Download Slide 1

Biomedical Treatments for
Autism 101:
An Introduction to Scientifically
Based Medical Treatment
Options
Autism Around the World
Symposium 2010
May 6-8, 2010
Zayed University
Dubai, United Arab Emirates
Lauren W. Underwood, PhD
1
***Disclaimer:
The information provided today is for
educational purposes only, and should
not be used in place of profession
medical and/or nutritional supervision.
If medical advice is needed, this
service should be given by a licensed
medical provider.
I do not receive any financial remuneration for anything
mentioned or referred to in this presentation.
Lauren W. Underwood, PhD
2
My training and employment. . .
 M.S. in Biology from Tulane University,
New Orleans, LA
 Ph.D. in Cell and Molecular Biology from Tulane
University, New Orleans, LA
 NIH Training Grant in Vision Research, LSU Eye
Center, New Orleans, LA
 Day job: Sr. Research Scientist, NASA SSC
Lauren W. Underwood, PhD
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Work related to autism . . .
 Independent Consultant,
Developmental Delay Consultant
 Autism One Mentor
 USAAA Scientific Advisory board
 IHA Scientific Advisory board
 CARD IRB
But most importantly, . . .
A parent of child recovering
from autism
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What is Autistic Spectrum
Disorder?
A developmental
disability resulting
from a neurological
disorder . . .
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That affects normal functioning
of the brain . . .
… affecting children in a
spectrum of ways . . .
. . . children with autism behave in a
spectrum of ways . . .
Autistic Spectrum Disorder
 Abnormal development of
 Communication skills
 Social skills
 Reasoning
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The tough part about autism is
that…
No one will tell you that there is
something that will definitively work . . .
Autism is treatable!
 Recent research shows that autism is
treatable
 Early interventions lead to the best
outcomes
 Be aware of symptoms, and begin
addressing them as soon as possible
There is still not a “cure”,
but there are many treatments
to consider
Educate yourself . . .
empower yourself with knowledge!




