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SAN FRANCISCO EAST BAY AUTISM/ASPERGERS CONFERENCE

SAN FRANCISCO EAST BAY AUTISM/ASPERGERS CONFERENCE. DECEMBER 1-2, 2006 ALAMEDA COUNTY FAIRGROUNDS PLEASANTON, CA. OVERVIEW: BIOMEDICAL TESTING AND TREATMENT OF AUTISM Jaquelyn McCandless, M.D. SUMMARY DAN! ASD BIO-MEDICAL TREATMENTS. 1) DIETARY RESTRICTION 2) NUTRIENT THERAPY

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SAN FRANCISCO EAST BAY AUTISM/ASPERGERS CONFERENCE

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  1. SAN FRANCISCO EAST BAY AUTISM/ASPERGERS CONFERENCE DECEMBER 1-2, 2006 ALAMEDA COUNTY FAIRGROUNDS PLEASANTON, CA

  2. OVERVIEW: BIOMEDICAL TESTING AND TREATMENT OF AUTISMJaquelyn McCandless, M.D.

  3. SUMMARY DAN! ASD BIO-MEDICAL TREATMENTS • 1)DIETARY RESTRICTION • 2) NUTRIENT THERAPY • 3) GUT PATHOGEN TREATMENT • 4) METHYLATION STRATEGIES • 5) DETOXIFICATION (CHELATION) • 6) IMMUNE ENHANCEMENT • 7) ANTI-VIRAL TREATMENT • 8) HBOT, NEUROFEEDBACK

  4. 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 1:10,000 TO ACQUIRED (“REGRESSIVE”) ASD 1:150 • RATIO - BOUS:GIRLS 4:1 for ASD, ADD/ADHD, LEARNING/BEHAVIOR

  5. AUTISM (ASD) CHARACTERISTICS AUTISM SPECTRUM INCLUDES: AUTISM, HFA, ASPERGER’S, PDD, ADD/ADHD ● FAILURE TO BOND ● LACK OF SOCIAL INTERACTION ● AVOIDANCE OF EYE-TO-EYE CONTACT ● DIFFICULTIES IN LANGUAGE DEVELOPMENT ● REPETITIVE BEHAVIORS CALLED “STIMMING”

  6. 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

  7. BASIC EVALUATION HISTORY, PHYSICAL EXAM BASIC GENERAL LAB SCREEN CBC, URINALYSIS SERUM CHEMISTRIES THYROID PANEL IRON PANEL

  8. BASIC DIAGNOSTIC TESTS FOR GUT: URINE ORGANIC ACIDS COMPREHENSIVE STOOL STUDY FOR NUTRIENT STATUS: ORGANIC ACIDS, AMINO ACIDS RBC MINERALS, FATTY ACIDS VITAMIN PANEL

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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 • INABILITY TO EXCRETE TOXINS/METALS

  14. ASD CAUSATION MODELS • 1) SIMPLY GENETIC? • 2) GUT HEALTH: MEASLES, GLUTEN/CASEIN INTOLERANCE, ENZYME DEFICIENCY, FUNGAL OVERGROWTH MODEL • 3) TOXIC CHEMICALS/HEAVY METALS –VACCINATIONS, AMALGAMS/FISH • 4) AUTOIMMUNITY, VIRAL MODEL

  15. GENETICS AS CAUSE? • RESEARCH HAS BEEN UNABLE TO IDENTIFY A SPECIFIC CHROMOSOME OR LOCATION ON A GENE THAT IS THE SITE OF A PRIMARY AUTISM DEFECT. • GENETIC SUSCEPTIBILITY PROBABLE

  16. GUT HEALTH:TREATMENTS THAT PARENTS CAN DO • ELIMINATE SUGARS AND JUNK FOOD FOR EVERYONE IN FAMILY • READ LABELS ON FOODS, GET EDUCATED ABOUT TOXINS IN BOTH FOOD AND WATER • GF/CF/SCD DIET • ENZYMES AND PROBIOTICS • BASIC NUTRIENT SUPPLEMENTATION

  17. GUT HEALTHTREATMENTS THAT REQUIRE A DOCTOR • LAB TESTING FOR GUT PATHOGENS • ANTI-FUNGAL PRESCRIPTIONS • ANTI-BACTERIAL PRESCRIPTIONS (FOR CLOSTRIDIA AND OTHERS) • SECRETIN, VIT M-B12 INJECTIONS • IMMUNOGLOBULIN, IV OR ORAL • ENDOSCOPY-ANTI-INFLAMMATORIES

  18. 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 • NEW: 2006 BUIE, KRIGSMAN VALIDATE WAKEFIELD’S FINDINGS: INCREASED GI INFLAMMATION IN ASD’S WITH 87% BIOPSIES SHOWING VACCINE STRAIN MEASLES IN GUT

