Autism

a young boy

Autism (AD) is a rare disorder and the archetype of the autistic spectrum disorder (ASD).  It is a neurodevelopmental disorder characterized by impairment of social and language interaction. From infancy, development is delayed and the child fails to interact with people and situations. The child may become distant, removed from most stimuli, and fixated upon certain objects or behaviors that often recur in repetitive patterns. They may fidget with their fingers for hours on end, even suffering injury from self-inflicted wounds as a consequence. The normal protective pain barrier seems to be absent. Occasionally, the children become hyper-agitated, so a parallel may be drawn to other hyperactive disorders, like ADHD. Parent involvement in autism management has accelerated treatment and understanding.

The statistics of the occurrence of AD and ASD suggests that these disorders have become epidemic. Prior to 1990, it was estimated that about 5 per 10,000 for AD and 20 per 10,000 for total ASD. By the late 1990s, the prevalence of ASD increased to 50 per 10,000. Recent estimates contend that the occurrence could be 1 in 150. Even though children diagnosed with autism spectrum has increased significantly in the last decade or two, the treatment for autism (as defined by the FDA and medical community) is considered ‘off-label,‘ meaning they have not approved any specific treatment. Every treatment is therefore to the discretion of the treating physicians along with the child and parents. However, there are some subcomponents of ASD that are approved by the FDA — allergies, inflammatory bowel disease and vitamin deficiencies.  The overall vision of conventional medicine is to positively impact the child’s life by meeting their biological, behavioral and nutritional needs.

In recent years the International Child Development Resource Center has been formed to meet the global crisis of neurodevelopmental diseases such as autism.

DIET

It is most often noted that gluten and casein-free diets are helpful in the treatment of autism. This is because molecules found in these foods increase the leakiness of the gut (sometimes another name for irritable bowel disease). In like manner, identifying food allergies and sensitivities may be vital to selecting an appropriate diet for these children. The most common foods that autistic or ADHD children may be sensitive to include milk and dairy products, wheat and white flour, sugar, red meat, caffeine, artificial sweeteners (aspartame, Nutrasweet), fried foods, all processed foods, eggs, citrus fruits, corn products, peanuts and other nuts.

Dietary restrictions, by some experts, include the removal of milk and other casein dairy products, wheat and other gluten sources, sugar, preservatives, chocolate and food colorings. Individual IgE or IgG testing can help to identify other non-immune mediated food sensitivities.

Any child with autism or any other disease associated with free radicals should eat a natural diet consisting of pure, mostly organic foods that are easily digestible and fully assimilated by the body. It is wise to drink plenty of pure fluids, water, fruit juices, and certain herbal teas. Antioxidant foods consist mainly of fresh and organic fruits and vegetables. The autistic child should eat a high-fiber diet consisting of 50-75% raw foods. Whole grains and breads are very favorable, as are legumes, cold water fish, sea vegetables, and some spices.

One of the most important natural, inexpensive and non-invasive ways to help identify a food allergy is to undertake the two-week Elimination Diet. This diagnostic tool for identifying food allergies can prove invaluable in improving all body functions including cognition, activity, sleep, and general well-being.

POTENTIAL CAUSES AND COMPLICATIONS

Heredity and Genetics – Since autism manifests in the first three years of life and persists into adulthood, and its pathology is poorly understood, the potential that heredity may play a role in the disorder must be recognized.  The genetic role may not be so much as an inborn error(s) but a strongly predisposing factor. There is continuing research into chromosomal disorders and how it is linked into various developmental disorders. The biggest problematic question for the proponents of the ‘mainly genetic’ reasoning is that the disorder is found in boys over 80 percent of the time, if genetics was the main culprit, logic would dictate that there would be a 50-50 split in sexes. Identical twins have up to a 90 percent rate of both having ASD. Fraternal twins have up to a 10 percent chance.   

Free Radical Component – Free radicals are linked to over 60 diseases and some researchers think they are responsible for 85 percent of degenerative diseases. Free radicals are short-lived, unstable free electrons that can significantly interfere with the pre-designed DNA and RNA genetic code in our cells. This distortion upsets our body’s stable chain reactions and damages cell-membrane DNA. This in turn damages protein enzymes and connective tissue, mutates genes, ages the skin, forms calcium deposits, and lessens natural antioxidant effects. Unfortunately, free radicals are everywhere in our world. They are produced from air, water and food pollution. Some of the myriad sources of free-radicals include food additives, sulfites in food,  toxic metals in the water supply, tobacco smoke, alcohol, prescription drugs, pesticides, chemicals, herbicides, chemotherapy, ozone, auto exhaust, stress, trauma, infections, and probably the strongest of all: radiation.

