Many autistic children have a deficiency of Vitamin B12, which is vital for the proper functioning of the brain and nervous system. This article examines the functions and benefits of vitamin B12.
Group B vitamins can act individually or in combination with the cellular enzymes to form vitamin B co-enzymes. These vitamin B co-enzymes are crucial to the metabolic pathways that generate the energy from carbohydrates, fat and protein, needed by every cell in the body.
Because they are co-dependent in their metabolic activities, a deficiency of one B vitamin can affect optimal functioning of organ systems throughout the body. Therefore, B vitamins are best taken in combination as vitamin B complex. However certain B vitamins like B12 and folic acid are more crucial, and these may be needed at higher doses.
Benefits of Vitamin B12
The most important role of vitamin B12 is it works synergistically with B vitamin folate in the common metabolic pathway supplying essential methyl groups for DNA, RNA and protein synthesis. This is crucial for neurons regeneration and growth in the treatment of autism. The next most important role is it maintains a healthy nervous system and it greatly improves cognitive function. Vitamin B12 other benefits are:
- It acts as a co-factor for methionine synthase, the enzyme that re-methylates homocysteine to methionine by using 5-methyltetrahydrofolate as a methyl donor. Vitamins B12 and folic acid are essential for maintaining a healthy physiological level of homocysteine in the circulation. Therefore, a deficiency of either will result in increased serum total homocysteine.
- It is necessary for the formation and regeneration of red blood cells. Because B12 converts folate to its active form, a physical or dietary deficiency of B12 can lead to anemia caused by folate deficiency. Inactive folate, due to a B12 deficiency, will slow DNA synthesis resulting in large immature red blood cells that are incapable of carrying oxygen or dividing. This is megaloblastic anemia.
- It promotes growth and therefore increases appetite in children.
- It promotes the metabolic pathways for energy release from fat and carbohydrates. This increases the energy level.
Types of Vitamin B12
Vitamin B12 is found mainly in meat products, and only in certain vegetable sources like spirulina. Therefore, vegetarians are more susceptible to a dietary deficiency of B12.
While cyanocobalamin form of vitamin B12 works well to prevent anemia, it is the methylcobalamin form that is required to maintain neurological health. Methylcobalamin is the active co-enzyme form of B12 and is the only type present in the brain and central nervous system required for transporting the vitally important methyl groups to proteins in the myelin sheath surrounding nerves.
The liver naturally converts a small amount of cyanocobalamin into methylcobalamin, but to regenerate neurons and the myelin sheath that protects axons and peripheral nerves, higher doses of methylcobalamin are necessary. Therefore, for healthy nervous system development additional methylcobalamin is advocated.
Methylcobalamin form is crucial in the treatment of autism. Higher dosages may be required and be given by injection. There is no known toxicity effect.
Importance of Methylcobalamin Vitamin B12 in Autism
Methylcobalamin B12 is commonly deficient among autistic children. Its deficient state contributes to the severity of autism, and often renders the treatment of autism rather difficult. Or, it even gives the impression of resistance to treatment. Why are autistic children “deficient” in methylcobalamin? Poor bio-availability of B12 is caused by the following:
- Picky eating habits leading to poor dietary B12 intake.
- Dysbiosis in the gut leading to poor and mal-absorption of B12. This may be associated to low intrinsic factor production.
- Neurodegenerative damage of the neurons as caused by autoimmune antibodies, neurotoxins, and heavy metals poisoning. This renders the neurons unresponsive to the standard B12 dose. Massive pharmacological dosing may be necessarily to produce any significant benefits.
- The capacity of transsulfuration, transmethylation and antioxidation are severely abnormal in autism. B12 is intricately involved in these metabolic pathways.
Conclusion
Vitamin B12, together with B1, B6 and Folic acid; calcium with magnesium; vitamins C with E, and omega 3 fatty acids, are crucial for the regeneration, growth and proper function of the brain. This is particularly relevant in the treatment of autism. Since only the methylcobalamin form the vitamin B12 is beneficial to the central nervous system, a trial of injection methylcobalamin might be justified. Vitamin B12 supplements are not well absorbed orally.
Dr. Ang Poon Liat
MBBS, M.Med (Paediatric), MRCP (UK Paediatric), FAMS, MD
Senior Consultant Pediatrician
