blog

Let's Talk About…Stimming

Sat, 21 Apr 2012 07:00:00 -0700

This month I have been asked to address STIMMING behaviors as they relate to Autism. Stimming is defined as repetitive body movements, formally called Stereotypy. These self-stimulatory repetitive movements of the body can be as simple as a lateral gaze or as obvious as running back and forth or jumping and clapping. Stimming behaviors can involve any body part, but the key is to look for repetition. The treatment of these behaviors will depend greatly on the cause of the behaviors.

Final Common Pathway

Stimming behaviors tend to result from a variety of causes. I have removed rice from one child’s diet and all stimming stopped. In another child, it was severe constipation, and in another, they were actually seizures! So you can clearly see that it is important to consider that the repetitive behaviors you are seeing may be actually due to a problem that can be fixed, and multiple problems can lead to the same external behaviors (stimming in this case).

Let’s Look for Patterns – this is NOT a complete list, just a good place to start:

In order to get clues about stimming behaviors, maybe we can discern when they escalate:

Before bowel movements – constipation
At school, when out shopping, with certain people or tasks– situational
After school – situational
After food – diet related
In the evening – tiredness
When demands are being placed - anxiety
Random times throughout the day, without known cause, abruptly leaving – seizure
All the time, from waking to sleep: allergies, inflammation, infection (bowels, sinus, etc)
Any combination of above
Let’s Get this Started

The first step is addressing the bowels. The goal here is to have one to two daily bowel movements. Constipation can be a very big problem for many of our children we see in the clinic. You can read about my approach to constipation, as well as chronic diarrhea at www.mendingautism.com. You will need the support of a physician to obtain stool cultures to help diagnose and treat abnormal gut bugs (yeast, bacteria, and parasites). If they are present, they must be eradicated if we hope to be successful with controlling stimming behaviors.

Diet changes are up next. I had a patient become super stimmy after eating some corn chips in my office. I asked mom about this, and since he ate these throughout the day, she had not put 2 + 2 together until I pointed it out. Corn was this child’s nemesis! Really, it can be just about any food. Once again, we may need the help of a physician to obtain a food allergy profile that may indeed give us clues as to which food or foods we need to remove. If this is just not available, you can remove all gluten and dairy (100%!), corn, rice, citrus and REALLY lower the daily amount of sugar taken in…even natural “sugar”…consumption of sugar must really be limited.

The home environment may also be a source of behaviors in children New carpets, furniture, paints, etc all can contribute to an environmental toxic overload, through off-gassing, which translates into stimming. Allergies, such as house dust mite, mold, pets, cigarette smoke, etc can also contribute to stimming behaviors. I recently had a child react very negatively to mom’s new car! Anything “toxic” to these children can contribute to stimming, and don’t forget perfumes and hair sprays can be toxic to some of our children.

Electronic toys and TV can be great provokers of stimming behaviors. It may be the end of a show and the TV credits are rolling, it may be the show itself, or any of the electronic toys with buttons or apps on the iPad. The best remedy I have found to mitigate stimming behaviors induced by these sources is the REMOVAL of these toys.

Anxiety is another really big source for stimming behavior in children. This cause is a little easier to figure out, as the behaviors tend to escalate in situations the child perceives as anxiety producing. Anxiety can be a symptom of adrenal fatigue and the body’s inability to produce enough cortisol. Cortisol levels can be measured in the saliva and to see if this may indeed be contributing to your child’s anxiety. There are natural approaches that can help with adrenal fatigue such as vitamin C and herbs such as Ashwagandha and valerian root extract.

Finally, there are some stimming behaviors that the children just prefer to do. These stims may last many years, even into adulthood. I like to see if we can contain, rather than “stop” these stims by directing when and where it might be more appropriate to stim, such as in one’s bedroom. I met with one young man at Disney, and the trees were all lit up, he expressed that he would love to just rock and stim on the lights, but knew it was “inappropriate.”

Stimming behaviors in children on the autism spectrum are very common. Many of these behaviors can be minimized if the underlying causes are addressed and corrected. When excessive body motions are reduced, these children become more teachable and responsive to their interventions and therapies, and thus, autism improves dramatically.

What is Chelation and How Can it Help My Child with Autism?

Fri, 20 Jan 2012 01:42:22 -0800

Dear Dr. Jerry,

I keep hearing about “IV chelation and that a lot of children lose their diagnosis—could this be a winner for my son Luca? I have been told that chelation is not used here in the UK?

Your advice would be greatly appreciated.

Many thanks & Kind Regards

Antonina

What is chelation?

Chelation is a medical intervention where an agent that attracts heavy metals is given in some form or another with the intent to remove heavy metals from the body. Chelation therapy is offered to patients who have laboratory demonstrated elevations of heavy metals including lead, mercury, and arsenic.

Where do these metals come from?

I have the privilege of seeing patients from all around the world. Different areas have different environmental pollutants. Some cultures have a diet which includes a lot of seafood and people from that culture tend to have high levels of mercury because there is a large amount of mercury in some of the species of fish they consume, some people live in a very polluted environment like Kuwait when the oil fields were set on fire, others live near heavily sprayed agriculture (or golf courses), and the list goes on and on.