You know your child best
Learn about the disorder
Learn about treatments
Make intelligent choices
about what would work
best for your child—for it is
a spectrum disorder,
affecting each child
differently
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Consider pursuing 3 major
treatment areas:
 Biomedical/Health
 Behavior/education & social interventions
 Sensory issues
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Interventions go
“hand-in-hand”
 Therapies or interventions are designed
to remedy specific symptoms in each
individual.
 The best-studied therapies include
educational/behavioral, sensory and
biomedical interventions.
Although these interventions
do not cure autism, they often bring about
substantial improvement
Lauren W. Underwood, PhD
My goal
as an educator,
 1. Biology
 Anatomy and cell biology
 2. Immunology
 3. Biochemistry
 4. Describe what can goes wrong with
these systems
Lauren W. Underwood, PhD
Then,
the reasoning behind what can go wrong
with these systems . . . explain how
issues with these systems can affect
behavior and behavioral intervention
. . . To enable you to understand
some of the biological approaches
currently available for the treatment
of the medical condition described as
autism,
. . . .so if you choose you can
consider applying them responsibly
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What does biomedical approach
mean?
 The application of the natural,
biological and physiological
sciences to clinical medicine
Lauren W. Underwood, PhD
Why consider biomedical
approaches for the treatment
of autism?
There is literature in peer review journals
and other related sources that suggests
that there are several biomedical
interventions that . . .
can be helpful for the treatment of the
symptoms in many autistic spectrum
disorder children
Lauren W. Underwood, PhD
http://www.pediatrics.org/cgi/con
tent/full/120/5/1162
http://aappolicy.aappublications.org/cgi/reprint/p
ediatrics;107/5/1221.pdf
Evaluation, Diagnosis, and Treatment
of Gastrointestinal Disorders in
Individuals with ASD: A Consensus
Report
Buie et al, 2010, Pediatrics;125;S1S18
http://www.pediatrics.org/cgi/content/
full/125/Supplement_1/
Abstract- Buie et al;
Pediatrics;125;S1-S18
“….The consensus expert opinion of the panel was that
individuals with ASDs deserve the same
thoroughness and standard of care in the
diagnostic workup and treatment of
gastrointestinal concerns as should occur for
patients without ASDs. Care providers should be
aware that problem behavior in patients with ASDs may
be the primary or sole symptom of the underlying
medical condition, including some gastrointestinal
disorders. For these patients, integration of
behavioral and medical care may be most
beneficial. Priorities for future research are identified to
advance our understanding and management of
gastrointestinal disorders in persons with ASDs.”
The Science
 The body is made up of specific systems,
including skeletal, circulatory, immune,
cardiovascular, nervous, digestive
 Digestive system
 Anatomy and function
 Food allergies/food intolerances
 Leaky gut/intestinal dysbiosis
 Immune system function
 Basic biochemistry
Digestive System
 Mouth
 Stomach
 Small intestine-absorption
 Duodenum
 Jejunum
 Ileum
 Large intestine/Colon
 Rectum
 Liver
 Pancreas-secretes enzymes and hormones
Digestionfunction of the digestive tract
 Digests food
 Absorbs nutrients
 Carries vitamins and
nutrients into
bloodstream
 Chemical detoxification
 Excretion
Small Intestine
Cross Section
 Serosa
 Connective tissue
 Muscularis Externa
 Inner circular and
outer longitudinal
fibers (muscle
cells)
 Submucosa
 Connective tissue
 Blood vessels
 Mucousa
 Epithelial cells
 Lamina propria
 Muscularis
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mucosa
Intestinal epithelial cell layer:
histological view
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How do you get nutrients from
foods? Protein
 Foods are made up of proteins
 When foods are eaten and properly
digested, proteins are broken down by
enzymes into peptides
 Peptides are then further broken down
into amino acids
 Amino acids are the building
blocks of life
What is a peptide
A little biochemistry . . . .
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Peptides are made
up of amino
acids that are
linked together
. . . Peptides are linked together
to form proteins
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What’s an Amino Acid?
Amino acids are the
building blocks of life
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There are 20 amino acids
H
the amino acidCysteine
S
H
O
H
C
H
C
C
H
N
O
H
H
CYSTEINE
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What can go wrong with the
GI?
1. “Leaky gut”
2. Intestinal dysbiosis
a. Constipation
b. Diarrhea
c. Enterocolitis
3. Allergy
“Leaky Gut”
Definition: an abnormal or unfavorable
increase in intestinal permeability
The intestinal lining is supposed to be
protective barrier between the gut and
the bloodstream
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Tight gap junctions
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1. What is “leaky-gut”?
Definition: an abnormal or
unfavorable increase in
intestinal permeability
 Epithelia are either 'tight'
or 'leaky'
 The intestinal lining is
supposed to be the
protective barrier between
the gut and the
bloodstream
Leaky Gut/
Increased permeability
 If the intestinal lining becomes damaged-it is
possible for incompletely digested proteins
and/or other by-products to “leak” through the
intestinal lining
 They can be recognized as foreign by the
immune system, and/or “leak” into
bloodstream
Lauren W. Underwood, PhD
How do you treat “leaky gut”?
 Cleanse the gut of toxins
 Avoid the non-food foods: sugars, refined
carbohydrates, fatty foods.
 Enhance the flow of digestive secretions
/enzymes.
 Provide proper nutrition to the body
 Supplements diet: vitamins, antioxidants,, probiotics
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What is intestinal
dysbiosis?
Intestinal flora-yeast
and bacteria -are
part of GI track
 Intestinal dysbiosis
occurs when there
is an
overgrowth/imb
alance of intestinal
flora(s)
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2. Dysbiosis
 Intestinal flora (yeast and bacteria) are a
normal part of digestive track
 Intestinal dysbiosis occurs when there is an
overgrowth/imbalance of intestinal flora(s)
 Dysbiosis results from
 Increased use of antibiotics, steroids, etc.
 Poor diet
 Diets high in sugar
 Stress
 Immune system dysregulation
How do your treat intestinal
dysbiosis?
 Try laboratory testing to determine
pathogen:
 Yeast, clostridia, or unfavorable bacteria
 Discuss Rx or OTC treatments with
your physician
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a. Constipation/ b. Diarrhea
a.
Constipation-having a bowel
movement fewer than three times per
week



