Doctor Reveals: Simple Ways To Lower Autism Risk Before Pregnancy | Dr. Jeff Zadeh

His journey took a pivotal turn after his brother connected him with Dr. David Ber, a pediatrician pioneering preconception counseling that reportedly reduced autism rates in his clinic from national averages down to 1 in 400. This revelation ignited Dr. Zadeh's motivation to compile the latest and most impactful scientific findings into practical guidance for families, culminating in his book titled Autism Prevention 5 Days a Week. While Luke is a social and engaging child, fitting the diverse spectrum of autism, Dr. Zadeh emphasizes that the severity and outcomes vary widely, underscoring the importance of preventive awareness.

Rising Autism Rates

The conversation highlights the staggering rise in autism prevalence over recent decades, from roughly 1 in 150 births in 2000 to current estimates near 1 in 31 children. Though a portion of this increase is attributed to improved diagnostic criteria and awareness—particularly evident in urban centers like San Diego—the evidence strongly suggests a genuine, multifactorial uptick. Contrasting regions such as San Diego and Laredo, Texas reveal disparities in diagnosis rates primarily due to access to care rather than true underlying incidence.

Furthermore, accessing diagnostic services is profoundly challenging due to extensive waitlists and overburdened healthcare systems, leading to delayed interventions that could otherwise improve developmental outcomes. Dr. Zadeh points out that early diagnosis, ideally around two and a half years of age, enables critical therapeutic interventions like speech and occupational therapy. The delay in getting diagnosed—sometimes extending over a year—hampers the potential for children to maximize developmental gains.

Preconception Prenatal Vitamins

One of the most striking revelations from Dr. Zadeh's research is the protective role of prenatal vitamins, specifically those containing methyl folate instead of the more common folic acid. Citing a landmark Boston Birth Cohort study involving approximately 1,000 mother-child pairs over nearly 20 years, he outlines that women who began taking an adequate prenatal vitamin containing methyl folate five days a week starting before or very early in pregnancy experienced a remarkable 70% reduction in autism risk in their offspring.

This 'flagship' recommendation underscores the importance of timing—starting prenatal vitamins ideally one month before conception and certainly very early in pregnancy to capture critical neural development windows. The distinction between methyl folate and folic acid is vital, as methyl folate is the bioactive form that the body can readily use, whereas some women struggle to convert folic acid efficiently. Notably, too high levels of folic acid or vitamin B12 may attenuate benefits, leading Dr. Zadeh to propose a five-day-on, two-day-off regimen to maintain a balance and avoid potential over-supplementation.

Iron Deficiency and Autism Risk

Maintaining sufficient iron stores before and during pregnancy emerges as the second most vital recommendation. Dr. Zadeh emphasizes that approximately half of women in North America become iron deficient during pregnancy, primarily due to menstruation, dietary insufficiency, and pregnancy demands. Iron deficiency anemia during early pregnancy correlates with nearly twice the rate of intellectual disability and increased autism risk in offspring.

Although iron supplementation is a common part of prenatal care, its timing is critical. Most European studies that failed to find a protective effect typically initiated iron supplementation late in pregnancy (20–24 weeks), missing the crucial early developmental window within the first month. Dr. Zadeh particularly favors ferric bisglycinate, a chelated form of iron with superior absorption and fewer gastrointestinal side effects than older iron salts, encouraging prospective mothers to get screened through affordable blood tests like serum ferritin and to correct deficiencies promptly.

Thyroid Function and Autism

Another important but less conclusively researched area Dr. Zadeh discusses is maternal thyroid function. Approximately 3% of women of childbearing age in the U.S. have some form of hypothyroidism, often undiagnosed due to subtle symptoms like fatigue, cold intolerance, and constipation. Existing studies associate maternal hypothyroidism with increased autism risk in children, though the effects of treating thyroid dysfunction on reducing autism remain an open question.

Despite the lack of definitive evidence, Dr. Zadeh recommends that thyroid function tests be part of preconception screening, given their established importance in fetal neurodevelopment. Early recognition and management of hypothyroidism are prudent as part of a comprehensive approach to mitigating autism risk alongside other modifiable factors.

