http://www.generationrescue.org/dr-jerry-s-blog/biomedical-intervention/ http://www.generationrescue.org/dr-jerry-s-blog/biomedical-intervention/what-is-hyperbaric-oxygen-therapy-and-can-it-help-my-child-with-autism/ <p><em>Dear Dr. Jerry, <br/><br/>We have a 4 1/2 year old grandson who was diagnosed last summer with Autism.  We read Jenny's and your books and immediately started him on GF/CF diet, found a DAN! doctor, started him with a Chiropractor, got him into Pre-K this past school year and he has improved so much.  Our next thing may be HBOT.  His parents are a little afraid of possible seizures (he has never experienced them before) and are reluctant to start him on the treatments in a chamber.  </em></p> <p><em>What can you tell us about this method that would ease their minds in starting it for him?  <br/><br/>Thank you,<br/>Diane H. </em><br/><br/></p> <h3>What is Hyperbaric Oxygen Therapy (HBOT)?</h3> <p>Let’s start off with explaining what hyperbaric oxygen therapy is.  Hyperbaric means “increased pressure,” much like the increased pressure inside a soda can (at least until you pop the top and the pressure escapes).  Oxygen refers to the gas used.  So, what we are really talking about here is using oxygen as a therapeutic “drug” and giving it under pressure. </p> <p>Now, going back to the soda can, the gas used here is Carbon Dioxide which, under pressure, will “dissolve” into the soda.  The sweet syrupy water was never intended to hold the carbon dioxide gas, but under mild pressure, it will, and we have the delightful little bubbles.  So, brown syrupy water, known as “cola” can have carbon dioxide gas dissolved into it under pressure.  <br/><br/>With HBOT, we are placed into a chamber (sort of like a soda can!) and the pressure is very gently increased along with the administration of oxygen.  The oxygen, under this mild pressure, is then easily “dissolved” into the blood stream and there is a LOT more oxygen available for tissues with each and every beat of the heart – much more when compared to the oxygen available with just breathing.<br/><br/></p> <h3>Why would we even consider doing this in children with the diagnosis of autism?</h3> <p>Studies have shown that children with Autism may have decreased blood flow through the brain, and more specifically, the sides of the brain.  This can be shown on a SPECT scan (a very special CT scan).  Less blood flow through the brain can be equated with decreased oxygen flowing through the brain as well, since one of the major roles of blood flow is to deliver oxygen to tissues.  By increasing the amount of oxygen carried by the blood stream (more specifically, the plasma), the greater opportunity for oxygen deprived tissue to receive more oxygen.   Here’s what I commonly see in my clinic:<br/><br/></p> <ul><li>Improved sleep</li> <li>Improved bowel function</li> <li>Regulation of bowel movements</li> <li>Improved immune functioning with a decrease in frequent infections</li> <li>Improved expressive language</li> <li>Improved receptive language</li> <li>Improved fine and gross motor skills</li> <li>Improved muscle tone and strength</li> <li>Increased mental alertness</li> <li>Increased calmness </li> <li>Improved mood</li> </ul><p> </p> <h3>How soon can we expect to see results, and how many of these treatments are needed?</h3> <p>The number of treatments varies on the severity of the symptoms, but you can usually figure on 40-120 treatments.  Results are generally seen within the first 40 treatments, but benefits, such as sleeping through the night can be seen within the first 10 treatments.  <br/><br/></p> <h3>Are there any risks with HBOT?</h3> <p>Every medical intervention has risks associated with it.  Hyperbaric oxygen therapy is no exception.  Make sure you talk to your doctor before doing any HBOT treatments.<br/><br/><strong>Seizure:</strong> There is a very small risk of seizure at pressures and amount of oxygen used for children on the autism spectrum.  Generally, the lower pressures and shorter treatment times (60 minutes versus 90 min or longer) make the risk of seizure in a hyperbaric environment incredibly small.<br/><br/><strong>Ear pain</strong> and even trauma to the ear drum (tympanic membrane) and sinus discomfort:  it is very important to have a well-trained technician watch you and your child as you go under pressure.  It can get uncomfortable if you are not able to equalize the pressure across the ear drum.  This can be likened to coming down in an airplane, you have to be able to yawn, swallow, etc to equalize the pressures.  Fortunately, most children and their parents can “instinctively” learn how to accomplish this maneuver.</p> <p><strong>Eye changes: </strong>temporary changes that can result in near-sightedness.  HBOT can also accelerate cataract development.<br/><br/></p> <h3>Are there children who should NOT undergo hyperbaric treatments?</h3> <p>It would be very rare for a child to have any conditions that would result in him or her not being able to undergo this kind of therapy.  Your doctor will know of these particular risks and double check that both the child and the parent or the “diving partner” does not have any of these conditions.</p> Thu, 01 Dec 2011 08:30:00 -0800 http://www.generationrescue.org/dr-jerry-s-blog/biomedical-intervention/what-is-hyperbaric-oxygen-therapy-and-can-it-help-my-child-with-autism/ http://www.generationrescue.org/dr-jerry-s-blog/biomedical-intervention/let-s-talk-about-gluten-and-going-gluten-and-casein-free-part-2/ <p>I am often asked if the Gluten and Dairy Free (GF/CF) diet is really necessary.  While that answer really depends on each individual child, in my practice up to 80% of the children I see clearly benefit from removing foods that contain dairy and gluten!<br/><br/></p> <h3>What is Gluten?</h3> <p>That’s what my wife asked me when I first suggested that my son, Josh, needed to go on the Gluten free diet.  Gluten is derived from the Latin word “glut” which means glue.  Gluten is found in many of the common flours we use in baking.  These flours include wheat, oats, rye, and barley.  Gluten is a protein that gives baked products their elastic, stretchable, and “hold together” consistency.  Imagine a pizza dough being tossed into the air as it is being formed, how it is so elastic it is almost rubbery.  This dough is made from gluten enriched flour.<br/><br/>The potential problem for children on the spectrum of Autistic Disorders is that they are often unable to substantially break down gluten during the process of digestion.  Instead, they end up with gliadorphins, also known as gluteomorphins.  These gliadorphins can act as opiates and cause a range of potential behavioral modifications in children, the same range of behaviors that the casomorphins found in dairy can cause.  These behaviors include:<br/><br/></p> <ul><li>Constipation </li> <li>Cravings</li> <li> Diarrhea</li> <li> Sleepless nights </li> <li>Hyperactivity </li> <li>Bed-wetting </li> <li>Resistance to potty training</li> <li> Hyperactivity
Aggressive behaviors </li> <li>Dark circles under the eyes </li> <li>Bloated belly</li> <li> Flatulence (lots of gas being passed)</li> <li> Irritability </li> <li>Self-injurious behaviors</li> <li> Severe self imposed dietary restriction (craving only milk containing products)</li> </ul><p><br/>A urine test, called urine peptides, can detect if gluteomorphins are present.  This laboratory test can tell us quickly if the child is not processing gluten containing products appropriately.   If your child is not properly processing gluten, small proteins called “peptides”, derived from partial break down of gluten containing foods in the digestive tract, show up in the test results.  These proteins act like opiates and have a profound impact on behaviors.<br/><br/>There are also a small number of children who are simply gluten intolerant, known as Celiac’s disease.  This disease can show up many different ways, but classically, in a child, when gluten containing foods are introduced, the child just stops gaining weight and the growth curve just flattens out.  This decline usually starts at about 7 months of age.   The Celiac Website estimates this problem occurs in 1/133 people, so this condition is bound to affect some of our children on the spectrum as well.  The treatment for this condition is just removal of gluten containing foods.  This gluten free diet has been well studied and documented, and is quite safe.  This diet should be considered with all our children on the spectrum for at least 3 months.<br/><br/><strong>Stopping Gluten
