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Wayne Obie, Talk International.com

A Comprehensive Guide to Managing Autism

Willis S. Langford

Warning: Do not scan and read this paper piecemeal. It must be studied to avoid missteps.

There are several very basic things discussed in this paper that can be done at home with little or no expensive testing. Foremost is the home testing for thyroid function discussed toward the end of this paper, and support of thyroid function. The "unloading of the donkey" is vital to possibly 80% of these troubled children for they are poisoned, drowning in their own toxic wastes. Elimination of bowel disorders is very first on the list of vital action. It is often as simple as supplying a digestive enzyme supplement, or removing milk. Autistic children can often be helped dramatically by medical procedures such as an infusion of the intestinal hormone secretin. The need and the beneficial response to secretin, I think, are dependent upon the amount of damage to the duodenum and upper small intestine from whatever cause, and on the stomach’s ability to produce adequate hydrochloric acid (HCl) for proper digestion. Since proper functionality of these two things largely determine proper digestion, it is vital that both be operative. Without adequate HCl, secretin infusion can, at best, be only partially effective in restoring digestion and proper physical and mental function. Secretin is reduced in hypothyroid rats (Robberecht et al, 1981), so first support the thyroid. With adequate HCl present, and with support for the thyroid, secretin infusion may be totally unnecessary.

The path of autism is different for each child. Some are prone to seizures, some are not; some behave aggressively while others are overly passive. However, children with autism and with ADHD share several factors. There is a deep disturbance in their fatty acid metabolism that impairs their utilization of amino acids, and often there is an imbalance in their electrolytes. Electrolytes control what’s called membrane traffic—what goes in and out of cells. This means that providing other nutritional supplements is relatively ineffective until the electrolyte (sodium-potassium-magnesium-calcium) imbalance is corrected. The delicate balance of electrolytes also controls the electrical activity within the brain. Additionally, there is often heavy metals poisoning: a recent study found 85 percent exhibited severely elevated Cu/Zn ratios in blood, suggesting a disorder of metallothionein (MT), a short linear protein responsible for homeostasis of copper and zinc and many other metals. "The severity of the Cu/Zn imbalance was far greater than that of any other population we have studied over the past 25 years," said Biochemist, William J. Walsh, Ph.D. and Physician, biochemist and chief scientist of the Pfeiffer Center, Naperville, Illinois. Blood and urine analyses yielded evidence of a metallothionein (MT) dysfunction in 499 of 503 patients (99 percent) diagnosed with autism spectrum disorders, according to Walsh, suggesting that autism may be caused by either a genetic MT defect or a biochemical abnormality, which disables MT protein. "An MT disorder may affect the development of brain neurons and may cause impairments in the immune system and gastrointestinal tract, along with hypersensitivity to toxic metals," he said.

Furrthermore, their minerals and amino acids are deficient and/or imbalanced. Their production of red and white blood cells is irregular. They have a dysfunctional immune system (often attacking "self"). Eighty percent suffer mitochondrial disorders (lack of energy production) according to Dr. Colemen, George Washington University Hospital. Ninety percent suffer some degree of hypothyroidism despite "normal" TSH readings (Raphael Kellman, MD). Eighty-three percent suffer dysfunctional Phase I and II, liver-enzyme activity (causing a build up of toxins and heavy metals), and 85% of autistic meet criteria for malabsorption leading to a multitude of nutrient deficiencies (B. Walsh). Both the autistic and the ADHD often suffer lymphoid modular hyperplasia (measles infection in the gut—Wakefield). Thus, children with autism do not absorb food properly, leading to nutrient deficiencies. The most common deficiencies are zinc, magnesium, calcium, and vitamins A, B₆, C, and D. The deficiencies can occasionally cause extreme behaviors; some children with autism have been reported to actually gouged out their eyes due to a calcium deficiency!

Children with autism have a lot of metabolic abnormalities as indicated, but that is a result of the problems with their immune system. Samplings of immune data reveal that most of these autism-spectrum disorder (ASD) children have atypical elevations of antibodies against otherwise common pathogens such as Epstein-Barr virus, Cytomegalovirus, and/or Human Herpes Virus 6 (EBV, CMV, HHV-6), and in some 30%, elevated anti-measles antibodies indicative of chronic infection from measles vaccine—Kawashima H, Mori T, Kashiwagi Y, Takekuma K, Hoshika A, Wakefield A; Department of Paediatrics, Tokyo Medical University, Japan. "Of the 160 autistic children we looked at, only five did not have bowel disease"—Wakefield. (Attenuated vaccines contain live viruses that don’t usually cause overt disease.) HHV-6 induces synthesis of a broad range of host cell proteins, including interferon alpha, CD4, interleukin-1 beta, and tumor necrosis factor alpha.

John O’Leary, Ph.D. a world class researcher and molecular biologist from Ireland, using state of the art sequencing technology, showed how he had found measles virus in the gut of 96% of autistic children, compared to 6.6% of normal children. This virus did not come from the natural disease; it came from the measles vaccine. In addition, Dr. O’Leary found measles virus present in 75% of children with Crohn’s Disease. Crohn’s has traditionally been an intestinal disease of adults, following years of dietary abuse. Its appearance in children is a new event, and Dr. O’Leary’s work points to measles virus from vaccines as the likely cause.

Their pathogenic (disease producing) power is derived from the fact that they can set up persistent infections within various lymph tissues (that of the gut, for example, as shown by Wakefield) as well as within circulating cells of the immune system. Wakefield found that controls had a prevalence in the gut of HHV-6 DNA similar to that of those with ulcerative colitis—86%! Virus infected monocytes travel freely throughout the body, and have been shown to enter the brain, take up residence there, and secrete cytokines toxic to brain tissue. They also serve as foci of infection. It is not uncommon for infants to run fevers and show other signs of acute inflammation after receiving multiple vaccinations. Interferon production is stimulated by infection with a virus to protect the body from superinfection by some other micro-organism. In this study, vaccination of one-year-old infants with measles vaccine caused a precipitous drop in the level of alpha-interferon produced by lymphocytes. This decline persisted for one year following vaccination, at which time the experiment was terminated—Journal of Infectious Diseases. Thus, this study showed that measles vaccine produced a significant long-term immune suppression. Similarly, the report in the British medical journal Lancet confirmed that a significantly higher percentage of these children had received a DTP shot within 30 days of the onset of polio compared to a control group of children without polio, 43 percent of polio victims compared to 28 percent of controls. The DTP vaccine suppresses the body’s ability to fight off the polio virus. Thus, we have evidence of long term damage to the immune system from vaccines. Starting at about 4 months, this leads to infections, antibiotics, more infections, and more vaccines that often precede autism.

"Complete IgE deficiency was seen in 10% of the patients. Almost 20% of the patients had low IgA, and 8% of them had a complete lack of it, which is quite high compared to the general population (1 in 700-1,000). About 25% of the subjects had IgG subclass deficiency. About 25% of the patients had a deficiency of various subsets of lymphocytes (e.g., CD3, CD4, and CD8 Killer T-Cells). In fact, almost 35% of these autistic children had a deficiency in Natural Killer Cells. In general, the cytokines IL-2 and alpha-interferon are increased, while IL-1 is normal"—Dr. Sudhir Gupta. IgG anti-brain autoantibodies were present in 27% with ASD, and with 2% from healthy children. IgM autoantibodies were present in 36% with ASD compared with 0% of controls. The presence of these antibodies raises the possibility that autoimmunity plays a role in the pathogenesis of language and social developmental abnormalities in a subset of children with these disorders—Serum autoantibodies to brain in Landau-Kleffner variant, autism, and other neurologic disorders. J Pediatr 1999 May;134(5):607-13.

Thirty-six children revealed grade I or II reflux esophagitis in 25 (69.4%), chronic gastritis in 15, and chronic duodenitis in 24. Low intestinal carbohydrate digestive enzyme activity was reported in 21 children (58.3%), although there was no abnormality found in pancreatic function. Seventy-five percent of the autistic children had an increased pancreatico-biliary fluid output after intravenous secretin administration—Gastrointestinal abnormalities in children with autistic disorder. J Pediatr 1999 Nov;135(5):559-63.

Children with autism produce higher levels of pro-inflammatory cytokines than children without autism. Autistic children have been shown to exhibit many anomalies in cell-mediated immunity, including abnormal T-cell activation (Warren et al, 1995), decreased relative numbers of helper-inducer lymphocytes, and a lower helper-suppressor ratio. (Denney et al, 1996) These last 2 measures were inversely correlated with severity of autistic symptoms. In children with these abnormal antibody patterns, selenium supplementation at a dose of 10 mcg/kg body weight for six months significantly increased IgG-2 and IgG-4 levels and reduced the number of infections. Low blood values of these two antibodies is associated with intractable seizures.

