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Autism and the Neurological Response

Part Three of Three in a Series on Children and Autism

By Jared M. Skowron, ND

We already established in the first two articles of this series that approximately 1 in 100 children is affected by autism. In this final article of a three-part series on autism and children, we will continue looking at the pathophysiology, connections and treatments for the gastrointestinal system.

Starting at the root of this disease, we can see how the branches and leaves of autism stem into all parts of the body. Beginning with toxic deposition of heavy metals or other chemicals, the body reacts to remove the offenders. The deeper the toxins are in the tissue, the stronger the reaction of the young body. Inflammation, altered immune response from vaccinations, altered endocrine response, increased action potentials of the nervous system, increased sympathetic tone and gut inflammation are all homeodynamic responses to removing the toxins buried deep within the tissue.

Our jobs as naturopaths are to detoxify the body, remove the cause of disease and balance the homeostatic response to improve the quality of life for the entire family.

Importance

The gastrointestinal system is one of the most important organ systems in the human body. It's the foundation of absorption, introducing energy, nutrients and vitality. It's the foundation of the immune system, deciding what to react to in the world. It's the foundation of the gut-brain connection, synergizing emotions, thought and the outside world.

Children with autism have an altered GI system. Involved in the triad of Nervous–Endocrine–GI systems, it's altered by changes in the other systems such as decreased parasympathetic tone and increased cortisol output, while also causing imbalances in those systems. At the base cause of autism, there is a stress reaction to toxicity. This reaction will inhibit digestion and alter development of the immune system. As this continues over months to years, improper digestion will lead to nutrient deficiencies which worsen the symptoms. And altered immune responses react with inflammatory responses to certain common foods. This continual viscous cycle of inflammation and poor absorption in the gut maintains a stress response in the body.

Intestinal Adaptations

There is a plethora of intestinal pathology in children with autism. Enlargement of the GALT (gut-associated lymphatic tissue) is characterized by ileo-colonic lymphoid nodular hyperplasia, 90 percent of autistics compared with 30 percent of healthy children.1 This anatomical alteration of the immune system also presents physiologically with reactions to certain foods. Children on the spectrum have an increased level of tumor necrosis factor alpha (TNF-alpha) and interleukin-12 (IL-12) to two milk proteins, alpha-lactoalbumin and beta-lactoglobulin, and also increased TNF-alpha to gliadin.2

Gluten-free and casein-free (GF/CF) diets which remove all gluten and dairy from the diet are very common, however they are not the only possible food allergen. Consider soy, peanuts, citrus, sugar and other common food sensitivities, which can create inflammation in the gut. Reduction of these foods in the diet will alter the immune system. Intestinal CD3 and TNF-alpha is reduced in those on a GF/CF diet,3 as well as reduction in intestinal eosinophil infiltrates.4

Certain foods, especially gluten, can metabolize into opiate-like chemicals, creating a spaciness or lack of focus in children. These opioid peptides are increased in children with autism and also can be tested in serum or urine,5 causing some of the symptoms of autism and also worsening gastrointestinal issues by heightening dysmotility.6 These peptides, in addition to bacterial toxins and medications, then further increase inflammation by binding to lymphocytes and causing a localized autoimmune reaction.7 The inflammation spreads across the entire GI tract with reflux esophagitis in 69 percent, low-carbohydrate enzyme production in 58 percent, and diarrhea in 90 percent.8 Even those children with no signs of gastrointestinal dysfunction have almost a 50 percent chance of gut mucosal damage and reduced intestinal permeability.9

Treatments

Treatment of the GI system is a necessity in children with autism. Improvement of digestion and absorption is the beginning of treatment. Digestive enzymes, Betaine HCl and other digestive aids are beneficial. Healing of the intestinal lining from chronic inflammation will improve absorption and reduce intestinal permeability. Glutamine, used for GI repair is considerably decreased in children with autism.10-12 Probiotics, the addition of beneficial gastrointestinal microflora, also can be used. Children on the spectrum have less gut flora than healthy children due to their increased amounts of antibiotic treatments and otitis media infections.13

Removal of food sensitivities also is an essential part of treatment. While GF/CF is popular and effective with certain children, in my clinical experience, I see GF/CF work approximately 50 percent of the time. Testing ELISA IgG food sensitivities will target an individualized elimination diet for each patient. GF/CF is intensive and a lot of time and frustration for a family, especially if they will not see any benefit from it. Find each child's unique food sensitivities. Balancing of the immune system eventually will alter food sensitivities. A patient of mine with autism reacted extremely violently to dairy. After a year of treatment, his mother started to give him ice cream as the warm summer days arrived. She called and was shockingly surprised he was not reacting to dairy. His food sensitivities had disappeared.

