Autism: A Whole-Body Disorder Affecting the Brain
Autism: A Whole-Body Disorder Affecting the Brain
Collective Treatment Efforts Yield Better Results
By Gabriella True
According to the Centers for Disease Control and Prevention, one in 68 children has autism spectrum disorder, or ASD. Autism affects individuals in five areas: communication, social skills, learning, behaviors and medical. Dr. Bernard Rimland challenged the notion that autism has a psychological origin rather than a physical one in his 1964 book, Infantile Autism: The Syndrome and Its Implication for a Neural Theory of Behavior. Newer scientific studies also challenge the idea autism is genetically hardwired and not treatable. For example, we now know that treating medical issues can positively impact the other four areas. Some treatments may create rapid improvements while others happen slowly. The collective effect of several treatments can be considerable.
Behavior is one way a child with autism communicates. When a child is not feeling well, behaviors can worsen. Too often, practitioners don’t look at the underlying medical problems; parents are told health problems are “just part of the autism”. The key is to work with an integrative doctor who treats autism as a whole-body disorder that affects the brain. Healing the body not only helps the child feel better but can also help a child reach their full potential. Children can become happier, healthier and able to function at a higher level; some even lose their autism diagnosis.
Common Medical Conditions with Autism
There are many medical conditions that occur at the same time as autism. They can affect the digestive, immune and nervous systems as well as the brain and the body’s biochemical processes. What do those conditions look like? Children can have bloated bellies, frequent illnesses, dry skin, rashes, insomnia, diarrhea or constipation, head banging, biting, obsessive-compulsive behaviors, anxiety, sensory issues, hyperactivity, inattentiveness, seizures and more.
Each child has a unique biochemical, genetic and medical profile; not every child has difficulties in all areas. One may need to address multiple deficiencies, environmental insults and toxins in a child whose genetics make them vulnerable to begin with. With proper diagnosis and attention, issues can be reduced, managed or even resolved.
There is no fixed protocol. Treatment plans must be tailored to each child based on medical testing, combined with family history and current medical profile, including which autistic behaviors are prominent. An integrative physician will examine the patient’s metabolic foundation and treat the underlying causes. First, they look at what the child is getting too much of and what he is not getting enough of. Therapy often includes environmental changes, such as reducing toxin exposure, limiting electromagnetic fields and dietary changes. The practitioner reinforces with vitamins, minerals and good fats. The next focus is on the gut, mitochondria, methylation, immune system and other areas of need.
These co-morbid conditions are interrelated. When one system is not functioning, the others either over-compensate or do not function fully. For example, a child with methylation pathway defect—such as the MTHFR gene mutation—is predisposed to detoxification issues, which may result in a toxic overload. Once the body has too many toxins, it is susceptible to increased allergies or intolerances. This can lead to inflammation, pathogen overload and gut problems. This burden precipitates immune dysfunction and oxidative stress, making the vicious cycle worse.
Dr. Nancy O’Hara of Center for Integrative Care in Wilton begins treatment by determining, “what this child needs to get that he or she is not getting enough of. The first thing is diet. Go gluten and casein free 100 percent for three months. If it is not a ‘Wow’, then continue with a good anti-inflammatory diet, less carbs, less sugars. Essential fatty acids are essential for a reason. Then add in a good probiotic. I then look at the individual child and what they need. Look at their history; it is not all about expensive tests.”
Healing Gastrointestinal Issues (GI)
Children with autism are more likely than typically developing peers to have a GI disorder. One study indicates that up to 91 percent of children with autism have a wide range of GI issues. These children have gut dysbiosis. Yeast levels can be high; signs of yeast overgrowth are rashes, headaches, inappropriate laughter, sleep disturbances, gut pain and constipation. With treatment, common improvements can be better focus, improved sleep, less hyperactivity, GI pain, constipation or diarrhea, self-injury or anxiety.
Treating GI Issues with Diet
The body needs nutrient dense foods to function correctly. Artificial and high inflammatory foods contribute to a leaky gut while food colorings and preservatives can increase hyperactivity. The most common diet utilized is gluten-free/casein-free but many tailor the diet to address specific needs. Even without a positive allergy (IgE) or intolerance (IgG), some children see positive changes with the removal of common food allergens. Some also lower histamines, carbohydrates, and oxalate. There is no one-size-fits-all diet; most need to be modified.
“I have seen children improve dramatically when a therapeutic diet tailored to their individual history and symptoms is utilized properly. For many of my clients, their biggest fear is that if they take away the few foods their picky child relies on, they won’t have anything to feed them. In most cases, when we remove the problem foods, we actually see kids broaden their food choices as their gut heals and their “drug of choice” is no longer available,” says Vicki Kobliner, MS RDN, of Holcare Nutrition in Wilton.