It is important to keep in mind that during the transition away from gluten, there can be 2-3 weeks of increased problem behaviors</strong> that include worse tantrums, increased aggression, worse sleep, etc.  Remember when I said that gluten can act like an opiate?  If it is, your child is addicted to it.  Josh, my son, would only eat a few gluten containing foods, but even so, when you remove an addict’s drug of choice, it is a bad thing around the house until they are finished detoxifying from it.<br/><br/>In our clinic, when children seem to be exhibiting these “special” behaviors of withdraw, we recommend, ibuprofen (like Advil, Motrin, etc), charcoal, and magnesium sulfate (Epsom Salts) baths.<br/><br/>Finally, since many patients don’t have access to laboratory testing, they will just do a 3 month trial of strict gluten removal from their child’s diet, usually after successfully removing dairy.  Obviously, that means no pizza, fruit loops, or regular crackers.  However, gluten containing products are very commonly used in packaged foods. Some packages will come out and tell you that the product contains no gluten, but every packaged food must be examined for all the “code names” of gluten.  There is a wonderful website that can really assist you in understanding about gluten free products: <a href="http://www.gfcfdiet.com" target="_blank">www.gfcfdiet.com</a>.  I would encourage you to go there to check on the permissible flours and products.<br/><br/>In the meantime, there are aisles in the grocery stores and sections in the health food stores that have many ready to eat GF/CF products.  Please keep in mind, many of these products do have huge amounts of sugar, so you will want to limit how much of them your child consumes.<br/><br/>And that’s my approach to removing gluten.</p> Mon, 31 Oct 2011 07:00:00 -0700 http://www.generationrescue.org/dr-jerry-s-blog/biomedical-intervention/let-s-talk-about-gluten-and-going-gluten-and-casein-free-part-2/ http://www.generationrescue.org/dr-jerry-s-blog/biomedical-intervention/let-s-talk-about-dairy-and-going-gluten-and-casein-free-part-1/ <p>I am often asked if the Gluten and Dairy Free (GF/CF) diet is really necessary.  While that answer really depends on each individual child, in my practice up to 80% of the children I see clearly benefit from removing foods that contain dairy and gluten!<br/><br/><strong>Some Clues About Dairy Intolerance:</strong><br/>You may have noticed that your child was having trouble with certain foods even as an infant. The first food an infant is exposed to, if not breast feeding is usually a cow milk or “dairy” derived formula.  Dairy intolerance presents in many ways in an infant.  Many children are diagnosed with reflux which is frequent spitting up or small vomits around 2-3 months of age, although it can be even earlier, usually shortly after dairy was introduced.  Reflux can alert the parents and physicians that whatever the child is currently ingesting is not being tolerated and the stomach is trying to push it back out.<br/><br/>Colic is another common symptom exhibited by children that are not tolerating dairy.  Colic describes a child who at about 4-8 weeks of life has a 3-4 hour fussy period during the day or evening.  Otherwise, they are a delight to be with.  This kind of colic usually has nothing to do with dairy.  However, colic, as it is used “today”, is a term for any fussy infant no matter how frequently he or she is cranky during the day.  This kind of colic definitely extends beyond the 4-8 weeks old marker.  The dairy sensitivity I have observed in my practice can cause colic behavior, be responsible for recurrent ear infections, asthma, eczema or dry skin, chronic diarrhea or constipation, and sleep disturbances.  Later on the child can actually become addicted to milk and crave milk as well as any products derived from milk.<br/><br/>Much has been written about what the dairy can actually be doing in these children’s bodies.  Obviously there can be an allergy or sensitivity involved.  The allergic reaction may include dry skin or eczema as well as frequent infections including ear infections, sinus infections, asthma, pneumonia (from reflux) and chronically enlarged tonsils.  In addition, when a doctor examines the urine for what is called casomorphin, a morphine-like substance derived from dairy, it is frequently positive.  This test is a simple laboratory test that can tell us quickly if the child is not processing dairy products appropriately, and if not, small proteins, more aptly called “peptides”, derived from partial break down of dairy foods in the digestive tract, are present.  What is clinically significant is that these proteins as like opiates and have a profound impact on behaviors.<br/><br/></p> <h5>These behaviors, seen all too commonly in my clinic include:</h5> <p><br/>•    Constipation<br/>•    Diarrhea<br/>•    Sleepless nights<br/>•    Hyperactivity<br/>•    Bed-wetting<br/>•    Resistance to potty training<br/>•    Hyperactivity<br/>•    Aggressive behaviors<br/>•    Dark circles under the eyes<br/>•    Bloated belly<br/>•    Flatulence (lots of gas being passed)<br/>•    Irritability<br/>•    Red cheeks and or red ears<br/>•    Severe self imposed dietary restriction (craving only milk containing products)<br/><br/><strong>Stopping Dairy</strong><br/>Doctors often switch infants suspected of dairy intolerance to Neocate Infant Formula® which is usually well tolerated and a great alternative to dairy containing foods.  We usually do not recommend soy formulas in our clinic because many children who cannot tolerate milk cannot tolerate soy either.<br/><br/>Older children can be switched to Rice Milk or Almond Milk.  Please note, the “milk” used in these titles are a great marketing ploy….there is nothing “milky” about these products, as rice and almonds are not mammals!  With that said, they are great in cereals and for cooking.  Many children will drink them like they would normal milk but some children have to be weaned slowly from their milk.  A good way to do this is to dilute the milk with rice milk, and every few days, make sure the dilution moves away from milk and toward the rice milk.  This may take 4-6 weeks for some children!<br/><br/>It is important to understand that during the transition away from dairy, there can be 2-3 weeks of increased behaviors that include worse tantrums, increased aggression, worse sleep, etc.  Remember when I said this can act like an opiate?  If it is, they are addicted to it.  Josh, my son, was drinking a gallon of milk per day before we removed it from his diet.  When you remove an addict’s drug of choice, it is a bad thing around the house until they are finished detoxifying from it.  During this period of withdrawal, it seems that whatever they do for “autism” they tend to do much more of it!  That is, if they are runners, they run a whole lot more, if they are prone to tantrums, these tantrums can become much more intense and more frequent, etc.<br/><br/>In our clinic, when children seem to be exhibiting these “special” behaviors of withdrawal, we recommend ibuprofen (like Advil, Motrin, etc), charcoal, and magnesium sulfate (Epsom Salts) baths.<br/><br/>Finally, since many patients don’t have access to laboratory testing, they will just do a 3 month trial of strict dairy free removal from their child’s diet.  Obviously, that means milk, ice cream and cheese.  But milk products are very commonly used in packaged foods. Some packages will come out and tell you that the product contains NO MILK, but every packaged food must be examined for all the “code names” of dairy.  You can see a list of these “code names” here.<br/><br/>And that’s my approach to removing dairy. </p> Mon, 24 Oct 2011 07:00:00 -0700 http://www.generationrescue.org/dr-jerry-s-blog/biomedical-intervention/let-s-talk-about-dairy-and-going-gluten-and-casein-free-part-1/ http://www.generationrescue.org/dr-jerry-s-blog/biomedical-intervention/what-can-i-do-to-help-my-son-with-aggression-q-and-a-with-dr-jerry-kartzinel/ <p>Self-injurious behaviors (SIBs) and aggression to others can be some of the most distressing behaviors a parent can witness!  I have seen many different displays of SIBS/aggression including:</p> <p> </p> <ul><li><span style="color: #000000;">Hitting of body parts: head and thighs most common</span></li> <li><span style="color: #000000;">Biting of hands, wrists, and lips</span></li> <li><span style="color: #000000;">Poking of eyes</span></li> <li><span style="color: #000000;">Grabbing and pinching self</span></li> <li><span style="color: #000000;">Pulling body parts really hard, for example the “pinkie” toe</span></li> <li><span style="color: #000000;">Jumping and falling directly onto knees</span></li> <li><span style="color: #000000;">Pulling hair</span></li> <li><span style="color: #000000;">Body slams into walls, furniture</span></li> <li><span style="color: #000000;">Myriad of aggressive behaviors to others and pets, too</span></li> </ul><p> </p> <p>The good news is we can usually stop these behaviors as soon as we can identify the source or sources.  I am convinced that the majority of children who exhibit theses destructive behaviors do so in order to somehow minimize discomfort with what they are feeling.  Sounds strange to most of us, but this can make sense.  Let me give you an example. </p> <p> </p> <p>When I was working with teens in a “half-way” house, I had the opportunity to take care of “cutters.”  These teens would cut themselves, intentionally, usually at night.  The next day, they would come to my clinic for a “patch.”  After gaining their confidence, I would ask them why.  I was told that they have such severe emotional pain or anxiety and that somehow, the physical pain would block this emotional pain and they could go to sleep.  So, how does physical pain decrease the mental anguish?</p> <p> </p> <p>The physiologic response to pain results in the body producing and releasing substances called endorphins and enkephalins, which belong to the family of opioids.  