In a recent article, Body Burden – The Pollution of Newborns (you can read the article here) the umbilical cord blood of 10 infants were tested. Tests revealed a total of 287 chemicals in the group. The umbilical cord blood of these 10 children, collected by Red Cross after the cord was cut, harbored pesticides, consumer product ingredients, and wastes from burning coal, gasoline, and garbage. Mercury was found in the cord blood too! We live in a toxic environment and susceptible individuals can inadvertently be poisoned by one means or another, starting from the womb.

Why don’t these metals come out naturally?

We have natural pathways that are designed to clear toxic metals from our body. We are all born with different capacities to accomplish this task. Some of our population is more easily “poisoned” than others. We know the very young and the very old are especially sensitive to poisonings and heavy metal exposures. In these cases, heavy metals can accumulate faster than they can be removed. When they do accumulate, they can poison enzyme systems that are necessary for normal metabolic function. Then there is a cascade of multiple metabolic dysfunctions that result in the child not being able to live at his or her full potential.

How do we test for heavy metals?

The science of detection of heavy metals is evolving nicely, but we have a long way to go. You see, when someone is exposed to heavy metals, the heavy metals are picked up by blood and transported quickly to the metal’s tissue of choice. This is like being in a taxi cab, you want to get to your destination and get out of the cab. Let’s take lead for example. Lead prefers to be bound to bone tissue. Thus when the body is exposed to lead, the blood stream transports it to bone, and the lead then deposits there. That’s why when a parent tells me that “they” tested the blood for lead and it was negative, all that tells me, is that the “taxi” is empty, currently (which is good because it means there is no on-going lead exposure), but tells me NOTHING about what happened 3 months ago or longer. There could have been a significant lead exposure, but today’s test won’t tell you that. One of the most sensitive tests available at most labs (like Lab Corp) is called a Porphyrin Profile. How this measures the total body burden of heavy metals as well as potentially pointing to a single agent is beyond the scope of today’s discussion. Suffice it to say that this test can be serially followed while doing chelation and you can actually watch the numbers improve. Another test, though less sensitive but a lot more gratifying is the urine toxic metal challenge. In this test, a pre-chelation urine is obtained and evaluated for several specific heavy metals, which are ascribed a value. When a chelating agent is then given, a follow up urine is obtained and if one or more of the heavy metals is increased, you can see quickly (they are usually bar graphs) what is coming out (i.e. lead or mercury) and “how much” more than without the chelator. There are some other ways to follow heavy metals, and your practitioner will certainly be well versed in one or more of these laboratory studies.

The Chelators

Calcium disodium EDTA (the only form of EDTA that I use)

This is an amino acid that attracts lead, other heavy metals, and some minerals from the bloodstream and expels the toxic elements in the urine. EDTA works to remove excess lead from the body, but is not specific to mercury or methyl mercury like DMSA or DMPS. It can be taken orally, rectal suppository, or given IV (intravenous).

DMSA

This is a FDA approved drug can be used in children when lead toxicity is suspected, but can remove other heavy metals including mercury and arsenic. It can be taken orally, transdermally, or given as a suppository.

DMPS (not FDA approved)

DMPS is given with the intent to remove mercury from the body. It can be given IV, intramuscularly, subcutaneously, transdermally, or by suppository.

The Procedure

Clinicians who include chelation therapy in their practice will have their “favorite” approach to both diagnosis and treatment and monitoring. They will often prescribe additional supplements because it is common for certain minerals to be removed during the process. Chelation can certainly be augmented with many different approaches, such as the addition of glutathione, vitamin B12, etc.

Clinical Outcomes

Yes, I have seen everywhere from marked improvement to no improvement. There are so many variables here: age of exposure (like in the womb, 1 day old, etc), amount of exposure, type of exposure (which metals/toxins), genetic ability to handle the exposure, route of exposure, and more. Regardless of the specifics on the variables, we know that we are trying to eliminate, to the best of our ability and as safely as possible, heavy metals. Two current obstacles remain in our way. One is that many of the metals’ preferred sites to “land” is the fatty tissues of the body, including the brain. Current chelators are water soluble and reaching into the fat can be very difficult. The second obstacle is having the chelators cross the blood-brain barrier. That is, actually getting the chelating agent into the brain to remove heavy metals there. With that said, there is no denying that many children improve with chelation, somehow in some manner that we just may not fully understand.

Beware!

There are many companies producing products that claim they chelate. I would like you to ask these four simple words, “HOW DO YOU KNOW?” They will tell you how the water changes color, the EEG changes, etc, but how do you know what you are doing is actually chelating? There needs to be some way to monitor what we are doing. Chelation should really be done with an experienced physician!

Want more info from Dr. Jerry? Send us your questions to monique.peltz @ generationrescue.org or post them in the comments section.

Are Enzymes a Secret Weapon For Weight Loss?

Wed, 11 Jan 2012 07:00:00 -0800

An Interview with Dr. Jerry Kartzinel by Zack Gonzalez - PART 1

Alright, so it’s winter. Basically, the time of year where we all eat just about twelve-times more than we promised ourselves we would on New Year’s Day. And although it’s winter, and it’s easy to hide our love handles under giant coats and jackets, how much of an impact can all this extra grubbing leave on our bodies? And what secret weapon(s) can we keep in our back pockets to make sure we aren’t completely throwing our bodies into havoc? Well, I got to sit down and get all the answers from Dr. Jerry Kartzinel. The big-dawg MD, himself.

