Journal of Autism and Developmental Disorders

, Volume 46, Issue 3, pp 1124–1130 | Cite as

Brief Report: Whole Blood Serotonin Levels and Gastrointestinal Symptoms in Autism Spectrum Disorder

  • Sarah Marler
  • Bradley J. Ferguson
  • Evon Batey Lee
  • Brittany Peters
  • Kent C. Williams
  • Erin McDonnell
  • Eric A. Macklin
  • Pat Levitt
  • Catherine Hagan Gillespie
  • George M. Anderson
  • Kara Gross Margolis
  • David Q. Beversdorf
  • Jeremy Veenstra-VanderWeele
Brief Report


Elevated whole blood serotonin levels are observed in more than 25 % of children with autism spectrum disorder (ASD). Co-occurring gastrointestinal (GI) symptoms are also common in ASD but have not previously been examined in relationship with hyperserotonemia, despite the synthesis of serotonin in the gut. In 82 children and adolescents with ASD, we observed a correlation between a quantitative measure of lower GI symptoms and whole blood serotonin levels. No significant association was seen between functional constipation diagnosis and serotonin levels in the hyperserotonemia range, suggesting that this correlation is not driven by a single subgroup. More specific assessment of gut function, including the microbiome, will be necessary to evaluate the contribution of gut physiology to serotonin levels in ASD.


Serotonin 5-HT Gastrointestinal (GI) IL-6 Medical comorbidities Autism Treatment Network 



Aberrant Behavior Checklist


Autism Diagnostic Observation Schedule


Autism spectrum disorder


Functional constipation




Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III


Repetitive Behavior Scale-Revised


Sensory Over-Responsivity Inventory


State-Trait Anxiety Inventory



We would like to thank the children and families who participated in this study. This research was supported by a Grant given to the Autism Treatment Network, Autism Intervention Research Network on Physical Health by the Health Resources Services Administration (HRSA Grant# UA3MC11054). This article was reviewed by the funding body prior to submission.

Author Contributions

SM and BF contributed to participant recruitment, data collection, data entry, data interpretation and manuscript writing. EL, BP, KW, PL, KG, DB, and JV contributed to study design, data interpretation, and manuscript writing. EM and EM performed the statistical analysis and contributed to manuscript writing. CG contributed to the immunoassays of IL-6 and manuscript writing. GA contributed to the HPLC assays of 5-HT and manuscript writing. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Conflict of interest

Dr. Veenstra-VanderWeele has served on advisory boards for Novartis and Roche Pharmaceuticals. He has received research funding from Novartis, Roche Pharmaceuticals, Seaside Therapeutics, Forest, Sunovion, and SynapDx. Dr. Beversdorf has received research funding from Seaside Therapeutics. The other authors report no conflicts of interests.

Ethical Standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Sarah Marler
    • 1
  • Bradley J. Ferguson
    • 2
  • Evon Batey Lee
    • 3
  • Brittany Peters
    • 1
  • Kent C. Williams
    • 4
  • Erin McDonnell
    • 5
  • Eric A. Macklin
    • 5
  • Pat Levitt
    • 6
    • 7
  • Catherine Hagan Gillespie
    • 8
  • George M. Anderson
    • 9
  • Kara Gross Margolis
    • 10
  • David Q. Beversdorf
    • 11
  • Jeremy Veenstra-VanderWeele
    • 12
    • 13
    • 14
  1. 1.Department of PsychiatryVanderbilt UniversityNashvilleUSA
  2. 2.Interdisciplinary Neuroscience Program, The Thompson Center for Autism and Neurodevelopmental DisordersUniversity of MissouriColumbiaUSA
  3. 3.Departments of Pediatrics, Psychology, and PsychiatryVanderbilt UniversityNashvilleUSA
  4. 4.Department of Gastroenterology, Hepatology, and NutritionNationwide Children’sColumbusUSA
  5. 5.Biostatistics CenterMassachusetts General HospitalBostonUSA
  6. 6.Developmental Neurogenetics, Institute for the Developing MindChildren’s Hospital Los AngelesLos AngelesUSA
  7. 7.Departments of Neurogenetics, Pediatrics, Neuroscience, Pharmacy, Psychiatry, Pathology and Psychology, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA
  8. 8.Department of Veterinary PathobiologyUniversity of Missouri College of Veterinary MedicineColumbiaUSA
  9. 9.Yale Child Study CenterYale University School of MedicineNew HavenUSA
  10. 10.Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and NutritionColumbia UniversityNew YorkUSA
  11. 11.Interdisciplinary Neuroscience Program, The Thompson Center for Autism and Neurodevelopmental Disorders, Departments of Radiology, Neurology, and Psychological SciencesUniversity of MissouriColumbiaUSA
  12. 12.Department of Psychiatry and Sackler Institute for Developmental PsychobiologyColumbia UniversityNew YorkUSA
  13. 13.New York State Psychiatric InstituteNew YorkUSA
  14. 14.New York Presbyterian Hospital Center for Autism and the Developing BrainWhite PlainsUSA

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