if only my child could talk!nac.nationalautismassociation.org/wp-content/... · pass thru the blood...

Speech, Fats, and Oxidative Stress

©2011 True Health Medical Center Anju Usman, M.D. True Health Medical Center

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IF ONLY MY CHILD COULD TALK!

Dr. Julie Logan D.C., MAPS True Health Medical Center

Naperville, Illinois

True Health Medical Center



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Disclaimer

•  Information is for educational purposes only • Not to be taken as specific medical advice • All medical decisions regarding your child’s

health issues should be discussed with your health care provider

A Child With Autism…

• “Doesn't speak or has delayed speech, or loses previous ability to say words or sentences • Can't start a conversation or keep one going, or only starts one to make requests or label items • Speaks with an abnormal tone or rhythm and may use a singsong voice or robot-like speech • Repeats words or phrases verbatim, but doesn't understand how to use them • Doesn't appear to understand simple questions or directions”



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Speech Makes Us Human

Neuro-Inflammation:

• Causes:

• Treatments: • Tried and True Therapies for Resolving

Apraxia and Restoring Verbal Communication:



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The Many Physiologic Stresses Our Kids Face •  Oxidative Stress •  Mitochondrial Dysfunction •  Impaired Detoxification

–  Methylation Defects –  Sulfation Defects –  Cysteine Deficiency –  Glutathione Deficiency (GSH)

•  Gastrointestinal Dysfunction –  Dysbiosis –  Malabsorption /Maldigestion –  Inflammation –  Intestinal Permeability

•  Immune System Dysregulation/Inflammation –  Proinflammatory Cytokines –  Microglial Activation –  Th1/ Th2 skewing –  Increased Autoimmune Markers

•  Neurological Dysregulation –  Abnormal EEG –  Neurotransmitter imbalances

All can lead to Neuroinflammation

Causes of Neuroinflammation

•  Toxic metabolites •  Autoimmunity •  Allergens •  Aging •  Microbes/Infections •  Viruses •  Traumatic brain injury •  Spinal cord injury •  Air pollution •  Passive smoke •  Mycotoxins



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Neuroinflammation leads to the familiar symptoms…

•  Behaviors –  Attention/Focus –  Hyperactivity –  OCD –  Stimming (verbal, visual, motor…) –  Mood Dysregulation

•  Social Delay •  Motor Skills •  Processing Problems (auditory, visual, tactile

smell) • Speech and Language Delays

Neuroinflammation

•  Neuroinflammation is widely regarded as a chronic process.

•  Acute inflammation usually follows injury to the central nervous system immediately, and is characterized by inflammatory molecules, endothelial cell activation, platelet deposition, and tissue edema.

•  Chronic inflammation is the sustained activation of glial cells and recruitment of other immune cells into the brain.



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The Unresolved Inflammatory Response aka Chronic Inflammation •  The Innate immune response is activated •  Mast Cells Degranulate-histamines and

prostaglandins •  Microglial cells are activated •  Glutamate is released •  Excess Excitation ensues, interferes with brain

tasking •  Leading to

–  Dysautonomia –  Mitochondrial dysfunction –  Oxidative stress

Nicolas G. Bazan, ... Ludmila Belayev, in Basic Neurochemistry 2012

Immune Dysregulation •  Th1 and Th2 skewing •  Abnormal cell-mediated immunity (Molloy, 2006) •  Abnormal T-cell subsets, decreased NK cells (Zimmerman, 1998; Gupta, 1996) •  Pro-inflammatory cytokines,TNF alpha, IL-6 (Jyonuchi, 2001; Maes, 2001) •  Mercury, Lead, and Aluminum cause Th1/Th2 skewed immune system •  Pro-inflammatory Cytokines in the Brain- MCP-1, TGF beta-1, •  Purkinje cell loss (Vargas, Pardo, Laurence, 2005) •  Microglial Activation, Innate immune system activation, Microvasculitis (Vargas,

Pardo 2005) •  Abnormal EEG, Seizure activity •  Increased Autoimmunity •  Autoantibodies to neural antigens (Connolly, 1999) •  Mylein basic protein and Neuronal Axonal Filament Protein Antibodies (Gupta,

1996 /Singh, 1997) • 



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Neuroinflammation Orchestration-Microglial Cells •  Innate immune cells of the CNS •  Microglia are key cells in overall brain maintenance—

they are constantly scavenging the CNS for plaques, damaged or unnecessary neurons and synapses, and infectious agents. Since these processes must be efficient to prevent potentially fatal damage, microglia are extremely sensitive to even small pathological changes in the CNS.

