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Showing posts with label Vitamin B6. Show all posts
Showing posts with label Vitamin B6. Show all posts

Wednesday, 18 March 2026

Improving the Blood–Brain Barrier and Cognitive/Mitochondrial Function in Alzheimer’s, and some Autism: Linking TNAP, GPLD1, Vitamin B6 and Exercise

 


 

Scientists Find a Mechanism for How Exercise Protects the Brain

UCSF study finds that an exercise-induced liver protein strengthens the blood-brain barrier, improving memory and slowing age-related decline.

Researchers at UC San Francisco have discovered a mechanism that could explain how exercise improves cognition by shoring up the brain’s protective barrier of blood vessels.

With age, this network of blood vessels — called the blood-brain barrier — gets leaky, letting harmful compounds enter the brain. This causes inflammation, which is associated with cognitive decline and is seen in conditions like Alzheimer’s disease.

Six years ago, the team identified a brain-rejuvenating enzyme called GPLD1 that mice produced in their livers when they exercised. But they couldn’t understand how it worked, because it can’t get into the brain.

The new study reveals that GPLD1 works through another protein called TNAP. As the mice age, the cells that form the blood-brain barrier accumulate TNAP, which makes it leaky. But when mice exercise, their livers produce GPLD1. It travels to the vessels that surround the brain and trims TNAP off the cells.

“This discovery shows just how relevant the body is for understanding how the brain declines with age,” said Saul Villeda, PhD, associate director of the UCSF Bakar Aging Research Institute.

 

Every few months Alzheimer’s research produces another “breakthrough.” Most focus narrowly on the brain — amyloid, tau, synapses.

Recent Alzheimer’s drugs, like lecanemab and donanemab represent a scientific advance, but their real-world impact remains modest. They cost about $30,000 a year, require intensive monitoring, and typically slow decline by only a few months.

A growing body of research is pointing somewhere else entirely.

Not just the brain, but the interface between the body and the brain.

At the center of this shift are three players:

  • TNAP (tissue-nonspecific alkaline phosphatase)
  • GPLD1 (an exercise-induced blood protein)
  • Vitamin B6 (PLP)

Together, they connect:

  • the blood–brain barrier (BBB)
  • neurotransmitters
  • mitochondrial function
  • inflammation

This same network appears not only in Alzheimer’s disease, but also in subsets of autism.

 

The Blood–Brain Barrier: The Overlooked Gatekeeper

The blood–brain barrier is not just a passive wall. It is an active, living system that determines what reaches the brain.

When functioning properly, it:

  • keeps out inflammatory molecules
  • regulates nutrient delivery
  • protects neurons from toxins

With age — and in many neurological conditions — this barrier begins to fail.

It becomes leaky.

This allows:

  • cytokines
  • immune cells
  • metabolic toxins

to enter the brain.

The result is chronic low-grade inflammation, one of the key drivers of cognitive decline.

 

TNAP: A Double-Edged Enzyme

TNAP sits at a critical junction.

Inside the brain:

TNAP helps regulate vitamin B6 availability, which is essential for:

  • GABA (the calming neurotransmitter, but excitatory in 30% of severere  autism)
  • dopamine
  • serotonin

Without sufficient active B6 (PLP), neurons become more excitable and unstable.

 

At the blood–brain barrier:

TNAP plays a different role.

With aging, TNAP accumulates in the BBB, where it begins to:

  • weaken barrier integrity
  • increase permeability
  • promote inflammation entering the brain

So TNAP is both

  • necessary for neurotransmitters
  • but potentially harmful in excess at the BBB

This dual role is key to understanding the system.

 

GPLD1: The Exercise Signal

Recent research from the University of California in San Francisco has identified a protein called GPLD1, released into the bloodstream during exercise.

Its function is remarkable.

