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• 3) GUT PATHOGEN TREATMENT• 4) METHYLATION STRATEGIES• 5) DETOXIFICATION (CHELATION)• 6) IMMUNE ENHANCEMENT• 7) ANTI-VIRAL TREATMENT• 8) HBOT, NEUROFEEDBACK

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

AUTISM (ASD) CHARACTERISTICSAUTISM 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”

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

BASIC EVALUATION

HISTORY, PHYSICAL EXAM

BASIC GENERAL LAB SCREENCBC, URINALYSIS

SERUM CHEMISTRIES

THYROID PANEL

IRON PANEL

BASIC DIAGNOSTIC TESTS

FOR GUT:

URINE ORGANIC ACIDSCOMPREHENSIVE STOOL STUDY

FOR NUTRIENT STATUS:ORGANIC ACIDS, AMINO ACIDSRBC MINERALS, FATTY ACIDS VITAMIN PANEL

CLINICAL HISTORY: EARLY INDICATIONS OF

GUT DYSFUNCTION

1) FAMILIAL DIGESTIVE DIGESTIVE DYSFUNCTIONS

2) INABILITY TO BREAST FEED3) PERSISTENT COLIC IN INFANCY

4) FREQUENT INFECTIONS (E.G. EAR) LEADING TO FREQUENT

ANTIBIOTICS 5) REACTION TO CERTAIN

VACCINATIONS

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

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

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

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

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

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

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

GUT HEALTH TREATMENTS 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

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

GUT MEASLES ASSESSMENT

• HISTORY, MMR RESPONSE• GUT ISSUES

• RUBEOLA ANTIBODIES TEST• BRAIN AUTO-ANTIBODIES TEST

• ENDOSCOPY• BIOPSY, CSF ANALYSIS

• PCR (POLMERASE CHAIN)

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

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

HIGH-DOSE VITAMIN A FOR GUT MEASLES

BAKER - McCANDLESS PROTOCOL200,000-400,000IU ORAL 2 DAYS EVERY SIX

MONTHS IF 3 OF 5 POSITIVE:1) HISTORY OF REGRESSION AFTER MMR2) PERSISTENT GUT PROBLEMS, PAIN3) MORE THAN SLIGHTLY ELEVATED IgG

SERUM RUBEOLA ABS4) ELEVATED ANTI-MBP & ANTI-NF ABS

5) ENDOSCOPY SHOWS ILH, CSF/BIOPSY+, PCR VACCINE STRAIN MEASLES

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 

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

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

SUMMARY: RX GUT DISORDER

• RESTRICTIVE GF/CF/SF DIET, PROBIOTICS

• REMOVE OFFENDING FOODS PER IGG HYPERSENSTITIVITY TESTING

• REPLACE NUTRIENT DEFICIENCIES, ENZYMES

• TREAT FOR PATHOGEN OVERGROWTHWITH NATURAL & PRESCRIPTIVE

ANTI-FUNGALS, BACTERIALS

TREATMENTS BEYOND THE BASICS

“TRIO:” 1) GLUTATHIONE, TD-ORAL-IV

2) TTFD (ALLITHIAMINE – AUTHIA)

3) M-B12 SUBCUT INJECTIONS

“QUARTET:”

4) ADD FOLINIC ACID

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

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.

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.

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

TTFD, CONT’D

• GENTLE CHELATOR FOR ARSENIC, CADMIUM, ALUMINUM, LESS FOR HG

• NON-TOXIC, NO PRESCRIPTION NEEDED, TRANSDERMAL CREAM TWICE DAILY

“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

TOXICITY

• TOXIC CHEMICALS

• HEAVY METALS

• GLUTATHIONE

• VACCINATIONS

• AMALGAMS, FISH INGESTION

DETOXIFICATION OF HEAVY METALS

• DMSA—ORAL, TD, NEW - SUPPOSITORIES

• DMPS—ORAL, TD, IV

• CaEDTA--- IV, SUPPOSITORY

• TTFD (AUTHIA) - TD

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

0.11±0.12

0.17±0.15

0.21±0.19

0.13±0.140.15±0.11

0.18±0.17

0.28±0.30

0.45±0.33

0.61±0.38

0.32±0.29

0.54±0.49

0.73±0.62

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0.6

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ANTIBODIES AGAINST MBP AND NEUROFILAMENTS IN CONTROLS AND CHILDREN WITH AUTISM .

MBP NFP

37

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

UNHEALTHY IMMUNITY

FAILURE OF THE Th1 ARM & OVERACTIVE Th2 ARM:

AIDS, CANCER

CFS (FATIGUE)

CANDIDIASIS

MULTIPLE ALLERGIES

MCS (CHEMICAL)

AUTISM

Th1/Th2 BALANCETh1 – 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

IMMUNE-ENHANCING

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

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

ANTI-VIRAL PRESCRIPTIVES

GENERAL IMMUNITY:ORAL, IM, IV IMMUNOGLOBULINS

LOW-DOSE NALTREXONEACTOS

ANTI-VIRALS: VALTREX (PRIMARY ONE I USE)

FAMVIR ACYCLOVIR FOR SMALL CHILDREN

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!!!!

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