This resource expands on what's known about herbal remedies, nutritional supplements, some brand-name "natural" remedies or supplements, and a few over-the-counter medications that you may hear about in connection with autistic spectrum disorders (ASDs). Because medications have not been proven to cure or reliably treat all cases and symptoms of autistic spectrum disorders, many people are interested in alternative medicine. We cannot recommend any of the possibilities listed here, but we encourage you to explore those that interest you in concert with your physician, a nutritionist, or other appropriate health professional.

As with medications, doses are specific to the individual, so you will want to consult a knowledgeable health professional. Books like The Herbal PDR are also helpful.

This appendix doesn't list homeopathic remedies--if you are interested in trying homeopathy, it's best to see a qualified homeopathic practitioner who can help you create a holistic treatment program. It also doesn't list many Asian or Ayurvedic remedies, simply because so little is known about these in the U.S. and Europe at this time. Much information on Chinese herbs can be found at http://www.rmhiherbal.org/ai/articles.html, and you can find a brief list of common Ayurvedic remedies, including a number of nervines, at http://www.niam.com/mediplnt.htm.

The information included here was gathered from a wide variety of sources, including standard herbal references, European studies of standardized herbal extracts, clinical data from the U.S. National Institutes of Health's alternative medicine project, the Autism Research Institute's reports on survey results, clinical trials of vitamins and some other substances and, in some cases, anecdotal reports from health care practitioners and parents. Because few of these remedies have undergone the intense scientific scrutiny given pharmaceuticals, there is less information available about possible side effects and interactions.

Aloe vera gel

Use: GI tract problems, ulcers

Action, if known: Nervine, anti-inflammatory (steroidal),: hormonal, antioxidant, laxative, and other effects. The active ingredient in aloe vera, allantoin, is also found in cabbage juice and comfrey.

Side effects: Nausea

Interaction hazards: None known

Tips: Has a bitter taste, so you may want to dilute it with water or juice.

Alpha tocopherol: see Vitamin E

Ascorbic acid: see Vitamin C

Aloe vera gel

Use: GI tract problems, ulcers

Action, if known: Aloe vera has nervine, anti-inflammatory (steroidal), hormonal, antioxidant, laxative, and other effects. The active ingredient in aloe vera, allantoin, is also found in cabbage juice and comfrey.

Side effects: Nausea may occur.

Interaction hazards: None known.

Tips: Aloe vera has a bitter taste, so you may want to dilute it with water or juice.

Aspirin, acetylsalicylic acid

Use: Pain, headache.

Action, if known: Aspirin thins the blood, makes compounds called lipoxygenase products, and is classified as a nonsteroidal anti-inflammatory drug (NSAID). It blocks enzymes called COX-1 and COX-2 (cyclooxygenase 1 and cyclooxygenase 2). COX-2 may damage nerve cells, is involved in the process of inflammation and fever, and is also believed to cause cancer and tumors to start growing.

Side effects: Aspirin thins the blood, and can cause internal bleeding or GI tract irritation if overused.

Interaction hazards: Aspirin is a "hidden" ingredient in many prescription and OTC remedies. Some foods and herbal remedies also contain aspirin-like salicytates. Too much aspirin can cause sudden drops in blood pressure; counteract the effects of buprobenecid, sulfinpyrazone, ACE inhibitors, beta-blockers, and diuretics; and strengthen the action of methotrexate, propoxyphene hydrochloride (Darvon) and some other narcotics, and Depakote or Depakene.

Tips: Children should not take aspirin due to the risk of Reye's syndrome, a rare complication of chicken pox or influenza B. Do not take aspirin if you have (or are at high risk for) stomach ulcers.

Beta carotene

Use: Improving energy metabolism, fighting the physical effects of stress, supporting liver function, protecting skin from the sun, supporting the immune system.

Action, if known: This fat-soluble antioxidant protects the lipid (fat) layer of cells.

Side effects: Too much beta carotene can give your skin an orangey color.

Interaction hazards: This vtamin is counteracted by mineral oil supplements, and may interact with nicotine or tobacco products. Although beta carotene is made into vitamin A by the body, it doesn't seem to carry a risk for hypervitaminosis like vitamin A.

Tips: It's best to eat your dark green leafy vegetables and yellow-orange vegetables rather than taking beta carotene supplements.

Bifidobacterium bifidum: see Probiotics

Biotin

Use: Biotin is used to improve the balance of intestinal bacteria.

Action, if known: Normally, biotin is produced by the symbiotic bacteria that live in the digestive tract. It lowers blood sugar, and may help to alleviate depression.

Side effects: None known.

Interaction hazards: Biotin is counteracted by raw egg whites and alcohol. It may change your dose requirements for insulin and diabetes medications.

Tips: If you are taking acidopholous or other supplements to maintain a healthy bacterial balance in the GI tract, you should not need to supplement with biotin. You may want to use it if you are taking antibiotics, however. You should take biotin if you are deficient in magnesium.

Bitter melon (Momordica charantia, karela)

Use: Viral infection, stomach ache, colitis, diabetes, high blood pressure. The green leaves and unripe fruit are used.

Action, if known: Bitter melon is the plant from which the active ingredient in some protease inhibitors is extracted. It has antioxident, antiviral, and antibiotic properties. It may also lower blood sugar and have a beneficial effect on the GI tract.

Side effects: Avoid this herb if you have low blood sugar.