GPLD1 appears to:

  • remove excess TNAP from the blood–brain barrier
  • restore barrier integrity
  • reduce inflammation entering the brain

In animal models this led to:

  • improved cognition
  • reduced amyloid pathology
  • better overall brain function

This is one of the clearest mechanisms yet showing how exercise protects the brain.

 

Vitamin B6: The Neurochemical Link

Vitamin B6 (in its active form, PLP) sits downstream of TNAP.

It is essential for:

  • converting glutamate → GABA
  • stabilizing neuronal firing
  • supporting mitochondrial enzymes

In some individuals — including subsets of autism — B6 metabolism appears to be impaired.

This can lead to:

  • low GABA
  • excess excitation
  • sensory sensitivity
  • tics or seizures

Correcting B6 availability can sometimes produce significant functional improvements.

 

Mitochondria: The Energy Perspective

All of this sits on top of a deeper requirement: energy

Neurons are extremely energy-dependent.

If mitochondrial function is impaired:

  • ion gradients fail
  • signaling becomes unstable
  • excitability increases

Both Alzheimer’s disease and autism frequently show signs of:

  • mitochondrial dysfunction
  • impaired energy metabolism

Vitamin B6 supports mitochondrial enzymes.


Exercise increases mitochondrial number and efficiency.

Again, the same network appears.

Exercise is not just “burning calories.”

It is activating PGC-1α, the master regulator of mitochondrial production, effectively increasing the brain’s energy-generating capacity.

A brain with more mitochondria is more stable, more resilient, and less vulnerable to both degeneration and developmental disruption.

  

Why This Matters for Autism

At first glance, Alzheimer’s and autism may seem unrelated.

But both conditions often involve:

  • neuroinflammation
  • mitochondrial dysfunction
  • synaptic instability
  • blood–brain barrier disruption

The difference is timing:

  • Alzheimer’s → degeneration of an aging system
  • Autism → altered development of the system

Understanding one can illuminate the other.

If BBB dysfunction drives inflammation in Alzheimer’s, it may also contribute to instability in developing brains.

If mitochondrial support improves cognition in aging, it may improve resilience in autism.

 

Exercise: The Overlooked Multi-System Therapy

Exercise is unique because it affects all parts of this network simultaneously.

  • increases GPLD1 → strengthens the BBB
  • increases BDNF → improves synaptic plasticity
  • improves mitochondrial function
  • reduces inflammation
  • enhances brain blood flow

It is not a single-target intervention.

It is a system-wide regulator.

Many autism interventions (e.g. Pentoxifylline, Agmatine and even beetroot juice) converge on improving cerebral blood flow.

Better blood flow → more oxygen and glucose delivered to the brain.

This supports mitochondrial ATP production, improving brain energy and stability.

Exercise complements this by increasing mitochondrial number via PGC-1α and strengthening the BBB (GPLD1/TNAP).

Together, these interventions enhance neurovascular–metabolic function, leading to more stable cognition and behavior.

 

A Unifying Model

We can now sketch a simple framework:

  • TNAP → Vitamin B6 → neurotransmitter balance (GABA)
  • Excess TNAP (BBB) → barrier breakdown → inflammation
  • Exercise → GPLD1 → removes excess TNAP → restores BBB
  • B6 + exercise → support mitochondria and brain stability

This links:

vascular function + metabolism + neurotransmitters + inflammation

into a single system.

 

The Bigger Insight

For years, Alzheimer’s research has tried to isolate single causes:

  • one gene
  • one protein
  • one drug target

But the brain does not work that way.

It is a network.

TNAP is not “the cause.”
GPLD1 is not “the cure.”

They are control points in a larger system.

Conclusion

This emerging biology suggests that:

  • protecting the blood–brain barrier
  • supporting vitamin B6 metabolism
  • improving mitochondrial function
  • and maintaining regular physical activity

may all be part of the same therapeutic strategy.

Not just for Alzheimer’s disease, but for understanding — and in some cases improving — aspects of autism.

The most sophisticated and expensive interventions may still lie in the future, but one of the most powerful has been available all along.

