GastroIntestinal and Liver PathoPhysiology in Autism

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Gastro-Intestinal and Liver Patho-Physiology in
Autism

• Jonathan Tommey
• BSc Sports Science / Clinical Nutrition
• Tel [phone]
• E-mail info_at_autismfile.com
• Website www.autismfile.com

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Agenda

• My personal experience with autism
• Gastro-intestinal disturbances
• The importance of the liver
• Diagnostic testing
• Leaky gut syndrome
• Healing and feeding the gut
• Conclusions

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Agenda

• My personal experience with autism
• Gastro-intestinal disturbances
• The importance of the liver
• Diagnostic testing
• Leaky gut syndrome
• Healing and feeding the gut
• Conclusions

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The Tommey Family

• My son Billy, now 9, was diagnosed with severe
  autism at 2 years 5 months

The Autism File / The Autism Trust
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Billys Early History

• Genetic predisposition inflammatory diseases
  and Th2 dominance within the family
• Not breast fed
• 2-5 months DPT 7-12 Months repeated antibiotics
  MMR at 12 months respiratory tract infection
• Hair loss and dry skin with extended abdomen and
  loss of all language
• Poor pallor, puffy face and black eye circles
• Increased allergies to foods and selective eating
  habits
• Pale lose stools, water retention, through to
  chronic diarrhoea with immediate and continued
  weight loss
• Disturbed sleep patterns, high pitched screaming
• Isolation (world of his own), loss of eye contact
  and no social interaction with his peers, siblings

The Autism File / The Autism Trust
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My Perspective on Autism

• Autism is a syndrome characterised by
• impairments in social relatedness and
  communication
• repetitive behaviours
• abnormal movements and
• sensory dysfunction
• Autism is a psychological disorder initiated by
  physiological, metabolic and biochemical
  abnormalities
• Most importantly, autism is not a brain disorder,
  but is a disorder that affects the brain

The Autism File / The Autism Trust
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Agenda

• My personal experience with autism
• Gastro-intestinal disturbances
• The importance of the liver
• Diagnostic testing
• Leaky gut syndrome
• Healing and feeding the gut
• Conclusions

The Autism File / The Autism Trust
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Gastro-Intestinal Disturbances

• Poor digestion low levels of amino acids,
  essential fatty acids, minerals, vitamins and
  trace elements
• Diarrhoea, constipation, bloated / abdominal
  distension, flatus, inflammation
• Light coloured, smelly stools often containing
  undigested foods
• Leaky gut syndrome
• Inadequate enzyme function
• Dysbiosis parasites, pathogenic flora, yeasts
  and viral infectious agents
• Inadequate HCl production/disturbed pH

The Autism File / The Autism Trust
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The Gut Function

• The size of a football pitch
• Constituents parts
• Mouth - mastication, amylase
• Stomach gastric secretions, digestion
  absorption
• Pancreas insulin, digestive enzymes
  bicarbonate
• Ileum absorption, fermentation digestion
• Colon absorption, water absorption digestion
• Rectum - elimination

Microvilli in small intestine
Ileum inflammation
The Autism File / The Autism Trust
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Altered Disrupted Gut Function

• Exists in 94 of autistic sufferers
• Intestinal permeability
• Inflammation - excessive mucus production,
  elevated lysosome and calprotectin (markers)
• Nutrient deficiencies - B and fat soluble
  vitamins (A,D,E,K)
• Altered gut ecology - disorganised micro biota,
  growth of yeasts, bacteria, viruses, parasites
  etc.
• Food allergens and food intolerances
• Benefits from Secretin and Bethanecol (pancreatic
  stimulants)
• Benefits derived from GI support pro and pre
  biotics, multivitamin and mineral supplementation
  etc.

The Autism File / The Autism Trust
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Agenda

• My personal experience with autism
• Gastro-intestinal disturbances
• The importance of the liver
• Diagnostic testing
• Leaky gut syndrome
• Healing and feeding the gut
• Conclusions

The Autism File / The Autism Trust
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The Key Functions of the Liver

• Re-packaging nutrients
• Immune system
• Toxin breakdown
• Hormone production insulin and adrenalin
• Protein structure manufacture
• Bile secretion - fat breakdown, prevention of
  constipation, pH balance, reducing food allergies
• Regulation of blood clotting

• Manufacture of vitamin D and storage of vitamins
  A, B, E and minerals
• Cholesterol production
• Conversion of glucose to glycogen for storage
• Regulation of blood levels of amino acids
• Conversion of ammonia to urea
• Destruction of pathogens e.g. bacteria via the
  Kupfer cells

The Autism File / The Autism Trust
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Detoxification Issues

