Autism Around the World Symposium 2010 May 6-8, 2010 Zayed University Dubai, United Arab Emirates

Lauren W. Underwood, PhD*Autism Around the WorldSymposium 2010May 6-8, 2010Zayed University Dubai, United Arab EmiratesBiomedical Treatments for Autism 101:An Introduction to Scientifically Based Medical Treatment Options

Lauren W. Underwood, PhD

Lauren W. Underwood, PhD****Disclaimer:The information provided today is for educational purposes only, and should not be used in place of profession medical and/or nutritional supervision. If medical advice is needed, this service should be given by a licensed medical provider.I do not receive any financial remuneration for anything mentioned or referred to in this presentation.

Lauren W. Underwood, PhD*My training and employment. . .M.S. in Biology from Tulane University, New Orleans, LAPh.D. in Cell and Molecular Biology from Tulane University, New Orleans, LANIH Training Grant in Vision Research, LSU Eye Center, New Orleans, LADay job: Sr. Research Scientist, NASA SSC


Work related to autism . . .Independent Consultant, Developmental Delay ConsultantAutism One MentorUSAAA Scientific Advisory boardIHA Scientific Advisory boardCARD IRB

Lauren W. Underwood, PhD*A parent of child recovering from autism

But most importantly, . . .


Lauren W. Underwood, PhD*What is Autistic Spectrum Disorder?A developmental disability resulting from a neurological disorder . . .

That affects normal functioning of the brain . . .

affecting children in a spectrum of ways . . .

. . . children with autism behave in a spectrum of ways . . .

Autistic Spectrum DisorderAbnormal development ofCommunication skillsSocial skillsReasoning



The tough part about autism is thatNo one will tell you that there is something that will definitively work . . .

Autism is treatable!Recent research shows that autism is treatableEarly interventions lead to the best outcomesBe aware of symptoms, and begin addressing them as soon as possible

There is still not a cure, but there are many treatments to consider

Lauren W. Underwood, PhD*Educate yourself . . . empower yourself with knowledge!You know your child bestLearn about the disorderLearn about treatmentsMake intelligent choices about what would work best for your childfor it is a spectrum disorder, affecting each child differently

Consider pursuing 3 major treatment areas:Biomedical/Health Behavior/education & social interventionsSensory issues



Interventions go hand-in-handTherapies or interventions are designed to remedy specific symptoms in each individual. The best-studied therapies include educational/behavioral, sensory and biomedical interventions. Although these interventions do not cure autism, they often bring about substantial improvementLauren W. Underwood, PhD


My goal as an educator,1. BiologyAnatomy and cell biology2. Immunology3. Biochemistry4. Describe what can goes wrong with these systems


Then, the reasoning behind what can go wrong with these systems . . . explain how issues with these systems can affect behavior and behavioral intervention

Lauren W. Underwood, PhD* . . . To enable you to understand some of the biological approaches currently available for the treatment of the medical condition described as autism,

. . . .so if you choose you can consider applying them responsibly

What does biomedical approach mean?The application of the natural, biological and physiological sciences to clinical medicine



Why consider biomedical approaches for the treatment of autism?There is literature in peer review journals and other related sources that suggests that there are several biomedical interventions that . . . can be helpful for the treatment of the symptoms in many autistic spectrum disorder childrenLauren W. Underwood, PhD


http://www.pediatrics.org/cgi/content/full/120/5/1162

http://aappolicy.aappublications.org/cgi/reprint/pediatrics;107/5/1221.pdf

Evaluation, Diagnosis, and Treatment of Gastrointestinal Disorders in Individuals with ASD: A Consensus Report

Buie et al, 2010, Pediatrics;125;S1-S18http://www.pediatrics.org/cgi/content/full/125/Supplement_1/

Abstract- Buie et al; Pediatrics;125;S1-S18.The consensus expert opinion of the panel was that individuals with ASDs deserve the same thoroughness and standard of care in the diagnostic workup and treatment of gastrointestinal concerns as should occur for patients without ASDs. Care providers should be aware that problem behavior in patients with ASDs may be the primary or sole symptom of the underlying medical condition, including some gastrointestinal disorders. For these patients, integration of behavioral and medical care may be most beneficial. Priorities for future research are identified to advance our understanding and management of gastrointestinal disorders in persons with ASDs.