There are various treatment protocols to treat dysbiosis, which is a microbial imbalance. Children with autism sometimes have low levels of enzymes and need to take digestive enzymes. Probiotics help populate the gut with good bacteria. Antifungal medications or supplements may help as well.
A healthy immune system recognizes foreign organisms, eradicates pathogens, prevents a subsequent infection from the same organism and does not cause injury to self. Many autistic children have a dysfunctional immune system due to immune dysfunction, hypersensitivity, autoimmunity and/or inflammation. Any autistic child with recurrent infections or atypical reactions should have an immune evaluation. An autistic child with chronic asthma, sinus or respiratory infections, GI issues or eczema should also be evaluated for food and environmental allergies and intolerances.
The hallmark symptoms of Pediatric Acute-onset Neuropsychiatric Disorders, (PANS), or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection (PANDAS) are sudden onset OCD, food restriction, anxiety, emotional lability, depression, aggression, behavioral regression, decline in learning abilities, sensory and motoric changes, sleep disturbances and enuresis. It is a clinical diagnosis and not based on one test. Treatment typically starts with antibiotics. Subsequent treatments, depending on clinical assessment and lab tests, include immune modulation with corticosteroids, intravenous immunoglobulin (IVIG) and plasmapheresis. Natural treatments can be used to promote further healing including anti-inflammatories, immune support, and anti-microbials.
Individuals with ASD may have several metabolic disorders.
- Redox metabolism
- Methylcobalamin B-12 can improve Glutathione metabolism.
- N-acetyl cysteine, can reduce oxidative stress and irritability. Treatments may improve core symptoms, hyperactivity, language and general functioning.
Mitochondrial (mito) metabolism
A 2010 study indicated that 80 percent of those enrolled had mito dysfunction (not mito disease). Mitochondria are in almost every cell; they are responsible for creating energy for the body’s functions. When mitochondria are dysfunctional, many symptoms occur including developmental regression, seizures, headaches, low muscle tone, GI issues or fatigue. Neuropsychiatric symptoms can include ADHD, anxiety, OCD and depression. Some triggers of mito dysfunction are overload of toxins and metals, pathogens, stress, gene mutations, and mineral and vitamin deficiency. Mito dysfunction treatment is multi-factorial. Some see immediate improvements while others never see any but treatment can delay the progression of the disease.
Neurologic and Sleep Disorders
Seizure disorders are more prevalent in individuals with ASD than typically developing peers. Some studies show up to 38 percent of individuals with autism have epilepsy. Seizures are commonly treated with antiepileptic drugs (AEDs). When AEDs are not effective by themselves other treatments are utilized: low-carbohydrate diet, IVIG, steroids and Vagus Nerve stimulator.
Problems sleeping are exceedingly common and can exacerbate behaviors. One study shows a defect in the gene that makes melatonin; however, not all sleep issues are resolved by melatonin. GI issues, specifically GERD, can disrupt sleep. A comprehensive GI workup should be considered. Seizures and PANS can also disturb sleep. If a child is unable to fall asleep for hours, rule out yeast, parasites, phenol sensitivity, and vitamin and mineral deficiency like magnesium and iron.
Several neurotransmitter deficiencies are seen in ASD. These include amino acids (GABA, glutamate), cholinergic (acetylcholine), hormone (oxytocin) and amino acids (serotonin, norepinephrine, dopamine). Autoantibodies can disrupt neurotransmitter function. Many medications used in ADHD to control dopamine and norepinephrine neurotransmission cause negative side effects in children with ASD. Medications targeting GABA (gamma-amino butyric acid) and glutamate may be effective due to abnormal excitatory/inhibitory balance. This intervention may improve language and core deficits. In some, galantamine can improve language and social functioning as it modulates acetylcholine.
Current research proves that the way we think about and treat autism continues to evolve. Why does it matter that many people still believe that autism is lifelong and not treatable, or not something some children can recover from? It means less funding is dedicated to research and treatment. Also most traditional therapies are discontinued after the primary years, closing the opportunities for growth and development of skills. It closes the door on hope when the door should always be left open for someone with autism to reach their full potential. Continued growth should be encouraged and celebrated. Treating co-morbid conditions does not negate the acceptance of a child’s uniqueness and autism. Making someone feel better and healthier should never be considered a problem. Treatment and acceptance can coexist.
Gabriella True is the mother of twin boys, one of whom has autism and PANS. She is the board president of New England PANS PANDAS and the coordinator for Talk About Curing Autism (TACA)’s Connecticut chapter. She and her family reside in Hartford County, Connecticut. Connect at [email protected].