Ferritin as an indicator of suspected iron deficiency in children with autism spectrum disorder: prevalence of low serum ferritin concentration

Is lead a concern in Canadian autistic children?

“…Of those who had ferritin measured (40 of 48 children), one child (9%) between six and 10 years of age and two children (5%) between three and 5.9 years of age had levels below the cut-off level in keeping with the reported prevalence rates of iron deficiency for those age ranges (15)(16)(17). If one uses the cut-off for ferritin as less than 22 µg/L, then 17 of the 40 children (42.5%) may have or may be at risk for iron deficiency.…”

“…To convert µmol/L to µg/dL, multiply by 20.72; 0.483 µmol/L=10 µg/dL. The cut-off values for ferritin (less than 10.0 µg/L for children aged three to five years and less than 12 µg/L for children aged six to 11 years) were used as an indicator of iron deficiency, which is at the fifth percentile for age (National Health and Nutrition Examination Survey [NHANES]) (15,16). Because the values for low ferritin vary among centres (6 µg/L to 22 µg/L), a value of greater than 12 µg/L but less than 22 µg/L was also recorded as a range for 'at risk' of iron deficiency.…”

“…Hemoglobin (Hb) and mean corpuscular volume (MCV) were recorded as g/L and fL, respectively. The cut-off for Hb of less than 110 g/L for children aged two to four years and less than 120 g/L for children aged five to 10 years, and MCV less than 80 fL were used as measures of iron-deficient erythropoiesis (15)(16)(17). Summary statistics were reported as mean ± SD and medians with ranges.…”

“…Regular child care visits should include screening questions that identify children at risk, but more importantly, provide preventive anticipatory guidance to all parents about lead poisoning in their children (3). Most of the practice parameters for the screening and diagnosis of autism recommend lead screening be restricted to those with identifiable risk factors for excessive lead exposure, specifically those with pica (15)(16)(17). Current guidelines do not include children with autism as a group requiring special consideration in defining the child at high risk for lead intoxication, yet research has shown that oral sensory seeking and pica behaviours are prevalent and do not always diminish around four years of age as in other developmentally delayed children, making them vulnerable in environments normally considered safe for children (21)(22)(23)(24)(25)(26).…”

Pharmacobiological Treatments in Autism Spectrum Disorders

“…Among vitamins, vitamin B6 and magnesium [39], and vitamin D [40], have shown beneficial effects in few studies, while others such as vitamin A, and vitamin B12 and folic acid have been proposed as potential treatment options for ASD. Minerals such as magnesium [39], iron [41], and zinc [42], have also been recommended for nutritional therapies in ASD. However, large-scale high-quality randomized-controlled studies are required to conclusively determine if nutritional supplements are an effective therapeutic approach for ASD.…”