Updated by: Harshita Nekkanti (Extern) and Kate McKenna, MEd, MSEd, MS, BCBA
Association for Science in Autism Treatment

Description

Autism Treatments SummarySecretin is a naturally occurring peptide hormone produced by the small intestine. Its main physiological role is to stimulate the pancreas to release bicarbonate-rich fluid, which neutralizes gastric acid entering from the stomach and helps regulate the intestinal environment for proper digestion (Klein & Kemper, 2016). Beyond its digestive functions, researchers became interested in secretin in the late 1990s after Horvath et al. (1998) reported that intravenous administration of porcine-derived secretin led to dramatic improvements in language, eye contact, and social behavior among children with autism (LeClerc & Easley, 2015). This sparked widespread media attention and clinical interest, prompting multiple double-blind, placebo-controlled studies to test its therapeutic potential.

Research Summary

Following early media reports in the late 1990s suggesting that intravenous secretin dramatically improved speech and social behaviors in children with autism, researchers conducted a series of randomized, double-blind, placebo-controlled trials to evaluate these claims. An early large-scale investigation, by LeClerc and Easley (2015), found that children who received porcine-derived secretin showed no measurable difference in social reciprocity, language acquisition, or cognitive performance compared to those given saline injections. Later studies attempted to address dosage and repetition, testing whether multiple secretin infusions over several weeks could produce delayed or cumulative effects, but again, outcome measures like the Autism Diagnostic Observation Schedule (ADOS) and parental behavior ratings revealed no statistically significant improvements (Lyra et al., 2017). The review by Lyra et al. (2017) pooled evidence from multiple randomized trials and found no evidence that single or multiple doses of intravenous secretin improved social interaction, communication, or repetitive behaviors in people with autism spectrum disorder (ASD).

Although current research suggests that secretin interacts with receptors in both the gastrointestinal tract and certain brain regions (Klein & Kemper, 2016; Wang et al., 2019), there is no evidence that it influences neurotransmitter systems such as Gamma-Aminobutyric Acid (GABA), dopamine, or serotonin, which are often implicated in autism (Klein & Kemper, 2016). Neuroimaging and neurochemical studies have failed to show changes in brain activity or connectivity following secretin infusion, further weakening the biological plausibility of the treatment (Chey & Chang, 2003).

These conclusions have been reinforced in systematic reviews and meta-analyses conducted by Williams et al. (2012) and Lamy et al. (2020). Williams et al. (2012) found that across numerous trials including over 900 children, secretin’s effects on communication, stereotyped behavior, and social functioning were indistinguishable from placebo, regardless of dose type, source (synthetic vs. natural), or number of administrations. These findings were consistent across age groups, gender, and autism severity levels, indicating no identifiable subgroup that benefited from treatment. To confirm these findings about secretin, Lamy et al. (2020) reviewed randomized controlled trials and systematic reviews assessing emerging pharmacologic treatments, including secretin, for behavioral symptoms in children and adolescents with ASD. Lamy et al. (2020) concluded that secretin does not meet clinical standards for efficacy or safety in the treatment of ASD. Clinical trials from this study reported monitoring for adverse events, including gastrointestinal disturbances and allergic reactions; however, none were clinically significant, and secretin remains outside the standard of care. The authors emphasized that resources should be redirected toward interventions with stronger empirical support.

Recommendations

Given the consistent lack of evidence supporting secretin as a treatment for ASD, current research and clinical guidelines, including the Agency for Healthcare Research and Quality, discourage its use in managing autism symptoms (LeClerc & Easley, 2015; Lamy et al., 2020). Similarly, the American Academy of Pediatrics concludes that there is a lack of significant impact of secretin in the treatment of ASD symptoms (Krishnaswami et al., 2011). Future research efforts should instead focus on identifying evidence-based interventions that address specific behavioral, cognitive, or sensory challenges associated with ASD. Promising areas include studies on targeted pharmacological therapies that affect neurotransmitter systems, as well as behavioral and developmental interventions that have shown long-term effectiveness, such as applied behavior analysis (ABA), risperidone, and aripiprazole (Hellings, 2023). Clinicians and caregivers should rely on interventions with demonstrated efficacy, such as ABA, social communication therapy, and early intervention programs, rather than unproven biological treatments like secretin (Yu et al., 2020). Overall, while secretin played an important historical role in prompting biomedical research into autism, the scientific consensus now firmly recognizes that it does not contribute to meaningful clinical improvement and should not be recommended for therapeutic use.

References

Systematic Reviews of Scientific Studies

Krishnaswami, S., McPheeters, M. L., & Veenstra-VanderWeele, J. (2011). A systematic review of secretin for children with autism spectrum disorders. Pediatrics, 127(5), e1322–e1325. https://doi.org/10.1542/peds.2011-0428

Lamy, M., Pedapati, E. V., Dominick, K. L., Wink, L. K., & Erickson, C. A. (2020). Recent advances in the pharmacological management of behavioral disturbances associated with autism spectrum disorder in children and adolescents. Pediatric Drugs, 22(5), 473–483. https://doi.org/10.1007/s40272-020-00408-0

Lyra, L., Rizzo, L. E., Sunahara, C. S., Pachito, D. V., Latorraca, C. de O. C., Martimbianco, A. L. C., & Riera, R. (2017). What do Cochrane systematic reviews say about interventions for autism spectrum disorders? Sao Paulo Medical Journal, 135(2), 192–201. https://doi.org/10.1590/1516-3180.2017.0058200317

Williams, K., Wray, J. A., & Wheeler, D. M. (2012). Intravenous secretin for autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd003495.pub3

Selected Scientific Studies

Horvath, K., Stefanatos, G., Sokolski, K. N., Wachtel, R., Nabors, L., & Tildon, J. T. (1998). Improved social and language skills after secretin administration in patients with autistic spectrum disorders. Journal of the Association for Academic Minority Physicians: The Official Publication of the Association for Academic Minority Physicians, 9(1), 9–15. https://pubmed.ncbi.nlm.nih.gov/9585670/

Wang, R., Chow, B. K. C., & Zhang, L. (2019). Distribution and functional implication of secretin in multiple brain regions. Journal of Molecular Neuroscience: MN, 68(3), 485–493. https://doi.org/10.1007/s12031-018-1089-z

Other References

Chey, W. Y., & Chang, T.-M. (2003). Secretin, 100 years later. Journal of Gastroenterology, 38(11), 1025–1035. https://doi.org/10.1007/s00535-003-1235-3

Hellings, J. (2023). Pharmacotherapy in autism spectrum disorders, including promising older drugs warranting trials. World Journal of Psychiatry, 13(6), 262–277. https://doi.org/10.5498/wjp.v13.i6.262

Klein, N., & Kemper, K. J. (2016). Integrative approaches to caring for children with autism. Current Problems in Pediatric and Adolescent Health Care, 46(6), 195–201. https://doi.org/10.1016/j.cppeds.2015.12.004

LeClerc, S., & Easley, D. (2015). Pharmacological therapies for autism spectrum disorder: A review. Pharmacy and Therapeutics, 40(6), 389. https://pmc.ncbi.nlm.nih.gov/articles/PMC4450669/?ut

Yu, Q., Li, E., Li, L., & Liang, W. (2020). Efficacy of interventions based on applied behavior analysis for autism spectrum disorder: A meta-analysis. Psychiatry Investigation, 17(5), 432–443. https://doi.org/10.30773/pi.2019.0229

Reference for this article:

Nekkanti, H., & McKenna, K. (2026). A treatment summary of secretin. Science in Autism Treatment, (23)3.

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