Autism: Beyond the Basics

Autism: Beyond the Basics

Treating Autism Spectrum Disorders

By William Shaw, Ph.D.

With Contributions By:

Kurt Woeller, D.O.

Daniel Rossignol, M.D.

Lenny González, M.D.

Denise Tarasuk, R.N., N.D.

Doris Rapp, M.D.

Smashwords Edition

Copyright 2010 © by William Shaw, Ph.D.

ISBN 978-0-9661238-7-6

A print copy of this book can be purchased at www.greatplainslaboratory.com

Smashwords Edition, License Notes

This ebook is licensed for personal use only. This ebook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each person. If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy. Thank you for respecting the hard work of this author.

DISCLAIMER

This book is a summary of current research and medical therapies in use for the treatment of autism and PDD. The authors have written this book to serve as a guide to therapies and as a reference source for both professionals and nonprofessionals. All of this information is meant to be used under the care of the patient's health care professional and the authors do not intend that the information in this book be considered as a prescription for medical therapy for anyone. Many of the therapies discussed in this book are relatively new and may be associated with risks that may not be known for decades. Every medical therapy has inherent risks. The reader and the medical professional who treats himself or his children are responsible for weighing the risks involved in any of the therapies reviewed in this book before instituting such therapies. Although the authors have exhaustively researched all sources to ensure the accuracy of the information in this book, we assume no responsibility for errors, inaccuracies, or omissions.

ACKNOWLEDGEMENTS

I would like to thank the following individuals who have assisted me in many different ways in this work: all of the coauthors of this book, the hundreds of other parents and professionals who supported and encouraged my work, my wife Leticia Dominguez-Shaw for her support and encouragement in writing this new book, Ricardo Martin del Campo and Tina Marie Kraemer for the graphic design assistance and illustrations, Laura Rangel for the proofreading and typing of the manuscript, and Lori Knowles for her excellent editing and suggestions.

William Shaw, Ph.D.

Table of Contents

Chapter 1

Nutritional Treatments in Autism by William Shaw, Ph.D.

General Considerations; Fatty Acids - Essential and Nonessential; Side Effects of Fatty Acid Supplements Associated With Carnitine Deficiency; Smith-Lemli-Opitz Syndrome, Autism, Sonic Hedgehogs, Brain Development and the Need for Cholesterol; Severe Cholesterol Deficiency in Children with Autism without SLOS; What is the Reason for the High Percentages of Very Low Cholesterol Values in Children with Autism; Testing for Cholesterol Deficiency in Autism; Benefits of Cholesterol Supplementation to People with Regular Autism; Paulina’s Story and Cholesterol; Lithium, the Autism Epidemic and the Bottled Water Craze; Amino Acids and Protein Intake; General Patterns of Amino Acid Abnormalities in Autism; Assessment of Adequate Protein Intake with Serum Prealbumin; Specific Amino Acid Abnormalities Prevalent in Autistic Spectrum Disorders; Methylcobalamin: A Special Form of Vitamin B-12 that Regulates Sulfur Amino Acid Metabolism; The Importance of Methionine and its Metabolites; Difficulties in Direct Supplementation of Certain Sulfur-Containing Amino Acids; Defects in Urea Cycle: The Importance of Orotic Acid in Autism; Vitamins; Vitamin B-6; Benefits of Vitamin B-6 in Autism; Side Effects of Vitamin B-6; The Importance of Antioxidants and How They Protect Against Oxidative Damage; Vitamin B-12 in Autism; Polymorphisms, Common Genetic Risk Factors for Autism; TMG and DMG; Need for Coenzyme Q-10 in Autism.

Chapter 2

Copper and Zinc Dysregulation by William Shaw, Ph.D.

Nature of Copper and Zinc; Biochemical Functions of Copper and Zinc; Mechanism of Copper Absorption, Transport and Excretion; Metallothionein, Zinc, Copper and Heavy Metals; Health Effects of Excessive Zinc; Defective Metallothionein as a Factor in Autism; Is Autism a Form of Wilson’s Disease or Closely Related Disease of Copper Excess; Inadequate Binding of Iron and Copper in Autism: Direct Correlation with Degree of Impairment in Autism.

