Transcript What To Do? - Autism One

Our Canaries
Why All The Asthma, Allergies,
ADHD and ASD?
Autism One
Saturday, May 23, 2009
Chicago, IL
Nancy O’Hara, M.D.
150 Danbury Road
Wilton, CT 06897
www.drohara.com
Excellence is the result of caring more than others think is wise,
risking more than others think is safe, dreaming more than others
think is practical and expecting more than others think is possible
Genetics Don’t Cause Epidemics
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Increases Over the Past 20 Years
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Autism:
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6000% Increase
1/10,000 to 1/150 (Fombonne et al, JAACAP, 2001)
ADHD: 400% increase
7x increase in prescriptions (Swanson et al, Neuropsych Rev
2007)
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Asthma:
Allergies:
Diabetes:
300% Increase
400% Increase
103% Increase
5 x increase in <5 year old (Bingley, 2007)
The Perfect Storm:
Four Catastrophic Changes
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Toxin Proliferation
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Hydrocarbons
Heavy metals
Other (hormones, antibiotics, chemicals)
Nutrition Deterioration
Vaccination Rates Increased (3 -> 34)
Ability to Detoxify Decreased
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Debilitation of Methylation and Sulphation
Toxins
Oxidative
Stress
Inflammation
Impaired
Pieces of the
Puzzle
Glutathione
and Sulfate
Toxins - Metals
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Mercury
Lead
Arsenic
Other
Mercury Sources
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Vaccines (187.5 mcg mercury)
Amalgams
Fish
Environmental
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Foundries (coal – burning)
Medical/dental waste
Fluorescent bulbs
Mercury – Amalgams
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Approximately 17mcg of mercury released from one amalgam
daily (mostly from chewing)
8 amalgams ~ 136 mcg mercury vapor released daily
15 % (17mcg) absorbed daily
Travels from blood to all organs and cells
Mercury can concentrate in placenta during gestation and in
fetuses (liver, kidney tissue) and infants (kidney, brain tissue)
If >8 amalgams, statistically significant increase in autism
17 mcg/day absorbed by pregnant mother
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270 during pregnancy
4590 mcg during gestation
Mercury Fish
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6 oz (170 grams) flounder = 42.5 mcg Hg (0.6
mcg/kg for 70 kg man)
6 oz swordfish = 2.4 3 mcg/kg
Most in swordfish, shark, tuna and sea bass
Mercury affects fertility – Hong Kong study
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Subfertile (4.5 ppm) males had 40% more mercury
than fertile (3.9 ppm) males
Vegetarians – very low levels of mercury (0.38 ppm)
Texas autism rates,
by school districts
Potential association
between autism rates,
environmental mercury
other toxins in Texas
Palmer, et al., Health and Place, 12 (2006) 203–209
1990-1993
1998-2000
Autism rates
On average, for each 1000
lb of environmentally
released mercury, there was
a 43% increase in the rate
of special education services
and a 61% increase in the
rate of autism.
Palmer et al. Health & Place 12 (2006) 203–209
All Reporting Facilities, All Chemicals TRI-(1987-2002)
Map shows 3,683 of 48,205 facilities reporting nationwide
Chemicals-TRI
(Toxic Release Inventory)
Total toxicity
United Nations Environment Program
Global Mercury Assessment, 2002
Lead
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Poisons developing nervous system
Decrease in IQ (inverse correlation
between IQ and blood levels at all ages
(British Medical Journal 1996)
Abortifacents
Lead Sources
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Metal Foundry
Poorly regulated factories engaged in metal finishing, grid insertion,
welding, casting
Herbal Pills, cosmetics
Cans, ceramics with lead solder
Chili powder
Cooking with Petroleum
Toys painted with lead paint
Exhaust emissions from leaded petrol
Insecticides
Lead pipes
Burning of newspapers, batteries
Other Heavy Metals and Toxins
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Arsenic
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Cadmium (industrial, incinerators)
Antimony (flame retardants – Australia study: SIDS)
Food additives
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Pressured-treated wood
Inorganic chickens (plus fed fish meal)
MSG (neurotoxin)
Fluoride
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China study: 7 point decrease IQ in community with high
fluoride levels
Toxins - Chemicals
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80,000 manmade chemicals
Need 6,320 million tests to evaluate pairs
9 tested pesticides
7 of 9 found to be neurotoxins
None have been banned
Chemicals
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PCBs/dioxins
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Disrupt thyroid and other hormonal loops
Depress vitamin A
Alter serotonin synthesis
Impair cognition
Depress IQ
Increase preservative behavior in newborn monkeys
fed levels commonly found in human BM (Rice,
EnvRes, 1999)
Chemicals
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PDBE
