ANJU USMAN, MD, is the
medical director o True Health Medical Center and Pure Compounding Pharmacy in Naperville, Illinois. She specializes in the biomedical treatment o children with autism/ADD and developmental delays. She has been involved in researching copper/zinc imbalances, metallothionein dysunction, hyperbaric oxygen therapy, nucca adjustments and chronic inections in ASD patients. She is actively involved in the Deeat Autism Now! movement as a speaker and advisor. She is also co-ounder o ACE (Autism Center or Enlightenment), a non-proft dedicated to education, resear research, ch, and support or amilies.
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AUTISMSCIENCEDIGEST:THEJOURNALOFAUTISMONE ISSUE01 APRI L 2011
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www. autsmone.org
The Bi Biome omedi dica cal l a pp ppR Roach To TReaTinG auTism specTRum disoRdeRs: an oveRview By ANjU USMAN, MD
INTRODUCTION
A lance at cuent autsm statstcs leaves no doubt that we ae n the mdst o a hoc epdemc that s nsdously “stealn” the health o thousands o ou chlden. Cuent estmates ae that 1 out o evey 110 chlden n Ameca ae ben danosed wth an autsm spectum dsode (ASD) (Centes o Dsease Contol and Peventon, 2010). Ts ate supasses the ncdence o both chldhood cance and Down syndome. rememben that t s medcally mpossble to have a enetc epdemc, the concluson that the autsm epdemc has envonmental oots s nescapable. Potental envonmental causes (a eecton o the toxc wold we nhabt) nclude oveuse o antbotcs and exposue to heavy metals, pestcdes, plastczes, and pollutants. Te use o pescpton medcatons to teat chlden wth ASD s common. Howeve, the antpsychotcs spedone and now appazole, the only medcatons speccally appoved by the US Food and Du Admnstaton (FDA) o the teatment o autsm (o the symptomatc teatment o tablty), have the potental o seous and le-theatenn advese eects. Psychotopc medcatons, epotedly used by moe than 27% o chlden wth ASD, also ental numeous sde eects whose lon-tem consequences have not been establshed (Amecan Academy o Pedatcs, 2010). Moeove, newe studes epot that SSris (selectve seotonn euptake nhbtos), whch ae commonly pescbed o obsessve behavos, have lttle eect on autstc patents wth compulsve o epettve behavos (Kn et al., 2009). The bIOmeDICAl AppROACh
gven the sn numbes o chlden aected by the autsm epdemc, t comes as no supse that paents om aound the wold have tuned to novel, unconventonal, and/o o-label teatments to help the chlden wth ASD. in a evew o the lteatue om 1943 to the pesent, rataczak (2011) outlnes evdence o homones, metaboltes, amno acds, and othe bomakes bomakes pesent n sncantly deent quanttes n autstc subects compaed to ae- and sex-matched contols. rataczak notes that these deences can be measued n the astontestnal, mmunoloc,
neuoloc, and toxcoloc systems o the body, wth some bomakes shown wde applcaton. applcaton. in addton, thee ae unyn concep concepts ts thouhout the autsm lteatue shown nceased vulneablty to oxdatve stess, mmune luta matec dysuncton, and pneal land malu ncton. Ts evdence base, collected ove ove the past 50 yeas, can be used n a udcous manne to develop sae and ndvdualzed teatment statees o patents patents suen wth autsm. Ts appoach, oen eeed to as the bomedcal appoach, has aned momentum and cedblty ove the past decade as moe clncal evdence s atheed eadn the eal medcal ssues aced by ASD patents and the eectve medcal teatments that ae aleady avalable to them. Paents and loved ones o someone wth autsm have come to ealze that an autsm danoss need not epesent a devastatn le sentence no be pooly manaed by psychotopc medcatons. Te heat o the bomedcal appoach les n the pncple that autsm s a medical disorder , not a mental health dsode. Te soul o the bomedcal appoach (the local coollay to the st pncple) s the convcton that autsm s treatable . OveRvIew Of bIOmeDICAl TReATmeNT OpTIONs
