Autism - the treatment of
Autism is becoming increasingly common for the same reason that other human diseases such as neuro-degenerative conditions (Alzheimer's disease and Motor Neurone Disease), chronic fatigue syndrome, organ failures and so on are becoming increasingly common. It is a result of life in the 20th and 21st century with changing diets, declining nutritional status, increasing toxic stress and increasing viral load because of the increasing world population and teh fact that so many people travel more widely than ever before. Therefore the overall approach to management is exactly the same for all these problems, although the emphasis for different problems will be slightly different.
My understanding of the treatment of autism specifically has been advanced by a book "The Puzzle of Autism: Putting It All Together" by Dr Amy Yasko and Dr Garry Gordon (see Link for The Puzzle of Autism). These two doctors have developed a protocol of treatment, which has benefited all the children they have treated to a greater or lesser extent. Much of what they do I already use in the treatment of autism, but there are other areas well worth exploring. I do recommend that you get the book, but it strikes me that the issues which have to be tackled are as follows:
Allergies and Excitotoxins
Almost all autistic children are improved by a diet which avoids grains, dairy, yeast, sugar, additives, colourings, flavourings and artificial foods. This could be explained by excitotoxins such as glutamate in the diet, which has a generally excitatory effect. Actually wheat gluten is 43% glutamate, milk protein is 23% glutamate and there are also high levels in MSG, Aspartame, Hydrolysed vegetable protein, yeast and so on. So doing this diet is the first port of call. There may also be allergies to foods which can cause associated symptoms in the gut and brain. See Stone Age Diet. In fact, more often I now prescribe the ketogenic diet - please see Ketogenic diet - the practical details and My book The PK Cookbook - Go Paleo-ketogenic and get the best of both worlds
There is overwhelming evidence that heavy metals are implicated in autism (as indeed in many neurological diseases such as Parkinson's disease, Alzheimer's disease and Motor Neurone Disease). Our environmental levels of toxic metals have increase dramatically since stone-age times as a result of mercury and aluminium being used in childhood immunisations, mercury in Rhesus antibody injections, aluminium is now used as an adjuvant in immunisations instead of mercury, lead poisoning is an extremely common problem. We also see mercury in dental amalgam fillings and in seafoods. We know that autistic children are less efficient at excreting heavy metals - hair analysis often shows levels of these lower than in normal children. This is because autistics dump these metals into their brains instead of excreting them into hair and nails. I recommend measuring urine elements following DMSA to establish whether there is a toxic metal load. See Toxic Elements screen - urine sample
Poor Ability to Detoxify
(This is an extension of the above).
Rosemary Waring has clearly demonstrated defects in sulphur metabolism in autistics and sulphur is an essential part of detoxing xenobiotics - not just heavy metals, but also endogenous toxins such as neuro-transmitters. Improving ability to detoxify by supplementing with vitamins, minerals, essential fatty acids and amino acids such as glutathione is an essential part of treatment. See CFS - The Methylation Cycle
Viruses do not have the molecular machinery to replicate themselves - they have to use the molecular machinery of the host cells to reproduce themselves. In order to achieve this they have to get round the immune system and they do this by causing immune suppression. One possible mechanism of this is that the viruses may encourage the body to accumulate heavy metals, thereby knocking off its immune system. Clever eh!
Three viruses (all single RNA strands) known to cause brain damage on their own are measles, mumps and rubella. Dr Richard Halvorsen's book "The Truth About Vaccines" (see Amazon Link for The Truth about vaccines) explores this in some depth and, indeed, in the introduction of this book Dr Peter Fletcher states that whilst we may not know the mechanism, there is no doubt that our present epidemic of autism is due to vaccination. I encourage all parents to read the Halvorsen book so they can decide for themselves the best vaccination schedule for their children.