ZACK: I heard that digestive enzymes help, not only to digest heavy food, but also to help beat belly bloat. True or false?

DR JERRY: I’m afraid the answer is false. While enzymes do help break down food, they don’t do anything to help with all of those excess calories! I will add that they may help with belly bloat if its because you’re eating foods you’re a little sensitive to, but if you know you’re sensitive to those foods, it’s best not to eat them.

ZACK: What other products might be helpful? For those with autism and for those without? And what makes them helpful?

DR JERRY: Overall, we have to treat the winter season the same way as we do the rest of the year. Healthy living is always in season. That being said, it can’t hurt to add some fiber to your diet to help your body stay regular if you’re eating more than usual of foods that may not be best for you. A multivitamin will always help with good nutrition, especially since the traditional favorite holiday foods aren’t usually vegetables. Finally, a probiotic might be a great idea to help those gut flora stay in balance with the additional sugar some people may be consuming.

ZACK: Now, clearly there's gonna be little weight gain post-holiday season, but I read something online that says that enzymes can actually help you lose weight. True or false? If they do help, how so? If not, what might be a common misinterpretation?

DR JERRY: Once again, this one’s false. Enzymes will help you breakdown food, but they don’t make the calories go away. This misinterpretation probably comes from a misunderstanding of how the digestive system works, and what our food does in our body. Put simply, the process of digestion involves the breakdown of foods to produce energy usable by the body. Enzymes help with the breakdown of the foods. The catch is, if you are consuming more energy than your body is using, your body will store it. So, when I eat a little more than I usually do (and more than my body needs), and especially if what I’m eating is simple carbohydrates and sugar, I’m getting a lot of extra energy that my body is going to store up for a rainy day. Really, moderation and limitation of those simple carbohydrates and sugar consumption will go a long way towards minimizing your holiday weight gain and help you a lot more than any enzyme will.

ZACK: Alright, so clearly enzymes aren’t magic weight loss pills. Now, with individuals with autism, their food sensitivities are more known than those of us without autism. So would enzymes be a good idea for all of us to have handy through out the year? Primarily those of us who aren’t very familiar with their personal food sensitivities. Like me. I eat a lot during the holidays. But I don’t know anything about my own food sensitivities.

Basically what I’m trying to say is, they don’t get rid of the calories, why should someone like me take them? You’re the car salesman. I don’t know why I NEED the car. Sell me the car, Doc. (And you know I want the car-fax.)

To find out the answer to this question and more, stay tuned for Part 2! (COMING SOON!)

You can watch Zack and Dr. Jerry on the all new season of it’s on with Zack.

You be sure get your hands on Dr. Jerry’s line of supplements, Kartzinel Heath.

For allergy-friendly holiday recipes, be sure to check out GFCF Done Easy!

What is Hyperbaric Oxygen Therapy & Can It Help My Child With Autism?

Thu, 01 Dec 2011 08:30:00 -0800

Dear Dr. Jerry,

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.

What can you tell us about this method that would ease their minds in starting it for him?

Thank you,
Diane H.

What is Hyperbaric Oxygen Therapy (HBOT)?

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.

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.

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.

Why would we even consider doing this in children with the diagnosis of autism?

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:

Improved sleep
Improved bowel function
Regulation of bowel movements
Improved immune functioning with a decrease in frequent infections
Improved expressive language
Improved receptive language
Improved fine and gross motor skills
Improved muscle tone and strength
Increased mental alertness
Increased calmness
Improved mood

How soon can we expect to see results, and how many of these treatments are needed?

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.

Are there any risks with HBOT?

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.

Seizure: 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.

Ear pain 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.

Eye changes: temporary changes that can result in near-sightedness. HBOT can also accelerate cataract development.

Are there children who should NOT undergo hyperbaric treatments?

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.

Let's Talk About…Gluten and Going Gluten & Casein Free - Part 2

Mon, 31 Oct 2011 07:00:00 -0700

What is Gluten?

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.

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:

Constipation
Cravings
Diarrhea
Sleepless nights
Hyperactivity
Bed-wetting
Resistance to potty training
Hyperactivity Aggressive behaviors
Dark circles under the eyes
Bloated belly
Flatulence (lots of gas being passed)
Irritability
Self-injurious behaviors
Severe self imposed dietary restriction (craving only milk containing products)

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.

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.

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 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.

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.

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: www.gfcfdiet.com. I would encourage you to go there to check on the permissible flours and products.

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.

And that’s my approach to removing gluten.

Let's Talk About…Dairy and Going Gluten & Casein Free - Part 1

Mon, 24 Oct 2011 07:00:00 -0700

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!

Some Clues About Dairy Intolerance:
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.

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.

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.

These behaviors, seen all too commonly in my clinic include:

•    Constipation
•    Diarrhea
•    Sleepless nights
•    Hyperactivity
•    Bed-wetting
•    Resistance to potty training
•    Hyperactivity
•    Aggressive behaviors
•    Dark circles under the eyes
•    Bloated belly
•    Flatulence (lots of gas being passed)
•    Irritability
•    Red cheeks and or red ears
•    Severe self imposed dietary restriction (craving only milk containing products)

Stopping Dairy
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.

