Candida Albicans is a yeast like fungus normally present in the human body primarily on mucous membranes.  However, if an immune system is comprimised Candida can flourish to unhealthy levels systemically.  It is common for immune system comprimise to occur with use of antibiotics.  Often children with autism present with ear infections or symptoms that would appear to mimmick an ear infection.  With obvious communication obstructions, it is even for difficult for children to project their symptoms to their parents.

The first mistake is the common  practice to diagnose acute otitis media (aom) with a brief history and minimal physical exam including a brief otoscopic visual exam.  Often there is no culturing or other testing for pathogens.  At this point it is common for the physician to prescribe a broad spectrum antibiotic.  This creates a problem on two fronts.  First, the question has to be asked if antibiotics were even indicated.  Studies presented in JAMA show that antibiotics have not been shown to shorten acute symptoms nor prevent secondary infections.  Parents are better suited to manage symptoms of discomfort and monitor the normal self limiting course of the condition.  Unfortunately parents are often guilty of pressuring their physician into prescribing antibiotics even when not indicated.

Second, the rampant growth of antibiotic resistant strains has created such an epidemic that the government has issued guidelines in an attempt to minimize utilization of antibiotics. I’ll expand on these issues in future entries.  For now it’s important for parents to understand the inherent risks associated with broad spectrum antibiotic use.

The proliferation of yeast is often treated using antifungal agents such as diflucan, nystatin or ketoconosal.  Supplementing with good bacteria such as acidophilus and eliminating yeast promoting foods from the diet are very important in restoring candida to healthy levels.  Other supplements that have been shown to help are caprylic acid, garlic, and colloidal silver.  There is much debate over the use of antifungal agents both in efficacy and duration of treatments.  I would limit the use of these agents for extreme cases.

More research is beginning to surface about the yeast-autism connection but parents should only view this association as peripheral.  In any condition it is fundamentally important to have a healthy immune system and systemic balance.  Keeping Candida to healthy levels is a very important part of this process.  Minimizing exposure to broad spectrum antibiotics is a step in the right direction.  If unhealthy levels are present there are treatment options available to restore balance to the system. 

Hyperbaric Oxygen treatment is a form of oxygen therapy utilizing compressed oxygen delivery. By pressurizing oxygen one can improve the level of oxygen red blood cells can deliver to tissues. This process is called altering oxygen tension or oxygen partial pressure (pO2) and is measured in millimeters of mercury (mmHg). A typical reading of pO2 is 40 mmHg. Research has shown that you can improve tissue healing if you can raise the pO2 to 80 mmHg. Compressed oxygen therapies can improve healing by raising this pressure gradient.

There is not a lot of research validating the indication of Hyperbaric Oxygen treatments for Autism and related disorders. I have read multiple case studies regarding this therapy with various injuries including head trauma and wound healing. It has been shown to be successful in helping with skin burns and grafts, diabetic wound healing, gas poisoning such as carbon monoxide, decompression sickness (think scuba diving), and tissue necrosis conditions such as post trauma or ischemia. I am seeing more studies in other central conditions such as seizure disorders and intracranial abscesses.

I am a big fan of oxygen therapies and would make the argument that most conditions of any sort would be better off with improved and optimal fuel delivery including the delivery of O2. With that said, patients need to be aware that typical treatment plans prescribed can be quite involved. Treatment plans tend to be very extensive and expensive as insurances tend not to cover many of these therapies (especially for experimental uses that aren’t approved).

I also believe that optimal utilization of these chambers would include more active treatment when it comes to changing central integrated states and plasticity of neuronal pathways. Typically the chamber is a static treatment that involves the patient seated during the course of the session while being exposed to the pressurized gas. Although this can be very effective for the aforementioned conditions, I believe that when trying to affect change to the central nervous system oxygen should be combined with active care. This may include particular exercises or other types of large or small diameter afferentation. Keep in mind that the general principle of nerve survival, growth and health is activation and fuel delivery. Although using oxygen therapy is a powerful tool to improve fuel delivery, it lacks in the activation of sensory receptors that would improve higher functional integration in the neocortex and cerebellum.

