Evidence supporting the use of: Folate
For the health condition: Autism

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Folate (vitamin B9) supplementation for autism spectrum disorder (ASD) is supported by a growing body of scientific literature, although the overall quality of evidence remains limited and further research is needed. The rationale for folate use in ASD stems from findings that some individuals with autism have abnormalities in folate metabolism, including the presence of autoantibodies that impair folate transport across the blood-brain barrier (cerebral folate deficiency). Several studies have reported that children with ASD and low cerebrospinal fluid (CSF) folate levels, or those who test positive for folate receptor alpha autoantibodies, may benefit from high-dose folinic acid (a form of folate) supplementation. Some clinical trials and case series have shown improvements in language, communication, and core autism symptoms with such interventions. For example, a randomized controlled trial published in 2016 found that high-dose folinic acid improved verbal communication in a subgroup of children with ASD and folate receptor autoantibodies.

Despite these promising findings, the use of folate for autism is not universally applicable to all individuals with ASD, and routine supplementation is not yet recommended for the entire autistic population. Most guidelines suggest considering folinic acid only for those with evidence of cerebral folate deficiency or folate receptor autoantibodies. Thus, folate's use in ASD is based on emerging scientific understanding of specific metabolic subtypes of autism rather than broad traditional use, and the overall evidence quality is moderate but not definitive (rated 2/5).

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