Allergy Connection - The Office Of Dr. Richard Layton

	Autism Spectrum Disorder - Latest News
	June 16, 2005 Developmental Delay Biomedical Treatments By: Richard E. Layton, M.D. Website: www.allergyconnection.com I. Developmental Delay – 1:6 children 4:1 Male:Female ADHD 1:30 – 1:20 3 – 5 % 2 – 4 million children Current Status ASD Rate 1/04 – CDC 1990 1:2000, 2004 – 1:166, now – 1:150 Prior to 1 year ago CDC/NIH/AAP – genetic only Today Show/Newsweek/AAP Multiple Genetic Factors – Environment/Causation “The Hidden Epidemic” Dr. Martha Herbert — Pediatric Neurologist-Harvard Medical School Inflammation – Brain, GI, Immune System White matter affected 2.5 X increased Head size - increased 2 SD Oxidative Stress Affects Limbic system Cerebellum – processing, connectivity Definition has changed Past – genetic, untreatable Current – multiple genetic factors – (genetic predisposition) Environment Biomedical - Brain/body – metabolic, GI, Immune system Treatable Many Autisms – not just 1 – recommends term “Metabolic Encephalopathy” Toxins include pesticides, PCB’s, heavy metals (mercury, arsenic, aluminum, cadmium) II. Biochemistry Defects in biochemical pathway - Methionine Methylation Glucaronidation Transsulfuration Folation Studies Document Neuro Inflammation – Johns Hopkins, Yale, Harvard Decreased Glutathione – Dr. Jill James Decreased cysteine (80% ASD) – Dr. Jill James Oxidative Stress Loss of neuronal symmetry (neural processing) – Dr. Deth III. Genetic Vs. Environmental – both Genetic Vulnerability – Immunizations most children are immunized and do well need immunization program with “common sense” subset of children can’t break down heavy metals Environmental Diet – casein, gluten; consider soy, corn, preservatives Antibiotics/infections (viral/bacterial) Environmental Toxins (chemical, heavy metals) Immunizations Allergies Inflammation – brain, gut, immune system IV. Sensory Integration – a major role Sound, smell, tactile, pain threshold, vestibular/proprioceptive Attention/Motor Planning/Processing – the most difficult problem to help V. Lab tests most helpful – consider: Gut GI Panel Organic Acid Test (OAT) - Microbiology Urinary Peptides – Casein/Gluten IgG Foods Metals Hair Analysis a screen Fecal/Urine Metals RBC Trace Minerals Metallothionein Profile CBC Platelets, Chemzyme, TSH, Iron, Ferritin Cysteine Glutathione Vitamin A Zinc, Copper Lead Level Celiac testing MBP, NFP – Autoimmune Antibodies Fragile X EEG Amino Acids NK Cells – Immune Panel VI. Treatment – Except for diet and Methyl B12 injections research is ahead of therapies. Diet Casein-free x 1 month Gluten-free x 3 months Consider soy/corn – chemical additives/preservatives SCD (Specific Carbohydrate Diet) Gut – leaky gut/yeast Probiotics/colostrum/Three Lac Antifungals/antiparasitics, (rarely antibiotics) Methyl B12 SQ injections Dr. Neubrander – claims “75% to 96% of children improve. Half do really well.” My opinion 20-40 percent get A or B – sticking your child every 3 days – want A or B. Glutathione – TD or Liposomal, IV, Nebulized. Supplements to consider - Response varies. Do one at a time. High rate of irratibility, insomnia, behavior worse. What may be great for one child can cause side effects in another. Vitamin A – Cod Liver Oil Digestive Enzymes- w/DPP IV – Enzyme Complete2/Carb Digest or Houston Enzymes Super Nuthera DMG or TMG with Folic/Folinic Acid Carnosine 5 HTP Taurine Zinc C, E, Selenium, Ca, Mg Carnitine NAC – N-Acetyl cysteine– ( caution - can flare leaky gut) Melatonin GABA Essential Fatty Acids (Omega 3-6 & GLA) – Omega Brite, Nordic Naturals Cor Omega Bethanechol LDN – Low dose Naltrexone (for inflammation) Secretin IV, Transdermal, Sublingual Inflammation - Curcumin (Tumeric) IVIG Meds Antifungals – Nystatin safest – also Diflucan, Sporanox, Nizoral Antivirals