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Perchlorates
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Flame retardant
Endocrine effects
Rocket fuel, fireworks
Endocrine effects
Pesticides and Herbicides
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Carcinogens, neurotoxins
(Vibera, ToxAppPharm, 2003)
Phthalates & Bisphenol A (BPA)
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Sources
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Plasticizers (#3 & #7)
PVC
Polycarbonate
Food wrap
High Correlation allergic rhinitis, eczema,
asthma and house dust concentration of
phthalates
Genetic Predisposition
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“Genes load the gun, environment pulls
the trigger” (Sudhir Gupta, MD)
Results in toxicities, nutritional deficits,
infections, inflammation, immune
dysfunction
Epigenetics
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DNA of cell switched on/off -> profound
function changes (Anway et al, Science, 2005)
Toxins
Oxidative
Stress
Inflammation
Impaired
Pieces of the
Puzzle
Glutathione
and Sulfate
Glutathione
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Detoxifies heavy metals and chemicals
Antioxidant
Preserve mitochondrial integrity and
promotes ATP production
Protects lining of gut
Promotes normal T cell function
Toxins
Oxidative
Stress
Inflammation
Impaired
Pieces of the
Puzzle
Glutathione
and Sulfate
THE IMMUNE-GUT-BRAIN AXIS
Brain
Gut
Immune
Detoxification
Development of Mucosal Immunity
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Balance of good and bad flora
Healthy gut flora:
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Plays a crucial role in maturation of the immune
system
70% immune system in gut (sIgA)
Sub-optimal stimulation of the sIgA-dependent
mucosal barrier function → increased frequency of:
• allergies & asthma
• autism
• inflammatory mucosal disorders
• Increased Risk of Systemic Inflammation
Dysbiosis
A state of imbalanced microbial ecology
both bacterial & fungal
that contributes to disease
The overgrowth of micro-organisms of low
intrinsic virulence induces disease
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by altering the nutritional status and/or
the immune response of the host
elimination capacity
How does it all fit?
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Maternal presence of decreased Ω3 &
increased Ω6, leads to increased inflammation
Commensal flora cultivated over 1st 2 years of
life provides the baseline for immune
development
Early introduction of solid foods, esp. grains
and sugar alters flora
Early vaccination stimulates TLRs (innate
immune system) and exacerbates TH1/TH2
imbalance and dysregulation!
What lies behind us and what lies before us
are small matters compared to
what lies within us.
How Does It All Fit?
The Immune Load
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Pathogens Overload (viruses, bacteria,
yeast)
Antibiotic Use (depletion probiotics)
Insufficient Nutrient Load (Poor diet, junk
foods)
Digestive enzyme deficiency (Lactose)
Vaccination Excess
Stress
How Does It All Fit?
What Does It Mean
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Digestive impairment
Inflammation, leaky gut
Immune deficiency  greater
susceptibility to dysbiosis, inflammation,
and food sensitivities  further immune
deficiency (vicious cycle)
Yeast overgrowth, bacterial dysbiosis
Toxins
Oxidative
Stress
Inflammation
Impaired
Pieces of the
Puzzle
Glutathione
and Sulfate
Factors Contributing to Oxidative Stress
Inflammation
Infection
Genes
ASD
ADHD
LD
Environment
Hormones
Timing
Gut Inflammation
Brain Inflammation
Immune dysfunction
Four Phases of Detoxification
Abnormalities Found with Oxidative
Stress
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Phase I – keeping toxins in gut to safely exit
body (dysbiosis, impaired immunity, slow transit)
Phase II – toxins moved from gut to liver and
converted into water-soluble material; “make
sticky” (antioxidants, silymarin)
Phase III – Conjugate toxins with detoxifying
nutrients (GSH, taurine, NAC)
Phase IV – Alkalinity more efficient
What Can We Do?
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Reduce and Eliminate Further Exposure
Efflux Existing Toxins (Detoxification)
The Three R’s
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Remove (germs, allergens, toxins)
Replenish (nutrients, good foods, probiotics)
Repair (inflammation, malabsorption,
methylation)
Reduce Further Toxins
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Remove Amalgam Fillings
Reduce Seafood (tuna, shark, swordfish,
sea bass)
Eat Organic Chicken
Filter Water
Eliminate Pollutants
Avoid Vaccination containing mercury (flu)
Avoid Further Toxins
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Avoid lead
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www.cehca.org
www.leadcheck.com
Avoid #3 (PVC), #6 (styrene) and #7
(BPA) plastics
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www.checnet.org
Enhance Output of Toxins
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Correct constipation – all stool is toxic
Maintain good hydration/fiber intake
Maintain alkalinity (diet, HC03)
Exercise to sweat
Keep Your Faith in All Beautiful Things:
In the sun when it is hidden, in the
spring when it is gone.
