The Plaza, Kansas City Comprehensive - PowerPoint Presentation

1. The Plaza, Kansas CityComprehensive Treatment Autism/ADHD William Shaw PhD The Plaza, Kansas City, MO

2. Autism: divergent viewsViewpoint one: Autism is a neurological disorder due to primarily genetic causes.Treatment is behavioral therapy and neuropharmacological therapy.

3. Autism: divergent viewsViewpoint two : Autism is a systemic disorder in which brain function is also affected due to toxic exposures, nutritional deficiencies, vaccine overuse or vaccine abuse, gastrointestinal dysfunction, food allergies, and genetic vulnerabilities. Treatment is directed to reduce and/or remove toxic chemicals, restore nutritional balance, restore beneficial flora, and remove foods that are not beneficial to the individual. Behavioral therapy helps to recover functions lost during suboptimum physiological state.

4. Thalidomide Introduced in 1956 as sedative (sleeping pill) and to reduce nausea and vomiting during pregnancy“Completely safe”Withdrawn in 1961-5 years too late for many childrenDiscovered to be a human teratogen causing absence of limbs or limb malformations in newborns5000 to 7000 infants effectedResulted in new drug testing rules

5. The causes of autismAlthough autism appears to be multifactorial, could there be a single factor that is much more important than others as in the case of thalidomide?Autism is more difficult to diagnose since children don’t have missing arms and legs

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9. Symptoms of autism/PDDPervasive developmental disorderLack of speech: expressive and receptiveStereotypical or odd behaviorSocial deficitsHyperactivity/hypoactivityPoor focus and concentrationReduced pain and danger perceptionPoor eye contact

10. Symptoms Underlying causesSleep disturbanceEye pain, eye touching or pokingHyperactivity, excessive laughingSpaced out, no sensitivity to pain, diet high in milk and wheatFrequent urination of small amounts of urineHead banging, hand bitingMelatonin, iron deficiencySevere calcium deficiencyGI candida, lead toxicityHigh concentration of opiate peptides from milk and wheatOxalate stones in urinary tractSevere GI pain

11. Symptoms Underlying causesBending over sofa with pressure against stomachWalking on toesExcessive droolingExtremely violent behavior, kicking, screaming, destructiveLooking at things by sideways glanceGI discomfort, painOxalate deposits in soles of feet, selenium deficiencyMercury toxicityClostridia overgrowthVitamin A deficiency

12. Comprehensive BiochemicalTestingOrganic acid test for genetic disease, toxics, and yeast and bacterial byproductsYeast culture and sensitivityCholesterol profileHeavy metalsIron stores-ferritinCopper/zinc profileComprehensive IgG food allergiesComprehensive inhalant allergiesImmune system deficienciesAmino acids and fatty acidsStrep antibodiesVitamin D

13. Reasons to give supplements for autism, ADHD and PDDMalabsorption due to lack of digestive enzymes or abnormal gastrointestinal floraDietary deficiencies due to special restricted dietNeed for higher than normally recommended nutrients due to abnormal metabolism or inborn errors of metabolism (genetic vulnerability)Help to detoxify toxic chemicals from environment or infections

14. Parental Rating of Various Nutrients for Autism compared to drugs

15. Why is the brain so susceptible to oxidative stress ?

16. The brain does not have adequate stores of antioxidantsThe brain has so much iron that it leads to significant production of free radicals that cause significant peroxidation of the fats in the cell membraneThe brain has a very limited capacity to regenerate after being damaged. Why the brain is a free-radical target

17. The brain has a very high percentage of essential fatty acids, that can be damaged by free radicalsThe brain requires a tremendous amount of the total oxygen used in the body, approximately 20% of the total oxygen.Why the brain is a free-radical target

18. Dolske MC, Spollen J, McKay S, Lancashire E, Tolbert L. A preliminary trial of ascorbic acid as supplemental therapy for autism. Prog Neuropsychopharmacol Biol Psychiatry. 1993 Sep;17(5):765-74.30-week double-blind,placebo-controlled trial of the effectiveness of ascorbic acid (8000 mg/70kg/day) for autistic childrenPacing, rocking, flapping, and whirling behaviors responded especially well to this high dose vitamin C regimen.

