What is Autism?
Autism or classical autism is the most common condition in a group of brain development disorders known as autism spectrum disorders (ASDs). Other ASDs include Asperger’s disorder, Childhood Disintegrative Disorder (CDD), Rett’s disorder, and PPD-NOS (Pervasive developmental disorder-no otherwise specified).

ASD is not a disease but developmental disorder, a condition in which there are disturbances in some stage of the child’s development.

Autism is characterized by impaired social interaction, problems with verbal and nonverbal communication and unusual repetitive or severely limited activities or interest.

Currently, conservative prevalence estimates are: 13/10000 for autistic disorder,

21/10000 for pervasive developmental disorders not otherwise specified, 2.6/10000 for Asperger disorder, and 2/100000 for childhood disintegrative disorder. Newer surveys suggest that the best estimate for the prevalence of all autistic spectrum disorders is close 6 out of 1000; however recent epidemiology studies indicate a higher incidence of about 1 out of 156 children. Boys are more likely to have autism than girls.

 
 

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Autism Hypothesis

 

What causes autism?
No one knows for sure what the exact cause of autism is. It is probably caused by the interaction between our human genetic makeup and the toxic environment. Studies suggests that autism could result from disruption of normal brain development early in fetal development caused by defects in genes that control brain growth and that regulate how neurons communicate with each other.

Genes play a role and some people have a genetic predisposition to autism. The risk of having a second child in a family with autism in approximately 5 percent or one in 20.

 

What are the likely biological mechanisms that may contribute to autism symptoms?

  1. Genetic
  2. Environmental
  3. Intestinal dysbiosis
  4. Metabolic disorder
  5. Poor detoxification
  6. Mitochondrial defects
  7. Endocrine imbalances
         
   
         
   

Possible Triggers of Autism
There is good evidence that autism is a multifactorial disorder; however there is still no clear understanding of the genetic and non-genetic causes. The incidence of autism has been rising and part of it may be due to better ascertainment and a broadening of the diagnostic concept. We cannot exclude that there is also some degree of true rise.

         
    Susceptibility Gene
The rate of ASD in the siblings of individuals with autism is about 6% compared to 0.5% in the general population. (Rutter 2005)

 

Chromosomal Anomalies
There is no clear culprit chromosome found. Most of the evidence comes from isolated case reports. 2-3% of ASD show the fragile X chromosomal abnormality. The other chromosomal anomaly associated concerns the maternal transmitted interstitial duplications of chromosome 15. (Folstein and Rosen_Sheidley 2001)

 

Prenatal Influences
Intra-uterine infections and toxins: various possible maternal circumstances that could affect the foetus include hypothyroidism, thalidomide use, valproic acid use cocaine or alcohol abuse and congenital cytomegalovirus infection. Congenital rubella (Chess el al 1971; Chess 1977)

 

Postnatal Risk Influences
Herpes virus with case report of herpes encephalitis causing autism (Gillberg 1986; Ghaziuddin et al 1992)

 

Measles Mumps Rubella and Thiomersol
There was a suggestion that MMR vaccine was responsible for the huge recent rise in the rate of diagnosed ASD (Rutter 2004) where the vaccine caused a gut disorder resulting in a leaky gut syndrome. There is up to now no clear evidence of the MMR hypothesis.

  • Gluten, casein, sugars, starches, phenolics, salicylates and oxalates
  • Yeast/ Candida in flora food and environment
  • Bacteria such as clostridia
  • PANDAS
  • Parasites: amoeba and pin worms which cause dysbiosis
  • Mercury, lead and other heavy metals
  • Pesticides
  • Chemicals
  • Streptokinase
  • Organophosphate
  • Immune disorder

 

Causation Models

  1. Genetic
  2. Toxic chemical model
  3. Heavy metal contamination
  4. PANDAs
  5. Autoimmune
  6. Viral infections
  7. Vaccinations
  8. Allergies
  9. Metabolic disorders
  10. Sulfation chemistry
  11. Mehylation chemisty
  12. Leaky gut and opiates
  13. Yeast overgrowth
  14. Metallothionein theory

 

Metallothionein Theory
Dr Walsh theorizes that dysfunction in a small peptide called metallothionein (MT) MT is responsible for

  • Regulation of zinc and copper levels in blood
  • Detoxification of mercury and other toxic metals
  • Development and functioning of the immune system and brain neurons.
  • Production of enzymes that break down casein and gluten
  • Response to intestinal inflammation
  • Modulates behavior control, emotional memory and socialization.

