Dr. Damien Downing's Column
...expert advice on treating environmental illnesses with ecological and nutritional medicine.
Dr. Damien Downing M.D. is President of the British Society for Ecological Medicine (www.ecomed.org.uk), Chief Medical Advisor to the charity Yes to Life (www.yestolife.org.uk), and Editorial Board member of the Orthomolecular News Service (www.orthomolecular.org). He is a practitioner of ecological medicine in London (www.newmedicinegroup.com) and York (www.naltd.co.uk) and author of several books including The Vitamin Cure for Allergies (USA, Basic Health Books, 2010).
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Monday, March 28th, 2011:
by Damien Downing MD
The field of neuroevelopmental disorders such as Autism and Autistic Spectrum Disorders is a fast-moving one these days, so it is encouraging for me to see what I wrote 7 years ago;
We appear to be in the middle of an epidemic of autism in most Western countries. The causes are not certain, but several factors look as though they play a part:
- mercury-based preservatives used in vaccinations
- multiple simultaneous vaccinations
- poor nutrition
- exposure to pesticides and other environmental toxins
- parental exposure to toxins
- allergies (and a family history of allergies)
- chronic infections
- hormonal influences in pregnancy
…..The list goes on and on.
— and to note that not much needs adding to that. The two things that do are;
As far as autism is concerned, it is clear that there are specific genes that can cause a child to be less efficient at removing toxins from the body, and particularly from the nervous system. It is almost certain that these are important risk factors for devloping autism etc. Knowing about this can help in deciding what treatments are best for him/her.
I’ve been dealing with genomics for almost two years, and one thing that’s clear is that there is so much we don’t know. But we are learning all the time. We have negotiated good prices for genomic testing now, and it is certainly one thing to consider in the work-up of your child.
A big component is sulphur-based detox; the molecules such as glutathione have a pair of sulphur atoms, which combine strongly with metals like mercury, and so are excreted still combined with them. There is a protein called Apolipoprotein E, which is a major “housekeeping molecule” within the brain; in its “normal’ configuration it has the same pair of sulphur atoms, but some people have a different configuration. In adults this predisposes strongly to disorders like Alzheimer’s; in children it may well predispose to autism. There are several other sulphur-based molecules which can vary, and which may predispose to autism, or simply to metal toxicity.
In the landmark Hannah Poling case in the USA in 2007 the US government admitted that Hannah’s autism was vaccine-induced, but suggested that this happened because she had rare abnormalities of her mitochondria (Hannah received 9 vaccines in one day, and regressed rapidly into autism). But Hannah’s father, Dr Jon Poling, and colleagues, retrospectively surveyed 159 other children with autism, and found suggestive abnormalities in at least 50%.
Mitochondria are vital producers of energy, the cellular batteries, of which every cell has at least hundreds. They are surprisingly vulnerable to toxin damage, and emerging (experimental, i.e. your GP won’t know about them) laboratory technologies make it possible to identify the toxins in most cases. We can then follow the progress of removal with lab tests.
Obviously this links in to the toxic factors listed above, from mercury to pesticides. There are a number of interesting papers listed on the Autism Research Institute website [http://www.autism.com/medical/research/advances/autism-mito.htm] — but bear in mind that the (mainstream medical) tests and instruments used there are not very sophisticated, and this is a rapidly developing field. We think we are doing better with the tests we use now in the UK, but this has not (yet) been demonstrated to be true for autism.
You might want to look at a study that is available on the BSEM website on mitochondria in chronic fatigue [http://www.ecomed.org.uk/publications/reports/cfs-and-mitochondrial-dysfunction]. There is a doctor in London who has published a book called “Defeat Autism: A Dangerous Delusion”; he somehow managed to get unchallenged airtime on Radio 4 to promote it. On air he expressed outrage that private clinics might use the same tests on children with autism as on adults with other diagnoses. Actually that’s just the point; we are all exposed to, and damaged by, the same vast cocktail of poisons, but they affect us differently at different stages of life.