b.
Stools are usually hard, dry, small in size,
and difficult to eliminate.
Can be painful to have a bowel movement
and
often experience straining, bloating, and the
sensation of a full bowel
Diarrhea-frequent loose or liquid
bowel movements (often associated
with infection, allergy and food
intolerances)
c. Enterocolitis
 Inflammation [itis](due to infection or
irritation) that affects part or all of the
intestines (the small [entero]and/or large
[col] intestines)
 Hyperplasia-general term for an increase
in the number of the cells of an organ or
tissue causing it to increase in size
 Endoscopy-looking inside, the human body
for medical reasons, by inserting a small
scope in the body
Ileonodular
Hyperplasia
Normal Terminal
Ileum
Consequences of intestinal dysbiosis
or “leaky gut”-if left untreated
 Nutrients and vitamins aren’t absorbed
properly---vitamin deficiencies
 Intestinal distress
 Food allergies are created
 Detoxification is compromised
 Bacteria and yeast can be mobilized
 Formation of antibodies you might not want--because of immune dysregulation
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3. Allergy
 A large part of the immune system is located
in or near the intestinal tract-to helps prevent
microorganisms in the intestine from entering
into the rest of the body
 1st line of defense against pathogens
 Defects in the immune system can lead to
gastrointestinal problems
 Therefore, the most obvious place for an
allergic reaction to food to take place is in
the GI track
 Reactions can range from acute to chronic
 Food allergies vs. food sensitivies
Food allergies
 An immune system response . . . to foods
 Body mistakes a protein in food as harmful, and
creates a defense against it (antibody)
 Allergy symptoms appear within minutes to an
hour or so after eating the suspected food-body
is battling invading food
 Symptoms include eczema, an itchy red rash
most common in the elbow creases or behind
the knees hives, nausea, swelling, difficulty
breathing and/or anaphylactic shock
Food sensitivities/food
intolerances
 Digestive system response to foods
 Not an immune system response
 Something in food irritates digestive system or
person is unable to breakdown/digest food
 Can include metabolic food disorders such as
lactose intolerance (missing enzyme)
 Symptoms include crapping, gas, nausea,
and stomach pain
Immune system function
The immune response is how your body
recognizes and defends itself against bacteria,
viruses, and substances that appear foreign
and harmful to the body
Normal immune system function, depends upon
proper immune system responses
1. Protects and defends against foreign cells
2. Memory-gets smarter
3. Responds appropriately
4. Do no harm
Normally, there is a balance between
infection and immunity
infection
immunity
Acquired
Innate
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Acquired
Immunity
 White blood cells
associated with
acquired immune
system are called
“lymphocytes”
 T Cells
 B Cells
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T cells--Two kinds of t cells
Helper T CellsRecognize
antigens
and help
other cells do
their
job
Killer T cellskills infected cell
. . . Th1 response
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B cells
Produces
antibodies
 An antibody is specific
to an antigen-something the body
recognizes as “nonself”
. . . Th2 response
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Cellular Communication
And, the balance can be altered
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With immune system dysregulation,
there is a “ shift or skewing”:
 One possibility . .
. when you are
attacking, the
“attack” is to
produce
antibodies
. . .to foods, yeast,
bacteria, etc.
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Things can go wrong with the
immune system . . .




Hypersensitivity
Autoimmunity
Inflammation
Immune system dysregulation
Immune system dysregulation
 Immune system dysregulation causes an
abnormal immune response
 There is a “ shift or skewing” – lack of
balance
 The immune system looses the ability to
respond appropriately. . . and when this
happens, it is possible that the body develops
abnormal responses to things it might not
normally react to . . .
like foods
What happens if the immune
system is compromised
 Immune dysregulation
 Abnormal balance and communication
between immune cells
 Chronic Inflammation
 An abnormal, persistent activation of
immune cells in the tissues
 Autoimmune reactions
 Antibodies targeting and causing injury to
normal body tissues
The immune system is closely connected to
virtually every other system of the body . . .
Disorders in the immune system can cause
disease
The Liver’s Mighty Detoxification
Powers
--designed to remove toxic
matter from the blood stream
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Liver Functions:
Produces
bile
Stores
glucose in the
form of glycogen
Metabolizes
protein and
fats
Stores
vitamins and
energy
Detoxifies,
and breaks
down “xenobiotics”
Removes
Lauren W. Underwood, PhD
toxic matter
What happens if liver function
is compromised?
 If detoxification systems are overloaded,
this can lead to destruction of nutrients
required for detoxification pathways
 if detoxification pathways become
overloaded, there will be build of toxins
 if transulfuration is disrupted, there is less
ant-oxidant protection, and
oxidative stress can result. . .
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Vicious Cycle of Toxic Overload
 Heavy metal exposure, environmental
toxins, foreign proteins
 Detoxification problems
 GI distress
 Allergy
 Immune problems
 Infections
 Treat with
 Antibiotics, steroids,
antifungals
Why detoxification?
 To prevent injury to the cells
and ultimately cell death
 In autism, toxins may be a
cause of the neurological and
immune dysfunction
 If toxins accumulate too
rapidly, without being safely
eliminated, they can cause
damaging effects upon cells
and tissues of the body
 Detoxification may help the
cells to recover and heal
Cell Damage and Disease
DetoxificationMethylation and Sulfation?
 two of the healthy body’s natural means of
ridding itself of toxic substances:
 Methylation
 Sulfation
 ASD children often need supplements to
provide them with the raw materials their
bodies need to carry out methylation and
sulfation.
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“Without methylation, there would
be no life as we know it”
-Craig Cooney,
author of Methyl Magic
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Methylation
 Methylation:
methyl group
molecule
the process transferring a
to another
 Methylation is an important part of :