What do we need to give to or get
out of our children?
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Exercise/Activity
Basic nutritional changes (change in diet..)
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Fresh, unprocessed, unrefined, unadulterated
Varied and rotational (try to vary day to day)
Non-allergenic (crave that which most sensitive to)
Protein (every 4-5 hours)
Vegetable juicing
Organic (especially pears, apples, peppers,
celery, strawberries, cherries, grapes,
spinach, lettuce, potatoes)
What To Do?
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Treat Constipation
At least 1 normal stool/day
Mg
Vitamin C
Fiber
Senna
Diet changes
What To Do?
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Remove
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Junk food, sugar, and other empty calories
Food additives – Artificial Sweeteners (Aspartame),
MSG, Dyes, Preservatives, etc
Raw animal food/unpasteurized food – risk of foodborne illness
Food Sensitivities – yours and those of your affected
child
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Instead of Gluten, consider quinoa, amaranth, millet, rice or other
grains
Instead of Casein, consider potato or almond milk
What To Do?
Remove Germs
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Bacteria (history of positive response to
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Virus
antibiotics)
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Fungus
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Monolaurin (Lauricidin)
Valtrex
Cyclovir (acyclovir, valacyclovir, famcyclovir, gancyclovir)
Virastop
Antifungal medication (Nystatin, Diflucan, Sporonox, Lamisil, Nizorel)
OTC (Citrus extract, caprylic acid, saccharomyces boulardii)
Diet (not because yeast in our diets is infective…)
Parasites (have to treat)
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B hominis (treat with Bactrim and Humatin or Yodoxin or herbals)
What To Do?
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REMOVE AMALGAMS – When? How?
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At least 3 to 6 months before conception while under the
care of a competent/holistic Physician and Dentist
PRE-Amalgam replacement regimen
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Start at least 3-4 wks prior
Consider a good Probiotic, Glutathione, Vitamin C, Vitamin
E, Milk thistle, B-Vitamins, Zinc, Magnesium, etc.
Consider taking Activated Charcoal 15 minutes before
procedure starts (to help bind swallowed mercury and
prevent circulation of the metal) AND immediately after the
procedure
POST-Amalgam replacement regimen
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Continue at least 4 to 6 weeks after
As above plus… consider IV Vitamin C within 24 hours of
procedure, double glutathione dose, amino acid complex
(mercury may deplete or impair utilization of several amino
acids, far infrared sauna therapy 3x/week
What To Do?
Replenish and Support Digestion
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Enzymes (speeds disassembly of foods;
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Mixed (helps kids with poor digestion)
• Plant based (papaya and pineapple)
• Peptidase specific (helps specific peptide
digestion)
Symptomatic (yeast die off)
• Activated charcoal (mop up toxins)
• Alka Seltzer Gold (alkaline)
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-ase)
What To Do?
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Replenish Probiotics
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Promote growth of healthy flora
Discourage pathogens
Support digestion
Produce SCFAs, reduce pH, synthesize
vitamins
Control inflammation and promote oral
tolerance
Encourage peristalsis
Minimum of 10 billion CFU/day, often > 50
billion CFU/day
What To Do
Fatty Acids and Immunity
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ESSENTIAL FATTY ACIDS (EFAs)
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DHA more important during pregnancy and
breastfeeding periods (DHA is in breast milk, not std
formulas)
Associated with brain development, visual acuity and
decreased inflammation
Maternal DHA levels ↓ in 3rd T – 200 mg/day DHA
increases level in mom, but need higher doses
(~1000 mg/day) to also ↑ levels in infant.
Take with antioxidant (Vit E) to prevent free radical
damage
Make sure product is pure
Sources: tilapia, trout, DHA-rich eggs (if not allergic)
What To Do
Fatty Acids in Childhood
Both DHA and EPA are important (any ratio
of 33-66% DHA:EPA is recommended)
Dosages need to be tailored in line with
severity of the condition.