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!

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.

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.

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.

And that’s my approach to removing dairy.

Is Constant Eating Common For Kids On The Autism Spectrum?

Mon, 17 Oct 2011 06:00:00 -0700

I have a 6 yr old grandson who is autistic & is constantly eating, although it is impossible he is hungry! Do you see this often with autistic kids? What can I do about it?

-Judi G.

I see autism as the sum total of unusual responses to everyday stimuli. In this case, the “usual” response to a full stomach is to STOP eating, but in your grandson’s case, he continues to eat. I care for some children with just the opposite response, they do not eat when they are hungry hungry! The main concept behind treating children with autism is to correct what is medically wrong with them. Then, you get to see more and more of the natural responses “kick” in and they start responding to more and more stimuli appropriately.

Q: I have a 6 yr old grandson who is autistic & is constantly eating, although it is impossible he is hungry! Do you see this often with autistic kids? What can I do about it?

-Judi G.

Dr. Jerry's Answer:

For more Q & A and articles from Dr. Jerry Kartzinel visit his Blog.

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.

Is It Too Early To See A DAN Doctor At 8 Months?

Mon, 10 Oct 2011 06:00:00 -0700

Q: Would a DAN doctor be worth involving for someone who has identical twins, age 8 months, who have been having feeding problems since early infancy? They gag easily and vomit their food.

Would a DAN doctor be worth involving for someone who has identical twins, age 8 months, who have been having feeding problems since early infancy? They gag easily and vomit their food.

-Liz.

Yes Liz, a doctor who specializes in a biomedical approach to treating children would be great! Due to their young age, it would be preferable to have this doctor be a pediatrician as well.

-Liz.

Dr. Jerry's Answer:

Yes Liz, a doctor who specializes in a biomedical approach to treating children would be great! Due to their young age, it would be preferable to have this doctor be a pediatrician as well.

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.

For more Q & A and articles from Dr. Jerry Kartzinel visit his Blog.

How Common Is It To Have More Than One Child With Autism

Mon, 03 Oct 2011 06:00:00 -0700

Q: I was wondering how common it is to have more than one child affected by autism?

I was wondering how common it is to have more than one child affected by autism?

-Lina B.

Great question. I often see more than one child in the family having autism in my clinic. But more than often, I see children that follow the child with autism do NOT have autism. The difference? The parents choose not to vaccinate the subsequent children, where as in the families with more than one child with autism, the siblings received vaccines as well. I rarely see unvaccinated children with autism, but they are out there as well.

-Lina B.

Dr. Jerry's Answer:

Do You Often See a Dual Diagnosis of Autism & Cystic Fibrosis? Q&A With Dr. Jerry

Tue, 20 Sep 2011 00:41:05 -0700

Dr. Kartzinel's ....

Answers To YOUR Questions

Beth Z. (Parent): Do you often see a dual diagnosis of Autism & Cystic Fibrosis?

Dr. Jerry Kartzinel: I see a lot of “dual” diagnosis of Autism and something, be it cancer, cerebral palsy, diabetes, bowel disease, autoimmune disorders, and cystic fibrosis in my clinic. This just stresses my point that each symptom the child exhibits must be dealt with in order to improve his or her quality of life!

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.

For more Q & A and articles from Dr. Jerry Kartzinel visit his Blog.

What Can I Do For My Child Who Has A Short Attention Span?

Thu, 08 Sep 2011 09:00:00 -0700

What do you recommend for a child that has a short attention span? My son goes to mainstream 2 hours a day and they would like to increase his time but his ability to pay attention for longer periods of time is an issue. Some teachers are recommending medication to increase his attention, which they have seen work for other children with autism that have already been fully mainstreamed but I don't really want to put him on any meds.

Dr. Jerry's Answer:

I often see Attention Deficit (AD) with or without hyperactivity in my clinic. Parents tell me that their child simply cannot stay focused on anything. There seems to be a great issue with the child’s ability to concentrate and in the classroom, this can look like:

•   Child requires many prompts to stay on task
•   Very little toy play, moves from object to object
•   Constant fidgeting
•   Easily frustrated
•   Poor recall of information already learned
•   Slow processing speed
•   Impulsivity
•   Poor social function

Here are several interventions that may help with ADD/ADHD. I have also written individual blogs discussing some of these interventions in much greater detail.

Methylation Defect

Genetically speaking, it is very common to find a family history of Attention Deficit disorder, depression, bipolar disease, and anxiety. This family history points to what is known as a methylation defect and can be improved with Vitamin B12, Di- or Tri- methyl glycine, folinic acid, cysteine, and glutathione.

Thyroid Disorders

Thyroid disorders can manifest as ADD/ADHD and need to be addressed and corrected.

Allergies

Allergies can definitely hamper ones ability to stay tuned in and focused. Thus, these have to be addressed and treated.

Inflammation

Any chronic inflammation must be addressed and treated.

