Naturopathic Interventions in the Holistic tx of Autism


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Naturopathic Interventions in the Holistic tx of Autism

  1. 1. Naturopathic Interventions in the Holistic Treatment of AutismGlenn B. Gero, N.D., D.Sc., M.Sc., M.H., M.E.S., C.L.C. Holistic Naturopathic Center Clifton, NJ © 2010 1
  3. 3. What is Naturopathy?Naturopathic medicine is a system thatfocuses on promoting and maintaininghealth and wellness by the use of naturalmeans, without the use of toxic therapies.Naturopathic doctors are trainedspecialists in non-invasive naturalmedicine utilizing holistic nutrition,botanical medicine, homeopathy, exercisetherapy, biofeedback and life coaching. 3
  4. 4. Check Engine LightShould We Treat the Symptom or Find the Cause? 4
  5. 5. Take Home PointsAutism is a multifactorial disease associated with a number of genetic, pre-conceptual, nutritional, neurotoxic, environmental, gastrointestinal, infectious and autoimmune conditions, requiring an individualized multi-faceted therapeutic approach.There are a number of safe and non-invasive nutritionally-based treatments which may provide significant benefits. 5
  6. 6. Multifactorial? 6
  7. 7. Autism Prevalence Rises to 1 in 110 Children The Centers for Disease Control and Prevention (CDC) recently released a new study stating that autism now affects 1 in every 110 American children and 1 in 70 boys. Until recently, the CDC had been saying autism occurred in 1 in 150 children. This new research confirms that autism is a real crisis and that early intervention services and state-of-the-art training and supports are more important than ever. 7 Source: CDC, January 19, 2010
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  9. 9. Is There an Autism Epidemic?A seven-fold increase in autism rates over thelast 15 years.The University of California study suggestedthat there must be something that fetuses andchildren are exposed to at an early age thattriggers the onset of autism. Potentialenvironmental causes may include pesticides,viruses, chemical and household cleaners. 9Source: University of California Study March, 2010
  10. 10. Genetics The biochemical basis of the disorder is not known. It is believed that a variety of heritable and non-heritable factors affecting the nervous system may be the cause Available evidence strongly suggests that genetic factors may play a major roleEpidemiological Review, June 2002. 10
  11. 11. GeneticsBoth identical and fraternal twin studies suggest a concordance rate of 90% and 30%, respectivelyA 75-fold increase in probability among siblingsSanford School of Public Policy, Duke University, April 2009. 11
  12. 12. Polymorphisms Polymorphism – a large-scale error in transcription (copying) of the DNA configuration leading to a genetic deviation (mutation) A variant of a gene called MET doubles the risk of autism causing nervous system, digestive and immune system dysfunction (Vanderbilt Kennedy Research Center) 12
  13. 13. Pre-conceptual Factors in Transcription Errors Unhealthful consumptive habits of both parents (diet, tobacco, alcohol, recreational or prescription drugs) Household contaminants Environmental toxins – pesticides, herbicides, industrial/atmospheric pollutants Emotional or stress factors – household disharmony 13
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  15. 15. Affects of Faulty Sulfation 15
  16. 16. Phenol Sulfotransferase Pathway (PST)The PST sulfation pathway is necessaryfor the breakdown and removal of certaintoxins in the body. This includes theprocessing of a type of chemical called aphenol.Phenols are a regular and necessary partof life. 16
  17. 17. Phenols & SalicylatesAll foods contain some phenolic compounds.Some foods have a much higher content than others.If the sulfation pathway is not functioning well, aswith many children with autism, a person may not beable to process out the phenolic compounds as fast asthey consume them. There is a cumulative effect.When the phenols start backing up in the system, it cancause a myriad of negative reactions. 17