•  –

Curr Med Chem. 2007;14(11):1189-97. Microglial activation and its implications in the brain diseases. Dheen ST1, Kaur C, Ling EA

•  The inflammatory response is mediated by the activated microglia, the resident immune cells of the CNS, which normally respond to neuronal damage and remove the damaged cells by phagocytosis.

•  Activation of microglia is a hallmark of brain pathology. The chronic activation of microglia may in turn cause neuronal damage through the release of potentially cytotoxic molecules such as proinflammatory cytokines, reactive oxygen intermediates, proteinases and complement protein



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Mast Cell Activation and Mutation • Triggers:

T-cell interactions Abnl microbiome

•  Infections: Lyme, H. pylori, EBV, …

• Ehlers-Danlos • Allergens • Mold

Various triggers cause Mast Cells to degranulate And release a variety of inflammatory compounds Mast Cells cause Microglial Activation (PANS Flare)



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Brain Excitotoxicity

• Microglia release proinflammatory mediators, that cause

• Glutamate release from neurons, • Glutamate binds to the NMDA receptor, • Allowing Calcium to flow into cells rapidly • Excess Calcium excites the cells and

causes damage to neurons

The principle excitatory receptor, the N-Methyl-D-Aspartate (NMDA) receptor, and its associated calcium (Ca2+) permeable ion channel are activated by glutamate.



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Stimulators of the Excitotoxic Cascade •  Immune response to infections (quinolinic

acid) • Calcium intake (sometimes) • Food based excitotoxins-glutamates,

MSG, amines, aspartate, nutrasweet, sometimes glutamine, caffeine, dyes, sulfites, proprionates, sometimes phenols

Oxidative Stress and Mitochondrial Dysfunction

•  The inner membrane of the mitochondria contains a large amount of free radical scavengers including: –  glutathione –  vitamin C –  vitamin E –  Anti-oxidant enzymes such as SOD-(superoxide dismutase)

•  Some children with autism have lower levels of reduced glutathione and SOD, which could lead to mitochondrial damage and dysfunction.

•  Impairments in mitochondrial function lead to further oxidative stress and continued lower glutathione levels.



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Oxidative Stress and the Brain

Neurons are highly vulnerable to oxidative stress and are the first cells to be affected • Brain has high energy needs-consumes

20% of body’s oxygen • Has high ATP requirement (mitochondria) • Neurons don’t make their own glutathione • Limited antioxidant capacity

Evidence linking oxidative stress, mitochondrial dysfunction, and inflammation in the brain of individuals with autism. Rossignol DA1, Frye RE2

•  “The brain regions found to contain these physiological abnormalities in individuals with ASD are involved in speech and auditory processing, social behavior, memory, and sensory and motor coordination.”

•  Front Physiol. 2014 Apr 22;5:150. doi: 10.3389/fphys.2014.00150. eCollection 2014.