Abnormal Gut Flora
The upper fermenting gut is an almost inevitable result of Western diets which are high in sugar and carbohydrates. Excessive use of antibiotics and vaccinations have the potential to further upset the gut flora and lead to a pro-inflammatory tendency, poor detox ability and a tendency to acquire infections. If you count up all the cells in the body including gut microbes, then you and I are 95% microbes! They have their own genes which code for many substances essential for normal health. Indeed there are many more bacteria genes than human genes and play an important role in normal detoxification and immune function. Do have a look at Fermentation in the gut and CFS
Neuro-transmitters, especially excitotoxin neuro-transmitters are metabolised by methylation, so if this is malfunctioning then excitotoxins as above will have a more malign effect. The enzymes involved in methylation are multiple and several pathways are involved, but one needs to start off by looking at B12 and folic acid, the latter may be best given as Folinic acid. Dr Yasko investigates this by doing FIGLU (folate) and urinary MMA (B12) and also SNPs test (pronounced snips, single nucleotide polymorphisms). See CFS - The Methylation Cycle
Borderline hypothyroidism is extremely common and it is essential to measure a Free T4, Free T3 and TSH. See Hypothyroidism
A Tendency to Inflammation
Inflammation will tend to flare all of the above and anything that can be used to reduce an inflammatory tendency will be helpful. Antioxidants help to control inflammation by damping down the inflammatory fire. See Inflammation
Poor Mitochondrial Function
The symptom of this may be poor levels of physical and mental energy. Mitochondrial support for some patients Dr Yasko finds very helpful and supplements including D-ribose, Co-enzyme Q10, Acetyl L-carnitine and NAD may be helpful. See CFS - The Central Cause: Mitochondrial Failure
The practical details of putting all this together are in Dr Yasko's book, but a broad outline is:
- Take a good multi-vitamin, minerals, essential fatty acids, vitamins C and D.
- Eat a "stoneage", or better still a paleo ketogenic, diet based on meat, fish, eggs, nuts seeds, vegetables and some fruit. Bottled mineral water. If multiple food intolerance suspected, then consider desensitisation with EPD.
- Culture probiotics on soya or goat's milk (whatever is tolerated) with Kefir to normalise the gut flora. See Kefir]
- Use supplements to improve detoxification and methylation, in particular B12 5mg daily, Folic acid as methyltetrahydrofolate 800mg (ActiFolate)and Glutathione 250mg daily.
- Check thyroid function
- Detox with Detoxing - Far Infrared Sauna (FIRS)
- Consider the possibility of a candida problem
Progress with the above can be monitored firstly by seeing clinically how the patient gets better with respect to behaviour, development, sleep and gut function.
There is increasing evidence that mitochondrial dysfunction is indeed a major player in autism - see: Mitochondrial dysfunction in autism spectrum disorders: a systematic review and meta-analysis by DA Rossignol and RE Frye
- Toxic Elements screen (Genova) – urine sample
- Thyroid profile: free T3, free T4 and TSH - this is a blood test, but contact the office to see if it can be done on a saliva sample;
- Comprehensive Digestive Stool Analysis - looking for efficiency of digestion, gut dysbiosis and parasites.
- Urinary Organic Acids (Metabolic Analysis Profile) - these look at many markers of biochemistry such as the methylation cycle (MMA and FIGLU), Kreb's citric acid cycle, ability to detox, gut function and neurotransmitter levels. A very useful screening test.
- Mitochondrial Function Profile - there is increasing evidence that autism may result from poor mitochondrial function in brain cells.
- Nutritional Supplements
- Stone Age Diet
- CFS - The Methylation Cycle
- Fermentation in the gut and CFS
- CFS - The Central Cause: Mitochondrial Failure
- Detoxing - Far Infrared Sauna (FIRS)
- Ketogenic diet - the practical details
- My book The PK Cookbook - Go Paleo-ketogenic and get the best of both worlds
- Please see the autism section of Micro Trace Minerals website - metals and disease research
- Link for The Puzzle of Autism
- Amazon Link for The Truth about vaccines
- Mitochondrial dysfunction in autism spectrum disorders: a systematic review and meta-analysis
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