• Low plasma sulphate levels and elevated sulphite
  levels (molybdenum deficiencies)
• Poor methylation and trans sulphation
• Inflammation leading to reduced glutathione
  levels
• Deficiencies in co-factors for super oxide
  dismutase and glutathione peroxidase (zinc,
  manganese, molybdenum and selenium)
• Ammonia
• Signs of cellular apoptosis
• Mitochondrial dysfunction
• DNA damage
• Low levels of anti-oxidants, increased heavy
  metals
• Stress leading to increased oxidative stress
• Inability to handle toxins

The Autism File / The Autism Trust
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The Liver and Autism

• Autistics have a poor ability to detoxify and
  also have
• Leaky gut syndrome which increases absorption of
  toxins, allergens and pathogens
• Hormone imbalances such as insulin, adrenalin,
  cortisol and serotonin
• Poor digestion of fats
• Candidiasis and constipation
• Low levels of beneficial flora (pH imbalance)
• Increased food allergens
• Low levels of B vits esp. B6, B12, Vit D
  deficiency and minerals
• Poor liver enzyme function
• Heavy metal toxicity
• The majority of these features are liver
  activities

The Autism File / The Autism Trust
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Liver Detoxification

• The liver employs two phases of detoxification
  using the p450 cytochrome enzymes
• Phase 1 Activation Toxins are pulled out of
  storage by activation enzymes, predominantly
  Super Oxide Dismutase (SOD)
• Phase 2 Conjunction The toxins are passed onto
  further enzymes, predominantly glutathione
  peroxidase, to be converted into water soluble
  toxins for elimination
• The liver has to be key to the treatment of
  autistics

The Autism File / The Autism Trust
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Vitamins Minerals in Support

• Phase 1 Activation
• SOD zinc, molybdenum and manganese
• Vitamin A (measles drains Vitamin A reserves)
• B2,B3,B6,iron,magnesium,zinc,C,E, beta carotene
  and selenium
• Phase 2 - Conjugation
• Glutathione Peroxidase Selenium
• Vitamin B6, folic acid, magnesium
• Support methylation and sulphation pathways
• TMG, DMG, Folic acid, sulphate, B6, B12

The Autism File / The Autism Trust
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Improving the Liver Nutrition

• Cut out all refined carbohydrates and sugar
• Cut out saturated trans and hydrogenated fats
• Increase water purified (1.5 litres per day)
• Increase specific vegetables consumption
  including garlic, leeks, Jerusalem artichokes,
  onions, Brussels sprouts, broccoli, parsley,
  beetroot, radish, cabbage, collards, kale,
  watercress, sesame seeds walnuts
• Increase fruit consumption including apricot,
  avocado, banana, blackberries, blueberries,
  pomegranates, strawberries, cranberries, lemons,
  papaya, pineapple, watermelon, tomatoes,
  tangerines, raspberries
• Increase amino acids including cysteine,
  methionine, taurine, lipoic acid and glycine.
• Drink dandelion tea, tinctures, lemon and green
  tea

The Autism File / The Autism Trust
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Agenda

• My personal experience with autism
• Gastro-intestinal disturbances
• The importance of the liver
• Diagnostic testing
• Leaky gut syndrome
• Healing and feeding the gut
• Conclusions

The Autism File / The Autism Trust
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Each Child is Different

• Each child is diagnosed under the same
  psychological umbrella as any other child with
  autism
• However, each child is an individual and may have
  a very different underlying aetiology and express
  very different biochemical, metabolic and
  physiological differences compared to others
• Diagnostic testing is at the heart of structured
  analysis

The Autism File / The Autism Trust
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Prioritise Any Tests

• Ask yourself these questions
• Does my child exhibit gut related disturbances?
• Does my child have problems with certain foods?
• Does my child have any symptoms associated with
  dysbiosis and liver stress?

The Autism File / The Autism Trust
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Relevant Tests

• Comprehensive Digestive Stool Analysis (CDSA)
• Intestinal Permeability
• Urinary Peptides
• Vitamin / Mineral Trace Element Disturbances
• Organix
• Food Allergy Panel
• Secretory IgA
• Kryptopyroles
• Sulphate/sulphite in urine
• Methylation markers
• Essential hair analysis, toxic and nutrient
  elements
• Oxidative stress analysis

The Autism File / The Autism Trust
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What to do with the Results?

• Seek appropriate guidance
• Gather information and direction from your
  selected experts continue if 2 or more agree
  with the protocol
• Advice must be given as to why each supplement /
  intervention is to be used what will it do?
• How will it help? What will it address? How long
  should I wait to see results? Could there be
  negative reactions or side affects?
• Follow guidance on dosage, when to give and how
  much and whether it should be accompanied with
  food, drink or given in isolation?
• Will your child swallow capsules or tablets? If
  not, are there any other forms such as liquid,
  cream, powder?
• Is all of this within your budget?

