The medical understanding of autism has changed since it was first described by Kanner.  Kanner believed that autism has a neurological cause, and most researcher and clinician’s did not look for medical explanations to autism, as they believed it was a disorder that was medically untreatable.

Bernard Rimland, a psychologist and father of an autistic son, was the first authoritative voice to dispute the Kanner model.  Rimland established the Autistic Research Institute (ARI) in 1967, and soon scientists and researchers began to come out with new findings and new ideas focusing on medical aspects of autism.

Nowadays science identifies many biological disorders associated with autism, which might contribute to the cause, or aggravate the condition.  The most prominent medical problems identified in many autistic children are gastrointestinal problems, including gastro-esophageal reflux disorder (GERD), pancreatic insufficiency, maldigestion, malabsorption, food intolerance, food allergy, disturbed gut bacteria (dysbiosis), celiac disease, irritable bowel syndrome and inflammatory bowel disease.  These gastrointestinal problems lead to malnutrition and vitamin, mineral and essential fatty acid deficiencies.  Immune dysfunction and chronic inflammation also play a significant role in aggravating the condition.  Numerous metabolic disorders have been identified, including disordered metabolism of neurotransmitters and disorders of metal ion transportation.  It is becoming generally agreed that autism is multifactorial and may be contributed to by many medical issues.

Paul Shattock and Paul Whitely proposed that autism may be a metabolic disorder, whereby biologically derived peptides form dietary gluten and/or casein are not metabolized correctly in autism.  The theory led to widespread use of the Gluten Free Casein Free (GFCF) diet as a biomedical intervention to treat autism.  This diet is highly rated as one of the most effective interventions among parents of autistic children, according to the ARI.  There is continuing research into understanding the mechanisms involved in this diet and some research indicates increased immune response to dietary peptides in autistic subjects.

While research by Andrew Wakefield remains controversial, his work did draw a lot of public attention to gut problems as an underlying cause of autistic behaviours, resulting in new studies by different research groups. For example Horvath found that 69% of non-verbal autistics studied had GERD, and 41% had chronic gastritis and 66% chronic duodenitis.  Disturbed gut bacteria (dysbiosis) seem to play an important role in autoimmune responses, by increased immune response to dysbiotic bacteria and yeast metabolites. In addition many autistics have problems of chronic constipation, which is some cases may be caused by paralysis of the peristaltic movement by bacterial toxins generated by dysbiotic bacteria.  As a result antibacterial and non-absorbed antifungal medications have been used to relieve both gastro-intestinal symptoms and help cognitive function.  

Since the Hanna Poling case there has been increasing interest in possible mitochondrial dysfunction in autistic patients.  Diagnosis of mitochondrial disorders are complex but could be evaluated through serum lactic acid or ammonia, or through nutritional biomarkers for carnitine and coenzyme Q10.  Elevated ammonia can present transiently and chronically in some autistic subjects, and may explain some behaviours and cognitive changes, and neurotransmitter dysregulation in autism.  Control of constipation and dysbiosis is well proven as a treatment for increased ammonia production in the gut.

Autistic symptoms may improve if patients are provided with individualized treatments for poorly recognized problems.   Many of the problems described above can be helped through dietary changes, resulting in improved gut health and nutrient availability.  The GFCF diet, the SCD and GAPS diet, the low sugar low yeast diet, the low allergen diet and the low oxalate diet, can all help the gastrointestinal tract to recovery.  As the gut heals the immune function becomes more regulated, some inflammation is reduced and mitochondria and the metabolism receive better essential nutrition.  This is why diet is particularly important in autism.

HI All

I attended and spoke at the Let's Connect Conference in Cork on Saturday 12th March.  It was great to meet and hear so many people speak.  It's something that should be done more often, but takes a lot of organising.

Work on our new website is progressing and we would hope to launch the first phase in April or May - so keep a look out for that.