The ScienceThe body is made up of specific systems, including skeletal, circulatory, immune, cardiovascular, nervous, digestiveDigestive systemAnatomy and functionFood allergies/food intolerancesLeaky gut/intestinal dysbiosisImmune system functionBasic biochemistry

Digestive SystemMouthStomachSmall intestine-absorptionDuodenumJejunumIleumLarge intestine/ColonRectumLiverPancreas-secretes enzymes and hormones

Digestion-function of the digestive tractDigests foodAbsorbs nutrientsCarries vitamins and nutrients into bloodstreamChemical detoxificationExcretion

Lauren W. Underwood, PhD*Small Intestine Cross SectionSerosa Connective tissue Muscularis ExternaInner circular and outer longitudinal fibers (muscle cells)SubmucosaConnective tissueBlood vesselsMucousaEpithelial cells Lamina propria Muscularis mucosa

Lauren W. Underwood, PhD*Intestinal epithelial cell layer: histological view

How do you get nutrients from foods? ProteinFoods are made up of proteinsWhen foods are eaten and properly digested, proteins are broken down by enzymes into peptides Peptides are then further broken down into amino acidsAmino acids are the building blocks of life

*A little biochemistry . . . .Lauren W. Underwood, PhDWhat is a peptide

Lauren W. Underwood, PhD*

Peptides are made up of amino acids that are linked together

. . . Peptides are linked together to form proteins

*Whats an Amino Acid?Amino acids are the building blocks of life


Lauren W. Underwood, PhD*There are 20 amino acidsthe amino acid-CysteineCYSTEINE

What can go wrong with the GI?Leaky gutIntestinal dysbiosisConstipationDiarrheaEnterocolitisAllergy

Lauren W. Underwood, PhD*Leaky GutDefinition: an abnormal or unfavorable increase in intestinal permeability

The intestinal lining is supposed to be protective barrier between the gut and the bloodstream


Lauren W. Underwood, PhD*Tight gap junctions


1. What is leaky-gut?Definition: an abnormal or unfavorable increase in intestinal permeabilityEpithelia are either 'tight' or 'leaky' The intestinal lining is supposed to be the protective barrier between the gut and the bloodstream

Leaky Gut/Increased permeabilityIf the intestinal lining becomes damaged-it is possible for incompletely digested proteins and/or other by-products to leak through the intestinal liningThey can be recognized as foreign by the immune system, and/or leak into bloodstream



Lauren W. Underwood, PhD*How do you treat leaky gut?Cleanse the gut of toxinsAvoid the non-food foods: sugars, refined carbohydrates, fatty foods.Enhance the flow of digestive secretions /enzymes.Provide proper nutrition to the bodySupplements diet: vitamins, anti-oxidants,, probiotics


Lauren W. Underwood, PhD* What is intestinal dysbiosis?Intestinal flora-yeast and bacteria -are part of GI trackIntestinal dysbiosis occurs when there is an overgrowth/imbalance of intestinal flora(s)


2. DysbiosisIntestinal flora (yeast and bacteria) are a normal part of digestive trackIntestinal dysbiosis occurs when there is an overgrowth/imbalance of intestinal flora(s)Dysbiosis results fromIncreased use of antibiotics, steroids, etc.Poor dietDiets high in sugarStressImmune system dysregulation

Lauren W. Underwood, PhD*How do your treat intestinal dysbiosis?Try laboratory testing to determine pathogen:Yeast, clostridia, or unfavorable bacteria

Discuss Rx or OTC treatments with your physician


a. Constipation/ b. DiarrheaConstipation-having a bowel movement fewer than three times per weekStools are usually hard, dry, small in size, and difficult to eliminate. Can be painful to have a bowel movement andoften experience straining, bloating, and the sensation of a full bowelDiarrhea-frequent loose or liquid bowel movements (often associated with infection, allergy and food intolerances)

c. EnterocolitisInflammation [itis](due to infection or irritation) that affects part or all of the intestines (the small [entero]and/or large [col] intestines)Hyperplasia-general term for an increase in the number of the cells of an organ or tissue causing it to increase in sizeEndoscopy-looking inside, the human body for medical reasons, by inserting a small scope in the body

Ileonodular HyperplasiaNormal Terminal Ileum

Lauren W. Underwood, PhD*Consequences of intestinal dysbiosis or leaky gut-if left untreatedNutrients and vitamins arent absorbed properly---vitamin deficienciesIntestinal distressFood allergies are createdDetoxification is compromisedBacteria and yeast can be mobilizedFormation of antibodies you might not want---because of immune dysregulation