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Dysautonomia

• Loss of balance between Sympathetic and Parasympathetic branches of the ANS

•  Increased release of norepinephrine, epinephrine, cortisol, excitatory neurotransmitters

• Chronic stress response • Loss of proper Vagal nerve function

Possible Signs and Symptoms of Vagus Nerve Dysfunction/Dysautonomia

in ASD

•  Poorselfregulation/tantrums•  Irritablewhenmissesmeals•  Difficulttransitioningtonewenvironment

–  Light,sound,temperaturesensitivities•  Needfordeeppressuretohelpregulate•  Headbanging,selfinjury•  Foodrefusal•  Lickingbehavior(saltseeking)•  Constipation/Dysmotility/Bloating/SmallIntestinalBacterial

Overgrowth



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True Health Medical Center Cell Membrane Repair/Apraxia Therapies •  Cell Membrane Repair-fats, cholesterol, fat-

soluble vitamins and antioxidants, phospholipids •  Methylation support •  Folate sources and BH4 •  Address Dysautonomia •  Decrease excitotoxicity •  Choline enhancing agents, cholinergics •  Mitochondrial support

The Need for Cell membrane Repair-Neuroinflammation is Cell Membrane Damage



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Cell Membrane Repair Consists of: Building Blocks • Healthy fats,-PUFA-Omega 3’s, saturated

fats, plant oils • Cholesterol • Fat soluble vitamins • Fat soluble antioxidants • Nutrients to support myelination • Substances to calm cellular excitotoxicity • Substances to improve cellular

detoxification

•  Fats, are an integral part of all cell membranes, and are vulnerable to destruction through oxidation by free radicals and neurotxoxins, like mercury.

•  Fatty acid oxidation in the brain leads to poor cell to cell communication, microglial activation, glutamate excitotoxicity, methylation/sulfation deficits, glutathione depletion, mitochondrial dysfunction and chronic inflammation! !!!

•  Fat Soluble Vitamins and Antioxidants are uniquely suited to pass thru the blood brain barrier and alleviate oxidative stress in the lipid(fat) portion of the brain. –  70% of the Brain is made up of fat. –  25% of our Cholesterol resides in the brain. –  The mylein sheath is predominantly fat.

Fats/Lipids are good for your brain!



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Cell Membranes are Mostly Fat • Phospholipids

• Choline • Serine • Inositol • Ethanolamine

• Cholesterol • Glycolipids

Cholesterol •  Cholesterol is abundant in the tissue of the brain and nervous system. •  Myelin, which covers nerve axons to help conduct the electrical

impulses that make movement, sensation, thinking, learning, and remembering possible, is over one fifth cholesterol by weight.

•  Cholesterol was found to be the most important factor in the formation of synapses, the basis of our learning and memory.

•  Cholesterol is a precursor to steroid hormones and vitamin D. •  The human body uses cholesterol to synthesize bile acids,

which are important for the digestion of fats.



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Cholesterol and Myelin

Myelin contains an especially high level of

cholesterol and insulates and protects the axon of the neuron.

Myelin increases the speed by which impulses travel along the neuron.

Low Cholesterol

•  Early death •  Suicide •  Personality disorders •  Mood disorders •  Penal confinement in men •  Aggressive and violent behavior •  Sensory issues •  Language issues (Martinez-Carpio, 2009)



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Cholesterol helps with ASD, hyperactivity, irritability, growth, sleep and interactions

Fat Soluble Vitamins

•  Vitamins A, D, E, K •  Antioxidant, anti-inflammatory effect •  Strongly immunomodulating •  Viruses and Pertussis disconnect retinoid

receptors in the eyes. •  Natural vitamin A may reconnect the retinoid

receptors critical for vision, sensory perception, language processing and attention.

•  Fat soluble vitamins often deficient in ASD due to gut issues and malabsorption



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Phospholipids-Phosphatidyl choline

•  Integral part of cell membranes –membrane fluidity •  Membrane fluidity is important for proper signaling and flow of

information and nutrients in and out of cells. •  Requires a large percentage of the available methyl groups to

make phospholipids. Undermethylated state will compromise the synthesis of this critical lipid

Phosphatidyl Serine •  Supports the function of many vital enzymes. •  Acts as an antioxidant, and quells inflammation in the

brain. •  Helps with stress induced damage in the brain. •  Specifically breaks down cortisol and decreases cortisol-

mediated damage to the structures of the brain responsible for learning and memory

•  Ulmann L. Brain and hippocampus fatty acid composition in phospholipid classes of aged-relative cognitive deficit rats. Prostaglandins Leukot Essent Fatty Acids. 2001 Mar;64(3):189-95.