Interaction hazards: This herb could addd to the action of medications for diabetes.

Tips: Bitter melon is considered a delicacy in Asia and can often be found in the produce section of Oriental food markets. It is also available canned. It is not known what effect processing may have on its medicinal qualities, however. It is not safe for pregnant women, according to some herbalists, because it may have tumor-dissolving capacities that could also endanger the fetus.

Black cohosh, Cimicifuga racemosa, squaw root

Use: Autoimmune disorders, especially rheumatism; Sydenham's chorea; nerve- related tinnitus; sore throat. The rhizome and root are used.

Action, if known: Black cohosh has central nervous system depressant, sedative, and anti-inflammatory qualities.

Side effects: The active ingredient in black cohosh appears to bind to estrogen receptor sites, so it may cause hormonal activity.

Interaction hazards: Do not use this herb with alcohol or other CNS depressants, or with drugs that are not recommended for use with CNS depressants.

Tips: Some multiherb remedies used for seizure disorders contain black cohosh.

Caffeine

Use: Pain relief, especially with aspirin; energizing effect.

Action, if known: Caffeine stimulates the central nervous system.

Side effects: Jitteriness, excess stomach acid, increased heart rate, or insomnia may occur. In extreme overdose, caffeine can actually kill.

Interaction hazards: Caffeine may counteract calcium and magnesium. It strengthens some asthma drugs and aspirin. Its action on aspirin can cause sudden drops in blood pressure, counteract the effects of probenecid, sulfinpyrazone, ACE inhibitors, beta-blockers, and diuretics; or strengthen the action of methotrexate, Depakote, or Depakene.

Tips: The use of OTC stimulants containing caffeine (such as No-Doz) can cause moodswings in people with diagnosed or undiagnosed bipolar disorder.

Calcium

Use: Preventing bone loss.

Action, if known: This mineral regulates nervous system impulses and neurotransmitter production, coagulates blood, builds and repairs bone, and activates the production of some enzymes and hormones. Many people with autism have lower than normal calcium levels.

Side effects: Excessive levels of calcium (hypocalcinuria) can result in stupor.

Interaction hazards: Calcium may be counteracted by corticosteroids, antispasmodics, thyroid hormone supplements, spinach and other green leafy vegetables, cocoa, soybeans, phosphates (including soda pop), caffeine, and phytic acid (found in bran and whole grains). It interacts with antacids, and its action may be strengthened by iron.

Tips: You must have enough vitamin D in the diet or by supplement to utilize calcium. It is best taken with a light meal or snack.

calcium ascorbate: see Vitamin C

calcium pangamate: see DMG

Caprylic acid

Use: GI tract problems, inclusing overgrowth of Candida yeast.

Action, if known: This long-chain fatty acid has antifungal properties.

Side effects: Some people report unpleasant "die-off" reactions when taking caprylic acid to combat intestinal yeast infections. Nausea or heache may occur.

Interaction hazards: None known.

Tips: Avoid caprylic acid if you have GI tract inflammation. Medium chain triglycerides (MCT oil, also called caprylic/capric triglycerides) is a liquid source of caprylic acid. Caprylic acid also occurs naturally in coconuts. It is absorbed quickly, so try a time-release or coated version for best results. Take it with food.

Carnitine (L-Carnitine, Carnitor)

Use: Heart trouble, muscle weakness. It is also taken to remedy inborn deficiency or to counteract depletion of carnitine from medications or diet.

Action, if known: A short-chain carboxylic acid, it transports fats from foods to the mitochondria of cells, which turn them into energy.

Side effects: Nausea, abdominal cramping and diarrhea may occur. Some people report increased body odor when taking L-carnitine.

Interaction hazards: Depakote and Depakene can deplete your body's supply of carnitine, as does the ketogenic diet.

Tips: You need an adequate supply of vitamin B6 to make your own carnitine from meat and dairy products. Some people may have an inborn carnitine deficiency, which can be discovered through testing. Carnitor is the best-known prescription carnitine supplement.

Carnitor: see Carnitine

Cat's claw (uncaria tomentosa, una de gato)

Use: Viral infection, diabetes, lupus and other autoimmune disorders, asthma, ulcers, irritable bowel syndrome and related disorders.

Action, if known: This herb has antioxidant, antibiotic, and antiviral qualities. It contains four oxindol alkaloids that appear to boost the immune system's ability to destroy foreign cells and to increase the production of white blood cells and other immune-system components. It may lower blood pressure.

Side effects: None known.

Interaction hazards: None known.

Tips: Cat's claw appears to have powerful effects, and should be used with caution. It is not recommended for use by transplant patients, pregnant women, or people with autoimmune disorders. Note: the traditional Mexican remedy of the same name is from a completely different plant.

Chamomile (Matricaria recutita)

Use: Insomnia or sleep disorders, nausea, irritable bowel syndrome.

Action, if known: This sedative herb contains volatile oils with antiseizure and anti-inflammatory effects.

Side effects: It can cause allergic reaction in people who are sensitive to daisies or ragweed.

Interaction hazards: None known.

Tips: Chamomile is safe enough for occasional use by children. It may be taken in capsule form or in the traditional chamomile tea.

Choline (phosphatidyl choline)

Use: Tourette's syndrome, bipolar disorder, Alzheimer's disease, tardive dyskensia, memory loss, sleepiness, irritability, insomnia, poor muscle coordination, learning difficulties, liver problems (including alcohol-induced cirrhosis).

