Posts Tagged ‘casein free’

Early Experience with Helminth Therapy in Autism Treatment

Sunday, September 3rd, 2017

Gastrointestinal issues are one of the most common co-morbidities in patients who experience signs and symptoms of ASD. Treatments have included prebiotics, probiotics, antioxidants, cathartics, detoxifying agents, antibiotics, antifungals, human fecal materials, and others. Singly, and in combination, they have resulted in sometimes limited success and frequent relapses.

Furthermore, patients with ASD suffer a variety of allergic and autoimmune conditions, including rheumatoid arthritis, food sensitivities, asthma, and eczema.

Filling that therapeutic void is the coming world of helminths. It is a unique form of gastrointestinal/allergy treatment, now being popularized by a highly respected pediatrician, Dr. Sidney Baker. At The Child Development Center and other Developmental Clinics, treatment with HDC is becoming an additional strategy for patients with autism.

What is helminth therapy?
According to the NCBI, it is “The treatment of immune system diseases by deliberate infestation with helminths. This therapy is partly based on the HYGIENE HYPOTHESIS which states that the absence of parasites increases immune dysregulation because of the lack of stimulation of REGULATORY T-CELLS.”

As researched and reported early in this century in Science, “The induction of a robust anti-inflammatory regulatory network by persistent immune challenge offers a unifying explanation for the observed inverse association of many infections with allergic disorders.”

As unappealing as it may seem, the rat tapeworm, Hymenolepis diminuta cysticerci (HDC), is considered a mutualist, providing benefit to the host without causing longterm harm. Out-of-the-box thinking by a few functional medicine doctors has taken the following course:

Chronic illness is an expression of autoimmunity
Gut problems and allergy in autism are a form of chronic illness and autoimmunity
HDC interferes with autoimmunity
Provide HDC for chronic illness, including autism

The Protocol
In our practice, an email is sent with the parent order form, directions explaining how to administer and store the HDC upon arrival, as well as some background information. I send a request and a summary of the medical history. After reading all of the information provided, the parents contact Dr. Baker, and the product is sent to the home.

How to take the product?
Patients take them by swallowing the supplied liquid (the organisms are barely visible), or adding it to another drink. The Primobiotics dose is 1-60 HDCs, given every 1-4 weeks. The usual plan is to start with a dose of five HDCs – fewer in young children. It may take up to 6 weeks to see positive indicators and six months to fully determine that it hasn’t helped. When found helpful, the length of treatment has yet to be determined.

What are the costs?
The costs (directly from the company) are $100 for 1–10, and an additional $25 for each additional 10. The maximum charge is $175 for 40 HDC. Above that there is no additional increase in charge. Shipping is usually $35-65 but for Western US and Canada, it may be $80-100.

What are the downsides?
Constipation should be taken care of before initiating the use of HDCs. There may be some digestive upset with mild abdominal discomfort and some changes in bowel movements. Hyperactivity or insomnia lasting for a day or two are experienced by less than half of recipients.

If, after the first dose there are no positive or negative effects, the dose is increased as the optimal dose is established. Some individuals may show indications that a dose is ‘too much’ – with a more robust digestive discomfort or hyperactivity/insomnia than is usually felt as part of the initial response, in which case the dose is reduced to the minimal number.

What if a worm doesn’t pass?
According to Dr. Baker, a worm ‘sticking’ is a rare and benign event that can be treated with a dose or two of appropriate medicine.

Discussion
Note that HDC is not an autism ‘cure’. Rather, it can be useful as a treatment for the myriad of co-morbid conditions that can cause signs and symptoms related to ASD. Perhaps that is why Dr. Baker reports a ~50% success rate, after recommending this therapy to nearly all of his chronically ill patients. “What’s the alternative?” he would ask.

Though he eschews fearlessness about his willingness to offer advice, Dr. Baker has assumed a significant amount of responsibility in this endeavor; from cultivating the critters, to teaching others how to breed them, to sending out his own ‘farm-fresh little dudes’. He has personally answered emails, and he even called one of our parents who had concerns.

Interested practitioners are working together to educate and gather experience, in order to optimize this intervention. Specific probiotics are indicated, as well as evaluating progress, and even examining  unusual stools that document the gut ‘reset’. For many, the question will be, “What to discontinue first?”

