Dr. Jerry Kartzinel: ICDRC Parent One Day Seminar

July 28, 2002

Vision: Positively impact children’s development

• 9 new autistic kids a day / 7 days a week in California  - we are in the midst of an epidemic
• $120,000 a year to institutionalize a person.  The costs will be staggering if we don’t fix these kids now. And stop the numbers from rising.
• Why did this happen?  We need to learn how to treat it. That is the purpose of the one day seminar.
• What’s biologically different / wrong in ASD kids:
  • Inflam. Bowel disease
  • Opioids involved
  • Persistent measles
  • Reflux esophagitis
  • Gastritis
  • Leaky gut
  • Food allergies
  • Heavy metal burdens
  • Brain autoimmunity
  • Dysbiosis (bad things in gut)
  • Thrombophilia (love of forming blood clots)
  • Seizures / sensory issues (30% of ASD kids)
  • Perfusion defects
  • Purine disorders
  • Elevated ammonia
  • Omega 3 deficit (fatty acids are out of balance)
  • Sulfation defects
  • Serotonin defect
  • Dopoamin defect
  • Nutritional defect
  • Melatonin deficit
  • Chromosomal (Fragile X, Rhetts, born this way disorder – only a few in the practice have this)

• What this tells us?
  • Tremendous number of problems that mean something
  • Sub groups of autism
  • Impact on body w/ subclasses
  • Gut & brain issues
• Precipitating Event
  • To make sense of the regression history we need a wounding event, which causes changes in the gut and the brain at nearly the same time.
  • What can cause this???
  • Toxins, viruses, metals are within the possibilities
  • Synergistic combinations are highly likely

• None Of these issues Can be Ignored – we need to prioritize
  • Progress requires attention to details
  • All issues will be addressed eventually
  • Priority is unique to each child
  • However, the gut is generally the best place to start
    
     
• Gut Issues Core Focus
  • Imflamm Bowel disease / measles
  • Opioids
  • Dysmotility = constipation / diarrhea / reflux
  • Leaky gut – matrix metaloproteinases
  • Dysbiosis (bad bugs in gut – yeast / bacteria / parasites)
    Got to change the environment so these don’t grow anymore.  You can get rid of it but it will come back if you do not change the environment so they cannot survive in the gut.
• Other important issues
  • Elevated ammonia
  • Sulfation deficits (IV Gluthione, Epsom salts)
  • Autoimmunity to myelin (body attacking self – mistake in immune system)
  • Antibodies to blood vessels
  • Thrombophilia
  • Seizures
  • Nutritional disorder
  • Heavy metals
  • Food allergies
• Chromosomal Abnormalities
  • No defining genetic patter
  • As many as 20 chromosomal areas may be acting in autism
• Gut Brain Link
  • Immune system, vagus nerve, toxins & liver

• Exogenous opioids
  • Gluten does not seem to digest properly in ASD children
  • Improper digestion converts the gluten to opioids in the gut.
  • Casein can do the same thing (dairy)
  • Start with
    • Take them off all dairy / milk products
    • Simultaneously prepare to go gluten free
    • Go gluten free (GFCF Gluten free/casein free)
  • 80% of the kids GREATLY benefit from GFCF Diet
  • Always recommends everyone stay off dairy because the weakened immune system.
  • No standards for how long to do the diet – just do the diet.

• Gastro Abnormalities
  • Upper and lower reflux
  • Gastritis
  • Defective secretin activation
  • And inflammation
• Immune Dysfunctions
  • Cytokines (when these release – we don’t feel good) – anything chronically inflamed – there will be cytokines productions.  The gut issues / bowel issues are important to handle.
• Persistent Virus Infections
  • Detection and sequencing of measles virus on patients w/ Imflamm. Bowel disease
  • Measles virus genomes in hyperplasia  / entercolitis
  • All documented that the measles exists in gut diseases with children that have developmental disorders.
    
     
• Result of Persistent Viral Infections
  • Autoimmunity to brain & gut
  • Wounding of gut  (here come the cytokines)
  • Failure to clear pathogens from the gut
  • Activation of coagulation
  • Activation of imflamm. Response
  • Alteration of the blood brain barrier?
    