As to the other major cause listed;
Too big a subject to cover it all here, and individual assessment is advisable, but the following points stand out.
Bruce Ames, probably the most respected nutritional researcher in the world, said in a 2002 paper; “more than a dozen reports… and a review of controlled trials have reported improvements in autistic patients with vitamin B6 and often magnesium supplementation”. In fact Bernard Rimland made the same point in the Journal of Nutritional and Environmental Medicine in 1991. It takes larger doses than the EU or the FDA would like you to take or give, of course, but with such doses about 45% of autistic children show a benefit from B6 and magnesium, across almost all the studies.
(An ironic note on the above; Dr Rimland recounts that he found some of the children who took B6 actually got worse. The person who told him to give them magnesium as well, which solved it, was Adele Davis — the much-maligned author of a number of books on nutrition and health, who had no medical qualifications, but somehow managed to be right extraordinarily often).
Dr Ellen Grant showed 20 years ago that children with dyslexia were likely to be zinc-deficient and have other nutritional deficits. This is even more true now, as many parents have been raised on poor diets. Good nutrition is essential to enable children to deal with the world.
Many parents try omega-3/omega-6 oil supplements before bringing their child to see me; sometimes it makes a real, and rapid, difference, and a few weeks of it will do no harm at all. If there is no benefit after 3 months, there is unlikely to be any, and I would want to examine the question in greater detail, perhaps with lab tests.
It’s impossible to cover all the options, but these are (most of) the tests we find typically useful and important.
B vitamins, vitamins A, C, D, E
Zinc, Magnesium, Selenium
Essential Fatty Acids
Cofactors: Coenzyme Q10, Biotin
Urine Toxic Metals
I don’t think it is enough to test only for mercury with a “Kelmer” test for instance. And I normally do a straight, unchallenged test first, then a challenged one to see how much the excretion rises. Before doing the second one the patient needs to have full protection in place.
Fat Biopsy, Mitochondrial studies
These are not always necessary, but can sometimes be crucial in identifying pesticides, flame retardants and other toxins that harm health.
I learnt the hard way — which for doctors means hard for the patient — that doing detox without adequate protection can make a child worse. The damage wasn’t lasting, but since then I take full precuations anyway. Detox is usually necessary for autists, but getting the full nutritional protection in place is necessary first.
(see Nutritional deficiencies above)
We run tests of nutritional status and correct any deficiencies we find. Sometimes this produces a real and rapid improvement, sometimes it does nothing evident, but it is still necessary; we all need full nutritional status to achieve full function.
Protect from toxic damage
Before removing heavy metals or other toxins we need to make sure that full protection is in place. This means not only good levels of all vitamins, minerals etc, but some specific supplements; vitamin C, melatonin, alpha-lipoic acid, etc, all as appropriate and tailored to the individual.
It’s complicated, and it can have side-effects if you’re not careful, but detoxing — removing heavy metals such as mercury (and lead, cadmium, even uranium) is often necessary. I use DMPS, DMSA and glutathione most often. And we give them transdermally — as an oil rubbed into the skin — by preference, although each child is individual and needs individual treatment.
James Neubrander showed that vitamin B12 by injection can, at least sometimes, produce a major improvement in autistic kids. We use his protocol often, although with our own precautions and checks. Doing this doesn’t remove the need to do the basics like correcting deficiencies though.
I’ll be honest; I haven’t used LDN (Low Dose naltrexone) for autistic children; I’ve used it in Multiple Sclerosis and other autoimmune diseases. Sometimes it works, sometimes it doesn’t; I suspect it’s the same in autism. Jacquelyn McCandless has researched this best and most, and says much the same. It’s a treatment option.
My view on what we do for autistic children is that we do our best to get them fit to take advantage of the training and learning options that are out there; that’s the purpose.
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