In workers exposed to fluorine, those with subclinical hypothyrosis [reduced tri-iodothyronine (T3) in 51%] had immune alterations that were more evident. T-lymphocytes count rose, but their functional activity declined, indicating impaired cooperation of immunocytes as a result of imperfect control under low concentrations of T3. (Balabolkin, 1995) Their immune system is driving with no brakes! These medical facts show that every symptom of these dear children is treatable! These kids are sick. They are not usually brain damaged. What seems to be occurring is an immune mediated, abnormal "shut down" of blood flow in the brain, and therefore an interference with central nervous system function.

Elevated serotonin levels have been consistently found in 30% -50% of autistic patients, and may represent a marker for familial autism. Hyperserotonemia in autism appears to be due to enhanced 5-HT uptake, as free 5-HT levels are normal and the current report of an excess of the long/long 5-HTTLPR genotype in autism could provide a partial molecular explanation for high platelet serotonin content in autism—PMID: 11378854

This paper is not meant as a medical prescription, nor does all the conditions and suggested interventions apply to every child. You must study this paper until you see your child’s face in it, then use the parts that are applicable to him. In all instances, it is good to consult with your medical professional when making any major nutritional changes.

Immune 101

There are three major classes of Immune Cell types: granulocytes, monocytes, and lymphocytes. Lymphocytes are divided into three subgroups: B-Cells, T-cells, and Natural Killer Cells. T-cells are divided into helper cells, suppressor cells, and cytotoxic CD8, Killer T-cells. T-helper cells are called CD4 cells. That is, they show the CD4 glycoprotein on their surface. During the first two years of life a delicate one-to-one ratio between CD4 (helper) and CD8 (suppressor) cells forms. CD4/CD8 ratios that do not equal 1:1 are indicative of abnormal immune systems. All these produce cytokines, chemical messengers that tell the other cells what to do. Cytokines, also called growth factors, are the common language of the immune, hormonal, and nervous systems regulating the growth and development of cells and tissues. Scientists state that: "Stimulation of the developing immune system can prevent auto-immunity" with clinical evidence proving that immune stimulation prevents auto-immune disease by up-regulating growth factors that bring the body back into balance with normal cell-to-cell communication.

Growth factors are biologically active, biochemically well-characterized, small proteins that regulate cell growth, repair, renewal and cell death throughout the body, including the developing nervous and immune systems. Growth factors need not enter cells to exert their effects upon DNA and cellular activities because they use specific cell receptors that carry their signals into the genes. Specific growth factors, such as platelet-derived growth factor (PDGF), insulin-like growth factor-1 (IGF-1) and transforming growth factor-beta (TGF_B) play critical roles early in the four-stage, cell cycle, during what is called G1 phase. These growth factors determine the cell’s fate by regulating what genes are turned on or off. If a gene is "turned on", it will be read and its message translated into protein. If a gene is "turned off", its message will remain dormant. Many viruses compete for the same DNA gene regulatory (transcription) sites as growth factors do since viruses need to overcome the growth factor’s control of the cell’s fate so that the virus can multiply and infect more cells. Growth factors contribute to healthy communication between the protective systems in the body, such as the nervous, immune, and hormonal systems. If growth factors do not work appropriately, there is aberrant cell-to-cell communication throughout the body, and a type of chaos ensues.

The CD4+, lymphocyte helper-cell activities are divided into Th1 (Cell-mediated immunity), and Th2 (humoral immunity). Th1 is the first-line of defense primarily against viral, fungi, and protozoa, while Th2 helps the B-cells to produce antibodies. The T-cells are separated into these two classes depending upon the specific cytokines the cells secrete in response to antigenic stimulation. Th1 cells primarily produce interferon (IFN) and interleukin-2 (IL-2), whereas Th2 cells produce IL-4, IL-5, IL-6, IL-10, and IL-13. The two helper T-cell classes also differ by the type of immune response they produce. While Th1 cells tend to generate responses against intracellular parasites such as bacteria and viruses, Th2 cells produce immune responses against helminths and other extracellular parasites. Interestingly, the cytokines produced by each Th subset tend to both stimulate production of that subset, and inhibit development of the other subset. Th1 and Th2 represent two, separate, counterbalancing functions of the immune system, and problems occur when they are out of balance.

After a strong Th1 response to infection gets on top of the search-out-and-kill activity, Interleukin 4 and 10 promotes a change of a class of antibody (IgG1) produced by memory cells, and suppresses the activity of the killer cells and starts to shut down the Th1 immune response. The production of memory cells is dependent on this strong Th1 immune response. For example: the immunological action taken against a primary attack of measles is primarily Th1, with a later back-up by a Th2 antibody that is dependent on the initial Th1 response, and then a dampening down of the Th1 system by the Th2 antibody. However, "These alterations support the hypothesis that the immunologic alterations induced by immunization do activate type-2 cell responses leading to improved antibody production, while suppressing type-1, T-cell responses leading to reduced lymphoproliferation." (JID 1996, Vol 173, pg 1324-1325) Do you understand the implications of this? There are plenty of antibodies at the expense of the ability to "search-and-destroy"—to fight other infections. This is the key—the difference between natural Th1, and vaccine induced Th2 immunity—and yet, some fail to show antibodies even when vaccinated and boosted and revaccinated! Could that be because they had no sufficient Th1 response?

To avoid rejection of the fetus, a Mother’s immune system shifts quickly to Th2, and the baby is born with this skew to Th2. After the baby is born, the healthy mother’s immune system changes back to normal Th1 dominance very quickly, and breast milk quickly starts the process of changing the baby’s balance towards a Th1 dominance. The vaccinated Mother’s immune function is likely to stay Th2 predominant, robbing her of her natural immunity to infections and allergies, and she passes this skewed system to her baby! The poor, bottle-fed child gets no help at all to restore Th1.

It’s most revealing to learn that the same insult given to those of different genetic makeup will cause some to have a Th1 response, whereas others will have a Th2 response! The ratio of these two is determined by the balance of adrenal steroids, notably cortisol and DHEA. Since cortisol is an antagonist of DHEA, stress-induced cortisol production shifts the number of CD4+ lymphocytes to predominantly Th2 expression. Cortisol also impairs liver detoxification, allowing buildup of environmental and physiological toxins. "Thus, even a potentially Th1-inducing virus may fail to induce Th1 during a time of stress"—Lancet, 1997, Volume 349, pg 1832.

When Th1 is diminished, Th2 predominates leading to a host of chronic diseases. Conditions are pro viral, pro candida. The chronic viral infection, whether measles or other, cannot be cleared as long as this bias exists. Furthermore, candida can enhance Th2. This increases IgE, causing candida to really flourish. A strong presence of IgE in the blood is evidence of prominent Th2 activity, and a deficiency of vitamin B₆. Elevated IgE is associated with a history of numerous allergies. Allergies are indicative of an overactive (reactive) immune system. So, if you have high IgE, suspect that candida and stress are at work, and supplement the vitamin B-complex. To reduce stress-produced cortisol by 47%, give the child 100 mcg of chromium each day. A 45-minute massage (back rub?) will give a like reduction. One study shows that glutathione levels in antigen-presenting cells determine whether Th1 or Th2 response patterns predominate. "Raising glutathione levels has been shown to alter the cytokine balance in favor of a Th1 immune response"—"The immune system", Peterson, JD, et al., 1998.

In addition to stress-induced, immune suppression, the body’s natural defense system is also susceptible to stress-induced malnutrition. When the body begins to suffer from stress-induced malnutrition, the cells of the immune system are deprived of critical nutrients necessary for their function. In addition to the macronutrients, myraid micronutrients that include zinc, selenium, vitamins A, C, E, and B₆, the amino acids glutamine, cysteine, and arginine, and proper ratios of Omega-3 and Omega-6 fatty acids are known to be necessary for a functional immune system. Observations indicate that Fatty Acids (FA) can modulate immune responses by acting directly on T-cells, and suggest that alteration of cellular FA toward Omega-3 may be a worthwhile approach to control of inflammation that often tends to cancer. It is vital to note that MMR vaccine, and the chronic measles infection so often following, depletes the body of vitamin A. A deficiency of vitamin A and zinc, in particular, hinders cell-mediated immunity (Th1), and "our" kids are universally lacking in these vital nutrients.