19. Eur Child Adolesc Psychiatry. 2006 May 13; Treatment of ADHD with French maritime pine bark extract, Pycnogenol.Results of double-blind placebo study show that 1-month Pycnogenol administration caused a significant reduction of hyperactivity, improves attention and visual-motor coordination and concentration of children with ADHD. In the placebo group no positive effects were found. One month after termination of Pycnogenol a relapse of symptoms was noted.

20. The plasma zinc/serum copper ratio as a biomarker in children with autism spectrum disorders. Scott Faber et al Biomarkers March 11,2009The Children's Institute, Pittsburgh, PA, USA A retrospective review of plasma zinc, serum copper and zinc/copper was performed on data from 230 children with autistic disorder, pervasive developmental disorder-NOS and Asperger's syndrome. The entire cohort's mean zinc level was 77.2 mcg/dl; mean copper level was 131.5 mcg/dl, and mean Zn/Cu was .608, which was below the 0.7 cut-off of the lowest 2.5% of healthy children. The plasma zinc/serum copper ratio may be a biomarker of heavy metal, particularly mercury, toxicity in children with ASDs.

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22. Destruction of vitamin C by free copper or iron ions without SODCu Cu Cu CuCu Cu Cu CuCu CuAscorbate (Vitamin C)DehydroascorbateFree copper has as much SOD activity as SOD

23. Zinc deficiency

24. Severe zinc deficiencyPhysical symptomsSkin rashPoor appetiteFrequent infectionsNail white spots

25. Children With Autism: Effect of Iron Supplementation on Sleep and Ferritin. J.Pediatr Neurol.2006.11.004. Cara F. Dosman MD, 33 children with autism in study.77% had restless sleep at baseline, which improved significantly with iron therapy, 69% of preschoolers and 35% of school-aged children had insufficient dietary iron intake. Mean ferritin increased significantly (16 μg/L to 29 μg/L), as did mean corpuscular volume and hemoglobin, suggesting that low ferritin in this patient group resulted from insufficient iron intake.

26. Need for calcium and/or vitamin D supplementation in autismBecause of milk and dairy restriction many children with autism or ADHD may be calcium deficient and may also be vitamin D deficient due to lack of milk and or not enough sun exposureMost children after 2 years of age need 1000 mg per calcium

27. Need for calcium and/or vitamin D supplementation in autismNeed for calcium in autism is critically needed for strong bones and teethSpecial need in autism due to eye poking behavior associated with calcium deficiency, milk-free dietOver 20 children with autism have poked out own eyes.

28. Cannell JJ. Autism and vitamin D. Med Hypotheses 2008;70:750-759.Children with rickets have hypotonia, decreased activity, developmental motor delay, listlessness, failure to thrive, and other autistic Children with the Williams syndrome , some of whom have greatly elevated calcitriol levels for several months in early infancy, have remarkable sociability, overfriendliness, empathy, and willingness to initiate social interaction, strikingly the opposite phenotype of autism.A placebo controlled three-month study of 20 autistic children found multivitamins with low doses of vitamin D (150 units or 3.75 mcg) significantly improved sleep and gastrointestinal problems

29. Recommended daily doses of essential minerals; more needed in deficiencyAge in yrsAmount of calciumAmount of magnesiumAmount of zinc1-4800 mg100 mg2.5 mg5-10 800-1000 mg200 mg5 mg>10 800-1200 mg350-45015 mg

30. J Am Coll Nutr. 2002 Feb;21(1):14-21. Lithium: occurrence, dietary intakes, nutritional essentiality. Schrauzer GN.Low lithium intakes from water supplies were associated with increased rates of suicides, rape, homicides and the arrest rates for drug use and other crimes.The available experimental evidence now appears to be sufficient to accept lithium as essential; a provisional RDA for a 70 kg adult of 1,000 micrograms/day is suggested.

31. Toxic Metals and Essential Minerals in the Hair of Children with Autism and their Mothers J.B. Adams1; C.E. Holloway1; F. George2; D. Quig3 The levels of 39 toxic metals and essential minerals in hair samples were determined for children with autism spectrum disorders and a subset of their mothers compared to controls.     Iodine levels were 45% lower in the children with autism (p=0.005).      Lithium levels were 30% lower (p=0.04) in the younger children with autism . The mothers of young children with autism had especially low levels of lithium.