  18. 18. Faulty Sulfation & Detoxification The detoxification pathway processes other phenolic compounds including salicylates (a subset of phenols), artificial food colorings, artificial flavorings, and some preservatives. Besides requiring PST, research has found the salicylates further suppress the activity of any PST enzyme present, making matters worse. Food dyes also have been shown to inhibit the PST enzyme. 18
  19. 19. Phenols & SalicylatesHigh phenol foods include: food dyes,tomatoes, apples, peanuts, bananas, oranges,cocoa, red grapes, colored fruits and milk.Other items to consider are perfumes andfragrances, nitrites and nitrates, monosodiumglutamate (MSG), hydrolized vegetableprotein (may contain MSG), sulfites/sulfitingagents, benzoates and corn syrup. 19
  20. 20. The Feingold DietThe Feingold list of highly phenolic/high salicylate foodsincludes: artificial colors and flavors (FD&C colors),vanillin, BHA, BHT, TBHQ and some naturalsflavorings, aspirin and products containing aspirin orsalicylic acid, salicylates, almonds, apples, apricots,berries (all), cherries, chili powder, cider & cider vinegar(apples), cloves, coffee, cucumbers & pickles, currants,grapes & raisins, nectarines, oranges, paprika, peaches,peppers (bell & chili), plums, prunes, tangerines, tea,tomatoes, wine & wine vinegar (grapes), oil ofwintergreen (methyl salicylate). 20
  21. 21. Food Allergies and Sensitivities  Autistic children have significantly higher levels of food intolerances (especially gluten and casein)  IgE testing – Type one sensitivities  IgG testing – Type two sensitivities  Marked behavioral improvement after eight weeks on elimination diet Journal of The American Dietetic Assn. Feb. 2010 21
  22. 22. Faulty Sulfation & Food Sensitivities Reduced sulphation has been associated with inflammation, gut dysfunction and increased permeability. Sulphates help to hydrolate* toxins out of your body. If the body builds up with toxins, the gut can become permeable to indigested peptides from gluten and casein, which then travel to the brain looking like pseudo neurotransmitters, but actually acting as opiods.*surround toxins with extra water molecules 22
  23. 23. Top Seven Food Allergies in Children Over 90 percent of food allergies (or sensitivities), especially in young children, are caused by seven foods:  Dairy products  Egg  Soy  wheat  Peanut  Tree nut  Shellfish Blood tests and skin prick tests are useful if food allergies are suspected, but these will unfortunately not provide information about food chemical sensitivities or intolerances. The gold standard method of identifying food chemical sensitivities is through specific IGG food sensitivity tests through a laboratory specializing in food sensitivity testing. 23Source: Daniel More, MD, board-certified allergist and clinical immunologist
  24. 24. Sub-clinical Celiac DiseaseWheatSpeltKamutRyeBarleyIn my practice, if I did nothing more than tell all ofmy patients to avoid gluten containing foods, 2/3would notice a significant improvement in theirhealth. With my patients diagnosed withautoimmunity, IBS, chronic fatigue, ADD, ADHDand autism, that percentage may escalate to nearly90%. 24
  25. 25. Symptoms Associated with Food SensitivitiesFatigue Hyperactivity/ADHDDepression Atopic DermatitisConstipation Bloating/gastritisDiarrhea Bowel disordersHypoglycemia Gastric refluxMigraines Inflammation/painWeight gain Muscle stiffnessBrain fog/ ADD Cognitive decline 25
  26. 26. Casein IntoleranceOne of the primary proteins in milk andmilk productsAn inefficiency of the DPP4 enzymeresults in only a partial breakdown ofcasein 26
  27. 27. Dietary Factors in Autism TherapyFactor % Improved % Deteriorated % No EffectGluten-Free 65 3 32Casein-FreeDairy-Free 50 2 48Wheat-Free 49 2 49Anti-Yeast 54 3 43Additive- 54 2 44FreeSugar-Free 48 2 50 27 Information compiled by the Autism Research Institute, Spring 2006
  28. 28. Supplementation Therapy Diet Alone Isn’t Enough 28
  29. 29. Why Diet Alone Isn’t EnoughAutistic children are believed to require higherlevels of nutrientsHigher nutrient levels are not availablethrough diet aloneAmerican food supply is nutritionally depleted& devitalizedTransport, GMO, hybridization, irradiation,pest control, fertilization, processing, chemicaladditives, preservation, economics 29