Additionally, the Australian, Archivide Kalokerinos, M.B., B.S., Ph.D., noted for his work among the Australian aborigines in which he reduced an infant morality rate approaching 50% to virtually zero. Noting features of scurvy among some of the infants and children, and observing that many deaths followed vaccinations, he hypothesized that the vaccinations provoked death by throwing the infants into fulminating scurvy. Based on these observations, he improved the nutrition of the children, provided generous amounts of vitamin C, and avoided vaccines when children were ill with colds or other minor infections. As a result of this work he was awarded the Australian Medal of Merit in l978.

Cell-mediated immunity (CMI) in many infants is probably low, and the vaccines lower CMI further. One vaccine decreases CMI by 50%; two together by 70%. Three? Yet, repeated immunizations with three vaccines simultaneously from four weeks to 12 or 18 months are given. All these triple vaccines markedly impair CMI, yet some uninformed doctors, solely for convenience and profit give 10 viruses into these struggling immune systems in one sitting! Don't let this happen to your child! The longest safety trial of the triple vaccine MMR (all live attenuated viruses) was three weeks!

Repeat DPT is given at 12 months. In mice, spectrally assayed cytochrome p450 was decreased by 50% for 7 days following DTP vaccination. Children receiving DPT show three times as many seizures as is the norm for children. A similar increase 3.3 times the norm occurred within four to seven days following MMR. This tends to harbor toxins within the system, leading to toxicity through a build up of heavy metals and other poisons, including the thimerosal (mercury), aluminum, formaldehyde and other poisons in the vaccine. Example: One bottle of formula is enough to change a baby’s gut dramatically, and it takes two weeks of breast feeding to return the gut to normal according to Dr. Robert Reisinger, DVM. How can this happen? E. Coli is the main culprit. This bacterium is putrefactive and protein-loving. The protein content of human breast milk is lower than in any other mammal, and the protein content of formula or any other milk supplement has a direct influence on the numbers of E. Coli in the gut often raising it to 1000 times higher levels. Not only does the acid gut and very low protein content of breast milk provide a more hostile environment for E. Coli, but breast milk also contains neutralizing factors against E. Coli. Absorption into the bloodstream over hours of time of small amounts of bacterial endotoxin, particularly that of E. Coli, not detoxified by a temporarily dysfunctional reticulo-endothelial system, results in removal of blood platelets and fibrinogen from the circulating blood. The result is a release of relatively large amounts of serotonin from platelets into the blood plasma (in some experiments the increase of plasma serotonin is almost 100-fold). This serotonin shock can cause such serious vasoconstriction as to cause sudden heart failure according to Dr. Reisinger. The cytochrome p450 (Phase I) enzyme pathway is the only way a baby has to deal with endotoxins from the gut. The Phase I system is one of several shut down temporarily by the DPT and other vaccines. These toxins from E. Coli (and those of candida), being given off when the liver is impaired by DTP, can have severe consequences, having been associated with Sudden Infant Death Syndrome! This is all the more likely when there is a chronic deficiency of vitamins A and C as might be induced by a poor diet or by a chronic measles infection of the gut. No effort should be made to eradicate bacteria and fungi, releasing as it does large amounts of endotoxins, without ensuring the child is adequately supplied with nutrients, particularly vitamins A and C. Use of AlkaSeltzer Gold™ is said to reduce the impact of this die off.

"The repeated use of vaccinations would tend to shift the functional balance of the immune system toward the antibody-producing side (Th2), and away from the acute inflammatory discharging side (the cell-mediated side or Th1). This has been confirmed by observation especially in the case of Gulf War Illness: most vaccinations caused a shift in immune function from the Th1 side (acute inflammatory discharging response) to the Th2 side (chronic auto-immune or allergic response).

"The wise use of vaccinations would be to use them selectively, and not on a mass scale. In order for vaccinations to be helpful and not harmful, we must know beforehand in each individual to be vaccinated whether the Th1 function or the Th2 function of the immune system predominates. In individuals in whom the Th1 function predominates, causing many acute inflammations because the cellular immune system is overreactive, a vaccination could have a balancing effect on the immune system and be helpful for that individual. In individuals in whom the Th2 function predominates, causing few acute inflammations, but rather the tendency to chronic allergic or autoimmune inflammations, a vaccination would cause the Th2 function to predominate even more, aggravating the imbalance of the immune system and harming the health of that individual"—Philip F. Incao, MD.

Multiple vaccinations, in shifting this delicate balance to a predominant Th2 response, favor the development of atopy (asthma, eczema, hay fever, and food intolerances) and, perhaps, autoimmunity through vaccine-induced, polyclonal activation leading to autoantibody production. An increase in the incidence of childhood atopic diseases may be expected as a result of concurrent vaccination strategies that induce a Th2-biased immune response.

The literature shows an association between antiviral vaccination and onset of childhood asthma. We have noted that attenuation of viral target by conventional vaccine preparation does not completely remove or degrade viral nucleic acids such as double-stranded RNA (dsRNA). It is known that viral dsRNA can induce activation of a host’s antiviral protein kinase (PKR). We have shown that activation of PKR by dsRNA leads to expression of Th2-type immune responses, e.g., allergy and asthma.—Farhad Imani, M.D., David Proud, M.D. Recent discovery shows the gamma-delta group of T-cells are responsible for allergic responses through their production of interleukin-4 (IL-4).

The odds of having a history of asthma were twice as great among (DTP) vaccinated subjects than among unvaccinated subjects (adjusted odds ratio, 2.00; 95% confidence interval, 0.59 to 6.74). The odds of having had any allergy-related respiratory symptom in the past 12 months was 63% greater among vaccinated subjects than unvaccinated subjects (adjusted odds ratio, 1.63; 95% confidence interval, 1.05 to 2.54). The associations between vaccination and subsequent allergies and symptoms were greatest among children aged 5 through 10 years.—Hurwitz, E.L., Morgenstern, H; UCLA School of Public Health, Department of Epidemiology, Los Angeles, California.

One study published in the "Journal of Infectious Diseases" documented a long-term depressive effect on interferon production caused by the measles vaccine. Interferon is a chemical produced by lymphocytes (a type of white blood cell) that renders the host resistant to infection. Vaccination of one-year-old infants with measles vaccine caused a precipitous drop in the level of alpha-interferon produced by lymphocytes. This decline persisted for one year following vaccination, at which time the experiment was terminated. Thus, this study showed that measles vaccine produced a significant long-term immune suppression. This suppression lays the child open to all sorts of infections.

For example: a study published in the "American Journal of Public Health Investigators" on children who contracted polio, a total of 1,300 cases in New York City and 2,137 cases in the remainder of New York State, discovered that children with polio were twice as likely to have received a DTP vaccination in the two months preceding the onset of polio than were the control children. More recently, in a polio epidemic in Oman, DTP vaccination caused the onset of paralytic polio. The report in the British medical journal "Lancet" confirmed that a significantly higher percentage of these children with polio (43% compared to 28% of the controls) had received a DTP shot within 30 days of the onset of polio. The DTP vaccine suppresses the body’s ability to fight off the polio virus.

Usually then, the autistic child needs to boost Th1 cells. This can be done with Omega-3 fatty acids [EPA at 1000 to 1500 mg a day (two to three teaspoons of CLO), and DHA between 1500 to 2500 mg a day (3 to 5 teaspoons of CLO or fish oil)]. The extra Virgin Olive oil, that contains oleic acid: four tablespoons a day of fresh oil that’s been refrigerated is very supportive of Th1, as is Vitamin A, 25,000 IU (adults), with a lot of carotenoids, a lot of vegetables, carrots, and things like that. In addition to that, L-glutamine, 10 to 20 grams (adult) a day, will strengthen Th1. Use Lactobacillus, two or three different kinds, and Bifidus, and magnesium, zinc, chromium, and silica. Hepatic glutathione is a key substrate for reducing toxic oxygen metabolites and oxidized xenobiotics in the liver enabling their clearance from the body. Depletion of hepatic glutathione is a common occurrence in mercury toxicity and Leaky Gut Syndromes contributing to liver dysfunction and liver necrosis. Many factors can affect liver function and glutathione availability. For instance, a recent or chronic-active infection, can deplete glutathione. Studies have found heavy metals to deplete glutathione and protein-bound sulfhydryl (SH) groups resulting in inhibiting SH-containing enzymes and production of reactive oxygen species such as superoxide ion, hydrogen peroxide, and hydroxyl radical.