32. What if water is too pure?

33. Hair elements test profile –autism-

34. Clinical usefulness of high dose vitamin-B-6 in autismV. E. Bonisch, reported in 1968 that 12 of 16 autistic children had shown considerable behavioral improvement on high dosage levels (100 mg to 600 mg per day) of vitamin B6. Three of Bonisch's patients spoke for the first time after vitamin B6 was administered in this open clinical trial.

35. Improvements in autism noted with vitamin B-6 megadoseBetter eye contactLess self-stimulatory behaviorMore interest in the world around themFewer tantrumsMore speech Some children spoke for first timeLess aggressive behavior

36. Benefits of different fats in autism and ADHD

37. What are omega-3 and 6 fatty acids                                                                                                        

38. Vancassel S, et al Plasma fatty acid levels in autistic children. Prostaglandins Leukot Essent Fatty Acids 2001;65(1):1-7.Total omega-3 fatty acids 20% lower than control group with mental retardationOne omega-3 fatty acid (DHA) was 23% lower than control groupThis deficiency has also been found in schizophrenia,attention deficit, and Rett’s syndrome20% of dry weight of brain is polyunsaturated fatty acids

39. JG Bell et al Prostaglandins Leukot Essent Fatty Acids. 2004 Oct;71(4):201-4. Essential fatty acids and phospholipase A2 in autistic spectrum disorders.Benefits of omega-3 supplementationLess aggression Less hyperactivity Improvements in sleep Improvements in speech and behavior Improved ability of the child to concentrate

40. High cholesterol in children is associated with decreased mortality57.5% of ASD childrenare below this value (<160)Child mortality rate in differentcountriesSerum cholesterol mg/dL

41. Cholesterol in children with autistic spectrum disorderLow cholesterol 57.5% Extremely low cholesterol 17.5%The Great Plains Laboratory cholesterol studyOf children with autistic spectrum disorder

42. Other new reports of cholesterol supplements in autism-Case 1Neurologist: Marked reduction in anxiety in 17 year old girl with autism. In addition, the girl had normal menstrual periods for the first time.

43. Other new reports of cholesterol supplements in autism-Case 2A woman called to say that her son is significantly less aggressive when on just one capsule (250 mg) of Cholesterol.He stopped head banging and being aggressive toward others.  In addition, after a couple of months on the product, her son started to spell for the first time.She stopped it for one week and his aggressiveness came back so she is a believer.

44. Other new reports of cholesterol supplements in autism-Case 3I wanted to let you know that my son’s cholesterol went up 20 points to 131 after taking cholesterol supplements for a month. He is improving wonderfully. However, the proof is in way more than the numbers. Babbling is back and he is watching my lips when I talk to him. He understands and follows verbal commands. He learned to give himself a drink from a cup (I used to give him a bottle) during the first month on sonic, two weeks ago he learned to climb stairs and yesterday he fed himself with a spoon. Best of all, he is happy now! He smiles and laughs -- with people!!! At 12 months of age my son would be best described as catatonic, rather than autistic -- he was extremely severe.

45. Other new reports of cholesterol supplements in autism-Case 4My son's cholesterol number came back at 106, the lowest our DAN's office had seen. We have been on cholesterol supplementation for 2 days and my son has been making great eye contact and been very interested in connecting with me. I haven't done anything else new in a while so I am pretty excited that this might be doing something.

46. Other new reports of cholesterol supplements in autism-Case 5 “Cholesterol supplementation raised my son's cholesterol level from 117 to 159. We have to give him 5 capsules/day to maintain that cholesterol level but we had a dramatic decrease in his aggression at school overnight when we started it. His teachers and therapists all asked us what we were doing. He is allergic to eggs, but we couldn't have given him enough eggs to make a difference anyway. It was a amazing for us.”