Conclusion
Doctors who have assumed the challenge of treating patients with autism must remain open to all treatments, and recognize that it is the PATIENT who we are treating, not a specific disease. Some interventions, like GcMAF, were helpful, but are no longer available. Others, like antifungals and antioxidants, have taken time, and we’ve gotten pretty good.

Our patients have been satisfied with the service. Within a couple of months, two of five children have already shown positive responses, with improved behavior and communication. Treatment appears to be a safe, effective and reasonably priced way to assist patients with significant GI and / or allergic challenges.

Published recently in the New York Times:
Too Clean for Our Children’s Good?

For those who wish to read more and utilize another HDC source, here is BiomeRestoration.com

Recognizing The Signs of Autism Recovery

Sunday, August 20th, 2017

As the autism epidemic has grown, so too, has the knowledge of professionals who shepherd treatment, and our recognition of success. It is helpful to offer predictive signs that reflect steady improvement. Due to the variations in autism presentation, there is no authoritative information about how long recovery takes.

However, it can be quite useful and encouraging for a parent to know that it is great news when a child who, after 9 months of treatment, is finally repeating words. It is just as important to understand that the lack of questions, or comprehension, is not pertinent at such a stage.

Patience is key – all affected families have already learned that virtue. But proper acknowledgement that the chid IS getting better should reassure families, hopefully adding a touch more perseverance to their storehouse of solutions.

The journey begins as the ‘fog’ lifts. Wandering should become exploration. New diagnoses do not suddenly ensue, they rise to the top of parental concerns.

It’s not apraxia AND autism. The lack of verbal communication ought to define that phase of autism. Speech arises as sounds, often verbal tics or ‘stims’, teeth-grinding, or screeching, progresses to occasional single words, more consistency, then more dependable expression.

At first, merely hearing the speech therapist say that your child is trying is a very positive sign. There is a pattern. Speak to yourself. Speak to toys. Speak to family. Sometimes, it make sense. Juice. Want juice. I want juice. Observe other children. Speak to safe children – older, younger, more docile. Sometimes, inappropriate.

The same arrangement can emerge with shorter, then longer, sentences. During this phase, parents may fear that the child doesn’t doesn’t comprehend, or is lazy. “He can do it if he wants to!” I think of it as paving newer, progressively wider, neural roadways. The quantum leaps in the appearance of knowledge, such as letters or numbers, are a result of the newfound ability to perform expressive language.

Repetition of words or phrases (echolalia, scripting) seems to be part of the fabric of the acquisition of this ‘skill’. If a child is supposed to say 1000 terms, e.g., and only has 300, they may say the same thing 3 times just to make up the difference, or repeat the last words that were spoken. (Neurotypical adults often do this, as well.)

Socialization will rarely ensue if these milestones, in some form, haven’t appeared.

Children who have repetitive behaviors and restricted interests do not develop obsessive-compulsive disorder. Yes, a youngster may appear to have OCD, but it’s the same problem they exhibited at 2 years of age. And, no pediatrician called it OCD back then. Furthermore, adult drugs for this ‘condition’ are dangerous and rarely perform as expected.

Sensory processing issues that involve hearing, vision, etc., do not develop into SPD. They may become highlighted at various points in the child’s recovery process as the cause of distraction or aggression. Stimming is frequently a symptom. Occupational therapy and other appropriate neural interventions can be quite helpful.

Likewise, lack of attention and focus, overactivity, and distractibility aren’t really a newly acquired ADHD diagnosis. This represents the remnants of an earlier autism. Signs and symptoms are only as subject to pharmacologic remedy as the resulting, appropriate anxiety.

Proper recognition of the challenging behaviors is key.
Does anyone know of a drug that would enable a 5 year-old to perform in a 2nd grade classroom?

Immaturity, tantrums, and difficult transitioning do not warrant a separate condition. Oppositional Defiance Disorder is a description. Behavioral interventions have proven value.

Conclusion
Some might be confused by my use of the word ‘recovery’. It depends on the definition. Subject to the age at the initiation of therapies (and a million other factors), The Child Development Center generally aims for a 3-to-6 year window, in order for a ‘typical’ patient to enter the general educational environment. There may be plenty of leftover challenging behaviors, as occurs in many of the other students in this century.

My point-of-view is that, 10 years after a crippling auto accident, the appearance of normalcy doesn’t erase the prior event. Five years following, however, the patient may experience muscle weakness and/or ‘pins and needles’. Such is the state-of-being for many of the children experiencing recovery in Autism Spectrum Disorder.

