Our previous article focused on the role of the immune system in the development of autism. Recently, it has been revealed that folinic acid can help with autism. Folinic acid is a highly active form of folate. It is even more bioavailable than methylfolate.
Folate is an essential B-vitamin, involved in methylation reactions and for generating glutathione antioxidants. Methylation is involved in the expression of DNA. Folate deficiency during pregnancy can be detrimental and lead to neural tube defects.
Folate Receptor Autoantibodies
Recent research has found that 76% of autistic children produce an antibody to folate receptors. This is in comparison to it being found in 29% of healthy controls.[i]
Antibodies are tags that the body produces to mark things as foreign invaders. If the body is producing these autoantibodies against its own folate receptors, folate is unable to bind to the proper channels to get transported to the brain, where it is needed.
Folate receptor autoantibodies (FRAAs) are classified under 2 different subtypes. Blocking type FRAA impedes the binding of folate to folate receptor whereas binding type FRAA actually binds to the folate receptor and prevents folate from binding to the folate receptor.
Folinic Acid Treatment for Autism
A study involving 93 autistic children[ii] with both blocking and binding types of Folate Receptor Autoantibodies treated with 2mg/kg of folinic acid daily up to 50mg/day found significant improvements in verbal and expressive language compared to untreated controls. Older children tended to be less responsive than younger children unless they were FRA negative. Side effects were minimal. 1 child developed insomnia and GI issues. 3 children taking risperidone for aggressive behavior showed worsening aggression while taking folinic acid.
Researchers have tied the development of these antibodies to exposure to certain proteins that look like the folate receptor found in the human brain. Interestingly, cows produce a folate binding protein in their milk that looks a lot like the human folate receptor in the brain[iii]. It is possible that exposing allergy-prone children to bovine folate binding protein could cause them to develop antibodies against folate receptor. Milk free diets have been found to reduce the production of folate receptor autoantibodies[iv]. Cow milk causes the greatest production of folate receptor autoantibodies and goat milk the leastiii.
Autism due to folate deficiency is also called cerebral folate deficiency and is usually diagnosed using a blood test for Folate Receptor Autoantibodies. Folinic acid/leucovorin is the preferred treatment and starting a milk-free diet can be helpful.
[i] https://onlinelibrary.wiley.com/doi/10.1002/aur.1934
[ii] https://www.nature.com/articles/mp2011175
[iii] https://pmc.ncbi.nlm.nih.gov/articles/PMC8398778/
[iv] https://onlinelibrary.wiley.com/doi/full/10.1111/j.1469-8749.2008.02053.x
About the Author:
Dr. Do co-founded DrFormulas in 2010 with his wife and partner. They completed medical school together. Their experience with the healthcare system and common medical problems has given them insight into the human body and most common medical problems. In addressing these problems, they take an integrative and holistic approach that is not bound by traditional medicine. Their focus is immunology, diet, and exercise and their goal is to maximize your health and well-being using all the tools and resources available to you.