Chapter 3

Oxalates in Autism by William Shaw, Ph.D.

Discovery of a Dietary Treatment and a Major Biochemical Abnormality in Autism; How Can High Oxalates Be Treated; Metabolism of Oxalates and Genetics of Oxalate Abnormalities; Adopting a Low Oxalate Diet; The Solubility Factor of Oxalate Salts; Other Evidence That Oxalates Cause Behavioral Disorders.

Chapter 4

A Typical Child Diagnosed with Autism by Kurt Woeller, D.O.

The Regressive Autism Child; Approaching Autism as a Medical Issue; Treating the Patient - Not Their Diagnosis; Your Child Deserves Better; My Comprehensive Biomedical Approach to Testing and Treatment for a Child with ASD – Various Scenarios of Intervention, Diagnostic Findings, and Patient Responses; A Comprehensive Laboratory Assessment; Test Highlight (Organic Acid Test); Clostridia – and the Case of Violent Behavior; The Importance of Dietary Intervention and the Powerful Impact Food Can Have On Behaviors; Oxalates (Oxalic Acid and the Low Oxalate Diet, (aka. LOD); Test Highlight: (Comprehensive Stool Testing); Test Highlight (Heavy Metal Assessment); Fecal Metals; Hair Analysis; Blood Metal Testing; Urine Metal Testing; Porphyrin Profile.

Chapter 5

The Use of Hyperbaric Oxygen Therapy in Autism by Daniel Rossignol, M.D.

Introduction; Review of the Pathophysiology of Autism and Possible Benefits of HBOT; HBOT and Cerebral Hypoperfusion; Neuroinflammation in Autism; Gastrointestinal Inflammation in Autism; HBOT and Inflammation; Immune Function in Autism; HBOT and Immune Function; Oxidative Stress in Autism; HBOT and Oxidative Stress; Mitochondrial Dysfunction in Autism; HBOT and Mitochondrial Dysfunction; Neurotransmitter Abnormalities in Autism; HBOT and Neurotransmitter Abnormalities; Toxin Exposure in Autism and HBOT; Dysbiosis in Autism; HBOT and Dysbiosis; Stem Cells and HBOT; Rationale for HBOT Use in Autism; Review of Studies in HBOT and Autism.

Chapter 6

Gastrointestinal Symptoms in Autistic Spectrum Disorders by Lenny González, M.D.

Review of the Gastrointestinal Tract and Terms; Etiology of the Pathology; Bacteria in the Gastrointestinal Tract; Yeast Overgrowth; Permeable Intestine: Characteristics of the Intestinal Mucosa; Clinical Manifestations; Clinical Workup of Patients in the Pediatric Gastroenterology Clinic; Endoscopy Studies; Therapeutic Approach to Treatment of the Gastrointestinal Tract in Autistic Spectrum Disorder; A Step-by-step Treatment; Conclusions.

Chapter 7

Healing Autism: A Holistic Journey by Denise Tarasuk, R.N., N.D.

Treating Autism Spectrum Disorders; Tarasuk Model of Wellness; Homeopathy: Stimulating the Vital Force; How is Homeopathy Useful; What Does Homeopathy Treat; What are the Most Helpful Treatments for Autism; Botanical Medicine; Nutritional and Dietary Interventions; Case Study: Ryder Tells the Truth; Assessment for Ryder; Care Plan for Ryder; A Case Study: Mark is a Very Passionate Person; Summary.

Chapter 8

ADHD to Autism: Some Fast, Easy and Inexpensive Answers by Doris Rapp, M.D.

Introduction; How to Recognize Unsuspected Allergies in Different Age Groups; Age-Related Clues to Allergy; Easy Clues to Help You Recognize and Possibly Treat Food Allergies; What Else Can You Do to Pinpoint Why Your Child is Ill; What Do You Do After You Have Found the Cause; Tips on Inside the Home, School and Workplace: Things to Consider.