Diet

The diet can have a HUGE influence of focus, concentration and behaviors. I cannot stress enough how much this has to be evaluated and managed. Food sensitivities must be addressed and eliminated, removal of sugar and food additives, and each meal must be properly balanced and contain a protein, a carbohydrate, and a fat. Omega oils are essential! Good vitamin and mineral supplementation may help as well.

Supplements

Theanine

Theanine is derived from the leaves of Camellia sinesis which is a green tea, as well as 2 other Camellia species. Studies from Japan confirm this has a generalized calming effect on the brain, which in turn, helps with focus and concentration. Dosing in our clinic usually starts with 100mg capsules take 1-4 caps twice daily.

Phosphatidylserine

Phosphatidylserine is the amino acid attached to a phosphatidyl fatty acid molecule. These are derived from soy bean. Research has been weak demonstrating effectiveness, but use in my clinic seems to be calming, especially when combined with omega 3 fatty acids. These are thought to help by incorporating themselves into neuron cell membrane and helping with overall normalization of this membrane. It may really be beneficial for those children who have had severe self-limited diets like cookies or French fries and have an overall nutritional deficit. These may be used cautiously in those children with soy allergies. Dosing is usually 100mg capsules, 1-4 caps twice daily.

Hyperbaric Oxygen Therapy (HBOT)

Many studies looking at attention disorder have focused on brain imaging and oxygen utilization/glucose utilization. Many of these studies note that there are definite areas of the “AD” brain that consistently show decreased oxygen utilization, or what is commonly termed “hypoperfusion.” Please note, that there are some other areas that have INCREASED perfusion as well. The rationale of using HBOT in children with autism and AD would then to increase the oxygen supply to these areas of hypoperfusion. We generally recommend starting at very modest pressures (this is measured in “atmospheres of pressure”), with 100% oxygen for 60 minutes, once daily. In about 20-40 sessions, we can generally see if this therapy is helpful. I will discuss hyperbaric therapy more extensively in a later blog.

Neurofeedback

Neurofeedback ultimately attempts to train the brain to have the most effective brain wave pattern for focus and concentration. There have been many pioneers in this research who have published impressive clinical results demonstrating marked improvement in the attention deficit. Briefly, a child’s brainwave pattern is determined by a qEEG (quantitative electroencephalography). After the therapist has evaluated this qEEG, a program is put into place where a child is usually allowed to play a video game or watch a video on computer. The trick is that the game or movie only plays if the child brain wave pattern conforms to the protocol set up by the therapist. Overtime, the brain “learns” what patterns are required to continue the play of the game/movie. What this translates into, eventually, is the minimizing of attention deficit.

MEDICATIONS

Sometimes medications may be required to induce focus and concentration. Of course, prior to using medications, it is important to try the natural options first. If the natural options are unsatisfactory, then prescription medications may be considered.

The goal is to find medications that work to help with inattentiveness, impulsivity, and hyperactivity. In addition, when you find a medication that addresses these problems, you often also find improvement in social skills, improvements with language - both expressive and receptive, and the general ability to learn improves as well.

Medications used in treating attention deficit are designed to stimulate receptor sites in the brain. Now it can get a bit confusing here. There are different classes of attention deficit medications and each class works on different receptor sites in the brain. The question is if we “tickle” the right receptor site in the brain, do we get more focus and concentration?

Many of us have used coffee as a “drug” to stimulate focus and concentration. Actually, it is the caffeine in coffee that stimulates caffeine receptors in the brain, and for some of us, it is just what we need to stay on task. Some use cigarettes. It is actually the nicotine that stimulates the nicotinic receptor sites in the brain, and that, for some, can stimulate focus and concentration.

A general rule of thumb when prescribing these medications is to start with a low dose and quickly work up the dose until it is working, or until side effects occur. Attention deficit medications work “today” and you do not have to wait more than 2-3 days before deciding on a dose adjustment.

Classes of attention deficit medications:

Atomoxetine: Strattera

Dextroamphetamine: Adderall and Vyvanse

Guanfacine: Intuniv

Methylphenidate: Ritalin and its long acting forms, Ritalin-SR, Metadate ER, Metadate CD, Methylin ER, Concerta

Tricyclic Antidepressants: include Anafranil and Tofranil

Side effects: Each class has its own potential side effects that must be reviewed individually as these medications can interact with other medications your child might be on, or, even conditions your child might have, such as epilepsy. As always, with everything we do in medicine, the benefits of a particular medication must outweigh the potential risks. With the children I see in my practice, when all the natural ways of inducing focus and concentration have failed to produce significant results, I do prescribe attention deficit medications.

The attention deficit medications, that I have found to have the fewest side effects in my patient population, are Strattera and Intuniv, so I usually start with one of these. Strattera can be compounded into a transdermal cream, which is great for those children unwilling to swallow capsules and have a hard time taking supplements in general. These medications dosages depend on the weight of the child. I always tend to start at a lower dose and work my way upward. It is important to be on the lookout for the side effects, I cannot stress that enough.

Several medications may have to be tried, and remember, we are stimulating different receptor sites in the brain. What works for one child may not for another child. Though I would prefer not to have to use any of these medications, some children will cease to progress academically without these medications, and for some, if not most parents I work with, that is intolerable. Benefits of learning and growing socially may then outweigh the risks of having to take some of these medications. This truly is a case by case intervention and definitely tailored to each child and their family.