Immune Dysfunction – There is substantial evidence to suggest the immune system plays an important role in the pathogenesis of autism. Many of the markers of immune function are abnormal, and some of these may have a genetic basis. Abnormalities of macrophages, B cells, T cells and natural killer cells have been reported.  The data on abnormal immune system involvement in autism is fragmented but substantial. This fact adds more credence to eating a healthy diet and effective supplementation.

Oxidative Stress – When oxidants exceed the body’s antioxidant defense biological systems suffer oxidative stress, with damage to biomolecules and functional impairment. Autism is a behavioral disorder, with communication and social deficits.  It is generally believed that oxidative stress plays a role in the pathophysiology of the disease. Some of the markers for oxidative stress in autism include lower antioxidant levels including glutathione, high organic toxins and heavy metals, high cytokines, and a higher production of xenobiotic pollutants. Xenobiotic are environmental chemicals and toxins that ‘mimic’ estrogenic hormones, Xenobiotics may include growth hormones, antibiotics and antibiotics in dairy foods, meat, poultry and eggs. Another huge source of xenobiotics is the amount of pharmaceutical drugs that are in our food and water supply. Xenobiotic overload can also come from toxins such as Ethyl or Methylbenzene, Toluenes, Heptane, Styrene and Xylenes. Accordingly, all sources of oxidative stress in autism imply problems in energy and excitotoxicity.

Low Glutathione – Dr. Richard Van Konynenburg has done ten years of research into the hypothesis for the pathogenesis with autism and chronic fatigue syndrome (caused by depleted glutathione levels.)  Low glutathione levels in autistic children block the methylation cycle that is associated with genetic variations in the genes. The author found that using certain supplements (Vitamin B12, folic acid, and trimethylglycine) can lift the block in the methylation cycle and restore glutathione.

Candida Albicans (Fungal Infections)Candida Albicans is a chronic problem in many autistic children. It can lead to chronic fatigue, memory loss, headaches, dizziness, nervousness, moodiness, depression, paranoia, hyperactivity, hives, acne, itching, and brittle browning of the nails. It is encouraged that autistic children eat less sugar, dairy, and processed foods that can lead to a build-up of candida. Also, supplementing with Lactobacillus, Bifidobacterium and other probiotic bacteria, including pancreatic enzymes, will increase the number of friendly bacteria when they make contact with the gut mucosa and stimulate cell-mediated immunity.

MERCURY AND AUTISM

Practically all physicians and health practitioners know that there has been a significant increase in reported cases of autism in American since 1990. In individuals with a genetic susceptibility–such as a defect in enzymes responsible for detoxifying heavy metal exposure, and prenatal and postnatal exposure to mercury–this may lead to neurological damage in autistic children. It is also well known that autistic children have an impaired capacity to detoxify mercury. Other potential exposures may be the consumption of contaminated fish (by the mother) and environmental toxins (mostly from air pollution from industry.)

Symptoms of mercury toxicity do parallel autism, so the association between the two seems plausible.  Mercury may cause a dysfunction with defects in the child’s immune system. These specific immune abnormalities have been found in 30-70% of autistic children.

THREE NATURAL APPROACHES

DETOXIFICATION – Detoxification is essential in an overall strategy for treating autism. Most kids today, but it seems more acute in autistic kids, are overwhelmed by environmental toxins and multiple stressors. A number of methods are available. Some practitioners use chelation with DMSA and EDTA, but this method may be a bit dangerous for some kids and remains controversial. Homeopathic methods of detoxification are probably the safest and have a good degree of effectiveness. One can also utilize the ion-cleanse machine, and energy medicine (the ETAscan, RIFE machine and the REBA Psychosomatic Energy Machine) to help to slowly detoxify the body.

NUTRITIONAL THERAPIES – Clinical nutrition, supplementation, and a healthy diet are crucial when it comes to improving all aspects of this condition.  In addition to supplementing with critical nutrients such as B-complex vitamins, magnesium, zinc, and omega-3 fatty acids, targeting amino acid therapy is also a primary objective.  Amino acids are building blocks for the body and for neurotransmitters.