Action, if known: Choline helps in the manufacture of cell membranes. It also assists production of the neurotransmitter acetylcholine, which controls the parasympathetic nervous system (including the GI tract), and also has effects within the brain. It promotes metabolism of fats, and reduces the level of "bad" cholesterol.

Side effects: In high doses, nausea, gas, excessive sweating or salivation, or fishy body odor may occur.

Interaction hazards: Phenobarbital and methotrexate may counteract choline.

Tips: Choline is one of the active ingredients in lecithin. Normally, your body should produce enough on its own. It is also found in eggs, soybeans, cabbage, and many other foods.

Cobalamin: see Vitamin B12

Coenzyme Q10, CoQ10, ubiquinone

Use: Immune disorders, including HIV/AIDS; GI tract problems, including gastric ulcers; gum disease; cancer.

Action, if known: CoQ10 is an antioxidant, and is believed to boost the immune system. It is part of the cellular process that uses fats, sugars, and amino acids to produce the energy molecule ATP.

Side effects: Sleeplessness, rashes, nausea, and abdominal pain have been reported.

Interaction hazards: This drug may interact with warfarin and insulin. Its effects may be weakened by drugs for diabetes or cholesterol reduction.

Tips: If you have liver problems or take medications that affect the liver, use CoQ10 only under medical supervision.

CoQ10: see Coenzyme Q10

dimethylglycine: see DMG

DMG, dimethylglycine, calcium pangamate

Use: Autistic spectrum disorders, communication disorders, heart and liver problems, high cholesterol, diabetes.

Action, if known: DMG appears to boost the immune system, possibly by increasing the number of natural killer (NK) cells and white blood cells. It also helps metabolize fats, and has minor antioxidant properties. It reduces lactate levels in muscle tissue, and increases the level of oxygen in the brain. It may help reduce the number or severity of seizures in some people. It has been shown in several studies to precipitate or increase speech in nonverbal or communication-disordered children.

Side effects: Increased hyperactivity may occur.

Interaction hazards: None known, although one report indicates that it could interfere with sulfation via Epsom salts.

Tips: DMG is usually found in the body-building/athletics area of a grocery or health food store. The sublingual tablets taste lemony, and dissolve readily under the tongue.

Echinacea

Use: Viral or bacterial infection, epilepsy.

Action, if known: This antibiotic and antiseptic herb may alsso have antiseizure qualities. It dilates blood vessels, increases the production of saliva and mucus, and activates white blood cells.

Side effects: None known, although it should not be used on a long-term basis.

Interaction hazards: Echinacea could strengthen or interfere with the action of medications that dilate the blood vessels or antiseizure drugs.

Tips: This herb is not recommended for use by people with autoimmune conditions. Some doctors also tell people with AIDS or tuberculosis to avoid it because it may affect T-cell function, although it may also have retrovirus-fighting abilities. It is often mixed with goldenseal in herbal remedies for cold and flu.

EFAs: see Essential fatty acids

Efalex

Use: Brand-name EFA supplement made by Efamol Nutriceuticals Inc. for people with developmental dyspraxia, ADD/ADHD, and related conditions.

Action, if known: See descriptions of essential fatty acids and other Efalex ingredients elsewhere in this appendix.

Side effects: Increased hyperactivity and agitation may occur . See listing for Essential fatty acids.

Interaction hazards: See listing for Essential fatty acids.

Tips: Efalex contains a mixture of fish oil, evening primrose oil, thyme oil, and vitamin E. Contact Efamol (http://www.efamol.com) for more information.

Efamol

Use: Brand-name EFA supplement made by Efamol Nutriceuticals Inc. for people with PMS.

Action, if known: See descriptions of Essential fatty acids and other Efamol ingredients elsewhere in this appendix.

Side effects: Increased hyperactivity and agitation may occur . See listing for Essential fatty acids.

Interaction hazards: See listing for Essential fatty acids.

Tips: Efamol combines evening primrose oil; vitamins B6, C, and E; niacin, zinc, and magnesium.

Epsom salts, magnesium sulfate

Use: Hydrated magnesium sulfate-the traditional Epsom salts bath-is an excellent remedy for sore, aching muscles and backache. Taken internally, it is a potent laxative. Some people with ASDs appear to have positive behavioral effects from Epsom salts baths, including reduced hyperactivity, agitation, and aggression; and increased ability to concentrate.

Action, if known: Magnesium sulfate in water is said to "draw out" inflammatory compounds. Epsom salts are sometimes given intravenously in a hospital emergency room to reduce dangerous seizures, especially in eclampsia (a seizure disorder that emerges in pregnancy). It stands to reason that they may have gentler antiseizure effects when taken in other ways.

Side effects: If taken internally, Epsom salts can cause nausea and diarrhea.

Interaction hazards: None known.

Tips: Do not take Epsom salts internally except under medical supervision.

Essential fatty acids

Use: Inflammation, autoimmune conditions of the nervous system, eczema, high blood pressure, hyperactivity, irritable bowel syndrome, arthritis, mood swings. One EFA, gammalinolenic acid (GLA) is available from evening primrose oil, black current seed oil, and other sources. Oil from certain cold-water fish, such as salmon and cod, contains eicospentaenoic acid (EPA) and docosahexaenoic acid (DHA). This is also called Omega-6 fish oil. Lauric acid, another EFA, is found in breast milk, coconuts, and a few other places. Its glycol ester (monolaurin or lauricidin) is available in supplement form.