3. AllergyA large part of the immune system is located in or near the intestinal tract-to helps prevent microorganisms in the intestine from entering into the rest of the body1st line of defense against pathogens Defects in the immune system can lead to gastrointestinal problemsTherefore, the most obvious place for an allergic reaction to food to take place is in the GI trackReactions can range from acute to chronicFood allergies vs. food sensitivies

Food allergies An immune system response . . . to foodsBody mistakes a protein in food as harmful, and creates a defense against it (antibody)Allergy symptoms appear within minutes to an hour or so after eating the suspected food-body is battling invading foodSymptoms include eczema, an itchy red rash most common in the elbow creases or behind the knees hives, nausea, swelling, difficulty breathing and/or anaphylactic shock

Food sensitivities/food intolerances Digestive system response to foodsNot an immune system response

Something in food irritates digestive system or person is unable to breakdown/digest foodCan include metabolic food disorders such as lactose intolerance (missing enzyme)Symptoms include crapping, gas, nausea, and stomach pain

Immune system functionThe immune response is how your body recognizes and defends itself against bacteria, viruses, and substances that appear foreign and harmful to the bodyNormal immune system function, depends upon proper immune system responsesProtects and defends against foreign cellsMemory-gets smarterResponds appropriatelyDo no harm

Normally, there is a balance between infection and immunityinfectionimmunity

Lauren W. Underwood, PhD*InnateAcquired


Lauren W. Underwood, PhD*Acquired ImmunityWhite blood cells associated with acquired immune system are called lymphocytesT CellsB Cells


Lauren W. Underwood, PhD*T cells--Two kinds of t cells

Helper T Cells-Recognize antigensand help other cells do theirjob

Killer T cells-kills infected cell

. . . Th1 response

Lauren W. Underwood, PhD*B cellsProduces antibodiesAn antibody is specific to an antigen-- something the body recognizes as nonself. . . Th2 response

Cellular Communication

Lauren W. Underwood, PhD*And, the balance can be altered


Lauren W. Underwood, PhD*With immune system dysregulation, there is a shift or skewing:One possibility . . . when you are attacking, the attack is to produce antibodies . . .to foods, yeast, bacteria, etc.

Things can go wrong with the immune system . . .HypersensitivityAutoimmunityInflammationImmune system dysregulation

Immune system dysregulationImmune system dysregulation causes an abnormal immune response There is a shift or skewing lack of balanceThe immune system looses the ability to respond appropriately. . . and when this happens, it is possible that the body develops abnormal responses to things it might not normally react to . . . like foods

What happens if the immune system is compromisedImmune dysregulationAbnormal balance and communication between immune cellsChronic InflammationAn abnormal, persistent activation of immune cells in the tissuesAutoimmune reactionsAntibodies targeting and causing injury to normal body tissues

The immune system is closely connected to virtually every other system of the body . . .Disorders in the immune system can cause disease

Lauren W. Underwood, PhD*The Livers Mighty Detoxification Powers --designed to remove toxic matter from the blood stream


Liver Functions:Produces bileStores glucose in the form of glycogenMetabolizes protein and fatsStores vitamins and energyDetoxifies, and breaks down xenobioticsRemoves toxic matterLauren W. Underwood, PhD


Lauren W. Underwood, PhD*What happens if liver function is compromised?If detoxification systems are overloaded, this can lead to destruction of nutrients required for detoxification pathwaysif detoxification pathways become overloaded, there will be build of toxinsif transulfuration is disrupted, there is less ant-oxidant protection, and oxidative stress can result. . .


Vicious Cycle of Toxic OverloadHeavy metal exposure, environmental toxins, foreign proteinsDetoxification problemsGI distressAllergyImmune problemsInfections

Treat withAntibiotics, steroids, antifungals

Why detoxification?To prevent injury to the cells and ultimately cell deathIn autism, toxins may be a cause of the neurological and immune dysfunctionIf toxins accumulate too rapidly, without being safely eliminated, they can cause damaging effects upon cells and tissues of the body Detoxification may help the cells to recover and heal

Cell Damage and Disease

Lauren W. Underwood, PhD*Detoxification-Methylation and Sulfation?two of the healthy bodys natural means of ridding itself of toxic substances: MethylationSulfationASD children often need supplements to provide them with the raw materials their bodies need to carry out methylation and sulfation.