Preface

A tremendous number of new therapies have been developed since the publication of my book Biological Treatments for Autism and PDD ten years ago. A large number of physicians now treat children on the autistic spectrum with a Defeat Autism Now approach termed biomedical, meaning that the therapies are directed at the underlying causes of autism rather than a pharmaceutical approach directed toward controlling symptoms. I wish to emphasize that I am not opposed to such pharmacologic intervention in an emergency situation until the parents and their physician implement the necessary tests and treatments.

Gastrointestinal abnormalities in autism were first detected by Andrew Wakefield, M.D. in the United Kingdom, and by Arthur Kriegsman, M.D. and Karolyn Horvath, M.D. in the United States of America. The origin of these abnormalities is controversial and complex with causation attributed to vaccine damage mediated by toxic chemicals such as thimerosal and live viruses in these agents, allergic reactions to milk, wheat, and other foods, as well as to infections with Candida, Clostridia bacteria, and parasites. Dr. Lenny González has confirmed most of the previous work in her gastroenterology clinic in Venezuela and offers a good overview of the common gastrointestinal abnormalities in autism.

Significant new biochemical abnormalities have been found in the majority of people with autism including a deficiency of cholesterol as well as elevated amounts of oxalates, which are toxic and even potentially fatal. Supplementation of cholesterol has reversed autistic symptoms present in the genetic disorder SLOS in which the major genetic defect is a deficiency in the enzyme needed for the body to make cholesterol. Early results appear equally promising in regular autism not caused by SLOS. A major double-blind placebo control study of autism is now underway. Research on the developmental protein Sonic Hedgehog has revealed a unique role for cholesterol such that, in addition to the role of cholesterol in cell structure and as a raw material for bile salts and steroid hormones, it also acts as a coenzyme in Sonic Hedgehog activation. The findings that low amounts of apolipoprotein B, a major cholesterol protein, is prevalent in autism and that the degree of deficiency of this protein is related to symptom severity are highly significant. It is likely that a significant portion of the unfolding story of cholesterol metabolism abnormalities will be intertwined with the story of autism's biology and may also provide insight into connections with the frequent Candida problem prevalent in autism as well as a possible connection to mercury toxicity.

Hyperbaric oxygen treatment has become a standard treatment for autistic spectrum disorders and Dr. Daniel Rossignol has done a good job in completing formal scientific studies that document its effectiveness. Dr. Kurt Woeller, a physician with more than ten years experience in the biomedical approach to autism treatments, summarizes the overall biomedical approach to the treatment of autism. The utilization of homeopathy in autism treatments is summarized by Dr. Denise Tarasuk. Dr. Doris Rapp, one of the giants in the field of pediatrics and environmental medicine, summarizes some of the most common approaches to the treatment of allergies and environmental sensitivities for people on the autistic spectrum.

About the Authors

William Shaw, Ph.D. received a Ph.D. in biochemistry and human physiology from the Medical University of South Carolina. He is board certified in the fields of clinical chemistry and toxicology by the American Board of Clinical Chemistry. He has supervised large endocrinology, nutritional biochemistry, and toxicology and immunology departments in positions at the Center for Disease Control (CDC) and Smith Kline Laboratories in Atlanta. He was Director of Clinical Chemistry, Endocrinology and Toxicology at Children's Mercy Hospital, the teaching hospital of the University of Missouri at Kansas City School of Medicine. Dr. Shaw is now the Director of The Great Plains Laboratory, Inc. for Health, Nutrition and Metabolism in Lenexa, Kansas specializing in comprehensive biochemical testing for autism spectrum disorders. He is author of Biological Treatments for Autism and PDD and is a frequent speaker at autism conferences worldwide. He is the stepfather of a child with autism and has helped thousands of parents and physicians successfully contribute to improving the lives of autistic children.

Kurt Woeller, D.O. is currently the medical director for Stillpoint Center for Integrative Medicine in Temecula, CA. Dr. Woeller lectures for, and is the Autism Outreach Clinical Director for The Great Plains Laboratory, Inc. He serves as a clinical consultant teaching doctor's the latest in biomedical diagnostic testing and treatment protocols for children with ASD. He is an osteopathic physician who specializes in traditional osteopathic medicine, cranial osteopathy and integrative medicine with a primary focus on ASD. He graduated in 1995 from the University of New England, College of Osteopathic Medicine (UNECOM) in Biddeford, Maine. After completing his postgraduate training in 1996 from Mesa General Hospital in Arizona he returned to San Diego, CA to begin private practice. Since 1998 Dr. Woeller has been a referral physician for Defeat Autism Now!

