Autism, ADHD, & ADD

Autism, ADHD, & ADD Q & A

For many parents of children with autism, attention deficit hyperactivity disorder (ADHD), or attention deficit disorder (ADD), medication is not the best option. If you’re searching for a more comprehensive, long-term solution to treating your child’s autism or ADD/ADHD, Dr. Kalpana Patel, a leading environmental and integrative medicine specialist at the Environmental Health Center–Buffalo (EHC Buffalo), provides alternative and complementary treatments and therapies for these conditions. If you have a child who needs special services and you are in or around Buffalo, New York, call the office for a consultation or schedule an appointment online to learn about options other than prescription medications.

How do alternative therapies help autism and ADHD/ADD?

Autism and ADHD/ADD are a complex group of lifelong developmental disorders that can affect the quality of your life or your child’s life in the long term. As a medical and integrative health care professional, Dr. Patel believes in treating the underlying causes and contributors of the symptoms of autism and ADHD/ADD rather than simply using medication. Although treating the underlying causes of these disorders may not “cure” you or your child, they can significantly reduce symptoms and enjoy a better quality of life.

What are the possible contributing factors for autism, ADHD/ADD, and learning disabilities?

Since Dr. Patel takes a holistic, integrative approach to managing autism, ADHD/ADD, and learning disabilities so you or your child can function optimally, the first step is to identify any contributing factors such as:

Since research suggests that ADHD/ADD, in particular, is the result of biochemical imbalances in the brain, diagnosing and treating these imbalances can help improve symptoms naturally, without dependency on pharmaceuticals. Similarly, learning disabilities may result from sensitivities to mold, pollens, foods, or chemicals in some children.

Dr. Patel focuses on restoring balance by treating vitamin or mineral deficiencies, removing harmful toxins, providing treatment for allergies and sensitivities, and correcting hormonal problems holistically, so treatment benefits you or your child as a whole person.

What natural treatment options are available for autism and ADHD/ADD?

Dr. Patel performs a comprehensive evaluation and then orders blood, urine, and stool testing to determine the underlying health conditions that need to be addressed to improve the outward symptoms of autism or ADHD/ADD. Depending on the results of these tests, she creates a customized treatment plan that may include any of the following:

If you or a family member suffers from autism or ADHD/ADD or learning disabilities, and you’re not getting the results you desire with medications and more traditional treatment methods, Dr. Patel and the integrative medical professionals at the Environmental Health Center–Buffalo may be able to help restore balance. Call the office or schedule a consultation online to learn about natural, holistic treatment options.

Treatment Options

Methyl-B12 injections to increase methylation and trans-sulfuration (e.g., glutathione) biochemistry. This is a critical nutrient that helps to improve speech and language, executive function, and appropriate emotions and socialization skills.Methyl-B12 seems to unlock the areas of the brain that are required to verbalize and communicate effectively. It is not uncommon to see improvements in expressive, receptive, and conversational language, as well as the ability to make longer sentences that include pronouns, adjectives, adverbs, etc. Methyl-B12 is known to increase eye contact, focus, attention, awareness, comprehension, and the ability to understand abstract ideas and concepts.

The children become more tolerant of change, transition much more easily, and become more flexible. They are able to communicate their wants and needs more effectively. Methyl-B12 improves their ability to stay on task and the ability to follow more complex commands. It helps with imaginative play, imitation skills, and engagement with others. Often, they become more in touch with their feelings and those of others.

Interests are widened, the children become more inquisitive, and they try new things. They become more self-confident, opinionated, and their need to be independent is heightened. The children learn more easily, their memory improves, and things that parents did not even know their children knew arenow expressed to their parent’s great surprise! The children become much more affectionate, cuddly, and loving and theyhave many more good days at home and school than they ever did before. In addition, methyl-B12 is known to improve the immune system and decrease allergic responses, and it often helps appetite, aids in increasing weight, and frequently helps gross and fine motor skills.