Exercise is not just good for the body. It is a direct regulator of brain biology.

  

A Final Thought: The Brain Is Only as Protected as Its Barriers

One of the more surprising directions in Alzheimer’s research is not a new drug or gene, but a shift in perspective.

The brain is not as isolated as we once thought.

It is protected by multiple biological barriers — and when these begin to fail, risk increases.

We have already looked at the blood–brain barrier, but this is not the only route.

There is also a direct pathway from the nose to the brain via the olfactory nerve — effectively bypassing the blood–brain barrier altogether. Animal studies have shown that certain bacteria can use this route, especially when the nasal lining is damaged, triggering immune responses in the brain that resemble early Alzheimer’s pathology.

(Note to self, don’t pick your nose!)

The gut can influence the brain through immune signaling and inflammation, particularly when the intestinal barrier is compromised.

Individually, these findings may seem unrelated — blood vessels, nasal tissue, gut bacteria.

But they point to the same underlying principle:

The brain depends on the integrity of the body’s protective barriers.

When those barriers are strong:

  • inflammatory signals are controlled
  • harmful agents are excluded
  • neuronal function remains stable

When they weaken:

  • the brain becomes exposed
  • immune responses increase
  • long-term damage may follow

This brings us back to the central theme of this article.

Exercise is not just improving fitness — it is helping to restore control over these systems:

  • strengthening the blood–brain barrier (via GPLD1)
  • reducing systemic inflammation
  • improving metabolic function
  • supporting mitochondrial health

In other words, it helps the body maintain the boundaries that protect the brain.

The emerging biology — TNAP, GPLD1, vitamin B6, mitochondria — is complex.

 

Oral bacteria and its link to brain function

Alzheimer’s and Parkinson’s research has also looked at the effect of the oral microbiome.

Tooth decay and gum disease are not just local problems — they influence whole-body inflammation.

·        Harmful oral bacteria (e.g. Porphyromonas gingivalis) increase with poor oral hygiene.

·        These bacteria can enter the bloodstream, especially when gums bleed.

·        This can contribute to systemic inflammation and stress the brain.

·        Inflammation may weaken the blood–brain barrier (BBB).

·        A weaker BBB allows more harmful molecules to reach the brain.

·        This links oral health to cognitive decline and dementia risk.

·        At the same time, some oral bacteria are highly beneficial.

o   These bacteria convert dietary nitrates into nitric oxide (NO).

o   Nitric oxide improves cerebral blood flow and brain function.

o   Overuse of strong antiseptic mouthwash can reduce these beneficial bacteria.

o   The goal is balance, not complete sterilization of the mouth.

·        Good oral hygiene reduces harmful bacteria without eliminating beneficial ones.

·        Healthy gums act as a barrier, preventing bacterial entry into blood.

·        Diet plays a major role in shaping the oral microbiome.

·        High sugar promotes tooth decay and harmful bacteria.

·        Nitrate-rich foods (e.g. vegetables, beetroot) support beneficial bacteria.

·        Maintaining teeth and gums is therefore part of protecting long-term brain health.

 


 

Saturday, 22 April 2023

Doom Scrolling vs Taking Action - more Game Changers


 


Arnie (in the brown jacket) fixing a local pothole

Source: https://twitter.com/Schwarzenegger/status/1645886847342743552

  

Some actors can act and some cannot

I recently went to see Keanu Reeves in John Wick Chapter 4 with both of my sons. Big brother thought it was great, like a three-hour non-stop video game with Keanu Reeves laying waste to hundreds of villains. My view was that there was almost no dialogue. I have more dialogue with Monty, aged 19 with classic autism, than Reeves has in this film. It was rather like watching a film with Sylvester Stallone or indeed Arnold Schwarzenegger. For Monty I think the best part was probably the popcorn.

Big brother told me that Arnie can act, that is why he also made films like Kindergarten Cop.  That apparently is acting.