Folic acid pathway
B6 pathway
B12 pathway
Needed for neurotransmitter synthesis
Important chemical events in the
body are made possible by
methylation
Detoxification pathways
 DNA synthesis
 RNA synthesis
 Cellular methylation rxts
 Neurotransmission
 Switching genes on and off

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Methionine/Glutathione
Transsulfuration Pathway
Transsulfuration
pathway
Methionine
THFolate
TMG
Methionine
Synthase
Methylene
THFolate
MTHFR
Remethylation
pathway
Methyl
THF
SAM
DMG
SAH
Homocysteine
Methyl
B12
B6
B12
Cysteine
Glutathione (GSH)
Critical to the body’s ability
to remove toxins!
Lauren W. Underwood, PhD
Methionine/Glutathione Transsulfuration
pathway in children with autism
Treatment Options: Where do I begin?
 1. Diet
 2. Supplements
 3. Testing
(These are not in any
particular order)
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1. Healthier Diet
Read labels . . . .
Are special diets so “special”
and which one do I choose?
 Many autistic children suffer from
inflammatory response/immune
system dysregulation
 Many autistic children don’t/can’t
digest their foods efficiently
 Diet options: GF/CF, SCD, BED, LOD,
 Pick one that works best for you and
your family
Regardless of diet choice,
it is important to ensure proper
nutrition
Gluten-free/Casein-free diet
(GFCF diet)
 Your can try it on
your own
 There is research
that suggests the
diet can help
many children . . .
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What is gluten?
Gluten and gluten-like proteins are found in
wheat and other grains, including oats, rye,
barley, bulgar, durum, kamut and spelt, and
foods made from those grains. It is also
found in food starches, semolina, couscous,
malt, some vinegars, soy sauce, flavorings,
artificial colors and hydrolyzed vegetable
proteins
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What is casein?
Casein is a protein found in milk and
products containing milk, found in such as
cheese, butter, yogurt, ice cream, whey
and most brands of margarine, and some
non-milk products such as soy cheese,
hot dogs, and tuna fish, in the form of
caseinate
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Diet: Gluten-free Caseinfree(GFCF) Diet
 A restrictive diet that removes all food
items that contain both
 gluten and casein
 The are two main theories currently
present in scientific literature that
explain why some people with autism
and PDD respond positively to a GFCF
diet
 improperly broken down dietary
peptides
 immune system dysregulation
Improperly broken down dietary
peptides
 Some people with ASD cannot properly digest
gluten and casein, which break down into
substances that act like opiates in their bodies
 According to this theory, these "drug-like"
substance alters the person's behavior,
perceptions, and responses to his environment
Casein/casomorphin and
gluten/gliadorphin
 Casein is a protein found in milk and products
containing milk
 Casomorphin (or caseomorhin) is a peptide
derived from the milk protein casein
 Gluten and gluten-like proteins are found in
wheat and other grains
 Gliadorphin (or gluteomorphin) is a peptide
derived from the wheat protein gluten
Or immune dysregulation causes
an abnormal immune response
The immune system
looses the ability
to respond
appropriately . . .
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Immune System Dysregulation
 Body develops abnormal responses to
things it might not normally react to
 An abnormal immune response can result
in
 Allergy
 Inflammation
 Hypersensitivity
 Autoimmunity
When this happens,
it is possible that the
body develops
abnormal responses
to things it might not
normally react to,
. . . like foods
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Consider this . . . .
 Although at the beginning the diet may
seem difficult, it maybe infinitely easier to
try the diet, and end up having a happier
healthier higher functioning autistic child,
than living with a bad/poorly functioning
one!!!
Which would you rather choose?
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How to begin a GFCF diet?
 Keep a daily log/diary
 Be systematic
 Try removing dairy first
 See what happens; generally within first few
days improvements can be observed
 Try for at least two weeks
 Try removing gluten
 Give this at least 3 months, and up to 6
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Books for suggested reading
for GFCF Diet beginners:
Special Diets for Special
Kids: Understanding
and Implementing
Special Diets to Aid in
the Treatments of
Autism and Related
Developmental
by Lisa Lewis, Ph.D.
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Some wonderful resources
available for GFCF beginners:
GFCF DIET web site
www.gfcfdiet.com
ANDI, autism network for
dietary intervention
http://www.autismndi.com
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Where do I get these types of
foods?
 Buy ready-made food items or
mixes
 Your local grocery store
 Your local health food store
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Ordering GFCF foods on-line:
 Miss Robens
http://www.allergygrocer.com
800-891-0083
 Kinnikinnick
http://www.kinnikinnick.com
877-503-4466
 Ener-G
http://www.ener-g.com/
800-331-5222
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2. Nutritional supplementation
Nutritional Supplements
 They are relatively safe-if used responsibly
 You don’t need an Rx
 You can purchase a good encyclopedia of
nutrition to educate yourself-go to your local
bookstore or library
Why?
 There is some literature that suggests that
some supplements can help many ASD kids . .
Particularly because of impaired detoxification
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***Disclaimer regarding
nutritional supplements:
The supplements mentioned today represents
products that I am familiar with; there may be other
supplements, besides these, which are acceptable.
I do not endorse, nor do I receive any financial
remuneration, for any of the items mentioned.
Please note its always wise to verify product/safety
information check with your healthcare provider,
before use!
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Why nutritional
supplementation?
 Nutritional deficiency
 involves a lack of one or more nutrients
obtained from food essential for normal cell
and body function
 occur due to
 Mal-absorption/poor absorption in the small
intestine
 Unhealthy eating, or
 Self-imposed/imposed dietary restrictions
 Poor utilization of nutrients because of genetic or
environmental factors
 Oxidative Stress
Nutritional deficiencies occur
due to:
 Mal-absorption/poor absorption in
the small intestine
 unhealthy eating, or
 self-imposed/imposed dietary
restrictions
 Poor utilization of nutrients because
of genetic or environmental factors
Lauren W. Underwood, PhD
There are nutritional deficiencies
associated with disease
 Rickets-vitamin D deficiency
 Scurvy-vitamin C deficiency
 Beriberi-thiamine deficiency
 Pellagra-niacin deficiency
 Goiter-iodine deficiency
What nutrients are commonly
deficient?










Vitamin B12
Vitamin B6
Folate or folic acid
Vitamin A
Vitamin C
Vitamin D
Zinc
Magnesium
Omega 3 fatty acids
Glutathione
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Nutritional supplements:
Which ones?
 Some useful information is provided at
www.ari/autism.com
 Discuss options with your physician or
nutritionist, and help to make the best
decisions for your child
 www.nutrition.gov for official government
reports
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Some basic nutritional support
to consider may include:
Vit B6/Mag
Probiotics
DMG and/or TMG
Zinc
Folic/Folinic acid Digestive enzymes
Glutathione
Calcium/Magnesium
Antioxidants
 Vit C
 Vit E
 CoQ10
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Signs and symptoms associated
with nutritional deficiency . . .