  19. GUT MEASLES ASSESSMENT • HISTORY, MMR RESPONSE • GUT ISSUES • RUBEOLA ANTIBODIES TEST • BRAIN AUTO-ANTIBODIES TEST • ENDOSCOPY • BIOPSY, CSF ANALYSIS • PCR (POLMERASE CHAIN)

  20. 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 NT’S

  21. GUT MEASLES TREATMENT • DIETARY RESTRICTION • ENZYMES • GENERAL IMMUNE ENHANCEMENT • METHYLATION • DECREASE HEAVY METALS • HEAL LEAKY GUT • ANTI-OXIDANTS • LIVER SUPPORT • ANTI-INFLAMMATORIES • HIGH DOSE VIT A PROTOCOL

  22. HIGH-DOSE VITAMIN A FOR GUT MEASLES BAKER - McCANDLESS PROTOCOL 200,000-400,000IU ORAL 2 DAYS EVERY SIX MONTHS IF 3 OF 5 POSITIVE: 1) HISTORY OF REGRESSION AFTER MMR 2) PERSISTENT GUT PROBLEMS, PAIN 3) MORE THAN SLIGHTLY ELEVATED IgG SERUM RUBEOLA ABS 4) ELEVATED ANTI-MBP & ANTI-NF ABS 5)ENDOSCOPY SHOWS ILH, CSF/BIOPSY+, PCR VACCINE STRAIN MEASLES

  23. ANTI-FUNGAL PRESCRIPTIONS (BASED on 40-50 # CHILD) • DIFLUCAN (FLUCONAZOLE - PRIMARY ONE I USE) 4-5mg/kg/day for 3-4 weeks in divided doses • NIZORAL (ITROCONAZOLE -GOOD FOR LOWERING TESTOSTERONE) 5mg/kg/day for 3 weeks in divided doses • SPORANOX (USE WHEN RESISTANCE TO FLUCONAZOLE) 75-100mg/day for 3-4 weeks • NYSTATIN (TOPICAL – MANY YEAST OUTGROW), BENIGN INEXPENSIVE 250,000 units qid

  24. ANTI-BACTERIAL PRESCRIPTIONS (Based on 50# child) • FLAGYL (clostridia, parasites) 250mg BID for 10 days • BIAXIN 125mg/BID (tonsillitis, sinusitis) • GENTAMYCIN 40-80mg BID for 10 days • VANCOMYCIN 1 gram/day in 1/4 gm QID doses 5-10 days

  25. NEUTRACEUTICAL COMPANIES I USE MOST FREQUENTLY (U.S.) • ECOLOGICAL FORMULAS 800-888-4585 • KLAIRE LABS 866-216-6127 • INTEGRATIVE THERAPEUTICS, INC. (NF FORMULAS/TYLER) 503-582-8386 • THORNE RESEARCH 800-228-1966 • VITAMIN RESEARCH 800-877-2447 • KIRKMAN LABS 877-365-9265 • PHYSIOLOGICS 800-765-6775

  26. SUMMARY: RX GUT DISORDER • RESTRICTIVE GF/CF/SF DIET, PROBIOTICS • REMOVE OFFENDING FOODS PER IGG HYPERSENSTITIVITY TESTING • REPLACE NUTRIENT DEFICIENCIES, ENZYMES • TREAT FOR PATHOGEN OVERGROWTH WITH NATURAL & PRESCRIPTIVE ANTI-FUNGALS, BACTERIALS

  27. TREATMENTS BEYOND THE BASICS “TRIO:” 1) GLUTATHIONE, TD-ORAL-IV 2) TTFD (ALLITHIAMINE – AUTHIA) 3) M-B12 SUBCUT INJECTIONS “QUARTET:” 4) ADD FOLINIC ACID

  28. METHYLCOBALAMIN • VIT B12 LEAST TOXIC, BEST TOLERATED • UPTAKE FROM ORAL INTAKE LOW, PARTICULARLY IN GI INFLAMMATION. • VIT B12 PLAYS KEY ROLE IN GSH STABILIZATION & REDUCTION STATUS FOR ENDOGENOUS ANTIOXIDANTS • DIFFICULT TO TEST FOR DEFICIENCY • ULTRA HIGH DOSES MAY REGENERATE NERVES

  29. GLUTATHIONE (GSH) • NATURALLY OCCURING TRI-PEPTIDE – FROM CYSTEINE, GLUTATMIC ACID, GLYCINE • PRESENT IN ALL LIVING CELLS, HIGHEST LEVEL FOUND IN LIVER • INHIBITS FORMATION OF FREE RADICALS • DETOXIFIES HARMFUL COMPOUNDS. • DEFICIENCY INCREASES SENSITIVITY TO THIMEROSAL AND OTHER PRO-OXIDANT AGENTS.

