A Word from the President, Fall 2010

From “L’Image”, Fall 2010

Unfortunately, because of a lack of time, I was not able to complete my Word from the President for this issue of Image. The reflections I wanted to share with you were about the important role that we, parents, are playing on the evolution of autism and ASDs, even now in 2010. We are confronted with a “classified file” at the government and that, with no openness or possibility of discussion. The budgets are clearly insufficient and the constant and important increase in ASD cases complicates the development of expertise and the organization of appropriate services. The continuous reforms of the MSSS are destabilizing the health system globally and we are the ones who have been forgotten, etc., etc. Thus, for someone like me who have been here for a long time, we are still facing a critical situation and the services offered are diminishing both in quantity and quality. We will have to “get angry”. It is because of our actions and willpower that we will be able to change things. We are currently thinking about several actions that would allow us to be more visible. We will work together with you. You will find below an article regarding the medical aspect of autism. We also need to concentrate on this aspect because in Quebec, the health of our closed ones and the medical research on the causes for autism are completely disparaged. For us, parents, it is important to be able to understand the importance of this issue and the direct relationship between the health of our children and the behaviors they display. “A healthy mind in a healthy body” has never been more true. Take care!

Except from the DAN! Conference, which was held in October 2010, at Long Beach, in the United States:

“Though there is much we still have to learn about Autism’s etiology, we do know that for most of those affected it is multi-factorial (i.e. there is no “smoking gun”). As a Disease of Modernity, a compelling framework for its cause is insult to the nervous system during developmentally critical time periods. Whether it results from mercury leeched from maternal amalgam fillings, Thimerisol from vaccination, pesticides from inorganic foods and pest control, off-gassed chemicals in the “new car smell” or any of thousands of industrial pollutants that come from distant smoke-stacks and as close as the vinyl coating on an infant’s mattress. Chemicals abound. These insults may be amplified by the immunological impact of the current recommended vaccine schedule (which has dramatically increased in the last quarter century alongside the epidemic), the altered flora from excessively over-utilized antibiotics, and/or stealth viruses which in a genetically susceptible individual may result in the “critical mass” that begins the neurological regression that is called Autism.

Of the many biochemical similarities seen in spectrum children, one of the most poignant and defining is their seemingly limited ability to detoxify effectively. This is evidenced by poor excretion of toxic metals in baby hair (Holmes et al.), increased excretions of Mercury with chelation challenges (Bradstreet et al.), possibly by aberrant porphyrin levels and most evidently by the clinical improvement associated with detoxification. It is important to remember that despite the desire for there to be a simple and exclusive relationship between Mercury and Autism, it is but one of thousands of toxic compounds that children can be exposed to in utero and during infancy’s critical developmental period. The “broken” Detox Pathways make the body’s exposure to small amounts of toxic elements (e.g. Lead, Mercury, Arsenic, etc) significant but these same pathways are designated to protect us from volatile organic compounds (VOCs), pesticides, and other synthetic materials (e.g. plastics). With failed detoxification pathways the poisons accumulate in the body which leads to further degradation of crucial biochemical pathways and the resultant vicious circle perpetuates the toxic presence and effect. Another factor (as if one were needed) is that these poisons are synergistically toxic and it is well known that combining toxins decreases the amounts required for a lethal dose. Ergo, less would be needed for a toxic effect as well.

One such effect is the sensitivity seen in affected children. The corrupted pathways cascade to create interference in our delicate biochemical environment. As outsiders, we plainly observe the neurological symptoms of Autism. This makes sense as it is half the Nervous System’s job to be sensitive, and it will sense and react (often, adversely) to changes in biochemistry. This is well defined in medicine. In Endocrinology, often the first symptom of an under-active thyroid is depression and this organic effect is present prior to many of the “physiologic” symptoms. As a result the symptom is commonly misapplied to endogenous depression and addressed with anti-depressants while the cause goes untreated. This is especially dangerous in Autism where many physicians still ignore dramatic pathophysiology (e.g. gastroenterologic and immune abnormalities) “because the child is Autistic” and thus symptomatic cries of pain are defined as “behaviors” and immune or other pathology is contextualized and often dismissed. Another effect of their heightened sensitivity is that spectrum children can be susceptible to side effects and abreactions to some treatments that may be crucial for their recovery. It is for this reason that treatment decisions need to be directed at the causes of the symptoms as opposed to palliating the symptom and dosing strategies taper upwards to allow for hidden sensitivities.