To date, we have prescribed and monitored many children on methyl-B12. We have used every route of administration but have found that theonly route of administration that consistently gives significant clinical benefits are from (painless) subcutaneous injections.Many parents are fearful of giving the shots, but after administering only one or two injections, 9 out of 10 parents are at ease. Usually, parents are able to evaluate whether or not the shots work. Approximately 94% of parents are able to “undeniably document” numerous benefits they have witnessed to occur during the first six weeks of treatment. During these six weeks of the initiation phase, we do not allow parents to make any other ‘biomedical’ changes to the child’s treatment program. This means we do not allow parents to add anything new or take away anything from what they are on.

Absolutely no change is allowed. Thus, when parents evaluate the progress of their child, everything that has occurred within the six-week period is from the addition of methyl-B12 therapy and not from any item. Also unique to our practice is the evaluation process; we have our parents document clinical progress from methyl-B12 therapy. Parents need to “know for sure without any lingering doubt” that methyl-B12 really is working for their child. In order to do this, we use a form called the Parent Designed Report Form. Language- use the numbers 1-10, improvement in the language progress that was noticed – that parent could tell their entire story.

Potential Gastrointestinal Issues

Gastrointestinal issues – diagnosis, treatment, and, when necessary, an appropriate referral. Children on the Autism spectrum have some type of GI symptoms more than 50% of the time. The common symptoms include loose stools (“mushy”; “like mashed potatoes”), diarrhea, constipation, infrequent bowel movements, bowel movements that are voluminous for the size of the child (“can fill up much of the toilet bowl”), extremely foul-smelling stools (“can clear the room”), stools with atypical or varying colors, much-undigested food, very hard or distended protruding abdomens (“looks pregnant”), gas, bloating, abdominal pain, “posturing,” etc.

In addition, scientific studies have demonstrated that there are as many neurons in the GI tract as there are in the brain, something now referred to as ‘the gut-brain connection’. The way this applies to children with autism is that frequently their GI problems are expressed behaviorally or in other ways that do not seem to be related to the GI tract. Examples include but are not limited to, aggression, head-banging, biting, kicking, fits of screaming, or outbursts for no apparent reason; unexplained behavioral changes that come on suddenly and then can leave just as quickly; serious sleep disorders; hyperactivity, stimming, etc.

Certain anaerobic bacteria from the Clostridia family produce propionic acid, which has been shown to turn normal rats into autistic rats. Many other types of aerobic bacteria also produce organic acids or have direct inflammatory effects that also affect children on the spectrum. This process is called ‘dysbiosis’. A few of the ‘dysbiosis’ bacterial species commonly seen from families other than the Clostridia family include but are not limited to, Klebsiella, Citrobacter, Pseudomonas, Proteus, etc. It is important to know if there are enough ‘beneficial’ bacterial species present and, if not, treat them using “probiotics.”

It is also important to know if there is enough “nutrient, food, and fiber” present for the beneficial bacteria to thrive. If not, treatment with “prebiotics” is indicated. Besides the absence, excess, and imbalance of anaerobic and aerobic bacteria, many different genera or species of yeast are often present. Also, it is not uncommon to find parasites in the child’s GI tract when tested. In addition to determining the types of organisms that are living within the child—good or bad types, it is important to know if the microbiome is out of balance. Furthermore, it is important to determine whether the child has digestion and or absorption problems, gastrointestinal inflammatory and gastrointestinal immune problems, including too much or too little protective ‘secretory IgA’ (the intestine’s first line of defense) produced by an individual.

When the child’s body is consuming too much protective ‘secretory IgA’ due to an intestinal inflammatory or infectious process, it will be deficient and not be protected from infectious organisms. There may be gastrointestinal, metabolic problems; improper fecal pH balance; their ability to process fats; deficiency of bile and digestive enzymes in the gut; and the presence of a “leaky gut” (increase in the intestinal permeability which allows entry of large molecule and thereby stimulating the immune system improperly triggering negative symptoms). When symptoms are severe enough and not resolved by the more standard and conservative treatments we use in my office, we refer patients for a comprehensive workup that may include an endoscopy, colonoscopy, and pill cam procedure that has a ‘camera’ pass through the small intestine. Each of these procedures is done in order to diagnose autistic enterocolitis (AE) and lymph nodular hyperplasia (LNH) vs. other types of bowel disorders.

