Recommended Therapeutic Approach.
There are different scales and gauges around the world that define many different symptoms that are considered to be a part of the autistic spectrum. This ranges from ADHD to those that require substantial support in home, social, school and work life.
Initial consideration has to be done through specialists trained in identifying the many problems that can be associated with ASD. These include obtaining life skills, challenging behaviour, aggression or self-harm, relationships and blending into the community.
There is no clear-cut cause of ASD. Research supports genetic and environmental factors and often a combination of both. Like any health condition, there is a trigger but there is also, with few exceptions, an underlying trait or issue with an individual’s health or well-being that allows the problem to develop.
My involvement as a doctor specialising in integrated medicine is to look for potential underlying causes that initiate or worsen those with ADS but, equally importantly, do everything that can be done to take the individual to an optimum level of health. This includes optimising nutrition, the ability to detoxify and avoid environmental pollutants, clarifying the possibility of an infectious cause, and establishing if lifestyle traits and habits are contributing to the problems.
The Benefits of Investigation.
Tests should only be undertaken if they are going to clarify the underlying causes of a condition and alter the therapeutic approach. As investigations come at a cost, we can always initially proceed with treatment recommendations and review the need for tests only if there is no sign of improvement.
If affordable it is certainly preferable to consider the following specific areas of investigation relating to ASD which would help guide and individualise optimal therapy. There are:
- Familial/hereditary genetics are frequently linked but certainly not always. Alongside this, environmental factors can alter gene behaviour which is particularly risky in those who are young and whose nervous systems are developing. With the advent of the clarification of the human genome, we are now able to alter inbuilt traits through nutrition and certain natural extracts which turn ‘on and off’ gene activity.
- Nutrition – because problems may improve through the use of various supplements we can investigate deficiency. Through correct diet, nutrition and supplementation evidence is substantial improvement can be made. There are at the time of updating this document over 95,000 published papers on the subject: https://tinyurl.com/37ztefc4. A specific test, Nutrition Genomics will identify the ideal foods for each person based on their genetic makeup. The, gives specific information regarding how your genes interreact with your nutrition, lifestyle, and environment and how best you can influence your cognitive, neurological and conditions associated with ASD through avoiding bad habits and optimising your ability to metabolise and detoxify – two areas of importance.
- Gut health – intestinal permeability (the leaky gut syndrome) and bad bacterial balance are known to be an issue. Testing for the presence of Candida, other yeasts, parasites and some bowel flora imbalance is important
https://www.scientificamerican.com/article/gut-bacteria-may-play-a-role-in-autism/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408485/
Pollutants, especially the presence of environmental or medicinal toxins and a genetic ability to detoxify can be tested. Metals, such as mercury, are particularly evidenced as associated https://tinyurl.com/yuusch2d
- Streptococcal infection (PANS & PANDAS) and mycotoxins from moulds and fungi are linked. https://tinyurl.com/yzk76je5 Lyme disease is now known to be associated
- Investigating chronic (ongoing) inflammation of the brain is of value as this would change the therapeutic approach.
Based on these considerations and a full understanding of the history of development of an individual’s ASD I may consider and recommend from this list of investigations:
- Comprehensive stool assay of 3 samples & Zonulin for Leaky Gut (Code REGEDD0003CM145 £605)
- Leaky Gut (intestinal permeability) –Advanced Intestinal Barrier Assessment. (Code: PD005 £475)
- Blood-brain barrier permeability (Code: CYRE001. £455) or Brain barrier disorders (Code L4M5038£292)
- Full nutritional analysis with relevant metabolic profiling (The NutrEval Test -Code: GENO00013 £990)
- Nutrition Genomic Profile (Cheek Swab. Code NUTR0001- £585).
- Neuroinflammation profile (Code L4M 6673)
- Precision 88 Food Allergy Testing (generally only once a leaky gut has been ruled out. (Code REGE0068 – £455)
- Additional tests may be considered based on an individual history. This would include The Cunningham Panel in those who consider PANDAS (past
streptococcal infection) or Lyme & Co-Infection may be an issue. https://tinyurl.com/bduh3s4m
Nutrition and dietetics
The start of any therapeutic approach has to include governance of nutrition and diet. Many nutritional programs have some evidence of benefit for ASD. You can read through this link to recognise the variety available: https://tacanow.org/family-resources/special-diets-for-asd/
The minimum requirement in my experience is the avoidance of gluten, gliadin and casein proteins and many books can guide a family in this. The Nemcheck Protocol is certainly worth knowing about https://www.thebrainpossible.com/treatments/nemechek-protocol
Ideally one should work with a nutritionist specialising in this area. I have worked with two who I think are exceptional:
Dr Lorene Amet D.Phil. M.Ed (Autism)
https://autismtreatment.org.uk/
Mulberry House
21 Manor Place
Edinburgh
EH3 7DX
Tel: 0131 558 7444
Mob: 075 90 69 87 80
Ms Irina Chifor
A minimum recommendation of supplementation would include:
Essential oils http://www.yes-supplements.com/products/yes-ultimate-efas.html
Phosphatidylserine and Phosphatidylcholine
Basic minerals such as Zinc/copper & magnesium
Inulin – a fibre associated with benefit in ASD through its prebiotic effects.
Butyrate (Butyric acid) is a compound made by healthy bowel bacteria strongly associated with ASD. I consider this very important inclusion in any therapeutic approach. You can read the abstracts from these other scientific papers if you wish:
- In Boys with ASD https://www.nature.com/articles/s41398-017-0089-z
- Butyrate producing bowel flora in Children with ASD
https://www.nature.com/articles/s41598-018-36430-z
- Mouse model: https://www.sciencedirect.com/science/article/abs/pii/S0028390815301672
- Here is a lecture on ASD
https://nutrined.wetransfer.com/downloads/b4a8aba4048ab0093819eeea656ada9920201016063418/265cda
Zeolite oral spray (a natural mineral that binds potentially toxic metals) if toxic metals are suspected or found.
Amino acid & multi-vitamins including Vit B12, 5-MTHFR & S-adenosyl methionine.
in addition to basic detoxification support.
Liposomal Glutathione – a potent detoxifier and antioxidant with evidence of benefit in ASD
Addition thought can be given and discussed concerning treatment with Low Dose Naltrexone, Photobiomodulation caps and Phospholipid exchange based on each individual.
Appointments.
An integrated approach to ASD is a complicated and long-term programme. An individual must work with a nutritionist specialising in this area and consider expensive investigations to take out some of the guesswork in deciding upon therapeutic options.
If you choose to book an initial consultation please bear that in mind and contact my practice asking to book an extended new patient consultation to ensure there is enough time for me to obtain the necessary in-depth understanding of the case and provide a clear programme of therapeutic approach.