•  Lomnitski L. Distinct alterations in phospholipid metabolism in brains of apolipoprotein E-deficient mice. J Neurosci Res. 1999 Nov 15;58(4):586-92.

•  Suzuki S. Oral administration of soybean lecithin transphosphatidylated phosphatidylserine improves memory impairment in aged rats. J Nutr. 2001 Nov;131(11):2951-6.

•  Castilho JC. Phosphatidylserine: an antidepressive or a cognitive enhancer? Prog Neuropsychopharmacol Biol Psychiatry. 2004 Jul;28(4):731-8.

•  Pepeu G. Nootropic drugs and brain cholinergic mechanisms. Prog Neuropsychopharmacol Biol Psychiatry. 1989;13 SupplS77-S88. •  Schreiber S. An open trial of plant-source derived phosphatydilserine for treatment of age-related cognitive decline. Isr J Psychiatry Relat

Sci. 2000;37(4):302-7.



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Antioxidants • Vitamin E • Vitamin A, vitamin K • Vitamin C • Selenium, Zinc • Reduced Glutathione (r-GSH) • Alpha-Lipoic acid, CoQ10, NADH, and GSH

act as a team • Carnitine, Phosphatidyl Choline, PS • Bioflavonoids (catechins) and Carotenoids • Superfruits (noni, goji, acai, mangosteen…)

True Health Medical Center Cell Membrane Repair/Apraxia Therapies

•  Cell Membrane Repair-fats, cholesterol, fat-soluble vitamins and antioxidants, phospholipids

•  Methylation support •  Folate sources •  Address Dysautonomia •  Decrease excitotoxicity •  AcetylCholine enhancing agents, cholinergics •  Mitochondrial support



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Proven Track Record Therapies to Help with Speech! .

Methylcobalamin Injections-Dr. James Neubrander •  “In my practice, 94% of children have been found to

respond to Methyl-B12 therapy. •  Executive function is improved in 90% of children –

things like awareness, cognition, appropriateness, eye contact when called, and “just being more like a normal kid.” Speech and language is improved in 80% of children – all phases including spontaneous language, more complex sentences, increased vocabulary, etc. Socialization and emotion is improved in 70% of the children – initiation and interactive play”

•  https://tacanow.org/family-resources/methyl-b12-a-treatment-for-asd-with-methylation-issues/



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Methylcobalamin: mechanism of Action •  Because oxidative stress is present in the majority of children on the

spectrum, there arises the continual need for the methionine-homocysteine-glutathione biochemical pathway to recycle enough homocysteine back to methionine to drive methylation reactions

•  In the brain this accounts for focus, attention, synchronization of brain waves, speech, language, socialization, emotion)

•  Also to shunt enough homocysteine onward to become glutathione to satisfy the body’s transsulfuration needs (quenching free radicals, decreasing inflammation, removing toxic chemicals and heavy metals from the body).

•  Methyl-B12: Doing It Right! Methylcobalamin Update USAAA Semi-annual Conference Denver, Colorado August 2007

Methylation, Folate, BH4 Cycles



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Methylcobalamin-High Statistical Success in Supporting Language Development

•  Effectiveness of Methylcobalamin and Folinic Acid Treatment on Adaptive Behavior in Children with Autistic Disorder Is Related to Glutathione Redox Status

Richard E. Frye, 1 ,* Stepan Melnyk, 1 George Fuchs, 1 Tyra Reid, 1 Stefanie Jernigan, 1 Oleksandra Pavliv, 1 Amanda Hubanks, 1 David W. Gaylor, 2 Laura Walters, 1 and S. Jill James 1

