HEALTH

Researchers discover how low vitamin D levels are linked to Autism Spectrum Disorder

BY Michael Johnsen

OAKLAND, Calif. — A study released Wednesday by Rhonda Patrick and Bruce Ames of Children’s Hospital Oakland Research Institute demonstrated the impact that vitamin D may have on social behavior associated with Autism Spectrum Disorder. 

Patrick and Ames show that serotonin, oxytocin and vasopressin, three brain hormones that affect social behavior, are all activated by vitamin D hormone. Autism, which is characterized by abnormal social behavior, has previously been linked to low levels of serotonin in the brain and to low vitamin D levels, but no mechanism has linked the two until now. 

In this study, Patrick and Ames show that vitamin D hormone activates the gene that makes the enzyme tryptophan hydroxylase 2 (TPH2), which converts the essential amino acid tryptophan, to serotonin in the brain. This suggests that adequate levels of vitamin D may be required to produce serotonin in the brain where it shapes the structure and wiring of the brain, acts as a neurotransmitter and affects social behavior. They also found evidence that the gene that makes the enzyme tryptophan hydroxylase 1 (TPH1) is inhibited by vitamin D hormone, which subsequently halts the production of serotonin in the gut and other tissues, where when found in excess, it promotes inflammation.

This mechanism explains many of the known, but previously not understood facts about autism including: 1) the "serotonin anomaly" low levels of serotonin in the brain and high levels in the blood of autistic children; 2) the preponderance of male over female autistic children: estrogen, a similar steroid hormone, also can boost the brain levels of serotonin in girls; 3) the presence of autoimmune antibodies to the fetal brain in the mothers of autistic children: vitamin D regulates the production of regulatory T-cells via repression of TPH1. The Patrick/Ames mechanism is relevant to the prevention of autism, and likely its treatment, the researchers concluded.

The study suggests dietary intervention with vitamin D, tryptophan and omega-3 fatty acids would boost brain serotonin concentrations and help prevent and possibly ameliorate some of the symptoms associated with ASD without side effects. There is little vitamin D present in food, and fortification is still inadequate as is the amount in most multivitamin and prenatal supplements. In addition, vitamin D levels should be routinely measured in everyone and should become a standard procedure in prenatal care.

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FDA advisory committees turn down Primatene HFA application for OTC status

BY Michael Johnsen

SILVER SPRING, Md. — A pair of Food and Drug Administration advisory committees on Tuesday voted against the over-the-counter sale of Armstrong Pharmaceuticals’ Primatene HFA, an epinephrine inhalation aerosol indicated for the temporary relief of mild symptoms of intermittent asthma for people ages 12 years or older.

Panelists at the joint meeting of the Nonprescription Drugs Advisory Committee and the Pulmonary-Allergy Drugs Advisory Committee voted 18 against and six in favor of bringing what amounts to Primatene Mist — a one-time $100 million brand — back to store shelves. 

A small majority (14-10) advised that the Primatene HFA inhaler was efficacious, but safety was an issue. The two panels voted 17-7 against its safety for OTC use. 

The most common adverse events that occurred more frequently in more than 3% of patients were tremor, throat irritation, cough, chest discomfort and feeling jittery, according to a published report. 

“OTC … provides asthmatics access without the need for additional visits to a physician’s office or to a hospital emergency room," testified David Spangler, SVP policy and general counsel & secretary for the Consumer Healthcare Products Association. "This availability especially benefits those asthmatics whose attacks are triggered by common environmental factors when immediate use may be essential. In addition, physician-diagnosed asthmatics who do not have easy access to medical care will continue to benefit from OTC use.”

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R.YOUNG says:
Mar-06-2014 04:59 pm

I'm 54 I've been using primatine mist since it came out. It work every time 100 percent I've try all the new stuff nothing works as good as primatine mist Some body is getting paid off to keep this off the market think about all the money they are making now because u have to see a doctor. Greedy people

mjohnsen@lf.com says:
Mar-04-2014 01:16 pm

An asthmatic myself, I can totally emphasize. However, note that the FDA has yet to make a decision on this. The agency to this point has only brought the issue to their advisory committees — which consist of doctors and healthcare experts in the relative field. And while the predominant thinking on the advisory committees cautioned against the safety profile of Primatene, the FDA has not yet made a final decision. The general rule of thumb is that the FDA follows the advise of its advisory committees, but that doesn't always hold true. For example, the FDA recently approved the switch of Merck's Oxytrol for Women from prescription-only to over-the-counter. However, the FDA advisory committees had some months before that approval recommended against the switch.

J.KESSLER says:
Feb-27-2014 01:57 pm

I do NOT understand this decision by the FDA. Primatene was on the market back when generic Ventolin / Proventil were still CFA and cost less than $10.00 for those insured. When they were forced to HFA, the cost to those insured soared to over $42.00 due the delivery and Primatene was forced off the market waiting HFA. Now it is HFA and FDA won't allow it back on the OTC market? The adverse events described in the article for only 3% is identical to those described for Ventolin / Proair, etc. Also, it has been my experience that physicians will no longer simply prescribe an inhaler. They insist on prescribing an asthma controller with it, such as Advair, Symbicort, etc. that are still branded and cost a lot, all with their own side effects to consider. Something just doesn't smell right about this decision.

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Survey: 4-in-5 moms turn to OTC option to treat head lice

BY Michael Johnsen

SWIFTWATER, Pa. — A new national survey released Wednesday found that the majority of moms who have experienced head lice in their household as an adult (81%) used an OTC treatment the last time they had an infestation. Less than a third of moms (27%) chose a prescription option.

The online survey was conducted by Harris Poll on behalf of Sanofi Pasteur during back-to-school season, among more than 2,000 U.S. moms aged 25 and older. Moms define the ideal head lice treatment as one that works quickly (78%), is safe (76%) and is easy to use (74%). Approximately 67% of moms are aware of prescription treatments and 80% are aware of over-the-counter treatments. Only 32% of moms who used an OTC treatment the last time they or a member of their household had head lice say the infestation was eliminated with just one treatment; the remainder (68%) say they used two or more OTC applications to treat the infestation or report the treatment did not resolve the infestation.

The Centers for Disease Control and Prevention advises that the removal of all nits after successful treatment is not necessary and there are numerous treatment options with a range of application directions and safety profiles.

However, most moms believe that in order to get rid of an infestation you have to comb out the nits (88% of all moms and 90% of those with experience as an adult) and more than half (55% of all moms and 54% of those with experience as an adult) think that all head lice treatments require multiple applications. 

Findings also demonstrate that more than three-in-four moms (77% of all moms and 89% of those with experience as an adult) believe that they know where to find reliable information about head lice — 17% turned first to a doctor, nurse or other healthcare provider and 19% turned first to a pharmacist for treatment advice the last time they had an infestation in their household.

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