Transcript DAN! 2005 FALL CONFERENCE - Autism

SAN FRANCISCO EAST BAY
AUTISM/ASPERGERS
CONFERENCE
DECEMBER 1-2, 2006
ALAMEDA COUNTY
FAIRGROUNDS
PLEASANTON, CA
OVERVIEW:
BIOMEDICAL TESTING
AND
TREATMENT
OF AUTISM
Jaquelyn McCandless, M.D.
SUMMARY DAN! ASD
BIO-MEDICAL TREATMENTS
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DIETARY RESTRICTION
NUTRIENT THERAPY
GUT PATHOGEN TREATMENT
METHYLATION STRATEGIES
DETOXIFICATION (CHELATION)
IMMUNE ENHANCEMENT
ANTI-VIRAL TREATMENT
HBOT, NEUROFEEDBACK
WORLDWIDE ASD EPIDEMIC
• FROM 2001-04, 1026% INCREASE IN FULLDIAGNOSIS ASD SCHOOL AGE CHILDREN
PER US DEPT OF EDUCATION.
• OVER 2 MILLION CHILDREN IN US HAVE
ASD, OVER 6 MILLION HAVE ADD/ADHD,
OVER 2 MILLION TAKE RITALIN
• INCIDENCE OF CLASSIC 1:10,000 TO
ACQUIRED (“REGRESSIVE”) ASD 1:150
• RATIO - BOUS:GIRLS 4:1 for ASD,
ADD/ADHD, LEARNING/BEHAVIOR
AUTISM (ASD) CHARACTERISTICS
AUTISM SPECTRUM INCLUDES:
AUTISM, HFA, ASPERGER’S, PDD,
ADD/ADHD
● FAILURE TO BOND
● LACK OF SOCIAL INTERACTION
● AVOIDANCE OF EYE-TO-EYE
CONTACT
● DIFFICULTIES IN LANGUAGE
DEVELOPMENT
● REPETITIVE BEHAVIORS CALLED
“STIMMING”
ASD BIO-MEDICALLY
• GENETIC PREDISPOSITION –
ALLERGIES, AUTOIMMUNITY, FAMILY
HISTORY
• WEAKENED IMMUNE SYSTEM,
FREQUENT INFECTIONS/ANTIBIOTICS
1st YEAR
• GUT INFLAMMATION, PATHOGENS
• IMPAIRED NUTRITIONAL STATUS
INABILITY TO EXCRETE THEREFORE
ACCUMULATE HEAVY METALS IN
THEIR BODIES
BASIC EVALUATION
HISTORY, PHYSICAL EXAM
BASIC GENERAL LAB SCREEN
CBC, URINALYSIS
SERUM CHEMISTRIES
THYROID PANEL
IRON PANEL
BASIC DIAGNOSTIC TESTS
FOR GUT:
URINE ORGANIC ACIDS
COMPREHENSIVE STOOL
STUDY
FOR NUTRIENT STATUS:
ORGANIC ACIDS, AMINO
ACIDS
RBC MINERALS, FATTY
ACIDS VITAMIN PANEL
CLINICAL HISTORY:
EARLY INDICATIONS OF
GUT DYSFUNCTION
1) FAMILIAL DIGESTIVE DIGESTIVE
DYSFUNCTIONS
2) INABILITY TO BREAST FEED
3) PERSISTENT COLIC IN INFANCY
4) FREQUENT INFECTIONS (E.G. EAR)
LEADING TO FREQUENT
ANTIBIOTICS
5) REACTION TO CERTAIN
VACCINATIONS
GASTROINTESTINAL
PATHOLOGY SYMPTOMS
REPORTED BY PARENTS
• PERSISTENT DIARRHEA AND/OR
CONSTIPATION, BLOATING, GAS AND
ABDOMINAL PAIN
• SELF-RESTRICTION OF DIET
• NIGHT WAKING – REFLUX
• GREATER ALLERGIC
SUSCEPTIBILITIES
G.I. HEALTH:
TREATMENTS PARENTS CAN DO
• ELIMINATE SUGARS AND JUNK FOOD FOR
EVERYONE IN THE FAMILY
• READ LABELS ON FOODS, GET EDUCATED