Te bomedcal appoach to autsm seeks to teat patents by analyzn the basc body unctons, dentyn beakdowns, and usn a combnaton o vtamns, mneals, amno acds, nutaceutcals, homones, enzymes, pobotcs pobotcs and pescpton dus to heal aeas that ae mbalanced (rossnol, 2009). Bomedcal clncans can ode specc laboatoy tests to check o many o the metabolc and comobd medcal condtons that seem to exacebate autstc-lke behavos. Many bomedcal teatments seem to wok by deceasn oxdatve stess and/ o nammaton. Oxdatve stess, whch damaes tssues and s neutalzed by antoxdants such as vtamns C, A , and E, s one o the coe medcal ssues that can be tested and addessed thouh bomedcal teatment. Evdence has mplcated oxdatve stess n many so-called psychatc dsodes, ncludn ASD ( james et al., 2004). 20 04). Othe studes n ndvduals w th ASD have descbed ceebal ceebal (L et al., 2009) and astontestnal (gi) nammaton (oente et al., 2002). Usn clncal tests to denty mpaed poducton o lutathone (the body’s man
remembeing that it is medical medicall l impossible impossible to have a genetic epidemic, epidemic, the t he conclusion concl usion that the t he autism epidemic has envionmental oots is inescapable. www. autsmone.org
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Ae ecevn a danoss o autsm, pevasve developmental dsode (PDD), o Aspee’s syndome (pesumn that enetc causalty has been uled out), t s mpotant o patents to undeo an electoencephaloam (EEg) to denty o ule out undelyn sezues. About 60% o moe o chlden wth autsm have subclncal sezue actvty, wth “subclncal” dened as abnomal electcal actvty n the ban n the absence o ull-blown sezues.
antoxdant and detoxe), bomedcal pacttones can ecommend appopate teatment. Eatn a vaety o antoxdant-ch oods and takn supplements such as lutathone and methyl B12 (whch helps the body make ts own lutathone) can allevate oxdatve stess and theeoe theeoe nammaton (james et al., 2009). Te top ten most eectve bomedcal teatment statees used ove the past decade (as epoted by 27,000 paents to the Autsm reseach insttute [2009] n San Deo) ae lsted below. Tese bomedcal nteventons, alon wth numeous othes, have been shown to esult n a hhe ate o patent mpovement and a lowe sde eect pole as compaed to phamaceutcal aents.
Vtamn B6 Manesum Znc Methyl B12 (nectons, o oal o nasal admnstaton) Essental atty acds (cod lve ol) Destve enzymes Melatonn Hypebac oxyen theapy Detoxcaton (chelaton) Specal dets (luten-ee/casen-ee, Specc Cabohydate Det™, alley elmnaton elmnaton))
CONClUsION
Te bomedcal appoach to teatn autsm s n ts nancy but has aleady shown eat pomse n bnn sae and nnovatve teatments to ASD patents. A own numbe o chlden ae losn the autsm danoss completely as a esult o ecevn bomedcal teatments. Tousands o these cases have been documented by the Autsm reseach insttute (Ari). Tese ecoveed chlden now have the potental to lead ull and poductve lves. We must contnue to leap owad wth teatments that addess the dsease pocess we call autsm and embace the pomse o a new, moe hopeul paadm. A eneaton o chlden’s lves depends on t.
REfEREncES
American Academy of Pediatrics. Child ren with autism frequently receive psychotropic medications. ScienceDaily. 2 May 201 2010. 0. 14 Februar y 2011 2011 Autism Research Institute. Parent ratings of behavioral effects of biomedical interventions. ARI Publ. 34, March 2009. Available at: /www.autism.com/pdf/providers/ ParentRatings2009.pdf.
wo uthe examples can seve to llustate the bomedcal teatment appoach as t petans to autsm-elated sezues and gi dsodes.
Buie T, Campbell DB, Fuchs GJ, Furuta GT, Levy J, Van de Water J et al. Evalu ation, diagnosis, and treatment of gastrointestinal disorders in individu als with ASDs: A consensus report. Pediatrics. 2010;125(Suppl): S1-S18.
seIZURes
Centers for Disease Control and Prevention. National Center on Birth Defects and Developmental Disabilities. Published online June 1, 2010, http://www.cdc.gov/ncbddd/ features/counting-autism.html.
