From: Saji. M. Idicula To: DAN-India@yahoogroups.com Sent: Saturday, December 17, 2005 10:26 PMSubject: [DAN-India] DAN Workshop at Bangalore -Topics covered

 

BIOMEDICAL APPROACHES FOR THE TREATMENT OF AUTISM

By Dr. Karima Hirani MD MPH, Los Angeles.

Workshop at Bangalore on 18th Dec. 2005

Brought to you by Autism India Network www.AutismIndia.net

 

Topics covered are:

 

WHAT IS DAN?

    Defeat Autism Now

    History of DAN

    Bernard Rimland PhD    www.autism.com/ari

Autism Epidemic=Epidemic of Toxic children

    From 1975-1995, the cancer rates in children rose 20%

    Asthma among U.S. preschool children grew 160% from 1980 to 1994

    1/6 children in the U.S. has been diagnosed with a developmental disorder or behavioral problem(ieADD)

 

Autism Epidemic

    15 years ago the incidence of autism was 4-5/10,000

    Today, the incidence is 1/166

    A stunning increase of over 1000%

 The assault of environmental toxins

     Air

     Food

     Vaccines

     Result: more sick children and adults, more children with autism

     Autism and the Environment:Exploring a connection. www.healthytomorrow.org (get the video)

 Biomedical approach

     Diet

     B12 shots

     Supplements

     Food allergies and avoidance

     Testing

     Treating GI related problems

     Heavy metal detoxification

     Being open to trying new promising therapies

 

Section One: Gluten-Free/Casein-free (GFCF) Diet

    There is research that suggests the diet can help many children

    You can try it on your own

    Suggested reading for beginners: “Special Diets for Special Kids” by Lisa Lewis

 

What is Gluten?

    Protein: wheat, oats, rye, barley, bulgur, durum, kamut, and spelt

    Also found in food starches: semolina, couscous, malt, some vinegars, soy sauce, flavorings, artificial colors, hydrolyzed vegetable proteins

 What is Casein?

    Protein found in milk and milk products like

cheese, butter, yogurt, ice cream, whey and most brands or margarine, and some non milk products such as soy cheese, hot dogs, and tuna fish, in the form of caseinate. Goat’s milk products also contain casein.

 Enzyme Link

    DPPIV an enzyme that breaks down casein and gluten in the GI Tract.

    Not working well in these kids

    Theory: it has been damaged by mercury

    Casein and Gluten are converted into opiate like molecules

    Opiate like effect in behaviours

 Immune dysregulation

    The immune system is effected

    The body develops abnormal responses to foods which can result in:

    Food allergies

    Leaky Gut

 Leaky Gut

     An abnormal or unfavorable increase in intestinal

permeability

     The intestinal lining is supposed to be the barrier between the GI tract and the blood stream

     It is now possible for incompletely digested proteins and/or other by-products to “leak” through this lining, leak into the blood stream and effect the immune system in a negative way

 How to treat Leaky Gut

    The GFCF diet: # 2 on list of most effective biomedical treatments

    Excellent websites for beginners:

    www.GFCFdiet.com

    www.Autismndi.com(autism network for dietary intervention)

 How to get started on the diet

    Meat, eggs, vegetables, nuts, fruits, use grains other than those mentioned.

    Rice, potato, nut milk instead of cows milk

    Rice/millet/potato/corn bread instead of wheat bread or wheat chapatis

 

Ordering GFCF foods on-line

    Miss Robens www.allergygrocer.com

    1800-891-0083

 

    Kinnikinnick www.kinnikinnick.com

    877-503-4466

    Note: beware of sugar content in these foods

 How to heal leaky gut

    Avoid sugars

    No sodas

    All juices should be 100% juice and diluted

    Learn to make desserts using natural sugar substitutes if possible ie, stevia, xylitol

 How to heal leaky gut

    Avoid refined carbs ie, white rice, pasta,

    Try to encourage whole foods

    Avoid fatty foods

    Enzymes

    Supplements

    Avoid allergenic foods

    Cleanse the gut of toxins(detoxification)