Lauren W. Underwood, PhD*Without methylation, there would be no life as we know it-Craig Cooney, author of Methyl Magic


MethylationMethylation: the process transferring a methyl groupto another molecule

Methylation is an important part of :Folic acid pathwayB6 pathwayB12 pathwayNeeded for neurotransmitter synthesis

Lauren W. Underwood, PhD*Important chemical events in the body are made possible by methylationDetoxification pathwaysDNA synthesisRNA synthesisCellular methylation rxtsNeurotransmissionSwitching genes on and off


MethionineHomocysteineCysteineGlutathione (GSH)Methionine SynthaseMethylTHFTHFolateMethyleneTHFolateMTHFRB6TMGDMGMethylB12B12SAMTranssulfurationpathwayRemethylationpathwayMethionine/Glutathione Transsulfuration PathwayCritical to the bodys ability to remove toxins!SAHLauren W. Underwood, PhD

Methionine/Glutathione Transsulfuration pathway in children with autism

Lauren W. Underwood, PhD*Treatment Options: Where do I begin?

1. Diet2. Supplements3. Testing(These are not in any particular order)

1. Healthier Diet

Read labels . . . .

Are special diets so special and which one do I choose? Many autistic children suffer from inflammatory response/immune system dysregulation Many autistic children dont/cant digest their foods efficientlyDiet options: GF/CF, SCD, BED, LOD, Pick one that works best for you and your family

Regardless of diet choice, it is important to ensure proper nutrition

Lauren W. Underwood, PhD*Gluten-free/Casein-free diet(GFCF diet)Your can try it on your own

There is research that suggests the diet can help many children . . .

Lauren W. Underwood, PhD*What is gluten?Gluten and gluten-like proteins are found in wheat and other grains, including oats, rye, barley, bulgar, durum, kamut and spelt, and foods made from those grains. It is also found in food starches, semolina, couscous, malt, some vinegars, soy sauce, flavorings, artificial colors and hydrolyzed vegetable proteins


Lauren W. Underwood, PhD*What is casein?Casein is a protein found in milk and products containing milk, found in such as cheese, butter, yogurt, ice cream, whey and most brands of margarine, and some non-milk products such as soy cheese, hot dogs, and tuna fish, in the form of caseinate

Diet: Gluten-free Casein-free(GFCF) DietA restrictive diet that removes all food items that contain both gluten and casein The are two main theories currently present in scientific literature that explain why some people with autism and PDD respond positively to a GFCF dietimproperly broken down dietary peptides immune system dysregulation

Improperly broken down dietary peptidesSome people with ASD cannot properly digest gluten and casein, which break down into substances that act like opiates in their bodies According to this theory, these "drug-like" substance alters the person's behavior, perceptions, and responses to his environment

Casein/casomorphin and gluten/gliadorphinCasein is a protein found in milk and products containing milkCasomorphin (or caseomorhin) is a peptide derived from the milk protein casein

Gluten and gluten-like proteins are found in wheat and other grainsGliadorphin (or gluteomorphin) is a peptide derived from the wheat protein gluten

Lauren W. Underwood, PhD* Or immune dysregulation causes an abnormal immune responseThe immune system looses the ability to respond appropriately . . .

Immune System DysregulationBody develops abnormal responses to things it might not normally react toAn abnormal immune response can result inAllergyInflammationHypersensitivityAutoimmunity

Lauren W. Underwood, PhD*When this happens, it is possible that the body develops abnormal responses to things it might not normally react to, . . . like foods

Lauren W. Underwood, PhD*Consider this . . . .Although at the beginning the diet may seem difficult, it maybe infinitely easier to try the diet, and end up having a happier healthier higher functioning autistic child, than living with a bad/poorly functioning one!!!

Which would you rather choose?


Lauren W. Underwood, PhD*How to begin a GFCF diet?Keep a daily log/diaryBe systematicTry removing dairy firstSee what happens; generally within first few days improvements can be observedTry for at least two weeksTry removing glutenGive this at least 3 months, and up to 6


Lauren W. Underwood, PhD*Books for suggested reading for GFCF Diet beginners:Special Diets for Special Kids: Understanding and Implementing Special Diets to Aid in the Treatments of Autism and Related Developmental

by Lisa Lewis, Ph.D.

