In the autistic community, it is common - both among parents and professionals - autism is a behavior-based disorder, that is, the diagnosis is based on monitoring behavior and treatment, aimed at mitigating complex behaviors. However, an increasing number of people in this expanding community also recognize that there is an equally important biomedical component for the disorder that should not be overlooked when planning treatment programs for people with autism spectrum disorders. Recognizing the need for biomedical testing, both parents and healthcare providers may be at a loss for understanding the many available tests and how to determine which test (s) are most suitable for a child or adult with ASD.
Recommendations for further testing are based on my 10 years of experience as a director of the Laboratory of the Great Plains Laboratory, a medical laboratory that has conducted more tests for people on the spectrum of autism than in any other place in the world. My recommendations are now also based on the experience of my 14-year-old stepdaughter Paulina, who has severe autism.
Food allergies
The most useful test for people with autism is a comprehensive test for IgG allergies. The most common foods that are abnormal in children and adults in the spectrum are milk, cheese, yogurt, wheat, barley, rye, food, and soy. We documented these allergies at the Great Plains Laboratory, testing thousands of people’s blood samples from around the world. Several articles in medical journals report such anomalies.
The frequency of high IgG antibodies to wheat and milk is about 90% in people in the autism spectrum. Most people with an IgG allergy or sensitivity to cow's milk are also allergic to goat's milk. Other common allergies include peanuts, eggs, citrus fruits, corn, sugar and baker's yeast. There are various tests for allergies, so it is very important to check what type of test for allergies is offered. Despite the usefulness in some cases, I did not see that testing for food allergy to IgE was just as valuable for people with ASD. Unfortunately, this is the only type of food allergy test most labs offer.
Determine whether food allergic IgG reactions are present. These allergies or sensitites are associated with the reaction of products with certain leukocytes that secrete powerful cytokines, protein substances such as gamma-interferon, which can cause various behavioral changes and even psychosis. IgG allergies are found in children and adults across the full spectrum of autism, including autism, pervasive developmental disorder (PDD) and Asperger syndrome. These abnormalities are also very common in attention deficit disorder.
Limiting wheat and milk has been one of the most successful treatments for people in the spectrum. Before starting a gluten-free and casein-free diet, Polina spent most of the day shouting, crying, throwing a tantrum and pulling things off the shelves. She could not dine at the restaurant because she was so hyperactive that she squirmed from her seat and wandered around the restaurant. All these difficult behavioral conditions ceased after the introduction of a gluten-free and casein-free diet (as well as antifungal therapy).
Testing for celiac disease
Celiac disease is another common disorder of intolerance to wheat with a frequency of about 1: 150 among people of European descent. The incidence of this disorder does not appear to be higher in patients with autistic spectrum than in the general population, although people in the spectrum often also have celiac disease. Celiac disease can be confirmed by the presence of antibodies to the transglutaminase of the intestinal enzyme, which is involved in the biochemical processing of gluten.
Inhalant Allergy Testing
Allergies to what is happening in the air are called inhalation allergies. These allergies, unlike food allergies, need to be tested with IgE tests. Some of the most common allergies are mold, mold, pollen, cats, dogs, birds and dust. One child with autism had a serious behavioral reaction when a special teacher entered the classroom. After testing for inhalation allergies, we found that the child had a serious allergic reaction to the cat. The teacher was a cat lover and had several houses. Cat's hair will get on the clothes of the teacher and cause allergic reactions in the child. The child was transferred to another teacher, and the severe behavioral reactions ceased.
Yeast testing
Another very common anomaly in autism is the gastrointestinal overgrowth of Candida. Candida is a member of the yeast family - a type of fungus. Drugs that kill yeast or fungi are called antifungal drugs. The largest part of Candida is present in the intestinal tract, although sometimes it can enter the bloodstream and was found in the blood of children with autism by a highly sensitive test called PCR, which measures Candida DNA. There are about a dozen Candida species, but three of the most common are Candida albicans, Candida parapsilosis, and Candida krusei.
There are many reasons to combat the proliferation of Candida. Excessive Candida can interfere with normal digestion and absorption of nutrients into the bloodstream, as well as prevent the production of important vitamins necessary for optimal health. Candida produces many toxic by-products, including gliotoxins, which can cause a deterioration of the immune system. In addition, large portions of the Candida cell wall protein (HWP1) have a structure that is specifically identical to wheat gluten protein. Because of this similarity, Candida binds to the transglutaminase enzyme that is present in the intestinal membrane. This binding to transglutaminase binds the long strands of yeast cells to the intestines, like ivy climbing a brick wall. This binding prevents the mechanical removal of yeast as it passes through digested food. The binding of Candida to transglutaminase also interferes with the normal function of this enzyme when digesting gluten. If pieces of the Candida cell wall protein (which is similar to gluten) get into the blood, they can react with one of the blood clotting factors, which also has transglutaminase activity, which leads to interference with the blood clotting mechanism. These modified proteins cannot be recognized by the immune system, which can result in autoimmune diseases. Finally, Candida cells can also produce digestive enzymes, such as proteases and phospholipases, that actually eat up the intestinal membrane, allowing undigested food molecules to pass through the bloodstream and, as a result, cause more food allergies.
