A quarterly publication of the Autism Research Institute

The Autism Research Review International is quarterly publication of the Autism Research Institute

Spring, 2023 | Number 2, Volume 36

Iron deficiency may be common in children with autism

A new study from Italy suggests that many children with autism spectrum disorders (ASD) suffer from iron deficiency and/ or deficiencies of vitamin B12 or folic acid. 

Andrea De Giacomo and colleagues enrolled 167 children in their study, including 93 children with ASD and 74 children with other neurodevelopmental disorders. Their analysis showed that the ASD group had significantly lower levels of ferritin. (Ferritin is a blood protein that contains iron; the lower the ferritin level, the less iron there is in the blood.) More than half of the children with ASD exhibited hypoferritinemia, or very low ferritin levels. 

The researchers note that iron deficiency in ASD could contribute to autism due to iron’s roles in early development, cell metabolism and survival, and brain function. Alternately, they say, low iron levels could be a result of the food selectivity and sensory issues common in ASD. 

While their study focused primarily on iron, the researchers also say, “Our ASD group had significantly higher mean corpuscular volume (MCV) values compared with the [control] group.” An elevated MCV value indicates the presence of red blood cells that are abnormally large, an anomaly that may point to a deficiency of vitamin B12 or folic acid. 

The researchers conclude, “Our results may support the hypothesis of altered iron status in ASD, justifying more frequent examinations of blood iron parameters in these children.” However, they note that their study has limitations, including a small sample size and the lack of a neurotypical control group.


“Peripheral iron levels in autism spectrum disorders vs. other neurodevelopmental disorders: preliminary data,” Andrea De Giacomo, Silvia Medicamento, Chiara Pedaci, Donatella Giambersio, Orazio Valerio Giannico, Maria Giuseppina Petruzzelli, Marta Simone, Massimo Corsalini, Lucia Marzulli, and Emilia Matera, International Journal of Environmental Research and Public Health, March 28, 2022 (free online). Address: Andrea De Giacomo, School of Medicine, University of Bari “Aldo Moro,” 70124 Bari, Italy, [email protected].