There is no doubt though that Arnie is a man of action, as well as being an action man.

I just got a link to him fixing a local pothole.  It is on his twitter feed. Not quite sure why I received it.

I forwarded the link to Monty’s Big Brother.

What does Dad have in common with Arnie?  We both go out and fix the pothole outside our house – the one that nobody wants to come and fix.

In our case I brought several bucket loads of steaming hot asphalt to fix the road. Arnie and his helpers used a few bags of cold repair asphalt – which looks a lot less bother.

When I went twice in search of asphalt, I explained to the road crews laying asphalt with a big machine that I just wanted a few bucket loads to repair an annoying hole in the road in front of our house. Both times the initial story was “you can’t do that ... you cannot fix the road yourself”. My approach, like Arnie’s, was “just watch me”.  The second time one of the road crew actually came to help.  Since then the whole road has been resurfaced, so my asphalting days are likely over.

 

Doom Scrolling

Even if you are not aware of the term "doom scrolling", if you have a smartphone you are probably already doing it.

 

Doom scrolling

The practice of obsessively checking online news for updates, especially on social media feeds, with the expectation that the news will be bad, such that the feeling of dread from this negative expectation fuels a compulsion to continue looking for updates in a self-perpetuating cycle.

 

It is similar to the echo chamber

In news media and social media, an echo chamber is an environment or ecosystem in which participants encounter beliefs that amplify or reinforce their pre-existing beliefs by communication and repetition inside a closed system and insulated from rebuttal.

 

These days many people have got hooked on reading about problems, rather than solving them. Severe autism being one such problem.

 

Taking action in Autism

I recently was contacted by a Dad who has been treating his child with autism for a few years.  He probably does not fix potholes like me and Arnie, but he does like to fix autism.  He is doing rather well.

He read my book and contacted me.  His very extensive investigation and trials resulted in his personalized therapy.  These were his game changers:-

 

SSRIs

Fluvoxamine         to treat OCD and improve cognition

(Luvox)

 

Antifungals

Fluconazole          The single most effective intervention. 

 (Diflucan)            It just lifted the fog.

Itraconazole 

          
Nystatin  


Antiviral

Valaciclovir (Valtrex)   

       

Antibiotics
Rifaximin               used extensively

 

Bumetanide             Improves cognition.

The antifungals and Rifaximin have the similar effect in terms of more situational awareness, “presence” and ability to interact.  Bumetanide improves cognition.

 

Vitamins

B1 (Sulbutiamine)   high doses (800mg) quickly solved the longstanding feeding problems like chewing and swallowing, the stubbornness (e.g. refusing to go through a door)

Another form of B1 has been covered in this blog. Benfotiamine was proposed by our reader Seth in 2016 and he wrote a guest post about it.

Benfotiamine for Autism

A researcher/clinician called Derek Lonsdale wrote about the potential to treat autism with vitamin B1. 

B6  high doses (> 150 mg a day) are essential to avoid explosive rages. 

Vitamin B6 with magnesium is an old autism therapy that was made popular by the late Bernie Rimland. Rimland founded and directed two advocacy groups: the Autism Society of America (ASA) and the Autism Research Institute. He was the force behind Defeat Autism Now! (DAN). 

Bupropion is transformative, but the effect unfortunately fades in 5 days. 

 The mechanism of action of bupropion in the treatment of depression and for other indications is unclear. However, it is thought to be related to the fact that bupropion is a norepinephrine–dopamine reuptake inhibitor (NDRI) and antagonist of several nicotinic acetylcholine receptors. It is uncertain whether bupropion is a norepinephrine–dopamine releasing agent. 

L type calcium channel blockers helped but Nimodipine caused side effects with gum inflammation; this is a well-known possible side effect.

 * * *

Fluconazole and Rifaximin are quite popular therapies in autism and certainly tell that something is amiss in the intestines.  In the US Rifaximin is very expensive and so you will see Vancomycin used.