Candida can be detected by cultivating stools on petri dishes or by measuring the amount of chemicals produced in the intestinal tract. These by-products can be measured in the Organic Acid Urine Analysis (OAT), which also checks for congenital metabolic errors, nutritional deficiencies and other factors. These chemicals or fermentation products are absorbed from the intestinal tract by blood vessels called portal veins. These blood vessels carry these fermentation products to the liver, where they are distributed throughout the bloodstream. The blood containing these fermentation products is filtered through the kidney and excreted in the urine.
It is important to know that stool testing can often skip the presence of Candida when there are large amounts of antibodies in the intestine, called IgA. These IgA antibodies can cover yeast cells and inhibit their growth enough to prevent them from growing in a petri dish, although they can still grow enough in the intestines to cause problems. This situation can lead to a false negative result.
By experiencing the fermentation products of yeast in the urine, this problem can usually be overcome. However, about 10% of the yeast does not produce total fermentation products. We solved this problem by offering a COMBO test for both yeast fermentation products - an organic acid test (OAT), and for a culture of yeast from a chair. If the yeast can be cultivated, there is an additional advantage in that it is possible to determine the sensitivity of the yeast to various drugs or natural agents. Many yeasts have developed resistance to various antifungal drugs due to the widespread use of these drugs in people with human immunodeficiency virus (HIV) infection. Like people with HIV, many people with autism experience a serious lack of immunity to Candida. One of the possible reasons that people with autism face this problem is that the measles vaccine virus can seriously impair the ability of the cellular immune system (the vaccine on January 8, 2001) to control Candida. We found the same lack of cellular immunity in people with autism. The Laboratory of the Great Plains expects that an inspection of this defect and possible treatment will be carried out in the near future.
Along with the GF / CF diet, reducing or eliminating excessive growth of yeast was one of the most effective methods for reducing the symptoms of autism. For several years, Polina was on antifungal treatment (Nystatin), but her behavior deteriorated markedly. Testing showed that her yeast developed resistance to nystatin. With this change, it has become extremely hyperactive and incompatible. She spent most of her time crying and stumbling, she hardly slept and rolled things off the table. Within six hours after the start of the antifungal drug Diflucan, her normal, smiling behavior returned. Unfortunately, with long-term use, Diflucan can sometimes cause liver damage, so we introduced a limited carbohydrate diet to help control the yeast after we stopped Diflucan. With successful antifungal treatment, parents reported reduced aggressive and arrogant behavior, improved schooling, improved attention and concentration, improved sleep, and decreased hyperactivity. Many parents do not understand that antifungal treatment is a long-term problem of autism; others are antifungal drugs that are ineffective. It is important that antifungal treatment is carried out under the supervision of a qualified medical professional. A less expensive microbial organic acid test can be carried out regularly to ensure that yeast or harmful bacteria have not returned.
Testing for Clostridia
A few years ago, I began a joint study with Dr. Walter Gattaz, a psychiatric researcher at the Central Institute of Mental Health in Germany in Mannheim, to evaluate the urine samples of patients with schizophrenia. These samples were very valuable, as they were obtained from patients who were drug free. Thus, any biochemical abnormalities would be caused by their disease, and not by the effect of the drug. Five of the twelve samples contained a very high concentration of the compound identified as a derivative of the amino acid tyrosine, which is very similar to, but not identical to, 3,4-dihydroxyphenylpropionic acid. Since then, I have identified this compound as 3- (3-hydroxyphenyl) -3-hydroxypropionic acid or HPHPA. This particular compound is associated with the colonization of the intestinal tract by Clostridia bacteria.
How important is it for autism? HPHPA was found to be much higher in the urine of children with autism than in normal children. People with autism who have high values of this compound can have extremely abnormal or even psychotic behavior. One child with high HPHPA in the urine beat out the windows of a family car during transportation to school. Clostridia can be treated with antibiotics Vancomycin or Flagyl. The first patient in the medical study improved after treatment with flatilo, but then regressed when the drug was discontinued. The same child retreated with a six-week course of Vancomycin. A development specialist calculated that after six weeks of therapy, the child received six months of development. Again, the child regressed after discontinuation of therapy. The use of beneficial bacteria, Lactobacillus acidophilus GG, whose trade name is Culturelle, is very useful for controlling Clostridia spp. In most cases and can be safely used for many years if necessary. This product contains about a million grams of casein milk protein in each capsule, but such a small amount certainly has a significant effect on most people who are sensitive to milk.