47. Dosing of eggs or cholesterolDetermine total cholesterolIf 160 or more,the patient doesn’t need more cholesterolSubtract patient’s cholesterol from 160 mg/dL, then divide by 10 to determine daily dose of cholesterol in 250 mg capsules or eggsIf patient’s cholesterol is 100,160-100=6060/10=6=number of eggs or 250 mg cholesterol capsules per day One average egg=250 mg cholesterol

48. AbnormalGastrointestinalFlora in autism

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52. Candida Overgrowth of Esophagus

53. Normal Intestine****

54. After Antibiotics

55. Stool Yeast and Urine Organic Acids in Child With IgA Deficiency and Autism  arabinose in urine* *mmol/mol creatinine Candida parapsilosisstool before therapy 341 4+after therapy with antifungals 51 nonedetected normal range 0-115 0-1+

56. Symptoms Improved by Antifungal Increased focus and concentrationImproved receptive and expressive languageReduced bowel symptomsIncreased eye contact and socializationReduced self-stimulatory behaviorReduced aggressive and self-abusive behaviorsReduced Candida symptoms such as thrushReduced skin rashes

57. Prescription AntifungalsNystatin-Mycostatin-very little toxicityAmphotericin BFluconazole-DiflucanItraconazole-SporanoxKetoconazole-NizoralTerbinafine-Lamisil

58. Over the Counter AntifungalsCaprylic Acid, caprylatesMCT oilCoconut oilGarlicOreganoAloe vera (oral)GoldensealPau d’arcoGrapefruit seed extractTanalbit Candex (cellulase enzymes)

59. Candida defense formulaBiotinZinc undecylenateOregano leaf extractPau d’arcoSodium caprylateBerberineCinammon bark extractGinger rootGrapefruit seed extract

60. Side Effects Associated with the Yeast “die-off” ReactionLethargy(tiredness)FeverIncreased stereotypical behaviorIncreased hyperactivityNausea,vomitingAlka-Seltzer Gold neutralizes some of the toxic acids produced

61. ClostridiaBacteriaand Autism

62. Endoscopy of Colon of Patient with MildClostridium Difficile Overgrowth

63. Endoscopy of Colon of Patient with Severe Clostridium Difficile Overgrowth- pseudomembranous Colitis

64. J Child Neurol 2000 Jul;15(7):429-35 Short-term Benefit from Oral VancomycinTreatment of Regressive-onset AutismSandler RH, Finegold SM, Bolte ER, Buchanan CP, MaxwellAP, Vaisanen ML, Nelson,MN, Wexler HM11 children with regressive-onset autism were recruited for an intervention trial using vancomycin. A clinical psychologist blinded to treatment status..noted improvement in 8 of 10 children studied. “…these results indicate that a possible gut flora-brain connection warrants further investigation”

65. Properties of Clostridia BacteriaStrict anaerobe-dies when exposed to oxygenCauses tetanus,diarrhea, and botulism (food poisoning)Forms spores that are highly resistant to heat and antibioticsAbout 100 species of Clostridia in GI tractControlled by vancomycin, metronidazole, and Lactobacillus acidophilus GG

66. HPHPA(MMOL/MOL CREATININE)0.00200.00400.00600.00800.001000.001200.001400.001600.001800.002000.00N = 14N = 30N = 211CONTROLMALEINFANTSCONTROLMALE CHILDRENAUTISTICMALES2 - 13 YRS2 - 13 YRSMale controlinfantsControlMales2-13 yrAutistic males2-13 yr

67. Structure of 3-(3-hydroxyphenyl)-3-hydroxypropionic acidHOCHOHCH2COOH

68. CH2CHCOOHNH2CH2CHCOOHNH2HOtyrosineCH2CHCOOHNH2HOmicrobialm- tyrosine CH2CH2COOHCH2CH2COOHHONH2phenylpropionic acidNH23-hydroxyphenyl-propionic acidCH2CHCOOHNH2HO3,4-dihydroxyphenylalanineDOPA)HOCH2CHCOOHNH2HOHODOPA analogmicrobial dopaminenorepinephrinedopamine analognorepinephrine analoghuman beta-oxidationCHOHCH2COOHHO3-(3-hydroxyphenyl)-3-hydroxypropionic acid HPHPAHOCOOH3-hydroxybenzoic acidglycine3-hydroxybenzoylglycine(3-hydroxyhippuric)microbialmicrobialhuman beta oxidation enzymesphenylalanine phenylalanine hydroxylasetyrosine hydroxylasetyrosine hydroxylase