     
• Autoimmunity brain vessels
  • Anti-myelin basic protein – (similar to Multiple Sclerosis)
  • TH1 / TH2 – are two arms of the immune system.   They need to be in balance.  TH1 fights bacteria, virus, fungi. TH2 fights cancer, allergies and antibody responses. 
  • Vaccines seem to cause in ASD kids TH2 goes up and TH1 goes down – causing an immune system imbalance.  Many of these kids cannot fight basic things like viruses, bacteria, fungi.
  • ASD kids then seem to become allergic to the world due the imbalance and autoimmune nightmares.
  • This is documented in ASD kids / medical journals.
    
     
• Possible simple solution:  Giving Vitamin A supplements prior to vaccinations
  
   
• Multiple Immunization and Immune Dysfunction:  November 2001 Dr Neopm –
  
   
• Safer Vaccines on the way
  • Dr Bellanti – nasal vaccines – the way nature intended to get viruses.  Not injections!
    
     
• Subtle Hyperammonemia
  • Ammonia comes from amino acids / proteins
  • Dysbiotic urease enzyme producing bacteria and yeast
  • 70% of ASD kids have this issue
  • Observed increased self stimulatory  (stimmy) behavior
  • Brain fog
    
     
• Essential Fatty Acid Depletion
  • Omega 3 fatty acids – need to supplement these
  • Fatty acids are crucial to brain development and healthy cells
    
     
• Nutritional disorders
  • Zinc deficit
  • Calcium deficit
  • Selenium deficit
  • Protein deficit
  • Magnesium deficit
  • B6 deficit
  • Folate deficit
  • Taurine deficit
  • Vitamin deficit

• Food Allergies
  • IgE: reactions to allergies (itchy eyes, nasal, rash).  Immunolabs is a good lab for blood allergy tests.
  • These are not 100% perfect
  • Rotate food allergies out for 3 months.  Then go three days on and four days off for food allergies that are not so extreme.
    
     
• Decreased Melatonin Activity
  • Sub group of ASD kids with poor sleep cycles

• Thrombophilia Data
  • Accelerated coagulation
  • Can cause strokes in very young patients
  • Or have low blood flow = sluggish
  • Many parents & siblings have this problem
  • Viruses and inflammation can trigger these abnormalities
  • This may have significant implications on what is broken and what we need to fix.
    
     
• Perfusion Abnormalities in the Brain
  • Spect scans finding cerebral blood flow abnormalities
  • Nemotope / Trental are drugs that helps blood flow / enhance distribution.
    
     
• Cytokines
  • Inflammation markers
  • Correlate to children who have seizures – over active cytokines
    
     
• Leaky Gut
  • Normal gut function
    • Digest
    • Assimilate
    • Defend
    • Prevent toxins
    • Largest surface area in body
  • This is broken in our ASD kids
  • What happens when but gets inflamed?  Don’t feel good.
  • MMP leads to leaky gut (Intestinal permeability)

• What can we do to help the leaky gut:
  • Reflux esophagitis:  deal with food allergies!
  • Small intestinal bacterial growth – get rid of this!
  • Constipation / impaction – help get the poop out!
  • Diarrhea
    
     
• To poop or not to poop!
  • Pain
  • Soiling
  • Constipation
  • Diarrhea
  • Little interest in eating
  • Night time wakening
  • Reflux
  • Foul smelling breath
    
     
• Nutritional deficiencies
  • Failure to thrive
    
     
• Sick Gut – what to test?
  • Urine organic acid test
  • Comprehensive stool analysis
  • Urine Peptide / opiates test
  • Food allergy profile
  • Treat Yeast
  • Treat Parasites
  • Bacteria – both good & bad
  • Overall digestion
    
     
• Our treatments for sick gut:
  • Colostrums
  • Probiotics
  • Antifungals
  • Antibiotics
  • Digestive enzymes
  • Fix constipation
  • Fix diarrhea
  • Fix both!
    