  30. 30. In terms of nutritional abnormalities: Zinc deficiency exists in 90% of autistic children Copper excess exists in 90% Calcium and magnesium deficiencies are common Omega-3 deficiency exists in nearly 100% Fiber deficiency exists in nearly 100% Antioxidant deficiency exists in nearly 100%Jeff Bradstreet, M.D., dir. International Child Develop. Resource 30 Center, 2002
  31. 31. Common Nutrient Deficiencies andInsufficiencies in Autistic Children Calcium Omega-3 Fatty Acids Magnesium Vitamin B-12 Selenium Vitamin B-6 Zinc Folic Acid Iron Methionine Cysteine Vitamin E Sulfate Vitamin D Taurine Vitamin A 31
  32. 32. Therapeutic Interventions Rated by hierarchyTherapy % Improved % Deteriorated % No EffectDetoxification 75 3 22Calcium 62 3 35Dig. Enzymes 58 3 39Vitamin C 56 2 42Omega-3 54 2 44Vitamin B-6 51 13 36Zinc 48 3 49Folic Acid 42 4 54Prozac 37 33 30Adderall 34 26 40 32 Source: Autism Research Institute, Spring 2006
  33. 33. Omega-3s and Autism Omega-3 fatty acids (EPA/DHA), especially DHA, almost universally recommended for children with autism by integrative practitioners Research indicates that children with autism are deficient in Omega-3 fatty acids Omega-3 fats nourish the nervous system and brain and reduce inflammation throughout the body 33
  34. 34. EPA/DHA and AutismStudies have also found that fish oil can help withbehavior, reading and spelling in children withdevelopmental disorders. This current study wasdesigned to see if fish oil capsules (1.5 grams ofomega-3 fatty acids per day) could help children withautism. The study had only 13 children who wereabout 11 years old.All children showed fewer signs of autism whentaking fish oil and the only side effects were somemild stomach upset and diarrhea.Biological Psychiatry, April 23, 2007 34
  35. 35. Vitamin D and Autism “The dramatic increase in the prevalence of autism over the last 20 years corresponds to the deficiency of vitamin D.” Pregnant and nursing mothers as well as infants need vitamin D, since it acts as a neurohormone stimulating brain development and may potentially reduce the risk for autism.Dr. John J. Cannell, executive director - Vitamin D Council and a forensic 35psychiatrist at Atascadero State Hospital in California
  36. 36. Benefits of Vitamin DRegulates calcium & phosphorusModulates moodStimulates brain functionRegulates immune systemProvides chemoprotectionPromotes cellular differentiationProvides anti-inflammatory effectsMay offset dangers of mercury toxicityRegulates blood pressureRegulates blood sugar levels 36
  37. 37. Vitamin D & Dosage Dose is commensurate with 25-hyroxyvitamin D levels in blood Safe levels for women during pregnancy is 1,000 to 2,000 i.u. Initial one-time dose at birth has been as high as 200,000 i.u. 37Michael Holick, M.D., P.HD. Professor of Medicine, Physiology and Biophysics at
  38. 38. Autism and Magnesium Magnesium is needed for more than 300 biochemical reactions. It is essential for proper brain and muscle function, as well as normal growth and development. The children with autism have been shown to have significantly lower levels of magnesium than children without autism.Biological Trace Elements Research, December 2006 38
  39. 39. Magnesium or Ritalin?“Magnesium and vitamin B-6 supplementationhas been shown to reduce central nervoussystem hyper excitability in children*.”Dosages of 200 to 300 mg of magnesium forASD or ADHD children have profoundlydemonstrated relief from anxiety,nervousness, hyperactivity and learningcapacity. 39*American College of Nutrition, August 2004
  40. 40. Folic Acid A mutation in the MTHFR gene may contribute to neurological issues, Down’s syndrome, memory issues, premature aging and cardiovascular disease*. Folic acid must be converted to the active form of methyl folate. A defect in the MTHFR enzyme will inhibit this conversion contributing to a deficiency in folic acid. Amy Yasko, N.D., Garry Gordon, M.D. 40