These in turn, bind to opioid receptor sites in the brain and block pain.  This process is likely the source of “runner’s high”, or that euphoric feeling of wellness after a strenuous workout.  </p> <p> </p> <p>Pain, be it psychological or physical in its origin, may be provoking the outward manifestation of a SIB response in order to generate these opioid-like acting agents making this pain more tolerable.  Hence, it would be wise to figure out the source of pain, fix it, and see if this diminishes the SIBs.  That is what I work to do in my clinic: Stop the pain and watch the SIBS diminish or entirely resolve.</p> <p> </p> <h3>Sources of Pain:</h3> <p> </p> <ul><li><span style="color: #000000;">Constipation</span></li> <li><span style="color: #000000;">Diarrhea</span></li> <li><span style="color: #000000;">Dysbiosis (abnormal gut bugs)</span></li> <li><span style="color: #000000;">Inflammation:</span></li> <li><span style="color: #000000;">Abdominal pain</span></li> <li><span style="color: #000000;">Gastritis</span></li> <li><span style="color: #000000;">Esophagitis</span></li> <li><span style="color: #000000;">Colonitis</span></li> <li><span style="color: #000000;">Sinusitis</span></li> <li><span style="color: #000000;">Headaches/migraines</span></li> <li><span style="color: #000000;">Arnold Chiari Malformation</span></li> <li><span style="color: #000000;">Allergies</span></li> <li><span style="color: #000000;">Anxiety (really big when aggression is toward others)</span></li> <li><span style="color: #000000;">Sleep disruption</span></li> <li><span style="color: #000000;">TOO much therapy/demands on the child</span></li> <li><span style="color: #000000;">Parental disharmony</span></li> <li><span style="color: #000000;">Noises emitted from siblings (crying), cell phones, microwave ovens, etc</span></li> </ul><p> </p> <h3>Treatment:</h3> <p>This depends on the underlying medical problems.  Each one of these potential sources must be explored and considered.  For example, a 10 day course of Pepcid, an “over-the-counter” antacid can tell you really quickly if some of the SIBS/aggression might be due to reflux and inflammation of the swallowing pipe, called the esophagus.  Or, a 5-7 day trial of Ibuprofen (such as Motrin or Advil) that improves these behaviors suggests the source IS pain, and could point to, for example, headaches.</p> <p> </p> <p>After exclusion of the common sources of SIB, I sometimes have to resort pharmacologic management.  Though I generally try very hard not to use medications, I will due to the severity of the behaviors.  </p> <p> </p> <h3>Medications to consider in order to control SIBS and aggression after all treatable sources of pain/discomfort have been addressed:</h3> <p> </p> <ul><li><span style="color: #000000;">Abilify</span></li> <li><span style="color: #000000;">BuSpar</span></li> <li><span style="color: #000000;">Depakote</span></li> <li><span style="color: #000000;">Neurontin</span></li> <li><span style="color: #000000;">Propranolol</span></li> <li><span style="color: #000000;">Risperdal</span></li> <li><span style="color: #000000;">SSRI: Prozac, Zoloft, Lexapro, etc </span></li> <li><span style="color: #000000;">And in those states where legal, medical marijuana can be considered.</span></li> </ul><p> </p> <p>It is worth mentioning that compared to the other medications listed above; the side effect profile for medical marijuana is truly minimal.  It also seems to be very effective in those children with high levels of anxiety which apparently then manifest with SIBs and aggression.  Once the anxiety is removed, SIBs and aggression just seem to stop.  This medication can be ingested in a capsule, administered as a tincture, or even baked into the child’s food.  The use of medical marijuana continues to be highly controversial and though some states approve its use, the state laws do conflict with federal laws.  </p> <p> </p> <p>Of course, these medications must be prescribed (or “recommended” in the case of medical marijuana) by physicians who can monitor the effectiveness and potential side effects.  Generally, we can avoid many of these medications by addressing the medical concerns first.</p> <p> </p> <h6>Dr. Jerry Kartzinel is Board Certified pediatrician and a Fellow in the American Academy of Pediatrics. He specializes in the recovery of neurodevelopmental, chronic neuro-inflammatory diseases, and hormonal dysfunctions. Dr. Jerry co-authored <a href="http://www.generationrescue.org/store/books/healing-and-preventing-autism-2/" target="_blank">Healing and Preventing Autism</a> with Jenny McCarthy. </h6> <p> </p> <h5>Visit Dr. Jerry's New Autism Information Site: <a href="http://www.kartzinelhealth.com/" target="_blank">MendingAutism.com</a> for thoughtful help for healing the bod and family. </h5> <p> </p> <h6>Do you have a question for Dr. Jerry? </h6> <h6>Ask your questions in the comments section below or you can send us an <a href="mailto:monique.peltz@generationrescue.org">email</a>. </h6> <div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Self-injurious behaviors (SIBs) and aggression to others can be some of the most distressing behaviors a parent can witness!  I have seen many different displays of SIBS/aggression including:</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Hitting of body parts: head and thighs most common</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Biting of hands, wrists, and lips</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Poking of eyes</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Grabbing and pinching self</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Pulling body parts really hard, for example the “pinkie” toe</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Jumping and falling directly onto knees</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Pulling hair</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Body slams into walls, furniture</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Myriad of aggressive behaviors to others and pets, too</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">The good news is we can usually stop these behaviors as soon as we can identify the source or sources.  I am convinced that the majority of children who exhibit theses destructive behaviors do so in order to somehow minimize discomfort with what they are feeling.  Sounds strange to most of us, but this can make sense.  Let me give you an example. </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">When I was working with teens in a “half-way” house, I had the opportunity to take care of “cutters.”  These teens would cut themselves, intentionally, usually at night.  The next day, they would come to my clinic for a “patch.”  After gaining their confidence, I would ask them why.  I was told that they have such severe emotional pain or anxiety and that somehow, the physical pain would block this emotional pain and they could go to sleep.  So, how does physical pain decrease the mental anguish?</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">The physiologic response to pain results in the body producing and releasing substances called endorphins and enkephalins, which belong to the family of opioids.  These in turn, bind to opioid receptor sites in the brain and block pain.  This process is likely the source of “runner’s high”, or that euphoric feeling of wellness after a strenuous workout.  </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Pain, be it psychological or physical in its origin, may be provoking the outward manifestation of a SIB response in order to generate these opioid-like acting agents making this pain more tolerable.  Hence, it would be wise to figure out the source of pain, fix it, and see if this diminishes the SIBs.  That is what I work to do in my clinic: Stop the pain and watch the SIBS diminish or entirely resolve.</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Sources of Pain:</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Constipation</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Diarrhea</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Dysbiosis (abnormal gut bugs)</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Inflammation:</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Abdominal pain</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Gastritis</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Esophagitis</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Colonitis</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Sinusitis</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Headaches/migraines</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Arnold Chiari Malformation</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Allergies</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Anxiety (really big when aggression is toward others)</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Sleep disruption</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">TOO much therapy/demands on the child</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Parental disharmony</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Noises emitted from siblings (crying), cell phones, microwave ovens, etc</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Treatment:</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">This depends on the underlying medical problems.  