     
• Diarrhea
  • Children can have anywhere from 1-6 of yellow, foul poops a day
  • This is letting us know that gut / digestion is a problem!
  • Treatments:  remove GFCF, add digestive enzyme, add probiotics, add fiber, add hydration, add magnesium, mirlax, leaky gut protocol, ADD zinc. Add antifungals, add anti parasites, add oral immunoglobulin, add supplements.
    
     
• Secretin:
  • This is a natural body hormone in the small intestine
  • Secretin tells pancreas to secret bicarbonate to neutralize the partially digested acidic food leaving the stomach.
  • Is the sulfur?  Is the combo of sulfur & bicarbonate?  Not sure.
    
     
• When there is normal poop:  we have a happy, healthier child (not always cured) but better!
  
• Constipation
  • Huge hard stools or pebbles
  • Infrequent in every 2 days or 1 a week
  • Foul smelling
  • Pellets

• Treatments for constipation – the restoration of motility
  • Enema
  • Glycerine suppository
  • EFA Plus (ground flax seed – can bake w/ it)
  • Miralax
  • Fruit-eze.com (2 tablespoons a day)  Prunes / raisins / yams
    • Can be an issue for yeastie kids
  • Magnesium citrate (600-800mg a day – side affect can start diarrhea)
  • Calcium & Zinc
  • Magnesium Glycinate (helps w/ hyperactivity)
  • There are others: they do not work consistently
    
     
• Constipation & Basic Green :  condensed form veggies in powder form. Available at www.gnd.org. Good for kids that don’t eat veggies well and need to increase the veggie intake.
  
• Miralax (prescription):  this is well published and safe in children.
  
   
• Monolaurin Lauricidin:  is antibacterial, antifungal that will help w/ constipation.
  • Hard to get kids to take
    
     
• Treat Ammonia levels
  • Alpha keta glutamate

• Supplements:
  • Primary goal of supplementation to optimize normal physiology
  • Improve function of immune system
  • Enhance cognitive abilities
  • Improve red cell membrane function (really all cells are improved)
  • Reduction of autistic behaviors
  • Improved GI Function
• Active Support for Normal Growth & Neural development
• Absorption of iron and calcium we understand and it is important.
• We lack the knowledge of Zinc.  We need to make sure our kids get zinc. Almost all ASD kids are low on zinc. 
  • Usually low Zinc is combined w/ a high copper and low selenium level.
  • Zinc 10-20mg daily – need to get zinc
  • Remove all copper intakes (high copper is likely to be increased because of low GSH – Glutothione)
• Selenium:  25-100 mcg daily
  • Packed red blood cell element will show
• Calcium 300-1000mg of calcium citrate (not tums) w/ 100-200mg of magnesium (fully reactive chelate or ionic)
• Chromium deficiency:  50-100mcg daily
  • Helps regulate blood sugar –
  • Do not use PRCB’s to guide chromium replacement – wrong valence in RBC
• Protein deficiency:
  • Rice protein powder one tablespoon / daily  - ages 4-6
    AGES 7-10  1 ¾ tablespoons a day
  • Need zinc to process protein (or it hurts to eat protein!!)
  • Sources of protein: Dairy, Soy, Fish, Rice protein powder = rice is better
• Essential Fatty acids
  • All ASD kids need Cod Liver oil – start here
    • Some are allergic to cod – there is also flax seed oil
    • Oils cannot be heated
  • Recommend RDA for all kids (recommended daily allowance)
  • Sign of too much vitamin a:  there can be toxic
  • Children ages 3-5 ½ tsp CLO a day
  • Older kids:  1 tsp a day
  • A blood test EFA can show deficiencies

• Iron deficiency:
  • A CBC reticulocyte count, serum ferritin, and total iron binding capacity.  If iron deficiency is noted, your local health care provider needs to provide iron.
    
     
• It is hard to get all these supplements in!
  • Got to be sneaky
  • Blend drinks
  • Break up doses during day
  • At age 5 try getting small capsules (make them from Kirkman empty capsules).  Cut them in ½ and use them.  Tip the child’s head face down and the capsules will float to the back of the throat to swallow.

