AUTISM: INTRODUCTION TO NUTRITIONAL

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AUTISM INTRODUCTION TO NUTRITIONAL BIOMEDICAL
INTERVENTIONS

• Jon B. Pangborn, Ph.D.

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WHO AM I? - DISCLOSURES

• Father of formerly autistic 41 year-old son
• Ph.D. Chemical Engineering, Syracuse U 1967
• Left Chem Eng 28 years ago, Met Bernie 1981
  Started Bionostics, 1981
• President Doctors Data Lab 1989-95
• Certified Clinical Nutritionist 1991 (IAACN)
• AAEM Teaching Faculty 1988-99
• Consultant, Genova Diagnostics 1997-2002
• Consultant to ARI and Kirkman Labs (present)
• Cofounder Defeat Autism Now! (Autism Research
  Institute)

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WHAT WE KNOW

• Autism is a disease of the body that affects the
  brain and the intestinal tract.
• Autism features (acquired) metabolic and immune
  dysregulations, endocrine disorder, and digestive
  deficits.

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WHAT WE KNOW2

• In rare cases now, autism results principally
  from inborn errors of metabolism, e.g.,
  succinyl-purinemic autism with adenylosuccinase
  lyase deficiency.
• To date, autism is a disease of every-increasing
  incidence that has reached epidemic proportions
  one in 150 births U.S. CDC, 2007

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WHAT WE THINK WE KNOW

• Autism features persistent oxidant stress,
  inflammation and ineffective but enduring
  epigenetic alterations of metabolic processes.
• Autism is the result of a maladaptive response to
  unresolved toxicity and/or infectious insult.

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WHAT YOU NEED TO KNOW

• Why is he/she autistic?
• Can autistics recover?
• When does a biomedical approach work?
• Why is it so difficult to reverse?
• How do you do it?

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WHY IS YOUR CHILD/PATIENT AUTISTIC?

• For most (gt95)
• Pre-existing (genetic) weakness(es) in
• Cellular housecleaning
• Immune response
• Dealing with oxidation
• Resolving inflammation
• Carbon, sulfur metabolism
• 2. Poor nutritional status
• 3. Exposure to toxic or infectious stressors

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AUTISM MALADAPTIVE RESPONSE TO UNRESOLVED
STRESSORS

• Toxic or infectious stress at age 6 months 30
  months can affect brain development and function,
  including neuronal connectivity and synchrony.
• Biochemistry adapts to chronic inflammation, and
  becomes deficient in aspects needed for
  integrative thought and expressive speech.
• The adaptation persists as long as the effects of
  the stressors exist.

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WEAKNESSES STRESSORS

• Preexisting weaknesses (subclinical)
• Inadequate detoxication capabilities
• Disordered folate, vitamin B12 chemistry
• Disordered processing of adenosine, homocysteine
  and glutathione
• Inhibited methylation (transferring CH3)
• Decreased energy delivery to neurons
• Decreased neuronal synchrony

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WEAKNESSES STRESSORS2

• Stressors
• Toxic elements mercury, arsenic, antimony, lead
• Organophosphate, organochlorine pesticides,
  xenobiotics. Vaccines?
• Measles virus, maybe mumps, streptokinase
• Intestinal dysbiosis

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• Energy delivery Methylation of neuron-
• To neurons receptor fatty acids
• Inflammation
• Downregulates
• METHIONINE Essential
  Amino Acid
• 
  possessing sulfur -CH3
• inflammation BROKEN
• upregulates
• CYSTEINE ? GSH
• 
  Antioxidant functions
• 
  Detoxifying functions

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THE GRIDLOCK OF AUTISM

• When the emphasis is switched from methylation to
  cysteine formation, this means energy transport
  (creatine phosphate, ADP ? ATP) is decreased
  epigenetic adaptation to oxidant stress and
  inflammation.
• Receptor methylation becomes deficient very bad
  at age 1-2 years hurts development of neuronal
  network connectivity.
• The child isnt able to connect multiple sensory
  inputs (shape, color, texture, sound, smell,
  etc.). S/he cannot respond with expressive speech.

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HOW CAN WE GET OUR AUTISTIC CHILDREN BACK?

• Break the gridlock by
• Removing dietary/environmental stressors
• Bolstering nutrition
• Relieving oxidant stress and inflammation
• Improving broken biochemistry
• Improving immune function
• Detoxification

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CAN AUTISTICS BE HELPED?