The Role of Tylenol During Pregnancy

Addressing inflammation during pregnancy, Dr. Zadeh reflects on data showing that maternal fever correlates with increased autism incidence, even fevers as mild as 99°F. However, timely treatment of fever with antipyretics such as acetaminophen (Tylenol) appears protective, bringing autism risk closer to baseline levels in mothers who experienced fever.

He acknowledges the controversy around Tylenol, with some studies implicating excessive use in elevated autism risk, while others find no such association, including sibling-controlled analyses. His balanced position advocates prudent use: treat fevers and manage pain appropriately, but avoid unnecessary or excessive medication, supporting consultation with healthcare providers to navigate these decisions responsibly.

Celiac Disease and Autism

Dr. Zadeh points out that celiac disease, affecting about 1% of the population but largely undiagnosed in three-quarters of cases, may increase autism risk if untreated during pregnancy. The auto-immune inflammation triggered by gluten in affected individuals can impair intestinal absorption of essential nutrients, compromising fetal brain development.

Research suggests that early detection through blood tests (such as transglutaminase IgA) and dietary management with a strict gluten-free diet before or early in pregnancy can mitigate these risks. While non-celiac gluten sensitivity lacks conclusive evidence linking it to autism, diagnosed celiac disease warrants attention in preconception counseling.

The Protective Potential of Fish Consumption

Omega-3 fatty acids, particularly docosahexaenoic acid (DHA), dominate the fatty acid composition of brain tissue and thus are biologically plausible protective agents in neurodevelopment. One notable study associated maternal fish consumption—not fish oil supplementation—with a 15% reduction in autism incidence, suggesting bioavailability or dietary context matters.

Although several studies found no significant benefit from fish oil capsules alone, Dr. Zadeh encourages eating low-mercury fish, primarily Alaskan-sourced species, during pregnancy to obtain natural DHA. This aligns with data supporting the inclusion of DHA in prenatal nutrients and traditional dietary wisdom found in cultures with high fish consumption.

Vitamin D Deficiency

Vitamin D deficiency during pregnancy is rampant globally, even in sunny regions, with startling studies showing less than 1% of pregnant women in Taiwan reaching sufficient vitamin D levels at early prenatal visits. Dr. Zadeh highlights recent studies demonstrating that raising maternal vitamin D levels to sufficient ranges with supplementation of 2,000 IU daily cuts preterm births by 40%, reduces preeclampsia by 60%, and lowers gestational diabetes by 50%.

Though direct links between vitamin D supplementation and autism prevention require more research, its role in improving overall pregnancy health and decreasing preterm birth—a known autism risk factor—is compelling. Dr. Zadeh advocates supplementing pregnancy vitamins with additional vitamin D beyond the current 600 IU guideline, aiming closer to 2,000 IU daily under medical supervision.

Environmental Toxins

Environmental exposures to toxins such as lead, pesticides, air pollution, phthalates, and industrial chemicals pose mounting concerns in autism risk. Studies from Canada and UC Davis provide preliminary evidence that adequate prenatal folate can buffer some of these harmful effects by aiding DNA repair mechanisms and shielding fetal brain development from toxic insults.

Dr. Zadeh emphasizes the value of adopting a low-toxic lifestyle—avoiding plastic food containers, using metal or glass bottles, minimizing the use of air fresheners, and steering clear of dry cleaning chemicals known to be neurotoxic—especially during the sensitive preconception and gestational periods. Simple actions like handwashing plastic bottles and avoiding microwaving in plastics serve as practical steps for minimizing chemical exposures.

Navigating Polarizing Autism Conversations

Throughout the interview, Dr. Zadeh stresses the importance of a balanced, compassionate dialogue surrounding autism. He acknowledges how polarized debates—ranging from the vaccine controversy to blame-centric narratives—often impede constructive discussions and the dissemination of research-backed preventive measures. His focus remains on sharing evidence-based, actionable guidance that any family can embrace without fear or judgment.

He acknowledges the beautiful diversity within the autism spectrum, including children like his son Luke who bring joy and unique human connection despite challenges. The larger message emphasizes empowerment through knowledge, early interventions, and preventive care while honoring the intrinsic value of all children, autistic or not.