Defeat Autism Now (DAN!)

Posted in Article on Sunday, November 14th, 2010 at 12:41 pm    2 Responses

 

INTRODUCTION

Having just attended the Defeat Autism Now (DAN!) conference in Long Beach, California, I was amazed by the collection of scientists, researchers, doctors and nutritionists all of whom have adopted a biomedical approach to treating children with Autism Spectrum Disorders (ASDs). It was really incongruent to have to remind myself that this approach, although seeped in so much science and even more common sense, still remains on the fringe when it comes to working with these children, particularly in South Africa. Here, most accept the notion that Autism is manageable, maybe. But what we should really be grasping rather, is that Autism is Treatable, definitely.

 

Background

 

ASDs include ADHD, Asperger’s Syndrome, Pervasive Development Disorder (PDD) and Autism.  Most recent publications suggest a continued rise in the prevalence of autism to approximately 1 in 91 children. In the past, it has been predominant in boys (4:1) but this is now thought to be changing.  Additionally, it is now believed that 1 in 16 children will be diagnosed with ADHD.
Autism has been classically defined as a behavioural disorder with diagnosis based on three DSM IV Criteria:

 

  1. Impaired social interaction
  2. Impaired social communication
  3. Markedly restricted repertoire of activities and interests

 

However, there is an emerging view that autism is a whole-body disorder that arises from a combination of genetic predisposition (or vulnerability) combined with environmental factors. More importantly, ongoing research has found that ASDs are associated with a combination of any of the following: oxidative stress, decreased methylation capacity, limited production of glutathione (GSH), mitochondrial dysfunction, intestinal dysbiosis, increased toxic metal burden, immune dysregulation and ongoing brain hypofunction. Many of these irregularities are also common in children with ADHD.

 

What is critical is that these latest associations mean that children with ASDs are amendable to targeted biomedical treatment.  But, individuality is key. Even in the midst of an epidemic in which we assume that the victims “have the same thing”, respect for each child’s differences is the key to finding that child’s best diagnostic and therapeutic options.

 

The Autism Triad: Brain-Gut-Immune Axis

 

Results from diverse fields now show clear and convincing evidence of bidirectional communication between the nervous and immune systems. The health and development of the nervous system is largely dependent on the health and function of the immune system. The gut itself works as a bridge between the two, not only housing high levels of neurotransmitters, but also high levels of immune regulators. All three systems are highly sensitive to oxidative stress and consequences thereof, especially during critical developmental windows. A toxic inflammatory insult in one can indirectly affect the development and function of the others.

 

Chronic oxidative stress & mitochondrial dysfunction

 

Oxidative stress is caused by an imbalance between the production of reactive oxygen species (ROS) and the body’s ability to detoxify them or easily repair the resulting damage. Mitochondria are the cells of the body that are responsible for producing energy and are the most sensitive target of oxidative damage.
A fragile homeostatic balance underlies reduced methylation capacity and oxidative stress. Methylation is the critical process involving methyl groups pairing with toxins that are then excreted or neutralised by the body. Methionine is a nutritionally essential amino acid providing both methyl groups and sulfur needed for normal metabolism. Some of it goes into building and repairing body tissues and some of it goes into a cycle where it is transformed into cysteine. Cysteine is the active form of many enzyme proteins, hormone peptides and the antioxidant and detoxificant, GSH. Methionine metabolism tends to be disordered in children with autism, upsetting the fragile homeostatic balance.

 

Chronic oxidative stress decreases both methylation capacity and GSH synthesis. This leads to increased susceptibility to infection and decreased ability to resolve inflammation, which is why children with ASDs are often sick. Additionally, mitochondria cannot synthesise GSH and low mitochondrial GSH promotes increased ROS generation and an increased inflammatory response.

A working hypothesis from the DAN! Conference is that an inability in children with ASDs to maintain glutathione redox status under chronic or inflammatory oxidative stress may be central to the development of the neurologic, immunologic, and gastrointestinal dysfunction often seen – the autism triad.

 

A working hypothesis from the DAN! Conference is that an inability in children with ASDs to maintain glutathione redox status under chronic or inflammatory oxidative stress may be central to the development of the neurologic, immunologic, and gastrointestinal dysfunction often seen – the autism triad.

 

Contributing factors

 

As the primary underlying genetic vulnerability appears to be, in many children, an impaired ability to detoxify, these children are much more susceptible to environmental insults.
These environmental insults include toxins such as:

 

  • heavy metals (mercury, aluminium, nickel, cobalt, cadmium, lead, arsenic, manganese),
  • solvents (alcohol, chlorinated solvents, benzene),
  • industrial chemicals (PCBs, pesticides, herbicides),
  • food sensitivities or allergies, and other infections.

 

Remember that combined sub-toxic dosages can reach a toxic threshold inducing oxidative stress and GSH depletion.

 

Making small changes in homes like eating organic, not heating food in plastic containers, never opening dry cleaning inside, using only eco-friendly organic cleaning products and using natural body care products, can go a long way in reducing toxin levels.

 

Laboratory testing in ASDs
The biomedical approach to ASDs is not based on guesswork. The following are just some of the tests that form the basis of any treatment programme. Labs should be ordered by a trained practitioner and then reviewed by him/her.

 

  • Blood chemistry and CBC analysis
  • Stool analysis
  • Food allergy tests
  • Amino acid analysis
  • Organic acid analysis
  • Fatty acid analysis
  • Immune testing
  • Genomics testing

 

Overview of the Healing Programme

 

 

The healing programme for ASDs is based around four elements:

 

1. Reduction of environmental toxins

This includes following an organic diet as much as possible and avoiding any potential allergens – both foods and environmental. Additionally, any underlying infections need to be treated (fungal, viral, bacterial or parasitic).

 

2. Dietary modifications

There are several diets that may be effective in managing symptoms in children with ASDs, particularly with regards to reducing inflammation. It is essential to work with a qualified practitioner to ascertain which one is most suitable.

3. Nutritional Supplementation

Nutritional supplements in ASDs should only be prescribed in conjunction with an analysis of both symptoms and results from laboratory testing. There is no one size fits all prescription. Additionally, it is essential that supplements are hypoallergenic and designed for children on the spectrum.

4. Detoxification

The first place to start when it comes to supporting detoxification pathways in children with ASDs is to support and heal the gastrointestinal tract.  Following this, consideration should be given to supporting both methylation and sulfation, particularly with regards to enhancing GSH synthesis.

 

An interesting place to start when it comes to the biomedical approach is to take a look at the parent ratings of biomedical interventions, which present the responses of over 25,000 parents showing the effectiveness of various interventions on their child. It can be viewed at:
http://www.autism.com/fam_ratingsbehaviorbiomedical.asp

 

CONCLUSION

 

It has historically been thought that autism is a fate that you accept. However, there are now a wide variety of treatment options that can be helpful. Some may lead to great improvement, and others may have little or no effect. But there are options out there and research is ongoing. I felt both humbled and inspired by the DAN! Conference and hope to see health care practitioners in South Africa embrace this approach in the years to come.

 

Contact Hannah Kaye for guidance on nutritional therapy for children who are living with Autism.

2 Comments

  1. Mathew November 15, 2010

    Wow so informative and what an inspiration to know that there is someone of your calibre here in South Africa. Will be contacting you soon after showing friend who has an amazing child as sure you can help. Regards Mathew

  2. sthe December 1, 2013

    At least there is hope for our children’s future.

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