Action, if known: Normally, linoleic acid is converted to gammalinolenic acid by enzymes, creating hormones and hormone-like substances called prostaglandins. These prostaglandins are involved in regulating the immune system, nervous system, and circulatory system. Lauric acid is known to have antibacterial and antiviral qualities.

Side effects: Evening primrose oil may lower the threshold for frontal-lobe seizures. EPA fish oil can cause fluctuations in blood sugar, so diabetics should use it with caution. Both EPA and DHA (and, to a lesser extent, GLA) thin the blood, and may increase your risk of bleeding or bruising easily.

Interaction hazards: The arachnoidic acid in evening primrose oil may counteract the effects of some antiseizure drugs, while EPA fish oil could counteract or add to the effects of medications for high or low blood pressure, or drugs that treat heart conditions.

Tips: EFAs are available as gelatin caps or liquids; of course, EPA fish oil can also be obtained by eating cold-water fish.

Essiac tea

Use: Cancer, autoimmune disorders.

Action, if known: There are a number of concoctions available under the name "Essiac tea." The original version contained sheep sorrel and burdock root, as well as slippery elm bark and turkey rhubarb root. These plants contain lots of vitamins and are said to have anti-inflammatory, astringent, vasodilating, antibiotic, antibacterial, antiviral, and mildly laxative effects. Slippery elm is especially good for assisting the GI tract's mucous membranes.

Side effects: Diarrhea, stomach pain, nausea.

Interaction hazards: None known, although sheep sorrel and burdock root are both fairly strong herbs.

Tips: Diabetics and people with a history of kidney stones should not use this tea. You can find some noncommercial information about Essiac tea at http://essiac-info.org/, including cautions about poor-quality (and even dangerous) products using the "essiac" name. It's best taken on an empty stomach. Do not exceed the recommended dose.

Evening primrose oil (see also "Essential Fatty Acids")

Use: PMS, high blood pressure, autoimmune disorders, tardive dyskinesia, eczema.

Action, if known: Evening primrose oil contains linoleic acid and gamma linolinic acid (GLA), which the body converts to prostaglandin-1. This hormone-like compound increases blood flow, thins the blood, and combats inflammation.

Side effects: Headache or nausea are sometimes reported.

Interaction hazards: None known.

Tips: Evening primrose oil and other GLA-containing products are not recommended for people with temporal lobe epilepsy. Adequate amounts of vitamin C, B6, niacin, magnesium, and zinc are needed with GLA to make prostaglandin-1.

Eye-Q (IQ)

Use: Support for eye and brain function.

Action, if known: Eye-Q (sold as IQ in Canada) is a brand-name EFA supplement made by Equazen. It contains fish body oil, evening primrose oil, and vitamin E.

Side effects: Loose stools are sometimes reported.

Interaction hazards: None known.

Tips: At press time, Eye-Q was being clinically tested for beneficial effects on children with ASDs, dyslexia, dyspraxia, and other neurodevelopmental disorders. For more information, contact Equazen (http://www.equazen.com/).

Feverfew

Use: Migraine, nausea, depression.

Action, if known: One compound found in feverfew, parthenolide, is a serotonin inhibitor. This compound also inhibits leukotrienes and serum proteases.

Side effects: Feverfew is irritating to the mouth if chewed.

Interaction hazards: None known, although it could be counteracted by medications that affect serotonin.

Tips: Use only standardized feverfew extract, as the amount of parthenolide varies widely from plant to plant.

Fish oil: see Essential fatty acids

Flax seed: see Essential fatty acids

"Flowers of sulfur": see MSM

Folic acid

Use: Depression, anemia, slow growth; needed to make B vitamins available to the body, so it's taken as part of B vitamin formulas for autistic symptoms. Also taken to counteract some of the side effects of methotrexate (Rheumatrex).

Action, if known: Folic acid is an anti-inflammatory, helps to produce white blood cells and other components of the immune system, helps to convert amino acids into proteins, and is necessary for building and rebuilding the nervous system.

Side effects: None known in proper dose.

Interaction hazards: Dilantin competes with folic acid in the GI tract and in the brain-if you take Dilantin, consult with your physician about how to get around this interaction.

Tips: Folic acid is found in green leafy vegetables, beans, asparagus, citrus fruits and juices, whole grain foods, and liver. However, many doctors (and the March of Dimes, which is campaigning against spina bifida and other birth defects linked to a lack of folic acid in the diet) do recommend taking a supplement.

Gammalinolenic acid: see Essential fatty acids

Garlic

Use: Immune disorders, high blood pressure.

Action, if known: Garlic is said to be active against yeast in the digestive tract while protecting helpful flora. It may lower blood pressure slightly.

Side effects: "Garlic breath" may occur if eaten, and it causes stomach discomfort for some.

Interaction hazards: None known.

Tips: Garlic is available as a food or a supplement. Incidentally, garlic contains high amounts of the mineral germanium (see below), as does ginseng.

Germanium

Use: Viral infection, immune disorders, cancer, inflammation, high blood pressure.

Action, if known: Germanium stimulates the body to produce its own interferon, lowers blood pressure (probably by dilating blood vessels), inhibits enzymes that reduce endorphin levels, and has anti-inflammatory properties.

