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Using Labs to Manage Your Child’s Biomedical Program and Interpret the Results Tracy Ziemann PA-C Sonja Hintz RN True Health Medical Center Naperville, IL Goals for this Presentation Basic Laboratory Tests your general practitioner can order How do the lab findings present in my child’s behavior Potential treatment options available for abnormal results Build your foundation Create your own History and Physical: some- times a time line is helpful Review your: Environment: Home, School and other places, what triggers are there Diet: texture, food choices, when your child eats Elimination: Are your Childs stool frequent, or infrequent, what color and odor do they have? Gathering information When a doctor sees an autistic child there is a need for the parent to relay the child's physical condition In the biomedical treatment of autism we look at behaviors and the physical condition of the child to place them in category Basic initial testing Blood CBC, CMP TSH, Free T4 Iron, Ferritin Lead, blood Copper (serum), Zinc (plasma) Ammonia, blood (Has to be sent Frozen) Immune system evaluation: IgG total and 4 subclasses, IgA and 2 subclasses, total IgE and IgM Additional Blood Tests Viral Titers QUANTITATVE IgG: CMV EBV HHV6 HSV Varicella Measles Mumps Rubella Hep. B surface Ab Polio Strep Titers ASO titer quantitative AntiDNASE B Ab quantitative Mitochondrial Tests: Blood Amino Acids Carnitine Panel Lactic Acid Pyruvate Acid Viruses Physical Presentation “Never sick” “Always sick” Regression after illness Poor eye contact Improved eye contact with a fever Stimmy Behavior • Hand flapping • Sideways glancing • Finger flicking Treatments Olive leaf extract Elderberry Oil of Oregano Herbs/Nutrients that support the immune system Antiviral medications: Valtrex High dose Vitamin A Homeopathy Enzymes Strep Physical Presentation Poor eating Clearing the throat Swollen lymph glands Obsessive thoughts/behavior Seizures Tics Someone else in the family has strep Treatments Biofilm treatment esp if strep is found in the stool Antibiotics: Zithromax Probiodics Immune supportive agents: IVIG Berberine Golden Seal Oregon grape root GI Health Markers Stool CDSA CPP x3 Microbiology Urine testing organic acid test (OAT) Great Plains lab- OAT Metabolic Analysis Profile (MAP) Genova diagnostics Yeast symptoms Giggly, inappropriate laughing Foggy, spacey Change in bowel movements (foul/yeasty smelling stools), gas, and bloated belly Yeasty rash/diaper rash, white coating on tongue, red ring around the anus, ringworm, cradle cap Bedwetting or accidents Sleep disturbance or Night waking Hyperactivity, hand flapping, toe walking Sugar craving Treatment Start a potent Probiotic Digestive Enzymes Clean up the diet Casein/Gluten free Limit sugar Consider SCD and/or Low oxalate Support the gut and reduce inflammation Vitamins/supplements, herbs, medications More Treatment options… Antifungals • Drugs Nystatin, Ampho B Fluconazole Itraconazole Ketoconazole • Herbals Berberine Grapefruit Seed Extract Oil of Oregano, Pau d’Arco Garlic, Samento Homeopathy Look OUT for “Die Off” Loose stools, diarrhea Behavior, irritability Head aches, head banging Fatigue Sleep disturbance Rashes Parasites What may keep you and your child up at night Signs and Symptoms of Parasites Discomfort and bloating of stomach Itchy buttocks, night waking, fecal smearing Diarrhea and constipation Teeth grinding Mal absorption of nutrients, pica, insatiable appetite Allergies Behavior changes and/or aggression, worse at full moon Picking Biting Restlessness Treatment for Parasites Probiotics Herbs • • • • • Wormwood Black walnut Pumpkin seeds Clove Coconut oil Homeopathy Antiparasitic medications • Metronidazole • Paromomycin They don’t go down without a fight!! Potential reactions when eliminating these pathogens Symptoms Irritability, aggression, behavioral issues Increased stimming, hyperactivity, sleeplessness Skin rash, diaper rash, fever Possible Causes Side effect of supplement or allergy to drug Yeast or Bacterial Flare-up (Balancing act) Detox Reaction = Too rapid of an effect leading to vitamin or mineral deficiency, oxidative stress, liver or kidney stress Die off = Rapid death of gut bugs, leading to excess release of toxins and subsequent liver or kidney stress Treatment Approach Rate severity, if severe stop supplement, notify physician Treat with Activated charcoal/Bentonite clay and/or Alka Seltzer Gold, homeopathic remedy, if helpful probably die off Rule out dysbiosis, treat accordingly Check ammonia level Add Liver Support • Milk thistle, artichoke extract, dandelion root • Give at bedtime Clostridia produce toxins and enzymes that create severe gut inflammation and produce watery diarrhea Clostridia issues Symptoms Aggressive Temper Agitation Irritable Very foul stools Mucus in stools Severe diarrhea following antibiotic use Treatment Probiotics, High Potency single strain Sacchyromyces Boulardii Antibiotics • Vancomycin • Metronidazole (Flagyl) Immune modulators Homeopathics HBOT Evaluation of Heavy Metal Toxicity Provocative Testing is often unconvincing in ASD due to impaired detoxification. Urine Toxics, Fecal Toxics, and Hair Analysis show excretion of toxic metals. We have no way to determine total body burden. RBC Blood testing is a poor measure of chronic heavy metal burden. However, blood may show acute exposure. There are no standards for diagnosing chronic toxicity. There are no tests to determine body burden of metals. Lead is a bone seeker and can only be measured in blood 12 hrs after exposure, therefore blood Pb is not an adequate indicator of low level chronic toxicity. Mercury has an affinity for fatty tissue and a developing brain, and is very rarely seen in blood. Urinary porphyrin testing – promising. Benefits of Chelation Better sleep Cognitive gains Better speech and language Improved eye contact Fine and gross motor improvement Better focus, attention, awareness IMPORTANT to continue to monitor symptoms. Labs can only help point us in the right direction. Have courage and follow your own path. Thank You and Good Luck on your Journey