Nutrient Deficiencies
Top Reasons for Nutrient Deficiencies
Diet - this could be due to picky eating, a diet low in nutrients, or a restrictive diet (ex: a gluten-free diet followed without care)
Poor Digestion - low stomach acid, imbalance of gut bacteria, or lack of digestive enzymes can affect how well you can absorb nutrients
Malabsorption - certain medical conditions may affect your gut’s ability to absorb nutrients well. This may include Celiac disease, food reactions, candida overgrowth, dysbiosis, and leaky Gut
Certain Medications - certain medications may cause certain nutrient depletions. Speak to your doctor or Registered Dietitian if your child’s medications could be putting them at higher risk for nutrient deficiency.
Common Deficiencies in Autism
Macronutrients (carbohydrates, protein, fats)
Children with ASD and selective eating consumed significantly fewer macronutrients and fiber compared to children without ASD. [3, 4-5]
Caregivers reported 67% omitted vegetables and 27% omitted fruits [3]
Micronutrients (vitamins & minerals)
Children with autism had lower average intake of calcium, vitamin B12, vitamin E and vitamin D. [3-4]
Selective eaters were significantly more likely than typical controls to be at risk for at least one serious nutrient deficiency (P < .001). [4]
78% consumed a diet at risk for five or more inadequacies.
97% risk for vitamin D, 91% for fiber, 83% for vitamin E, and 71% for calcium [3]
Omegas
A deficiency or an insufficient intake of omega-3 fatty acids can cause abnormal development of the nervous system in childhood, resulting in loss of concentration, hyperactivity, dyslexia, and dyspraxia. [6]
See the Omega-3 note for more research.
Signs & Symptoms
Signs of nutrient deficiency will vary based on the nutrient. In general, deficiency symptoms can include:
Fatigue
Weakness
Trouble breathing or shortness of breath
Unusual food cravings
Lightheadedness
Constipation
Hair loss
Ridged or splitting nails
Skin lesions
Pica (craving of non-food items)
Testing for Nutrient Deficiencies
Nutrients can be tested both extracellularly (outside of the cell) and intracellularly (inside of the cell)
Extracellular micronutrients
Free-floating in your blood and exist outside the cells
Measured via serum
May fluctuate based on supplements or diet in the short-term
Intracellular micronutrients
Micronutrients absorbed by your white and red blood cells
Cellular nutrient absorption is an important step to maintaining and promoting optimal health in our cells
Even though a person is consuming an adequate or healthy diet or supplements, the cellular intake levels of those nutrient may not be sufficient
Can reveal functional nutrition status over a much longer time (4-6 months) than extracellular testing
Blood work typically done at a physician’s office will only test the serum (extracellular nutrients). We also want to test intracellular nutrients. Labs that do this specialized type of testing include:
Vibrant America Micronutrient Panel (bonus: includes omegas)
SpectraCell Micronutrient Panel
Genova Diagnostic Labs NutraEval
NOTE: These are specialized tests by specialized labs, and often aren’t available at the conventional doctor’s office. Validity is extremely important, so you want to be sure to use a specialty lab.
A urine panel for nutrients (such as an Organic Acids Test) is not the most accurate way to measure nutrients. The most accurate way will be via a blood sample.
DISCLAIMER: Consult your healthcare provider to help you choose the test that will be the best match for you.
Next Steps
Diet & Supplements
Diet should always be the first approach to resolve nutrient deficiencies. See each nutrient note for food sources of each respective nutrient, or each food note for the nutrient breakdown of each food
For picky eaters, picky eating should be addressed via Feeding Therapy. See the picky eating note for more guidance.
Supplements may be a great way to replenish nutrients quicker than diet alone, or especially if a child is a picky eater
You can supplement with isolated nutrients or with a multivitamin for well-rounded support
In the case of suspected poor digestion, digestive enzymes may be warranted
In the case of malabsorption, gastrointestinal issues should be addressed.
Consider if food reactions are present, which may be contributing to nutrient deficiency or malabsorption
Lifestyle
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[1] Williams BL, Hornig M, Buie T, et al. Impaired carbohydrate digestion and transport and mucosal dysbiosis in the intestines of children with autism and gastrointestinal disturbances. PLoS ONE. 2011;6(9):e24585.
[2] Nutrient Absorption by Location in the Digestive Tract. Vibrant Wellness Website. Accessed 22 April 2020.
[3] Sharp WG, Postorino V, McCracken CE, et al. Dietary Intake, Nutrient Status, and Growth Parameters in Children with Autism Spectrum Disorder and Severe Food Selectivity: An Electronic Medical Record Review. J Acad Nutr Diet. 2018;118(10):1943-1950. doi:10.1016/j.jand.2018.05.005
[4] Zimmer, M.H., et al., Food variety as a predictor of nutritional status among children with autism. Journal of Autism & Developmental Disorders, 2012. 42(4): p. 549-56.
[5] Liu X, Liu J, Xiong X, et al. Correlation between Nutrition and Symptoms: Nutritional Survey of Children with Autism Spectrum Disorder in Chongqing, China. Nutrients. 2016;8(5)
[6] Kawicka A, Regulska-Ilow B. How nutritional status, diet and dietary supplements can affect autism. A review. Rocz Panstw Zakl Hig. 2013;64(1):1-12
