GENERAL CONFERENCE AUTISM SPECTRUM DISORDER

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GENERAL CONFERENCEAUTISM SPECTRUM DISORDER

• THURSDAY, APRIL 27, 2006
• 830 TO 530
• RAANANA
• AMDOCS COMPANY

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JAQUELYN McCANDLESS, M.D.WITH JACK
ZIMMERMAN, PhD
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A BIO-MEDICAL APPROACH TO AUTISM

• EVALUATION AND TREATMENT PROTOCOLS
• BASED ON
• LABORATORY TESTING AND CLINICAL EXPERIENCE

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WORLDWIDE ASD EPIDEMIC

• FROM 2001-04, 1026 INCREASE IN FULL-DIAGNOSIS
  ASD SCHOOL AGE CHILDREN PER US DEPT OF EDUCATION.
  
• OVER 2 MILLION CHILDREN IN US HAVE ASD, OVER 6
  MILLION HAVE ADD/ADHD, OVER 2 MILLION TAKE
  RITALIN
• INCIDENCE OF CLASSIC 110,000 TO ACQUIRED
  (REGRESSIVE) ASD 1150
• RATIO - BOUSGIRLS 41 for ASD, ADD/ADHD,
  LEARNING/BEHAVIOR ISSUES

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AUTISM CHARACTERISTICS

• ASD AUTISM, HFA, ASPERGERS, PDD, ADD/ADHD
• FAILURE TO BOND
• LACK OF SOCIAL INTERACTION
• AVOIDANCE OF EYE-TO-EYE CONTACT
• DIFFICULTIES IN LANGUAGE DEVELOPMENT
• REPETITIVE BEHAVIORS STIMMING

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ASD BIO-MEDICALLY

• GENETIC PREDISPOSITION ALLERGIES, AUTOIMMUNITY,
  FAMILY HISTORY
• WEAKENED IMMUNE SYSTEM, FREQUENT
  INFECTIONS/ANTIBIOTICS 1st YEAR
• GUT INFLAMMATION, PATHOGENS
• IMPAIRED NUTRITIONAL STATUS INABILITY TO
  EXCRETE THEREFORE ACCUMULATE HEAVY METALS IN
  THEIR BODIES

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CAUSATION MODELS

• 1) SIMPLY GENETIC?
• 2) GASTROINTESTINAL GLUTEN/CASEIN INTOLERANCE,
  ENZYME DEFICIENCY,
• YEAST OVERGROWTH MODEL
• 3) TOXIC CHEMICALS/HEAVY METALS VACCINATIONS,
  AMALGAMS/FISH
• 4) AUTOIMMUNITY, VIRAL MODEL

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METABOLIC IMBALANCES IN AUTISM SPECTRUM DISORDER

• MULTIPLE NUTRITIONAL DEFICIENCIES
• ELEVATED IgG ANTIBODIES GLUTEN/CASEIN
• IMBALANCE GUT BACTERIAL FLORA
• URINE BACTERIAL/FUNGAL BYPRODUCTS
• MYELIN SHEATH INJURY IN BRAIN
• EVIDENCE OF IMMUNE IMPAIRMENTS
• METHYLATION DISORDERS
• ACCUMULATION OF HEAVY METALS

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NUTRIENT DEFICIENCIES in ASD

• B6 AND MAGNESIUM
• ZINC, SELENIUM AND OTHER MINERALS
• CALCIUM
• VITAMINS A, C, E
• ESSENTIAL FATTY ACIDS
• AMINO ACIDS
• B-VITAMINS B1, 2, 3, 5, 12, FOLATE
  (FOLINIC ACID)

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OVERVIEW BIO-MEDICAL TREATMENTS

• 1) RESTRICTED DIET, GF/CF/SF
• 2) NUTRIENTS
• 3) TREAT GUT PATHOGENS
• 4) CORRECTING METHYLATION DYSREGULATION
  (Quintet)
• 5) CHELATION REDUCING TOXIC METALS IN THE
  BODY
• 6) ANTI-VIRAL TREATMENT

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BASIC EVALUATION

• HISTORY, PHYSICAL EXAM
• BASIC GENERAL LAB SCREEN
• CBC, URINALYSIS
• SERUM CHEMISTRIES
• THYROID PANEL
• IRON PANEL

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BASIC DIAGNOSTIC TESTS

• FOR GUT
• URINE ORGANIC ACIDS
• COMPREHENSIVE STOOL STUDY
• FOR NUTRIENT STATUS
• ORGANIC ACIDS, AMINO ACIDS
• RBC MINERALS, FATTY ACIDS VITAMIN PANEL

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CLINICAL HISTORY EARLY INDICATIONS OF GUT
DYSFUNCTION

• 1) FAMILIAL DIGESTIVE DIGESTIVE DYSFUNCTIONS
• 2) INABILITY TO BREAST FEED
• 3) PERSISTENT COLIC IN INFANCY
• 4) FREQUENT INFECTIONS (E.G. EAR) LEADING
  TO FREQUENT ANTIBIOTICS
• 5) REACTION TO CERTAIN VACCINATIONS

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GASTROINTESTINAL PATHOLOGY SYMPTOMS REPORTED
BY PARENTS

• PERSISTENT DIARRHEA AND/OR CONSTIPATION,
  BLOATING, GAS AND ABDOMINAL PAIN
• SELF-RESTRICTION OF DIET
• NIGHT WAKING REFLUX
• GREATER ALLERGIC SUSCEPTIBILITIES

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G.I. HEALTH TREATMENTS PARENTS CAN DO

• ELIMINATE SUGARS AND JUNK FOOD FOR EVERYONE IN
  THE FAMILY
• READ LABELS ON FOODS, GET EDUCATED ABOUT TOXINS
  IN BOTH FOOD AND WATER
• GF/CF/SF OR SCD DIET
• ENZYMES AND PROBIOTICS
• BASIC NUTRIENT SUPPLEMENTATION

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G.I. HEALING TREATMENTS THAT REQUIRE A PHYSICIAN

• LAB TESTING FOR GUT PATHOGENS
• ANTI-FUNGAL PRESCRIPTIONS RX
• ANTI-BACTERIAL PRESCRIPTION RX (CLOSTRIDICA AND
  OTHER)
• SECRETIN, VIT M-B12 INJECTABLES
• IMMUNOGLOBULIN, IV OR ORAL, ENDOSCOPY

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ANTI-BACTERIALSANTI-FUNGALS

• NATURALS
• CAPRYLIC ACID, UVA URSI, GRAPEFRUIT SEED
  EXTRACT, LAURICIDIN
• PRESCRIPTIVES FLAGYL, GENTAMYCIN, VANCOMYCIN,
  DIFLUCAN, NYSTATIN, NIZORAL, SPORANOX

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TREATMENTS BEYOND THE BASICS

• METHYLATION
• DETOXIFICATION
• VIRAL/IMMUNE ISSUES
• RECENT NEW TREATMENTS

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METHYLATION TREATMENT QUINTET

• 1) GLUTATHIONE (GSH), ORAL, TD, OR IV
• 150-MG BID ORAL, 125-MG BID TD,
• 300-600-MG IV
• 2) ALLITHIAMINE (TD - TTFD)
• 50-MG BID (COMPOUNDED OR AUTHIA)
• 3) METHYLCOBALAMIN (INJECTABLE M-B12) CONC
  25-MG/ML, 64.5-MCG/KG Q 3 DAYS
• 4) FOLINIC ACID, 800-MCG TWICE DAILY
• 5) DMG, 125-MG PER YR OF AGE, ALL IN AM
• OR TMG, 500-1000-MG TWICE DAILY

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METHYLCOBALAMIN

• VIT B12 LEAST TOXIC, BEST TOLERATED, H20 SOLUBLE
  - EXCESSES URINATED
• OUT WITHOUT HARM.
• UPTAKE FROM ORAL INTAKE LOW, PARTICULARLY IN
  GI INFLAMMATION.
• VIT B12 PLAYS KEY ROLE IN GSH STABILIZATION AND
  KEEPING OTHER ENDOGENOUS ANTIOXIDANTS IN REDUCED
  STATE.
• DIFFICULT TO TEST FOR DEFICIENCY SERUM LEVELS
  INADEQUATE AS
• MARKER FOR DEFICIENCY.
• ULTRA HIGH DOSES MAY REGENERATE NERVES

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GLUTATHIONE (GSH)

• NATURALLY OCCURING TRI-PEPTIDE FROM CYSTEINE,
  GLUTATMIC ACID,
• AND GLYCINE.
• PRESENT IN ALL LIVING CELLS,
• HIGHEST LEVEL FOUND IN LIVER.
• WORKS TO INHIBIT FORMATION OF FREE RADICALS,
  DETOXIFYING HARMFUL COMPOUNDS.
• DEFICIENCY INCREASES SENSITIVITY
• TO THIMEROSAL AND OTHER
• PRO-OXIDANT AGENTS.