In Singapore one of the US-trained MAPS (autism) doctors recently got in trouble prescribing Fluconazole/ Diflucan and Vancomycin to young children with autism. The kids' pediatricians heard what he was prescribing and complained to the medical regulator. 

 

Doctor ordered to temporarily stop prescribing antibiotics, antifungal medication to children after specialists complain

Dr Erwin Kay Aih Boon, a general practitioner in private practice at Healthwerkz Medical Centre, had prescribed antibiotic Vancomycin and antifungal medication Fluconazole – trade name Diflucan – to children with autism.

It comes after four paediatricians in a hospital, which was unnamed in the grounds, complained to the Singapore Medical Council (SMC) about Dr Kay’s management of children with autism.

They said his management of the children were “not based on evidence”, the grounds read.

“Hospital A’s paediatricians were of the view the use of antibiotics and antifungal agents for the treatment of children with (autism spectrum disorders) was unnecessary and had the potential for harm,” said the committee in its grounds.

 

Conclusion

It is rather addictive reading the news that appears on your phone.

Making your own news, even if you choose not to share it with the wider world, looks like a better option.

I was asked by one person who reviewed a draft of my book, why do I not include a collection of autism treatment case studies. I explained that most people who have been successful do not want to publicly share their results.  That is a pity, but it is human nature – why take an unnecessary risk? Even Dr Kay in Singapore gets himself into trouble, just trying to help other people.

In spite of there being no autism treatment gazette with hundreds of detailed case histories for parents to look through, there are nonetheless many clues in the published research.

The key point is that therapy needs to be personalized. Antifungals, antibiotics and antivirals might do wonders for one person, but do absolutely nothing for your child.    

The worst problem of all can be aggression and self-injurious behavior; vitamin B6 clearly works for some, but most people will need one of the numerous other therapies.





 

Friday, 21 July 2017

Electro Convulsive Therapy (ECT) and Cannabidiol (CBD) in Autism


Today’s post is another one to fill in some of the gaps in this blog.
Psychiatrists have long been using electric shocks, of one kind or the other, to treat their patients. There is even a special school in the US (the Judge Rotenberg Center) where they used electric shocks as aversive therapy, until very recently.  


Cannabis, in the form of Cannabidiol (CBD), is currently the subject of an autism trial in Israel, home to some very innovative people.


Electroconvulsive therapy (ECT)

Electroconvulsive therapy (ECT), formerly known as electroshock therapy, and often referred to as shock treatment, is a psychiatric treatment in which seizures are electrically induced in patients to provide relief from mental disorders. The ECT procedure was first conducted in 1938 is often used as a last line of intervention for major depressive disorder, mania, and catatonia.
As of 2001, it was estimated that about one million people received ECT annually.
Several hundred people with autism have been treated with ECT in the US. 

Transcranial Magnetic Stimulation (TMS)
Do not confuse ECT with Transcranial Magnetic Stimulation (TMS).
Transcranial magnetic stimulation (TMS) is a magnetic method used to stimulate small regions of the brain. During a TMS procedure, a magnetic field generator is placed near the head of the person receiving the treatment. The coil produces small electric currents in the region of the brain just under the coil via electromagnetic induction. This is rather similar to the way the base station of a rechargeable electric toothbrush works.
A big fan of TMS is Manuel Casanova, a neurologist and Autism blogger. 

A while back I watched a BBC documentary following an autistic girl adopted from a Serbian orphanage by a US family. All was going well until she later developed a serious problem with aggression and self-injury that was being treated by monthly visits to the hospital for electroconvulsive therapy.  The shocks did indeed seem to do the trick and suppress her aggressive tendencies. She is an example of what I call double tap autism, where an autistic person later suffers a profound setback for some reason. 

Video:- 

My Child, ECT (electric shock) and Me (click the picture below)



Long article from Spectrum News:- 


What I found interesting was that you could see that when you took away the SIB, the girl was pretty high functioning. She could read, write and do math.