Neurological symptoms
Memory loss
Psychosis
How can a
Bruising
child attend,
Confusion
focus, and learn?
Impaired learning
Growth retardation
Loss of appetite
Poor immune function
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Tricks of trade: How do you get kids
to take these things?
Swallow capsules-oil/straw trick Hiding in food:
Syringe approach
-Icing
Trandermal preps-require Rx
-Frozen fruit juices
-Jell-O
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What are transdermals?
Trans - across
Dermal - skin
Compounding pharmacists formulate vitamins,
minerals, hormones, and medications into
cream and gel bases that are, when applied to
the skin, actively transported through the skin
for absorption into the bloodstream
Transdermals offers almost complete delivery
without many of the side effects/problems
associated with oral administration
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What about oxidative stress?
 Caused by an imbalance between the
production of reactive oxygen (free
radicals) and a biological system's ability
to readily detoxify/repair damage
 Can impose upon the cells and affect
normal cell function, causing oxidative
stress
 Can supplement with antioxidants to
counter-act effects of oxidative stress
upon the cell
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To combat oxidative stress




Vitamin E
Calcium
Vitamin C
Selenium
Glutathione
Zinc
Vitamin B6 or
its activated form,
pyridoxal-5-phosphate (P5P)
with Magnesium
Lauren W. Underwood, PhD
But no matter which
interventions you try, . . .
 implement them
slowly, one at a
time, so that you
can try to identify
what exactly has
had a positive or
negative effect.
Lauren W. Underwood, PhD
115
3. Additional laboratory testing
Why consider other
testing?
Because if you don’t
look for the problem,
you might not find it
Lauren W. Underwood, PhD
116
Some standard laboratory testing
to consider:
 Full Immunological work-up
 IgA, IgM and IgE
 IgG with subclasses
 Comprehensive Allergy Profile
 For food and inhalants (including delayed
food hypersensitivity IgG for food allergies)
 Toxic metal screening
 Hair, urine and blood
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117
Additional advanced laboratory
testing
 Comprehensive