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GLUTATHIONE, Contd.

• VIT C, E, A-LIPOIC ACID (ALA), N-ACETYL CYSTEINE
  (NAC), SELENIUM, GLUTAMINE, AND SILYMARIN ENHANCE
  GSH LEVELS BY HELPING BODY MANUFACTURE IT.
• VITAMIN B12 HELPS MAINTAIN GLUTATHIONE IN ITS
  USEFUL REDUCED BIOLOGICAL STATE.

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TOXINS DIAGNOSTIC EVALUATION

• 1) EXPOSURE HISTORY MOTHER DIET, AMALGAMS,
  RHOGAM VACCINATION HISTORY
• 2) HAIR ELEMENTS ANALYSIS
• 3) RBC MINERALS AND TOXICS
• 4) METALLOTHIONEIN CELLULAR TEST

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TTFD (ALLITHIAMINE)

• TTFD IS THIAMINE TETRAHYDROFURFURL DISULFIDE,
  SYNTHETIC COUNTERPART TO ALLITHIAMINE, A
  DERIVATIVE OF VIT B1 (THIAMINE) NATURALLY FOUND
  IN GARLIC.
• THIAMINE IS WATER-SOLUBLE, NECESSARY FOR
  METABOLISM PROTEINS, CARBS, AND FATS
• THIAMINE DEFICIENCY IN ALCOHOLISM, MALNUTRITION,
  USE OF CERTAIN DRUGS
• GENTLE CHELATOR FOR ARSENIC, CADMIUM, ALUMINUM,
  LESS FOR HG
• NON-TOXIC, NO PRESCRIPTION NEEDED, TRANSDERMAL
  CREAM TWICE DAILY

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PREPARATION for REMOVING HEAVY METALS

• NUTRIENT READINESS ADEQUATE MINERALS BEFORE AND
  DURING CHELATION PROBIOTICS, ENZYMES
• GUT READINESS CHELATION CAN ENCOURAGE PATHOGENS
  TO GROW, PREPARE AND PLAN FOR THIS
• LAB STUDIES CBC, CHEMISTRY PANEL BEFORE
  STARTING CHELATION

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CHELATION AGENTS

• DMSA (CHEMET) FDA APPROVED for LEAD REMOVAL IN
  CHILDREN, HIGH SAFETY INDEX, OTC AS CAPTOMER.
  NEWLY EFFECRIVE TD FORM, SAME SCHEDULE AS ORAL 3
  ON, 11 OFF, Q 4 OR 8 HRS.
• DMPS, NOT FDA APPROVED FOR CHILDREN BUT LEGAL FOR
  COMPOUNDING. SMALL ORAL DOSES EFFECTIVE, SAFE,
  IV CONTROVERSIAL BUT USED AND EFFECTIVE, NEW TD
  FORM.
• ALA (ALPHA LIPOIC ACID) OTC ANTI-OXIDANT THOUGHT
  TO CROSS THE BBB, SO NOT TO BE USED UNTIL METAL
  REMOVAL WITH DMSA HAS PLATEAUED.

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IMMUNOLOGY IN ASD

• IMMUNOLOGICAL ISSUES IN AUTISM
• FAMILY HISTORY IMPORTANT
• IMMUNE TESTING AS GUIDANCE FOR TREATMENT

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DIAGNOSTIC EVALUATION IMMUNE SYSTEM

• SPECIALTY LAB Tests, MINIMAL
• 1) COMPREHENSIVE VIRAL PANEL 3
• 2) NK CYTOTOXICITY TEST
• 3) MYELIN BASIC PROTEIN (MBP) PANEL
• 4) RUBEOLA ANTIBODIES

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PREMIER ASD IMMUNE PANEL, ISL