Lauren W. Underwood, PhD*Some wonderful resources available for GFCF beginners:

GFCF DIET web site www.gfcfdiet.com

ANDI, autism network for dietary interventionhttp://www.autismndi.com

Lauren W. Underwood, PhD*Where do I get these types of foods?Buy ready-made food items or mixesYour local grocery storeYour local health food store


Lauren W. Underwood, PhD*Ordering GFCF foods on-line:Miss Robenshttp://www.allergygrocer.com800-891-0083Kinnikinnickhttp://www.kinnikinnick.com877-503-4466Ener-Ghttp://www.ener-g.com/800-331-5222


2. Nutritional supplementation

Lauren W. Underwood, PhD*Nutritional Supplements They are relatively safe-if used responsiblyYou dont need an RxYou can purchase a good encyclopedia of nutrition to educate yourself-go to your local bookstore or library

Why?There is some literature that suggests that some supplements can help many ASD kids . . Particularly because of impaired detoxification


Lauren W. Underwood, PhD****Disclaimer regarding nutritional supplements:The supplements mentioned today represents products that I am familiar with; there may be other supplements, besides these, which are acceptable. I do not endorse, nor do I receive any financial remuneration, for any of the items mentioned. Please note its always wise to verify product/safety information check with your healthcare provider, before use!

Why nutritional supplementation?Nutritional deficiencyinvolves a lack of one or more nutrients obtained from food essential for normal cell and body function occur due toMal-absorption/poor absorption in the small intestine Unhealthy eating, orSelf-imposed/imposed dietary restrictions Poor utilization of nutrients because of genetic or environmental factorsOxidative Stress

Nutritional deficiencies occur due to:Mal-absorption/poor absorption in the small intestine unhealthy eating, orself-imposed/imposed dietary restrictions Poor utilization of nutrients because of genetic or environmental factors


There are nutritional deficiencies associated with diseaseRickets-vitamin D deficiencyScurvy-vitamin C deficiencyBeriberi-thiamine deficiencyPellagra-niacin deficiencyGoiter-iodine deficiency

Vitamin B12Vitamin B6Folate or folic acidVitamin AVitamin CVitamin DZincMagnesiumOmega 3 fatty acidsGlutathione

What nutrients are commonly deficient?Lauren W. Underwood, PhD

Lauren W. Underwood, PhD*Nutritional supplements: Which ones?Some useful information is provided at www.ari/autism.comDiscuss options with your physician or nutritionist, and help to make the best decisions for your childwww.nutrition.gov for official government reports


Lauren W. Underwood, PhD*Some basic nutritional support to consider may include:Vit B6/Mag ProbioticsDMGand/or TMGZincFolic/Folinic acidDigestive enzymesGlutathioneCalcium/Magnesium AntioxidantsVit CVit ECoQ10


Signs and symptoms associated with nutritional deficiency . . .Neurological symptomsMemory lossPsychosisBruisingConfusionImpaired learningGrowth retardationLoss of appetitePoor immune functionHow can a child attend,focus, and learn?Lauren W. Underwood, PhD

Lauren W. Underwood, PhD*Tricks of trade: How do you get kids to take these things?Swallow capsules-oil/straw trickSyringe approachTrandermal preps-require Rx

Hiding in food:-Icing-Frozen fruit juices-Jell-O

Lauren W. Underwood, PhD*What are transdermals?Trans - acrossDermal - skinCompounding pharmacists formulate vitamins, minerals, hormones, and medications into cream and gel bases that are, when applied to the skin, actively transported through the skin for absorption into the bloodstream Transdermals offers almost complete delivery without many of the side effects/problems associated with oral administration

What about oxidative stress?Caused by an imbalance between the production of reactive oxygen (free radicals) and a biological system's ability to readily detoxify/repair damage Can impose upon the cells and affect normal cell function, causing oxidative stressCan supplement with antioxidants to counter-act effects of oxidative stress upon the cell


To combat oxidative stressVitamin ECalcium Vitamin C SeleniumGlutathione ZincVitamin B6 or its activated form,pyridoxal-5-phosphate (P5P) with Magnesium Lauren W. Underwood, PhD

Lauren W. Underwood, PhD*But no matter which interventions you try, . . .implement them slowly, one at a time, so that you can try to identify what exactly has had a positive or negative effect.

Lauren W. Underwood, PhD*3. Additional laboratory testing

Why consider other testing?