Dietary Recommendations, Testing, Treatments

Casein-free gluten-free diet (CFGF); Specific carbohydrate diet SCD); food allergy diets and non-allergic food intolerance/sensitivity diets; elimination/rotation diets; yeast-free diet; Feingold and related-type diets (salicylates, phenols, food additives of all types, etc); low oxalate diet (LOD); Gut and Psychology Syndrome diet (GAPS); Body Ecology diet (BED); fermented foods diet, etc. Each of the diets shown above has the potential to help key issues in specific individuals.

Finding the right diet often requires professional help. Knowing what diets have tests that can be ordered, what tests are most likely to be helpful, and whether the information gained from the test will justify the cost almost always requires a professional’s advice. In addition, it is very important to consult with a professional to make sure that foods that ‘test positive’ really do not need to be eliminated, or if they must be eliminated, that they are not eliminated for periods of time longer than required.

It is very common for a parent to obtain a food allergy or food hypersensitivity test and eliminate all the ‘flagged foods’ or eliminate them for a year or more when this is not necessary or far too long to avoid the food. Just as common, if not more common, is when parents obtain a test for ‘allergies or hypersensitivities’ that comes back with 25-33% of the foods marked as moderately to significantly abnormal with a report that says to eliminate the foods. Accurate interpretation of such a test requires a professional who knows how to differentiate between a ‘leaky gut pattern’, a GI problem that does not require all the foods be eliminated, or a true food hypersensitivity problem that will require at least some of the foods be eliminated, though not necessarily all of them.

Mitochondrial Disorder

Mitochondrial “disorder/distress” screening and treatments. Mitochondrial “distress” is not the same thing as severe mitochondrial disease. It is referred to specialty clinics that handle such severe cases of mitochondrial problems. Mitochondrial ‘distress’ can be considered aphenomenon in which the mitochondria cannot meet the body’s demand to make enough ATP, whether all the time or just intermittently when the body’sdemands are higher than usual. We find such ‘stress’ on the mitochondria to be much more common than was currently believed to be present in children with autism. Once found, effective treatments can be implemented. Mitochondrial distress/disorder (and disease) is found to be more frequent in children who have seizure disorders. Studies show that approximately 33% of children on the spectrum have some type of seizure activity. The take-home message is that just because parents have never witnessed any type of seizure activity in their child does not negate the fact that if their child was evaluated under controlled scientific conditions, 1/3 of them would test positive.

Heavy Metal Testing:

Many children on the Autism spectrum have defective detox systems. As a result, they have an accumulation of Toxic metals in their body, having adverse effects on the developing brain and the immune system besides other organs. There are many chelating agents that are used for the diagnostic challenge test. These chelating agents are like DMPS, DMSA, or EDTA, but especially when DMPS is used, there is a significant shift to the right for almost all the essential elements shown on the Doctors' Data test results data page. Remember, the further the tip of the black bar goes to the right, the more of an element is lost in the urine, and the further the tip of the black bar goes to the left, the less of an element is lost in the urine. The chelating agent is given in the pill form. Once it goes through the bloodstream into the tiny capillaries and bathes the tissues, it comes in contact with a toxic metal [either good minerals or bad minerals — essential minerals or toxic metals]. Thereafter, a chelating agent/mineral complex is formed, which eventually gets excreted by the kidney and eventually finds its way into the urine. It is also important to understand that the test result data graphs are really based on normal values and are not based on values that occur with a chelating agent.

Therefore, should one collect a regular urine specimen without swallowing a chelating agent [or doing an IV], the graph you see showing the different percentile rankings should fall within the green columns, the 16th to 84th percentiles, essentially the normal parts of the standard bell shaped curve, those that represent one standard deviation from the mean. Those that fall in the yellow columns are borderline and are within two standard deviations of the mean.