Daniel Rossignol, M.D. is on staff at the International Child Development Resource Center (ICDRC), a former Clinical Assistant Professor at the University of Virginia Department of Family Medicine and a Defeat Autism Now! (DAN!) physician. He received his Doctorate of Medicine at the Medical College of Virginia and completed his residency in family medicine at the University of Virginia. He is the father of two children with autism, ages six and four. International Child Development Resource Center, 3800 W. Eau Gallie Blvd., Suite 105, Melbourne, FL 32934. Phone: 321-259-7111; email: rossignolmd@gmail.com.

Lenny González Chávez, M.D. is a surgeon and Defeat Autism Now-trained physician. She trained at the Universidad del Zulia, Venezuela. She is a specialist in Gastroenterology, Child Nutrition, Pediatrics and Pediatric Radiology of the gastrointestinal tract at the Dr. Miguel Pérez Carreño Hospital, Caracas, Venezuela, a previous Vice-president of the Latin American Society of Gastroenterology, Hepatology and Pediatric Nutrition, and President of the Pediatric Gastroenterology of the Venezuelan Society of Child Care and Pediatrics. She is also a member of the Venezuelan Society of Gastroenterology and of the Medical Board of the Caracas Metropolitan District. Dr. González is a frequent speaker at international conferences and seminars on autism in Latin America, Europe, and the United States, is an author of several scientific papers and was awarded the Second National Pediatrics Prize in 2005. In the last few years she has actively worked in research on gastrointestinal issues in autistic children.

Denise Tarasuk, R.N., N.D. is a licensed doctor of Naturopathic Medicine. She has a doctorate degree from Southwest College of Naturopathic Medicine in Tempe, Arizona and currently has a family practice. She is a registered DAN! Practitioner and a bi-weekly speaker for Autism One Radio. Dr. Tarasuk specializes in children with behavioral problems and children on the autistic spectrum. Her natural treatments and therapies include: homeopathy, botanical (herbal) medicine, nutrition, Ayurvedic medicine and lifestyle changes using a holistic approach when treating children and adults in her family practice.

Doris Rapp, M.D. is a world-famous, board-certified environmental and allergy specialist and pediatrician. She has published many articles and is a New York Times bestselling author who has appeared on Oprah and many other nationally-televised talk shows. Dr Rapp was a clinical assistant professor of pediatrics at the State University of New York at Buffalo. She is the founder of the Practical Allergy Foundation in Buffalo and is a past president of the American Academy of Environmental Medicine. Her books include Is This Your Child's World?, Is this your child?, and Our Toxic World.

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Chapter 1

Nutritional Treatments in Autism

By William Shaw, Ph.D.

A wide variety of nutritional supplements may be helpful to the child on the autistic spectrum because of the

following factors:

• Many children with autism may have genetic diseases or be carriers of genetic diseases that make them more vulnerable to deficiencies of vitamins or other nutritional factors. Documented genetic vulnerabilities include: increased incidence of heterozygous state for mutations in methionine synthetase(1), methylene tetrahydrofolate reductase(2), and vitamin B-6 dependent enzyme reactions(3,4). Because of these defects, higher than normal amounts of vitamins are needed for these critical biochemical reactions to proceed at a normal rate.

• Exposures to toxic chemicals may impair the rate of various enzyme reactions. For example, mercury inhibits methionine synthetase(5). Supplementation with high doses of methylcobalamin, a methylated form of vitamin B-12 may be able to bypass this metabolic block(6).

• A child with a picky or poor appetite may not get the necessary balance of nutrients in his restricted diet. In addition, children with severe esophageal Candida may not eat because their esophagus is so raw that the passage of food is painful.

• Diarrhea may result in such a rapid transit of food across the digestive tract that there is inadequate time for food to be digested or absorbed. Constipation may also result in decreased digestion or absorption of food due to the lack of physical space or surface area for digestion and absorption to occur.