Each one of these potential sources must be explored and considered.  For example, a 10 day course of Pepcid, an “over-the-counter” antacid can tell you really quickly if some of the SIBS/aggression might be due to reflux and inflammation of the swallowing pipe, called the esophagus.  Or, a 5-7 day trial of Ibuprofen (such as Motrin or Advil) that improves these behaviors suggests the source IS pain, and could point to, for example, headaches.</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">After exclusion of the common sources of SIB, I sometimes have to resort pharmacologic management.  Though I generally try very hard not to use medications, I will due to the severity of the behaviors.  </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Medications to consider in order to control SIBS and aggression after all treatable sources of pain/discomfort have been addressed:</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Abilify</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">BuSpar</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Depakote</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Neurontin</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Propranolol</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Risperdal</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">SSRI: Prozac, Zoloft, Lexapro, etc</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">And in those states where legal, medical marijuana can be considered.</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">It is worth mentioning that compared to the other medications listed above; the side effect profile for medical marijuana is truly minimal.  It also seems to be very effective in those children with high levels of anxiety which apparently then manifest with SIBs and aggression.  Once the anxiety is removed, SIBs and aggression just seem to stop.  This medication can be ingested in a capsule, administered as a tincture, or even baked into the child’s food.  The use of medical marijuana continues to be highly controversial and though some states approve its use, the state laws do conflict with federal laws.  </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Of course, these medications must be prescribed (or “recommended” in the case of medical marijuana) by physicians who can monitor the effectiveness and potential side effects.  Generally, we can avoid many of these medications by addressing the medical concerns first.</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Dr. Jerry Kartzinel is Board Certified pediatrician and a Fellow in the American Academy of Pediatrics. He specializes in the recovery of neurodevelopmental, chronic neuro-inflammatory diseases, and hormonal dysfunctions. Dr. Jerry co-authored Healing and Preventing Autism with Jenny McCarthy. </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">  </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Visit Dr. Jerry's New Autism Information Site: MendingAutism.com for thoughtful help for healing the bod and family. </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Do you have a question for Dr. Jerry? </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Ask your questions in the comments section below or you can send us anSelf-injurious behaviors (SIBs) and aggression to others can be some of the most distressing behaviors a parent can witness!  I have seen many different displays of SIBS/aggression including:</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Hitting of body parts: head and thighs most common</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Biting of hands, wrists, and lips</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Poking of eyes</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Grabbing and pinching self</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Pulling body parts really hard, for example the “pinkie” toe</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Jumping and falling directly onto knees</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Pulling hair</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Body slams into walls, furniture</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Myriad of aggressive behaviors to others and pets, too</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">The good news is we can usually stop these behaviors as soon as we can identify the source or sources.  I am convinced that the majority of children who exhibit theses destructive behaviors do so in order to somehow minimize discomfort with what they are feeling.  Sounds strange to most of us, but this can make sense.  Let me give you an example. </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">When I was working with teens in a “half-way” house, I had the opportunity to take care of “cutters.”  These teens would cut themselves, intentionally, usually at night.  The next day, they would come to my clinic for a “patch.”  After gaining their confidence, I would ask them why.  I was told that they have such severe emotional pain or anxiety and that somehow, the physical pain would block this emotional pain and they could go to sleep.  So, how does physical pain decrease the mental anguish?</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">The physiologic response to pain results in the body producing and releasing substances called endorphins and enkephalins, which belong to the family of opioids.  These in turn, bind to opioid receptor sites in the brain and block pain.  This process is likely the source of “runner’s high”, or that euphoric feeling of wellness after a strenuous workout.  </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Pain, be it psychological or physical in its origin, may be provoking the outward manifestation of a SIB response in order to generate these opioid-like acting agents making this pain more tolerable.  Hence, it would be wise to figure out the source of pain, fix it, and see if this diminishes the SIBs.  That is what I work to do in my clinic: Stop the pain and watch the SIBS diminish or entirely resolve.</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Sources of Pain:</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Constipation</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Diarrhea</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Dysbiosis (abnormal gut bugs)</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Inflammation:</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Abdominal pain</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Gastritis</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Esophagitis</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Colonitis</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Sinusitis</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Headaches/migraines</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Arnold Chiari Malformation</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Allergies</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Anxiety (really big when aggression is toward others)</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Sleep disruption</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">TOO much therapy/demands on the child</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Parental disharmony</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Noises emitted from siblings (crying), cell phones, microwave ovens, etc</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Treatment:</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">This depends on the underlying medical problems.  Each one of these potential sources must be explored and considered.  For example, a 10 day course of Pepcid, an “over-the-counter” antacid can tell you really quickly if some of the SIBS/aggression might be due to reflux and inflammation of the swallowing pipe, called the esophagus.  Or, a 5-7 day trial of Ibuprofen (such as Motrin or Advil) that improves these behaviors suggests the source IS pain, and could point to, for example, headaches.</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">After exclusion of the common sources of SIB, I sometimes have to resort pharmacologic management.  Though I generally try very hard not to use medications, I will due to the severity of the behaviors.  </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Medications to consider in order to control SIBS and aggression after all treatable sources of pain/discomfort have been addressed:</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Abilify</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">BuSpar</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Depakote</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Neurontin</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Propranolol</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Risperdal</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">SSRI: Prozac, Zoloft, Lexapro, etc</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">And in those states where legal, medical marijuana can be considered.</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">It is worth mentioning that compared to the other medications listed above; the side effect profile for medical marijuana is truly minimal.  