 How to determine if your child has food allergies

    Testing by blood (IgG antibodies)

    Allergy elimination diet (by Dr. Doris Rapp)

    #4 on the list of most effective biomedical interventions

 Detoxification

    Methylation and Sulfation

    Two natural ways the body gets rid of toxins

    ASD children often are lacking in the nutrients needed to promote these biochemical reactions

 Methylation

    Turns genes on and off

    Involved in neurotransmitter synthesis

    DNA and RNA synthesis

    Detoxification

 

Methylation

     B12 shots # 3 on the list of most effective biomedical interventions

     Methyl B12 (not Cyano B12)

     Extremely safe, non toxic

     Must be injectable, subcutaneous

     Given 2 times a week

     DAN doctor must prescribe it for you

     60-70% of children have shown improvement

 A word about B12

    Why injectable and not oral?

    Strict vegetarians can be B12 deficient

    Germs in the gut make B12 but not the useful kind

    B12 levels in the blood are falsely elevated and of the un useful kind

    Injectable B12 must be kept away from sunlight and not exposed to air

 Adverse Reaction to Methyl B12

    Hyperactivity

    Consider Taurine supplementation

    Try DMG

    Try TMG

    Try Folate

    Stop methionine or SAM

 MethylB12 and Dr. Neubrander

    For more detailed information, go to    www.drneubrander.com

    Note: I don’t follow all his recommendations

 Summary

    Start the GFCF diet

    Reduce sugars in the diet

    Work on Food allergies

    Start the B12 shots (needs a prescription)

 

Section Two: Supplements:

4 general rules

    Always start with a low dose

    Discontinue if there are adverse effects

    Introduce supplements one at a time with the exception of B6 and magnesium

    Keep records

 Supplements: How to administer

    Many are in capsules, so you must open them and disguise in the child’s food or liquid or give via a syringe diluted with liquid

    Some are in liquid

    Some are tablets, so you must crush if child cannot swallow

 Supplements: Phase One

     Digestive enzymes

     #6 on list of most effective

     Contains the DPPIV enzyme to help digest casein and gluten

     Helps digest other proteins, fats, carbohydrates

     2 with each meal and 1 with a snack

     Must open capsule and mix in liquid or food, unless the child will swallow

 

Digestive Enzymes

    Many brands available

    I like the Isogest formulation=new disacharidase containing

    Helps heal leaky gut

    Ensures proper digestion of all foods

 Adverse Reaction to Digestive Enzymes

    I have rarely encountered this

    Worsening of autistic traits, hyperactivity, and irritability

    This is almost always temporary

    Possibly due to a period of opiate-like withdrawal which may last 5-10 days or longer.

 Melatonin

     #5 on the list of most effective

     The highest benefit score of any single oral nutrient

     Hormone like substance made in the body by methylation from serotonin

     Helps regulate circadian rhythm, sleep,intestinal motility, and increase antioxidation

     1-2mg at bedtime may help with sleep and behaviour

 Melatonin:    Adverse reactions:

    Disturbed sleep instead of better sleep.

    If this occurs try a time-released formulation or discontinue it

 Vitamin B6/P5P

     B6 must be converted to P5P(Pyridoxal 5-Phosphate to be active

     Studies show that autistics have slow conversion to P5P

     B6 needs in autism can greatly exceed the government recommended amounts

     21 of 22 consecutive clinical studies have shown beneficial effects for autistics with doses much larger than RDA of B6

    Optimal dose is about 8mg/pound body weight per day

    Do not exceed 500mg/day

    Benefits are more favorable when magnesium is used with B6

B6: Adverse Reactions

     Irritability, hyperactivity

     Worsening of behaviours and autistic traits

     We know of 5 possible reasons why:

     B6 given without adequate food

     Zinc is severely deficient

     Amino acid levels may be deficient

     An impure grade of B6 is used

     Magnesium is required when B6 is used

 

