Addressing Underlying Medical Conditions in Autism
By Dr. Deb Bossio
The Centers for Disease Control and Prevention currently estimate that 1 in 110 children in the United States are diagnosed with autism. In 1990, the figure was 1 in 2,000. While the prevalence of autism has rapidly increased since the early 1990’s so too has our understanding of the medical conditions that contribute to this troubling condition. In the past, an autism diagnosis was tantamount to a sealed fate – treatment options were few and far between. For better or [sometimes] worse, the pendulum has swung. As the public profile of autism spectrum disorder has increased in recent years, the number of treatment options, some efficacious and some dubious, has grown to bewildering proportions. Separating out the most effective treatments from those that are ineffective can be a challenge for both concerned parents and physicians alike.
As a naturopathic physician, my approach is to find and treat the underlying causes of illness, rather than merely alleviate symptoms. This same approach holds true when addressing patients with autism. By utilizing the appropriate diagnostic and functional testing we can elucidate and treat underlying medical conditions contributing to autistic symptoms. Fundamental to my approach is an understanding of some of the most common medical issues affecting children on the autistic spectrum. These issues include: food allergies/sensitivities, gastrointestinal disorders, nutritional deficiencies, and heavy metal toxicity. One of my initial interventions, typically, is to utilize appropriate testing to determine if any of these complications are impacting my patient. I can then apply a simple guiding principle, central to the naturopathic approach: remove what is causing harm and add what is missing. As each of the following sections will show, this approach can provide key insight in to effectively treating autism spectrum disorder.
Food Allergies and Sensitivities
Anyone who has worked with or who has a child with autism has probably heard of a number of different diets that physicians are known to recommend (e.g. gluten free, casein free, low oxalate diet, specific carbohydrate diet, soy free, egg free, anti-candida diet, Feingold diet, etc). It can be quite overwhelming for a parent of an autistic child to figure out which of these diets to implement. Thankfully, simple laboratory testing can help gather significant, patient-specific data that can help in determining an appropriate course of action.
For example, through an IgG food allergy test we can determine if a child is having an immune response to specific foods. These reactions can contribute to the behavioral, neurological and digestive symptoms associated with autism. The test I typically run looks at 95 different foods including the most common allergens like: wheat, dairy, soy, egg, corn, and sugar. If a patient’s results show moderate or high reactivity to any foods, then those foods become the focus of a restricted diet plan.
Unfortunately, there are some people that may not show an IgG reaction to foods containing gluten (the protein in grains such as wheat) or casein (the protein in dairy products) even if these foods are contributing to their autistic symptoms. For this reason, a urinary peptide test (which looks for protein fragments in the urine) works well in conjunction with the IgG food allergy panel. The pertinence of the urinary peptide test is borne out in the common experience of many children with autism – often, patients with autism seem addicted to wheat and dairy products. This may be due to the incomplete digestion of the proteins gluten and casein. These undigested pieces of proteins, called peptides, can react with opiate receptors in the brain, mimicking the effects of opiate drugs. The peptides from gluten and casein are specifically important in autism because they can affect speech, auditory integration, cognitive function, and decrease the ability to feel pain. By utilizing the urinary peptide test we can determine if peptides are being produced from gluten and casein in the diet.
There are a number of nutritional deficiencies commonly seen in autistic patients. This may be the result of poor digestion, restricted diet, or a higher than average need for certain nutrients. Whatever the cause, determining the specific nutritional deficiencies and supplementing appropriately can improve the health of a child. Where to begin? Common deficiencies can be uncovered by using targeted testing such as an organic acid profile, as well as vitamin D, zinc, copper, and iron testing. When used in conjunction with a cholesterol panel we gain a comprehensive view of the most common nutritional deficiencies linked with autism. The organic acid test will not only pinpoint key vitamin deficiencies such as B vitamins and Vitamin C, but also problems with fatty acid metabolism and amino acid imbalances.
Children with autism often suffer from many gut-related issues, some of which include: dysbiosis (an imbalance in the normal bacteria of the digestive tract); constipation; poor enzyme production; low stomach acid; reflux; and inflammation. Through the use an organic acid test we can detect dysbiosis, specifically excessive levels of yeast and bacteria in the digestive tract, which lead to toxic metabolites that are closely linked with behavioral, cognitive, and gastrointestinal symptoms. For autistic patients with dysbiosis, utilizing natural anti-fungal and anti-bacteria therapies along with probiotics can have dramatic impact on symptoms. Coupling the information provided by the organic acid test with a comprehensive stool analysis helps to confirm yeast or bacterial overgrowth and tells us specifically which natural anti-fungal and anti-bacterial therapies will be effective against the microorganism strains detected. The comprehensive stool analysis also provides indicators of overall intestinal health, enzyme production, inflammation, and immune function.
Heavy Metal Toxicity
Lastly, high levels of toxic heavy metals deposited in the body can lead to developmental and neurological damage. Clinical outcomes have shown that children with autism often have excessive burdens of mercury, lead, aluminum, arsenic, cadmium and other toxic metals due to their inability to detoxify effectively. Once heavy metal toxicity is diagnosed through either urine, hair or blood analysis, we can implement the appropriate chelation and detoxification protocol to remove the metals and detoxify the body.
Deb Bossio, N.D., is a naturopathic physician practicing in Ridgefield, CT. Dr. Bossio provides natural health care to all members of the family. Patients can expect individualized treatment plans that may include diet and nutritional therapy, herbal medicine, and homeopathy. In addition to her general practice, Dr. Bossio also specializes in pediatrics, women’s health, Lyme disease, and digestive disorders. Dr. Bossio sees patients at 10 South St., Suite 205, Ridgefield, CT, 203-431-1688. For more information visit www.drdebbossio.com or email firstname.lastname@example.org.
Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment.