Maldigestion--elevated urinary peptides P Shattuck (Brain Dysfunct 1990; 3: 338-45 and 1991; 4: 323-4) KL Reicheldt (Develop Brain Dys 1994; 7: 71-85, and others) Z Sun and R Cade (Autism 1999; 3: 85-96 and 1999; 3: 67-83)
Microbial Overgrowth--fungal, bacterial and viral William Shaw, Biological Basis of Autism and PDD, 1997. E Bolte on Clostridium (Med Hypoth, 1998; 51: 133-144) P Shattock and A Broughton IAG elevations W Walsh and W McGinnis pyrrole elevations Andrew Wakefield, Lancet 1998; 351: 637-4) TJ Borody, Center for Digestive Diseases, New S. Wales, Austral.
Abnormal Intestinal Permeability P D'Eufemia (Acta Pediatr 1995; 85; 1076-9)
G.I. Symptoms reported by parents: diarrhea, constipation, gas, belching, probing, visibly undigested food and need for rubs
Phase II Depression (S. Edelson, DAN Conference Sept, 1997, and Toxicology and Industrial Health 14 (4): 553-563 1998) Sulphation low in 15 of 17 (mean 5 vs. nl 10-18) Glutathione Conjugation low in 14 of 17 (mean 0.55 vs 1.4-2.9) Glucuronidation low in 17 of 17 (mean 9.6 vs. 26.0-46.0) Glycine Conjugation low in 12 of 17 (15.4 vs. 30.0-53.0)
Peroxisomal Malfunction (P Kane, J of Orthomolec Med 1997; 12-4: 207-218 and 1999; 14-2: 103-109)
Higher blood lead levels in Autism and documented response to EDTA Chelation (Am J Dis Chld 130: 47-48, 1976)
Apparent temporal association autism onset and lead exposure (Clinical Pediatrics 27: 1; 41-44 1988)
Sulphation low in 15 of 17 (mean 5 vs. nl 10-18)
Glutathione Conjugation low in 14 of 17 (mean 0.55 vs 1.4-2.9)
Glucuronidation low in 17 of 17 (mean 9.6 vs. 26.0-46.0)
Glycine Conjugation low in 12 of 17 (15.4 vs. 30.0-53.0)
4. Abnormal Nutritional Profile in Children with Autism
Lower serum Magnesium than controls (Mary Coleman, The Autistic Syndromes 197-205, 1976)
Lower RBC Magnesium than controls (J. Hayek, Brain Dysfunction, 1991)
Low activated B6 (P5P) in 42%. Autistic group also higher in serum copper. (Nutr. and Beh 2:9-17, 1984)
Low EGOT (functional B6) in 82% and all 12 subjects low in 4 amino acids (tyrosine, carnosine, lysine, hydroxylysine). Dietary analysis revealed below-RDA intakes in Zinc (12 of 12 subjects, Calcium (8 of 12), Vitamin D (9 of 12), Vitamin E (6 of 12) and Vitamin A (6 of 12) (G. Kotsanis, DAN Conf., Sept, 1996)
B6 and Magnesium therapeutic efficacy--multiple positive studies (start with Am J Psych 1978; 135: 472-5)
Low Derivative Omega-6 RBC Membrane Levels 50 of 50 autistics assayed through Kennedy Krieger had GLA and DGLA below mean. Low Omega-3 less common (may even be elevated) (J Orthomolecular Medicine Vol 12, No. 4, 1997)
Low Methionine levels not uncommon (Observation by J. Pangborn)
Below normal glutamine (14 of 14), high glutamate (8 of 14) (Invest Clin 1996 June; 37(2): 112-28)
Low-Level Lead Exposure Induces Hyperactivity in Rats (Science 182(116): 1022-1024
Marked Improvement in 7 of 13 Chelated for "Non-Toxic" Lead Levels (A J Psych 1976 133(10): 1155-1158)
Neonatal and Maternal Hair Lead Predict LD at Age 6 (Lancet 2:285 1987)
Hair Lead Levels Correlate with Teacher-Rated and Physician-Diagnosed ADHD (Arch Environ Hlth 1996; 51(3): 214-20)
Striking Chelation Results in 50 Vancouver Children (Turning Lead into Gold, paperback, Nancy Hallaway and Ziggert Strauts 1996)
4. Abnormal Nutritional Profile In ADHD
Zinc Deficiency Lower urinary, serum, nail and hair zinc than controls plus quick drop in serum and salivary zinc with double-blind tartrazine. United Kingdom. (J Nutr Med 1:51-57, 1990) Plasma, erthrocytes, urine and hair lower than controls. Poland (Psychiatr Pol 28(3):345-53 1994) Zinc deficiency in attention-deficit hyperactivity disorder. Israel. (Biol Psychiatry 40(12):1308-10 1996) Serum zinc--and free fatty acids--lower. Turkey. (J Child Psychol Psychiatry 37(2):225-7 1996) In vitro study demonstrates decreased loss of fatty acids from mesenteric phospholipids with perfusion of physiological zinc. Canada. (Can J Physiol Pharmacol 68(7): 903-907 1990)
Fatty Acid Deficiency Lower serum DHA, DGLA and AA in hyperactives than controls. (Clin Pediatr 26(8):406-411 1987) Double-blind administration of evening primrose oil to a subgroup of prior study was associated with improved parent ratings for Attention and Excess Motor Activity compared to placebo. (J Abn Child Psychol 15(1): 75-9 1987) Evening Primrose oil (GLA) 1 gram/day improved 53 of 79 hyperactive children selected as a subgroup on the basis of mood swings. The most striking improvement was noted in children with sleep disorders, crying spells and family history of alcohol or bipolar. (Muriel Blackburn, Crawley Hospital, Sussex , U.K.) Lower plasma DHA, EPA and AA, and lower RBC AA in ADHD than controls (Am J Clin Nutr 62: 761-8 1995) (Same group above correlated greater tendency to behavioral problems with lower total plasma Omega-3, more colds and antibiotics with lower total Omega-6. Physiology and Behavior Vol 59, Nos. 4/5 915-920 1996) Zinc and Evening Primrose Oil the mainstay for thousands of successes claimed by the HACSG, Sussex England (Personal Communication, Vicky Colquhoun 1997)
Magnesium Deficiency Magnesium deficiency measured in 95% of 116 Polish children with ADHD: 78% low hair, 59% low RBC's, 34% low serum. (Magnesium Research 10(2): 143-148 1997) Double-blind adminstration of 200 mg elemental magnesium per day to 25 of the above group produced measurable decrease in hyperactivity over 6 months compared to control. (Magnesium Research 10(2): 149-156 1997)
Iron Deficiency Preliminary study showed improved behavior in nonanemic hyper-actives given 5 mg/kg/day of Iron for 30 days, with significant increase in serum ferritin. (Neuropsychobiology 1997; 35(4):178-80) Lower Iron plasma, RBC, Urine and Hair levels in 50 Hyperactives (Psychiatr Pol 1994; 28(3): 343-53)
Calcium Deficiency Plasma, RBC, urine and hair Calcium in 50 hyperactive Polish children lower than controls. (Psychiatry Pol 1994; 28(3):
B6 in ADHD B6 to hyperactives with low serotonin levels resulted in normal serotonin levels and behavior. (Pediatrics 55: 437-41, 1975) B6 to 6 hyperactives with low serotonin levels increased serotonin and reduced hyperactivity better than Ritalin in double blind cross-over. Benefit carried over into the following placebo period, but not with Ritalin. (Biol Psychiatry 14(5):741-51 1979) Significant subgroup of patients with ADHD (and Autism) found to have pyrroluria by Bill Walsh (Pfeiffer Treatment Center, Napperville, IL) and Hugh Riordan (BioCenter, Wichita KS). Good clinical track record for response to generous B6 and Zinc in thousands of pyrroluric patients. (Walsh also finds Biotin very useful in "slender malabsorber group")
B12 in ADHD Elevated urinary methylmalonic acid and early reports of response to oral B12 from John Linnell, research director at The Children's Medical Charity, U.K. Some reports of response to B12 shots.
Lower urinary, serum, nail and hair zinc than controls plus quick drop in serum and salivary zinc with double-blind tartrazine. United Kingdom. (J Nutr Med 1:51-57, 1990)
Plasma, erthrocytes, urine and hair lower than controls. Poland (Psychiatr Pol 28(3):345-53 1994)
In vitro study demonstrates decreased loss of fatty acids from mesenteric phospholipids with perfusion of physiological zinc. Canada. (Can J Physiol Pharmacol 68(7): 903-907 1990)
Lower serum DHA, DGLA and AA in hyperactives than controls. (Clin Pediatr 26(8):406-411 1987)
Double-blind administration of evening primrose oil to a subgroup of prior study was associated with improved parent ratings for Attention and Excess Motor Activity compared to placebo. (J Abn Child Psychol 15(1): 75-9 1987)
Evening Primrose oil (GLA) 1 gram/day improved 53 of 79 hyperactive children selected as a subgroup on the basis of mood swings. The most striking improvement was noted in children with sleep disorders, crying spells and family history of alcohol or bipolar. (Muriel Blackburn, Crawley Hospital, Sussex , U.K.)