Magnesium

    Important for energy delivery in cells

    Helps convert methionine to SAM

    Helps with sulfation which is low in autistics

    Optimal dose is 4mg/pound body weight or more

    Adverse reaction:loose bowels/diarrhea

    Reduce dose if this occurs

 B6 with Magnesium

    Give together

    Give with food

    Almost 50% of autistic patients benefit

    Start these early in the nutritional intervension

 Taurine

     Synergistic with magnesium

     Magnesium sparing

     Needed for bile salt formation which assists absorption of essential fats, vitamins A,D,E

     Powerful antioxidant

     This supplementation should be in place before trying TMG

     I normally check levels and only prescribe if low

Taurine

    100 to 250mg/day for 2-5 year olds

    250-500mg/day for 6-12 year olds

    Can be helpful in seizure disorder

    Adverse reactions quite uncommon

 Vitamin C

     Can keep stools loose and bowels regular (20mg/kg body weight per day)

     Supplementation has a high benefit ratio (20:1) for autistics

     Several documented metabolic functions which could be important in autism

    neutralizes harmful oxidants and can regenerate vitamin E

    results in harmless radicals and easily recycled

    required for efficient formation of L-carnitine, amino acid that is carrier  of fatty acids into cells for energy

    helps convert folic acid to folinic acid which is beneficial in autistics

     Very good food sources: broccoli, collards, horseradish, kale, parsley, turnip greens, black currant and guava

     Moderate sources: citrus, strawberry, papaya, beet, greens, cauliflower, cabbage, chives, watercress, mustard greens and spinach

     250mg/day for body weight less than 50 pounds

     500mg/day or more for kids 50-100Lb

     Note: most health food stores Vitamin C is corn based and a  lot of autistics are allergic to corn. So use a non corn source if possible

     Averse reactions: loose stools. Reduce amount if this occurs

 Zinc

     Low in many autistics and can be difficult to normalize cellular levels by supplementation

     85% autistics show a high copper:zinc ratio in

blood

     Assists in digestion, methylation, immune response

     Supplementation helps autistics accept changes in their diet

     Zinc assimilation depends on GI conditions, form of supplement and assisting nutrients

     Effective supplemental forms: citrate, picolinate, gluconate, aspartate

     Can be beneficial in autistics when introduced at an early stage of intervension

     Do not give with meals, or with calcium, iron or folate

     Start with low dose 5mg/day for a small child and may go up to 35mg/day for a 100 pound child

    Adverse reactions:worsening of behavior is usually due to the substance that the zinc is combined with. Try a different form (ie picolinate instead of citrate

 Molybdenum to lower high copper

    If molybdenum deficiency is present, then copper can be retained excessively in the cells.

    25-250micrograms per day is used.

    Try sodium molybdate form

    Good food sources: buckwheat, lima beans

 Calcium

     Low levels have been postulated for a subset of autistics per urine levels

     Supplementation is behaviorally beneficial for 35%

     Diets that are casein free will significantly increase the need for calcium

     Necessary for bones, teeth, cell signaling and hormonal messenger activities

     Calcium carbonate is a good form for supplementation when combined with another more soluble form.

     Carbonate form is 40% calcium by weight versus 20% for most citrates

     Vitamin D should be part of the supplement

     How much to give? 600mg-1200mg per day

     Best given with meals away from zinc

 Vitamin A

    Supplementation has a high benefit ratio with autistics

    Enhances immunity

    May be helpful in cases of persistent GI Measles

    Almost always low in blood testing I have done

     I recommend any where from 5,000-10,000 iu per day in the form of retynl acetate.