• Calorie deficient:
  • Come ASD kids just don’t eat
  • Hide calories in the foods or drinks they will eat
  • Trick to beef up calorie content
  • Use high oleic oils (will withstand heat) – safflower oil, olive oil, coconut oil.   Rotate oils.  Canola oil is overused – take advantage of the great substitutes.

• Carbohydrate Excess:
  • Remember, carbs are just complex forms of sugar
  • Need to lower sugars and lower carbs
  • Kids can crave sugar which can/will alter behaviors.
  • Important to remember: balance each meal with protein, carbs and a fat.
  • Chromium – will help balance sugar swings

CERTAIN THINGS YOU EAT WILL AFFECT BEHAVIORS.  Think about your kids.  Garbage in / garbage out.

• Maldigestion and Malabsorption
  • Many ASD kids lack the digestive enzymes for breaking down foods
  • Do Comprehensive Stool Analysis
  • Start w/ small dose ½ capsule with each meal (before meal) – Kirkman Labs Enzyme Complete w/ DPP-IV.
  • Creon (Cade’s research)
    
     
• Trace Mineral Deficiency
  • Multiple dietary limitations – minerals are surely deficient
    
     
• Improve function of immune system
  • Vitamin A – form of Cod Liver Oil (CLO)
  • Vitamin C 250-500mg daily
  • Vitamin E 100-200 IU
  • B6 and its activated form of P5P:  25-50 mg
    
     
• Probiotics
  • Friendly bacteria that live in the gut
  • They help create a friendly environment that is very hostile for yeast and unfriendly bacteria
  • Good sources:  Kirkman, Culturelle, Primal Defense and Natren
    
     
• Colostrum:
  • Can also be considered Transfer factor
  • It appears to be toxic to viruses and fungi to repair intestines
  • High in Lactoferin
  • American grown cow based without casein

• Methylation Pathways
  • We typically recommend 500-1000mg of TMG daily
  • TMG is demonstrated as affected as prozac (breaks down like a SAMe supplement)
  • TMG enhances proper fat absorption and also helps toxins from building up in the brain
  • Try DMG and TMG – one will work – either of these help speech
    
• Sulphonation Pathways:
  • ASD classically drop sulfur
  • Use Epsom salt baths!!    ½ cup of Epsom salts each bath.
  • N acetylcysteine (NAC)
  • Bad day:  Epsom salts and some Motrin (can get commercially grade Motrin or compounded Motrin without dyes, additives.)
  • Too much sulfur feeds the yeast
  • Topical or IV Glutothione (adding sulfur back.)
  • MSM (grows yeast!)
  • Glucosomine sulphate (watch for yeast)
  • Test: Plasma cysteine or Plasma Sulfate will show low sulfur (will help justify IV Glutothione)

• Alpha Lipoic Acid
  • This is a potent anti-oxidant that goes after free radicals
  • Caution: some do great /some CRASH!!
  • Do not use it w/ DMSA (contrary with other practioners)
     
• Milk Thistle
  • Herb that demonstrates to help liver w/ phase 1 detoxification
  • It is Good – no toxicity
  • 1 cap a day – 300mg
    
• Enhance Cognitive Abilities
  • B vitamins B6, B12 and magnesium
  • Start w/ SuperNu Thera SNT from Kirkman labs
  • Many children respond well to B vitamins
  • Many children respond to B6 / B 12 shots
  • Essential fatty acids (CLO, ProEPA, DHA Junior)
  • Minerals
  • CoQ10 (Vitaline) 30 to 300/day
  • NADH
  • TMG/DMG
  • Ginkgo biloba (kind of )
  • DMAE – Pediactive
  • NeuroPlus (Tyler Pharmaceuticals)
  • AKA (Alpha Keteroic Acid)

If supplements are PRESCRIBED, they are tax DEDUCTABLE!!!!!

• Reduction of ASD behaviors
  • P5P plus magnesium
  • Hyperactivity / OCD / Stimming:  neurotin
    
     
• Improved GI Function
  • Secretin – IV or transdermal
    • Can normalize bowel functions
• Tantrums & Meltdowns & Trouble Transitions
  • GF CF leaks
  • Look for offending agent:  mold?  Chemicals?  Fluorescent lights?
  • