Carnosine Dosage in Autism

Dear Dr. Dean To my surprise our local TV news focused on carnosine as a treatment for autism and Alzheimers. They had several parents giving testimony as to how helpful carnosine was for their autistic children. They surmised that since it can pass the brain barrier it would be helpful for dementia also. Do you have the medical references for such studies so parents would know what dosage to try (with physician approval)? Thanks M. Swanson

Dear Ms. Swanson Below is an internet-only study that used 400 mg of carnosine twice daily in autism (800 mg daily). Although this is a higher dose than VRP currently recommends it may be that VRP may need to consider increasing the recommended dosage. Alternatively it may indicate that higher doses of carnosine are required only in those with autism due to their disordered brain chemistry. The LD 50 of carnosine is quite high (15 gm per kilogram in mice!) so the 800 mg dose still appears to be quite safe. Ward Dean M.D. Double-Blind placebo-controlled Study of L-carnosine supplementation in children with autistic spectrum disorder Michael G. Chez M.D. Cathleen P. Buchanan Ph.D. Jamie L. Komen M.A. Marina Becker R.N. Objective: L-Carnosine is an amino acid dipeptide that may enhance frontal lobe function. We therefore sought to investigate whether L-Carnosine supplementation for children with Autistic Spectrum Disorders (ASD) results in observable objective changes in language and/or behavior in contrast to placebo. Design/Methods: Thirty-one children (21 M mean age= 7.45; range = 3.2-12.5 yrs )meeting inclusion criteria were enrolled in an 8 week blinded trial of either 400 mg BID powdered L-Carnosine or placebo. Children were assessed at a pediatric neurology clinic with the Childhood Autism Rating Scale (CARS) the Gilliam Autism Rating Scale (GARS) the Expressive and Receptive One-Word Picture Vocabulary tests (E/ROWPVT) and biweekly parental Clinical Global Impression of Change (CGI) at baseline and 8 week endpoint. Results: Children who were on placebo (n=17) did not show statistically significant changes on any of the outcome measures. After 8 weeks on L-Carnosine children (n=14) showed statistically significant improvements on the GARS total score GARS Behavior Socialization and Communication subscales and the ROWPVT (all ps<.05). EOWPVT and CARS showed trends in improvements which were supported by parental CGI. Conclusions: Oral supplementation with L-Carnosine resulted in demonstrable improvements in autistic behaviors as well as increases in language comprehension that reached statistical significance. Although the mechanism of action of the amino acid is not well understood it is believed that it acts to modulate neurotransmission and affect metal ion transfer of zinc and copper in the entorhinal cortex. This may enhance neurological function or act in a neuroprotective fashion.