Side effects: Soft stools, sleep disturbance, and mood swings are sometimes reported.

Interaction hazards: None known, although it could interfere with medications for high or low blood pressure.

Tips: Germanium supplements should not be used on a long-term basis, as it can adversely affect the kidneys. Make sure you buy the sesqui-oxide form of germanium, or get your germanium from food sources or other herbs.

Gingko biloba

Use: Forgetfulness, dementia, depression, Reynaud's disease, tinnitus.

Action, if known: An antioxidant, Gingko biloba increases blood flow to the brain, and increases the uptake of oxygen, glucose, and neurotransmitters by neuronal cells.

Side effects: Stomach or intestinal upset, headache, or allergic skin reactions may occur.

Interaction hazards: This herb interacts with aspirin, ibuprofin, and blood-thinning drugs. Avoid using it if you take celecoxib, diclofenac, diflunisal, ketorolac, warfarin, or similar medications.

Tips: Look for Gingko biloba from reputable manufacturers, in a standardized dose.

Grapeseed oil: see Proanthocyanidins

Hap Caps: see NutriVene-D

Inosital

Use: OCD, depression, panic disorder, degenerative and autoimmune disorders of the nervous system (including diabetic neuropathy), liver disease.

Action, if known: Required by the neurotransmitters serotonin and acetylcholine, inositol helps the nerves conduct impulses correctly, possibly by rebuilding the myelin sheath. May also have sedative effects in high doses.

Side effects: None known.

Interaction hazards: Caffeine counteracts inositol.

Tips: Inositol is one of the active ingredients in lecithin. People with ASDs who test positive for anti-myelin antibodies in the blood might want to try inositol.

Lactobacillus acidophilus, Lactobacillus bulgaricus: see probiotics

Lauricidin: see Essential Fatty Acids

Lecitin, phosphatidyl choline

Use: Tourette's syndrome, bipolar disorder, Alzheimer's disease, tardive dyskensia, memory loss, sleepiness, irritability, insomnia, poor muscle coordination, learning difficulties, liver problems (including alcohol-induced cirrhosis), OCD, depression, panic disorder, degenerative and autoimmune disorders of the nervous system, seizure disorders.

Action, if known: See listings for inositol and choline.

Side effects: None known.

Interaction hazards: Caffeine counteracts the inositol in lecithin.

Tips: A phospholipid found mostly in high-fat foods, lecithin is available in capsules or granules. One of the tastiest ways to take it is by blending the granules into a fresh-fruit smoothie. Lecithin is not a cure for any neurological disorder, but both anecdotal reports and recent studies indicate that it may help in some cases.

Licorice, Glycyrrhiza glabra

Use: Asthma, coughs, GI tract disorders.

Action, if known: Boosts hormone production, including secretin and other hormones active in the GI tract and brain.

Side effects: None known.

Interaction hazards: None known.

Tips: Medicinal-quality licorice is a lot stronger than the sweet, licorice-flavored candy familiar to the American palate. Children may not like the taste: gel caps, powdered licorice root capsules, or licorice tea might be better tolerated.

linoleic acid: see Essential Fatty Acids

Magnesium

Use: Insomnia, heart problems, muscle pain, high blood pressure. If you are supplementing with B6, you will need to add magnesium as well.

Action, if known: Magnesium lowers blood pressure, and helps regulate nerve impulses and neurotransmitter production.

Side effects: This mineral blocks calcium channels. It also dilates blood vessels, reducing blood pressure.

Interaction hazards: Fatty foods may interfere with the metabolism of magnesium. Talk to your doctor about taking magnesium if you take pharmaceutical calcium channel blockers.

Tips: Magnesium is part of the ARI's recommendations for autistic symptoms.

Ma Huang: see Ephedra

Melatonin

Use: Insomnia, seasonal affective disorder (SAD), mood swings, regulatory disorders, anxiety, depression.

Action, if known: Melatonin is a hormone made by the pineal gland, which regulates the body's sleep/wake cycles. It is also believed to be important to the immune system and to other parts of the endocrine system, particularly for women.

Side effects: None known, although if too large a dose is taken, you may still be tired in the morning.

Interaction hazards: None known in normal doses.

Tips: Detailed information about the use of melatonin by people with autism is available at http://www.autism.org/melatonin.html.

methyl-sulphonyl-methane: see MSM

Monolaurin: see Essential Fatty Acids

MSB Plus: see NutriVene-D

MSM, metyl-suphonyl-methane, sulfur

Use: Diabetes, joint pain, high cholesterol, dysentery/GI tract dysfunction, yeast infections. Some people with ASDs appear to have a metabolic error in how they process sulfur. These individuals may need to supplement with sulfur or a related compound.

Action, if known: MSM is involved in converting fats into energy; collagen production; activating and producing enzymes that aid in digestion and in protecting the mucus lining of the GI tract; and reducing blood sugar, cholesterol, and blood pressure.

Side effects: Some people are very allergic to sulfur. Others are somewhat sensitive, and may experience sulfurous intestinal gas or burping.

Interaction hazards: None known.

Tips: Sulfur is also found in egg yolks, asparagus, garlic, onions, meat, and beans. Epsom salts baths are another option.

N-Acetyl-Cysteine (NAC)

Use: Seizure disorders, heavy metal poisoning, aspirin or acetaminophen poisoning, viral infection, epilepsy, diabetes, movement disorders, degenerative neurological disorders, including multiple sclerosis.

