Autism spectrum disorder (ASD), a disorder characterized by social, communication, and behavioral impairments, has increased dramatically in recent years. The conventional medical paradigm defines ASD as a neurological disorder. Conventional treatments rely on behavioral therapies and psychotropic medications but have limited success and tolerability. A new paradigm is emerging that views ASD as a multisystem disorder accompanied by metabolic and mitochondrial impairments. A clinical approach to assess and treat metabolic dysfunction in ASD is reviewed here.
Here it is our aim to describe 3 metabolic impairments associated with ASD: methylation, transulfuration, and mitochondrial function. We review the pathophysiological mechanisms, assessment, and treatment of these metabolic impairments. We hope that clinicians will gain a greater awareness of, a deeper understanding of, and a confidence to navigate these complex metabolic pathways in children with ASD.