I would not want to deter parents who had the time and resources for Hyperbaric therapies but would caution their expectations and understand it is a largely experimental area in central neurological treatments.

One concept in the diagnosis and treatment of Autism is the effect of heavy metal toxicity on the central nervous system. The major offender is thought to be Mercury exposure due to the use of Thimerosol used in vaccines and flu shots. Another common documented source in older children are amalgam fillings used by dentists.

First, your doctor needs to assess whether there are heavy metals present. A baseline 24 hour urine sample is taken and then followed by another 24 hour sample after DMSA (Dimercaptosuccinic acid) has been given. DMSA is a chelating meso isomer that can cross the blood-brain barrier and has been shown to extract metals such as mercury, lead, arsenic and bismuth.

If indicated a typical treatment utilizes 10 mg/kg three times a day for three days with a break period of 2 weeks. This on again, off again program is performed until tests show a decrease in metal toxicity. Lab tests should be performed regularly such as a CBC and to monitor liver enzymes to evaluate the effect of DMSA.

Other supplements that have been shown to augment the effect of DMSA are lipoic acid, magnesium and selenium.

This treatment is recommended in conjunction with other therapies such as nutritional supplementation and dietary eliminations discussed in other entries.

The treatment of Autism is a multimodal approach with one of the cornerstones being nutritional therapy. This entry is a summary of some of the common treatments and recommendations for utilization of these therapies. Parents should understand that there is not a single recipe for success and what works for one child may not work for another. It is also important to note that nutrition is only a part of successful therapeutic intervention for Autism, albeit a very important one.

First is Vitamin B12 injections. The common dose is 1000 micrograms 2-3 times per week for the first 4-6 weeks then gradually diminish to maintenance levels on a monthly basis. Parents should note there has never been a reported case of B12 toxicity and high doses can be administered safely.

Intramuscular Magnesium has been shown to be helpful although there are reported cases of increased agitation during its use. Magnesium is the fourth most abundant mineral of the body and is used in over 300 functions in the humans.

Colloidal Silver is a suspension of silver particles in water. It has been show to be an immune system booster and may be helpful in systemic disorders.

Pancreatic enzymes are a common treatment but have been shown to have mixed effects on the children. Starting these enzymes should be done seperately as to observe its effect on the patient. Common ones are Creon and Cotazym.

I believe some of the most important supplements are Omega-3 fatty acids. ALA, EPA and DHA are critical fats in a number of tissues. They are important for decreasing systemic inflammation by their effect on the Cox 2 enzyme. They are also important in the cell membrane stabilization of neurons in the central nervous system. Dosage ranges from higher than 10 grams during initial therapies to maintenance levels of 1 gram per day. I recommend 3-5 grams for my patients at the beginning of treatment.

Dimethylglycine (DMG) in a non-protein amino acid that is found naturally in animal and plant cells and is an intermediate in the metabolism of choline to glycine. It is often described as an “oxygenator” when supplemented and there have even been cases reported of DMG stopping drug resistant seizures. Dosage depends on age but it is common to start with one 125mg capsule per day.

Calcium supplemenation has been shown to have beneficial effects on sleep related problems associated this syndrome.

There is research surfacing about the effect of Vitamin A with the idea that Autism is a related to a defect in the G-Alpha Protein. This theory is tied into the D.P.T. vaccine and inserting a G-Alpha Protein into genetically at risk children. This is the Pertussis Toxin of the D.P.T. vaccine and has been demonstrated to seperate the G-Alpha protein from retinoid receptors. It is believed that natural Vitamin A may help with the reconnection of retinoid receptors critical for vision, sensory perception, language perception and attention. Typical dosage is 5000 IU (2500 IU B.I.D.). Those most at risk have at least one parent with a history of a G-Alpha Protein defect, exhibited in disorders such as night blindness, pseudohypoparathyroidism and adenomas of the thyroid or pituitary gland.

Another treatment protocol to discuss with your physician is the promotion of Metallothionein (MT).  This involves a combination of Zinc preloading followed by introducing MT promoting supplements.  This is accomplished by a combination of multiple 14 amino acids, Selenium and GSH.  Again, this should be monitored with lab testing and is typically done in conjunction with elimination diets.