Chelation with DMSA needs GSH or NAC to metabolize out as disulfide-bound DMSA-GSH or DMSA-NAC. If replacement NAC/GSH is not supplied, DMSA and DMPS (3-4 times more so than DMSA) consume available stores leaving a dangerous deficiency. In humans, oral glutathione is readily absorbed by the gut mucosa, repleting its glutathione supply; but all remaining GSH is then broken down by the mucosa preventing systemic absorption. This may explain why oral glutathione has been of help to autistic children even when there is apparently no systemic absorption. This being true, one must support the body in its manufacture of GSH to avoid a dangerous lack due to chelation. Nevertheless, given the gut dysfunction found in many autistic children, oral glutathione at 250 - 500 mg/day may be of significant help.

Methionine, betaine, and choline enhance liver function and increase the levels of SAMe and glutathione. In addition to the above supplements, use these that build glutathione: garlic, dandelion, shark liver oil, rice bran extract, lysine, and SAMe. All are totally nontoxic. Carotenes enhance immune response and "spare" the glutathione, a Phase II detoxification enzyme in the liver that we rely on to safely eliminate pollutants and toxins from the body. You might even want to add, after careful testing, Pregnenolone or DHEA, (both suppress cortisol), because the higher the levels of DHEA, within normal, the better Th1 performs. Thyroid, along with the retinol form of vitamin A, is needed to create progesterone and pregnenolone, so it may be better to support the thyroid and use cod-liver oil as suggested herein. Chromium reduces cortisol by 47%. Vitamin E, vitamin B-complex, panax ginseng, digestive enzymes, Transfer Factor™, even some things called arabinogalactans and glyconutrients (AmbroStart™ by Mannatech™), all build Th1. Aloe (Manapol™—a stabilized standardized Aloe), Ambrotose®, Phyt•Aloe®, PLUS, and ImmunoStart™ (all from Mannatech, Inc.) are without peers in producing glutathione, and in modulating this function of the immune system. A good back rub will make it all come together.

Additionally, it is known that Vitamin C seems to suppress the Th2 system, and promote the Th1 system, which is why asthmatics on Vitamin C have fewer and less severe attacks than those who don’t take Vitamin C (Trop Geogr Med 1980;32:132-7). It has also been shown that the mean vitamin C level in patients with asthma is significantly lower than in healthy control subjects (Afr J Med Sci. 1985;14:115-120), and that Vitamin C can have a protective effect and block Exercise-Induced Asthma (Arch Pediatr Adolesc Med Vol 151, April 1997, pg 367).

Other than vaccines, candida, and stress, what causes Th2 to be elevated? Faulty digestion, a leaky gut, white sugar, over consumption of glucose (sugar) and processed foods (that weakens systemic resistance to infection), transfatty acids, a diet high in the Omega-6 fatty acids like linoleic acid (cut canola, use olive), all of these promote over-functioning of Th2. This makes the cell membranes porous, and very vulnerable to infection. Adrenal exhaustion or a lack of glutathione may promote a cytokine shift from Th1 to Th2. Any suffering allergies undoubtedly have two conditions undiagnosed: hypoglycemia and hypoadrenocorticism. These must be corrected by temporary elimination of allergens, a low carbohydrate, high protein intake, and a supplement of nutrients chosen to support the adrenals and pancreas, including desiccated, whole-adrenal glandular. If not needed, the adrenal tablets may make you feel weak. The doctor may wish to offer whole, adrenal-cortex extract injections for faster results. Do not accept cortisone or prednisone!

Additionally, vitamins B₆, B₁₂, A, C, E, para–aminobenzoic acid, pantothenic acid, and the minerals zinc, magnesium, and calcium aid the adrenals in conditions of hypoadrenocorticism (adrenal cortex deficiency). Pantothenic acid (300 mg), vitamin C (2000 mg), for adults, will support the pancreas. The bioflavonoids will reduce allergic reactions to foods and other substances.

A "Journal of Allergy and Clinical Immunology" at McGill University and the Institute Pasteur in France article says, "A new study has found additional evidence that a chemical involved in inflammation may play a role in asthma. The study found more of the chemical known as interleukin 9 (IL-9)." IL-9 is one of those Th2 substances that gets overactive, suppresses Th1, and you wind up with asthma. They believe that if you can lower IL-9 this is going to help treat, and even prevent, asthma. It says, "Interleukins have been known to play a role in regulating the immune system, and in particular, to be responsible for causing the early stages of inflammation." They found that if you can lower the Th2, especially these interleukins, and boost Th1 with all the nutrients we’ve been speaking about, they’re going to help dramatically in the management of a wide range of illnesses, including multiple sclerosis, psoriasis, rheumatoid arthritis, inflammatory bowel disease, AIDS, Chronic Fatigue, candida, multiple allergies, multiple chemical sensitivities, hepatitis, Gulf War Syndrome, cancer, and other autoimmune diseases, like autism. Just the elimination of candida has been found to cure a third of all eczema, irritable bowel, some asthma, joint pains, and virtually all psoriasis. Other symptoms of candida: internal bloating of the lower abdomen that is aggravated by beer, bread, pasta, sweets, or juices. Another good clue (90% probability) is when one reacts adversely to taking vitamins orally. To this add a high sensitivity to yeast and fungi or products containing them, like yeast, yeast breads, beer, mushrooms, cheese, mustard, vinegar, and mold spores that will cause discomfort when in bathrooms, basements, areas with wet leaves, summer beach houses, etc.

Cytokines (hormone messengers secreted by immune cells), actively transported into the Central Nervous System (CNS), play a key role in this immune activation. It was recently observed that cytokines activate astrocytes and microglia cells (immune system cells), that in turn produce cytokines by a feedback mechanism. Where T-cells are stimulated, they produce large numbers and amounts of cytokines that cause inflammation in the body, muscular pains, headaches, and often weight loss, and malnourishment. The free radical damage to "self" is great. Moreover, cytokines strongly influence the dopaminergic (dopamine), noradrenergic (noradrenaline), and serotonergic (serotonin) neurotransmission. There are indications that the cascade of cytokines can be activated by neuronal processes. These findings close a theoretical gap between stress and anxiety and their influence on immunity (they greatly lower the natural-killer-cell function). "When we are fit and healthy it means our bodies are working properly and keeping the germs and bugs at bay. It is only because the immune system falls down that we get ill," said Michael Endecott, research director of the Institute for Complementary Medicine in London.

Gluten (from grains) and casein (from milk) have immune, as well as neurotransmitter, impacts. Therefore, they have the ability to cause immune dysregulation and neurotransmitter imbalance. Opioids decrease T-cell proliferation via the mu-receptors, and this may cause a mild, immune suppression. Opioids can increase levels of gamma interferon also. When an opioid molecule attaches to a receptor in which it "fits", adenylate cyclase is inactivated, leading to a decrease in intracellular Cyclic AMP (cAMP). Cyclic AMP is an important messenger system in the brain and body. When intracellular cAMP levels have been lowered because of constant (inappropriate) stimulation of opioid receptors on the cell surface, less tryptophan hydroxylase is phosphorylated, and therefore more of the enzyme is inactive. When this happens, tryptophan is not converted into serotonin, but is shunted down alternate pathways, eventually leading to urinary IAG (indolyl acryloyl glycine) and 3-indoleacetate. It is reported this affects 93% of autistic children. Urinary excretion of IAG in 15 normal subjects was significantly increased in June-September against the November-April collection in the same subjects. Elevated levels of IAG are also found in Hartnup's and SAD.

Organo-phosphate pesticides cause paralysis by inhibiting certain enzyme systems. One of these pesticides, Diazinon, has been shown to seriously interfere with the metabolism of tryptophan in a way that might force tryptophan metabolism towards the IAG route. Are these pesticides contributing to the increased IAG in the urine samples from the majority of people with autism and related disorders? In England, about 80% of those with autism or ADD/ADHD have high IAG levels. Increased IAG could contribute to increased intestinal permeability (leaky gut), and perhaps increased blood-brain barrier permeability. In animals, high opioid levels cause indifference to mother and others in the family.

Immune B-cells can secrete the antibodies, immunoglobulins IgD, IgM, IgG, IgA, and IgE, which bind with the foreign antigen and produce red cell lysis, inactivate the virus, or produce bacterial phagocytosis. Most autistic children have delayed allergic reactions to some foods (show high IgG), and/or immediate, strong reactions to foods, inhaled pollens or mold (high IgE). These allergic reactions disrupt normal immune balance and alter interleukin-2 levels exacerbating their symptoms. IgA is normally secreted into the digestive tract in response to incoming food. IgA protects the mucosal surfaces of the mouth, nose, throat, gastrointestinal tract, ears and the eyes. Recurrent infections are an indication of deficient IgAs. Secretory IgA (sIgA) levels are elevated in the presence of infection or overgrowth of unwelcome germs, and are depressed if the infection or overgrowth is excessive. The incidence of selective IgA deficiency is 10 times higher in those with celiac disease than in the general population. IgA is found at very high levels in colostrum. The use of Bovine Colostrum should be very productive in overcoming these chronic infections, and should be preferred to repeated courses of antibiotics. When there is active infection, take a dose of colostrum every four hours around the clock until symptoms are fully cleared.