It also seems to be very effective in those children with high levels of anxiety which apparently then manifest with SIBs and aggression.  Once the anxiety is removed, SIBs and aggression just seem to stop.  This medication can be ingested in a capsule, administered as a tincture, or even baked into the child’s food.  The use of medical marijuana continues to be highly controversial and though some states approve its use, the state laws do conflict with federal laws.  </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Of course, these medications must be prescribed (or “recommended” in the case of medical marijuana) by physicians who can monitor the effectiveness and potential side effects.  Generally, we can avoid many of these medications by addressing the medical concerns first.</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Dr. Jerry Kartzinel is Board Certified pediatrician and a Fellow in the American Academy of Pediatrics. He specializes in the recovery of neurodevelopmental, chronic neuro-inflammatory diseases, and hormonal dysfunctions. Dr. Jerry co-authored Healing and Preventing Autism with Jenny McCarthy. </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">  </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Visit Dr. Jerry's New Autism Information Site: MendingAutism.com for thoughtful help for healing the bod and family. </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Do you have a question for Dr. Jerry? </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Ask your questions in the comments section below or you can send us an email. </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> email. </div> <p>Self-injurious behaviors (SIBs) and aggression to others can be some of the most distressing behaviors a parent can witness!  I have seen many different displays of SIBS/aggression including:</p> <p> </p> <ul><li><span style="color: #000000; ">Hitting of body parts: head and thighs most common</span></li> <li><span style="color: #000000; ">Biting of hands, wrists, and lips</span></li> <li><span style="color: #000000; ">Poking of eyes</span></li> <li><span style="color: #000000; ">Grabbing and pinching self</span></li> <li><span style="color: #000000; ">Pulling body parts really hard, for example the “pinkie” toe</span></li> <li><span style="color: #000000; ">Jumping and falling directly onto knees</span></li> <li><span style="color: #000000; ">Pulling hair</span></li> <li><span style="color: #000000; ">Body slams into walls, furniture</span></li> <li><span style="color: #000000; ">Myriad of aggressive behaviors to others and pets, too</span></li> </ul><p> </p> <p>The good news is we can usually stop these behaviors as soon as we can identify the source or sources.  I am convinced that the majority of children who exhibit theses destructive behaviors do so in order to somehow minimize discomfort with what they are feeling.  Sounds strange to most of us, but this can make sense.  Let me give you an example. </p> <p> </p> <p>When I was working with teens in a “half-way” house, I had the opportunity to take care of “cutters.”  These teens would cut themselves, intentionally, usually at night.  The next day, they would come to my clinic for a “patch.”  After gaining their confidence, I would ask them why.  I was told that they have such severe emotional pain or anxiety and that somehow, the physical pain would block this emotional pain and they could go to sleep.  So, how does physical pain decrease the mental anguish?</p> <p> </p> <p>The physiologic response to pain results in the body producing and releasing substances called endorphins and enkephalins, which belong to the family of opioids.  These in turn, bind to opioid receptor sites in the brain and block pain.  This process is likely the source of “runner’s high”, or that euphoric feeling of wellness after a strenuous workout.  </p> <p> </p> <p>Pain, be it psychological or physical in its origin, may be provoking the outward manifestation of a SIB response in order to generate these opioid-like acting agents making this pain more tolerable.  Hence, it would be wise to figure out the source of pain, fix it, and see if this diminishes the SIBs.  That is what I work to do in my clinic: Stop the pain and watch the SIBS diminish or entirely resolve.</p> <p> </p> <h3>Sources of Pain:</h3> <p> </p> <ul><li><span style="color: #000000;">Constipation</span></li> <li><span style="color: #000000;">Diarrhea</span></li> <li><span style="color: #000000;">Dysbiosis (abnormal gut bugs)</span></li> <li><span style="color: #000000;">Inflammation:</span></li> <li><span style="color: #000000;">Abdominal pain</span></li> <li><span style="color: #000000;">Gastritis</span></li> <li><span style="color: #000000;">Esophagitis</span></li> <li><span style="color: #000000;">Colonitis</span></li> <li><span style="color: #000000;">Sinusitis</span></li> <li><span style="color: #000000;">Headaches/migraines</span></li> <li><span style="color: #000000;">Arnold Chiari Malformation</span></li> <li><span style="color: #000000;">Allergies</span></li> <li><span style="color: #000000;">Anxiety (really big when aggression is toward others)</span></li> <li><span style="color: #000000;">Sleep disruption</span></li> <li><span style="color: #000000;">TOO much therapy/demands on the child</span></li> <li><span style="color: #000000;">Parental disharmony</span></li> <li><span style="color: #000000;">Noises emitted from siblings (crying), cell phones, microwave ovens, etc</span></li> </ul><p> </p> <h3>Treatment:</h3> <p>This depends on the underlying medical problems.  Each one of these potential sources must be explored and considered.  For example, a 10 day course of Pepcid, an “over-the-counter” antacid can tell you really quickly if some of the SIBS/aggression might be due to reflux and inflammation of the swallowing pipe, called the esophagus.  Or, a 5-7 day trial of Ibuprofen (such as Motrin or Advil) that improves these behaviors suggests the source IS pain, and could point to, for example, headaches.</p> <p> </p> <p>After exclusion of the common sources of SIB, I sometimes have to resort pharmacologic management.  Though I generally try very hard not to use medications, I will due to the severity of the behaviors.  </p> <p> </p> <h3>Medications to consider in order to control SIBS and aggression after all treatable sources of pain/discomfort have been addressed:</h3> <p> </p> <ul><li><span style="color: #000000;">Abilify</span></li> <li><span style="color: #000000;">BuSpar</span></li> <li><span style="color: #000000;">Depakote</span></li> <li><span style="color: #000000;">Neurontin</span></li> <li><span style="color: #000000;">Propranolol</span></li> <li><span style="color: #000000;">Risperdal</span></li> <li><span style="color: #000000;">SSRI: Prozac, Zoloft, Lexapro, etc </span></li> <li><span style="color: #000000;">And in those states where legal, medical marijuana can be considered.</span></li> </ul><p> </p> <p>It is worth mentioning that compared to the other medications listed above; the side effect profile for medical marijuana is truly minimal.  It also seems to be very effective in those children with high levels of anxiety which apparently then manifest with SIBs and aggression.  Once the anxiety is removed, SIBs and aggression just seem to stop.  This medication can be ingested in a capsule, administered as a tincture, or even baked into the child’s food.  The use of medical marijuana continues to be highly controversial and though some states approve its use, the state laws do conflict with federal laws.  </p> <p> </p> <p>Of course, these medications must be prescribed (or “recommended” in the case of medical marijuana) by physicians who can monitor the effectiveness and potential side effects.  Generally, we can avoid many of these medications by addressing the medical concerns first.</p> <p> </p> <h6>Dr. Jerry Kartzinel is Board Certified pediatrician and a Fellow in the American Academy of Pediatrics. He specializes in the recovery of neurodevelopmental, chronic neuro-inflammatory diseases, and hormonal dysfunctions. Dr. Jerry co-authored <a href="http://www.generationrescue.org/store/books/healing-and-preventing-autism-2/" target="_blank"><span style="color: #000000;">Healing and Preventing Autism</span></a> with Jenny McCarthy. </h6> <p> </p> <h5>Visit Dr. Jerry's New Autism Information Site: <a href="http://www.kartzinelhealth.com/" target="_blank"><span style="color: #999999;">MendingAutism.com</span></a> for thoughtful help for healing the bod and family. </h5> <h6/> <h6>Do you have a question for Dr. Jerry? </h6> <h6>Ask your questions in the comments section below or you can send us an <a href="mailto:monique.peltz@generationrescue.org"><span style="color: #000000;">email</span></a>. </h6> <h6/> <p> </p> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> Wed, 17 Aug 2011 00:05:05 -0700 http://www.generationrescue.org/dr-jerry-s-blog/biomedical-intervention/what-can-i-do-to-help-my-son-with-aggression-q-and-a-with-dr-jerry-kartzinel/ http://www.generationrescue.org/dr-jerry-s-blog/biomedical-intervention/is-autism-reversible-q-and-a-with-dr-jerry-kartzinel/ <p> </p> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Jackie E. writes to Dr. Jerry Kartzinel: Do you believe in reversing autism??