Action, if known: This antioxidant amino acid increases synthesis of glutathione. It appears to have chelating effects that help remove toxic heavy metals from the body. NAC is the acetylated version of the sulfur amino acid, l-Cysteine. In the body, it turns into l-Cysteine, which in turn is a precursor to glutathione.

Side effects: Nausea, dry mouth, dizziness, and headache have been reported.

Interaction hazards: NAC may interfere with the absorption of magnesium and zinc. Interactions witgh a variety of drugs have been reported, particularly metoclopramide, and nitroglycerin. Talk to your doctor before using NAC.

Tips: A report on the latest studies on NAC and neurological disorders can be found at http://neuro-www.mgh.harvard.edu/neurowebforum/MovementDisordersArticles/NAcetylCysteineReport.html. This report indicates that encouraging results have been found, although NAC tends to only arrest the progression of these disorders rather than causing improvement.

Niacin: see Vitamin B3

NutriVene-D

Use: Developed as a nutritional supplement for people with Down's syndrome. Contains A, B, C and other vitamins, inosital, a variety of minerals and amino acids, essential fatty acids, and other ingredients. A "night time" formula is also available that contains L-Tryptophan and other amino acids associated with normalizing sleep patterns.

Action, if known: NutriVene-D has antioxidant action, and is based on known and possible metabolic defects resulting from this chromosomal abnormality.

Side effects: See the complete list of NutriVene-D ingredients at http://www.nutrivene.com/, and then see side effects for each component.

Interaction hazards: NutriVene-D should be taken under a doctor's supervision.

Tips: Take with non-protein food or shortly after a meal.

Pepcid AC, famotidine

Use: GI tract problems, particularly acid reflux disease ("heartburn"); used to treat social deficits in children with autism with some success in one study at the St. Luke's-Roosevelt Hospital Center in New York City (Linda A. Linday, MD, et al., "Oral famotidine: A potential treatment for children with autism," Medical Hypotheses 48, no. 5 [May 1997]: 381-6).

Action, if known: Pepcid AC blocks histamine-2 (H2) receptors, which should reduce inhibitory signals to the brain.

Side effects: Diarrhea may occur. Pepcid AC can mask the pain of serious GI problems.

Interaction hazards: Antacids interact with a number of medications, and H2 blockers in particular have a number of known interactions with other drugs. Consult your pharmacist before using Pepcid.

Tips: : Tagamet and Zantac are two other H2 blockers. They may or may not have similar effectiveness for ASD symptoms in some people.

phosphatidyl choline: see Choline

Proanthocyanidins

Use: Proanthocyanidins are the active ingredients in several naturally occurring antioxidant compounds. The best-known of these, grapeseed oil, is just what its name indicates. Pycogenol is a brand-name formulation derived from maritime pine bark. Both have been tried by people with PDDs and other neurological disorders, sometimes with beneficial effects for seizure control, reduced aggression, and improved immune-system function.

Action, if known: Strong antioxidant activity.

Side effects: Loose stools, increased hyperactivity and/or aggression in some.

Interaction hazards: None known.

Tips: Pycogenol tends to be more expensive than other proanthocyanidins, as it is a trademarked product.

Probiotics

Use: Digestive problems, chronic constipation or diarrhea, irritable bowel syndrome and related disorders, yeast infection, autoimmune disorders.

Action, if known: Probiotics are "friendly" bacteria that flourish in the intestine to help with digestion, or substances that protect these bacteria from depredation by antibiotics or other forces.

Side effects: None known.

Interaction hazards: None known.

Tips: Lactobacillus acidophilus, Bifidobacterium bifidum, and Lactobacillus bulgaricus are friendly bacteria more familiar to most of us as the "active cultures" found in some yogurts. Yogurt itself is a good probiotic for those who eat dairy products.

Pycogenol: see Proanthocyanidins

Pyridoxine: see Vitamin B6

Retinol: see Vitamin A

Riboflavin: see Vitamin B2

Sarsaparilla

Use: GI tract disorders, asthma, psoriasis.

Action, if known: Sarsaparilla appears to have steroid-like action against inflammation.

Side effects: Stomach irritation is sometimes reported

Interaction hazards: Sarsparilla interacts with digitalis and bismuth (th active ingredient in Pepto-Bismol and similar indigestion remedies).

Tips: Several different plants are known as "sarsaparilla," all with a similar, slightly spicy, taste and similar actions. Like licorice, sarsaparilla seems to affect hormone production as well as settling the stomach and calming the nerves.

Selenium

Use: GI tract disorders; increased sperm production; selenium deficiency (Keshan disease), which occurs in some people with celiac disease and other autoimmune disorders.

Action, if known: The cooperation of vitamin E and selenium produces the vital antioxidant peptide enzyme selenium-glutathione-peroxidase. Appears to help stimulate the production of antibodies, and may stimulate synthesis of protein.

Side effects: Rash, nausea, fatigue, brittle teeth and hair may occur. Muscle, vision, and heart problems have been observed in animals getting too much selenium, and could occur in humans as well.

Interaction hazards: None known.

Tips: Selenium supplements are a must for people who are fed intravenously or tube- fed. If you or your child experiences GI tract problems, you may want to use a supplement of this mineral, preferably in its easily absorbed chelated form (L-selenomethionane). You can also get it in the diet. It is plentiful in fish, shellfish, red meat, grains, eggs, chicken, liver, garlic, brewer's yeast and wheat germ. Only 50 to 200 micrograms of selenium is needed daily.