One additional bit of advice: Never, ever let a child be vaccinated if he has had a recent infection/sickness, or is prone to repeat infections with the related antibiotic courses. Early and high frequency rates of ear infection are associated with greater severity of autism (J Autism and Dev Dis 17:585,1987). It is the children who have had three or more antibiotic courses who have a 4-times higher rate of adverse vaccine reaction. It is the ones vaccinated while suffering an infection or after a recent infection that often regresses into autism. Be warned. It all has to do with the immune function. Never accept a vaccine containing Thimerosal™, and never accept more than one shot per day. To pump ten viruses with the related mercury and other toxins into a child at one sitting is asinine and stupid, and should be criminal!

Yeast species like candida are known to induce immune changes, and to produce neurotoxins, and most autistic children have yeast problems. Yeast binds the B-vitamins, and in absence of Bifidus flora, create subclinical pellagra and beriberi. This lack of B-vitamins, particularly vitamin B₆ will interfere with the production of serotonin, melatonin, and other important neurotransmitters that controls behavior—so normal brain chemistry in the presence of yeast overgrowth is unlikely. Clostridia, found in approximately 20% ASD patients, and other harmful bacteria, also cause neurotoxic effects. These immunological changes (altered interleukins, cytokines, histamine, neuro-hormones, and other immune factors) affect brain chemistry, especially in the cerebellar and sensory components of the brain, and most autistic children have altered sensory perception. Reactions to clostridial toxins in mice suggests that it enhances glutamate efflux, leading to seizure and hippocampal neuronal damage. The possibility of each of these imbalances should be examined, and, if present, corrected.

Since a major consequence of this immune imbalance is allergy, it is good to note some frequent manifestations. "Toddlers have excessive infections. They whine, they pinch, they hit, they spit, they kick, they bite in excess between two and four years. They bite their siblings, their mother in particular, sometimes their father. They have excessive temper tantrums. They have a lot of intestinal symptoms. They vomit clear mucous, and that means milk allergy. They dislike being held. They say the same sentence over and over again. They’re hyperactive, fatigued, and they have bowel problems. These are characteristic symptoms that frequently are related to something they ate, touched, or smelled. (You can often tame the Terrible Two’s with a zinc supplement—WSL.) Any food can cause diarrhea, but the food that’s most apt to cause constipation in any age group is milk and dairy products. Abdominal complaints such as swelling, belching, bloating, rectal gas, that sort of thing, is the result.

"Bad breath is almost always milk, wheat and eggs. Bedwetting, after age five, if it’s related to a food, is due to milk or it’s due to a fruit juice. Soiled underwear: when they leak, and they have a little bowel movement on their pants all the time, it’s frequently due to grapes and raisins, but other foods can also cause it (like undigested fats, shown by light-colored stool—WSL). Leg aches, called growing pains—take the milk out of the diet for a week, then add the milk back, and you’ll see that many leg aches are due to milk sensitivities. Again, there are other causes for leg aches, but this is one of the causes. Clucking throat sounds—that’s a milk allergy. The pot belly, is very characteristic of people who have food allergies. There are many other causes; you may have parasites, enzymatic dysfunction, or a malfunction in your gut, but one reason is allergies.

"Learning, behavior problems, and depression: Young children four and five that want to kill themselves. Again, ask what did they eat, touch, or smell? They have headaches. They make strange noises. They bark like dogs. That sort of thing. They have asthma, hay fever, and eczema. When a person eats a food that causes eczema, which is an itchy rash in the creases of the arms and the legs, the area will get red when you’re eating the food, and the next day, they have the rash. So, there’s a delayed reaction, and that makes it difficult to put cause and effect together. But, if you watch the skin while they’re eating, you’ll be able to tell when it feels red and hot and that’s when they’ve eaten a food to which they are sensitive.

"The adolescents have intestinal problems. Depression and fatigue are much more common. They say they have a ballooned, fuzzy head. They recognize that their head’s not thinking, not feeling right. Their muscles and joints ache. They frequently have an irregular heart beat. Take your pulse. It should be nice and regular, if it’s irregular; something’s wrong (it could be a lack of potassium or magnesium—WSL). What did you eat, touch, or smell? Start to pay attention to your body, especially to your pulse. It’s like a smoke alarm in a room. (Get "The Pulse Test" by Dr. Arthur F. Coca, MD—WSL.)

"Irritability and aggressiveness in adults are very common. I believe that much battering—wife battering, husband battering, sibling battering, mother battering—I think a lot of that is due to unrecognized sensitivities to foods and chemicals, and things of that sort. Now, the adults tend to be too tired. The women, in particular, cry easily, and are very depressed. Many times, they are moody and easily upset."—(edited) Dr. Doris Rapp, MD. Aggression has been connected to both too much and too little magnesium. Usually it is too little. Magnesium controls the breakdown of serotonin. It is nature’s SSRI, and the best calcium channel blocker.

In addition to allergy or opioid production, it has been found that milk and dairy can actually cause a microscopic blood loss in the intestine by a "reactive" inflammation of the bowel. This can lead to anemia. Curiously, a child that might go berserk on milk may not have a reaction to "processed" cheese. When the protein structure is changed, the food will not give as large an allergic reaction. "Unless a child has eczema where yolk or egg is triggering off a skin reaction, for some reason the immune pathway fired off by eggs doesn’t seem to play a role in what we are talking about in the brain. I rarely have to worry about taking a child off of eggs, even though you may have this ‘huge reaction’ on the food screen"—Dr. Michael Goldberg.

There is evidence of immune suppression on exposure to testing doses of phenolics (see PST). There may be a drop in T-suppressor cells or total T-cell numbers. An overabundance of B-cells was interpreted as a reflection of toxic image to the immune system. An increase in helper cells, antibody formation, and elevation of some immunoglobulins was also noted. Other findings on phenolic exposure have been depressed serotonin, elevated histamine, and prostaglandins, abnormal complement and immune complex formation. It can contribute to the toxic overload in PST, or it can precipitate an allergic reaction.

These alterations in normal body chemistry are largely due to a damaged, chronically-irritated, gastrointestinal tract largely caused by vaccinations, heavy metals, particularly mercury, antibiotics, resulting candida and bacterial overgrowth, and by chronic viral infections, and milk. While it is important to remove the allergens and to deal with the yeast, the single most effective, least expensive way to treat the cause and not the secondary symptoms, is homeopathy. I know the principles of homeopathy offend reason and the good American Way, "more is better". With homeopathy, "less is more". There are forces we do not begin to comprehend working in this body, and homeopathy is working with one. Find a skilled homeopath, and ask him to clear the vaccine damage and resultant virus infections, and the heavy metals poisoning. There seems to be two schools. Some will treat individual allergies. If you treat the causes (vaccine damage to the immune system, and the metal overload) and not the allergic symptoms, expensive tests and therapies for allergies will be unnecessary. The method I recommend uses the actual vaccine to clear vaccine damage and the toxins and metals that vaccine introduced into the body. When this is done, the gut is usually healed, there will be few if any allergies left, and candida will likely no longer be a problem. You will be amazed at the simplicity and low cost, and immediate results, though there is some temporary regression with each course. This will restore the immune function to balance, and then other necessary, nutritional and behavioral interventions will be 10 times more effective. Until you have done this, other efforts will be very expensive and not fully effective. To those who are ready, I will supply the name of a homeopath using real vaccine remedies that are not usually offered by other homeopaths.