Because if you dont look for the problem, you might not find it

Lauren W. Underwood, PhD*Some standard laboratory testing to consider:Full Immunological work-upIgA, IgM and IgEIgG with subclassesComprehensive Allergy ProfileFor food and inhalants (including delayed food hypersensitivity IgG for food allergies)Toxic metal screening Hair, urine and blood


Lauren W. Underwood, PhD*Additional advanced laboratory testingComprehensive diagnostic stool analysisUrinary organic acid testSleep EEGMRI +/- CAT scanThyroid profileFragile XLiver panel

Urinary peptide levelsInborn error of metabolismSerum copperPlasma zincAutoimmune test forAnti-MBP


Lauren W. Underwood, PhD*Some advanced biomedical interventions: Require medical supervision/RxMethyl-B12 injectionsIVIG-intravenous immunoglobulinOral IGSecretinIV GlutathioneHBOT-Hyperbaric oxygen therapyChelation TherapyTransdermal DMPSOral DMSA


Lauren W. Underwood, PhD*What do we know now?Mercury in a known neurotoxin-Dr. Boyd HaleyThimerosal (50% ethyl mercury) can inhibit methionine synthase-Dr. Richard DethThese children have less antioxidant protection against oxidative stress-Dr. Jill James


Lauren W. Underwood, PhD*What we do know nowIn 2001, the Institute of Medicine (IOM) determined that such a relationship (between thimerosal and neurodevelopmental disorders) is biologically plausible, but that not enough evidence exists to support or reject this hypothesisThimerosal neurotoxicity is associated with glutathione depletion James et al, 2005Recent work by Dr. Mark Geier and David Geier have shown strong epidemiological evidence for a causal relationship between thimerosal and neurodevelopmental disorders in children-Geier and Geier, 2007


Why detoxification?

Maybe there is a genetic susceptibility, environmental factors can affect trigger effects. . .Lauren W. Underwood, PhD

The environmental factors issues is gaining broader acceptanceLauren W. Underwood, PhD

Findings: For every 1000 pounds of mercury that is emitted from Texas smokestacks there is a 61% increase in Autism rates in that state.Health Place. 2006 Jun;12(2):203-9. Lauren W. Underwood, PhD

EHP Vol 6, 2006: Online 21 June 2006Methods: Subjects included 284 children with ASD and 657 controls, born in 1994 in theSan Francisco Bay Area. We assigned exposure level by census tract of birth residence for 19 chemicals we identified as potential neurotoxicants, developmental toxicants, and/or endocrine disruptors from the 1996 HAPs database. Results: Adjusting for these three groups simultaneously led to decreased risks for the solvents and increased risk for metals (AORs for metals: fourth quartile 1.7, 95% CI 1.0-3.0; third quartile 1.95, 95% CI 1.2-3.1). The individual compounds that contributed most to these associations included mercury (highest odds ratio), cadmium, nickel, trichloroethylene, and vinyl chloride.Conclusions: Our results suggest a potential association between autism and estimated metal concentrations, and possibly solvents, in ambient air around the birth residence, requiring confirmation and more refined exposure assessment in future studies.

Autism Spectrum Disorders in Relation to Distribution of Hazardous Air Pollutants in the

San Francisco Bay Area

Gayle C. Windham, Lixia Zhang, Robert Gunier, Lisa A. Croen, Judith K. Grether

Division of Environmental and Occupational Disease Control, California Department of

Health Services, Richmond, CA; Impact Assessment Inc, La Jolla, CA; and Kaiser

Permanente Medical Care Program Division of Research, Oakland, CA

Why is detoxification important?To prevent injury to the cells and ultimately cell deathCell injury and cell death is badIn autism, toxins may be a cause of the neurological and immune dysfunctionDetoxification may help the cells to recover which will enable for healing If toxins accumulate too rapidly, without being safely eliminated, they can cause damaging effects upon cells and tissues of the body

How does your body detoxify?Designed to remove/eliminate toxic substances from the bodyPrimary function of liver and kidney GlutathioneOnce toxins are bound they are eliminated via bile and urineCan also be achieved via artificial (chelation) or supplementary (sauna) means through hyperbaric oxygen therapy (HBOT)


How do you implement a detoxification program?Should be done under the direction of an experience physician or other practitionerSupport the bodys own detoxification systemnutrients, methylB12, glutathione, etc.Remove accessible toxinschelation, saunas, etc.Monitor closelyLauren W. Underwood, PhD

Environmental Disease in HumansHypothesis:

Most human disease results from the interaction of genetic susceptibility and exposure to environmental factors

Genetic susceptibility generally relates to the inability of the liver to detoxify certain potentially lethal toxicants


The abnormal metabolic profile in children with autism is consistent with the abnormal genetic profile and strengthens the hypothesis that genetic susceptibility to oxidative stress and reduced methylation capacity may predispose these children to neurological, immunological, and gastrointestinal dysfunction that occurs with autismDr. Jill JamesLauren W. Underwood, PhD

Paradigm switch

autism is not a psychological condition it is a neuro-gastro-immunological disorder resulting from an genetic susceptibility and an environmental insult


Lauren W. Underwood, PhD*Dont try to do everything all at once!!!!

