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Should I give my child with autism tetrahydrobiopterin?

Theresa Lyons 08/01/2017
Another comorbidity common in those with autism is the metabolic disorder related to tetrahydrobiopterin. If your child has tetrahydrobiopterin deficiency treating it has been shown to improve autism symptoms. In this week's Ask Dr. Lyons I answer the question "Should I give my child with autism tetrahydrobiopterin?"

Healing autism involves healing comorbidities

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 tetrahydrobiopterin.


Tetrahydrobiopterin is abbreviated BH4 and is involved in:
  • Breakdown of phenylalanine…tyrosine…dopamine...
  • Production of monoamine neurotransmitters
  • Production of nitric oxide
  • Necessary hydrogen-providing cofactor for tryptophan to become 5-HTP…serotonin… melatonin…

Indications of Need

Many with autism who are deficient in BH4 experience:
  • High levels of phenylalanine
  • Low neurotransmitter levels
    • Lack of muscle tone
    • Overproduction of salvia/difficulty swallowing
    • Loss of coordination
    • Abnormal movements/spasms
    • Delayed motor development
  • Failure to thrive

BH4 and Autism

Cerebrospinal fluid of those with autism show low levels of BH4. Which could lead to low levels of CNS BH4 thus low levels of CNS neurotransmitters.

Over the years there have been numerous clinical trials studying BH4 in the autism population. A recent study in 2013, looked at 46 children, 3-7 years of age diagnosed with ASD who were randomly assigned to double-blind treatment with 20 mg/kg/day BH4 or placebo for 16 weeks. A quote from the researchers “These results indicate that BH4 offers promise in reducing symptoms of ASD.” The symptoms that BH4 treatment helped were social awareness, autism mannerisms, hyperactivity, and inappropriate speech.

Tetrahydrobiopterin Treatment

Disorders of tetrahydrobiopterin deficiency can be classified as transient, mild or severe and treatment depends on severity. Treatment can include neurotransmitter precursors or even Biomarin’s Kuvan is FDA approved to reduce blood levels of phenylalanine. There are many supplements that can increase or decrease availability of BH4 but it is important to be guided by a skilled health care practitioner when treating the comorbidity involving tetrahydrobiopterin. This is a very specific comorbidity and you will waste time trying to hack it yourself.

Tetrahydrobiopterin & Diet

Can’t get BH4 from diet. Our body makes it. AND certain bacterial strains make it too!! 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. It's the best place to start.

If you prefer to learn by watching then just click play on the video...

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