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.

Visit Dr. Jerry's New Autism Information Site: MendingAutism.com for thoughtful help for healing the bod and family.

What Can I Do To Help My Son With Aggression? Q&A With Dr. Jerry Kartzinel

Wed, 17 Aug 2011 00:05:05 -0700

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:

Hitting of body parts: head and thighs most common
Biting of hands, wrists, and lips
Poking of eyes
Grabbing and pinching self
Pulling body parts really hard, for example the “pinkie” toe
Jumping and falling directly onto knees
Pulling hair
Body slams into walls, furniture
Myriad of aggressive behaviors to others and pets, too

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.

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?

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.

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.

Sources of Pain:

Constipation
Diarrhea
Dysbiosis (abnormal gut bugs)
Inflammation:
Abdominal pain
Gastritis
Esophagitis
Colonitis
Sinusitis
Headaches/migraines
Arnold Chiari Malformation
Allergies
Anxiety (really big when aggression is toward others)
Sleep disruption
TOO much therapy/demands on the child
Parental disharmony
Noises emitted from siblings (crying), cell phones, microwave ovens, etc

Treatment:

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.

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.

Medications to consider in order to control SIBS and aggression after all treatable sources of pain/discomfort have been addressed:

Abilify
BuSpar
Depakote
Neurontin
Propranolol
Risperdal
SSRI: Prozac, Zoloft, Lexapro, etc
And in those states where legal, medical marijuana can be considered.

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.

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.

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.

Visit Dr. Jerry's New Autism Information Site: MendingAutism.com for thoughtful help for healing the bod and family.

Do you have a question for Dr. Jerry?

Ask your questions in the comments section below or you can send us an email.

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:

Hitting of body parts: head and thighs most common

Biting of hands, wrists, and lips

Poking of eyes

Grabbing and pinching self

Pulling body parts really hard, for example the “pinkie” toe

Jumping and falling directly onto knees

Pulling hair

Body slams into walls, furniture

Myriad of aggressive behaviors to others and pets, too

Sources of Pain:

Constipation

Diarrhea

Dysbiosis (abnormal gut bugs)

Inflammation:

Abdominal pain

Gastritis

Esophagitis

Colonitis

Sinusitis

Headaches/migraines

Arnold Chiari Malformation

Allergies

Anxiety (really big when aggression is toward others)

Sleep disruption

TOO much therapy/demands on the child

Parental disharmony

Noises emitted from siblings (crying), cell phones, microwave ovens, etc

Treatment:

Medications to consider in order to control SIBS and aggression after all treatable sources of pain/discomfort have been addressed:

Abilify

BuSpar

Depakote

Neurontin

Propranolol

Risperdal

SSRI: Prozac, Zoloft, Lexapro, etc

And in those states where legal, medical marijuana can be considered.

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.

Visit Dr. Jerry's New Autism Information Site: MendingAutism.com for thoughtful help for healing the bod and family.

Do you have a question for Dr. Jerry?

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:

Hitting of body parts: head and thighs most common

Biting of hands, wrists, and lips

Poking of eyes

Grabbing and pinching self

Pulling body parts really hard, for example the “pinkie” toe

Jumping and falling directly onto knees

Pulling hair

Body slams into walls, furniture

Myriad of aggressive behaviors to others and pets, too

Sources of Pain:

Constipation

Diarrhea

Dysbiosis (abnormal gut bugs)

Inflammation:

Abdominal pain

Gastritis

Esophagitis

Colonitis

Sinusitis

Headaches/migraines

Arnold Chiari Malformation

Allergies

Anxiety (really big when aggression is toward others)

Sleep disruption

TOO much therapy/demands on the child

Parental disharmony

Noises emitted from siblings (crying), cell phones, microwave ovens, etc

Treatment:

Medications to consider in order to control SIBS and aggression after all treatable sources of pain/discomfort have been addressed:

Abilify

BuSpar

Depakote

Neurontin

Propranolol

Risperdal

SSRI: Prozac, Zoloft, Lexapro, etc

And in those states where legal, medical marijuana can be considered.

Visit Dr. Jerry's New Autism Information Site: MendingAutism.com for thoughtful help for healing the bod and family.

Do you have a question for Dr. Jerry?

Ask your questions in the comments section below or you can send us an email.

email.

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:

Hitting of body parts: head and thighs most common
Biting of hands, wrists, and lips
Poking of eyes
Grabbing and pinching self
Pulling body parts really hard, for example the “pinkie” toe
Jumping and falling directly onto knees
Pulling hair
Body slams into walls, furniture
Myriad of aggressive behaviors to others and pets, too

Sources of Pain:

Constipation
Diarrhea
Dysbiosis (abnormal gut bugs)
Inflammation:
Abdominal pain
Gastritis
Esophagitis
Colonitis
Sinusitis
Headaches/migraines
Arnold Chiari Malformation
Allergies
Anxiety (really big when aggression is toward others)
Sleep disruption
TOO much therapy/demands on the child
Parental disharmony
Noises emitted from siblings (crying), cell phones, microwave ovens, etc

Treatment:

Medications to consider in order to control SIBS and aggression after all treatable sources of pain/discomfort have been addressed:

Abilify
BuSpar
Depakote
Neurontin
Propranolol
Risperdal
SSRI: Prozac, Zoloft, Lexapro, etc
And in those states where legal, medical marijuana can be considered.