Return of the Yeast Issue

Sunday, August 6th, 2017

It has become a ‘given’ lately, in the ASD-alternative-medicine world, that successful treatment protocols often involve antifungal medications. So, when the Child Development Center offers our advice, too often we assume that parents have a thorough knowledge of this common complication in patients with autism.

What is the evidence for this form of medical intervention for ASD?
TheAutismDoctor.com has presented a variety of stories about how overgrowth of yeast can interfere with typical development:

In a two part series, A Yeast Story, 6 years ago, The Autism Yeast Connection highlighted the mechanism by which the critters take over the intestinal flora. The symptoms appear to start with increased ‘fog’ (not attending), then progress to include increase in ‘stimming’, sensory processing disorders, silly behaviors, regression in speech, disturbed sleep, increased ‘OCDs’, and reduced gastrointestinal health.

In the second part of that piece, I offered my view that, the major cause of fungal overgrowth appears to be more of a poorly digested food problem than simple sugars (not to be confused with the observation that too much sugar heightens hyperactive behaviors). However, the overuse and ubiquitous use of antibiotics must be an overwhelming contributor to this phenomenon.

Get Your Child Off the Couch and Out of the House pointed out how constipation leads to slowing down the entire body ecosystem, making outdoor play a chore. Less activity can further deteriorate the situation. Warm, wet, dark, stationary places (a non-motile gut) make an excellent home for yeast, which robs nutrition, alters the immune system, and creates toxic byproducts. In addition to probiotics, healthier foods, and anti fungal preparations, adequate muscle activity will push the food along.

Poor motility in the smooth muscles in the gut that could lead to reflux, or constipation, and possible yeast overgrowth, was discussed in A Brief Discussion of Mitochondrial Function and Autism.

I have written about complicated treatments, such as Stem Cell infusions, Fecal Transplants or Hyperbaric Oxygen chambers, where patients can still benefit from the recognition and treatment of recurring signs and symptoms of yeast – the extreme therapy notwithstanding.

Even standard protocols, such as B12 ‘shots’ can go awry when fungus has overtaken the gastrointestinal tract, as discussed in When Methyl B12 Doesn’t Work for Autism.

Earlier this year, in The Challenge of Challenging Behaviors, I warned that disruptive, aggressive, or self-injurious behaviors first needed to be evaluated from a GI point of view, lest the patient end up on multiple anti-psychotic medications that merely mask the underlying problem.

‘Die-Off’ in Autism Treatment detailed the journey that ensues when pharmaceutical medications are administered to deter the fungus. Complications can be addressed with the judicious use of activated charcoal. Furthermore, the use of nystatin and saccharomyces boulardii may be considered, or needed, if liver function is not optimal. Plus, natural antifungals, probiotics, and probiotics can be of value for prevention.

The Chronicity of Autism, presented documentation of one family’s journey to a successful outcome, by paying very close attention to GI health, and treating yeast when the symptoms suggested.

My 2014 holiday salute to the condition concluded with, “Yeast in the G-I system is one of the few causes of the signs and symptoms of autism that CAN be successfully treated with safe and effective supplements, diet and medication. This is a great time to provide natural anti-fungals, such as apple cider vinegar, garlic oil, olive leaf, etc., to the extent that products are palatable and well tolerated.”

Our experience with antifungal treatment was documented in Anti-fungal Treatment for Autism? The conclusion was that medications can have serious side effects and drug interactions. Present practitioners should follow a written, rigorous protocol and document progress. Appropriate followup laboratory testing should be performed. Other sources of inflammation should be explored and addressed, as well. Under a physician’s care, with the parents’ full understanding and consent, within 2 or 3 short courses, a simple, oral, antifungal medication was well-tolerated, and effective in reducing many symptoms that are generally assumed to be ‘autistic’.

Conclusion
This list is provided to document our experience with thousands of patients. There is solid scientific and clinical evidence for those who are new to the diagnosis, or parents who wish to explore the possibilities that yeast may be affecting your child’s development,

The hyperlinks (and hyperlinks to hyperlinks) should help convince even the most skeptical of professionals that this is a safe, effective treatment for signs and symptoms associated with ASD.

Is there an Autism ‘Smart Gene’?

