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Another recurring limitation emerges on antioxidant-based interventions in ASD, constrained by a fundamental methodological gap: most clinical studies report behavioral or functional improvements without directly measuring oxidative-stress biomarkers

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Conversely, enterohepatic circulation is reduced by establishment of enteral nutrition, by increasing the frequency of feeding,98 by oral feeding of agar, which binds bilirubin in the gut,99 and by oral administration of bilirubin oxidase.100 It should be noted that the latter two treatments must be considered “off-label” and have not been subjected to any approval process of which we are aware