     Betacarotene is a provitamin A but is not always converted as needed to

     Adverse reactions: acute toxicity from hypervitaminosis A is rare: headache, nausea,vomiting, dizziness or vertigo, blurred vision, dry scaly skin at the back of the neck

 Vitamin D

    I usually supplement if blood levels are low

    Usually present in most calcium supplements and in cod liver oil

    Unless levels are low, further supplementation is usually not necessary

 Cod liver oil

    50% of autistics derive benefit

    Natural source of vitamin A and D

    In my opinion, there is not enough vitamin A that is needed in these kids

    ¼ teaspoon given to infants contains 1250 iu vitamin A and 2/3 teaspoon given to 10+ year old is

only 3330 iu of vitamin A

Cod liver oil     Adverse reactions:

    Allergic like sensitivity to palmitic acid or palmitate. Switch to another form ie synthetic Vitamin A acetate

    Note: when using codliver oil, always use a brand that guarantees no mercury ie Nordic Naturals, Metagenics

 Fatty Acids

    #7 most effective biomedical intervension

    Make up cell walls or membranes

    Responsible for fluidity of membranes and ensuring proper flow across membranes of nutrients

    Examples are DHA, EPA, ALA,

    Essential, our bodies do not make them

    I typically measure these in all my kids

    Omega-3: DHA and EPA 20-60mg per kg body weight(note: if already using codliver oil you may not need to give this)

    Omega-3 ALA found in flax seed. I recommend 1-2 tablespoons a day, less if using canola oil to cook with

    Omega 6: LA found in canola oil or sunflower seeds. I recommend 1-2 tablespoons a day

    Omega 6 : GLA found in evening primrose oil. I recommend 120-200mg per day(2 capsules)

    Be sure to supplement with taurine, digestive enzymes

 

Fatty Acids:Adverse Reactions

    Uncommon, and usually related to spoilage.

    Smell the oil if rancid, throw it away

    Check expiration date

    Omega 3 oils need to be refrigerated after opening

    Giving too much all at once can cause gas or diarrhea

 Probiotics

    Friendly bacteria found in the GI tract

    Helpful against bad bacteria

    Saccharomyces boulardii, a good yeast that kills the bad yeast, then leaves

    Lactobacillus rhamnosis is beneficial, but requires refrigeration

    Make sure they are dairy free 

    Won’t implant and flourish if the following have not been attended to:

    removal of food intolerances

    maldigestion

    constipation

    intestinal acidity(pancreatic dysfunction)

    deficient bile production 

    Large daily doses will show beneficial effects. I prescribe 30-60 billion organisms 2 times a day

    Try Kirkman’s Multiflora Spectrum

    Good brands need refrigeration

    Always needed like digestive enzymes

 

Probiotics:What do they do?

    Predigest sugars and proteins that could be hard for us to deal with, ie lactose

    Produce vitamins for us: B vitamins

    Produce natural antibiotics that inhibit growth of bad bacteria

    Reduce toxicity in the intestine

 Probiotics: 5 recommended strains

      1.Saccharomyces boulardii -yeast that kills other yeast like candida.

    Needs to be refrigerated

    Does it’s job and leaves

    Killed by prescription antifungals

    I usually prescribe this after stool test or urine organics reveals presence of yeast

    Clinical clues of yeast:

    Chronic diarrhea, constipation, Gas/Bloat/Abdominal pain, tired, decreased cognition, worsening behaviour with chelation

    I prescribe 1 pill 3 times a day preferably b/w meals

 

Die Off Reaction

     Can be seen with use of saccharomyces boulardii or other probiotics.

     As the pathogenic bacteria or yeast are dying, they will give off toxins to which the child can react to.

     Symptoms: headache, hyperactivity, temporary diarrhea, stimming and irritability. If they occur at all, they should resolve in a week or so.

 

     2. Lactobacillus Rhamnosus

     Similar to famous Lactobacillus GG but without any casein.

     In the right conditions, it will implant and colonize lower part of small intestine vigorously

     Survives normal stomach acidity

     30-60 billion organisms per day

     Needs refrigeration

     3. Lactobacillus Acidophilus

    “old reliable”, must be dairy free, refrigerated

    Produces an antibiotic that kills pathogens in food

    Can stop or decrease diarrhea due to pathogens

    Most strains survive stomach acid

     4. Bifidobacteria

    Also produces an antibiotic

    Colonizes the large bowel like acidophillus

    Complements acidophillus

    Help balance the acid-base balance in the bowel

    Reduces putrefaction, Refrigerate

 

    5. Streptococcus thermophilus

    Does not implant and colonize, but helps others to

do so.