HPHPA testing is also included in the complete organic acid test or the microbiological acid test in the Great Plains laboratory. It is important to know that some laboratories illegally measure DHPPA as a marker Clostridia.DHPPA is a by-product of chlorogenic acid, a common substance found in beverages and in many fruits and vegetables, including apples, pears, tea, coffee, sunflower seeds, carrots, blueberries , cherries, potatoes, tomatoes, eggplants, sweet potatoes and peaches. In addition, it is also a chemical by-product of good bacteria, E-coli and Lactobacillus.
Mercury toxicity
Mercury is a natural metal found in the environment. Mercury can enter the environment from ore deposits containing mercury due to wind or rain or from human actions. In addition to the mercury from the Thimerisol vaccine preservative, other major sources of mercury that contaminate humans are dental fillings, which make up about 50% of mercury and large fish such as tuna and swordfish.
Mercury exists in two basic forms, inorganic and organic. Inorganic mercury consists of metallic mercury and inorganic mercury compounds, called salts. Metallic mercury is a liquid at room temperature. It is a shiny silver material in thermometers and is usually combined with silver as an alloy for dental fillings. Liquid mercury from thermometers can release steam if the thermometer breaks, which can then be absorbed through the lungs. Mercury is also used in alkaline batteries. Organic mercury compounds include methylmercury, ethylmercury and phenylmercury. Methylmercury is produced from inorganic mercury by microorganisms in the environment and possibly microorganisms in the intestinal tract. Methyl mercury is extremely toxic. The impact of three drops of methyl mercury in the hands of the researcher's gloves was fatal. Exposure to mercury should be avoided at all costs.
It is important to note that the symptoms of mercury toxicity closely reflect the clinical symptoms of autism. The parents of a child who had developmental delays and muscle breakdown contacted me because the tests for children revealed high levels of mercury in the hair and blood. They reported that their child ate salmon or tuna five or six times a week. Although fish is an excellent source of essential fatty acids, most large fish have a significant amount of methylmercury. The FDA recommended that pregnant women refrain from certain fish with high mercury content. Since methylmercury is fat soluble, it can also contaminate additives derived from fish oil. In addition, mercury was used as an antifungal agent in paint until 1992. Before any of the older homes should know that flaking paint or flaking existing paint can lead to mercury. Mercury in pregnant women’s fillings can be a significant source of exposure to developing babies in the womb. Essential mercury, the most common preservative found in vaccines, is present as a preservative in other products: contact lens solutions, nasal sprays, as well as in ear and eye drops.
Heavy Metal Testing
Heavy metals can often have combined effects, so that exposure to several heavy metals at low levels can be as toxic as exposure to a single metal at a high level. Heavy metals found in children and adults with autism and PDD include uranium, mercury, cadmium, arsenic, lead, aluminum, and antimony. Hair is the simplest sample to collect in most cases and is usually considered one of the best samples for screening heavy metals, since heavy metals, such as mercury, can be 250 times higher in hair than in blood. However, the use of metal hair testing is inconsistent. New York State prohibits hair testing for heavy metals, while the Environmental Protection Agency (EPA) of the US government promotes hair screening for mercury as a very useful method. В штате Нью-Йорк могут потребоваться тесты на использование тяжелых металлов в крови или моче вместо волос. Хелатное лечение хелатирующим агентом DMSA, вероятно, является наиболее эффективным методом лечения в настоящее время для людей с ненормальными значениями.
Множественные тесты могут быть очень полезными, чтобы выявить наиболее значительные биохимические аномалии, чтобы лечение можно было сосредоточить на наиболее важных проблемах. Хотя каждый ребенок-аутист будет испытывать различные уровни успеха с помощью биомедицинских тестов и лечения, я хотел бы поделиться одной историей успеха, в которой излагается, что может случиться в некоторых случаях. Три года назад семья посетила Турцию со своим четырехлетним сыном с тяжелым аутизмом. Они застраховали, что им нужен каждый тест, предлагаемый лабораторией. Я попытался убедить их уменьшить финансовое бремя, предложив, какие тесты могут быть отложены позднее. Они не слушали и твердо заявляли, что получают все имеющиеся тесты. Через два года я получил письмо от родителей, которые выполнили все методы лечения, указанные в ходе тестирования. Их сын полностью выздоровел и успешно посещает обычный школьный класс без помощника.
Тесты, подчеркнутые в этой статье, были полезны людям с аутизмом любой степени тяжести. Родители и лечащие профессионалы, которые хотят начать биомедицинское тестирование, должны сначала начать с этой группы. Многие другие тесты могут быть полезны людям с аутизмом любого возраста; они указаны в таблице 1. Большинство тестов покрываются за счет страхования, но HMO обычно не платят, если врач не получает одобрение комитета по обзору.
Что касается родителей и специалистов, жизненно важно, чтобы мы были целостными в нашем подходе к лечению и изучали, влияют ли биомедицинские / биохимические агенты на аутичные симптомы. Только тогда мы сможем успешно справиться или устранить поведенческие проблемы, связанные с расстройствами аутистического спектра.