SPV-30

Use: Viral or bacterial infection, including HIV/AIDS; immune disorders; tuberculosis; inflammation.

Action, if known: SPV-30 is a reverse transcriptinase inhibitor with antiviral, antibiotic, and steroidal anti-inflammatory activity.

Side effects: Stomach cramping, skin rash, and diarrhea have been reported. If cramps occur, drink more water. Some people taking SPV-30 in AIDS studies noted that taking it earlier in the day rather than after dinner prevents a possible side effect of insomnia.

Interaction hazards: None known, but it could interact with other antivirals.

Tips: SPV-30 is derived from active ingredients found in the European boxwood tree (Buxus sempervirens). It has shown some promise as an antiviral in AIDS medication trials.

St. John's wort (Hypericum perfortum)

Use: : Depression, anxiety.

Action, if known: There are at least ten active ingredients in St. John's wort that have some neurological activity. Its exact method of action is not yet known, but clinical studies indicate it is an effective treatment for mild to moderate depression.

Side effects: Increased sensitivity to light may occur. St. John's wort may cause mood swings or mania in people with diagnosed or undiagnosed bipolar disorder.

Interaction hazards: This drug may interfere with the action of protease inhibitors used to treat AIDS. Follow the restrictions in diet and medication indicated for pharmaceutical MAOI and SSRI antidepressants.

Tips: Hypericin, an extract that separates out one active ingredient from St. John's wort, may or may not be as effective as the whole herb.

Sulfur: see MSM

Super Nu-Thera

Use: Autistic spectrum disorders.

Action, if known: This multivitamin supplement has been crafted to the specifications of the Autism Research Institute. It contains vitamin B6, magnesium, and other nutrients.

Side effects: Increased agaitation and hyperactivity are sometimes reported. If numbness or tingling occurs in hands or feet, reduce dose or discontinue use.

Interaction hazards: None known.

Tips: This product is available in liquid, powder, and capsule form. There is more than one formulation: contact Kirkman Labs (http://www.kirkmanlabs.com) for more information.

Thiamin: see Vitamin B1

Tryptophan (L-tryptophan, 5-HTP)

Use: Depression, especially with agitation; insomnia; irritability; anxiety; chronic pain.

Action, if known: Tryptophan is aprecursor for increased brain levels of serotonin and for the body's production of niacin. The 5-HTP version is also said to contribute to the production of melatonin.

Side effects: Reduced appetite may occur.

Interaction hazards: None known, although one should be cautious about using this amino acid with any drug known to have an effect on serotonin, such as an antidepressant.

Tips: Tryptophan is not recommended for people with autoimmune disorders or asthma, or for pregnant women. It is not available in US. 5-HTP, a plant-derived type of tryptophan, is available in the US, however, and L-Tryptophan can be purchased via mail order. Tryptophan can also be obtained by eating pineapple, turkey, chicken, yogurt, bananas, or unripened cheese, preferably with a starch.

Tyrosine (L-Tyrosine)

Use: Anxiety, depression, fatigue, thyroid disorders, allergies, headaches, chronic pain; also used as an aid to drug and alcohol withdrawal.

Action, if known: Tyrosine is an amino acid precursor to epinephrine, norepinephrine, and dopamine. The body normally synthesizes tyrosine from phenylalanine.

Side effects: None known.

Interaction hazards: Do not take tyrosine with an MAOI antidepressant.

Tips: Take tyrosine on an empty stomach.

ubiquinone: see Coenzyme Q10

Vitamin A (retinol)

Use: Viral or bacterial infection, GI tract disorders.

Action, if known: An antioxidant, it helps maintain the mucus lining of the intestines.

Side effects: Vitamin A can be deadly in doses of more than 25,000 units per day. Overdose indicators include headache, blurred vision, chapped lips, dry skin, rash, joint aches and pain, and abdominal tenderness.

Interaction hazards: None known.

Tips: People with celiac disease have a hard time getting enough A, and often experience a deficiency of this vitamin.

Vitamin B (thiamin)

Use: Wernicke's syndrome, Korsakoff's psychosis (often seen as a complication of alcoholism), peripheral neuropathy, cardiac disorders. Thiamin levels are sometimes low in autistic people.

Action, if known: Vitamin B is needed for the production of acetylcholine and nucleic acids. It is part of the process of impulse initiation in neuronal membranes.

Side effects: None known

Interaction hazards: None known.

Tips: In the diet, thiamin is found in lean pork, legumes, and yeast. However, thiamin in foods is destroyed by cooking.

Vitamin B2 (riboflavin)

Use: Hormonal disorders, jaundice in newborns, depression, inflammation, inborn metabolic disorders.

Action, if known: It takes part in the conversion of tryptophan to serotonin, and in the synthesis of your body's own anti-inflammatory substances, the corticosteroids.

Side effects: None known.

Interaction hazards: Chlorpromazine, imipramine, and amitriptyline inhibit riboflavin, as may some other antidepressants.

Tips: Dietary sources for riboflavin include milk, eggs, ice cream, liver, some lean meats, and green vegetables. In the US and some other countries, breads and other baked goods made with white flour are routinely enriched with riboflavin. If you follow a vegetarian or gluten-free and/or casein-free diet, you probably should add B2 to your diet a matter of course.

