Salud Santa Barbara FAQ’S

Find our frequently asked questions and answers here.

Quick Find

Who is Salud Santa Barbara?

Salud Santa Barbara is a fiscal sponsorship fund at the Santa Barbara Foundation supporting families in Santa Barbara county with autistic children, and supports physicians who treat these children. Santa Barbara Foundation is an established 501c(3) nonprofit organization.

What is autism?

Autism is a developmental disability where a person may have difficulties with communicating, social interaction, recognizing emotion, and/or recognizing faces.

Why is folate important in autism?

Folate is a vitamin (vitamin B9) that is used by cells of the brain to regulate genes, meaning that it is needed to turn on and off gene activity during brain development. Studies show that approximately 70% of autistic children do not have enough folate in their brain. This is because they make an antibody that prevents it from crossing from the blood to the brain via the blood-brain barrier. It is believed that this folate anemia affects brain development.

How do I know if I need folate?

Because the folate blockage across the blood-brain barrier is due to an antibody that a person makes, there is a blood test to see if that antibody is present in a person. The antibody is called the folate receptor auto-antibody (FRA). While 70% of autistic
children have this antibody, only 5-10% of the general population make it. Individuals that test positive for the antibody may need supplemental folate.

What kind of folate do I need and where can I get it?

If someone makes the FRA, then the folate they get from foods is usually not sufficient, and they may need to take a supplement. Folate comes in two forms: (1) the natural form that is present in foods, and (2) the synthetic form, called folic acid. If somebody has the FRA, they can benefit from taking the natural form of folate, and it is available as a prescription. As it is needed in medical doses (large amounts), natural folate supplements must be prescribed by a physician.

What does prescribed folate do, and does it work for everybody that is autistic with the antibody?

For children that have the FRA, clinical trials have shown that about 2/3 of them have improvement in their communication within three months when they take prescribed folate (in the form of leucovorin).

What ages are most benefited by adding folate?

The clinical trials indicate that younger children (preschool-early elementary school years) benefit more from the added folate than older children.

What are the side effects of folate and folic acid?

Since folate is a B vitamin, it is readily available in many foods. Even when it is prescribed at medical doses, there are no known side effects. Synthetic folate, or folic acid, can have an extra effect at high doses, because it interferes with natural folate when someone has more than 1/2 mg of folic acid per day.

Where else can I get folate?

Folate is a vitamin that can be oxidized by exposure to air. In its natural form it is reduced, and after a time in the air it becomes oxidized. The reduced form is called methyl-folate, and the oxidized form is called folic acid. Methyl-folate is in most foods, with higher levels in spinach, beans, nuts, seeds, and several fruits. Folic acid is added to all grain products in the US, and is the form in most multivitamins. Since our body needs the reduced form, our gut converts folic acid to methyl-folate, but it has a limit of less than 1/2 mg of folic acid per day that it can convert. If there is more folic acid, it can prevent absorption of methyl-folate in some people. 

Can I get enough folate from my food?

Most people get enough folate from their food. If the person makes the FRA, then they would need a larger amount of folate to get enough to their brain, and this amount is higher than is available in foods.

What foods contain folate?

  1. Broccoli

  2. Brussels sprouts.

  3. Leafy green vegetables, such as cabbage, kale, spring greens, and spinach.

  4. Peas.

  5. Chickpeas and kidney beans.

  6. Liver (avoid if you are pregnant).

Does folate help all autistic people?

In clinical trials, additional folate shows to be helpful for the 70% of autistic children that have the folate receptor auto-antibody (FRA), but only 2/3 of those children have shown an improvement in their communication.

Can I have a folate deficiency without autism?

Yes, 5-10% of the general population makes the FRA, so it is believed that all of them have a folate deficiency in their brain (folate anemia).

Where can I learn more?

Our website has links to some key research papers about autism and folate. You can read our summaries of them and read the papers as well. We also have pages for families and for physicians that explain this work.