Antiparasitics – Flagyl, Nitazoxanide Anti Colitis meds – (Sulfasalazine and Colozal)-high rate of side effects ADD – Low dose Strattera (Stimulants – Amphetamines and Methylphenidate generally poorly tolerated) Risperdal (or Abilify) – can be great – may soon get FDA approval – increased side effects SSRI’s – Lexapro/Zoloft Tenex – for hyperactivity Clonidene – sleep, tics Mood Stabilizers – Trileptal, Neurontin, Depakote, Tegretal Singulair – allergies and gut inflammation Reflux meds – Prevacid, Pepcid Prednisone Allergy meds – Claritin, Zyrtec, Allegra, Allergy Testing/ Immunotherapy Actos ?? For Methylation with sulfation-The Therapeutic Quintet to augment chelation Methyl B12 injection Glutathione TTFD Folinic Acid DMG or TMG Mercury Toxicity Avoid Tuna, Swordfish – (foods containing mercury) Epsom Salt Baths Magnesium Sulfate Cream Cilantro, garlic in diet Metal-free, NDF, PCA-RX – milder chelators TTFD – “skunk cream” Infrared sauna Higher rate of success/risk DMSA – Prefer DMSA TD 5 mgm/kgm 3x/day 3 days on 11 days off or 3 days on 7 days off DMPS – prefer DMPS TD (Dr. Buttar, modified) - Start .2 of recommended dose and increase gradually over two months CBC, platelets, liver & kidney function monitor every 3 months; trace minerals, gut (OAT & GI Panel), Urine and/or Fecal Metals – periodically follow. Alpha Lipoic Acid Others - EDTA (I don’t use), No IV chelation VII. Early Intervention – extremely important. (Dr. Landa-Kennedy Krieger) “Parental Hunch” Education – Individualized to the individual child. PECS - TEECH ABA/Play Therapy RDI CARD (Center for Autism and Related Disorders) Speech – OT – PT Auditory Integration Training Home-Earobics, Samonas – Music Therapy Fast Forward, Interactive Metronone– Computer Berard – 10 day program Tomatis VIII. MY OPINION Need to set aside differences/avoid rigidity and listen to other parents open minded – no place for “medical religion” An epidemic – no such thing as “genetic epidemic” Many parents need a co-captain - listening to the individual medical history is best way for MD to help. This is most difficult, complex, confusing medical problem of all Nobody knows a lot. I rely on parents, opinion, child observation. Who does this child remind me of? Studies of 1 – Common sense Clinical judgement Medical history determines medical recommendation ASD 1:2000 ---- 1:166 WHY??? Developmental Delay 1:6 ADHD 1:30 – 1:20 IX. Books to Read Children With Starving Brains – Jaquelyn McCandless * Biomedical Intervention Biologic Treatments for Autism and PDD – William Shaw Order from DDR – (310) 652-2263 * Biomedical Intervention Unraveling the Mystery of Autism and Pervasive Developmental Disorder Karyn Seroussi Special Kids/Special Diets – Lisa Lewis Casein and/or Gluten-free diet Order from DDR – (301) 652-2263 Breaking the Vicious Cycle – Elaine Gottschall Specific Carbohydrate Diet Incredible Edible, Gluten-free Food for Kids – Sheri Sanderson – order from Amazon.com Conquering Autism – Reclaiming Your Child through Natural Therapies – Stephen B. Edelson, M.D. Facing Autism – Lynn M. Hamilton Is This Your Child? – Doris Rapp, M.D. Effect of Allergies on Behavior (best book to explain my medical practice) The Out of Sync Child – Carol Kranowitz Sensory Integration Disorder - Order from DDR – (301) 652-2263 Unblocking the Potential of Secretin – Victoria Beck * Secretin Information – Contact Autism Research Institute – Dr. Bernard Rimland Address: 4182 Adams Ave., San Diego CA 92116. Phone: (619) 281-7165. Awakening Ashley – Sharon Ruben * Auditory Integration Training X. Websites for Biomedical Interventions ANDI – (Autism Network for Dietary Interventions) www.gfcf.com (GFCF) www.pecan.com (SCD) Chelating Kids 2 CSB (Children with Starving Brains) www.autismwebsite.com (Autism Research Institute) www.talkautism.org