Lauren W. Underwood, PhD*What you can do now . . .1st Stabilize intestinal dysbiosis2nd Maximize metabolism3rd Healthier diet Consider removing casein from the dietConsider removing gluten from the diet4th Do some standard laboratory testing5th Introduce supplements, one at a time6th Do additional testing7th Consider advanced biomedical intervention, . . .


A happier, healthier child is going to be more responsive to behavioral, social and sensory interventions


Books recommended for an introduction to biomedical interventions for autismChildren With Starving Brains: A Medical Treatment Guide for Autism Spectrum Disorder by Jaquelyn McCandless, M.D.Lauren W. Underwood, PhD

. . .and,Unraveling the Mystery of Autism and Pervasive Developmental Disorder: A Mothers Story of Research and Recovery

by Karyn Seroussi


Understanding Autism for DummiesS. Shore, L. Rastelli,T. GrandinProvides the simple breakdown of behavioral, medical and other interventionOffers practical advice on how to educate children, as well as insights on helping people with autism maximize their potential

Lauren W. Underwood, PhD*More and more autistic children are getting better every day, and although there is no guarantee . . .today, there are more reasons to be hopeful that your child could be part of the extraordinary journey towards recovery

A new paradigm in autismAutism is an environmental illness with a genetic component.It is a complex metabolic disease, not just a developmental disability.Autism is treatable, but . . .We must continue fighting for a cure!


Remember, . . .Be patientBe inspiredHave strengthNever give up hope, andNever give up courageLove your child!Lauren W. Underwood, PhD

The End

******23,376 days of solitary confinement and still countingby John FaupelDoes painting for supporting charities**************See hand outs***********To help understand these concepts*Define amino acids, how many etc.**Define amino acids, how many etc.**The intestinal lining is supposed to be barrier between the gut and the bloodstreamIf the intestinal lining becomes damaged-it is possible for incompletely digested proteins and/or other by-products to leak through the intestinal liningrecognized as foreign by the immune system, and/or leak into bloodstream*****Intestinal flora-yeast and bacteria that are part of GI trackgastrointestinal tract contains a huge number of microorganisms. The total is estimated to be more than 10 times of all the number of cells in the body. It could be said that the body to 90% consists of microorganisms

********ProtectGet smarterRespond appropriatelyDo no harm***IgG testing can sometimes help determine suspect foodsMay not happen right after you eat the food; this can making them hard to detect

***INNATE-inborn from birth/ ACQUIRED-by being exposed

The immune response is how your body recognizes and defends itself against bacteria, viruses, and substances that appear foreign and harmful to the body. That way the next time your immune system is better able to fight it off.The immune system protects the body from potentially harmful substances by recognizing and responding to so-called antigens. Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, or bacteria. Non-living substances such as toxins , chemicals, drugs, and foreign particles (such as a splinter) can be antigens. Substances that contain these antigens are recognized and destroyed by the immune system. Even your own body cells have proteins that are antigens. These include a group of antigens called HLA antigens . Your immune system learns to see these antigens as normal and does not usually react against them.

*Acquired immunity is when the body is exposed to various antigens and builds a defense that is specific to that antigen. Lymphocytes are a special type of white blood cell. B lymphocytes (also called B cells) produce antibodies . Antibodies attach to a specific antigen and make it easier for the phagocytes to destroy the antigen. T lymphocytes (T cells) attack antigens directly, and provide control of the immune response. B cells and T cells develop that are specific for ONE antigen type. When you are exposed to a different antigen, different B cells and T cells are formed.As lymphocytes develop, they normally learn to recognize the body's own tissues (self) as different from tissues and particles not normally found in your body (non-self). Once B cells and T cells are formed, a few of those cells will multiply and provide "memory" for the immune system. This allows the immune system to respond faster and more efficiently the next time you are exposed to the same antigen, and in many cases will prevent you from getting sick.For example, an individual who has had chickenpox is immune to getting chickenpox again.