    Makes enzyme lactase, digests lactose, then produces lactic acid which usually improve environment for acidophillus and bifidobacter

 Probiotics Adverse Reactions

    Die Off reaction-not every kid gets this, in my experience, not very common.

    Lower dose of probiotic or try activated charchoal

    Double check to see if it is dairy free

Die off Reaction – How to Treat

    Activated charchoal given 1 pill up to 3 times a day.

    Acts as a sponge, soaks up the toxins given off

    Do not give with a meal/sacc. Boulardii/other supps. It will soak all these up

 Dimethylglycine(DMG)

    Provides chemical parts for folate to do its many jobs

    For autism, relatively high doses can have positive results for speech and eye contact

    Start with low trial dose

    Once tolerating the DMG, may triple the dose.

    Start at 125mg 3 times a day for about a month

    Then increase to 375mg 3 times a day. If no significant improvement in language or eye contact then go back to lower dose or try TMG

 DMG Adverse Reactions

    Stimming or hyperactivity

    May be due to folate deficiency

    Supplement with folinic acid and B12

    800mcg of folinic acid 3 times a day give along with the DMG

 Trimethylglycine(TMG)

    Helps methylate homocysteine to make methionine, then it becomes DMG

    Can help with speech and eye contact

    Do not confuse with Betaine-HCL

    Start Taurine first, then add TMG

 TMG vs DMG

     Wise and safe to start with DMG first

     If no benefit was derived with high dose of DMG, then try DMG with folate/B12 first.

     If no benefit from DMG with folate/B12, then switch to TMG

     TMG can deplete cysteine and hence Taurine and Glutathione which can be detrimental

    44% of parents have reported benefit

    Large doses are needed as with DMG

    Adverse response to TMG? Make sure Taurine was started first.

    If no benefit from TMG then try TMG with folate/B12

 Creatine

    Important in cellular communication

    70% or SAM’s methylation is used to produce it.

    Deficiency can coincide and be causative of expressive speech defecit

    Mercury inhibits phosphorylation of creatine. Therefore, if it doesn’t work initially, try it later on.

Clues to creatine insufficiency

    Low muscle mass(hypotonia) and history of floppy baby

    Low serum creatine

    Low urine creatinine

    Hi ornithine in amino acid analysis

     Large therapeutic amounts needed

     300-1000mg/kg body weight per day in divided doses

     Adverse reactions: ask if the product is pure, are you detoxing(mercury) at the same time? If so then consider stopping temporarily

     Note: I have not been using this product in my practice yet

 Amino Acids

    Blood testing reveals that many autistics are low in these

    Address diet, digestion and intestinal dysbiosis first before supplementation

    Some pharmacies can customize the amino acid formula based on deficiencies

    Supplementation objective is to form a pool of amino acids that can be used to make creatine, serotonin, melatonin, glutathione to name a few

    Wait to use until after Gut issues have been addressed.

    Kirkman makes a good blend of the amino acids found to be commonly low

Amino Acids-Adverse Reactions

    Ask, is gut dysbiosis present?

    Ensure adequate B Vitamin intake

    Ensure adequate mineral intake

    Note: SAM and methionine are often poorly tolerated in autism regardless of the levels in blood/urine

 Folate

    B vitamin very important for methylation and regeneration of SAM

    For autism, folinic acid is the most versatile supplement form

    You can try FolaPro(5-meTHF) the active form of folate, but if no benefit, then stick to folinic acid

 Glutathione(GSH)

    Small protein, very very important in detoxification, immune enhancement

    In autism, GSH is low

    Occasional adverse reaction to supplementation occurs(I have rarely seen this)

    TMG and folinic acid can enhance its activity

 Glutathione(GSH)

    Oral supplementation is definitely beneficial (the kind used may be important)

    I use it in my practice a lot for immune enhancement

    400mg-800mg of reduced L-glutathione(recancostat brand by Tyler)

 Carnosine

    Dietary peptide contains histadine and beta-alanine (found in meat and fish)

    Can reduce seizures and improve speech

    Problems with its use have occurred.