Methylcobalamin Administration

• 75 mcg per kg every 3 days is starting protocol-this can be modified as needed

• Given subcutaneously by the parents or to self

• Almost painless • Filled by a compounding pharmacy such

as Pure Compounding Pharmacy in Naperville, IL



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Synapsin Nasal Spray

• Neuroprotective • Decreases excitotoxicity • Decreases oxidative stress induced

inflammation •  Improves neuroinflammation outcomes • Blend of nicotinamide riboside, panax

ginseng extract, and MB12 •  * JooSS etal.Prevention ofinflammationͲmediatedneurotoxicitybyRg3anditsrolein

microglialactivation.BiolPharmBull.2008Jul;31(7):1392Ͳ6. * BaoHY, ZhangJ,YeoSJ,etal.Memoryenhancingandneuroprotectiveeffectsofselected ginsenosides.ArchPharmRes.2005Mar;28(3):335Ͳ42.

Leucovorin: Rx Folinic Acid

•  Dr. Richard Frye MD, PhD & his group recently published the results of a multi-year study that demonstrated that Folinic Acid improved speech and language and other symptoms in children with autism.

•  Cerebral folate deficiency (CFD) was discovered a little over 10 years ago. As more and more cases were described with this disorder, it was clear that many cases had symptoms consistent with autism.

•  This disorder (CFD) was caused, in some cases, by Folate Receptor Alpha Autoantibodies (FRAAs) which were blocking the transportation of folate into the brain.

•  Benefit greatest in kids who have brain autoimmunity with antibodies that block the vitamin’s transport into brain cells – https://www.nofone.org/dr-frye-q-and-a-folinic



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Folatereceptorautoimmunityandcerebralfolatedeficiencyinlow-functioningautismwithneurologicaldeficitsNeuropediatrics2007Quadros,Ramaeker

•  Twenty-five patients with early-onset low-functioning autism with or without neurological deficits, were evaluated.

•  In spite of normal serum folate, CSF 5MTHF was low in 23 of 25 patients. The reduced CSF folate in 19 of these 23 patients could be explained by serum FR autoantibodies blocking the folate binding site of the membrane-attached FR on the choroid epithelial cells.

•  Oral folinic acid supplements led to normal CSF 5MTHF and partial or complete clinical recovery after 12 months.

•  Serum FR autoimmunity appears to represent an important factor in the pathogenesis of reduced folate transport to the nervous system among children with early-onset low-functioning autism associated with or without neurological deficits.

Forms of Folic Acid •  Folate/Folic Acid

–  Least active form –  Needs to be converted to DHF and THF

•  Folinic (5-formyl THF) –  Non-methylated active form –  Dose for Cerebral Folate Deficiency .5-2mg/kg/day in 3 divided

doses –  Rx called Leucovorin –  Can be compounded to avoid excipients (lactose) –  Available OTC

•  Methylfolate (5-methyl THF) –  Methylated form –  Most active form –  Rx called Deplin, Cerefolin (also contains NAC) –  Available OTC



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Motor Connect-Neuromuscular Coordination of Speech

•  Motor-Connect was developed to provide key nutrients involved in neuronal health. The four nutrients in this formula work together to help with neuronal connectivity, energy production, cell membrane integrity, and overall neuronal health. Specifically targeting the cerebellar role

Speech and the Cerebellum

•  The Cerebellum coordinates movement patterns

•  Specifically, the cerebellum plays an important role in speech articulation, prosody (i.e. characteristics of speech style including rhythm, speed, emphasis, and pitch), and planning and processing of speech and language

•  The cerebellum is important for all types of eye movements and for ensuring fixation stability

•  (FYI) visual input is incredibly important for normal brain development

•  The neural basis of ataxic dysarthria.Spencer KA, Slocomb DL •  Cerebellum. 2007; 6(1):58-65.



