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Autism Therapy: Vitamin B6 and magnesium
========================================

definition of Vitamin B6 and magnesium: Vitamin B6, also known as
pyridoxine, is a nutrient found in fish, meat and bananas. It is an
essential vitamin, which means it can only be obtained through the
diet. Vitamin B6 is important for the health of every cell in the
body. Magnesium is an essential mineral that is needed for the health
of every cell in the body. Some parents supplement a child's diet with
a combination of vitamin B6 and magnesium as an alternative therapy
for autism.

Factsheet

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Vitamin B6 and Magnesium Therapy for Children with Autism
---------------------------------------------------------

Published Nov 6, 2009, last updated Dec 21, 2009

What is it?
-----------

Vitamin B6 (pyridoxine) is an essential vitamin that is necessary for
more than 60 biological processes in a healthy human body. The body
converts vitamin B6 into pyroxidal-5-phosphate (PLP), a compound that
is used to release energy from carbohydrates and starches, and to
break down proteins. PLP is also used in the production of important
chemicals in the brain (1).

Magnesium (Mg) is an essential mineral that is necessary for the
health of every cell in the body, including the proper functioning of
brain and muscle cells. While, magnesium deficiency is rare, some
research suggests that children with autism may have too little
magnesium (2 3).

Some parents supplement a child's diet with a combination of vitamin
B6 and magnesium as an alternative therapy for autism.

What's it like?
---------------

Vitamin B6 and magnesium supplements can be purchased online, or from
almost any grocery, drug, or health-food store (see Resources).

Vitamin B6 is found in many foods; avocados, liver, nuts, chicken,
fish, wheat germ, and bananas are good sources of the vitamin. Vitamin
B6 is often included as one of many vitamins in a multivitamin
supplement, but check with your child's pediatrician before starting a
supplement. Vitamin B6 supplements can be taken every day, but may be
difficult to give to children, since some children may find that
vitamin B6 tastes bitter in tablet or powder form. Liquid B6
supplements are also available and may be better tasting (4). Doses of
vitamin B6 in research studies varied from 0.6 mg/kg/day (about 10.8
mg/day for a 40-pound child) (3 ), to 30 mg/kg body weight/day (about
545 mg/day for a 40-pound child) (5, 6).

By comparison, the U.S. recommended daily allowance (RDA) for vitamin
B6 is 1.3 to 1.7 mg/day for adults, and 0.5 to 0.6 mg/day for children
ages 1 to 8 years old (7).

Magnesium is found in many foods, but is especially plentiful in green
vegetables, seeds, nuts, and whole grains. A supplement containing
magnesium can be taken every day, but check with your child's
pediatrician before starting a supplement. While it is not clear what
the proper dose for children with autism should be, research reports
used a dose in the range of 6 to15 mg/kg/day (or about 108 to 270 mg
total daily for a 40-pound child) (3, 8).

For comparison, the U.S. Daily Reference Intakes for magnesium is 320
to 420 mg/day for adults, and 80-130 mg/day for children ages 1 to 8
years old (7). Some parents supplement magnesium by giving their
children Epsom salt (magnesium sulfate) baths. While magnesium can be
absorbed through the skin, it is hard to say what dose of magnesium a
child is getting from an Epsom salt bath.

If you choose vitamin B6 and magnesium as an alternative therapy, ask
your child's pediatrician about the dose appropriate for your child.
Vitamin B6 can cause upset stomach when not taken with a meal, so also
ask a physician to provide a sample schedule for taking B6 and
magnesium (see Is it Harmful?).

What is the theory behind it?
-----------------------------

The enzyme that is used to break down vitamin B6 into PLP may not work
as well in children with autism (4, 9). PLP is needed for the
production of dopamine, a brain chemical that is very important for
many behaviors (1). If children with autism are not producing enough
PLP from the vitamin B6 they have in their diets, then supplementing
with extra B6 may help boost the production of PLP to more normal
levels (9).