The elimination recommendations typically entail two important food groups, those containing Gluten and Casein. The most common test for tolerance is a simple Urinary Peptide test that detects by-products of incomplete digestion of Gluten and Casein. It is recommended that even without positive test findings, Autistic children should eliminate these two. Gluten is found in foods such as wheat, barley, rye and oats. Casein is found in dairy such as milk, cheese, yogurt and ice cream.

It is believed that when these proteins are broken into peptides they can pass through imperfections in the lining of the gut, commonly referenced as “leaky gut syndrome” and have a negative autoimmune response on the body.

Parents report dramatic effects from eliminating these products. It should not be done “cold turkey”, but rather a gradual withdrawal of Gluten and then Casein products.

There are many other potential and lesser known nutritional therapies that I haven’t discussed in this post, but this is a summary of the more common recommendations that have shown to be successful in the treatment of Autism.  The aforementioned topics can be used as a general guideline to discuss with your physician in treating Autistic Spectrum Disorders.  Outcomes will vary from individual to individual, but nutritional therapies are vital in promoting improved neurophysiology and biochemistry in Autism disorders.

Did you know that the first reported cases of Autism were reported in the early 1940’s which, coincidentally, was shortly after Thimerosal (ethyl mercury) was added to the Pertussis vaccine in the United States? I also found it interesting that cases were not reported in Europe until the 1950’s after Thimerosal was added to their vaccinations. I know this is purely an anecdotal observation, but there is and has been compelling evidence to the link behind vaccinations and the onset of Autistic Spectrum Disorders.

In the 1950’s vaccinations were limited to 4 (pertussis, diptheria, small pox and tetanus). Cases of Autism were reported to be around 1 in 10,000 at that time. Children currently receive approximately 12 vaccines and numerous booster shots. By the age of 2 most children receive a total of 33 shots and what would amount to over 200 micrograms of mercury exposure. The rates of Autism have continued to skyrocket during this time with 1 in 100 boys and 1 in 400 girls being diagnosed with the disorder in the United States. This condition is not only devastating for the child but also for the family. Currently 1 in 68 families has an autistic child.

There has been pressure on the Vaccine makers to reduce or remove mercury in their products in recent years. Unfortunately, many flu shots given to kids also contain Thimerosal.

An interesting fact is that the state of California began keeping record of the disease and that since the phase-out of Thimerosal began in 2000 their Autism rates have dropped 6 percent. Unfortunately, most battles over thimerosal removal are at the state level. The FDA has not recalled the existing vaccines containing Thimerosal and physicians are still using the existing stockpiles.

The debate rages on about the scientific cause of the disorder. Possible reasons include the childs ability or inability to detoxify mercury. Another is synergistic toxicity, which is the enhanced effect of mercury toxicity when other metal poisons are present such as aluminum. The most compelling evidence is associated with the Autoimmune response where the body is exposed to a toxin and has an immune response against its own cells or tissues.

Naysayers laugh at the notion that there is any scientific link between mercury and Autism, and write off the evidence as circumstantial. I believe that where there is smoke there is fire and would much rather error to the side of caution. I did not follow the CDC guidelines for vaccinating my children. I spaced out my schedule for my my kids so that all vaccines were given at an older age than recommended and minimized multiple types of vaccines at once. The MMR vaccine has had one of the worst track records and should be used with caution. I waited until after 2.5 years for the first MMR shot rather the the recommended 12 to 15 months.

My childrens pediatrician stated that multiple vaccinations bundled together “enhanced” their effectiveness. Not only could I not find a single study validating this claim I also referenced the CDC website stating that studies show that vaccines are as effective when given individually as they are when administered simultaneously. Once again validating my point of why I errored to the side of caution to have vaccines administered individually and later in life.

Parents should be cautioned when it comes to vaccines. Like any drug introduced to the human body, they can have dire consequences. Regardless of whether or not you believe the Mercury link is junk science, it is important to at least understand there are risks. I would challenge even the biggest cynics to convince me that there is anything wrong with taking precautions on how your children are given their immunizations. By minimizing the number of vaccines given at once, starting shots later in life and spacing them apart I feel as though I’ve given my kids a safer route to navigate through this critical time in their development.