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.

Visit Dr. Jerry's New Autism Information Site: MendingAutism.com for thoughtful help for healing the bod and family.

Do you have a question for Dr. Jerry?

Ask your questions in the comments section below or you can send us an email.

Is Autism Reversible? Q&A With Dr. Jerry Kartzinel

Mon, 08 Aug 2011 09:00:00 -0700

Jackie E. writes to Dr. Jerry Kartzinel: Do you believe in reversing autism??

Dr. Jerry’s Response:

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.

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”).

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.

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!

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!

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.

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.

http://www.amazon.com/Healing-Preventing-Autism-Complete-Guide/dp/0525951032

Visit Dr. Jerry's New Autism Information Site: MendingAutism.com for thoughtful help for healing the bod and family.

http://www.generationrescue.org/store/books/healing-and-preventing-autism-2/

http://www.kartzinelhealth.com/

Do you have a question for Dr. Jerry?

Ask your questions in the comments section below or you can send us an email.

Jackie E. writes to Dr. Jerry Kartzinel: Do you believe in reversing autism??

Dr. Jerry’s Response:

Autistic children do not respond normally to the many activities of daily living…such as sleeping, 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”).

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? Unless you love massive amounts of pain, you will pick the child who slept well.

Biomedical interventions 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!

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.

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.

Visit Dr. Jerry's New Autism Information Site: MendingAutism.com for thoughtful help for healing the bod and family.

Do you have a question for Dr. Jerry?

Ask your questions in the comments section below or you can send us an email.

Mending Autism: The Role Of Supplementation

Fri, 29 Jul 2011 18:30:00 -0700

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.

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.

Aside from replenishment of lacking nutrients, what we really are trying to do in our children:

Optimization of Normal Physiology

Improve Function of the Immune System

Enhance Cognitive Abilities

Improve Red Cell Membrane Function

Reduction of Autistic Behaviors

Improve Gastrointestinal Function

Minimize our NEGATIVE genetic influences

So, let’s take a look at the major types of supplements.

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.

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.

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.

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.

Where to Begin:

1. Multivitamin and minerals

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:

GMP compliant –“Good Manufacturing Process” is strictly adhered to in production

Non-GMO – products are derived from sources that have not been “genetically modified”

Hypoallergenic GF/CF

Must have nutrients in amounts that that are not only appropriate for the child but can be absorbed by the child’s digestive tract.

2. Omega Oils

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.

3. Digestive Enzymes

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.

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.

Visit Dr. Jerry's New Autism Information Site: MendingAutism.com for thoughtful help for healing the bod and family.

http://www.generationrescue.org/store/books/healing-and-preventing-autism-2/

http://www.kartzinelhealth.com/

Aside from replenishment of lacking nutrients, what we really are trying to do in our children:

Optimization of Normal Physiology
Improve Function of the Immune System
Enhance Cognitive Abilities
Improve Red Cell Membrane Function
Reduction of Autistic Behaviors
Improve Gastrointestinal Function
Minimize our NEGATIVE genetic influences

So, let’s take a look at the major types of supplements.

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.

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.

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.

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.

Where to Begin:

1. Multivitamin and minerals

GMP compliant –“Good Manufacturing Process” is strictly adhered to in production
Non-GMO – products are derived from sources that have not been “genetically modified”
Hypoallergenic GF/CF
Must have nutrients in amounts that that are not only appropriate for the child but can be absorbed by the child’s digestive tract.

2. Omega Oils

3. Digestive Enzymes

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.

Visit Dr. Jerry's New Autism Information Site: MendingAutism.com for thoughtful help for healing the bod and family.

Let’s Talk About…Methylation, Glutathione, and Vitamin B12

Wed, 25 May 2011 07:00:00 -0700

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.

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.

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.

Methyl B12: 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).

Vitamin B6: aides in the production of glutathione.

Folic acid: 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.

Dimethylglycine: also known as DMG. DMG also supports the Methylation pathway as a “methyl donor”.

Trimethylglycine: 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.

Methionine: an amino acid that can be considered the “chassis” or the starting molecule that can eventually be transformed to glutathione

N-acetyl cysteine: also known as NAC. This is precursor for cysteine and glutathione

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).

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.

And that’s my approach to Methylation.