This made me recall a previous idea of mine that you might grade people’s autism in terms of both their good days and their bad days.  So on a scale of 100, this girl might have been 30/100.  On a bad day she was a major danger to herself and those around her and so she scored 100, but on a good day she was able to be part of the family and be educated.  She clearly had autism but not such a severe kind, so she might score a 30.
The point missed by the BBC was that in this example, electric shock therapy was not an autism therapy, it was an SIB therapy and it appears to have been a pretty effective one.
Many people with autism do not have flare-ups, they do not have SIB; they are pretty constant in their behavior, so they might be a constant 30/30.  

Cannabis 

Much is written on the internet about the use of cannabis for all kinds of conditions, the ones relevant to this blog are autism and epilepsy.  There is a study currently underway in Israel where they are using CBD oil, the non psychoactive part of cannabis, as an autism therapy.
As you might expect they had no difficulty recruiting people to participate in the study, which is still ongoing. 




Dr. Aran is the Director of the Neuro-pediatric unit in Shaare Zedek Medical Center and his latest research involves treating the symptoms of autism using medical marijuana. “So far,” Aran tells NoCamels, “our impression is that it’s working.”

The clinical study began in January 2017 in Jerusalem at the Shaare Zedek Medical Center. There are 120 participants, including children and young adults, diagnosed with various degrees of ASD ranging from mild to severe. Dr. Aran hopes to have final results by December 2017.

According to Dr. Aran, “there are theories” for why medical cannabis can alleviate symptoms of autism, “but we don’t know exactly how. There are theories and models but we don’t know. It can’t be explained.”

This is worrisome given that cannabis is being given to children with little knowledge of why or how it may help. Of course, “We are worried with children because of the long-term impact. But it is considered mostly safe and we have already tested it with epilepsy.” Other studies, like the one published in Seizure: European Journal of Epilepsy 2016, conducted in Israel, successfully demonstrated that cannabis reduced the number of seizures of children with epilepsy. Nonetheless, Aran admits that “There are always worries that something will happen that we don’t know about.”

It is key to note that the participants are receiving cannabidiol (CBD), a non-psychoactive compound, as opposed to the more commonly known tetrahyrdrocannabinol (THC), which creates the “high” feeling. Therefore, the benefits they seem gain from the treatment “help the children cooperate more,” reduce behavioral problems, and “improve their functioning.”

While the study offers much hope for the children and families affected by ASD, Aran warns that “It won’t cure the symptoms, that’s for sure. It will never cure autism. But it certainly can help the quality of life of the families.” 

The lead researcher recently made some revealing comments, he suggested that the results so far are very positive and that it seems that the quality of life has been improved but it does not cure the symptoms. That made be draw the connection to the adopted child in the US; the therapy does indeed seem to be helpful because it is treating the “100” in the 30/100. So it may not improve cognition or reduce stereotypy, but it makes life better, just like the girl receiving the electric shocks.  Hopefully when they publish the results Dr Aran will be much more precise as to the effect of his therapy, since perhaps I am inferring too much from his comments. 

Why does any of this matter?

Well if you want to solve a problem, you have to define it and the more precisely you can define it, the more likely you are to find a solution.
If you have a girl who is a stable 30/30 with no SIB and no epilepsy, it might well be shown that neither electric shocks nor CBD oil will help here.
If you have a girl who is 30/100 with SIB and epilepsy it might well be the case that both electric shocks and CBD oil might help here; but it appears that neither will improve her core autism (which is the 30).


Mode of Action

Neither the doctors using electric shocks nor CBD oil claim to fully understand the mode of action. There are of course various plausible theories.
In the case of CBD it is an antagonist of GPR55, a G protein-coupled receptor and putative cannabinoid receptor that is expressed in the caudate nucleus and putamen in the brain. It has also been shown to act as a 5-HT1A receptor partial agonist, and this action may be involved in the antidepressant, anxiolytic, and neuroprotective effects of cannabidiol. It is an allosteric modulator of the μ- and δ-opioid receptors as well.  Cannabidiol's pharmacological effects have additionally been attributed to PPARγ agonism and intracellular calcium release.