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Benfotiamine inhbits iNOS, COX-2, HSP 70, TNF-alpha, and IL-6 in microglia (and improves cerebellar function)

Biotin has immunomodulatory and anti-inflammatory effects independent of biotin dependent carboxylases



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True Health Medical Center Cell Membrane Repair/Apraxia Protocol •  Cell Membrane Repair-fats, cholesterol, fat-soluble

vitamins and antioxidants, phospholipids •  Methylation support •  Folate sources and BH4 •  Decrease Excitotoxicity •  Address Dysautonomia •  Choline enhancing agents, cholinergics •  Mitochondrial support •  Low pressure HBOT

Address Excitotoxicity

-Namenda and Amantadine (RX)-oppose the NMDA receptor and glutamate mediated cascade -L theanine, melatonin, GABA, glycine -Magnesium-blocks the calcium channel -Lithium orotate-inhibits NMDA receptor -Vinpocetine and benfotiamine -AVOID excitotoxins in foods!!!!!



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Natural Agents to Decrease Microglial Activation •  Resveratol- neuroprotective •  Pycnogenol- antioxidant •  Vinpocetine-Ca regulation •  Gastrodia elata- brain injury neuroprotective •  Pipera kadsura (Japanese pepper)- PGE2

inhibitor •  (Reishi Mushroom)-immune modulatory •  (Horny Goat Weed)- improves blood flow •  PQQ (pyrroloquinoline quinone)- PGE2 and

COX-2 inhibitor

Address Dysautonomia

Down-regulate Sympathetic (high NE, Epi) •  Adaptogenic Herbs- Adrenal glandular support. •  Beta Blockers- Propranolol •  Alpha 2 adenoreceptor agonists- Clonidine, Guanfacine •  NMDA receptor antagonists- Memantine, Amantadine •  Upregulate inhibitory neurotransmitters- GABA, L-theanine, Taurine,

Glycine •  Chiropractic adjustments •  Benfotiamine/Biotin (Motor-Connect)

Up-regulate Parasympathetic •  Acetylcholine (phosphatidylcholine, phosphatidylserine) •  Acetylcholinesterase Inhibitors (galantamine, huperizine A,

piracetam) •  Vagus Nerve Stimulation-TENS unit or Chiropractic adjustments

Address Gut Issues- especially SIBO



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Down-regulate the Sympathetic Physiologic Response • Propranolol- beta adrenergic receptor

antagonist • Blocks the effects of excitatory

neurotransmitters epinephrine/norepinephrine

• Studied for anxiety, aggression, excitation • Grade A for research for this use

Propranolol for treating emotional, behavioral, autonomic dysregulation in children and adolescents with autism spectrum disorders. Sagar-

Ouriaghli I1, Lievesley K1,2, Santosh PJ1,3,2. •  Propranolol led to significant improvements in cognitive

performance - verbal problem solving, social skills, mouth fixation, and conversation reciprocity; and improvement in semantic networks and functional connectivity.

•  Improvements in EBAD-emotional, behavioral and autonomic dysregulation, anxiety, aggressive, self-injurious and hypersexual behaviours.



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EffectofPropranololonVerbalProblem

SolvinginAutismSpectrum

•  SomestudiessuggestdrugsdecreasingnoradrenergicactivityarebeneficialinASD.

•  Inindividualswithoutneurodevelopmentaldiagnoses,propranololisbeneficialonlyfordifficultnetworkflexibility-dependentproblems.

•  However,inpopulationswithalterednoradrenergicregulation,propranololalsobenefitsperformanceforsimpleproblems.DuetodecreasedflexibilityofaccesstonetworksinASD,wewishedtoexaminetheeffectofpropranololonNFinASD.

•  ASDsubjectsbenefitedfrompropranololonsimpleanagrams,whereascontrolsubjectswereimpairedbypropranolol.

• Neurocase:TheNeuralBasisofCognition2008Beversdorf

Adaptogens plant compounds that have a normalizing impact on the HPA axis under times of stress, help with blood sugar regulation, anxiety, immune modulation

• Panax Ginseng- lowers cortisol • Siberian Ginseng • Holy Basil- anticonvulsant properties • Licorice/Glycyrrhizin- increases cortisol • Rhodiola rosea • Ashwaganda- blood sugar regulation • Bacopa • Gotu Kola • Moringa oleifera- anti-inflammatory • Schisandra

• Adrenal Cortex Extract



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True Health Medical Center Cell Membrane Repair/Apraxia Protocol •  Cell Membrane Repair-fats, cholesterol, fat-soluble

vitamins and antioxidants, phospholipids •  Methylation support •  Folate sources and BH4 •  Decrease Excitotoxicity •  Address Dysautonomia •  Choline enhancing agents, cholinergics •  Mitochondrial support •  Low pressure HBOT

ACETYLCHOLINE

•  Known as the learning neurotransmitter, acetylcholine improves mental function including memory storage and recall, attention control, social interaction, language abilities, reasoning, logic and creative thoughts.