A critical means of getting to the core of the problem is to effectively address toxicity. While the body is “toxic”, there will continue to be problems with metabolism and further physiologic dysregulations (i.e. digestion, a functional sensorium, inflammation, immune dysregulation). For this (and other good reasons) addressing the toxic source can go a long way to improving the downstream effects. This being said making the correct choices for approach to detoxification including the choice of medication, strength, frequency and mode of administration (i.e. orally, rectally, intravenously or transdermally). Part of making a good decision regarding detoxification requires this appreciation for the other compounds (non-metal) that need to be cleared and when contemplating the results of a provocative challenge, that the quantity of other diuressed poisons (excreted in the urine) be evaluated or at least considered (i.e. no mercury or lead in a urine sample does not mean that there are no metals in the body, if the Detox agent is bound to a toxin not being analyzed and this isn’t taken into account the results may be misinterpreted). A paper from China has shown that DMPS, a medicine used to treat Mercury poisoning, is highly effective at binding and detoxifying certain non-metallic pesticides (organophosphates). In the context of an underwhelming provocative challenge, it is reasonable to consider that the agent is not sitting inert in the urine sample but instead bound to a host of unanalyzed poisons. Currently, it is considered by many that an effective way to survey this murky ground is by analyzing porphyrin levels (metabolites of Heme production that are felt to be an accurate means of divining toxic effect). This may be reasonable to do in some patients but as with many exciting discoveries, they tend to pale when brought out into light of day for full viewing. What remains is an absence of perfect tools for assessment, which if interpreted “concretely” will leave many children under or untreated. And with so many children with impaired of overwhelmed detoxification pathways, the situation often necessitates robust pursuit of a sundry of unidentified toxins.

Part of the “cure”, certainly requires avoiding further toxic exposure. Toxins have become ubiquitous and can penetrate our defenses from every corner. From the air we breathe outdoors, which is more likely than not be contaminated with industrial pollutants to our in-door or in-vehicle air which is almost assured contaminated with vinyl off-gassing. Foods contaminated with pesticides, hormones and non-stick coating from cookware. Water can suffer contamination with a host of pollutants however even the disinfectants used by most municipalities produce by-products which are felt by many to be unsafe to drink and can be absorbed through bath-water as well. Whether through the digestive tract, the lungs or the skin we did not evolve with the defenses to protect us from the host of man-made toxins in our current environment. Clean water and air, organic food and clothing, elimination of amalgam fillings (safely) and avoidance of many synthetic chemical can be a “turnpike” toward recovery. 

Much is known regarding the impact of diet on the symptomatology in a developmentally delayed child. There are many reasons why a food may have an effect on the nervous symptom with the cause being primary or secondary (i.e. direct effect on the neuron receptor or conversely by propagating dysbiosis, immune effects or some other process that causes change “downstream”). Bear in mind that “you are what you eat” and endeavouring to accomplish a restricted diet by supplanting one offending food with a different food that is allowable but will likely create other problems isn’t necessarily helpful. Many parents with the best of intentions, for example, will eliminate casein and gluten but have a resultant diet that filled with junk “carbs”, fried foods and candy and the end result is trading one set of problems for another and; in all likelihood, not reap the fruit of their labors. Clearly, it is a large undertaking to drastically eliminate many of the food choices in an idiosyncratic eater who likely doesn’t tolerate change well. But it is a path worth taking so long as it is done correctly and with technical and emotional preparedness.

Concurrently, there are other metabolic pathways known to be problematic in affected children. By shifting our focus, we see aberrant methylation, transsulfuration, a host of digestive abnormalities driven by acute and chronic inflammation, immunopathology and endocrine disturbances. In fact by focusing too acutely on one purported cause or biochemical reaction, we can fail to see the “big picture”. Certainly “one straw can break the camel’s back” but it is the context of the number of straws that precede it. It is neither one vaccine, nor the mercury that preserves it, neither is it a single peptide in cheese or wheat, nor a different conglomeration of foods to avoid. This being said, some children with find their way back by one or another or approach to combat or reverse the offending agent, but this may ring hollow for the next child. It is the quagmire of variability in the illness that belies the “cure”. Each child is different. There is sadly no one cure or treatment, but many treatments which open the door to each child’s innate healing ability. Biomedical interventions and functional medicine endeavour to synergistically restore, rebuild and support the damage and the inherent weaknesses that are present so as to normalize the body’s function and allow the body’s innate healing capacity to take over. The right treatment at the right time, to lift the burden imposed on the fragile biochemistry of an affected child. “

 

Carmen Lahaie

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