  

Do the therapies “work”?

What we have seen in this blog to date is that there are very many things that do seem to help specific people.  It is sometimes hard to figure out for sure the mode of action; but if high doses of biotin, or vitamin B6, or anything else consistently improve someone’s condition over years of use you have to take note.
The electric shocks did indeed seem to successfully control SIB for 3-4 weeks.  Maybe someone clever might figure out the biological cause triggering her SIB and so provide an alternative  drug therapy, but for now it seems she will go once a month for more shocks.
There are people who think long term use of CBD oil will have negative effects and I guess monthly electric shocks may also have some unforeseen consequences.
The Israeli researchers seem pretty keen on pursuing CBD oil and so they may well end up with a large enough clinical trial to make people take notice.
I do not see hundreds of parents signing up to a clinical trial of electric shock therapy, so it looks likely to be a niche therapy used by one or two clinicians.
CBD oil is the sort of therapy that will appeal to many parents and it is being trialed on so many different people we will soon know if there are harmful long term effects.
  

My Take

It looks to me that electroconvulsive therapy is rather crude and while it does evidently help some people, it might not be without serious risk. If the person has uncontrollable SIB, it looks a risk worth taking.
Short term use of CBD oil looks a safer bet, but if the effect required is just calming/sedating there may be other ways to achieve this.  Many parents are already using CBD oil as a home autism therapy.
There are hundreds of clinical trials completed, or in progress, using CBD to treat everything from ulcerative colitis to anxiety. It is being trialed in schizophrenia and even Dravet Syndrome and other kinds of epilepsy.  There is even a trial of a CBD chewing gum to treat Irritable Bowel Syndrome. CBD actually now has designated orphan drug status with the FDA for Dravet Syndrome.
I have no plans to use either therapy; I seem to have addressed the variable nature of my case of autism.  I am more interested in treating the core autism symptoms, the “30” in the 30/100; it is clear that much more remains possible.  

Tackling the “30”

An interesting recent finding came from a study on Oxytocin at Stanford. This time researchers had the good sense to actually measure the level of the oxytocin hormone in the blood of the trial participants before and after they started having oxytocin squirted up their noses. 

Not surprisingly it was people with low natural levels of oxytocin who were the favorable responders and interestingly those in the placebo group who also responded actually increased their natural level of oxytocin production.
As we know there are other ways to increase you level of oxytocin, one of which is via certain L. reuteri probiotic bacteria.
Oxytocin would fit in the tackling the “30” category, for those with naturally lower levels of this hormone.
The Stanford researcher is again Dr Hardan, from that interesting phase 2 trial of the antioxidant NAC.  He is now planning a larger oxytocin trial. Has he forgotten about making a phase 3 trial of NAC?   

Self Injurious Behavior (SIB)

You do wonder why some clinician does not compile a list of all the known causes and therapies for self-injurious behavior (SIB) in autism.  There is even a study planned at Emory University to test the efficacy of NAC to treat SIB, but with only 14 participants, I do not really see the point.
We do know that a small number of people with SIB respond well to NAC. If just 10% are responders, you would need a really large trial prove anything at all. With 14 participants you should have just one, but as luck might have it, it could be none.
With a more scientific/engineering approach you might identify five sometimes effective SIB therapies, and then go systematically through testing each therapy on each person with SIB. Then you would have some useful data.    
As I mentioned in a recent comment, the late Bernie Rimland from ARI, was a big believer in high dose vitamin B6 to treat SIB.  For some people it is a nicotine patch, for my son in summer it is an L-type calcium channel blocker.
The reality is that numerous complex dysfunctions can lead to SIB, but so do some simple things like untreated pain and inflammation, which could be from IBS/IBD or even tooth eruption/shedding or just tooth decay.