  41. 41. Methylfolate (5-methyltetrahydrofolate) Low levels of 5-methyltetrahydrofolate, the active form of folic acid, in the spinal fluid of children who had normal neurodevelopment until age 4 to 6 months was associated with subsequent neurological regression. The addition of methylfolate as a dietary supplement corrected the symptoms. This observed favorable response further supports its central role in at least some developmental disorders. 41Neuropediatrics, December 2002
  42. 42. Vitamin and Mineral Imbalances Most common vitamin deficiencies are folic acid, vitamin B-6 and vitamin B-12 Most common mineral imbalances are magnesium and a decreased zinc-to-copper ratio Vitamin and mineral imbalances are common and can be corrected Encouraging scientific confirmations 42
  43. 43. Primary Nutritional Needs DHA Magnesium Vitamin D Probiotics Zinc Vitamin C Vitamin E Calcium B Vitamins 43
  44. 44. Secondary Nutritional NeedsDigestive Enzymes MelatoninTaurine Methyl B-12Vitamin D Methyl folateSelenium IronChromium Milk thistleCoenzyme Q10 Anti-oxidantsTMG N-acetyl cysteineTaurine Colostrum 44
  45. 45. Tertiary Nutritional Needs Partial ListAcetyl L-carnitine DMAE5-HTP L-carnosineQuercitin DMSACaprylic Acid L-glutamineGarlic MolybdenumPhosphatidylcholine MethionineSAMe L-theanineActivated charcoal Inositol 45
  46. 46. Comprehensive Protocols versus “Single Bullet Cures”Patient care in a holistically-oriented practice should have a multi-factorial emphasisUse a variety of functional assessments to determine the real etiological factors contributing to the patient’s imbalanceSelect products and therapies that are therapeutically inclusive“Human health is more of an ecological function than a single-bullet function” 46
  47. 47. Beware of Clinical Myopia 47
  48. 48. Biochemical IndividualityThere is no such thing as the average person—we areall genetically and biochemically unique (RogerWilliams, 1956)For optimal function, we each have unique nutritionalneeds and specific environmental requirements(IBID)Utilizing universal protocols may be inappropriateunless we access an individual’s specific weaknessesand requirements 48
  49. 49. Always look for the connections and the underlying causes Fill the Bucket and Stop the Leak 49
  50. 50. Digestive Insufficiency Studies confirm high propensity of GI symptoms Dysbiosis – abnormal gut flora Pathological bacterial, fungal overgrowth Parasitic Infections Chronic gastritis Reflux esophagitis Chronic colitis or constipation Intestinal permeability (leaky gut syndrome) Frequent antibiotic use 50
  51. 51. Neurotoxic FactorsHeavy metal toxicity – mercury, lead, cadmiumPesticides, herbicides, PCBs, chemical toxins, petrochemicals, food additives, exhaustsA July 2005 study found over 200 toxic chemicals in umbilical cord bloodVaccinations 51
  52. 52. Infectious Disease and Autism The proven and suspected role of microbes does not stop with physical ailments; infections are increasingly being examined as associated causes of, or possible contributors to, a variety of serious, chronic neuropsychiatric disorders and to developmental problems, especially in children Institute of Medicine, June 15, 2004 52
  53. 53. MicrobesChronic bacterial infectionsChronic viral infectionsToxic metals and microbesAluminum binds staphylococcus aureusLyme Disease – Autism Connection 53
  54. 54. The Viral Infection Link Viral infections lead to the increased absorption or retention of metals in the body Herpes has been implicated in seizure activity Retroviruses may be involved in triggering asthma and there is an association between autism and the presence of family members with asthma 54
  55. 55. What’s in Our Vaccines? Ingredients found in some vaccinesAluminum Polysorbate 20 & 80Ethyl Mercury SucroseFormaldehyde Chicken SerumMSG Cow SerumPhenoxyethanol Sheep CellsAntibiotics Mouse Protein Source: National Vaccine Information Center 55
  56. 56. The DPT Vaccine Diphtheria, Pertussis, Tetanus The DPT vaccine is made with toxoid, which is toxin that has been inactivated Tetanus toxin has been shown to disrupt the production of various neurotransmitters, possibly contributing to an excitatory reaction 56