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

  31. TTFD (ALLITHIAMINE) • TTFD: THIAMINE TETRAHYDROFURFURL DISULFIDE, SYNTHETIC COUNTERPART TO ALLITHIAMINE, DERIVATIVE VIT B1 (THIAMINE), FOUND IN GARLIC. • THIAMINE: WATER-SOLUBLE, REQUIRED METABOLISM PROTEINS, CARBS, FATS • THIAMINE DEFICIENCY IN ALCOHOLISM, MALNUTRITION, USE OF CERTAIN DRUGS

  32. TTFD, CONT’D • GENTLE CHELATOR FOR ARSENIC, CADMIUM, ALUMINUM, LESS FOR HG • NON-TOXIC, NO PRESCRIPTION NEEDED, TRANSDERMAL CREAM TWICE DAILY

  33. “TRIO – QUINTET” DOSES 1) GLUTATHIONE (GSH) 150 MG BID ORAL, 125 MB BID TRANSDERMAL, 300-600MG IV WEEKLY OR BI-WEEKLY OR MONTHLY 2) ALLITHIAMINE (TD-TTFD) 50 MG 2X DAILY (COMPOUNDED OR AUTHIA) 3) METHYLCOBALAMIN (INJECTABLE M-B12) CONC 25-MG/ML, 64.5 MCG/KG 2X/WEEK 4) FOLINIC ACID, 400-MCG TWICE DAILY

  34. TOXICITY • TOXIC CHEMICALS • HEAVY METALS • GLUTATHIONE • VACCINATIONS • AMALGAMS, FISH INGESTION

  35. DETOXIFICATION OF HEAVY METALS • DMSA—ORAL, TD, NEW - SUPPOSITORIES • DMPS—ORAL, TD, IV • CaEDTA--- IV, SUPPOSITORY • TTFD (AUTHIA) - TD

  36. VIRAL-IMMUNE ISSUES IN AUTISM • EVIDENCE OF EFFECTS OF PSYCHOTROPIC VIRUSES IN AUTISM & OTHER DEVELOPMENTAL DELAY DISORDERS • POSITIVE RESPONSES TO ANTI-VIRAL TREATMENTS IN AUTISM

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  38. HEALTHY IMMUNITY • BALANCE 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

  39. UNHEALTHY IMMUNITY FAILURE OF THE Th1 ARM & OVERACTIVE Th2 ARM: AIDS, CANCER CFS (FATIGUE) CANDIDIASIS MULTIPLE ALLERGIES MCS (CHEMICAL) AUTISM

  40. 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

  41. IMMUNE-ENHANCING • OMEGA-3 FATTYACIDS • GLUTATHIONE • METHYLCOBALAMIN/FOLINIC • DIETARY RESTRICTION • PROBIOTICS • VITAMIN C, E, A, CO-Q-10 • ANTI-FUNGALS • ANTI-VIRALS

  42. NATURAL ANTI-VIRALS • LAURICIDIN (ENVELOPED VIRUSES) • GARLIC, OLIVE LEAF EXTRACT • GLUTAMINE, PROBIOTICS • BLACK ELDERBERRY • OIL OF OREGANO • IP- 6 (INOSITOL HEXAPHOSPHATE) • GRAPEFRUIT SEED EXTRACT • PROTEASE ENZYMES (VIRASTOP) • HEALTHY LIFE STYLE

  43. ANTI-VIRAL PRESCRIPTIVES GENERAL IMMUNITY: ORAL, IM, IV IMMUNOGLOBULINS LOW-DOSE NALTREXONE ACTOS ANTI-VIRALS: VALTREX (PRIMARY ONE I USE) FAMVIR ACYCLOVIR FOR SMALL CHILDREN

  44. LIFE-STYLE ANTI-VIRAL MESSAGES • EAT LOTS OF FRESH VEGETABLES • DON’T SMOKE • GET ENOUGH SLEEP • DON’T EAT JUNK FOOD • DON’T DRINK TOO MUCH ALCOHOL • NURTURE YOUR RELATIONSHIPS • DO WORK YOU BELIEVE IN • LAUGH AT YOURSELF • IF VACCINATE, GET HG-FREE!!!!

  45. SUMMARY DAN! ASD BIO-MEDICAL TREATMENTS • 1)DIETARY RESTRICTION • 2) NUTRIENT THERAPY • 3) GUT PATHOGEN TREATMENT • 4) METHYLATION STRATEGIES • 5) DETOXIFICATION (CHELATION) • 6) IMMUNE ENHANCEMENT • 7) ANTI-VIRAL TREATMENT • 8) HBOT, NEUROFEEDBACK

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