ABOUT TOXINS IN BOTH FOOD AND
WATER
• GF/CF/SF OR SCD DIET
• ENZYMES AND PROBIOTICS
• BASIC NUTRIENT SUPPLEMENTATION
G.I. HEALING
TREATMENTS THAT REQUIRE A
PHYSICIAN
• LAB TESTING FOR GUT PATHOGENS
• ANTI-FUNGAL PRESCRIPTIONS RX
• ANTI-BACTERIAL PRESCRIPTION RX
(CLOSTRIDICA AND OTHER)
• SECRETIN, VIT M-B12 INJECTABLES
• IMMUNOGLOBULIN, IV OR ORAL,
ENDOSCOPY
METABOLIC IMBALANCES IN
AUTISM SPECTRUM DISORDER
• MULTIPLE NUTRITIONAL DEFICIENCIES
• ELEVATED IgG ANTIBODIES
GLUTEN/CASEIN
• IMBALANCE GUT BACTERIAL FLORA
• URINE BACTERIAL/FUNGAL BYPRODUCTS
• MYELIN SHEATH INJURY IN BRAIN
• EVIDENCE OF IMMUNE IMPAIRMENTS
• METHYLATION DISORDERS
• INABILITY TO EXCRETE TOXINS/METALS
ASD CAUSATION MODELS
• 1) SIMPLY GENETIC?
• 2) GUT HEALTH: MEASLES,
GLUTEN/CASEIN INTOLERANCE,
ENZYME DEFICIENCY, FUNGAL
OVERGROWTH MODEL
• 3) TOXIC CHEMICALS/HEAVY METALS –
VACCINATIONS, AMALGAMS/FISH
• 4) AUTOIMMUNITY, VIRAL MODEL
GENETICS AS CAUSE?
• RESEARCH HAS BEEN
UNABLE TO IDENTIFY A
SPECIFIC CHROMOSOME
OR LOCATION ON A GENE
THAT IS THE SITE OF A
PRIMARY AUTISM DEFECT.
• GENETIC SUSCEPTIBILITY
PROBABLE
GUT HEALTH:
TREATMENTS THAT PARENTS CAN DO
• ELIMINATE SUGARS AND JUNK FOOD
FOR EVERYONE IN FAMILY
• READ LABELS ON FOODS, GET
EDUCATED ABOUT TOXINS IN
BOTH FOOD AND WATER
• GF/CF/SCD DIET
• ENZYMES AND PROBIOTICS
• BASIC NUTRIENT
SUPPLEMENTATION
GUT HEALTH
TREATMENTS THAT REQUIRE A
DOCTOR
• LAB TESTING FOR GUT PATHOGENS
• ANTI-FUNGAL PRESCRIPTIONS
• ANTI-BACTERIAL PRESCRIPTIONS (FOR
CLOSTRIDIA AND OTHERS)
• SECRETIN, VIT M-B12 INJECTIONS
• IMMUNOGLOBULIN, IV OR ORAL
• ENDOSCOPY-ANTI-INFLAMMATORIES
WAKEFIELD: INFLAMMATORY
BOWEL DISEASE IN AUTISM
• GUT BIOPSIES, 1998: MEASLES VIRUS
DETECTED IN DENDRITIC CELLS AND
MATURE LYMPHOCYTES IN 75/91 ASD
CHILDREN VS 5/70 CONTROLS WITH
LYMPHOID NODULAR HYPERPLAXIA
• NEW: 2006 BUIE, KRIGSMAN
VALIDATE WAKEFIELD’S FINDINGS:
INCREASED GI INFLAMMATION IN
ASD’S WITH 87% BIOPSIES SHOWING
VACCINE STRAIN MEASLES IN GUT
GUT MEASLES ASSESSMENT
• HISTORY, MMR RESPONSE
• GUT ISSUES
• RUBEOLA ANTIBODIES TEST
• BRAIN AUTO-ANTIBODIES TEST
• ENDOSCOPY
• BIOPSY, CSF ANALYSIS
• PCR (POLMERASE CHAIN)
MEASLES AND BRAIN VIRAL
AUTO-ANTIBODIES IN ASD
• SINGH 1998: 70% OF AUTISTIC SERA
HAD ANTI-MYELIN BASIC PROTEIN
ANTIBODIES, NONE IN NT CHILDREN.