Let’s Talk About…Diarrhea

Tue, 26 Apr 2011 05:00:00 -0700

Diarrhea can be defined as a child having anywhere from 1-6 or even more liquid stools per day. They can be explosive, foul smelling, and have a variety of colors. Some pediatrician may call it “toddler’s diarrhea” and say it should be ignored, but diarrhea is never normal unless associated with a passing viral infection. These children with recurring diarrhea tend to be in pain, have bloated tummies and are commonly very uncomfortable after eating. They also tend to have a lot of self-injurious behaviors. Many would rather not eat and thus have muscle wasting in the extremities.   Initial laboratory studies for your doctor to consider:

STOOL For:
•   Stool for culture and sensitivity
•   Stool for fungal cultures
•   Stool for blood/occult blood
•   Fecal leukocytes
•   Stool for ova and parasites
•   Stool for quantitative fecal fat
•   Clostridia toxin A and B
•   Stool lactoferrin
•   Stool calprotectin

BLOOD
•   Complete blood count
•   Comprehensive metabolic profile
•   Inflammatory Bowel Disease Profile
•   Erythrocyte Sedimentation Rate
•   C Reactive Protein
•   Quantitative IgG, IgA, IgM, and IgE levels

Miscellaneous testing:
•   Sweat Chloride skin test (evaluating for Cystic Fibrosis)

Sources of diarrhea that must be addressed first and foremost:

Dietary: removal of dairy, gluten, and then consider removing fruits and juices.
Enzymes: add digestive enzymes, we use KARTZINEL HEALTH ENYMES at our clinic
Antibiotics: if considering the diarrhea to be of bacterial origin
Antifungals: if considering the diarrhea to be of fungal origin
Anitparasitics: if considering the diarrhea to be of parasitic origin
Zinc: adding 20-60mg per day may be very helpful
Fiber: a must to be added to the diet of children with chronic diarrhea, in our clinic we use KARTZINEL HEALTH FIBER
Probiotics: The importance of these helpful pills cannot be stressed enough. They can really help the bowel function. There are many very good probiotics. In our clinic we use the Kartzinel Health Probiotics.

Many studies have been published affirming the positive outcomes when using probiotics.

Gastro-intestinal (GI) Referral: This step may be considered if the child continues to have chronic diarrhea. The child may then undergo an endoscopy where the physician can look at the GI tract from the mouth down to the end of the stomach and then look at the large bowels. If the child is diagnosed with Inflammatory

Bowel Disease, then your GI doctor can institute medical interventions that may dramatically help.

And that’s my approach to diarrhea.

Let’s Talk About…Sleep

Thu, 31 Mar 2011 14:30:00 -0700

The majority of children I see initially in my clinic are having tremendous difficulties with sleep. These sleep disturbances can manifest in many different ways:

Not able to settle for sleep
Not able to fall asleep until very late
Goes to sleep well, but wakes up in the middle of the night and is up for the next 18 hour
Cat naps, 20min at time

Some of the children I see did in fact develop normal sleep patterns and somewhere between 1 and 2 years of age these patterns fall apart. They can happen abruptly or over time. Usually the parents adapt and develop some very unusual ways of coping with it…just to get some sleep!

Sleep interruptions can manifest in different ways as well, with the child waking up:

In a full panic
Giddy and laughing
Crying and sobbing
Full out screaming
With certain needs like the lights on, the TV on, requiring a parent to sleep near them
Bowel movement
Just plain happy to be up (usually much to the parents dismay)
Some parents have to actually drive the child around in the car to sleep!

We certainly need to find out the cause or the causes of the sleep problems. I usually start with the gut.

Gut issues to address:
Constipation: see Let’s Talk About…Constipation
Diarrhea issues: see Let’s Talk About…Diarrhea
Dietary changes: begin dairy free diet, followed by gluten free diet. Let’s Talk About….Dairy Free Diet and Let’s Talk About…Gluten Free Diet

It has been published, in fact over 20 years ago, that there are a subgroup of children and adults who have autism and dysfunctions of brain melatonin. Melatonin is VERY important for initiating sleep. So, this is another area that we address in our clinic….we just add some melatonin each night!

For children who have issues of initiating sleep, we commonly start in our clinic:

Melatonin: ½ mg to 3 mg before bedtime
5 Hydroxytryptophan (5HTP) 50 to 100mg. I have found this especially useful when taken with Vitamin B6 and magnesium
Calcium and magnesium supplements
Vitamin D3 given with dinner, usually about 1000IU
GABA 125 mg with dinner
Vitamin B6 50mg with Niacinaminde 500mg
Inositol 100mg at bedtime (helps with REM sleep)
Herbs such as valerian, and chamomile tea can be helpful, but most children won’t take these as they are not very tastey.

If these interventions are not successful, I can add in Benadryl and Ibuprofen at night time.
This helps with possible allergic sources as well as pain and inflammation.

Now, for the really tough kids, where none of the above interventions have proven helpful, prescriptive medications may be required. Your physician will have to be involved here.

Naltrexone (low dose): either transdermal cream or oral, give 2-4 mg at bedtime
Hydroxyzine: this is an allergy/anti anxiety medication that can be helpful
Clonidine 0.1mg tabs, starting with ¼ tab each evening, but may have to go to a full tab
Trazadone 0.75mg-1mg/2.2pounds of body weight at bedtime
Risperidone 0.25mg-1mg at bedtime
Buspirone 2.5mg -5mg divided twice daily

Anti-seizure medications: These can really help when abnormal brain wave patterns are seen on EEG. Lamictal and Depakote have really helped with sleep in children with possible seizure disorders.

Hyperbaric Oxygen Therapy Treatments: Many children sleep amazingly well with this intervention, in fact, it seems to be one of the earliest changes seen.

Again, I would like to stress the importance of getting the bowel function in order for helping with sleep issues.

And that is my approach to…Sleep.