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One of the first things you might hear about regarding nutrition tools for autism, besides special diets like GF CF or SCD, is vitamin B6 (pyridoxine). Why is it one of the most studied treatments for autism? Here’s what you should know.

– B6 is a vitamin – which means, we need to eat it. We can’t make our own supply. It has various metabolic forms that our body uses, including pyridoxal-5-phosphate (P5P), another popular supplement. Among its many jobs is supporting production of neurotransmitters like dopamine and serotonin – both of which have shown altered status in persons with autism.

– There is a long pedigree for B6’s success in treating seizures; about a third of persons with autism have seizure disorders. Deficiency of this vitamin can cause seizures or other neurological symptoms.

– There is also a long pedigree for using vitamin B6 therapeutically for psychiatric disorders, like schizophrenia, along with other nutrients.

– B6 is a water soluble vitamin, which means the body doesn’t store it. Whatever is not used is excreted in urine, usually within hours. If you’ve ever noticed bright yellow urine after taking a multivitamin with extra B6 in it, you are likely seeing some of this in your toilet!

– Bernard Rimland PhD, founder of the Autism Society of America and the Autism Research Institute, pioneered the use of B vitamins in the 1960s for his own son, who was affected by autism.

– B6 has low toxicity, with a good track record of being safe to use. High doses are usually well tolerated, with any side effects resolving once it is stopped.

So should your child supplement it? Will it help autism features? As always, the best strategy is to ask an experienced and licensed health care provider to help you assess your child’s total nutrition needs. B vitamins work en suite – together – with other nutrients and with food to support brain chemistry, extract energy from food, and help nerve impulse transmission. Giving just B6 alone in a high dose – without other B vitamins, magnesium, or adequate diet – may fail to produce any results. That said, it’s one of the safest nutrients to supplement. Here’s the scoop on B6 and autism:

– Children with autism may well need higher doses of vitamin B6 than healthy typical peers, for many reasons: Picky diets that lack vitamins, gut inflammation that impedes absorption of B vitamins, or gut microbial infections that eat up B vitamins before your child can absorb them. Mitochondrial disorders (inherited or acquired) can trigger higher need for B’s too, as can an inability (inherited or acquired) to convert B6 to its active form in cells. One study noted that indeed, children with autism had high levels of B6 but low levels of its metabolically active form P5P. This would mean that dozens of enzyme actions needed to balance neurotransmitters in the brain would not function to potential.

– A number of studies testing high dose B6 have showed benefits. In a survey of 7256 parents, 49% reported symptoms of autism improved in their children with B6 and magnesium supplement.

Where to start? Begin with a high purity, high potency multivitamin and mineral supplement for your child. Reputable brands are Kirkman Labs, ProThera, Pure Encapsulations, and many others. You can browse products I choose in my practice, in the NutritionCare.net virtual dispensary (use access code MyNCFC and PW 80303 – my office zip code – to set up your own account and start browsing.)

1) Decide on the format your child can accept: Liquid, powder, capsules, or chewables.

2) Choose a product that provides the entire B group of vitamins (B1, B2, B6, niacin, folic acid or folacin, B12 as a blend of methyl and cyanocobalamin, pantothenic acid, biotin) at potencies of at least 100% of daily recommended value.  Make sure that this product also contains magnesium to at least 100 mg; more may be preferable. Some multi’s add P5P, such as Kirkman’s Spectrum Complete and Klaire Labs VitaSpectrum.

3) Let your child trial this multivitamin and mineral daily for 2 weeks, withdrawing if you note reactions or side effects.

4) Once it’s clear that your child is tolerating this well, consider adding a product that adds more P5P and magnesium, such as P5P with Magnesium from Klaire Labs or Kirkman Labs.

5) Give the additional P5P early in the day with the multi, not toward evening, as B vitamins are usually energizing and may keep kids awake if taken too late. A reasonable starting dose is 5 mg P5P for a 30 pound child; older children may benefit from 25mg P5P, which is well above usual intakes from food or ordinary supplements, but possibly beneficial for those with metabolic disorders that prevent conversion of B6 to P5P in the body.

6) Continue if you note benefits. Reported benefits include improved communication, less stereotypical behavior, less sound sensitivity, improved expressive language, improved attention, and less hyperactivity.

Caveat:  Some children become hyper and agitated when given very high doses of P5P. Start low and go slow; withdraw if you see worsening hyperactivity. Your child may do fine on a lower dose, or may benefit from B6 more after treating bowel infections for yeast and other microbes (which also use B vitamins).

B6 is a promising, easy-to-test option for any child on the autism spectrum. Get input from parents who have succeeded and from your child’s health care team. If your child is using medications, it’s especially important to check with your doctor and pharmacist about drug-nutrient interactions.