine, caffeine (God, I hope not. You can never pull people from their coffee...but you know there has been a large increase in people buying coffee since Starbucks took off), alcohol (no safe level), second hand cigarette smoke, viruses (we know at least one definitely causes autism: rubella, but there could be more). It could also be from tire dust. If so it would be something added in the last 30 years. It could be dust from breaks, again something added in the last 30 years. It could be the replacements for freon. Superglue, well, anything new in the last 30 years. Contact lens cleaner? The new plastic lining in can goods like soup? Air fresheners/scented candles? Something given off by cheap computer power supplies?

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  5. Hi Seth Bittker, Your theory is along the same line as mine and I would like to get in touch with you. I have a group called pubmed parents on facebook, please drop me a line, thanks, from Katy

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    1. Maggy Momma,
      It would be great to speak with you about your similar theory. I wrote a bit more on this topic subsequently in the links below. My email address is included in each of these papers:
      1) http://www.hoajonline.com/autism/2054-992X/2/1
      2) http://www.omicsgroup.org/journals/infant-exposure-to-excessive-vitamin-d-a-risk-factor-for-autism-2165-7890.1000125.pdf

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    2. Very interesting article (https://www.omicsgroup.org/journals/infant-exposure-to-excessive-vitamin-d-a-risk-factor-for-autism-2165-7890.1000125.pdf)

      I found that vitamin D in our family creates increased stimming and aggression, even when supplementing a small amount. I have tried increasing my intake, only 1000-2000 IU a day and within a few days it made me irritable and short-fused. I've tried a few different dosages, all with the same result.

      I find all of this very interesting - if vitamin D is basically a regulator of VGCCs (voltage gated calcium channels) is vitamin A considered an antagonist of VGCCs, thus creating a balance between the two? Does this rationalize different reactions people have to each of these 2 vitamins? I will continue to read more, but thanks for the link - very interesting.

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  6. Look at COMT and VDR Taq and Fok sites. Environmental variables-How do toxins effect Vitamin D synthesis? Yes, the somali population is seeing a high incidence of Autism. Theories as to why....How do the somali's on average synthesize and utelize vit D compared to other races? What is happening when the refugees are migrating to America...Sunlight differences than what they are used to or something else? Possibly biologically they have less of what other races have in terms of getting vitD from sunlight because they are wearing less and over time white races evolved to have more. I don't give Vit. D as often in the summer as I do in the winters here where I live. I have noticed that my son does better when he gets Vit. D from sunlight instead of supplements. I don't know that the supplements are working all that well for him. When I give fish oil I don't give orthomolecular D3 with K2. I have however noticed that the fish oil seems to benefit more than the orthomolecular D3 with K2. I alternate though because the fish oil is potent and I don't want him getting too much and triggering seizure activity. He is VDR TaqTT. I am still learning about this and what it means for various functions in the body. The Vitamin A literature is interesting in regards to fish oil.

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