Leaky Gut

In a test of 36 autistic children reported by Repligen Corporation, 75% had a greater than normal pancreatic response to secretin infusion, especially among those with diarrhea (whose stool improved in consistency for several weeks afterward). These children are probably producing too little secretin, and thus receptor sites have proliferated. Human secretin receptor is a G-protein-coupled receptor that is functionally linked to the cAMP second messenger system by stimulation of adenylate cyclase (Ng et al, 1999). When given secretin, there is overactivity of the pancreas. I.V. Secretin causes a five-fold increase in the output of IGF-1 in pancreatic fluid. They also documented a pattern of intestinal inflammation (esophagitis, gastritis, and duodenitis that would greatly hinder absorption of nutrients) in the majority. The most frequent gastrointestinal complaints were chronic diarrhea, gaseousness, and abdominal discomfort and distension. Histologic examination in these 36 children revealed grade I or II reflux esophagitis in 25 (69.4%) with symptoms of wakefulness with irritability or crying, pressing of the lower abdomen, and diarrhea. Chronic gastritis was detected in 15, and chronic duodenitis in 24. Low intestinal carbohydrate digestive enzyme (amylase) activity was reported in 21 children (58.3%), although there was no abnormality found in pancreatic function. Thirty-nine percent were deficient of the enzyme Lactase, and thus had digestive problems with milk, with bloating, gaseousness, and a loose stool (these symptoms can be alleviated with a digestive enzyme supplement containing lactase). None showed signs of Helicobacter Pylori infection, or of fungal or bacterial overgrowth even in the one-third with suspected fungal or bacterial overgrowth based on urine acid test results.

This inflamed gut (dubbed "Leaky Gut" because it has become porous allowing large, food particles both protein and undigested starch to pass unnaturally into the blood) produces a number of symptoms. Increased intestinal permeability (IP) may reflect damage to the microvilli, which can reduce levels of lactase, the enzyme needed to digest milk sugar, eventually triggering osmotic diarrhea. Once this disease process starts, small bowel mucosal damage, indicated by higher IP ratios, remains "an important factor" associated with increased acidosis, hypokalemia (lack of potassium), iron deficiency, dehydration, and parasitic infection. Sucrose (table sugar) leaks into the blood, and this abnormal sugar in the blood stream causes a host of problems. Particles [especially from milk (casein) and grains (gluten/gliadin)] called peptides pass through the "Leaky Gut", and activate the immune system creating many allergic symptoms, and also creating opioids in the brain that cause much of the "weird" behavior. Dermorphin and other opioid-like peptides can reduce stomach acid output and change emptying time for the stomach, and therefore, hamper digestion.

Mothers are often perplexed when, having been on Gf/Cf for a period, they find high levels of peptides still present. When a person goes Gf/Cf the body takes the opportunity to dump these things in the blood/urine again. That is why we see them in the urine for some time afterwards. In celiac literature, it speaks of taking 7 years to totally clear the system! "Treatment of the latter (candida) with conventional synthetic antifungal agents often causes impairment of liver detoxification functions, and a decrease in synthesis of phosphosulfotransferase, an enzyme necessary to cleave food proteins, e.g., casein, into smaller easily absorbable peptides."—Dr. Hugh Fudenberg, MD. Thus, fungicides exacerbate the opioid problem, and increase the potential for toxicity in PST kids. Are the symptoms being suffered symptoms of "autism", or of malnutrition, toxicity, and immune changes induced by that chronically inflamed, out of balance, gastrointestinal tract? Can nutritional intervention ameliorate these "autistic" symptoms?

Digestion 101

Digestion begins in the mouth. Here foods are to be chewed until totally fluid, thus mixing ptyalin and other enzymes necessary to digestion of starch with the food. No fluids should be taken during chewing. Furthermore, thorough mastication of food may nourish the gut by providing it with salivary Epidermal Growth Factor (EGF) that is healing to the epithelial lining of the gut. Purified Epidermal Growth Factor has been shown to heal ulceration of the small intestine.

The food then passes to the stomach where it is thoroughly mixed and "ground" down to smaller pieces, separated and held back as required for proper digestion. It may be held for an hour while starches continue to digest. Food ready for digestion passes to the lower stomach, the pyloric antrum, where most digestion takes place. This highly sensitive area of the stomach controls the acidity of the stomach digestive juices. Secretions of the parietal cells into the stomach creates the acid necessary to the breakdown and digestion of proteins. Acting as a thermostat, its G-cells secrete varying amounts of gastrin into the blood which signals the H2 cells of the upper stomach to produce more or less acid as needed. Histamine acts on the H2 receptors of the upper stomach’s parietal cells empowering them to produce hydrochloric acid (HCl) when called for by gastrin. Acetylcholine, released by the nerves, also affect the amount and timing of HCl production. Stress and emotions, then, also affect HCl production. "Intrinsic factor" necessary to utilization of vitamin B₁₂, is also released by these same cells. Sodium and potassium are required in optimal amounts for production of HCl. If these things are not happening, your child may refuse meat, or will not digest it well.

This dislike for meat, or a loss of taste, could indicate cellular distress and possibly cancer, or a lack of hydrochloric acid, or a zinc deficiency, for zinc controls the enzyme that makes HCl. Because there is a strong association between protein and zinc content in virtually all foods, insufficient protein intake, or stress on fish and fowl, may often be the cause of zinc deficiency. The food additive tartrazine is found to act directly as a zinc-chelating agent. Zinc is an essential component of about 70 metalloenzymes (including dehydrogenases lactate, malate, alcohol, and glutamate), alkaline phosphatase, carbonic anhydrases, carboxypeptidase A and B, and DNA and RNA polymerases. Zinc is thus widely found, and in relatively high concentrations throughout the body. A deficiency has far reaching consequences. Studies show that a marginal zinc deficiency reduces serum testosterone levels by 50% in adults. This adversely affects muscle tone and strength as well as digestion and utilization. Acrodermatitis enterophatica is presently the most well recognized human zinc responsive syndrome attributable to an inherited defect of zinc absorption. However, there are also a variety of other conditions that have been found to respond to zinc therapy, such as idiopathic hypogeusia, improvement in wound healing, gastric ulcers, acne, rheumatoid arthritis, as well as dyslexia. Zinc controls the release of vitamin A from the liver. An inadequate zinc nutriture has been linked with a variety of immune deficiency disorders, including cancers in both animals and in humans.

Complex nitrogen (protein) metabolism appears to flourish in children with seizures, developmental delay, and Autism Spectrum Disorder (ASD) involving not only Nitric Oxide (NO), but nitrogen retention as a whole (described previously as purine autism by Mary Coleman). Kids presenting with suppression of carbon dioxide (CO₂) may shun nitrogen rich foods due to the formation of ammonia (an alkaline compound of nitrogen and hydrogen) leading to a state of hyperammonemia. Excitotoxic effects of ammonia are augmented by increased synthesis of nitric oxide (NO), which is associated with N-Methyl-D-Asparate (NMDA) receptor activation and/or increased synaptic transport of arginine. The behavior associated with excess NO production in the autist is maniacal laughter.

Hyperammonemia means that ammonia, instead of being discharged by the liver, is recirculated into the blood stream. It is apparently caused by a deficiency of four Amino Acids: Citrulline, Aspartic Acid, Threonine, and Arginine. Vegetarians are especially susceptible to Hyperammonemia because of the lack of essential, Medium-Chained Amino Acids (L-Leucine, L-Isoleucine, and L-Valine which in turn cause a deficiency of those Amino Acids named above. Thus, a hyperammonemic state yields the spacy "brain fog" reaction, or in more severe instances may lead to seizures. [Overbreathing, expelling too much carbon dioxide through fast, shallow or even fast, deep breathing is part of the primitive stress response built into every human body. If this natural fight-or-flight response becomes chronic the lack of CO₂ causes much havoc. Additionally, apnea is the absence of effective breathing for 20 seconds (15 in a preemie), and is associated with color changes (blue, gray, or dusky) and/or reduced muscle tone (turning "floppy"). In the infant, whether premature or not, breathing is exquisitely controlled primarily by the level of carbon dioxide in the blood, and to a lesser extent by oxygen levels]. The method of children re-breathing their own air through "masking" used at The Institutes for the Achievement of Human Potential has often been helpful with these children as they raise their CO₂ and oxygen levels (and acidify the system). Dr. Robert Fried found that hyperventilation (low CO₂/alkalinity) precedes seizures and results in arterial constriction, including brain arteries, and spasms. This reduces flow and oxygen supply to the brain. This affects the brain’s metabolism, therefore its function. He concluded that the abnormal electrical activity picked up on EEGs is the result of seizures, not the cause, nor the seizure itself. CO₂ is the main regulator of Cerebral Blood Flow, so this impaired vasoreactivity (constriction) may reflect the brain dysfunction in the seizure focus and adjacent areas.