• 57% ASD HAD ANTI-NEURON-AXON
FILAMENT PROTEIN, NONE IN NT
KIDS
• HIGHER ANTI-MEASLES ABS THAN NT
KIDS, MUMPS AND RUBELLA NOT
DIFFERENT FROM NT’S
GUT MEASLES TREATMENT
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DIETARY RESTRICTION
ENZYMES
GENERAL IMMUNE ENHANCEMENT
METHYLATION
DECREASE HEAVY METALS
HEAL LEAKY GUT
ANTI-OXIDANTS
LIVER SUPPORT
ANTI-INFLAMMATORIES
HIGH DOSE VIT A PROTOCOL
HIGH-DOSE VITAMIN A
FOR GUT MEASLES
BAKER - McCANDLESS PROTOCOL
200,000-400,000IU ORAL 2 DAYS EVERY SIX
MONTHS IF 3 OF 5 POSITIVE:
1) HISTORY OF REGRESSION AFTER MMR
2) PERSISTENT GUT PROBLEMS, PAIN
3) MORE THAN SLIGHTLY ELEVATED IgG
SERUM RUBEOLA ABS
4) ELEVATED ANTI-MBP & ANTI-NF ABS
5) ENDOSCOPY SHOWS ILH, CSF/BIOPSY+,
PCR VACCINE STRAIN MEASLES
ANTI-FUNGAL PRESCRIPTIONS
(BASED on 40-50 # CHILD)
• DIFLUCAN (FLUCONAZOLE - PRIMARY ONE I USE)
4-5mg/kg/day for 3-4 weeks in divided doses
• NIZORAL (ITROCONAZOLE -GOOD FOR LOWERING
TESTOSTERONE)
5mg/kg/day for 3 weeks in divided doses
• SPORANOX (USE WHEN RESISTANCE TO FLUCONAZOLE)
75-100mg/day for 3-4 weeks
• NYSTATIN
(TOPICAL – MANY YEAST OUTGROW), BENIGN
INEXPENSIVE
250,000 units qid
ANTI-BACTERIAL PRESCRIPTIONS
(Based on 50# child)
• FLAGYL (clostridia, parasites)
250mg BID for 10 days
• BIAXIN125mg/BID (tonsillitis, sinusitis)
• GENTAMYCIN 40-80mg BID for 10 days
• VANCOMYCIN 1 gram/day in 1/4 gm QID
doses 5-10 days
NEUTRACEUTICAL COMPANIES
I USE MOST FREQUENTLY (U.S.)
• ECOLOGICAL FORMULAS 800-888-4585
• KLAIRE LABS
866-216-6127
• INTEGRATIVE THERAPEUTICS, INC.
(NF FORMULAS/TYLER) 503-582-8386
• THORNE RESEARCH
800-228-1966
• VITAMIN RESEARCH
800-877-2447
• KIRKMAN LABS
877-365-9265
• PHYSIOLOGICS
800-765-6775
SUMMARY: RX GUT DISORDER
• RESTRICTIVE GF/CF/SF DIET, PROBIOTICS
• REMOVE OFFENDING FOODS PER IGG
HYPERSENSTITIVITY TESTING
• REPLACE NUTRIENT DEFICIENCIES,
ENZYMES
• TREAT FOR PATHOGEN OVERGROWTH
WITH NATURAL & PRESCRIPTIVE
ANTI-FUNGALS, BACTERIALS
TREATMENTS
BEYOND THE BASICS
“TRIO:”
1) GLUTATHIONE, TD-ORAL-IV
2) TTFD (ALLITHIAMINE –
AUTHIA)
3) M-B12 SUBCUT INJECTIONS
“QUARTET:”
4) ADD FOLINIC ACID
METHYLCOBALAMIN
• VIT B12 LEAST TOXIC, BEST TOLERATED
• UPTAKE FROM ORAL INTAKE LOW,
PARTICULARLY IN GI INFLAMMATION.