diagnostic stool analysis
 Urinary organic
acid test

 Sleep EEG

 MRI +/- CAT scan

 Thyroid profile
 Fragile X
 Liver panel
Urinary peptide levels
Inborn error of
metabolism
Serum copper
Plasma zinc
Autoimmune test for
 Anti-MBP
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118
Some advanced biomedical
interventions:
 Require medical supervision/Rx
 Methyl-B12 injections
 IVIG-intravenous immunoglobulin
 Oral IG
 Secretin
 IV Glutathione
 HBOT-Hyperbaric oxygen therapy
 Chelation Therapy
 Transdermal DMPS
 Oral DMSA
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Lauren W. Underwood, PhD
120
What do we know now?
 Mercury in a known neurotoxin
-Dr. Boyd Haley
 Thimerosal (50% ethyl mercury) can inhibit
methionine synthase
-Dr. Richard Deth
 These children have less antioxidant
protection against oxidative stress
-Dr. Jill James
Lauren W. Underwood, PhD
121
What we do know now
 In 2001, the Institute of Medicine (IOM) determined
that such a relationship (between thimerosal and
neurodevelopmental disorders) is biologically
plausible, but that not enough evidence exists to
support or reject this hypothesis
 Thimerosal neurotoxicity is associated with
glutathione depletion –James et al, 2005
 Recent work by Dr. Mark Geier and David Geier
have shown strong epidemiological evidence for a
causal relationship between thimerosal and
neurodevelopmental disorders in children-Geier
and Geier, 2007
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122
Why detoxification?
Maybe there is a genetic
susceptibility,
environmental factors
can affect trigger effects. . .
Lauren W. Underwood, PhD
The environmental factors issues is gaining broader acceptance
Lauren W. Underwood, PhD
Health Place. 2006 Jun;12(2):203-9.
Findings: For every 1000 pounds of mercury that is emitted
from Texas smokestacks there is a 61% increase in Autism
rates in that state.
Lauren W. Underwood, PhD
EHP Vol 6, 2006: Online 21 June 2006
Autism Spectrum Disorders in Relation to
Distribution of Hazardous Air Pollutants in the
San Francisco Bay Area
Gayle C. Windham, Lixia Zhang, Robert Gunier, Lisa A. Croen, Judith K. Grether
Division of Environmental and Occupational Disease Control, California Department of
Health Services, Richmond, CA; Impact Assessment Inc, La Jolla, CA; and Kaiser
Permanente Medical Care Program Division of Research, Oakland, CA
Methods: Subjects included 284 children with ASD and 657 controls, born in 1994 in the
San Francisco Bay Area. We assigned exposure level by census tract of birth residence for
19 chemicals we identified as potential neurotoxicants, developmental toxicants, and/or
endocrine disruptors from the 1996 HAPs database.
Results: Adjusting for these three groups simultaneously led to decreased risks for the
solvents and increased risk for metals (AORs for metals: fourth quartile 1.7, 95% CI 1.0-3.0;
third quartile 1.95, 95% CI 1.2-3.1). The individual compounds that contributed most to
these associations included mercury (highest odds ratio), cadmium, nickel,
trichloroethylene, and vinyl chloride.
Conclusions: Our results suggest a potential association between autism and
estimated metal concentrations, and possibly solvents, in ambient air around the birth
residence, requiring confirmation and more refined exposure assessment in future studies.
Why is detoxification important?
 To prevent injury to the cells and ultimately cell
death
 Cell injury and cell death is bad
 In autism, toxins may be a cause of the
neurological and immune dysfunction
 Detoxification may help the cells to recover
which will enable for healing
 If toxins accumulate too rapidly, without