  57. 57. Autoimmunity and Autism Data supports the notion of local autoimmunity in the gut leading to altered cognitive functioning by a failure to detoxify neuroactive substances. There is also an increased prevalence of autoimmune disorders in families of autistic children. Molecular Psychiatry, vol. 7, 2002 57
  58. 58. Functional Assessments Blood Chemistry Analysis  Salivary Hormone Testing Quantitative Fluid  Blood Microscopy Analysis  Tongue, Face, Nail, Pulse Hair Mineral Analysis Analysis Urine Provocation  Blood Pressure Testing Symptom Analysis  Bioimpedence Lifestyle Analysis  Fitness Assessment Dietary Analysis  Body Measurements Muscle Response Testing  Structural/Postural Adrenal Response Testing Assessment Food Sensitivity Testing  Pulmonary Function Test Neurotransmitter Testing Heart Rate Variability  Iridology/Sclerology Amino Acid Profile  Genetic Testing 58
  59. 59. Then Connect the Dots Look for Continuity and Patterns of Imbalance 59
  60. 60. Protocols should be both Individualized &Condition Specific 60
  61. 61. Conventional vs. Nutritional Approaches Drug therapies have been shown to be mostly ineffective for use in the treatment of ASD Dietary therapies, while being controversial, do not cause the often unpleasant and sometimes very dangerous side effects associated with drugs 61
  62. 62. Symptoms That May Improve Through Diet Modification Inability to concentrate Eye contact difficulty Aggression and hyperactivity Digestive complaints Poor language skills Sleep difficulties Difficulties in ADLs Atopic dermatitis, urticaria, rosacea Aberrant behavior 62
  63. 63. Nutritional Screening Simple hair, blood, urine, stool assessments can determine levels of: Vitamins – A, folic acid, B-12 Mineral levels – calcium, magnesium, zinc, copper, iron Toxic metals – lead, mercury, aluminum, cadmium, etc. Other nutrients – EFAs, amino acids, protein, enzymes 63
  64. 64. Immune Dysregulation Simple hair, blood, urine, stool assessments can also determine levels of:High yeastBacterial metabolitesHigh viral titersAutoantibodiesNK cell activityImmunoglobulins 64
  65. 65. Where to Begin? 4-Rs Realize Remove Replenish Repair 65
  66. 66. Realize Request a Broad Range Functional Assessment CBC, CMP, Urinalysis, Thyroid, Vitamin D Premier Autism panel Urine, Hair, Fecal metal panel Plasma amino acids Plasma fatty acids Genetic testing Urine metabolic analysis/organic acids Comprehensive digestive stool analysis IgG/IgE food antibody testing 66
  67. 67. Remove Eliminate sugars, junk foods, preservatives, artificial sweeteners, artificial colors, preservatives, refined flours, sugared soft drinks and food sensitivities Eliminate toxins in water supply, foods, home (mold, dust mites, asbestos, lead paint, carpets, etc.) Air purification system 67
  68. 68. Replenish Organic Whole Foods Beneficial Flora (Probiotics, Fermented Foods) Enzymes Nutrients – vitamins/minerals Essential Fatty Acids Botanicals Fiber 68
  69. 69. RepairAntimicrobialsAntifungalsAntiviralsAntibacterialsImmunotherapyDetoxificationFunctional Restoration (physical, neurological,psychological and nutritional) 69
  70. 70. SummaryAutism spectrum disorder is a complex mutifaceted, multifactorial diseaseEach individual case must be assessed on the specific imbalances and deficienciesFunctional testing should be comprehensive and relevantSingle-bullet “cures” are not generally successfulASD requires a holistic broad-spectrum approach 70
  71. 71. SummaryDietary choices may be a critical component toward improvementFood allergens/sensitivities should be determined and eliminatedSupplements should be chosen on the basis of need and taken in the appropriate dosage and form in each caseIntegrating consistent, conventional and holistic approaches will yield the best possible opportunities for improvement 71
  72. 72. SummaryA diagnosis of autism is a call to arms for an entire familyThe most effective treatment is creating a consciousness of emotional, physical and nutritional wellness for the entire family 72
  73. 73. Thank You 73
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