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Carnitine deficiency is a common metabolic disorder comorbid with autism. And luckily it's easily treatable. In this week's Ask Dr. Lyons I answer the question "Does my child with autism need carnitine?"
Comorbidity is defined as the simultaneous presence of two chronic diseases or conditions in a patient. It is very common for those with autism to have one or more comorbidities so when healing autism comorbidities should be healed as well. Treatments for some of the comorbidities are well known therefore there is no reason for your child to suffer with certain comorbidities. This week we are focusing on the metabolic disorder involving carnitine deficiency.
L- Carnitine is a transporter molecule aka a shuttle molecule. The inner mitochondrial membrane is where carnitine transports long-chain fats into the mitochondrial compartment. That’s important because the fats are turned into CO2, bicarbonate, water, co-factors (like NADPH), and vital adenosine triphosphate (ATP)…think of ATP as cellular energy...cerebral ATP has been shown to be low in those with autism.
Many say that anyone with an autism diagnosis should try L-carnitine supplementation but that is a conversation for you to have with your healthcare provider. Here are specific needs:
Blood carnitine deficiency
Documented methylation defects
Benefitted from methylation supplementation (melatonin, DMG, TMG, etc)
Documented mitochondrial distress
Low muscle tone, fatigue, muscle weakness
A distinct enzyme, the trimethyllysine hydroxylase (TMLHE), executes the first step of carnitine biosynthesis. Clinical associations of TMLHE mutations with increased autism riskare now established however the mechanism remains unknown. Also, fatty acid metabolism disorders occur in those with autism.
Randomized, double-blind, placebo-controlled clinical trial reported in 2012 of 34 children with autism and treatment with L-carnitine. L-carnitine therapy (50 mg/kg bodyweight/day) over 3 months significantly improved several clinical measurements of ASD severity. Significant correlations between increasing levels of serum free carnitine and several positive clinical outcomes. Individual dosing varies so discuss this with your healthcare provider.
Carnitine is important in the transportation of short chain fatty acids produced by the microbiota. Certain common antibiotics may impair carnitine-dependent processes by altering gut flora favoring certain bacteria associated with autism and by directly inhibiting carnitine transport across the gut. A deficiency in carnitine could result from imbalances in host-microbiota interactions. Those with autism are known to have abnormal microbiota…this is why special diets that focus on rebuilding the gut are so efficient in healing autism symptoms and/or comorbidities. Click play if you prefer to learn by watching a video...
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