Ae ecevn a danoss o autsm, pevasve developmental dsode (PDD), o Aspee’s syndome (pesumn that enetc causalty has been uled out), t s mpotant o patents to undeo an electoencephaloam (EEg) to denty o ule out undelyn sezues. About 60% o moe o chlden wth autsm have subclncal sezue actvty (Chez, 2006; Lew ne, 1999), 1999), wth “subclncal” dened as abnomal electcal actvty n the ban n the absence o ull-blown sezues. Subclncal sezues can oen be helped wth supplements such as vtamn B6, taune, manesum, ma nesum, and olnc acd o wth appo appopate pate medcatons. Some patents may expeence mpovements n behavo, lanuae, and speech when the subclncal sezue actvty s teated. GAsTROINTesTINAl sympTOms
in 2010, the ounal Pediatrics publshed a consensus epot on the “evaluaton, danoss, and teatment o astontestnal dsodes n ndvduals w th ASDs” (Bue et al., 2010). Ts epot epot n a mansteam medcal ounal nall y acknowledes what paents o ASD ch lden and bomedcal clncans have lon known, namely, that patents wth autsm oen have ut patholoy that may pesent wth behavoal ssues and aesson. Te specalsts epesented n the Pediatrics epot make t clea that patents wth autsm who ae expeencn astontestnal symptoms deseve medcal attenton and medcal teatment o ssues that may nclude abdomnal pan, astoesophaeal eux, dahea, constpaton, and even mtochondal dsease. Te bomedcal appoach—whch uses detay nteventons, pobotcs 12
(ood bactea), pebotcs (be that eeds ood bactea), destve enzymes, and natual antmcobals, antbotcs, antbotcs, and antunals—s antu nals—s oen helpul n teatn these gi condtons. Phamaceutcal aents may also be needed to teat moe dfcult cases.
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Chez MG, Chang M, Krasne V, Coughlan C, Kominsky M, Schwartz A . Frequency of epileptiform EEG abnormalities in a sequential screening of autistic patients with no known clinical epilepsy from 1996 to 2005. Epilepsy Behav. 2006; 8(1): 267-71. 267-71. James SJ, Cutler P, Melnyk S, Jernigan S, Janak L, Gaylor DW, Neubrander JA. Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism. Am J Clin Nutr. 2004;80(6):1611-7. James SJ, Melnyk S, Fuchs G, Reid T, Jernigan S, Pavliv O, Huba nks A, Gaylor DW. Efficac y of methylcobalamin and folinic acid treatment on glutathione redox status in children with autism. Am J Clin Nutr. 2009;89(1):425-30. King BH, Hollander E, Sikich L, McCracken JT, Scahill L, B regman JD, Donnelly CL, Anagnostou E, Dukes K, Sullivan L, Hirtz D, Wagner A, Ritz L, for the STAART Psychopharmacology Network. Lack of efficacy of Citalopram in children with autism spectrum disorders and high levels of repetitive behavior: Citalopram ineffective in children with autism. Arch Gen Psychiatry. 2009;66(6):583-90. Lewine JD, Andrews R, Chez M, Patil Patil AA, Devinsky O, Smith M, Kanner A, Davis JT, Funke M, Jones G, Chong B, Provencal Provencal S, Weisend M, Lee RR, Orrison WW. Magnetoencephalographic patterns of epileptiform activity in children with regressive autism spectrum disorders. Pediatrics.1 .1999;104(3): 999;104(3): 405-18. Li X, Chauhan A, Sheikh AM, Patil S, Chauhan V, Li XM, Ji L, Brown T, Malik M. Elevated immune response in the brain of autistic pa tients. J Neuroimmunol. 2009;207(1-2):111-6. Ratajczak L. Theoretical aspects of autism: Causes? A review. J Immunotoxicol. 2011;8(1):68-79. Rossignol DA. Novel and emerging treatments for autism spectrum disorders: a systematic review. Ann Clin Psychiatry. 2009;21(4): 213-36. Torrente F,F, Ashwood P, Day R, Machado N, Furlano RI, Anthony A, Davies SE, Wakefield AJ, Thomson MA, Walker-Smith JA, Murch SH. Small intestinal enteropathy with epithelia l IgG and complement deposition in children wi th regressive autism. Mol Psychiatry. 2002;7(4):375-82, 334.
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