•  It regulates digestion and mood •  Acts in both the brain and the peripheral

nervous system. Increasing it can increase plasticity, cognition , brain performance



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Galantamine-nootropic Ghaleiha A. et al. (2013) Galantamine efficacy and tolerability as an augmentative therapy in autistic children: A randomized, double-blind, placebo-controlled trial. Journal of Psychopharmacology. 28(7), Read Abstract (New Window)

•  In addition to blocking Ach-Esterase, galantamine has a second benefit, unique to it over all other inhibitors which can have decreased efficacy over time.

•  Galantamine can also mimic the effects of Acetylcholine by acting directly on and modulating nicotinic receptors. This interaction allows it to maintain it’s effectiveness long term.

•  You can find it available both as an over the counter supplement —derived from plant sources (snowdrop and daffodil) and as a prescription — a chemical synthesized to match the molecular structure of the natural source.

A Prospective, Open-Label Trial of Galantamine in Autistic Disorder

Dr. Rob Nicolson, Beth Craven-Thuss, and Judy Smith. Journal of Child and Adolescent Psychopharmacology.

October 2006, 16(5): 621-629.

•  Thirteenchildrenwithautism(meanage,8.8±3.5years)participatedina12-week,open-labeltrialofgalantamine

•  Results:Patientsshowedasignificantreductioninparent-ratedirritabilityandsocialwithdrawalontheABC

•  SignificantimprovementsinemotionallabilityandinattentionontheConners’ParentRatingScale—Revised

•  Clinicianratingsshowedreductionsintheangersubscale•  Eightof13participantswereratedasrespondersonthebasisof

theirimprovementscoresontheClinicalGlobalImpressionsscale•  Overall,galantaminewaswell-tolerated,withnosignificant

adverseeffectsapartfromheadachesinonepatient



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Other Cholinergics/Nootropics

• L-theanine • Caffeine • Piracetam • Bacopa • Panax ginseng • Rhodiola • Gingko biloba • GetSmart formula

Reduce Oxidative Stress

• Detox metals • Detox molds, chemicals , pesticides •  Increase glutathione levels-Transdermal,

oral, nebulizer, IV • Antioxidants-see earlier slide • Nrf-2 pathway inducers-regulate cell

protective responses • Balancing pH



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Support Mitochondrial Function

• Vitamin B1, B2, B3, B5, and Biotin • Antioxidants

– Glutathione – Alpha Lipoic Acid- careful – Coenzyme Q10 – Vitamin E – Vitamin K

• L-Carnitine, creatine • Magnesium

When Looking for More- Non Responders • Removal of toxic metals • Antiviral therapy • Chronic infections • Mold exposure • Vision Therapy-does your child need this? • HBOT



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Hyperbaric Oxygen Reduces Neuroinflammation

Hyperbaric treatment for children with autism: a multicenter randomized, double blind, controlled trial BMC Pediatr. 2009 Mar 13;9(1):21.

Rossignol DA, Rossignol LW, Smith S, Schneider C, Logerquist S, Usman A, Neubrander J, Madren EM, Hintz G, Grushkin B, Mumper EA.

CONCLUSIONS: Children with autism who received hyperbaric treatment at 1.3 atm and 24% oxygen for 40 hourly sessions had significant improvements in overall functioning, receptive language, social interaction, eye contact, and sensory/cognitive awareness compared to children who received slightly pressurized room air.

PMID: 19284641



Page # 36

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Thank You! Do not forget to eat your healthy fats.

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