</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Dr. Jerry’s Response: </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Let’s consider autism to be a collection of mismanaged incoming information and stimuli.  The more mismanaged the information and stimuli, the more severe we consider the individual with Autism.  Let me illustrate this point with a word picture.  Imagine someone with too many alcoholic beverages “on board.”  We can easily recognize by how he responds to incoming information (stimuli) such as his language, how he walks (or how he drives) that he has had way too much of alcohol.  Of course, the more alcohol on board, the more distorted his response to the environment and the more “severe” or “toxic” we consider the individual.  If we remove the source of the alcohol, we can expect some degree of recovery.  Similarly, with autistic children, if we remove the sources of the mismanagement of incoming stimuli and information, we can expect a certain amount of improvement.</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Autistic children do not respond normally to the many activities of daily living…such as sleeping, http://www.generationrescue.org/dr-jerry-s-blog/treatment-reading/let-s-talk-about-sleep/ waking, eating, lights, sounds, ability to understand and speak language, and mood regulation, to name a few.  For example, my son Josh, in the early days of his diagnosis, would walk on hot gravel in bare feet!  Apparently the nerve endings in his feet were indeed picking up heat and “sharp” but his brain was not able to initiate the correct response (to get off and “cry”).  </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">It’s as if their “hard drive” is no longer making sense of input coming in from the body’s senses.  This is why we have to approach the child with autism as a medical concern and not merely behaviorally.  We have to fix the hard drive to enable our “software engineers” (you know, the speech therapists, occupational therapists, physical therapists, etc) to have much more success.  Case in point, if you were a therapist, would you prefer to work with a child who has been up all night (because of altered sleep cycles) or a child who had a great nights sleep? http://www.generationrescue.org/dr-jerry-s-blog/treatment-reading/let-s-talk-about-sleep/  Unless you love massive amounts of pain, you will pick the child who slept well. </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Biomedical interventions http://www.generationrescue.org/recovery/biomedical-treatment/ allow us to restore the natural rhythms that include sleeping, eating, normal bowel movements, and a body that is free of pain. Once this restoration is accomplished, we will have a child really ready to take on the challenge of catching up!  </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">This process of recovery includes many steps such dietary interventions, treatment of infections, management of allergies, management of inflammation, and regulation of perceived needs and rituals. That’s just a few of the many possible therapeutic interventions!</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">We have found, in our clinic, the more appropriate responses to stimuli, be it words on a page (reading) or questions from mom, the less and less our children appear to be “autistic” and more and more they become harder to differentiate from their neurotypical peers.  Are they cured?  Maybe the wrong question.  Are they able to participate in the activities of childhood, have friends and develop relationships, and grow in academics?  That’s what we are after here.</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">I encourage you to read as much as you can about this process of recovery, and a good place to start is Healing and Preventing Autism written by myself and Jenny McCarthy.  This will give you a good basic understanding to Autism and many of the medical issues can be addressed and the improvement of autistic behaviors that follow.</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">http://www.amazon.com/Healing-Preventing-Autism-Complete-Guide/dp/0525951032</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;"> Dr. Jerry Kartzinel is Board Certified pediatrician and a Fellow in the American Academy of Pediatrics. He specializes in the recovery of neurodevelopmental, chronic neuro-inflammatory diseases, and hormonal dysfunctions. Dr. Jerry co-authored Healing and Preventing Autism with Jenny McCarthy.   </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Visit Dr. Jerry's New Autism Information Site: MendingAutism.com for thoughtful help for healing the bod and family. </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">http://www.generationrescue.org/store/books/healing-and-preventing-autism-2/</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">http://www.kartzinelhealth.com/</div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Do you have a question for Dr. Jerry? </div> <div id="_mcePaste" style="position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px; overflow-x: hidden; overflow-y: hidden;">Ask your questions in the comments section below or you can send us an email. </div> <p><strong>Jackie E. writes to Dr. Jerry Kartzinel: Do you believe in reversing autism??</strong></p> <p><strong>Dr. Jerry’s Response: </strong></p> <p>Let’s consider autism to be a collection of mismanaged incoming information and stimuli.  The more mismanaged the information and stimuli, the more severe we consider the individual with Autism.  Let me illustrate this point with a word picture.  Imagine someone with too many alcoholic beverages “on board.”  We can easily recognize by how he responds to incoming information (stimuli) such as his language, how he walks (or how he drives) that he has had way too much of alcohol.  Of course, the more alcohol on board, the more distorted his response to the environment and the more “severe” or “toxic” we consider the individual.  If we remove the source of the alcohol, we can expect some degree of recovery.  Similarly, with autistic children, if we remove the sources of the mismanagement of incoming stimuli and information, we can expect a certain amount of improvement.</p> <p> </p> <p>Autistic children do not respond normally to the many activities of daily living…such as <a href="http://www.generationrescue.org/dr-jerry-s-blog/treatment-reading/let-s-talk-about-sleep/" target="_blank">sleeping</a>, waking, eating, lights, sounds, ability to understand and speak language, and mood regulation, to name a few.  For example, my son Josh, in the early days of his diagnosis, would walk on hot gravel in bare feet!  Apparently the nerve endings in his feet were indeed picking up heat and “sharp” but his brain was not able to initiate the correct response (to get off and “cry”).  </p> <p> </p> <p>It’s as if their “hard drive” is no longer making sense of input coming in from the body’s senses.  This is why we have to approach the child with autism as a medical concern and not merely behaviorally.  We have to fix the hard drive to enable our “software engineers” (you know, the speech therapists, occupational therapists, physical therapists, etc) to have much more success.  Case in point, if you were a therapist, would you prefer to work with a child who has been up all night (because of altered sleep cycles) or a child who had a <a href="http://www.generationrescue.org/dr-jerry-s-blog/treatment-reading/let-s-talk-about-sleep/" target="_blank">great nights sleep</a>?   Unless you love massive amounts of pain, you will pick the child who slept well. </p> <p> </p> <p><a href="http://www.generationrescue.org/recovery/biomedical-treatment/" target="_blank">Biomedical interventions</a> allow us to restore the natural rhythms that include sleeping, eating, normal bowel movements, and a body that is free of pain. Once this restoration is accomplished, we will have a child really ready to take on the challenge of catching up!  </p> <p> </p> <p>This process of recovery includes many steps such dietary interventions, treatment of infections, management of allergies, management of inflammation, and regulation of perceived needs and rituals. That’s just a few of the many possible therapeutic interventions!</p> <p> </p> <p>We have found, in our clinic, the more appropriate responses to stimuli, be it words on a page (reading) or questions from mom, the less and less our children appear to be “autistic” and more and more they become harder to differentiate from their neurotypical peers.  Are they cured?  Maybe the wrong question.  Are they able to participate in the activities of childhood, have friends and develop relationships, and grow in academics?  That’s what we are after here.</p> <p> </p> <p>I encourage you to read as much as you can about this process of recovery, and a good place to start is <a href="http://www.amazon.com/Healing-Preventing-Autism-Complete-Guide/dp/0525951032" target="_blank"><em>Healing and Preventing Autism</em></a> written by myself and Jenny McCarthy.  This will give you a good basic understanding to Autism and many of the medical issues can be addressed and the improvement of autistic behaviors that follow.