being safely eliminated, they can cause
damaging effects upon cells and tissues of
the body
How does your
body detoxify?
 Designed to remove/eliminate toxic
substances from the body
 Primary function of liver and kidney
 Glutathione
 Once toxins are bound they are
eliminated via bile and urine
 Can also be achieved via artificial
(chelation) or supplementary (sauna)
means through hyperbaric oxygen
therapy (HBOT)
Lauren W. Underwood, PhD
How do you implement a
detoxification program?
 Should be done under the direction of
an experience physician or other
practitioner
 Support the body’s own detoxification
system—nutrients, methylB12,
glutathione, etc.
 Remove accessible toxins—chelation,
saunas, etc.
 Monitor closely
Lauren W. Underwood, PhD
Environmental Disease in
Humans
Hypothesis:
“Most human disease results from the
interaction of genetic susceptibility and
exposure to environmental factors”
“Genetic susceptibility generally relates to
the inability of the liver to detoxify
certain potentially lethal toxicants”
Lauren W. Underwood, PhD
“The abnormal metabolic profile in children
with autism is consistent with the abnormal
genetic profile and strengthens the hypothesis
that genetic susceptibility to oxidative
stress and reduced methylation capacity
may predispose these children to
neurological, immunological, and
gastrointestinal dysfunction that occurs with
autism”—Dr. Jill James
Lauren W. Underwood, PhD
Lauren W. Underwood, PhD
Paradigm switch
autism is not a psychological condition –
it is a neuro-gastro-immunological
disorder resulting from an genetic
susceptibility and an environmental
insult
Lauren W. Underwood, PhD
Don’t try to do everything all at
once!!!!
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135
Lauren W. Underwood, PhD
What you can do now . . .
 1st Stabilize intestinal dysbiosis
 2nd Maximize metabolism
 3rd Healthier diet
 Consider removing casein from the diet
 Consider removing gluten from the diet




4th
5th
6th
7th
Do some standard laboratory testing
Introduce supplements, one at a time
Do additional testing
Consider advanced biomedical
intervention, . . .
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137
A happier, healthier child is going
to be more responsive to
behavioral, social and sensory
interventions
Lauren W. Underwood, PhD
Books recommended for an introduction to
biomedical interventions for autism
 Children With
Starving Brains: A
Medical Treatment
Guide for Autism
Spectrum Disorder
by Jaquelyn
McCandless, M.D.
Lauren W. Underwood, PhD
. . .and,
 Unraveling the
Mystery of Autism and
Pervasive
Developmental
Disorder: A Mother’s
Story of Research and
Recovery
by Karyn Seroussi
Lauren W. Underwood, PhD
Understanding Autism for
Dummies


Provides the simple
breakdown of behavioral,
medical and other intervention
Offers practical advice on how
to educate children, as well as
insights on helping people
with autism maximize their
potential
S. Shore, L. Rastelli,
T. Grandin
More and more autistic children are
getting better every day, and although
there is no guarantee . . .
today,
there are more reasons to be hopeful
that your child could be part of the
extraordinary journey towards
recovery
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142
A new paradigm in autism
 Autism is an environmental illness
with a genetic component.
 It is a complex metabolic disease, not
just a developmental disability.
 Autism is treatable, but . . .
 We must continue fighting for a
cure!
Lauren W. Underwood, PhD
Remember, . . .
Be patient
Be inspired
Have strength
Never give up
hope, and
 Never give up
courage
 Love your
child!




Lauren W. Underwood, PhD
The End