    Supplement with 600-1200mg per day, take with Zinc, Magnesium, Taurine, B6

  Other important nutrients

     Vitamin E 200-400iu per day(metagenics brand)

     B complex 50-100mg per day(kirkman’s 1 teaspoon per day)

     coQ10 50-100mg

     L-carnitine 500-1000mg per day on empty stomach

     Mineral complex (kirkman’s mineral 1 pill 1-2 times a day) or elyte liquid trace minerals one dose 2 times a day www.emersonecologics.com for Elyte

 First Tier Supplements, while the GFCF diet is introduced

      Digestive enzymes

      B6/magnesium

      Taurine

      C and E

      Zinc

      Calcium

      Vitamin A

      Cod-liver oil/fish oil

      Melatonin

      B Complex

      Mineral complex

Next step Treating dysbiosis

    Milk thistle (liver support) 200mg-400mg per day

    Probiotics

    S. boulardii

    Activated charcoal if needed

 Second Tier options during mercury detoxification

     More vitamin C

     Glutathione

     coQ10

     DMG/TMG

     B12 injectable, folinic acid

     creatine,

     L-carnitine

     L-carnosine

     Amino acids

 Carnosine

     Be wary of use if:

     Levels are already high in the amino acid analysis

     Taurine is high in the urine amino acid test

     Taurine is low in the blood amino acid test

     Zinc is deficient in the blood

     Creatine is low in the blood

 Section Three: Testing

     Can be very beneficial if one has the financial resources and the means

     Baseline Testing: I do on all children in my practice

    Complete blood count(CBC)

    Chemistry (liver, kidney function, electrolytes)=Chem Panel

    Iron levels and storage

    Baseline hair analysis (GSDL)

    Comprehensive parasitology (stool test) GSDL

    Food allergies (ImmunoLabs)

Testing

    Ion Panel (includes amino acids, fatty acids, antioxidant levels, oxidative stress analysis, red blood cell minerals, urine organic acid testing) this panel is very comprehensive and cost effective(metametrix)

    Thyroid panel

Tests that can easily be done in India:

    CBC, chem panel, thyroid, iron and ferritin.

    Tests that may be difficult to do but should be attempted to obtain: all the rest, especially the comprehensive parasitology

Web Addresses of the Specialty Labs

    www.GSDL.com

    www.Doctorsdata.com

    www.immunolabs.com

    www.metametrix.com

    The above labs may be able to send to your doctor the kits to draw the blood/urine/stool and then you can send back 

 

What if you cannot get specialty tests done

     Get the basic tests that can be easily done in India.

     Get started on the diet and first tier supplements.

     When appropriate, ask your doctor to get you methyl B12 injectable. I use on average 2000mcg per shot subcutaneous 2 times a week.(www.MCGuff.com). 10ml bottle can last more than 3months

 Heavy Metal Detoxification

     #1 most effective therapeutic treatment according to DAN and me too!

     Does this implicate the childhood vaccines containing thimerisol (mercury)?

     Mercury injures methylation which could lead to widespread consequences

     The transdermal route of detoxification is very promising

Heavy Metal Detoxification

    Read “Treatment options for Mercury/Metal Toxicity in autism and related developmental disabilities:consensus position paper” February 2005. www.autism.com/ari

 

DMPS as a therapeutic agent

    Been in active use for over 50 years

    Long track record of safety

    Originally used intravenously and orally(limited absorption)

    Most recently available in a transdermal form thanks to dr. Buttar

    Considered to be more potent than dmsa(another chelating agent)

Transdermal DMPS

     Applied every other day with the rest day used to replenish with minerals

     Common side effects:

     behavioral which respond to improving gut flora and function or enhancing trace mineral intake

     occasionally liver enzymes may go up but promptly come down with milk thistle or GSH

     Kidney toxicity is not considered to be a risk for dmps.