In April I will be attending the Autistic Research Institute conference in Atlanta, USA.FAfter the 4 day DAN! conference I will run a 1 day seminar in May about Diets, Supplements and Testing, including relevant updates from the conference'. The seminar will run in Cork, on Sunday May 15th at the Rochestown Park Hotel, and in Dublin, on May 29th at the Clarion Hotel Liffey Valley. For more details click SEMINARS in the tab bar at the top of the page.   

Noreen 

Vitamin B1 (Thiamine)- General

Vitamin B1 is an essential water soluble vitamin. You cannot store it therefore you need some everyday.  It is important for maintaining proper functioning of the nervous system and the cardiac system. It also helps the immune system to work to it’s capacity, helps us deal with stress, and helps to prevent vision problems  such as cataracts.

Vitamin B1 is found in pork and pork products, wholegrains, rye, and navy beans and kidney beans.

Deficiency of vitamin B1 causes Beri beri, a disorder characteristed by confusion, nerve problems, muscle wasting and rapid heartbeat.  A diet consisting mainly of white flour, white sugar and other highly processed carbohydrates may cause thiamine deficiency. Deficiency is commonly seen in people who drink heavily (often instead of eating), as Wernickes–Korsakoff syndrome.

The recommended daily intake for healthy individuals is 1.5mg daily.

Vitamin B1& Autism Research

In a study of nutritional status among Chinese children with autism the vitamin B1 intake was 80-90% of the daily recommended intake.¹

A case of Wernike’s encephalopathy in a 3 year old child with autism, was resolved on treatment with intravenous  vitamin B1.  The child had an eating disorder, which escalated to very restrained eating over 3 weeks, and presented at hospital unconscious with clusters of seizures.²

Allithiamine is a derivative of vitamin B1. It is commonly found in garlic that has been chopped and exposed to the air before cooking.  It has potent anticancer properties.  The use of allithiamine as TTFD in autism has received some attention, as it has been shown to increase the excretion of heavy metals – by chelation. Lonsdale³ published a pilot study in 2002, but there have been no followup large scale studies reported.  TTFD can be administered as a suppository or used as a topical cream, marketed as Authia from Westlake labs. 

References in Vitamin B1 & Autism:

1.   A preliminary study of nutritional status and intake in Chinese children with autism

      Xia et al..

      Eur J Pediatr 2010 Oct; 169(10): 1201-6

2.   Treatment of autism spectrum children with thiamine tetrahydrofurfuryl disulphide: a pilot stud.

      Xia et al..

      Eur J Pediatr 2010 Oct; 169(10): 1201-6

3.   A preliminary study of nutritional status and intake in Chinese children with autism.

      Lonsdale..

      Neuro Endocrinol Lett 2002 Aug: 23(4): 303-8

 

 

A major study result was published in the Journal of the American Medical Association in December 2010.* The report indicates that children with autism show strong evidence of mitochondrial dysfunction.

The mitochondria are the ‘power houses’ in cells  in the body, and they produce the energy needed for cellular activities.  The brain, in particular, needs large amounts of this energy for crucial brain function. The study indicates that 80% of autistic children had a 66% reduction in mitochondrial activity of the NADH oxidase enzyme complex. Reduced activity was also identified in the succinate oxidase, ATPase and cytochrome c oxidase mitochondrial enzymes.

Also, if mitochondrial dysfunction, then they produce large amounts of oxygen free radicals, which harm tissues and contribute to oxidative stress.  Oxidative stress in autism could influence the onset of autism. 

We don’t yet know the role that  mitochondrial dysfunction plays in the onset of autism, but it could be caused by damage from environmental toxins, which depending on when the child is exposed may explain why there is such a range of symptoms of autism.

The urinary organic acid can be used to identify if mitochondrial dysfunction is an issue.  This test will also help to identify if there are nutritional deficiencies  of L-Carnitine, CoQ10, vitamins B2 and B5, important for mitochondrial functioning.

 

Helping you help them.

Noreen

 

“Mitochondrial Dysfunction in Autism” Pessah et al, JAMA, (2010); 304: 21; 2389-96.