BALANCING NEUROTRANSMITTERS – In general, neurotransmitters fall into 2 categories, inhibitory and excitatory.  The major excitatory neurotransmitters are: epinephrine, norepinephrine, glutamate, phenylethylamine, and histamine. The key inhibitory neurotransmitters are: serotonin, GABA, glycine, and taurine. Dopamine is one of the few that can be both inhibitory and excitatory. Since autistic kids are mainly described as “excitotoxicity,” typically they show marked increases in excitatory neurotransmitters and very low levels of serotonin and GABA.

CLINICAL AND LABORATORY FINDINGS

Congenital – inborn errors of metabolism, prenatal susceptibilities and differing genetic overload.

Biochemical – impaired sulfoxidation capacity and multiple nutritional deficits.

Liver impaired liver detoxification and frequent low cysteine, taurine and glutathione levels.

Central nervous system – altered sensitivity to sensory and expressive information and altered neurotransmitter balance.

Gastrointestinal – impaired digestion with poor bowel flora alterations. Leaky gut is common as it increases permeability to poorly digested food particles.

Immune system – an abnormal antibody and cell-medicated process that includes pro-inflammation, autoimmune antibody imbalance and hypersensitivity should be examined.

SUPPLEMENT PROTOCOL

  1. ESSENTIAL FATTY ACID (EFA) especially DHA
    The importance of supplementing EFAs for autistic children cannot be underestimated. EFAs are important for cell structure and act as building blocks for cell membranes and are critical in cell function and are a source of energy. They are important for a healthy heart, gastrointestinal system, brain development and immunity. EFAs that are derived from cold water fish and flaxseed help to maintain a healthy brain. Docosahexaenoic (DHA) is an essential nutrient for infants, children, and teens to maintain cellular fluidity and support memory, focus, cognition and emotional well-being. DHA aids in proper fetal development, making it especially useful for expectant mothers and nursing women. EPA assists in the homeostasis (cellular balance) of cell membranes, relaying signals similar to hormones to decrease inflammation and improve brain function. The average American diet is critically low in EFAs, with a marked deficiency in many American children (especially with ADHD). Dosage: DHA 100-500 mg daily, EPA 50-400 mg daily, or as directed by a qualified practitioner.
  2. MULTIPLE VITAMIN-MINERAL SUPPLEMENT
    A good multi-vitamin is an insurance policy for just about every health condition. Since autistic children typically have poor nutrition, poor digestion, and compromised intestinal permeability, most autistic children will benefit from a daily multi-vitamin nutrient, especially if it contains additions green foods. Dosage: As directed on label
  3. B-COMPLEX VITAMINS
    B complex vitamins are some of the most common vitamins lacking in autistic children. In many instances Folic acid, Vitamin B3 (Niacin), Vitamin B6 (Pyridoxine) and Vitamin B15 (Pangamic acid) may be especially lacking. Some of the best food sources for B vitamins include apricots, whole grains, pumpkin, brown rice, and sunflower and sesame seeds. Folic acid has been reported to be helpful in autism. Supplementing with 250 mcg of folic acid per pound of body weight per day can bring improvements. In its active form of Vitamin B6 (pyridoxine-5-phosphate) is an essential cofactor for a majority of metabolic pathways of neurotransmitters, including GABA, serotonin, dopamine and epinephrine. Vitamin B6 (is best when given with magnesium) was found to be helpful in almost half of all autistic children and adults. Dosage: See a qualified practitioner for doses higher than what is contained in a multiple B-vitamin supplement.
  4. MAGNESIUM, CALCIUM and VITAMIN D3
    Magnesium and calcium may be two of the most important mineral supplements for the autistic child. Magnesium acts directly on smoothing the muscles and calming the nerves. Magnesium is also an essential mineral required for a wide range of enzyme-catalyzed metabolic pathways. Essential for normal brain and nervous system function, both magnesium and calcium are found deficient among autistic children. Adding calcium may be useful since it is advisable to have autistic children significantly reduce their consumption of dairy products. Vitamin D3 (calcitriol) is a potent neurosteroid hormone with critical roles in brain development in mammals. Autistic children have immunological abnormalities that are those similar to those produced by vitamin D deficiency. Administer magnesium with vitamin B6 to enhance the effects. Dosages: Magnesium 3 or 4 mg per pound of body weight, up to 600 mg per day for adults (decrease if diarrhea occurs). Calcium 250-1500 mg daily, depending on the age of patient.
  5. DIMETHYLGLYCINE (DMG) VITAMIN B15
    Supplementation with this compound has been shown to improve behavior, concentration and speech. DMG has been reported to increase levels of verbal communication, eye contact, frustration tolerance, immune response to infection, and physical performance. Dosage: 100 mg daily. Higher doses may be experimented with safely.
  6. AMINO ACIDS
  7. At least two-thirds of autistic children have abnormal amino-acid levels, as measured in urine and blood. L-glutamine is an amino acid that is the preferred source of energy and food for the cells that line the digestive tract. It is critical for the repair of intestinal tissue. Glutamine is also an ideal source of energy for the brain.  Supplementation can relieve mild depression and fatigue, and may provide an individual with stamina and physical equilibrium. In autism it may help to raise I.Q. levels, control mild epilepsy and seizures, and help control the hypoglycemic craving for sugar sweets. Cysteine abnormalities are also found in autistic children. Acetyl-L-Carnitine has been used in treating a variety of neurological and cognitive conditions. L-carnitine participates in the production of cellular energy and enhances serotonin. Glutathione supplementation may increase cellular levels that may increase the methionine cycle associated with causing chronic fatigue syndrome. L-Theanine is an amino acid found in green tea. L-theanine has been investigated for its ability to promote a restful, relaxed state without diminishing daytime alertness. L-theanine appears to cause significant increases in serotonin and/or dopamine concentrations in the brain. Dosage: As directed by a qualified practitioner.