69. Effect of anti-Clostridia therapy on urine excretion of HPHPA* in woman with depression and chronic fatigue

70. Effect of anti-Clostridia therapy on urine excretion of HPHPA* in young woman with acute psychosis

71. Treatments for Clostridia BacteriaVancomycinFlagyl (metronidazole)Lactobacillus acidophilus GG (Only probiotic patented for use in control of Clostridia)Saccharoyces boulardii-occasionally causes hypoglycemia-cannot be used with antifungal agents

72. Bacteriologist Elie Metchnikoff in his laboratory "Etudes sur la flore intestinale. 1er mémoire : Putréfaction intestinale " Ann. Inst. Pasteur Paris, 22, pp. 929-955.

73. William Shaw Ph.D, in his laboratoryField trip to the Amazon rainforest

74. Pyrethrins-common insecticide

75. Pet shampoo: Contain pyrethrins and piperonyl butoxide, inhibitor of cytochrome P-450

76. I. Hertz-Picciotto, et al Public Health Sciences and the M.I.N.D. Institute, University of California at Davis, International Meeting for Autism Research (IMFAR) Household Pesticide Use in Relation to Autism, May 2008Mothers exposed to pet shampoos (almost all pyrethrins) were twice as likely to have a child with autism.The worst exposure time was the second trimester.

77. Pesticide Application

78. E. Guillette et al, "An Anthropological Approach to the Evaluation of Preschool Children Exposed to Pesticides in Mexico," ENVIRONMENTAL HEALTH PERSPECTIVES 106: 347-353,1998.The pesticide-exposed children● Far less physical endurance in a test to see how long they could keep jumping up and down ● Inferior hand-eye coordination● Could not draw a simple stick figure of a human being, which the nonexposed children could readily do.

79. "Some valley (pesticide-exposed) children were observed hitting their siblings when they passed by, and they became easily upset or angry with a minor corrective comment by a parent. These aggressive behaviors were not noted in the [pesticide-free] foothills [children]."E. Guillette et al, "An Anthropological Approach to the Evaluation of Preschool Children Exposed to Pesticides in Mexico," ENVIRONMENTAL HEALTH PERSPECTIVES 106:347-353,1998.

80. Eric M. Roberts, et al Maternal Residence Near Agricultural Pesticide Applications and Autism Spectrum Disorders among Children in the California Central Valley Environ Health Perspect. 115(10): 1482–1489, 2007Children exposed to pesticides called organophosphates used to kill insects had more than twice the risk of developing pervasive developmental disorder (PDD). For organochlorines,there was 7X autism rateMothers exposed to such pesticides were also likely to have shorter pregnancies and their children to have impaired reflexes .

81. Reduced ability to detoxify pesticides in autism. Life Sciences 78 (2006) 2244-2248AutismControlsPON1Enzyme activity

82. Autism rates in Texas1990-19931998-2001

83. Comparison of autism rates and industrial pollution in TexasAutism rate1998-2001Pounds of industrial toxic release

84. Victim of mercury toxicity

85. Hair mercury values in Minamata bay victimsValues of hair mercury were all elevated. Most of those who died were extremely elevated(500-1000 ppm)1787 people diedGreat Plains has tested some people in this range who used a beauty cream with mercury

86. Effect of mercury dose on autism incidence in the USA

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88. Environmental mercury release, special education rates, and autism disorder: an ecological study of Texas Raymond F. Palmer, et alThere has been a significant increase in the proportion of children in special education and autism associated with mercury released into the environment. For every 1000 lb of mercury liberated into the environment, there has been a 43% increase in the rate of special education students and a 61% increase in the percentage of students with autism.

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92. Lead increases death from many diseases

93. Hair metals in boys with autismn=40 boys per group, age matchedAutism 9:290-298,2005

94. Comprehensive BiochemicalTestingOrganic acid test for genetic disease, toxics, and yeast and bacterial byproductsYeast culture and sensitivityCholesterol profileHeavy metalsIron stores-ferritinCopper/zinc profileComprehensive IgG food allergiesComprehensive inhalant allergiesImmune system deficienciesAmino acids and fatty acidsStrep antibodiesVitamin D

95. The Plaza, Kansas CityNutritional Treatment Autism/ADHDWilliam Shaw PhD The Plaza, Kansas City, MOThank You!