</p> <p> </p> <h5><em>Dr. Jerry Kartzinel is Board Certified pediatrician and a Fellow in the American Academy of Pediatrics. He specializes in the recovery of neurodevelopmental, chronic neuro-inflammatory diseases, and hormonal dysfunctions. Dr. Jerry co-authored </em><a href="http://www.generationrescue.org/store/books/healing-and-preventing-autism-2/" target="_blank"><span style="color: #999999;"><em>Healing and Preventing Autism</em></span></a><em> with Jenny McCarthy.   </em></h5> <h5><em>Visit Dr. Jerry's New Autism Information Site: </em><a href="http://www.kartzinelhealth.com/" target="_blank"><span style="color: #999999;"><em>MendingAutism.com</em></span></a><em> for thoughtful help for healing the bod and family. </em></h5> <h6>Do you have a question for Dr. Jerry? </h6> <h6>Ask your questions in the comments section below or you can send us an <a href="mailto:monique.peltz@generationrescue.org"><span style="color: #000000;">email</span></a>. </h6> <p> </p> Mon, 08 Aug 2011 09:00:00 -0700 http://www.generationrescue.org/dr-jerry-s-blog/biomedical-intervention/is-autism-reversible-q-and-a-with-dr-jerry-kartzinel/ http://www.generationrescue.org/dr-jerry-s-blog/biomedical-intervention/mending-autism-the-role-of-supplementation/ <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Mending Autism can be very complicated and the tackling of the subject of supplements for these children can prove to be quite daunting and confusing. There are so many different approaches on the subject that can range from adding absolutely no supplements to a $1000 per month (or more) supplement bill!  The truth of the matter lies somewhere between these two approaches.  Let’s take a rational and easily understood approach to the basics of supplementation.</div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">A dietary history on most of our children typically reveals sources of Vitamins, Minerals, and Essential Fatty Acids are missing from their diet.  Many of our children have self-limited diets and they simply do not ingest adequate amounts of vital nutrients.  For example, vitamin C cannot be synthesized (made) by human beings, it must be ingested regularly.  The main sources of Vitamin C are citrus fruits (lemons, oranges, limes, and grapefruits), tomatoes, and potatoes.  When children do not eat these common sources of Vitamin C, they are at risk for developing scurvy!  In these children, it is easy to argue for adding the supplement Vitamin C to the diet.  </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Aside from replenishment of lacking nutrients, what we really are trying to do in our children:</div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Optimization of Normal Physiology </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Improve Function of the Immune System</div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Enhance Cognitive Abilities </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Improve Red Cell Membrane Function </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Reduction of Autistic Behaviors </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Improve Gastrointestinal Function </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Minimize our NEGATIVE genetic influences</div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">  </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">So, let’s take a look at the major types of supplements.  </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Vitamins: Vitamins are critical micronutrients for normal cellular metabolism and function.  They must be consumed regularly as our bodies are not able to synthesize these vital nutrients in sufficient amounts.  Vitamins are required for proper cell signaling, mediators of cell growth, function as antioxidants, and even hormones. </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Minerals: The main electrolytes are Sodium, Potassium, Calcium, Magnesium and Chloride. Proper levels of these minerals in the body allow the body to have energy, better muscle and nerve function (including faster stress recovery) and improved function in many other areas.  The so called trace minerals including selenium, iodine, chromium, magnesium, molybdenum, just to name a few, need to be replenished daily, ideally through the diet. </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Omega 3 Fatty Acids : These fatty acids help maintain the fluidity and stability of cell membranes and protect the body from harmful substances such as bacteria and viruses. They must be obtained through diet or supplementation with EFA(Essential Fatty Acids) -rich food oils. They have an amazing affect on behaviors, mood, focus and concentration.</div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Digestive Enzymes break down the foods that we eat into smaller compounds that can be readily absorbed and put into the blood-stream.  The enzyme class of proteases breaks down proteins to amino acids. The enzyme class of lipase is responsible of breaking down fats to fatty acids, and the carbohydrases break down carbohydrates into simple sugars.</div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Where to Begin:</div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">1. Multivitamin and minerals  </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">If your child does not swallow capsules, then you can go to either a liquid or powder.  Liquids tend to have a really strong flavor that is hard to mask.  Powders can be easily mixed in the patients drink and given through out the day.  Please note that multivitamins very tremendously in both quality and in price!  Look for ones that are formulated in the United States and look for: </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">GMP compliant –“Good Manufacturing Process” is strictly adhered to in production </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Non-GMO – products are derived from sources that have not been “genetically modified” </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Hypoallergenic GF/CF </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Must have nutrients in amounts that that are not only appropriate for the child but can be absorbed by the child’s digestive tract. </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">2. Omega Oils </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">These oils need to come from sources that specialize in using smaller fish caught in pristine waters.  There are different ways to ensure both the quality and purity.  I have found that the process of molecular distillation is the safest way to make sure all heavy metal contaminants are removed from the oil.    </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">3. Digestive Enzymes</div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Published studies have demonstrated that some children on the autistic spectrum have a diminished ability to produce adequate digestive enzymes that are required for the normal breakdown of food and its subsequent absorption into the blood stream.  It can be readily apparent by just looking at undigested food the stool.  Make sure to seek out a digestive enzyme that is truly complete and contains multiple enzymes that break down amylose, proteins, peptides, fats, cellulose, lactose, maltose, and even hemicelluloses. </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">After the basics are covered, supplements are usually targeted to improve a certain condition such as problems with focus and concentration, chronic constipation, or even language to name just a few.  We will tackle these subjects and much more with future articles.</div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Dr. Jerry Kartzinel is Board Certified pediatrician and a Fellow in the American Academy of Pediatrics. He specializes in the recovery of neurodevelopmental, chronic neuro-inflammatory diseases, and hormonal dysfunctions. Dr. Jerry co-authored Healing and Preventing Autism with Jenny McCarthy.   </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">Visit Dr. Jerry's New Autism Information Site: MendingAutism.com for thoughtful help for healing the bod and family. </div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">http://www.generationrescue.org/store/books/healing-and-preventing-autism-2/</div> <div id="_mcePaste" style="overflow: hidden; position: absolute; left: -10000px; top: 0px; width: 1px; height: 1px;">http://www.kartzinelhealth.com/</div> <p>Mending Autism can be very complicated and the tackling of the subject of supplements for these children can prove to be quite daunting and confusing. There are so many different approaches on the subject that can range from adding absolutely no supplements to a $1000 per month (or more) supplement bill!  The truth of the matter lies somewhere between these two approaches.  Let’s take a rational and easily understood approach to the basics of supplementation.</p> <p>A dietary history on most of our children typically reveals sources of Vitamins, Minerals, and Essential Fatty Acids are missing from their diet.  Many of our children have self-limited diets and they simply do not ingest adequate amounts of vital nutrients.  For example, vitamin C cannot be synthesized (made) by human beings, it must be ingested regularly.  