Woody McGinnis talk -
Fatty-Acid Primer for Autistic ChildrenFatty-Acid Primer for
Dr. Woody McGinnis
Providing the right amounts and proportions of needed nutritional oils can be
very important to children with autism or other behavioral disorders. Irene
(Vicky) Colquhoun, an English lay0erson with a severely hyperactive grandson,
discovered over twenty years ago that hyperactive children tended to have
physical signs of fatty-acid deficiency as well as abnormal behavior. She also
determined that both their physical symptoms and behavior improved, often
dramatically, with addition of certain oils to the diet. We now know the same is
true in autistic children.
Basic Fatty-Acid Science
Fatty acids are exceedingly important to the function of cells, including nerve
cells. Fatty acids are the primary building blocks for the cell membrane and the
precursors for important chemical messengers called prostaglandins, which
directly influence resistance to infection, allergic response and permeability
of the intestinal membranes. Fatty acids named EPA DHA and GLA are particularly
important. The average American diet provides only small quantities of these
particular fatty acids, so the body must manufacture them from precursor fa5ts
like corn oil or flax seed oil. In behavioral children the chemical co-factors
needed for this manufacturing process – Zinc, Magnesium, Vitamin B6 low toxin
levels – are often suboptimal, so just giving the precursor oils may not be
enough to boost EPA, DHA, and GLA sufficiently. Further, the dietary intake of
essential fatty acids may need to be higher in autistic children because of
their tendency to malabsorb fats.
Understanding the Supplements
Regular fish oil is used to supplement EPA and DHA, and evening primrose oil to
supplement GLA. Fish oil must be certifiably-free of contaminants such as
mercury or PCB’s , and neither oil in acceptable if rancid to taste or smell.
Refrigerated storage is best for these relatively fragile oils, which are prone
to oxidation. To improve tolerance of these oils, it is desirable to quiet
excess oxidative stress in the body by giving Vitamin C and Vitamin E for at
least a few days before initiating the oils and on an ongoing basis thereafter.
Cod liver oil and other fish liver oils are excellent sources of Vitamin A and
Vitamin D, and also contain some EPA and DHA. Due to dosing limits on the amount
of Vitamin A and D which can be given via these fish liver oils, regular fish
oil is often needed in addition to fish liver oil in order to deliver enough EPA
Many autistic children benefit from both fish oil (EPA, DHA) and evening
primrose oil (GLA) in combination, but some children only need one or the other.
Physical signs and symptoms, laboratory measurement of red blood cell membrane
fatty acid levels and clinical response all help decide which oil(s) to select
and how much to give. Generally, allergic symptoms (hay fever, asthma, eczema,
food allergies) suggest potential benefit from more EPA. Dry hair, dry skin and
phrynodermia (“chicken-skin” on back of upper arms or front of thighs) also
suggest low EPA/DHA.
Frequent infections, leaky gut, growth delay or phyrroluria suggest the need for
more GLA from evening primrose oil. DHA, the building block for nerve and retina
cells, is found along with EPA in all commercially available fish oils. Children
with low or lowish DHA levels definitely can benefit from extra DHA. However, in
some persons clinically in need of EPA for allergy, DHA levels may be
unexpectedly elevated, in which case use of one of the fish oils with a higher
EPA to DHA ratio may be warranted.
Red-blood cell membrane fatty acid levels appear to most useful, and several
laboratories perform this analysis. Levels take 3-4 months to re-equilibrate
after oils have been newly introduced or dosages changed. The need for
supplemental oils may change with other changes in the nutritional program,
general health, size or age, so periodic re-testing can be most useful.
Clinically, it is found that when it comes to key parameters (EPA, DHA, GLA
levels), low-normal laboratory measurements should usually be treated as dietary
deficiencies, to assure really robust status of these nutrients. Clinical
presentation and individual response may outweigh actual laboratory numbers in
judgments about giving oils. Some overlap exists in structural and functional
roles of these fatty acids and clinical response to the. For example, as a
rule-of-thumb, EPA should be considered the strongest anti-inflammatory fatty
acid for most purposes, but GLA can also lesson (or sometimes increase)
inflammation by different mechanisms.
Therapy with fish oil and /or evening primrose oil is approached without
screening laboratory study by some clinicians. Children with significant
allergies should probably be started with fish oil, once Vitamin C and E are
on-board, working up to a dose of 200-500 mg. EPA daily. (Higher EPA should be
avoided if any bleeding or excessive bruising tendencies exist.) In the allergic
child, once allergic symptoms are improved with EPA from fish oil, evening
primrose oil may be initiated at starting doses of 50-100 mg GLA daily, up to
several hundred mg as tolerated. If allergies flare unacceptably, GLA may need
to be reduced, at least temporarily. Infrequently, excessive evening primrose
oil will potentiate hyperactivity, so only lower daily doses of 50-100 mg of GLA
may be tolerated initially. Because the beneficial effect on gut and immune
function can be great, tolerance for more GLA should be tested periodically.
Tolerances for fish oil also vary individually and over time.
Children without a predominance of allergic symptoms may receive evening
primrose oil first (once Vitamins C and E are on-board), and then fish oil.
Occasionally, children will tolerate combined administration of balancing doses
of EPA and GLA better than one-at-a-time introduction. As with administration of
all the nutrients, careful observation for physical and behavioral effects,
manipulation of single variables to assess tolerance, and good record keeping
give best results. These oils should not be heated, but the evening primrose oil
in particular is relatively bland in taste, and can be folded into cool or
cooling foods, or in the youngest or most reluctant children, even rubbed onto
the skin for partial absorption.
What to Expect
Behavioral or physical effects of these oils may be quite noticeable in some
cases within days, but generally take much longer to work, as cell membranes
re-build, allergies lessen, intestines stop leaking and chronic infections
subside. In autism, fish oil and evening primrose oil really are two of our
strongest nutritional tools, and once rationally initiated, should only be
discontinued for cause. A large number of autistic children have already
benefited from fatty-acid supplementation, which may prove applicable to older
individuals in the future.
Submitted by Karen from the autismandenzymes