And those that are in the salmon-colored columns are seriously high or low and represent values three standard deviations away from the mean. Without the chelating agent, the heavy metals cling to the tissues and are not washed off the tissues into the bloodstream. Therefore, just a normal amount of minerals/metals come out in the urine. However, now consider what is normal when one takes a strong chelating agent. The medicine floats through the body and magnetically attracts good AND bad metals [minerals]. Heavy metals are more attracted to the chelating agent than they are to the tissues. In addition, because chelating agents can also bind the essential [good] minerals, these essential minerals will also come out in higher amounts than they would under normal conditions. Therefore, when the amounts of essential minerals are measured by Doctors Data [or other labs] in the urine, they appear to be present in very high amounts. This is the phenomenon called THE SHIFT TO THE RIGHT. The reason it is called this is because the tips of the black bars are now found on the right side of the 50th percentile column. In fact, usually, these minerals are shifted very far to the right, and a very healthy urine challenge test with a strong chelating agent has many of the bars off the graph to the right. Now, think of this. When using a strong oral or IV chelating agent, what we want to see and what indicates the child has a healthy amount of minerals is a strong shift to the right. However, when you find elements that are able to be attracted by the chelating agent the doctor has selected [this will vary, so do not overinterpret this without the help of the doctor] and they are found to be below the midrange 50th percentile column, in reality, these minerals were really very low to start with and only with the chelating agent help were able to be seen anywhere near normal. Therefore you will erroneously think that everything is OK when really the child is mineral deficient. Therefore, when taking a strong chelating agent, what is normal is a strong shift to the right. Things that shift only mildly are mild to moderately deficient, and things to the left of the 50th percentile column are moderate to significantly deficient!

CAUTION: Each chelating agent has binding affinities for different toxic and essential metals/minerals, and some chelating agents cannot bind to some things at all. For example, DMPS and DMSA do not bind to aluminum. In addition, when a chelating agent can bind to the same essential or toxic metal, they have different degrees of attraction. For example, DMPS, DMSA, and EDTA can all bind to lead and mercury. However, EDTA binds to lead the strongest and DMPS the weakest with DMSA being in the middle. The exact opposite is true for the binding affinities to mercury, whereby DMPS is strongest, EDTA is weakest, and DMSA is in the middle. One other important point is that the route of administration will have asignificant bearing on how much or how little of a metal one finds in the urine. For example, transdermal DMPS will pull very little heavy metals into the urinewhile oral DMPS will pull more and IV DMPS will pull the most. It is important to note that exceptions occur, such as an example of the body in a repletion mode. As an example, I have a patient who illustrates a specific instance where a significant shift to the left did not indicate a worsening of the child's condition but rather a significant improvement. My comments to the parents read as follows: the past, red blood cell elements were found to be low so the parents increased the mineral supplementation amounts their child was taking to correct the problem. In addition to the low red cellminerals, the same test showed many urine essential elements were low normal or low but at that time were not extremely low. Eight weeks later, on follow-up, the red cell elements have all improved, whereas the urine essential elements now measure extremely low, causing the parent to be very worried and upset. However, the correct interpretation is that the minerals were now being incorporated into the red cells quite efficiently. In the process, theadditional minerals that were floating around in the blood waiting to enter the red cells were not electing to be urinated out — the proper thing for the bodyto choose to do. Therefore, the urine essential elements on the urine test would show up in far lesser amounts than they were on the previous urine testbecause they were being utilized by the cells and not being lost through the kidneys! Please copy and paste. You can see, accurate interpretation requires comparing the current history as compared to the past history, including supplementation, the chelating agents being used, new therapies, other medications being used, etc. [especially for the last 8 to 12 weeks], and the previous blood and urine tests as compared to the current blood and urine tests.

THEREFORE DO NOT INTERPRET URINE TEST RESULTS WITHOUT THE HELP OF A DOCTOR WELL VERSED IN THE PROPERTIES OF CHELATING AGENTS AND IN THE CHELATION PROCESS ITSELF!