  8. HERBS for CALMING
    There are a number of herbals that have a calming and relaxant affect on children with autism. Passionflower elicits a relaxing effect and is helpful for muscle twitches, spasms, heart palpitations, and sleep disturbances.  Tilia is useful for lowering blood pressure and controlling nervous due to stress. St. John’s wort can be effective for treating mild to moderate depression, feelings of isolation, and being disconnected.  Dosage: See a qualified practitioner.
  9. GABA (GAMMA-AMINOBUTYRIC ACID)
    GABA is a calming neurotransmitter in the body that helps to balance glutamate. It is useful in helping to decrease stress, calming moods, increase speech, eye contact, and improve social interactions. GABA levels (along with serotonin) are almost always low in autistic children. Dosage: As directed by qualified practitioner.  Sometimes GABA is more effective if given along with magnesium and other amino acids such as Taurine and Tyrosine.
  10. PROBIOTIC SUPPORT and DIGESTIVE ENZYMES
    Bacteria flora such as Lactobacillus acidophilus and Bifidobacterium bifudis are important supplements to re-establish a balanced bowel flora. Autistic children often have an imbalance in gut flora, thus making supplementation imperative. Probiotics can stimulate systemic cell-mediated immunity and can reduce allergy symptoms. Probiotics can be complemented by giving the child Digestive enzymes for gastro-intestinal abnormalities and malabsorption. Dosage: See a qualified practitioner.
  11. ZINC
    Lower zinc status in autism is well established (low levels in 40 percent of autism patients). Among its many functions, zinc is needed for the development and maintenance of the brain, adrenal glands, intestines, and immune system. Zinc picolinate in high doses (2-3 mg per kg body weight) has been found to improve behavior. This essential antioxidant mineral lowers nitric oxide levels and is protective against oxidation damage. Dosage: 10-40 mg a day or as directed by a qualified practitioner. Excessive zinc supplementation will cause glutamate release.
  12. MELATONIN
    This natural hormone can be safely given to children or adults to help induce a restful sleep. Since the neurotransmitter serotonin is usually extremely low in autistic children, and since it is required for the synthesis of melatonin, (which also tends to be low) supplementing with small doses of melatonin may significantly improve sleep disturbances. Dosage: 1-5 mg at bedtime, as directed.
  13. VITAMIN C and additional ANTIOXIDANTS
    Vitamin C is a strong antioxidant and its benefits seem to be tailored to autism. Vitamin C provides good neuron protection against nitric oxide toxicity and is known to help prevent excitotoxicity.  Since vitamin C is found in high concentrations in the brain, it is not surprising that adult autistic patients have found significant improvement with supplementation. Multi-antioxidant vitamins may help quench free-radical damage. These anti-oxidants include Vitamin A (Beta Carotene), Vitamin E, Pycnogenol, Grape seed extract, Bioflavonoids, and Alpha lipoic acid.  Dosage: Higher doses are recommended 500-8,000 mg, titrated per age of person.  Other antioxidants as directed by a qualified practitioner.
  14. HEAVY METAL DETOXIFICATION
    Unfortunately many children with autism frequently feature heavy metal overload. Heavy metal, such as mercury, lead and arsenic should be removed via chelation or detoxification. In certain cases, moderate amounts of ammonia are found in children diagnosed with autism. See a qualified health care practitioner before attempting to do extensive detoxification or chelation.
  15. HOMEOPATHIC REMEDIES and BACH FLOWER REMEDIES
    A number of homeopathic remedies have successfully been used to improve the symptoms of autism.  Some of the most effective include Gelsemium, Ignatia, Staphysagria, and Nux vomica. Bach flower remedies are gentle remedies made from flower essences to help autistic children better deal with every day stress. The most effective product appears to be Rescue remedy. Dosage: As directed on package.
  16. COENZYME Q10
    CoQ10 is a potent antioxidant that aids in the production of cellular energy. Supplemental CoQ10 protects DNA from oxidation damage and enhances DNA repair enzyme activity. Children diagnosed with autism are more susceptible to systemic Candida overgrowth, and Candida may prevent dietary CoQ absorption, requiring supplementation to achieve therapeutic effect. Dosage: 30-100 mg a day.
  17. CALCIUM D-GLUCARATE
    Calcium D-glucarate is a naturally occurring substance that is not present in sufficient amounts to counteract natural and external carcinogens. Nearly all autistic children show abnormal liver detoxification profiles and abnormal distribution panels for glucaric acid, a biomarker for contamination by most toxic xenobiotics. Calcium D-glucarate will aid in the binding and elimination of toxins and spent hormones. Dosage: As directed on package.
  18. SELENIUM
    Levels of selenium are also found to be low in autistic children.  Selenium is an antioxidant that is needed for the immune system to fight off free radical damage.  Deficiencies are associated with mitochondrial dysfunction. Take with VITAMIN E. Dosage: 50-300 mcg daily.
  19. GINKGO BILOBA
    Ginkgo biloba is a powerful free-radical destroyer that protects the brain. Ginkgo appears to modulate genetic expression, protect against neuronal death, and counteract cognitive deficits that follow stress and brain injury. Ginkgo can also improve symptoms associated with cerebral insufficiency such as memory loss, depression, and tinnitus. Dosage: 60-180 mg daily.
  20. COLOSTRUM
    Colostrum may help to regulate abnormal bacteria in the intestines. Dosage: As directed.
  21. MILK THISTLE
    This liver-healthy herb should be added if liver functions are affected. Milk thistle is used clinically to protect the integrity of the liver, and helps to lessen damage from potentially hepatotoxic drugs. Dosage: 1-3 capsules daily.
  22. SAMe
    SAMe is critical in the manufacture of many body components, especially brain chemicals. It is also a natural antidepressant. Dosage: see health care professional. Dosage in children may begin at 200mg a day, but see a qualified health care practitioner.