"By examining blood chemistries, the data that began to unfold was fascinating and clearly earmarked the acidosis and hypoxic state (low serum bicarbonate = low oxygen levels). Seizures were often brought under control by examining the electrolytic disturbance, and matching them to the child’s needs. Potassium bicarbonate, sodium bicarbonate, magnesium carbonate, and the like were used. (These normally alkaline minerals release the carbonate raising carbonic-acid levels, acidifying the system. CO₂ acts as an anticonvulsant, and also reduces glucose metabolites which accumulate around the foci—WSL.) Now we began to understand why so many children responded to Buffered C (potassium bicarbonate, calcium carbonate, magnesium carbonate), and others needed a more specific buffer (in some children for example niacin was grossly depleted, and they required niacin bicarbonate). (Calcium carbonate tends to constipate, and may be useful in controlling diarrhea, or when magnesium is tending to loose bowels—WSL.) Buffers and butyrates attenuate (lessens the effects of) abnormal nitrogen metabolism, however, children with ASD are unique in their presentations, and as we examine nitrogen retention/NO, electrolyte stability, catalysts, and lipid status to determine disturbances in metabolism, it requires that we act upon these aberrations in an integrative manner from a cellular perspective, not as singular interventions....We found that mineral endings contained in many multiples were worthless (magnesium oxide—a laxative), or irritating to the CNS (aspartates), or to the urea cycle (picolinates), but the children responded beautifully to alkaline salts such as Buffered C, the carbonates, and digestive support, including duodenum (naturally containing secretin and other components of the small intestine—1 teaspoon after meals—WSL), and pancreas (available in porcine, bovine, or bovine derivatives—1 to 2 capsules after meals—WSL)"—Patricia Kane. "I found...that many, many of these children are in negative nitrogen balance. Their BUN-to-creatinine ratios are very high"—Dr. Mary Megson. Nitrogen retention is dependent upon dietary consumption of nitrogen-rich foods, along with lipid consumption, electrolyte stability, and mineral density and balance. Those with organic acidemias or amino acidemias will often exhibit this same protein intolerance.

Purines are key building blocks for the synthesis of DNA and RNA, and are involved in a variety of other cellular processes. "Purine autism" was first characterized in the 1970s by Mary Coleman who noted elevated levels of uric acid in the urine of some patients. Uric acid is the end product of purine metabolism, and is elevated in other diseases of purine metabolism such as Lesch-Nyhan Syndrome. Recent studies at UCSD suggest that some of the autistic patients with elevated urate levels also have evidence of abnormally high rates of intracellular purine synthesis further indicating that they have a purine metabolism defect. A few of these patients have been treated with an analog of uridine for several years, with improvements observed in cognitive performance and muscular function. Repligen Corp now hold the patent to uridine treatment for this condition.

Through its conversion into carbonic acid, carbon dioxide is the most vital player in the maintaining of the body’s acid-base balance. Lowering carbon dioxide in the lungs by hyperventilation shifts the body’s pH towards alkalinity, which slows the rate of activity of all body ferments, enzymes, and vitamins. Chronic hyperventilating is not good for an alkaline system is more susceptible to virus and allergies. This shift in the rate of metabolic-regulator activity disturbs the normal flow of metabolic processes and leads to the death of the cell. The lowering of carbon dioxide in the nerve cells heightens the threshold of its excitability, alerting all branches of the nervous system and rendering it extraordinarily sensitive to outside stimuli. This hypersensitivity to light, sound, touch, taste, smell, heat or cold leads to irritability, sleeplessness, stress problems, unfounded anxiety, fears, allergic reactions, and inordinate stress. Concurrent with this, the breathing center in the brain is further stimulated causing a further loss of carbon dioxide. A vicious cycle has commenced. The detrimental influence of the rapid, deep breathing on the organism is a direct result of the creation of a carbon-dioxide deficit. It is clear that a deepening of the breathing does not necessarily mean an increase in oxygen uptake. On the contrary, it can mean a decrease in oxygenation, which leads to hypoxia, an alkaline imbalance, and cell spasming. "You are hyperventilating if breathing is predominantly thoracic (chest); if little use is made of the diaphragm (abdominal movement is minimal); if breathing is punctuated by frequent sighs; if sighing has an effortless quality with a marked forward and upward movement of the sternum but little lateral expansion."—Dr. Robert Fried.

If the above condition is suspected, one should obtain a roll of pH paper and check the pH of saliva and urine. Details of this testing are found in my electronic book "Self-help to Good Health", (34 Chapters, 535 Pages, $21.95 US) in the Chapter "Digestion and Utilization". An excessively acid condition would likely signal a too high CO₂. The lungs are not getting the carbon dioxide out and the needed oxygen in. The opposite would be true for an excessively alkaline condition—there is too little CO₂, yet the cells will be starving for oxygen. The best time for checking pH is mid morning and late afternoon before the evening meal. A word of warning: in using sodium bicarbonate excessively, potassium can be excreted producing a potassium deficiency that can cause heart palpitations. Use of too much bicarbonate can cause the system to become overly alkaline.

If suffering hyperammonemia, or overalkalinity of any cause, calm the child’s breathing in whatever manner you can in order to raise CO₂ levels, and use these carbonate buffers to restore CO₂ and body acidity. One quick way to restore acidity is to drink a teaspoon of raw, unfiltered, apple-cider vinegar every hour or so until desired acidity is restored. Deep breathing can be used consciously, and perhaps unconsciously, to make more alkaline an already acid system—quite common in ASD. As Dr. Fried states, the overbreathing may be "the body’s best adjustment to its present needs." If the acidity is that of excess lactic acid, consciously hyperventilating would likely make the condition worse. Use these methods also to stop severe allergic reactions. The average asthmatic, for example, over-breathes 3-5 times the recommended amount, sometimes more. If you think someone’s having an allergic reaction, and you don’t have those (bi)carbonate buffers, try half a teaspoon or a teaspoon of baking soda in a half-glass of water. Sometimes, that will stop a reaction within 10 to 15 minutes. Three commercial, bicarbonate products AlkaAid™, AlkaSeltzer Gold™, and AlkaLime™, or alkali salts (from health food stores, usually a combination of sodium and potassium and sometimes calcium carbonate) can be used. This is very effective, not only in stopping reactions, but if you take it before you eat a food to which you are sensitive, you can sometimes prevent a reaction. If you’re going to dinner, and you’re not quite sure what they’re going to serve, you certainly should try to take that in advance. Supporting the thyroid will increase carbon dioxide production. A word of warning: in using sodium bicarbonate excessively, potassium can be excreted producing a potassium deficiency that can cause heart palpitations, and reduce HCl production. It is possible to cause the system to become overly alkaline. Many have found bee pollen, or perhaps more so, honeycomb, from local honey farms to be highly effective in relieving environmental allergy. Start with very small amounts, and slowly increase amounts until the allergy is overcome.

ButyrEn™ (butyric acid) by Allergy Research Group/Nutricology, Inc (800-782-4274) is a short-chain, fatty-acid, dietary supplement in the form of an enteric-coated formulation of calcium and magnesium salts of butyric acid (2 tablets crushed, 2x daily, mixed in food). It supports the integrity of colonic mucosa by acting as primary fuel for the colonic epithelium. It is normally produced by colonic bacteria, but when these bacteria are disrupted this supplement will support colon health as you rebuild colon flora. This has been shown to modulate local electrolyte flux, thereby mediating diarrhea. Alpha ketoglutarate clears ammonia, and butyrate clears ammonia, spores, and nitrogen. Butyrate and another short-chain fatty acid, caprylic acid, are frequently used as anticandida agents. Ecological Formulas (800) 654-4432 supplies a fluid butyrate. Liver and gallbladder congestion are major issues in states of toxicity. To insure that your gallbladder bile flow is functional add magnesium taurate or taurine, and butyric acid. An increased amount of niacinamide will be helpful too. Vitamins E, C, selenium, CoQ10, and low dose Alpha Lipoic Acid all support the liver.

As indicated, the undigested protein turns into ammonia and goes to the brain. Kane recommends that one hour after every meal, when the body is supposed to be producing its own bicarbonate the carbonate buffers be given, along with a big glass of carbonated water. I feel this is too soon for it will stop protein digestion and defeat the purpose of intervention. Though dumping takes place in small lots over time, it seems to me that 2 1/2 or 3 hours after eating would coincide with dumping time, and serve the purpose better. A child with these problems will consume mostly carbohydrates. All those carbs cause high glucose which produces more insulin than is healthful, and that interferes with fatty acid metabolism and protein utilization, and produces insulin resistant cells, tending to overweight and diabetes. Overweight children with high levels of insulin in their blood are also likely to have high levels of homocysteine, a substance that appears to raise the risk of heart disease, stroke, and birth defects, as well as possibly other adverse effects as well. In addition, these children and adolescents appear to have lower levels of folate, a vitamin that can lower homocysteine levels. These children may have high albumin—which is the substance that transports toxins out of the body. High albumin means high levels of toxins are presently being transported.