Vitamin B3 (niacin, nicotinic acid)

Use: Autistic symptoms, schizophrenia, high cholesterol, deficiency (pellegra).

Action, if known: Vitamin B3 helps red blood cells carry oxygen, and is believed to reduce inflammation. It helps build tissue, including nerve tissue, raises blood sugar, and relaxes blood vessels. It's needed for fatty acid and corticosteroid synthesis.

Side effects: Flushing (red face) may occur, produced by a sudden release of prostaglandins and histamine. Skin rash or agitation are sometimes reported. Hypouricemia and liver problems are rarely seen, but possible.

Interaction hazards: Vitamin B3 may strengthen the action of some antiseizure drugs.

Tips: Choose "no-flush" (buffered) niacin if flushing bothers you. People with diabetes, gout, or ulcers should not take niacin-although nicotinamide, a closely related enzyme, is under investigation as a treatment for diabetes.

Vitamin B5, pantothenic acid

Use: Depression, insomnia, heart problems, fatigue, problems of the peripheral nervous system.

Action, if known: B5 is needed for metabolism of carbohydrates, proteins, and lipids; synthesis of lipids, neurotransmitters, steroid hormones, porphyrins, and hemoglobin. It is also necessary for normal antibody production.

Side effects: Diarrhea, agitation, or hyperactivity may occur.

Interaction hazards: None known.

Tips: Foods that are high in B5 include organ meats, lobster, poultry, soybeans, lentils, split peas, yogurt, avocado, mushrooms, and sweet potato-however, heat destroys pantothenic acid.

Vitamin B6, pyridoxine

Use: Seizure disorders.

Action, if known: B6 is needed for metabolism of amino acids, protein, essential fatty acids, stored starches, neurotransmitters, and glycogen. It also influences the production of neurotransmitters, particularly norepinephrine, dopamine, and serotonin. It binds to steroid hormone receptors, may regulate steroid hormone action, and may influence the immune system.

Side effects: Agitation and hyperactivity are sometimes reported. If you choose to supplement with more than 50 mg of B6 per day, as the ARI recommends, do so under a doctor's supervision. If you feel a tingling sensation in your hands or feet, stop taking B6 and contact your doctor.

Interaction hazards: Many medications counteract B6-talk to your doctor before supplementing with this vitamin.

Tips: B6 must be given with magnesium, and preferably with other B vitamins, as it increases the metabolism of riboflavin. Food sources include poultry, fish, pork, bananas, and whole grains.

Vitamin B12, cobalamin

Use: Depression, anemia; demyelination of spinal cord; demyelination of brain, optic, and peripheral nerves; ADD/ADHD

Action, if known: Vitamin B12 helps build the myelin sheath around nerve fibers. It is needed for amino acid and fatty acid metabolism.

Side effects: Agitation or hyperactivity may occur.

Interaction hazards: None known.

Tips: B12 can be deficient in people who are not making a normal amount of digestive enzymes, such as those with GI tract disorders. People with ASDs who test positive for auto-antibodies to myelin protein should definitely supplement with B12. Vegetarians and others may want to do so as well, as B12 is found only in meat, eggs, and dairy products. Spirulina, blue-green algae, and some other "vegetarian" B12 supplements contain a form of B12 that cannot be absorbed by humans.

"Vitamin B15": see DMG

Vitamin C, ascorbic acid

Use: Deficiency (scurvy), gum disease, fatigue, degenerative disorders, immune disorders. Vitamin C has shown benefits for some people with autism.

Action, if known: This antioxidant is necessary for synthesis of neurotransmitters, steroid hormones, and carnitine. It converts cholesterol to bile acids, and helps with metabolism of tyrosine and metal ions. It may enhance the bioavailability of iron.

Side effects: Nausea, abdominal cramps, or diarrhea may occur.

Interaction hazards: It strengthens the action of iron.

Tips: Do not start using megadoses of C and then suddenly stop. Research indicates should vitamin C should be accompanied by vitamin E. The acidic nature of ascorbic acid can also contribute to kidney stones: the buffered form, calcium ascorbate, is more easily tolerated. Food sources include citrus fruits, berries, melons, tomatoes, potatoes, green peppers, and leafy green vegetables. Vitamin C is easily destroyed by heat and prolonged storage.

Vitamin E, alpha tocopherol

Use: Immune disorders, heart disease, neurological disorders.

Action, if known: This fat-soluble antioxidant is believed to be important for proper immune-system function. It influences signal transduction pathways and thins the blood.

Side effects: Thins the blood.

Interaction hazards: Do not take vitamin E with anticoagulant drugs, or if you have a vitamin K deficiency.

Tips: People who take antipsychotics, atypical antipsychotics, tricyclic antidepressants, or other medications that carry a known risk for tardive dyskensia may want to supplement them with vitamin E. It appears to have protective and symptom-reduction qualities regarding this movement disorder. Vegetables and seed oils, including soybean, safflower, and corn oil sunflower seeds, nuts, whole grains, and wheat germ are all good sources for vitamin E.

Zinc

Use: Viral infection, common colds.

Action, if known: Antiviral action has been proposed, as has the possibility that zinc boosts production of natural interferon.

Side effects: Nausea may occur.

Interaction hazards: Citric acid (as found in orange juice-or even in some commercial zinc lozenges for colds!) may counteract the effects of zinc. Coffee and tea should not be taken at the same time as zinc.