Children with autism can have significantly lower levels of magnesium
in hair and blood than non-autistic children (2, 3, 10). There is
evidence that magnesium supplementation can have a calming effect on
some children with attention-deficit hyperactivity disorder (ADHD) (11).

Aside from the necessity of magnesium for the overall physical health
as well as the proper functioning of the brain, there is no specific
theory about how magnesium deficiency could contribute to autism. The
two supplements are often given together, as some researchers have
reported that the side effects of vitamin B6 treatment are eliminated
by magnesium (12). However, studies in which vitamin B6 was used alone
did not report any adverse side effects (8, 13).

Does it work?
-------------

There is some controversy surrounding the evidence for the
effectiveness of vitamin B6 and magnesium in autism (12). Two small
but well-controlled studies showed no effects, positive or negative,
of combined vitamin B6 and magnesium therapy (14, 15). One larger, but
less well-controlled study showed positive and significant behavioral
effects of combined vitamin B6 and magnesium, but not vitamin B6 or
magnesium alone (14).

Additional studies showed that vitamin B6 and magnesium had
significant positive effects on behavior in children with autism (3, 8,
16, 17). There were, however, major problems with the designs of these
studies. In particular, the researchers in these studies knew that the
children were receiving supplements. Therefore, their ratings of the
children's behavior could be biased. However, one of these studies did
include another small, double-blind, portion suggesting that vitamin
B6 and magnesium therapy can improve behavior in some children with
autism (16).

The difference in outcomes of the various studies could be because
vitamin B6 and magnesium results in positive behavioral effects for
about half of those who try the therapy (18). Another explanation is
that vitamin B6 and magnesium supplementation is not effective. The
better-designed studies suggest that this may be the case, although
these studies were so small, it is difficult to draw conclusions from
them (12, 18).

Is it harmful?
--------------

Vitamin B6 can cause nerve problems at high doses (in adults, over
2g/day) (19). However, studies of children with autism taking vitamin
B6 and magnesium have reported no significant side effects (4, 14).
Furthermore, in children with epilepsy who had been taking high doses
of vitamin B6 or PLP (900 mg for a 40-pound child) for six months, no
significant side effects were reported (13).

Magnesium can be toxic at doses greater than 600 mg a day. However,
studies using magnesium supplements at moderate doses (around 200 mg a
day) have not reported significant side effects (8, 11).

Check with your child's pediatrician before starting treatment.

Cost
----

A bottle of 100 multivitamin tablets containing B6 can cost anywhere
from $10 to $40, and a bottle of 100 tablets of magnesium supplements
at 250 mg per tablet can cost anywhere from $5 to $20. Prices depend
on the store and the brand of the supplement.

Magnesium and vitamin B6 can come in several forms; ask your child's
pediatrician which forms are best for your child.

Resources
---------

Healing Thresholds has partnered with Webvitamins. They have a large
selection of top quality vitamins and supplements.

Vitamin B6 and magnesium can be purchased online or in a drugstore.
They can be included in a multivitamin supplement or they can be
purchased individually. Supplements can also be found online,
sometimes at a discount.

back to top

References
----------

1. Holman, P. 1995. "Pyridoxine - Vitamin B-6." Journal of
  Australian College of Nutritional & Environmental Medicine
  14(1):5-16.

2. Strambi, M., et al. 2006. "Magnesium Profile in Autism."
  Biol.Trace Elem Res 109(2):97-104.

3. Mousain-Bosc, M., et al. 2006. "Improvement of Neurobehavioral
  Disorders in Children Supplemented with Magnesium-Vitamin B6. II.
  Pervasive Development Disorder-Autism." Magnes Res. 19(1):53-62.

4. Adams, J.B., and C. Holloway. 2004. "Pilot Study of a Moderate
  Dose Multivitamin/Mineral Supplement for Children with Autistic
  Spectrum Disorder." J Altern.Complement Med. 10(6):1033-1039.