• Streptococcal Peptides (M5, M12, M19) (IgG)
• Gliadin Peptides Antibodies (IgG, IgM, IgA)  
• Casein Peptides Antibodies (IgG, IgM, IgA)
• Antibodies to Hg Binding Antigen (Fibrillarin)
  (IgG, IgM, IgA)  
• Dipeptidylpeptidase (DPP IV) Antibodies (IgG,
  IgM, IgA)  
• Anti-Myelin Basic Protein Antibodies (IgG, IgM,
  IgA)  
• Anti-Neurofilament Antibodies
• Metallothionein (Cellular Level)
• NK Cell Activity  
• Measles Antibodies (IgG, IgM)
• VIRAL SCREEN 3 Varicella Zoster Virus (IgG)
• Cytomegalovirus (IgG, IgM)
• Epstein-Barr Virus or VCA (IgG, IgM)
• Herpes Type 1 2 Virus (IgG, IgM)
• Herpes Type 6 Virus (IgG, IgM)
• Immunoglobulins (IgG, IgA, IgM)
• 1644, 50 DISCOUNT AS PANEL 822 PRE-PAID
• Blood Required, 2 yellow tops, 1 red top (10 cc
  in each tube)

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MEASLES AND BRAIN VIRAL AUTO-ANTIBODIES IN ASD

• SINGH 1998 70 OF AUTISTIC SERA HAD ANTI-MYELIN
  BASIC PROTEIN ANTIBODIES, NONE IN NT CHILDREN.
• 57 ASD HAD ANTI-NEURON-AXON FILAMENT PROTEIN,
  NONE IN NT KIDS
• HIGHER ANTI-MEASLES ABS THAN NT KIDS, MUMPS AND
  RUBELLA NOT DIFFERENT FROM NTS

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WAKEFIELD INFLAMMATORY BOWEL DISEASE IN AUTISM

• GUT BIOPSIES, 1998 MEASLES VIRUS DETECTED IN
  DENDRITIC CELLS AND MATURE LYMPHOCYTES IN 75/91
  ASD CHILDREN VS 5/70 CONTROLS WITH LYMPHOID
  NODULAR HYPERPLAXIA
• THOUGHTFUL HOUSE 2005 STUDY CORROBORATES
  INCREASED RATE OF SWOLLEN INTESTINAL LYMPH
  GLANDS, INCREASED INTESTINAL LINING INFLAMMATION
  IN ASDS WITH BOWEL ISSUES.

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IMMUNITY TREATMENT NATURAL ANTI-VIRALS

• LAURICIDIN (ORIGINALLY FOUND IN BREAST MILK
  COCONUT, NOW SYNTHETIC (WWW.LAURICIDIN.COM)
• OLIVE LEAF EXTRACT, GREEN TEA
• LARCH ARABINOGALACTINS
• IP- 6 (INOSITOL HEXAPHOSPHATE)
• GRAPEFRUIT SEED EXTRACT

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PRESCRIPTIVE ANTI-VIRALS

• ACYCLOVIR 800MG 3X/DAY (FOR UNDER 30, 10-12KG)
• VALTREX (MAIN ONE I USE) 250MG 1500MG 2x DAILY,
  DEPENDING UPON SIZE
• ALTERNATE WITH FAMVIR 250MG 500MG/DAY
  DEPENDING UPON SIZE
•  

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RECENT THERAPY REFINEMENTS

• NEW DIETS BEYOND GF/CF/SF (SCD) SPECIAL
  CARBOHYDRATE DIET
• (OLD) OXALATE-LOWERING DIET
• MB-12 METHYLCOBALAMIN DAILY HIGH DOSE
  INJECTIONS NEUBRANDER)
• NASAL SPRAY MB-12 FOLINIC ACID
• TD DETOX AGENTS, TD-DMPS, TD-DMSA

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RECENT NEW TREATMENTS

• PPARS (ACTOS) FOR GUT AND BRAIN INFLAMMATION,
  SHIFTS T2 TO T1
• LOW-DOSE NALTREXONE FOR IMMUNE MODULATION,
  SOCIABILITY
• NASAL MB-12 FOLINIC ACID
• ANTI-VIRAL TREATMENT FOR ALMOST ALL CHILDREN,
  NATURAL AND/OR PRESCRIPTIVE

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ACTOS AND IMMUNE MODULATION FOR BRAIN-GUT
INFLAMMATION

• PPAR ACTOS (PIOGLITAZONE), PX FOR PRE-DIABETES,
  LOWERS GUT AND NEURO-INFLAMMATION, REGULATES
  LIPID AND GLUCOSE METABOLISM, SHIFTS IMMUNITY
  FROM T2 HUMORAL (AUTO-IMMUNITY) TO T1 (CELLULAR)
• . CLINICAL STUDY gt300 CHILDREN, DR.
  BORIS/GOLDBLATT, PROMISING