Sunday, May 28th, 2017

When evaluating new research, it is important to:
1) Determine if the conclusion makes sense (regardless of statistical values), and
2) Review documented evidence – both pro and con.
That brings me to an article that recently appeared in Nature Genetics, entitled,  ‘Genome-wide association meta-analysis of 78,308 individuals identifies new loci and genes influencing human intelligence’.

Are People with ‘smart genes’
more likely to have Autism?

The Study
Combining data from multiple studies, researchers identified hundreds of minor genetic variations associated with IQ, including many new ones. “The identified genes are predominantly expressed in brain tissue… “

“Significant genetic correlations were observed with 14 traits… Moderate, positive genetic correlations were observed with smoking cessation, intracranial volume, head circumference in infancy, autism spectrum disorder and height.”

The authors concluded, “These findings provide starting points for understanding the molecular neurobiological mechanisms underlying intelligence, one of the most investigated traits in humans.”

The Good
In this study, autism is linked to intelligence, rather than a decades-long belief that, “ASD just used to be called mental retardation.”

This finding offers hope that patients who can successfully shed the sensory and social stigmata, have an additional IQ cushion to achieve success.

The Bad
The story, as generally reported in the media, was represented by this British news headline, “Autism is linked to intelligence: People with ‘smart genes’ are more likely to have the disorder”. To say the least, that’s not accurate.

The manner in which the data was collected and analyzed is complicated. Really complicated. Multiple, convoluted arguments for validation were offered, begging the question, “Why so much information manipulation?”

It is always suspect when science over-emphasizes the contribution of genes to intelligence. Comparable information has been misused for over a century, to ‘select’ for superiority. Therefore, even when discussing this knowledge as it applies to the world of autism, such assertions could prove pernicious.

The Ugly
This finding, if accurate, might represent a future net loss in human intelligence. Given that 2% of males are presently affected, with many who suffer significant impairment to typical socialization, possibly resulting in fewer ‘good’ qualities that make it into the total pool. Autism could be ‘culling the herd’ of ‘smart genes’, if the tide of this epidemic is not stemmed.

Conclusion
Our understanding of how genes lead to visible effects, due to the event(s) in which they are involved, will underlie our future understanding of human development, as well as autism.

Professionals who care for children with ASD are never surprised when parents claim that their kids are bright. It appears that there are other, multiple disturbances in central nervous system processing that lead to symptomatic challenges.

At the least, this association helps confirm such observations, and might provoke novel strategies for discovery.

Susceptibility Factors for Autism

Sunday, January 22nd, 2017

For over twenty years in the last century, I spent my medical training practicing the care and feeding of sick infants. Studies that tie events in the perinatal period to autism carry particular significance. To the extent that research identifies supplements, medications, procedures and interventions, by altering suspect behaviors, we are encouraging ASD prevention.

Here is some recent information that deserves discussion.

Meconium exposure and autism risk.
“Children exposed to meconium were more likely to be diagnosed with autism in comparison with unexposed children… Resuscitation of neonates with respiratory compromise from in utero meconium exposure may mitigate long-term neurodevelopmental damage.”

There has been some debate in the past decade about whether the removal of stool from the windpipe of children who experience some type of stress in the womb prior to birth is the best course of action. This study supports the protocol and also highlights the improvement when a trained clinician examines the newborn’s trachea and takes appropriate action.

Folinic Acid Shown Effective in Autism
Folate is a vitamin that takes several forms as it becomes active in the formation of antioxidant products involved in the B12 pathway. A recent study identified that, “Folinic acid improves verbal communication in children with autism and language impairment: a randomized double-blind placebo-controlled trial.” Various preparations containing a high dose of this supplement are becoming available at more reasonable prices.

This intervention could be important for all ASD patients who experience speech apraxia.

Folate Receptor Antibody Test (FRAT) now readily available for blood
Although the knowledge that deficiency of, and antibodies to, some form of folate may exist in, and be responsible for, some types of ASD, the reality has been that performing a spinal tap (putting a needle in the spine) on children was possibly risky and impractical.

A company has come forward with a reasonably priced, useful blood test that accurately reflects binding and blocking antibodies in the central nervous system. The implication is that providing relief for this condition will result in improved signs and symptoms for affected individuals.