5. Rimland, B., and S.M. Baker. 1996. "Brief Report: Alternative
  Approaches to the Development of Effective Treatments for Autism."
  J Autism Dev Disord. 26(2):237-241.

6. Hunsinger, D.M., et al. 2000. "Is There a Basis for Novel
  Pharmacotherapy of Autism?" Life Sci 67(14):1667-1682.

7. U.S.Department of Agriculture. 2009. "Food and Nutrition
  Information Center: Dietary Guidance." USDA National Agricultural
  Library.

8. Martineau, J., et al. 1985. "Vitamin B6, Magnesium, and Combined
  B6-Mg: Therapeutic Effects in Childhood Autism." Biol.Psychiatry
  20(5):467-478.

9. Adams, J.B., et al. 2006. "Abnormally High Plasma Levels of
  Vitamin B6 in Children with Autism not Taking Supplements Compared
  to Controls not Taking Supplements." J Altern.Complement Med.
  12(1):59-63.

10. Fido, A., et al. 2002. "Biological Correlates of Childhood
  Autism: Trace Elements." Trace Elem Electrolytes 19:205-208.

11. Starobrat-Hermelin, B., and T. Kozielec. 1997. "The Effects of
  Magnesium Physiological Supplementation on Hyperactivity in
  Children with Attention Deficit Hyperactivity Disorder (ADHD).
  Positive Response to Magnesium Oral Loading Test." Magnes.Res
  10(2):149-156.

12. Nye, C., and A. Brice. 2005. "Combined Vitamin B6-Magnesium
  Treatment in Autism Spectrum Disorder."
  Cochrane.Database.Syst.Rev. (4):CD003497.

13. Wang, H.S., et al. 2005. "Pyridoxal Phosphate is Better than
  Pyridoxine for Controlling Idiopathic Intractable Epilepsy."
  Arch.Dis.Child 90(5):512-515.

14. Findling, R.L., et al. 1997. "High-Dose Pyridoxine and Magnesium
  Administration in Children with Autistic Disorder: an Absence of
  Salutary Effects in a Double-Blind, Placebo-Controlled Study." J
  Autism Dev Disord. 27(4):467-478.

15. Tolbert, L., et al. 1993. "Brief Report: Lack of Response in an
  Autistic Population to a Low Dose Clinical Trial of Pyridoxine
  Plus Magnesium." J Autism Dev Disord. 23(1):193-199.

16. Lelord, G., et al. 1981. "Effects of Pyridoxine and Magnesium on
  Autistic Symptoms-Initial Observations." J Autism Dev Disord.
  11(2):219-230.

17. Rimland, B., et al. 1978. "The Effect of High Doses of Vitamin
  B6 on Autistic Children: A Double-Blind Crossover Study." Am J
  Psychiatry 135(4):472-475.

18. Pfeiffer, S.I., et al. 1995. "Efficacy of Vitamin B6 and
  Magnesium in the Treatment of Autism: A Methodology Review and
  Summary of Outcomes." J Autism Dev Disord. 25(5):481-493.

19. Schaumburg, H., et al. 1983. "Sensory Neuropathy from Pyridoxine
  Abuse. A New Megavitamin Syndrome." N.Engl.J Med. 309(8):445-448.

Showing 1 results

The Role of Vitamins and Minerals in Psychiatry

Integrative Medicine Insights, by Cornish, S., and MehlMadrona L.,
published in 2008, summarized Jun 4, 2009

Vitamin B6 and magnesium therapy may help some children with autism.

In one older study, 42% of children with autism had low levels of
vitamin B6. These results prompted doctors to try vitamin B6 therapy
for patients with autism. Parents of some children with autism
reported improvements in behavior with vitamin B6 treatment alone.
Some children also showed improvement after combined treatment with
vitamin B6 and magnesium. A recent large study (Rimland and Edelson)
of 5,780 autistic children and adults reported clinical improvement in
47% of the patients who received combined vitamin B6 and magnesium
therapy.