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LOW-DOSE NALTREXONE (LDN)

• FDA APPROVED OPIOID ANTAGONIST 1985, BRAND REVIA,
  ALSO GENERIC USED IN 50 - 150MG DOSES AS OPIOID
  ANTAGONIST FOR NARCOTIC/ALCOHOL ADDICTION
• MUST BE PRESCRIBED AND COMPOUNDED IN CAPSULES OR
  TRANSDERMAL CREAM

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LOW-DOSE NALTREXONE AS IMMUNOMODULATOR

• OPIOIDS ALTER BOTH INNATE AND ADAPTIVE IMMUNE
  CELLS NK CELLS, MACROPHAGES, IMMATURE
  THYMOCYTES, T CELLS AND B CELLS
• BRIEF BLOCKADE OF OPIOID RECEPTORS ELEVATES B-AND
  OTHER ENDORPHINS
• NORMALIZATION OF PLASMA CHEMICAL PROFILES
  ELEVATED NOREPINEPHRINE, ARGININE-VASOPRESSIN,
  SEROTONIN (BOUVARD, LENSING, PANKSEPP, 1995)

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THERAPEUTIC USE IN ASD

• USE IN TINY DOSES (1.5 4.5MG)
• REGULATES MOOD MODULATES
• IMMUNE SYSTEM, USE ONCE DAILY BETWEEN 9PM-12AM
  FOR 2-4 AM ENDORPHIN RUSH, LASTS 18 HRS
• AS IMMUNOMODULATOR - INCREASES NATURAL
  ENDORPHINS,SHIFTS T2 (HUMORAL IMMUNITY) TOWARD
  T1 (CELLULAR) IMMUNITY

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ENDORPHINS

• NEUROHORMONES - MODIFY NERVE CELL OPIATE
  RECEPTORS TO NEUROTRANSMITTERS, ANALGESIC
• ENKEPHALINS/ENDORPHINS ALPHA-BETA-GAMMA
  SIGMA-ENDORPHIN
• STIMULATE ENDORPHIN SECRETION
• LDN
• PHYSICAL EXERCISE
• TOUCH - MASSAGE/ACUPUNCTURE LAUGHTER
• CHOCOLATE

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BETA-ENDORPHIN

• ENDORPHIN COLLECTION MICHAEL W. DAVIDSON
  (NHMFL)
• FLORIDA STATE UNIVERSITY

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TH1-TH2 BALANCE

• TH1 CELLULAR IMMUNITY, DIRECTS NK T-CELLS AND
  MACROPHAGES TO ATTACK ABNORMAL CELLS AND
  PATHOGENS INSIDE THE CELL
• TH2- HUMORAL IMMUNITY, CREATES ANTIBODIES TO
  NEUTRALIZE FOREIGN INVADERS OUTSIDE CELL

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HEALTHY IMMUNITY

• BALANCED BETWEEN Th1 - Th2, SWITCHES BACK AND
  FORTH AS NEEDED
• INABILITY TO RESPOND ADEQUATELY TO Th1 CHRONIC
  INFECTION CANCER
• OVERACTIVE Th2 RESPONSE PLAYS ROLE IN
  AUTOIMMUNITY AND ALLERGIES

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UNHEALTHY IMMUNITY

• FAILURE OF THE Th1 ARM OVERACTIVE Th2 ARM
• AIDS
• CFS (FATIGUE)
• CANDIDIASIS
• MULTIPLE ALLERGIES
• MCS (CHEMICAL)
• CANCER
• AUTISM

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SUMMARY BIO-MEDICAL TREATMENTS

• 1) RESTRICT DIET, GF/CF/SF, SCD
• 2) NUTRIENTS
• 3) TREAT GUT PATHOGENS
• 4) CORRECTING METHYLATION DYSREGULATION
  (Quintet)
• 5) DETOXIFICATIOIN REDUCING TOXIC METALS IN
  THE BODY
• 6) ANTI-VIRAL TREATMENT
• 7) ENHANCE IMMUNE SYSTEM

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• 2nd Edition
• 2003