• VIT B12 PLAYS KEY ROLE IN GSH
STABILIZATION & REDUCTION STATUS
FOR ENDOGENOUS ANTIOXIDANTS
• DIFFICULT TO TEST FOR DEFICIENCY
• ULTRA HIGH DOSES MAY REGENERATE
NERVES
GLUTATHIONE (GSH)
• NATURALLY OCCURING TRI-PEPTIDE –
FROM CYSTEINE, GLUTATMIC ACID,
GLYCINE
• PRESENT IN ALL LIVING CELLS,
HIGHEST LEVEL FOUND IN LIVER
• INHIBITS FORMATION OF FREE RADICALS
• DETOXIFIES HARMFUL COMPOUNDS.
• DEFICIENCY INCREASES SENSITIVITY
TO THIMEROSAL AND OTHER
PRO-OXIDANT AGENTS.
GLUTATHIONE, Cont’d.
ENHANCE GSH LEVELS BY HELPING
BODY MANUFACTURE IT:
• VIT C, E, A-LIPOIC ACID (ALA), NACETYL CYSTEINE (NAC),
SELENIUM, GLUTAMINE, AND
SILYMARIN
• VITAMIN B12 HELPS MAINTAIN
GLUTATHIONE IN ITS USEFUL
REDUCED BIOLOGICAL STATE.
TTFD (ALLITHIAMINE)
• TTFD: THIAMINE TETRAHYDROFURFURL
DISULFIDE, SYNTHETIC COUNTERPART
TO ALLITHIAMINE, DERIVATIVE VIT B1
(THIAMINE), FOUND IN GARLIC.
• THIAMINE: WATER-SOLUBLE, REQUIRED
METABOLISM PROTEINS, CARBS, FATS
• THIAMINE DEFICIENCY IN ALCOHOLISM,
MALNUTRITION, USE OF CERTAIN DRUGS
TTFD, CONT’D
• GENTLE CHELATOR FOR
ARSENIC, CADMIUM,
ALUMINUM, LESS FOR HG
• NON-TOXIC, NO
PRESCRIPTION NEEDED,
TRANSDERMAL CREAM
TWICE DAILY
“TRIO – QUINTET” DOSES
1) GLUTATHIONE (GSH)
150 MG BID ORAL, 125 MB BID
TRANSDERMAL, 300-600MG IV WEEKLY
OR BI-WEEKLY OR MONTHLY
2) ALLITHIAMINE (TD-TTFD)
50 MG 2X DAILY (COMPOUNDED
OR AUTHIA)
3) METHYLCOBALAMIN (INJECTABLE MB12)
CONC 25-MG/ML, 64.5 MCG/KG
2X/WEEK
4) FOLINIC ACID, 400-MCG TWICE DAILY
TOXICITY
• TOXIC CHEMICALS
• HEAVY METALS
• GLUTATHIONE
• VACCINATIONS
• AMALGAMS, FISH INGESTION
DETOXIFICATION
OF HEAVY METALS
• DMSA—ORAL, TD, NEW SUPPOSITORIES
• DMPS—ORAL, TD, IV
• CaEDTA--- IV, SUPPOSITORY
• TTFD (AUTHIA) - TD
VIRAL-IMMUNE ISSUES IN
AUTISM
• EVIDENCE OF EFFECTS OF
PSYCHOTROPIC VIRUSES IN
AUTISM & OTHER
DEVELOPMENTAL DELAY
DISORDERS
• POSITIVE RESPONSES TO ANTIVIRAL TREATMENTS IN AUTISM
1
ANTIBODY LEVELS BY ELISA O.D. AT 405 nm
MBP
NFP
0.8
0.73±0.62
0.61±0.38
0.6
0.54±0.49
0.45±0.33
0.4
0.32±0.29
0.28±0.30
0.21±0.19
0.2
0.18±0.17
0.15±0.11