Detoxification and chelation therapy

Detoxification and chelation therapy have the potential to be a valuable treatment for many children. However, its ‘potential’ need and ‘documented’ benefits have been largely exaggerated, both by professionals and parents alike. The alarm and fear that websites, chat rooms, and parent blogs havecreated is nowhere close to what we have been able to document in our practice after doing this with hundreds of children over many years.Any individual child is considered to be a unique being; chelation may play a valuable role in that child’s overall set of treatment modalities to move him or her toward recovery, but not for everyone. We do not believe in blindly chelating a child (or adult). However, if key laboratory screening tests indicate that chelation “may” be a valuable treatment option, and if parents decide they want to chelate, we will proceed to the next step. There are few critical steps that include full informed consent by both parents; the mother and father, a detailed discussion as to the pros and cons of chelation, what are the ‘knowns and unknowns’ of chelation itself, as well as what will occur with the chelation process we will be using, its potential benefits vs. its relative risks, the costs involved tofrequently monitor various tests for safety (liver, kidney), and the steps required to prevent getting into trouble by being too aggressive and not replacing the essential minerals that will also be removed along with the toxic minerals. Once we come to a mutually acceptable understanding, we will begin the chelation process for the child. At this point, we will discuss with the family the method of chelation that I believe will be the best one to use. This decision is based on many factors, e.g., the family’s financial state, where they live relative to our clinic, their belief system and/or fears, their ability to obtain safety tests on a regular basis, and the knowledge base they have relative to everything known about the various options we can use to chelate their child. Such options include but are not limited to: oral DMSA; oral DMPS; intravenous DMPS; intravenous Ca-EDTA; suppository forms of DMSA, DMPS, or EDTA; transdermal DMPS or DMSA; the “Cutler method” that requires no lab tests; and more natural methods of chelation, e.g. supplements, glutathione, herbal agents, etc.

Folate receptor autoantibodies

Folate receptor autoantibodies diagnosis and subsequent treatment options. This is vital information necessary to complete treatment options forthree of the most critical biochemical pathways that we find affected to some degree in the majority of children on the autism spectrum: methylation, trans-sulfuration, and the ‘reduced’ forms of the folic acid family. Antibody formation of folate receptors is an autoimmune phenomenon that blocks methyl folate from crossing the blood-brain barrier in order to enter neurons. In our practice, we find approximately 2/3 of children have such antibodies. In addition, folate receptor autoantibodies are believed to be more frequent in children who have seizure disorders. On a related side note, it is important to realize that studies demonstrate approximately 1/3 of children on the spectrum are affected by seizures. Such seizures are mostly nocturnal, usually not witnessed by parents, and typically not severe enough for parents to even notice. However, they are there, affect the children, and should be treated.

Articles. Presentations about the use of Methycobalamin. Click on the links below to download a file Scientific Validation For The Use Of Methyl-B12 – S J JamesScientific Validation For The Use Of Methyl-B12 – R Deth Methyl-B12; Myth, Masterpiece, or MiracleAutism One, Chicago 2005 USA AA MB12 August 25, 2007 Articles. Presentations about HyperbaricOxygen TherapyA randomized double-blind placebo-controlled study on HBOT using 1.3 ATA for Autism of which our clinic was a partThailand study on 1.3 ATA HBOT and Autism showing 75% improvement in patients HBOT And Brain Function Improvement, Before & After SPECT scans on Autistic BrainsPediatrics Article on Neurocognitive Changes from HBOT Largest study of its kind to date on the effects of 1.3 ATA, 1.5 ATA and 1.75 ATA on Cerebral Palsy – First of 7 VideosPublished result of Dr. Mukherjee study (see above videos)USA AA HBOT August 25, 2007 Articles about the use of IV treatments with Autism PANDAS Improvement in children with autism treated with intravenous gamma globulin

PANDAS and IVIG Separating fact from fiction (Pediatrics Article) IVIG Treatment Study Articles. Presentations about Folate Receptor Autoantibodies Folate receptor autoimmunity and cerebral folate deficiency in low-functioning autismwith neurological deficits A milk-free diet downregulates folate receptor autoimmunity in cerebral folate deficiency syndromeFolate Receptor Alpha Defect Causes Cerebral Folate Transport Deficiency: A TreatableNeurodegenerative Disorder Associated with Disturbed Myelin MetabolismMitochondrial diseases associated with Cerebral Folate DeficiencyArticles about GI issues with AutismGastrointestinal microflora studies in late-onset autismFocal-enhanced gastritis in regressive autism with features distinct from Crohn and Helicobacter pylori gastritis Constipation With Acquired Megarectum in Children With Autism Dysregulated innate immune responses in young children with autism spectrum disorders: their relationship to gastrointestinal symptoms and dietary intervention Food allergy and infantile autismThe ScanBrit randomised, controlled, single-blind study of a gluten- and casein-free dietary intervention for children with autism spectrum disorders A milk-free diet downregulates folate receptor autoimmunity in cerebral folate deficiency syndrome The possibility and probability of a gut-to-brain connection in autism The gastrointestinal system association with autism.

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