• Dysbiosis, or abnormal gastrointestinal flora, impacts nutrition in multiple ways. First, these organisms compete with their human host for essential vitamins, minerals, amino acids, carbohydrates, and fats. Second, these organisms may produce chemicals that inactivate key nutritional factors or block their effects. A good example is the blockade by arabinose of key enzymes that require biotin, lipoic acid, or vitamin B-6 derivatives discussed in the chapter on organic acids. Dysbiosis is also a common cause of diarrhea and constipation. Furthermore, microbial antigens like Candida cell wall antigens bind to key enzymes(7) in the gastrointestinal tract, blocking the digestion of important proteins like gluten. In some cases, Candida may even destroy certain important vitamins like coenzyme Q-10(8). I find that high levels of glutaric and succinic acids are common in the organic acid test of The Great Plains Laboratory when Candida metabolites are present. The enzymes that breakdown these acids are both coenzyme Q-10 dependent.

• Excess additional nutrients may be needed to speed up the elimination of toxic chemicals to which the person may have been exposed. For example, glutathione has been shown to be a required substance for the detoxification of halogenated hydrocarbons, pesticides like DDT, and environmental contaminants like polychlorinated biphenyls (PCBs)(9, 10).

GENERAL CONSIDERATIONS

The following factors need to be considered with the use of all nutritional supplements.

• Almost all supplements are tolerated better when combined with food.

• Even if children can swallow pills or capsules, taking large numbers of these at one time may lead to nausea or vomiting, which won’t be helpful at all. Relax a little and go at a slower pace!

• Supplements like vitamin B-6 and vitamin C may be given in megadoses, or doses far in excess of generally accepted recommendations. These supplements should be given by themselves so that any potential side effects can be recognized. Also, dosing at lower amounts and increasing slowly will help minimize any adverse reactions.

• If you are unsure whether any particular reactions may be due to a supplement, discontinue the supplement and see if the reaction stops. Try the supplement again at a much lower dose.

• Always make sure that you have correctly read all of the appropriate information about dosages and are giving the recommended amounts.

• Sometimes reactions may be due to colors, flavors, or fillers in the supplement, not the active agent itself. The use of the same supplement in a more pure form with minimal additives may be very useful in such cases.

• I have known of isolated cases in which children with autism have had odd reactions against virtually every supplement I know.

FATTY ACIDS – ESSENTIAL AND NONESSENTIAL

Fatty acids are the major components of chemical compounds called fats or triglycerides. Both animals and plants have the ability to make a wide variety of fatty acids with different numbers of carbon atoms. The majority of fatty acids found in foods have an even number of carbon atoms with a maximum number of carbon atoms approaching 22. Individuals with genetic diseases called peroxisomal disorders have increased amounts of fatty acids in the blood with as many as 30 carbon atoms due to an inability to breakdown these larger fatty acids. Humans possess the ability to add a chemical grouping called double bonds to fatty acids. The addition of these double bonds makes the part of the molecule holding the double bond more rigid. Fatty acids with double bonds have a tendency to liquefy at lower temperatures than fatty acids without theses double bonds. Fatty acids or fats containing double bonds are called unsaturated while those containing no double bonds are called saturated (Figure 1). If there are multiple double bonds in the unsaturated fat, it is called a polyunsaturated fat. An example of an unsaturated fatty acid with a single double bond is oleic acid, which is present in high amounts in olive oil. Polyunsaturated fats include vegetable oils from corn, safflower, and canola. These oils have the problem that the oxygen in the air can oxidize them or cause them to turn rancid. Foods that contain rancid fats have an unpleasant odor and taste. When similar rancidity occurs within the body, it is called oxidative damage. Oxidative damage is more likely to occur when the supplies of antioxidants such as vitamin C, vitamin E, and reduced glutathione are low.

A review of labels on processed foods in the supermarket reveals that many of these foods contain partially hydrogenated fats. Hydrogenation is a chemical process that removes some of the double bonds so that the product will be more solid at room temperature. Unfortunately, hydrogenation also