*Killer t cellprevents bug from reproducing by killing the cell that its in/autoimmunity responseTH 1-pro inflammatory, tissue destructiveAlthough antibodies can recognize an antigen and lock onto it, they are not capable of destroying it without help. That is the job of the T cells. The T cells are part of the system that destroys antigens that have been tagged by antibodies or cells that have been infected or somehow changed.

TH1 cells secrete IL-1 and gamma interferon , which enhance cell-mediated responses and inhibit both TH2 subset cell activity and the humoral immune responses. TH1 is inflammatory , produces IL2, IFNgamma, TNFbeta, provides help to B-cells in IgG2a production, activates macrophages and CTL and stimulates delayed type hypersensitivities

*seeking out their targets and sending defenses to lock onto them-foreign substance that invades the body is called an antigen (pronounced: an-tih-jun). When an antigen is detected, several types of cells work together to recognize and respond to it. These cells trigger the B lymphocytes to produce antibodies. Antibodies are specialized proteins that lock onto specific antigens. Antibodies and antigens fit together like a key and a lock.

An antibody is specific to an antigen.

Humoral immunity is most effective against bacteria, bacterial toxins, and viruses prior to these agents entering cells.

Allergy response/allergen driven responseTH2 cells, the other subset of T-helper cells, are also involved in cell-mediated immune responses. TH2 cell activity and secretions are thought to inhibit cell-mediated responses and to enhance the humoral response. TH2 cells produce IL4 , IL5, IL6, IL10 and IL13, which provide help to B cells and induce class switch to IgE and IgG1 , as well as supporting eosinophils and mast cells

*****Autistic children have High levels of proinflammatory cytokinesChronic and acute inflammation in the gutInflammation in the brainAutoantibody production

****To understand detoxification, you need to understand liver functionXenobiotic-chemicals ammonia, metabolic waste, drugs, so that they can be excreted****ASD kids do not absorb sulfur based substances well\B12, folic acid and b 6 and methionine synthase and MTHFR******Methionine--get from foods, cant supplementbasic building block for creation of most important transfer moleculeSAM-most important transfer molecule in the body-takes methyl group and transfers it all over bodychemical rxtsIn a perfect world sufficient levels of b12, active folic acid and enzymes-to take SAM back to MethionineMS and MTHFR are enzymes-methylene tetra hydrofolate reductasei.e. heating water to boilFolic acid-important in the formation of nucleic acids=tetrahydrofolateMethyl THF is converted back to THF with MS + B12B12 gives the Methyl group to HCY to it can be recycled to MethionineHYC + cystathione B synthase

*******Restrictive diet that removes both gluten and casein from the diet*We are what we eat Gluten is a protein*Casein is a protein****loses the ability to "react appropriately (properly) to foreign proteins (substances)" and "the body develops abnormal responses to things it might not normally react to" like foods. j**There is no scientific study yet of a head-to-head comparison of children with autism on or off the GFCF diet such a study is expensive and difficult to do - and there is no foolproof test to determine who will be a responder. However, for any parent of a child caught in the vicious circle of autism, this is treatment worth trying *Many children benefit both behaviorally and physicallyBehavior and biological go hand in had*Consider the following questions: Did being away from the food reduce any of his symptoms?If the answer is yes, Did anything happen when you went back to the suspect food that didnt happen during the previous week? Did your child become particularly withdrawn or particularly aggressive within hours of eating the food?

***Rice cakes***Need to understand biochemistry*******For over 20 years ARI observed and writtenEnzymes for proper digestion and absorption of nutrients need to be replacedBypass methylation defects, by supplementing with intermediatesZinc dependent digestive enzyme formationProbiotics to promote healthy population microorganisms*********There is no absolutely reliable test to determine who will be a responder to any kind of dietA test isnt always necessaryMy help some parents make the decision whether or not to consider tyring a GFCF dietor convince other family member

Igg food intolerances*******Underlying genetic predispositions, acted on by overlying environmental facts could explain this epidemic********The message is quite clear***But no matter the interventions you try, implement them slowly, one at a time, so that you can try to identify what exactly has had a positive or negative effect ******the lowdown on behavioral, educational, medical, other interventions. it offers practical advice on how to educate children as well as insights on helping people with autism use their strengths to maximize their potential in life.****

Autism Around the World Symposium 2010 May 6-8, 2010 Zayed University Dubai, United Arab Emirates

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Transcript of Autism Around the World Symposium 2010 May 6-8, 2010 Zayed University Dubai, United Arab Emirates