0.17±0.15
0.13±0.14
0.11±0.12
0
IgG
IgM
IgA
IgG
ANTIBODIES AGAINST MBP AND NEUROFILAMENTS IN CONTROLS
IgM
IgA
AND CHILDREN WITH AUTISM
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37
HEALTHY IMMUNITY
• BALANCE BETWEEN Th1 - Th2,
SWITCHES BACK AND FORTH AS
NEEDED
• INABILITY TO RESPOND
ADEQUATELY TO Th1 – CHRONIC
INFECTION & CANCER
• OVERACTIVE Th2 RESPONSE –
PLAYS ROLE IN AUTOIMMUNITY
AND ALLERGIES
UNHEALTHY IMMUNITY
FAILURE OF THE Th1 ARM &
OVERACTIVE Th2 ARM:
AIDS, CANCER
CFS (FATIGUE)
CANDIDIASIS
MULTIPLE ALLERGIES
MCS (CHEMICAL)
AUTISM
Th1/Th2 BALANCE
Th1 – CELLULAR IMMUNITY,
DIRECTS NK T-CELLS AND
MACROPHAGES TO ATTACK
ABNORMAL CELLS AND
PATHOGENS INSIDE THE CELL
Th2- HUMORAL IMMUNITY, CREATES
ANTIBODIES TO NEUTRALIZE
FOREIGN INVADERS OUTSIDE CELL
IMMUNE-ENHANCING
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OMEGA-3 FATTYACIDS
GLUTATHIONE
METHYLCOBALAMIN/FOLINIC
DIETARY RESTRICTION
PROBIOTICS
VITAMIN C, E, A, CO-Q-10
ANTI-FUNGALS
ANTI-VIRALS
NATURAL ANTI-VIRALS
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LAURICIDIN (ENVELOPED VIRUSES)
GARLIC, OLIVE LEAF EXTRACT
GLUTAMINE, PROBIOTICS
BLACK ELDERBERRY
OIL OF OREGANO
IP- 6 (INOSITOL HEXAPHOSPHATE)
GRAPEFRUIT SEED EXTRACT
PROTEASE ENZYMES (VIRASTOP)
HEALTHY LIFE STYLE
ANTI-VIRAL PRESCRIPTIVES
GENERAL IMMUNITY:
ORAL, IM, IV IMMUNOGLOBULINS
LOW-DOSE NALTREXONE
ACTOS
ANTI-VIRALS:
VALTREX (PRIMARY ONE I USE)
FAMVIR
ACYCLOVIR FOR SMALL CHILDREN
LIFE-STYLE
ANTI-VIRAL MESSAGES
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EAT LOTS OF FRESH VEGETABLES
DON’T SMOKE
GET ENOUGH SLEEP
DON’T EAT JUNK FOOD
DON’T DRINK TOO MUCH ALCOHOL
NURTURE YOUR RELATIONSHIPS
DO WORK YOU BELIEVE IN
LAUGH AT YOURSELF
• IF VACCINATE, GET HG-FREE!!!!
SUMMARY DAN! ASD
BIO-MEDICAL TREATMENTS
•
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1)
2)
3)
4)
5)
6)
7)
8)
DIETARY RESTRICTION
NUTRIENT THERAPY
GUT PATHOGEN TREATMENT
METHYLATION STRATEGIES
DETOXIFICATION (CHELATION)
IMMUNE ENHANCEMENT
ANTI-VIRAL TREATMENT
HBOT, NEUROFEEDBACK