The main sources of Vitamin C are citrus fruits (lemons, oranges, limes, and grapefruits), tomatoes, and potatoes.  When children do not eat these common sources of Vitamin C, they are at risk for developing scurvy!  In these children, it is easy to argue for adding the supplement Vitamin C to the diet.  </p> <h5>Aside from replenishment of lacking nutrients, what we really are trying to do in our children:</h5> <p> </p> <ul><li><span style="color: #000000;">Optimization of Normal Physiology </span></li> <li><span style="color: #000000;">Improve Function of the Immune System</span></li> <li><span style="color: #000000;">Enhance Cognitive Abilities </span></li> <li><span style="color: #000000;">Improve Red Cell Membrane Function </span></li> <li><span style="color: #000000;">Reduction of Autistic Behaviors </span></li> <li><span style="color: #000000;">Improve Gastrointestinal Function </span></li> <li><span style="color: #000000;">Minimize our NEGATIVE genetic influences</span></li> </ul><p>So, let’s take a look at the major types of supplements.  </p> <p><strong>Vitamins:</strong> Vitamins are critical micronutrients for normal cellular metabolism and function.  They must be consumed regularly as our bodies are not able to synthesize these vital nutrients in sufficient amounts.  Vitamins are required for proper cell signaling, mediators of cell growth, function as antioxidants, and even hormones. </p> <p><strong>Minerals: </strong>The main electrolytes are Sodium, Potassium, Calcium, Magnesium and Chloride. Proper levels of these minerals in the body allow the body to have energy, better muscle and nerve function (including faster stress recovery) and improved function in many other areas.  The so called trace minerals including selenium, iodine, chromium, magnesium, molybdenum, just to name a few, need to be replenished daily, ideally through the diet. </p> <p><strong>Omega 3 Fatty Acids:</strong> These fatty acids help maintain the fluidity and stability of cell membranes and protect the body from harmful substances such as bacteria and viruses. They must be obtained through diet or supplementation with EFA(Essential Fatty Acids) -rich food oils. They have an amazing affect on behaviors, mood, focus and concentration.</p> <p><strong>Digestive Enzymes</strong> break down the foods that we eat into smaller compounds that can be readily absorbed and put into the blood-stream.  The enzyme class of proteases breaks down proteins to amino acids. The enzyme class of lipase is responsible of breaking down fats to fatty acids, and the carbohydrases break down carbohydrates into simple sugars.</p> <h4>Where to Begin:</h4> <p><strong>1. Multivitamin and minerals  </strong></p> <p>If your child does not swallow capsules, then you can go to either a liquid or powder.  Liquids tend to have a really strong flavor that is hard to mask.  Powders can be easily mixed in the patients drink and given through out the day.  Please note that multivitamins very tremendously in both quality and in price!  Look for ones that are formulated in the United States and look for: </p> <p> </p> <ul><li><span style="color: #000000;">GMP compliant –“Good Manufacturing Process” is strictly adhered to in production </span></li> <li><span style="color: #000000;">Non-GMO – products are derived from sources that have not been “genetically modified” </span></li> <li><span style="color: #000000;">Hypoallergenic GF/CF </span></li> <li><span style="color: #000000;">Must have nutrients in amounts that that are not only appropriate for the child but can be absorbed by the child’s digestive tract. </span></li> </ul><p><strong>2. Omega Oils </strong></p> <p>These oils need to come from sources that specialize in using smaller fish caught in pristine waters.  There are different ways to ensure both the quality and purity.  I have found that the process of molecular distillation is the safest way to make sure all heavy metal contaminants are removed from the oil.    </p> <p><strong>3. Digestive Enzymes</strong></p> <p>Published studies have demonstrated that some children on the autistic spectrum have a diminished ability to produce adequate digestive enzymes that are required for the normal breakdown of food and its subsequent absorption into the blood stream.  It can be readily apparent by just looking at undigested food the stool.  Make sure to seek out a digestive enzyme that is truly complete and contains multiple enzymes that break down amylose, proteins, peptides, fats, cellulose, lactose, maltose, and even hemicelluloses. </p> <p>After the basics are covered, supplements are usually targeted to improve a certain condition such as problems with focus and concentration, chronic constipation, or even language to name just a few.  We will tackle these subjects and much more with future articles.</p> <p> </p> <h5><em>Dr. Jerry Kartzinel is Board Certified pediatrician and a Fellow in the American Academy of Pediatrics. He specializes in the recovery of neurodevelopmental, chronic neuro-inflammatory diseases, and hormonal dysfunctions. Dr. Jerry co-authored <a href="http://www.generationrescue.org/store/books/healing-and-preventing-autism-2/" target="_blank">Healing and Preventing Autism</a> with Jenny McCarthy.   </em></h5> <h5><em>Visit Dr. Jerry's New Autism Information Site: <a href="http://www.kartzinelhealth.com" target="_blank">MendingAutism.com</a> for thoughtful help for healing the bod and family. </em></h5> <p> </p> <p> </p> <p> </p> <p>/</p> Fri, 29 Jul 2011 18:30:00 -0700 http://www.generationrescue.org/dr-jerry-s-blog/biomedical-intervention/mending-autism-the-role-of-supplementation/ http://www.generationrescue.org/dr-jerry-s-blog/biomedical-intervention/let-s-talk-about-methylation-glutathione-and-vitamin-b12/ <p>The Methylation Pathway seems to be linked to many chronic diseases, including the autism that many children are diagnosed with. A “pathway” merely describes a factory that produces a product.  The Methylation factory produces glutathione similar to the way a Ford Factory produces pick up trucks.  Just like a truck factory requiring numerous steps to produce a finished product, the Methylation factory has lots of steps required before producing the finished product: glutathione.   </p> <p>Glutathione is very important in maintaining and restoring physical health, and even mental health.   We know that children with autism tend to have lower levels of glutathione when compared to neurotypical children.  We also know that families that genetically tend to have lower amounts of glutathione, that is, their factories just produce lower amounts of glutathione,  also tend to have problems with schizophrenia, alcoholism, bi-polar disease, depression, attention deficit disorder, constipation, and autism.  Glutathione is essential for protecting cells from toxins - it is our master anti-oxidant, and seems to play in FOCUS, CONCENTRATION, AND LANGUAGE.</p> <p>We can actually increase our body’s ability to produce glutathione….even if we are genetically challenged!  Dr. Jill James proved that we can increase the production of glutathione by supplying our Methylation factories with necessary key ingredients.</p> <p><strong>Methyl B12:</strong> this is vitamin B12 in its “methyl” form.  It can be given with a nose spray, subcutaneous injection, or orally.  It seems to work best for some in a nose spray (if the child tolerates it) or subcutaneous injection.  Dosing is variable based on age and weight, and how you are going to administer it (intranasal or subcutaneous).</p> <p><strong>Vitamin B6:</strong> aides in the production of glutathione.</p> <p><strong>Folic acid:</strong> this is a B vitamin that works as a cofactor in the Methylation factory.  This can be combined in the B12 injection or in the nasal spray.  For some children this can be rather activating and can cause hyperactivity, and thus will have to be removed.</p> <p><strong>Dimethylglycine: </strong>also known as DMG.  DMG also supports the Methylation pathway as a “methyl donor”.  </p> <p><strong>Trimethylglycine: </strong>also known as TMG.  TMG is DMG plus another methyl group.  Again, we are trying to provide the assembly line of the factory an “incentive” to make more glutathione.</p> <p><strong>Methionine: </strong>an amino acid that can be considered the “chassis” or the starting molecule that can eventually be transformed to glutathione</p> <p><strong>N-acetyl cysteine:</strong> also known as NAC.  This is precursor for cysteine and glutathione</p> <p>In addition to providing supplements to aid in the production of glutathione, you can also supplement glutathione directly.  It can be given as an IV infusion, inhaled with a nebulizer, rubbed in as a cream, and orally (which I usually do not recommend since it seems to enhance the growth of yeast).</p> <p>Improving the function of the Methylation pathway impacts many functions of the cell, right down to how DNA is read.  What the parents report, and what we are commonly after, is the improvement of language!  It appears that when we improve glutathione production, many children can make significant improvements with focus, concentration, and language.</p> <h3>And that’s my approach to Methylation.</h3> Wed, 25 May 2011 07:00:00 -0700 http://www.generationrescue.org/dr-jerry-s-blog/biomedical-intervention/let-s-talk-about-methylation-glutathione-and-vitamin-b12/