Dr. Parris Kidd’s Ten-phase Integrative Protocol for Autism Management

  1. Establish diagnosis.
  2. Explore behavioral modification in cooperation with school and caregiver.
  3. Supervise a casein (dairy) and gluten-free diet modification. Supplement with multi-vitamin-mineral, Vitamins B6, B12, Folate, DMG, and Omega-3 fatty acids, and certain amino acids recommended by a qualified practitioner.
  4. Educate parents and caregivers on zero tolerance for toxins. Test for mercury and other metals.
  5. Implement mercury removal by various means of detoxification.
  6. Assess gastrointestinal abnormalities: malabsorption, dysbiosis, colitis, and IgE/IgG food allergies. Support with probiotics, enzymes, prebiotics, glutathione, and GI nutrients.
  7. Once detoxification is complete, test for appropriate nutrient levels.
  8. Check liver function.
  9. Test for immune system abnormalities: low white blood cell count, antibody deficiencies, autoimmunity.
  10. Periodically retest laboratory values and adjust management as indicated.

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Fighting Autism Conference Notes. February 28, 2004. Wexford, PA.

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Kidd, P. Th1/Th2 Balance: The Hypothesis, its Limitations, and Implications for Health and Disease. Alternative Medicine Review, August 2003. 8(3): 223-244.

Konynenburg, RA. Chronic fatigue Syndrome and Autism. Townsend Letter, #279. October 2006. Pp. 84-86.

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Rihmland, B. What is the Right Dosage for Vitamin B6, DMG, and other Nutrients Useful in Autism? Autism.com/ari/editorials/dosage.html, Autism Research Center.

Weinhold, H. Homeopathy & Natural Methods to Help Improve the Symptoms of ASD. Lecture Notes. September 12, 2006. Nutri-farmacy bldg. www.doctorheidi.net

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