The Autism File / The Autism Trust
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Order of Treatment

• Firstly improve the liver function
• If your child has increased permeability,
  dysbiosis, allergenic responses and inflammation
  it is inevitable that more toxins will reach the
  liver and therefore put much more stress on it.
  Do not add more stress to the liver by treating
  G.I. disturbances first
• Second address the performance of the gut by
  testing for and then treating any intestinal
  permeability or Leaky Gut

The Autism File / The Autism Trust
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Agenda

• My personal experience with autism
• Gastro-intestinal disturbances
• The importance of the liver
• Diagnostic testing
• Leaky gut syndrome
• Healing and feeding the gut
• Conclusions

The Autism File / The Autism Trust
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What is Leaky Gut?

• The gut lining is inflamed and more porous than
  normal
• 70 of our total immune system surrounds the gut
• The gut will allow pathogens, undigested
  proteins, fats and waste not normally absorbed
  into the blood system
• Protection by secretions mucus, sec IgA,
  epithelium and intramural lymphocytes
• Liver stress increases toxic exposure from
  endotoxins, xenobiotics, toxic wastes,
  polyamines, and allergenic peptides
• Poor diet, stress and antibiotics all increase
  the condition

The Autism File / The Autism Trust
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Testing for GI Disturbances
The Autism File / The Autism Trust
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The Autism File / The Autism Trust
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Digestive Stool Analysis with Parasitology (CDSA)

The Autism File / The Autism Trust
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Organix

The Autism File / The Autism Trust
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Agenda

• My personal experience with autism
• Gastro-intestinal disturbances
• The importance of the liver
• Diagnostic testing
• Leaky gut syndrome
• Healing and feeding the gut
• Conclusions

The Autism File / The Autism Trust
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Healing the Gut Where to Start

• Stop exposures to NSAIDs or cytotoxic drugs
• Reduce inflammation by getting rid of pathogens
  and allergens and correct dysbiosis
• Eliminate allergenic foods
• Check HcL levels and B6 and zinc status
• Address pathogenic bacteria
• Reduce antibiotic usage
• Increase secretory IgA

The Autism File / The Autism Trust
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Use of Probiotics

• Benefits of beneficial bacteria
• Fermentation of soluble fibre to SCFAs
• Butyrate 70 of colonic fuel
• Vitamin synthesis especially B vitamins
• Degrade Gluten and Casein (mindlink)
• Immuno modulation stimulation of secretory IgA
• Custom Probiotics d-lactate free formulation
• Lactobacillus GG

The Autism File / The Autism Trust
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Candida

• Symptoms
• Poor sleep patterns inappropriate giggling /
  laughing intense carbohydrate cravings fatigue
  behavioural problems bouts of screaming dark
  eye circles
• Causative Issues
• Excessive antibiotic use
• Poor diet refined carbohydrates and sugar rich
  foods
• Apples, grapes and raisins
• Immune suppression esp. low TH1and Sec IgA

The Autism File / The Autism Trust
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Candida Therapy

• Pharmaceutical interventions nystatin /
  diflucan / amphotericin B
• Hemicellulases and xylanases break down yeast
  cell membranes
• Pau darco
• Capryllic acid
• Goldenseal
• Garlic, oregano, olive leaf extract, grapefruit
  seed extract
• Probiotics - lactobacillus GG
• No Glutamine as it encourages Candida growth

The Autism File / The Autism Trust
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Beneficial Foods for the Gut

• Cabbage, Brussels sprouts, broccoli, raw garlic,
  onions, leeks, radishes, fenugreek, ginger root,
  hot chilli, lemon juice, turmeric, mustard,
  rosemary, parsley, spinach, pineapple and papaya
• Foods to avoid
• Refined carbohydrates promotes dysbiosis
• Excessive protein leads to smelly stools,
  putrefaction
• All allergenic foods
• Excessive fat intake red meats, fried food

The Autism File / The Autism Trust
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Other Therapies

• Enzymes important for individuals with leaky
  gut as they breakdown peptides that may pass
  across the gut membrane allergenic response
• L-Glutamine (not with candidiasis treat first) -
  70 fuel for small intestine (may cause
  hyperactivity/excitation) 1-3 g/day
• Butyrate 70 fuel for large intestine, a short
  chain fatty acid derived from fermentation of
  soluble fibre

The Autism File / The Autism Trust
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Agenda

• My personal experience with autism
• Gastro-intestinal disturbances
• The importance of the liver
• Diagnostic testing
• Leaky gut syndrome
• Healing and feeding the gut
• Conclusions

The Autism File / The Autism Trust
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In Summary

• Support the liver with beneficial foods,
  nutrients and herbs
• Use relevant diagnostic tests to identify and
  isolate Gastro intestinal disturbances
• Remove pathogens and allergens
• Stimulate and balance immune response and reduce
  inflammation
• Heal the gut
• Re-test for Gastro-intestinal disturbances

The Autism File / The Autism Trust
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Through close diagnosis and a focus on the liver,
we can improve the condition and lives of those
suffering from autism

The Autism File / The Autism Trust