Children 1-4 yrs 600-1800mg DHA/EPA
per day
Children 4-12 yrs 1000-3500mg DHA/EPA
per day
What To Do
Fatty Acid Status in ADHD
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Both conditions strongly correlate with low red blood cell
membrane concentration of DHA,EPA,and GLA
Lower levels of DHA and EPA also correlate with increased severity
of conditions Stevens et al 1996
Forty one children with ADHD and associated learning disorders (
mainly dyslexia) were supplemented with 480mg DHA 186mg EPA
and 96mg ALA for 10 weeks.
Significant improvement found in:
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Four global scales of ADHD measurement
Four out of seven sub-scales of the Comprehensive Parent Rating
Scale
Numerical but not significant improvement in two other scales
What To Do?
Replenish Nutrients
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Iron
Magnesium
Calcium
Selenium
Zinc
Vitamins C, A, E, D, Bs
GIVE TMG
MB12 shots
Folinic acid
ADD DPPIV
AVOID CASEIN
GIVE P5P
REDUCED
GLUTATHIONE
THERAPEUTIC
T
H
INTERVENTIONS
T
H
E
What To Do?
Replenish Nutrients
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IRON
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Important in oxygen transportation, cell
differentiation and heme/RBC function
Associated with enzymes involved in energy
production and metabolism. Also a cofactor in
neurotransmitter synthesis.
Low levels in infancy can be associated with↓
cognitive performance in teens (even if treated early)
With deficiency – anemia, malabsorption, fatigue
Take with Vitamin C to boost absorption
Sources: liver, meat, seafood, spinach, kidney beans
What To Do?
Replenish Nutrients
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CALCIUM
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Many women are deficient before pregnancy
Reduces preeclampsia
Vitamin D status is important in calcium absorption
Important in bone health, enzyme activity, muscle contraction,
neurotransmitter release, blood clotting
Bone/tooth/muscle/nerve function; cell membrane permeability
Deficiency causes rigidity, poor sleep, anxiety, teeth grinding
Secondary deficiency
Absorption vs taste
Sources: tofu, green leafy vegetables
What To Do?
Replenish Nutrients
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MAGNESIUM
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(Martineau et al, 1985)
> 300 enzymatic functions; neuromuscular, neurotransmitters,
BP
Deficiency causes hyperactivity, anxiety, twitches, insomnia
Sighing/salt craving/constipation
↓ magnesium associated with pre-eclampsia, pre-term delivery,
and fetal growth retardation
Chromium
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Important for glucose control, insulin/liver function
With deficiency – insulin resistance, Syndrome X, neuropathy
What To Do?
Replenish Nutrients
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SELENIUM
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Important for proper fetal growth/development
↓ selenium has been associated with some SIDS cases
Important for redox reactions, antioxidant
With deficiency – immune dysfunction, cell fragility
With excess – fatigue, brittle hair/nails, parasthesias
Toxicity in high doses (> 1000 mcg/day)
Sources: wheat germ, brazil nuts, oats
Molybdenum
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With deficiency – poor detoxification, chemical sensitivity
With excess – high uric acid, low copper, anemia
What To Do?
Replenish Nutrients
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ZINC
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Important part of most enzymes, protein synthesis, cell growth, sensory
function (taste, etc), and hormone and immune function (Sturniolo et
al, 2001)
> 200 enzymatic functions; in energy metabolism, protein, immunity,
detox
Acne, mouth sores, spots/lines on nails, pica, loss of smell, taste
Deficiency causes language, attention and immune issues
Best given alone, at night (piccolinate, acetate)
Deficiency is teratogenic in rats, abnormal brain development seen in
monkeys
Ratio with copper; taste test
Excess zinc can displace copper and ↓ copper can be harmful to fetus
Sources: animal protein, seeds, nuts, beans
What To Do?
Replenish Nutrients
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Vitamin C (ascorbic acid)
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Anti-oxidant, helps balance amino acids, hormone levels,
important in collagen metabolism (critical for immune function,
nerve transmission, carnitine)
With deficiency – bruising, poor immune function, anxiety,
depression (diarrhea with excess
Sources: citrus, broccoli, brussel sprouts, peppers
Vitamin E
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Anti-oxidant, incorporates into fatty part of cell membranes and
helps protect cells from heavy metal/chemical damage, boost
immunity and sulphation (glutathione and methylB12)
With deficiency – jaundice, xs clotting, impaired reflexes
Sources: seeds, nuts, polyunsaturated fatty acids
What To Do?
Replenish Nutrients
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VITAMIN D
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Important for calcium absorption
↓ associated with various chronic illnesses
Daily sun exposure for 20 minutes should be enough to avoid
extra oral supplementation beyond what is in the prenatal
vitamins
Sources: cod liver oil, salmon, herring, egg yolks
Vitamin A
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Teratogenic (birth defects with > 10,000 IU/d – NEJM Study)
Anti-oxidant, anti-viral, and immune regulation functions
With deficiency – vision, immune dysfunction
Sources: liver, carrot, dandelion root, kale
What To Do?
Replenish Nutrients
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B12 (COBALAMIN)
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Important in synthesis of DNA, RBC’s, and the myelin sheath
(nerve transmission)
Produced in gut by good flora – chronic antibiotic use decreases
B12 levels
Deficiency - decreased communication, anemia, memory loss,
poor balance
Methyl B12- SQ, IN, TD, oral; need adequate folate
Sources: animal foods – liver, kidney, eggs, fish, cheese, meat
FOLATE
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Important for intracellular metabolism and DNA synthesis/repair
400 mcg/day associated with ↓ incidence of neural tube defects
and pregnancy loss
Sources: green leafy vegetables, asparagus, oranges, legumes
What To Do?
Replenish Nutrients
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B1 (thiamine)
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B2 (riboflavin)
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Part of an enzyme essential for energy production,
carbohydrate metabolism, and nerve cell function
Deficiency can cause ataxia, enuresis, sensory loss)
Sources: brown rice, sunflower seeds, peanuts
Important in energy production and regeneration of
glutathione
Deficiency can cause mouth fissures, photophobia
Sources: organ meats, almonds, mushrooms, whole
grains
B3
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Important for energy production and regulation of blood
sugar, antioxidant mechanisms, and detoxification reactions
Sources: organ meats, eggs, fish, peanuts
What To Do?
Replenish Nutrients
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B5 (pantothenic acid)
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B6 (PYRIDOXINE; P5P)
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Deficiency can cause toe walking, grinding, restlessness,
insomnia
Important in immune function (antibody formation), protein
formation, nerve transmission, and RBC and prostaglandin
formation
Deficiency can cause immune dysfunction, anemia, sensory
issues, tantrums)
Sources: whole grains, legumes, bananas, seeds, nuts, sprouts
B15 (DMG/TMG)
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Deficiency leads to poor communication
Give with folate to decrease hyperactivity
Repair
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Oxidative Stress
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Antioxidants do not work alone (more like
rungs of a ladder; vitamins A, C, D, E,
glutathione, pycnogenol)
Gut (germs, enzymes, clean out)
Immune -EFAs
Hormonal
Detoxification
You gain strength, courage and confidence by every
experience in which you really stop to look fear in
the face…. You must do the thing you think you
cannot do.
-Eleanor Roosevelt
How does it all fit?
Fostering A Healthy Environment
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Breast is BEST!
•  Production of beneficial Bifidobacter in 1st
year
Delay introduction of solid foods, minimizing or
avoiding wheat & milk, support flora
Infants with a family history of atopic allergy
who received a Lactobacillus probiotic had a
50%  in atopy @ 2yo
How does it all fit?
Fostering A Healthy Environment
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Foods
Start soon after 6 months (some studies
show that waiting too long after that
increases the incidence of allergies, etc)
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Good options for first foods are avocado,
fruits and vegetables
Avoid any foods that siblings or parents are
sensitive to
Continue breastfeeding as long as possible
How does it all fit?
Fostering A Healthy Environment
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Vaccines
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Consider modified schedule –separate all vaccines in
time (gives child’s immune system more time to
develop)
Always use Thimerosal free vaccines
Avoid Flu shots unless necessary
Avoid vaccines during pregnancy
Support with antioxidants (Glutathione, Vitamin C, A, E)
Keep children on nutrient-rich diets
Do not give to sick kids (fever, cold, on antibiotics, etc)
Check titers before giving boosters
Follow those who seek the truth but
flee from those who have found it.
Yaclav Havel
Basic biomedical interventions
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HEAL THE GUT
Avoid what harms
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Gluten?
Casein?
Additives?
Toxins?
Give what heals
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Nutrients (MVI)
Probiotics
Omega 3 EFAs
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FIX METABOLIC PROBLEMS
 Additional
Vitamins/Minerals
 Magnesium
 Calcium
 Iron
 Antioxidants
 Vitamins A, C, D, E
 Anti-inflammatories
 Pycnogenol
 Detoxification
 Sweat
What Is It That My Child Needs:
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To Get
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To Get Rid Of
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My Courage
“Courage does not always roar.
Sometimes it is the quiet voice at the end of
the day saying,
“I will try again tomorrow.”