Tuesday, November 17, 2009

The Role of Cholesterol in Autistic Behaviors

By: William Shaw, PhD


The concept of “good” and “bad” cholesterol is a frequent topic of conversation these days. While diet plays an important role in the formation of cholesterol, the genetic factors involved with the synthesis and transport of cholesterol are what typically predispose an individual to cholesterol-related health problems. Many people are unaware that cholesterol is actually manufactured by the body’s own cells. Determining the significance of serum cholesterol values is not as simplistic as some might believe.


Discussions about cholesterol in the media are focused primarily on elevated levels in relation to cardiovascular risk; rarely taken into consideration are the risks associated with insufficient cholesterol values of 160 mg/dl or less. The truth is that low cholesterol can predispose people to violent behavior, suicide, depression, anxiety, bipolar disease, Parkinson’s disease, manganese deficiency, celiac disease, hyperthyroidism, liver disease, malabsorption, and malnutrition.


This is because cholesterol plays an important role in many physiological factors in the body. The formation of sterol hormones, cell membranes, and bile acids, would not be possible without cholesterol. In fact, the brain is the most cholesterol rich organ in the body requiring a large amount to sustain the myelin sheath which coats nerve cells and helps conduct electrical impulses. More recently, it has been discovered that cholesterol is needed to activate a gene called Sonic Hedgehog (SHH) which plays a central role in neural patterning, mood regulation, and cerebral development. This could be why individuals with cholesterol deficiency are more prone to aggressive behavior, lack of attention, increased number of infections, and motor difficulty.


It is not surprising then that a genetic condition which causes deficiency of cholesterol in the body called Smith-Lemli-Opitz syndrome (SLOS) is associated with autistic features. Doctors and researchers have known about SLOS for decades, however most autistic children are not routinely screened for cholesterol deficiency because only a small portion of the autistic population carries this gene mutation. This paradigm may change in the near future due to recent research that is showing that cholesterol deficiency is common even in the autistic population absent the SLOS gene mutation. Dr. Richard Kelly and Dr. E. Tierney at John Hopkins University involved in SLOS research investigated the incidence of cholesterol deficiency in blood samples from a group of subjects with autism spectrum disorder (ASD) from families in which more than one individual had ASD, but not SLOS. Although no sample had values consistent with SLOS, 19 samples (19%) had total cholesterol levels lower than 100 mg/dl. The researchers found that cholesterol was low, not as a result of excessive breakdown, but because of reduced production. These extremely low values are considered to be in the fifth percentile of normal children the same age. The prevalence in cholesterol deficiency was confirmed at The Great Plains Laboratory, Inc which performed cholesterol testing on 40 children diagnosed with ASD. Compared to the 19% of the Tierney study, 17.5% of those studied at The Great Plains Laboratory, Inc had extremely low values under 100mg/dL. In addition to the population which presented extremely low values, another 57.5% of the children studied had moderately low cholesterol values of less than 160 mg/dL. When the low values are combined, as many as 75% of the children studied had low cholesterol.


The children with cholesterol deficiency who were given medical grade cholesterol supplementation quickly improved. Many accounts were within days of taking cholesterol supplementation before cholesterol values had increased in the blood. This indicates that the improvements may be a result of cholesterol forming its derivatives - such as steroid hormones or bile salts. Parents reported that their children were sleeping through the night, overcoming aggressive behaviors, learning to walk, speaking and becoming more responsive to family members. Other parents reported a decrease in the rate of infections, reduced skin rashes, reduction in self-injurious behaviors, improved muscle tone, rapid growth and improved behavior overall. It was reported that one autistic adult, without speech, even spoke for the first time.


Cholesterol screening is an extremely useful tool to determine if dietary changes and cholesterol supplementation are necessary. The Advanced Cholesterol Panel performed at The Great Plains Laboratory, Inc. includes reference ranges which take into account the significance of low cholesterol and also measure important markers in cholesterol transport, Apolipoprotein A-1 (Apo A-1), Apolipoprotein B (Apo B), Apolipoprotein a (Apo a) and homocystine. The test is inexpensive and should be ordered routinely by physicians for their autistic patients. Parents of autistic children should seek testing for cholesterol deficiency without hesitation. Individuals may also take advantage of the free nutritional consultation that is available to both patients and physicians with their lab report. A pure medical grade cholesterol supplementation called “sonic cholesterol” is available with a physician prescription through New Beginnings Nutritionals for patients with cholesterol values that are below 160mg/dL.

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