Vitamin D Supplementation for Autism
The significance of this recent study cannot be over-emphasized. Pregnant women should be tested for levels, and treated appropriately. And, all diagnosing clinicians should understand that, along with making an accurate diagnosis, the medical workup should include determination this important nutrient.

Conclusion
Finally, here is some good news surrounding the research of autism cause(s) and treatment(s).

12 Days of Autism Christmas

Friday, December 23rd, 2016

On the first day of Christmas, my practice sent to me…

A bunch of kids who got better from ASD.

On the twelfth day of Christmas, my practice sent to me…

12 Who started speaking

 11 Picky eaters

  10 Toe walkers

    9 Happy flappers

     8 From foreign countries

      7 Poopy pictures

       6 Sensory seekers

    — 5 With ADHD

         4 Terrible tantrums

          3 Bad biomes

           2 Red rashes

and a bunch of kids who got better from ASD 😉

Happy Holidays, Everyone

With much love and hope from Dr. Udell
and the staff at The Child Development Center©

Flu Shots in Pregnancy May Increase Autism Risk

Sunday, December 4th, 2016

jamaThe Journal of the American Medical Association recently published a study entitled, Association Between Influenza Infection and Vaccination During Pregnancy and Risk of Autism Spectrum Disorder.

Whispering Down the Lane
Health News from NPR, Fox News, Medscape.com and even the American Academy of Pediatrics echoed each other, claiming the paper offers proof of the flu vaccine’s ‘safety’ when given during pregnancy.

Do these reporters really read the research? I reviewed the same literature, and decided that the title of this post should highlight the opposite position.

Results
1. “…maternal influenza infection during pregnancy was not associated with increased autism risk.”
If a pregnant woman gets the flu, the child is considered safe from the standpoint of developing ASD. This is not necessarily supported by other research (1 , 2, 3, 4), but this finding provides some level of comfort.

2. “There was a suggestion of increased risk of autism spectrum disorders among children whose mothers received an influenza vaccination during their first trimester…”
At the earliest time in gestation, many women may not be aware of a pregnancy, which might be risky, if they receive the ‘shot’. Fudge factor: “…the association was statistically insignificant after adjusting for multiple comparisons, indicating that the finding could be due to chance.”

3. “Our findings do not call for vaccine policy or practice changes but do suggest the need for additional studies.”
Is that explanation supposed to make that make families feel more comfortable about this issue? How about this? One of the principle authors “…received research grant support from GlaxoSmithKline, Sanofi Pasteur, Merck, Pfizer, Protein Science, MedImmune, and Novartis.”

Other literature
Research demonstrating effectiveness of the vaccine, especially in the face of a specific epidemic is the principle motivation for the recommendation to vaccinate in pregnancy. The publications from the beginning of this century have demonstrated efficacy and safety for the mother and the baby. Previous studies have also shown an increase in small or preterm infants associated with influenza during pregnancy.

However, there is a lack of research regarding ASD outcome when flu vaccine is administered, and pharmaceutical industry funding is ubiquitous.

The flu shot is not recommended for children under the age of 6 months. It is advocated for pregnant women. So, it’s OK if you are a fetus? The use of acetaminophen for a fever, which is certainly a known complication of ‘shots’, has been identified as a possible contributor to ASD.

Conclusion
Whose interests are being served by the widespread use of these vaccinations? For the very old or infirm, it seems a reasonable option. Concerning the immunocompromised, even if herd immunity could be achieved (~90% vaccinated), that would only cover only a handful of the possible viral pathogens that exist – with new ones popping up every day.

The product generates billions of dollars for the drug makers. Money used to fund studies, such as these, needs to come from completely independent sources.

The present study indicates a slightly increased risk of autism from a flu vaccination given early in pregnancy. Since there is less evidence that the flu, itself, leads to significant developmental disorders, it appears that more information needs to be made available in the face of the modern autism epidemic.

Curcumin for Autism and ADHD

Sunday, November 27th, 2016
Turmeric plant

Turmeric plant

Over the past year, The Child Development Center has been successfully utilizing a natural supplement (Enhansa®) that appears to be improving the health of our patients’ gastrointestinal system, body and mind.

The turmeric plant and its product, curcumin, have been the subject of a number of media reports, lately. How can the preparation help patients with ADHD and ASD?