Secretin has been a popular treatment in the past. Similarly to GF/CF, some families have had success while others have had none. Research has shown secretin to not be effective (12 out of 13 studies prove ineffective),14 however many of those studies gave one dose of secretin; perhaps prolonged treatment is necessary to observe results.15-16 Always observing our GI-CNS-Endocrine triad, secretin not only is a digestive enzyme stimulant, but also a GABA agonist and neurotransmitter.17-18

Yeast and anti-candidal treatments also have become popular for children with autism. While organisms might be growing in the GI tract, they only are there due to an imbalanced immune system. Once removed, they will return unless alteration is done to the immune system. Candida is not the cause of autism. It's an opportunistic organism that finds an environment. Removal of the yeast might improve symptoms temporarily, but the focus of your treatment must be removal of toxins and balancing of the stress response.

Individualization

Each child with autism is unique. As naturopaths, our testing and individualized treatments set us far and above conventional treatments for autism, with more than 95 percent of families seeking non-conventional treatments.19

Your testing must include:

  • Heavy metal testing
  • Mineral/Vitamin screen
  • Food allergy IgG
  • Endocrine testing
  • Gut microbiology/Candida
  • Opioid peptides

These results will guide your treatments, however these five areas must be addressed:

  • Detoxification
  • Endocrine balancing
  • Gut rejuvenation
  • Nervous system calming
  • Vitamin/Mineral replenishing

Autism is completely treatable and you will be amazed at how children can awaken and mainstream. I would be happy to answer questions or review case discussions with anyone learning to treat autism. E-mail me at DrSkowron@SpectrumAwakening.com.

References

  1. Wakefield AJ, Ashwood P, Limb K, Anthony A. Eur J gastroenterol Hepatol. 2005 Aug;17(8):827-36.
  2. Jyonouchi H, Geng L, Ruby A, Reddy C, Zimmerman-Bier B. J Pediatr. 2005 May;146(5):605-10.
  3. Ashwood P, Torrente F, Wakefield AJ. J Clin Immunol. 2004 Nov;24(6):664-73.
  4. Ashwood P, Anthony A, Pellicer AA, Torrente F, Walker-Smith JA, Wakefield AJ. J Clin Immunol. 2003 Nov;23(6):504-17.
  5. Reichelt KL, Knivsberg AM. Nutr Neurosci. 2003 Feb;6(1):19-28.
  6. Wakefield AJ, Puleston JM, Montgomery SM, Anthony A, O'Leary JJ, Murch SH. Aliment Pharmacol Ther. 2002 Apr;15(4):663-674.
  7. Vojdani A, Pangborn JB, Vojdani E, Cooper EL. Int J Immunopathol Pharmacol. 2003 Sep-Dec;16(3);189-99.
  8. Horvath K, Papadimitriou JC, Rabsztyn A, Drachenberg C, Tildon JT. J Pediatr. 1999 Nov;135(5):559-63.
  9. D'Eufemia P, Celli M, Finocchiaro R, Pacifico L, Viozzi L, Zaccagnini M, Cardi E, Giardini O. Acta Paediatr. 1996 Sep;85(9):1076-9.
  10. Aldred S, Moore KM, Fitsgerald M, Waring RH. J Autism Dev Discord. 2003 Feb;33(1):93-7.
  11. Zavala M, Castejon HV, Ortega PA, Castejon OJ, Marcano de Hidalgo A, Montiel N. Rev Neurol. 2001 Sep 1-15:33(5):401-8.
  12. Rolf LH, Haarmann FY, Grotemeyer KH, Kehrer H. Acta Psychiatr Scand. 1993 May:87(5):312-6.
  13. Niehus R, Lord C. J Dev Behav Pediatr. 2006 Apr;27(2 Suppl):S120-7.
  14. Ashwood P, Anthony A, Torrente F, Wakefield AJ. J Clin Immunol. 2004 Nov;24(6):664-73.
  15. Levy SE, Souders MC, Wray J, Jawad AF, Gallagher PR, Coplan J, Belchic JK, Gerdes M, Mitchell R, Mulberg AE. Arch Dis Child. 2003 Aug;88(8):731-6.
  16. Molloy CA, Manning-Courtney P, Swayne S, Bean J, Brown JM, Murray DS, Kinsman AM, Brasington M, Ulrich CD 2nd. J Autism Dev Disord. 2002 Dec;32(6):545-51.
  17. Clement HW, Pschilbul A, Schulz E. Int Rev Neurobiol. 2005;71:239-71.
  18. Ng SS, Yung WH, Chow BK. Mol Neurobiol. 2002 Aug;16(1):97-107.
  19. Harrington JW, Rosen L, Garnecho A, Patrick PA. J Dev Behav Pediatr. 2006 Apr;27(2 Suppl):S156-61.

About the Author: Jared M. Skowron, ND, is in private practice in Hamden, Conn., where he specializes in pediatrics and successfully treating children on the spectrum. A graduate of NCNM, he is the senior naturopathic physician with Metabolic Maintenance and has formulated a vitamin/mineral/amino supplement therapy for autism, currently undergoing clinical trials. Dr. Skowron also is an adjunct professor at the University of Bridgeport, teaching Pediatrics, CPD and EENT.



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Date Last Modified - Friday, 17-Oct-2008 12:10:28 PDT