• See ARI Publication 34 Parent Responses
• Educational/behavioral intervention (48 recover)
  Lovaas UCLA Young Autism Project (Sallows,
  Am.J.Mental Retard. 110 no.6 2005 417-438)
• ARI 1100 recovered with documentation per
  parents DVD, Recovered Autistic Children

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ONLINE -

• Go to www.autism.com
• See ARI/Autism Research Institute of San Diego
• Click on Recovery
• Enjoy!

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WITH AUTISM, MOST UNDERLYING PROBLEMS ARE -

• Metabolic effects of acquired toxicities and
  infectious agents that can be remedied,
• Epigenetic changes that can be reversed by
  treating inflammation and by removal of the
  instigating stressors,
• Genetic traits that become subclinical conditions
  after toxic and infectious stressors are removed.

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WHAT IS BIOMEDICAL INTERVENTION?A remedial
strategy that selects treatment options for the
individual based on history, needs and
presen-tations, diagnostic workups and response
to trials. Options include

• Improving diet
• Improving digestion
• Clearing dysbiosis
• Nutritional supplements
• In conjunction with relational therapy

• Avoidance diets
• Immune support, antivirals
• Metabolic remedies
• Detoxification

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THE DAN! BIOMEDICAL APPROACH

• Not a protocol
• Intelligent choice of options for the individual
• Dont need to know the entire recovery path
• Go step by step with trials
• Dont need lots of expensive tests
• Dont expect a magic bullet
• Results take time
• Keep a log or diary of trials - outcomes

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DOES IT ALWAYS WORK?

• Severe inborn errors of metabolism missing or
  damaged genes Rett syndrome, Fragile X, Angelman
  syndrome, Smith Magenis, Adenylosuccinate lyase
  deficiency NOT CORRECTABLE (YET), SOME
  IMPROVEMENTS MAYBE
• Maybe not forever. PKU featured autism in 40
  now PKU autism is very rare.
• MOST OF TODAYS AUTISTIC CHILDREN CAN RECOVER OR
  BE SIGNIFICANTLY IMPROVED.

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SUGGESTED ORDER OF INTERVENTIONS
BASIC NUTRITIONAL SUPPLEMENTS
CLEAN UP DIET
DIGESTIVE AIDS
TRIAL CF, GF,SC DIETS
TREAT DYSBIOSIS
IMMUNE SUPPORT
METABOLIC MANIPULATIONS
DETOXIFICATION
ABA
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SUGGESTED STAGING OF INTERVENTIONS
First-tier Options
CLEAN UP THE DIET
Digestive enzymes Vitamin B6 and
magnesium Taurine Vitamins C and
E Zinc Calcium Vitamin A, cod liver oil Fatty
acids Melatonin Multivitamins, multiminerals
TRIAL CF DIET
TRIAL GF DIET
TRIAL SPECIFIC CARBOHYDRATE DIET
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Activated charcoal Silymarin (milk
thistle) Probiotics S.boulardii as
needed ?-ketoglutaric acid
Treat dysbiosis, repeat as needed
Second-Tier Options
More vitamin C Antioxidant formulations N-acetylcy
steine Glutathione
Detoxification
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DMG, TMG MethylCbl, folinic acid Amino
acids Creatine L-carnitine CoQ10 Mg
malate Carnosine
Metabolic manipulations
ABA, Special Ed programs
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• As parents, we need to act in our childrens best
  interests.
• Chances are, they wont outgrow it. Usually,
  the sooner you begin, the better the results.
• Should I wait for orthodox medical science to
  find a solution?

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DAN! BIOMEDICAL APPROACH

• Read the manual.
• Autistics are individuals address the
  individuals problems. Autism is not a single
  entity its a spectrum of disorders with
  multiple contributing causes.
• To proceed, all you have to do is decide, what do
  we do next? Dont expect a magic bullet. Dont
  try to do everything at once!
• Proceed with care. Take one step at a time.
• Keep careful records.

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• The next DAN! Defeat Autism Now meeting is in
  San Diego, California, October 24-26, 2008.
• See ARI website, www.autism.com
• DAN! Is a parent-clinician collaborative effort
  of the Autism Research Institute of San Diego.
• ARI is cooperating with ASA and other
  parent-oriented autism interests.
• ARI 619-281-7165
• ARI website www.autism.com