Dr Walsh postulates that deregulations of MT from the combination of a genetic defect involving marginal or defective MT functioning and an environmental insult during early development disables MT.

I believe that there are 3 main problems which addressed will help children with ASDs

  1. Remove stressors and remove toxins/ heavy metals by detoxification
  2. Restore the gut and Replace essential nutrients and vitamins
  3. Help immune system recover

 

PANDAS

PANDAS stand for pediatric autoimmune neuropsychiatry disorder associated with Streptococcus.

Some children exposed to group A haemolytic streptococcus, the same bacteria that cause strep throat develop antibodies that mistaken attack the basal ganglia in the brain as well as the strep bacteria.

The children have symptoms similar with obsessive compulsive disorder (OCD) and /or Tourette’s syndrome. The blood marker B lymphocyte antigen D8/17 is found in 78% of autistic children studied and the presence correlates with the severity of compulsive behaviors. (Hollander R et al 1999)

 

Immune Disorder

Dr Bernard Rimland (founder of Autism society of America) and Dr Stephen M Edelson have stressed the connection between ASDs and autoimmune or immune dysfunction. Evidence suggests that the immune systems of some patients develop MBP (myelin basic protein) antibodies which attack the myelin sheath that covers the spinal cord and nerves. Conduction of messages by nerves depends on an intact myelin sheath.

 

Viral Connections

Autism like symptoms can follow viral meningitis. Epidemiology studies indicate that rates were higher in children who caught both the rubella and mumps during the same period. Herpes virus has also been linked to autism with 2 published cases. Chicken pox virus and cytomegalovirus has been linked to neuropsychiatric illness.

Parents of children with ASDs usually notice a higher incidence of ear infections such as otitis media.

 

Allergies

Sometimes ASDs disorders appear linked to or is worsened by allergies. Some people have spectacular progress by simply removing allergens from their diet and environment. Allergies are a type of immune disorder. When you suffer an allergy, you body’s immune response goes into hyper drive while it tries to rid itself of the perceived toxin.

 

Metabolic Disorders

Today most babies are screened for PKU (phenylalanine). PKU is normally broken down to tyrosine. However some people have a problem breaking down PKU. PKU then builds up in the blood stream causing brain damage, mental retardation.

 

Sulfation Chemistry

Some people with ASDs are short on sulfate, the essential substrate of a sulfotransferase enzyme called phenolsulfotransferase (PST) which breaks down phenols and amines. Thus toxic phenolic compounds build up in the body.

Sulfate is also necessary for other detoxification process, including activating and deactivating certain hormones and neurotransmitters. Other sulfotransferases have the job of maintaining the integrity if the gut wall by surrounding cell surfaces with sulfated sugars attached to a protein core. These are called glycosaminoglycans (GAGs) or mucopolysaccharides. GAGs are released when inflammation occurs. Thus supplementing with MSM (methyl-sulfonyl-methane) and N acetyl cysteine may be helpful. Epson salt baths can also help sulfation.

 

Methylation Chemistry

Defects in transmethylation can affect vital biochemistry reactions at many places in intermediary metabolism. Vitamin B12, folate and thiamine are important in the methylation cycle. Transmethylation defects results in depletion of glutathione, a major antioxidant essential for detoxification in the body.

 

Leaky Gut and Opiates

Proteins from the diet are digested to peptides. Peptides can escape the gut wall when there is gut inflammation commonly due to over colonization by Candida albicans. This is often referred to as “leaky gut” syndrome. Once in the blood stream, the peptides would make its way to the brain. The brain sometimes mistakes these peptides as natural opiates. Alternatively the immune system may overreact to the peptides, producing auto immune antibodies which attack the myelin sheath found in nerves and the brain.

Commonly peptides such as Gluten found in wheat and casein found in cow’s milk are the main culprits. Some ASDs lack a digestive DPPIV enzyme which can digest these peptides to the smallest molecular amino acid form which is harmless to the body. The undigested peptides are similar to opiates. Quite a few people have experienced improvements in behavior, attention and general ability when one or both of these proteins are eliminated from the diet.

 

Candida Yeast

Overgrowth of yeast in a common problem for people who take a lot of antibiotics and those with impaired immune systems. It is normal for Candida to be in our system, but too much Candida can lead to yeast infections of the skin, mouth and Gastrointestinal tract, causing leaky gut.

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