Methylation & Autism: a practical approach


Methylation is one of the biochemical processes that is fundamental to life.  About a decade ago a researcher named Jill James and her collaborators published a remarkable paper that established that autism often features a methylation deficit (  Some therapies that have been tried to increase methylation include folinic acid and methylcobalamin.  While these therapies usually do not fully normalize biochemistry in autism they often bring the biochemistry closer to normal. See James’ work as well for some color on this (  In addition a number of parents including myself have noticed significant improvement with this therapy or variants of it.

Folinic acid is a form of folate that is methylated to form methylfolate in the body.  So when methylation is an issue, supplementation with methylfolate may be a more natural choice than folinic acid.  Based on my experience with my son, I feel methylfolate did in fact work better.  Many practitioners recommend methylcobalamin shots rather than oral methylcobalamin in autism.  In fact James’ studies were based on giving children shots of methylcobalamin rather than oral form.  However, methylcobalamin seems to be well-absorbed orally (  So in my opinion shots are unnecessary.  Also many of the oral formulations suggest sucking on a tablet under the tongue for best absorption.  Don’t worry if your kid just eats it.  Mine does and my experience is that plenty of it will be absorbed.  In addition you can always give marginally more orally if you feel after trying it that not enough is absorbed well in your child.
To see if your child could be a candidate for methylfolate and methylcobalamin therapy you could ask your medical practitioner about ordering an organic acid test and/or a test to analyze oxidized and reduced glutathione.  If forminoglutamic acid is high, methylmalonic acid is high, or the ratio of oxidized to reduced glutathione is high, then your child may be a good candidate for this therapy.
With my son who is about 75 pounds we use about 5 milligrams of methylcobalamin per day and 1600 micrograms of methylfolate per day.  I think this improves his communications, his eye contact, and his socialability.  Of course your child could react differently than mine.  If you do choose to try this, it probably makes sense to give these methylators in the morning as high doses of methylcobalamin can cause insomnia and in fact with much higher doses I saw this in my son.  As with most therapies it makes sense to start at a very low dose and work up if you feel the therapy is working.
If you use this therapy or some variant of it already or you try it with or without success, please feel free to comment here.


One response to “Methylation & Autism: a practical approach”

  1. Seth Bittker says :

    There is more information on methylcobalamin and folinic in autism in some interviews that I did with Dr. Robert Hendren and Dr. Richard Frye. The transcript is here:

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