Lower plasma DHA, EPA and AA, and lower RBC AA in ADHD than controls (Am J Clin Nutr 62: 761-8 1995)
(Same group above correlated greater tendency to behavioral problems with lower total plasma Omega-3, more colds and antibiotics with lower total Omega-6. Physiology and Behavior Vol 59, Nos. 4/5 915-920 1996)
Zinc and Evening Primrose Oil the mainstay for thousands of successes claimed by the HACSG, Sussex England (Personal Communication, Vicky Colquhoun 1997)
Magnesium deficiency measured in 95% of 116 Polish children with ADHD: 78% low hair, 59% low RBC's, 34% low serum. (Magnesium Research 10(2): 143-148 1997)
Double-blind adminstration of 200 mg elemental magnesium per day to 25 of the above group produced measurable decrease in hyperactivity over 6 months compared to control. (Magnesium Research 10(2): 149-156 1997)
Preliminary study showed improved behavior in nonanemic hyper-actives given 5 mg/kg/day of Iron for 30 days, with significant increase in serum ferritin. (Neuropsychobiology 1997; 35(4):178-80)
Lower Iron plasma, RBC, Urine and Hair levels in 50 Hyperactives (Psychiatr Pol 1994; 28(3): 343-53)
Plasma, RBC, urine and hair Calcium in 50 hyperactive Polish children lower than controls. (Psychiatry Pol 1994; 28(3):
B6 to hyperactives with low serotonin levels resulted in normal serotonin levels and behavior. (Pediatrics 55: 437-41, 1975)
B6 to 6 hyperactives with low serotonin levels increased serotonin and reduced hyperactivity better than Ritalin in double blind cross-over. Benefit carried over into the following placebo period, but not with Ritalin. (Biol Psychiatry 14(5):741-51 1979)
Significant subgroup of patients with ADHD (and Autism) found to have pyrroluria by Bill Walsh (Pfeiffer Treatment Center, Napperville, IL) and Hugh Riordan (BioCenter, Wichita KS). Good clinical track record for response to generous B6 and Zinc in thousands of pyrroluric patients. (Walsh also finds Biotin very useful in "slender malabsorber group")
Elevated urinary methylmalonic acid and early reports of response to oral B12 from John Linnell, research director at The Children's Medical Charity, U.K. Some reports of response to B12 shots.
Emerging Possibilities
VITAMIN A HYPOTHESIS- M Megson
CALCIUM DYSREGULATION HYPOTHESIS-W McGinnis
Interventional Strategies for Behavioral Children
Low Glycemic
Big Breakfast, Protein First, Frequent Meals
Good Fats
No Excitotoxins
Organic as Possible
Plenty of Fiber
Careful with the Copper
Baseline CBC, UA, Thyroid Urinary pyrrole RBC Fatty Acid Analysis Hair Mineral Analysis/Other Mineral Studies (PHF)
Start with these incrementally, continue until proven otherwise:
Zinc with Manganese B6 (and/or P-5-P) with Magnesium Calcium Vitamins C and E
Then Address Fatty Acids
Evening Primrose for GLA (Careful Seizures or Asthma)
Address lactose, phenolic and high-arabinose intolerance
IgG food antibody blood testing
Variable degrees of hyperactivity or agitation lasting days to weeks have been associated with Secretin for some time. More worrisome was a relatively brief first-time seizure in a two-year-old boy receiving his first infusion of Secretin early this year. A solitary event of this sort, particularly from a population of children known to have a high natural incidence of seizures, left us unsure about the cause of the event. Now we have additional information.
We have learned of two new cases which parents and physicians should know about in order to ensure that Secretin is administered in the safest possible manner. The first of these also involved a previously seizure-free child. This seven-year-old boy had improved with three prior infusions. At the end of his fourth infusion he experienced a very difficult first-time seizure and required prolonged efforts by physician and paramedic personnel to sustain breathing. He made a rapid, full recovery and his mother is disappointed that he cannot continue infusions, because she feels even this last infusion helped his behavior.
A third case involved a child who had no apparent seizure activity, but like the second case, lost breathing after repeated infusion. The practical lesson from these three cases is that even if only a tiny percentage of autistic children have seizure or breathing problems with Secretin, the prudent thing to do is assure that Secretin is administered in a truly "resucitation- ready" medical setting. Just in case.
From an ethical point of view few would question that the parent needs to know these facts in making the Secretin decision. An informed choice will be the right choice.
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