Vitamin B6, Magnesium, and Combined B6-Mg: Therapeutic Effects in
Childhood Autism

Biol Psychiatry, by Martineau, J., Barthelemy C., Garreau B., and
Lelord G., published in 1985, summarized Dec 12, 2008

This article describes a study showing that the behavior of children
with autism may be improved with supplementation using vitamin B6 and
magnesium together, but not vitamin B6 or magnesium alone.

The focus of this report is on 60 children with autism (3-14 years
old). Over a two-week treatment period, of these children who received
vitamin B6 and magnesium, some received vitamin B6 alone, and some
received magnesium alone. Over another two-week period, the children
received a placebo that looked and tasted like the supplement they had
received during the treatment period. The dose of vitamin B6 was 30
mg/kg/day (about 500 mg daily for a 40-pound child), and the dose of
magnesium was 10-15 mg/kg/day (about 180-270 mg daily for a 40-pound
child). Each child was observed before and after the treatment and
placebo periods, and behavior was rated. The observers did not know
which kind of supplement the child was taking. Brain waves were
recorded before and after treatment to determine whether each
treatment affected the way the brain responded to sounds. The results
showed that significant improvements in behavior resulted only from
the combined vitamin B6 and magnesium treatment. This was also the
only treatment that showed positive effects on brain wave patterns.

Combined Vitamin B6-Magnesium Treatment in Autism Spectrum Disorder

Cochrane Database Syst Rev., by Nye, C., and Brice A., published in
2005, summarized Nov 15, 2006

This paper concludes that there is not enough information available to
determine whether vitamin B6 and magnesium supplementation can
effectively improve the behavior of children with autism.

This article reviews research on the effectiveness of vitamin B6 and
magnesium treatment for autism. Some researchers have reported
improvements in the behavior of children with autism that seem to
result from treatment with vitamin B6 and magnesium. The purpose of
this article is to take a critical eye to the research showing that
vitamin B6 and magnesium help improve the behavior of children with
autism. As a result, the authors have very high standards for the
types of studies they analyzed. They found only two studies published
between 1861 and 2002 were up to the level of these standards (Tolbert
et al. 1993, Findling et al. 1997). Both studies had very small
numbers of participants (10 in one study, 15 in the other). The study
with 15 participants (Tolbert et al. 1993) used doses of vitamin B6
that were lower than in previous studies (200 mg/70 kg body weight per
day or about 52 mg for a 40-pound child). This study showed no effect
of vitamin B6 and magnesium on behavior. The lack of effect, however,
could be due to the low dosage used in the study. In the study with 10
participants, a higher dose of vitamin B6 was used (30 mg/kg body
weight per day or about 545 mg for a 40-pound child, Findling et al.
1997). The authors of that study concluded that vitamin B6 and
magnesium resulted in no significant improvements in behavior. The
authors of this review examined the results of this 10-person study
carefully and found that vitamin B6 and magnesium did result in some
significant improvement in behavior. Findling and colleagues (authors
of the research) did not report this result in the study. Therefore,
the authors of this review questioned the analysis and reporting of
the authors of that study.

Efficacy of Vitamin B6 and Magnesium in the Treatment of Autism: A
Methodology Review and Summary of Outcomes

J Autism Dev Disord., by Pfeiffer, SI, Norton J., Nelson L., and Shott
S., published in 1995, summarized Oct 21, 2006

This article provides a systematic overview of the research testing
whether the behavior of children with autism can be improved by high
doses of vitamin B6 and magnesium. The authors conclude that while
some children may be helped by the treatment, more well-controlled
studies must be done.

This article reports on a thorough search of the research studies on
B6 and magnesium supplementation as an alternative therapy for autism.
The authors find twelve studies published before 1995, most of which
suggested that B6 and magnesium can help improve the behavior of about
half of children who have been diagnosed with autism. The authors
note, however, that there are several problems with the designs of
these studies. These problems include: not measuring long-term effects
of supplementation, using only small numbers of children in each
study, and not defining precise behavioral outcome measures.

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