Part 2: B12 for Autism Spectrum Disorder
- Sara L
- Mar 2, 2024
- 5 min read
So the data here is a little more patchy but supplementation of vitamin B12 may be beneficial for a small portion of children with ASD. Therefore a trial of the supplement may be worth considering for your child. B12 is important for brain development in children.
B12 plays an important role in a process that happens in every cell of the body called Methylation. Methylation helps the body make a lot of different chemicals such as vitamins, amino acids, brain signaling chemicals, hormones, red blood cells, antioxidants and genetic material. So as you can see it is important.
It is believed that in children with ASD methylation is not happening the way that it should be, impacting the body’s ability to make all the things listed above. This could make some of their symptoms such as depression, anxiety and sleep problems, digestive problems, problems with low energy and thinking worse.
What type of B12 is best?
The ones to look out for in the store are Hydroxocobalamin, aka Hydroxo b12 , and Adenosylcobalamin or Adeno/Adenosyl B12. These are easier for your body to absorb compared to Cyanocobalamin, which is less easy for your body to absorb.
Another type pf B12 called Methylcobalamin. It is also a great option and is thought to stay working in the body for longest and is also easy to absorb¹ making it MVP.
Whichever type you choose, read the label on the front and back to figure out what type of B12 you are buying.
Potential benefits of B12 supplementation
Dosages
A word on the Recommended Daily Allowances (RDAs) numbers. These guidelines were established by The Institute of Medicine of the national academies as well as the Food and Nutrition Board. These RDA values are based on meeting the nutrient requirements of 97 to 98% of ‘healthy individuals’ without the metabolic and nutritional complexities of ASD leading to malnutrition. The Food and Nutrition Board acknowledges that the RDAs that they recommend are not intended for individuals with specific health conditions, like ASD (Godbout Laake & Compart, 2013).
In addition, the RDAs are the amounts recommended from all sources, food and supplements. Children with ASD may be getting a lot less B12 from food compared to their neurotypical friends thanks to picky eating habits. They are going to require higher doses of supplementation compared to their neuro typical friends.
I have provided the RDA values below for reference so that you can see the dosing recommendation for ‘healthy’ individuals and compare it to the dosing recommendations for ASD that follow.
Recommended Dietary Allowances (RDAs)²
Age | Dose (mcg) |
1-3 years | 0.9 |
4-8 years | 1.2 |
9-13 years | 1.8 |
14-18 years | 2.4 |
19+ years | 2.4 |
Through my own research I've seen multivitamins on the market with B12 doses as high as 100mcg. Another source suggests for ages 4-10 years old take 25mcg per day and increasing to 50 mcg daily from age 11³. These numbers are for ‘healthy’ children in general and are not specific to ASD.
The ADHD and Autism Nutritional Supplement handbook (Godbout Laake & Compart, 2013) suggests dosages in the table below specifically for Methylcobalamin. Again these doses are much higher than what you see in the RDA table above highlighting the differing daily requirements of children with ASD compared to neurotypical children.
Age | Dose (mcg) | Total daily dose from all sources (mcg) |
2-5 years | 50-100 | 100 |
6-10 years | 100-500 | 500 |
11+ years | 500-1000 | 1000 |
Research studies have used 500mcg/day specifically for ASD⁴. though studies using 1000-2000 mcg/day also exist.
So what does this mean for dosing?
So it appears that B12 is something where the dose can be increased slowly beyond what you see in the RDA table above as no Tolerable Upper Limits exist given how safe it is. The Tolerable Upper Limit is the maximum amount of a nutrient that can be taken every day without causing harm to the body. So, even at large doses, vitamin B12 is generally considered to be safe because the body does not store excess amounts because you pee it out.
Looking specifically at the children’s brand multi vitamins on the market, I am seeing dosages anywhere from 0.9 mcg all the way to 100mcg per dose showing you the wide range available and how different the dosages are between brands.
How to start B12 dosing
When starting your child on B12 I would start with the half dose of whatever is the lowest dose of the Methylcobalamin, or your chosen form of B12, that you are using. Using a liquid form is going to be best for this as you only draw up the syringe what you need. Use the table from The ADHD and Autism Nutritional Supplement handbook (Godbout Laake & Compart, 2013) for guidance.
You may find yourself having to start higher than the lower ranges in the table above, as the B12 supplement may not exist in the smaller dosages listed in the table. Using a liquid form will allow you to draw up only what you need in a syringe.
If you choose a multivitamin you will get doses lower than 500mcg per dose, but you're also getting other vitamins and minerals which you may or may not want.
As always discuss supplement dosing with your child’s healthcare provider before starting and when increasing the dose so they can guide and monitor your child.
Toxicity and side effects
B12 is considered relatively safe because the body does not store high amounts meaning that it doesn't build up to high enough levels to cause toxic problems.
But high doses may cause these side effects
Headache
Nausea and vomiting
Diarrhea
Fatigue or weakness
Tingling sensation in hands and feet
Medications your child may be taking that B12 interacts with:
Stomach acid blockers like omeprazole (Prilosec) lansoprazole (Prevacid)
Histamine 2-receptor antagonists, such as cimetidine (Tagamet) and ranitidine (Zantac). These two medications will decrease the amount of B12 that the stomach is able to absorb.
Metformin. This is used to treat high blood sugar and reduces the amount of B12 that the body is able to absorb.
People who should avoid B12:
People with allergies to B12 or Cobalt.
In the PDF here that I have attached, I have provided a Cheat Sheet for Moms with a summary of B12's characteristics discussed above, as well as a ‘cut the dotted line’ section for when it comes time to shop for B12 with steps and recommendations to keep in mind when purchasing including checking for third party testing to ensure that what you are buying is high quality.
This site is for general informational purposes only and does not constitute the giving of medical advice. The contents do not constitute the practice of medicine, nursing, or other professional health care services. No provider–patient relationship is formed. Please consult with your child's healthcare provider when considering supplementation for children.
Godbout Laake, D. & Compart, P. J. MD (2013) The ADHD and Autism Nutritional Supplement Handbook. Fair Winds Press. To purchase on Amazon click here.
Comments