Turmeric subsoil stems>powder>curcumin molecule

Turmeric subsoil stems>powder>curcumin molecule

What it is
Turmeric is part of the ginger family, mostly known for its role as the main spice in curry. Curcuminoid compounds are utilized to treat a variety of medical conditions; including auto-immunity in the blood, rashes in the skin, problems with the gut, parasites within the body, and disorders of the liver, kidney, and brain.

Why it works
Many doctors ask, “How can one chemical help so many diverse conditions?”
An emerging theme in the practice of modern medicine is the ability of an affected body part to heal itself. Such a belief has been central to other therapeutic sciences for a long time. In that paradigm, natural substances that promote repair are at least as important as medicines that attack a presumed cause.

Turmeric contains curcumin, which possesses antioxidant and anti-inflammatory properties. Given that the compound successfully accomplishes those tasks, improvements in the efficiency and function of any organ throughout the body should be understandable.

How it is administered
Various preparations have been marketed as the ‘best’ formulation; including pills, crushed, with/without taste, and offerings from numerous manufacturers. Powder with black pepper is popular.

Similar to most medications, it is best to go ‘low and slow’. As the patient displays individual tolerance to a given pattern, the dose and/or frequency can be adjusted.

Effects
We have received lots of emails describing a variety of results – mostly positive, some negative, all instructive:
I have noticed great improvements in cognition and language with your suggested supplement. She seems a little more irritable, but the the gains are so good.
-The curcumin has been amazing. Improved language and cognition. Significant improvements.
-He felt warm for two days, but never registered a fever. He is doing amazing in school! He is now sitting with the other kids and doing his seat work. According to the school staff, they have witnessed attempts to talk and word approximations. The ABA therapist visited him at school yesterday, and reported the same. She is extremely pleased with his progress, and we are as well. I’m going to send you a picture.
-Our child reacted well to the turmeric and LDN compound. At first we thought he had a reaction to it, but he was getting sick. We have continued on the path and he seems to be reacting nicely. He is babbling much more and mood has improved…
-This supplement has been amazing so far at 75 mg bid. Her focus and sustained attention and receptive language are much improved and all her therapists across the board have noticed!
-It has been amazing. Improved language and cognition. Significant improvements.

Side Effects
I also wanted to ask, his poop has turned yellowish, it used to be dark brown. Is this normal with the supplements?
Changes in the color of urine and stool are due to the intense yellow color.
Our child was on the product for two days and an intense rash developed around his eyes! I stopped giving it, and it is slowly getting better.
Rashes are the most common side effect, so far. Reducing the dose often improves the problem, but close medical supervision is paramount.

Conclusion
As with all medical interventions, your child should be under the care of an experienced practitioner who can make specific recommendations. It is impossible to test all brands. Patients and problems are so diverse that, generally, doctors stick with the supplements with which we become most familiar.

When given to the appropriate population, with close followup of the clinical course, adding curcumin to the treatment protocol appears safe, and can provide significant improvement for patients with ASD.

cumin

Cumin plant, powder, seeds

By the way
Curcumin is not cumin, which is a different spice that is derived from seeds. Both products are used in curry. They share many similar flavoring and medicinal properties.

 

Gut Anxiety?

Sunday, November 20th, 2016

Sherryjpg

Dr. Sherry Eshraghi, of Natural Health Power Works has been consulting with families at The Child Development Center of America, where she provides knowledgeable advice about nutrition and naturopathic intervention.

This week (11/16), Dr. Sherry writes:

If you have ever had a panic attack, you are well aware of how bad it feels. Many sufferers have it on a regular basis, others have experienced only occasional short periods of these episodes.

Often, the feeling comes out of the blue; even in a relaxed state, while reading a book, watching a movie, sitting in a park…
Suddenly you start feeling light-headed, dizzy, your pulse starts racing and you feel like you are going to have a heart attack. You feel like you can’t catch your breath and then the panic sets in, mostly the feeling that you are going to die.

The reaction can be so overwhelming that you phone for an ambulance, or go to the emergency room. After a thorough check-up, you may be informed that you are fully healthy and nothing is wrong. If you are given an accurate diagnosis – that you’ve had a panic attack – you feel dumbfounded and incredulous. When you start having regular anxiety spells, you may become concerned that something is wrong with you mentally. Perhaps you start taking medications that might, or might not, work.