"Albumin binds organic acids and neutralizes their toxic effect to some extent. A low serum albumin is a significant risk factor that results in a more serious clinical episode in patients with organic acidemias. The administration of valproic acid (Depakene™), or salicylates, should be carefully evaluated in cases of suspected organic acidemias, since these drugs also bind to albumin, and diminish the protective effect of albumin in neutralizing toxic organic acids. Swedish developmental biologist Rodier has found that valproic acid, a common anti-seizure drug known to induce autism, causes brain damage in rodents, and precisely in the places expected, based on what's known about this disease. Anytime you are taking Valproic Acid, you must supplement L-carnitine (Carnitor™) and folic acid to the avoid deadly consequences of their deficiency.

"Lactic acid may be elevated in a wide range of conditions including the pyruvate dehydrogenase, pyruvate carboxylase, 6 diphosphatase, and phosphenol-pyruvate carboxykinase, and dihydrolipoyl dehydrogenase deficiencies, glycogen storage disease type I, fructose 1, and respiratory chain deficiencies"—Wm. Shaw. Additionally, vigorous exercise, bacterial overgrowth of intestines, shock, and anemia will elevate lactic acid. A deficiency of lipoic acid results in reduced muscle mass, brain atrophy, failure to thrive and increased lactic acid accumulation. The pyruvate is broken down by an enzyme complex that contains lipoic acid, niacin, and thiamine. If pyruvate is high, I would supplement these nutrients.

When the mitochondrial respiratory chain (Krebs or citric acid cycle) is blocked, metabolites that are normally processed by its enzymes may build up in the cells and cause problems. When glutathione levels are compromised the mitochondrial respiratory chain is a vulnerable target and cell death ensues. Aluminum interferes with the citric acid cycle (alpha-ketoglutarate), and thereby reduces energy production from foods. This has been shown to influence mood and energy levels. Pyruvate is a chemical derived from glucose that’s normally shipped into the mitochondria, and then processed further so that its potential energy can be harvested by the respiratory chain. However, when the respiratory chain is blocked, pyruvate accumulates outside the mitochondria, and when too much pyruvate has accumulated, the cells start to convert it to lactic acid. "Many patients with mitochondrial disease have lactic acidosis—lactate in the blood," neuroscientist Eric Schon of Columbia University in New York says. "And there’s decent evidence that the lactate isn’t just a sign of faulty mitochondria, but that the lactate itself is bad—especially in the brain, but probably also in the muscle. If this is true, then holding that lactate down would help the patient." Sport by Mannatech™ can aid in removing excess lactic acid, whether in sports, or in autism; however, supplementing small amounts of alpha lipoic acid (several times a day), NADH, and CoQ10 may enable the mitochondria to use the pyruvate. Children with inborn errors of pyruvate metabolism showed symptomatic improvement with a supplement of Alpha Lipoic Acid.

Cellular energy production itself produces free radicals that can damage cell structures, including the mitochondria, and ultimately lead to various diseases if the body’s natural antioxidant capacity is inadequate. Acetyl l-carnitine and Alpha Lipoic Acid are both endogenous (naturally present in the body) antioxidants that have been shown to restore mitochondrial function and reduce free radical damage. (Hagen TM et al., 1998; Lyckesfeldt J et al., 1998) Together with NADH and coenzyme Q10, they work to maintain the function of the mitochondria. Elevated levels of free radicals from immune activation produced by dietary intake of food substances identified as pathogens (allergens) in the autist contribute significantly to the production of toxic and neurotoxic substances. Mitochondria are vulnerable to a wide array of endogenous and exogenous factors that appear to be linked by excessive nitric oxide production. Strategies to augment mitochondrial function, either by decreasing production of endogenous toxic metabolites, reducing nitric oxide production, or stimulating mitochondrial enzyme activity may be beneficial in the treatment of autism. To accomplish the strategies to augment the mitochondrial function requires that the dietary pathogens be identified and eliminated, the nitrogen containing amino acids be regulated, and the metabolism functioning at optimal level with healed mucosal linings, and the recognized essential nutrients present and available.

The volume of hydrochloric acid needed for digestion may be as important as its strength (acidity). It must register a pH of 3 or below for pepsinogen to be converted to pepsin—needed to dissolve proteins into polypeptides in the first step of reducing protein to amino acids that the body can use. In today’s crazy world, even children do not produce enough HCl to digest their foods properly! It seems that autistic children in particular have a preponderant number who are lacking HCl.

Conditions associated with the depressed secretion of hydrochloric acid include infancy, aging, elevated levels of prostaglandin E2, cannabis use, billiard disease, allergies, autoimmune phenomenon, disorders in calcium metabolism, Vitiligo, and the signs and symptoms associated with fat-soluble vitamin deficiencies (A, E, D, K, Fas). Fatigue, vague epigastric distresses after meals, reflux, chronic excessive intestinal gas, constipation, belching, abdominal distention, coated tongue, nausea, vomiting, morning diarrhea, and frequent appearance of undigested food in stools all signal that HCl secretion may be impaired.

Chyme leaves the stomach in small dumps. When the chyme leaving the stomach is sufficiently acid, it triggers the release of secretin from the duodenum walls into the blood. HCl is the only known stimulus of secretin. Zinc appears to influence the bioavailability of secretin as well as the availability of HCl. The amount of secretin released is dependent on the volume and pH of the chyme. This release of secretin does three things immediately. It signals the stomach to: 1) shut down HCl production (indicating that infusions should not be administered immediately after a meal, and that signs of an acid stomach after the stomach is empty may be due to a lack of secretin output), 2) to release bicarbonate of soda in precisely the right amounts to neutralize the acid, and 3) to release pancreatic enzymes to continue the digestion of the food. The secretin passes throughout the system, even into the brain, where it affects many body functions. Slowed emptying time of the stomach, reduced gastrointestinal symptoms, and—in many—dramatic improvements in behavior, as manifested in improved eye contact, alertness, and expansion of expressive language, are documented in many of those receiving infusions.

Secondarily, secretin generates a signal to the gall bladder to send down appropriate amounts of bile to aid the digestion of the sensed amount of fat present. The body has many "backup" or secondary systems to function under varied conditions. When fat and protein enter the duodenum, apparently even in the absence of sufficient acid to trigger secretin production, cholecystokinin (CCK) is secreted from the walls of the duodenum which signals both the pancreas and the gall bladder to do their thing. That is why we can exist without HCl, but not well, for the protein has not been broken down by HCl/pepsin in the stomach, and vitamin B₁₂ is not being assimilated. Similarly, if food is not thoroughly chewed, some carbohydrate digestion will still take place in the small intestine due to the pancreatic enzyme Amylase (that is often deficient in Autism).

CCK is dependent upon an adequate supply of the amino acid phenylalanine. Secretin and other hormones are also dependent upon adequate amino acid substrates. Due to poor digestion, and the poor eating habits of these children, amino acid concentrates must be supplemented. Lewis Laboratories’ Brewer’s yeast, or desiccated liver, or pure amino acid supplements must be supplied. Seacure™, a specially predigested concentrate of white fish, is a good way to go since it is absorbed by those too weak to digest regular protein.

If the fat is not digested because of insufficient bile or a lack of the pancreatic enzyme lipase, or there is a deficiency of lipotrophic agents (primarily vitamin B-complex) there will develop a fatty acid deficiency affecting the amino acid balance, and a deficiency of the fat soluble vitamins A, D, E, and K contributing to many of the "autistic" symptoms, and causing heart problems in adults. The already dysfunctional immune system will be further compromised. If the stool floats, is light tan or gray in color, bulky, shiny, and foul smelling, then fat is not being digested and a supplement of magnesium taurate or L-taurine and L-glycine are needed. If these do not correct the problem soon, then a supplement of ox bile or of bile salts is needed. I’ll say more on that later. It is of interest to note that lipase is present in good amounts in raw meat, but not at all in cooked meat, and cooking destroys all enzymes found in raw food. To compensate for our cooked-food diet, we must use a digestive enzyme supplement. I recommend SpectraZyme™.

As with secretin, CCK does many things throughout the body. There are two receptors identified: CCKA found abundantly in the pancreatic acinar cells, and CCKB, that functions also as gastrin receptors. That is the predominant form found in the brain where CCK produces satiety. Both secretin and CCK have a direct gut/brain connection. It would appear that gastrin, a hormone produced by the G-cells of the lower stomach, but secreted not into the stomach but into the blood stream, may have widespread effects also as it uses CCKB receptors.

"Many forms of CCK are active but the