     Most commonly we see a depletion of minerals. Therefore it is very important to replenish minerals and where possible test for RBC minerals at a minimum every 2 months

(Metametrix Labs).

Is your child a candidate for heavy metal detoxification?

    Common laboratory evaluation to determine body burden of mercury and other toxic metals are not always reliable.

    The best test is to try the TD-DMPS

    You must go to a trained doctor to obtain this and he/she should monitor the child

TD-DMPS

    Where to get it from: AMT pharmacy

    Be careful of other pharmacies

    When to start heavy metal detoxification?

    Once the Gut is clean, i.e. child is on the GFCF diet, enzymes, food allergy avoidance, probiotics etc.

 

What if I cannot obtain TD-DMPS

    If cost is an issue, this may be overcome stay tuned.

    Try all other recommendations in the mean time especially diet, methyl B12, supplements

Other Heavy Metal Detoxification options

    DMSA: oral or TD

    EDTA: oral/suppository/iv

    Natural ones: be careful

    Bottom Line: I have had the most success with TD-DMPS, some docs are using TD-DMSA with equal results. So TD (topical) seems to be the best route for now.

 Vaccines

     Thimerosal(mercury) in vaccines

     Websites to determine content

    http:/www.vaccinesafety.edu/thi-table.htm

    http:/www.fda.gov/cber/vaccine/thimerosal

     Most vaccines in U.S.A as of 2004 are free of thimerosal.

     Read Stephanie Cave’s book “Children’s Vaccinations-what Your Doctor May Not Tell You”

 Section Four: Clinical Approach to Common Problems in Autism

Protein deficiency: Rice protein powder directly into their drink. www.nutribiotics.com. Under 3 years, 1 gm per 2 pounds body wt. If 4-6 years, 1 tablespoon daily. 7-10 years, 1 ¾ tablespoon daily. 10+ years old, 2 tablespoons per day.

Constipation

     Benefiber (guar gum) 1 teaspoon in juice or water

3 times a day

     Prune juice

     Magnesium(milk of magnesia)

     Vitamin C high dose

     Oxypowder(oxypowder.com) high dose magnesium and germanium

     Fruit-eze(www.fruit-eze.com)

     Prescription laxatives(miralax)

Diarrhea

     Colostrum (transfer factor)

     Probiotics-see supplements section(this includes s.boulardii) 

     Digestive enzymes

     Biocidin 1 drop per 10 pounds body weight(www.drhoffman.com)

     GFCF diet if already on it, suspect a leak.

     Xray of abdomen (as it could be a sign of constipation)

     Do the comprehensive parasitology test

Self-Abusive Behaviors and Rage, impulsivity, disinhibition

      Suspect GFCF leak

      Inositol 1-6 gm 3 times a day

      Chromium 100-200mcg per day(in the mineral formula)

      Taurine up to 10gm per day

      GABA up to 10 gm per day

      Low sugar/carb diet

      Eliminate Artificial colors

      Heavy metal detoxification

      Low dose Naltrexone(prescription)

      Consider Risperidal(prescription drug)

Poor Sleep

     Melatonin 1-3mg at bed can split it up twice daily(may be drowsy initially in the day time)

     Taurine 1000-4000mg at bed

     GABA 1000-5000mg at bed

     DMPS

     TMG day time dose

     Magnesium 400-800mg at bed

     5htp  50-100mg at bed

     Naltrexone (prescription)

In Closing

    There are many new Therapies on the horizon. Find a DAN doctor

    The biomedical approach must be balanced with behavioral therapies

    Don’t give up

    Letters from families of recovered children (patients of mine)

 

Brought to you by Autism India Network. www.AutismIndia.net

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