But don’t worry…you are not crazy! Although prolonged stress can trigger anxiety attacks, there are other factors that play a role but are often overlooked. Generally, people do not pay attention to the earliest signs – feeling gassy, belching, passing gas, or that their bowel habit has changed.

serotonin-emoji-2You have probably heard about the fascinating research demonstrating that there is a gut-brain connection. Indeed, the gut is often referred to as our ‘second brain’. In fact, a very important neurotransmitter – serotonin – is primarily produced in the abdomen. A deficiency in the chemical can cause anxiety, poor sleep, inability to focus, agitation and mood swings, depression, and more.

What leads to a deficiency in serotonin?
Prolonged stress, leaky gut, malabsorption, inadequate nutrient dense foods, food allergies and lack of beneficial gut bacteria are all culprits. Recent studies show that gut bacteria are key components in the production of serotonin.

What can you do to prevent and minimize the number of anxiety attacks?
Heal your gastrointestinal system! Get a food allergy test, replenish the gut with beneficial bacteria, reduce sugar and processed foods, adopt an anti-inflammatory diet, exercise regularly and learn to manage your stress early on.

Remember, you’re not out of your mind…
It’s all in your gut!

Sources:
Emeran A. Mayer, Rob Knight, Sarkis K. Mazmanian, et al., “Gut Microbes and the Brain: Paradigm Shift in Neuroscience”, Journal of Neuroscience, 2014
Jessica M. Yano, Kristie Yu, et al, “Indigenous Bacteria from the Gut Microbiota Regulate Host Serotonin Biosynthesis”, Cell, 2015

Autism vs. Insurance

Sunday, November 13th, 2016

insurance4If insurance is a wager to cover the expenses incurred due to some rare, catastrophic event, then health insurance is only a distant cousin. It’s betting how much you will owe hospitals and doctors when you are un-well. For people who will never get sick or injured, medical coverage is unnecessary.

However, for an increasing number of modern families, an autism diagnosis will become a reality. The lifetime costs range from ~$1.5M – $2.5M, or more. Actuaries know this, of course. Presently, and for the foreseeable future, to the extent that is ‘allowed’, coverage will be significantly limited for medical conditions that fall under the ASD banner. It’s the insurance business.

How Not to Cover an Autism Claim
An underlying principle is that, the longer it takes to pay, the more interest is generated on a company’s reserve dollars. Any excuse to deny, therefore, can improve profitability.

Since coverage is provided based on the type of diagnosis, the more specific and verifiable, the less likely likelihood of a disagreement about expected costs. Autism is neither a precise entity, nor can it be confirmed with scientific instruments.

Even the usual and customary therapies, such as ABA, OT, PT, and Speech&Language are disputed. Insurance plans have gone kicking and screaming into paying for those proven services. Plus, the practitioner must possess the credentials that are acceptable to the payor. Barriers are erected at each step along the way.

Getting reimbursed for a proper workup can be difficult. An MRI or EEG may be customary, but not a genetic test or food allergy panel. Successful patient outcomes are not as convincing as university research. Funding for a study on dietary effects on behavior based on laboratory evidence carries little profit motive.

For ASD, the primary on-label medications are very potent and potentially harmful. Due to formulary limitations based on cost, practitioners are even instructed to prescribe a more dangerous drug over others that might be better tolerated. More effective and less expensive supplements are not even considered.

The Folate Example
For over a decade, variations in the genes that propel an important metabolic pathway have been tied to problems in patients with autism. That has not deterred insurers from denying reimbursement to the accepted testing laboratories – and increasing charges for out-of-pocket expense.

Utilizing a relatively inexpensive supplement, a recent study has demonstrated, “…treatment with high-dose folinic acid for 12 weeks resulted in improvement in verbal communication as compared with placebo…”

Not surprisingly, insurance companies refuse to pay for this medicine, either.

Conclusions
Families of patients with ASD already know that they must pay out of pocket for many of the treatments. If they work great, it’s worth it.

As new insurance products take shape, it may be a good opportunity to lobby nascent companies for improved coverage of all autism treatments that show validity. Showing a cost savings matters more to companies that intend to stick with an insured.

Measuring markers of autism, such as folic acid metabolites, for diagnosis and results of treatment, will go a long way toward discovering – and getting reimbursed for – newer interventions.

The role of prevention cannot be overemphasized. Our external and internal environments must be scrutinized. More appropriate standards created and implemented for safe food, air, and water, should reduce the cost of all health insurance.

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Brian D. Udell MD
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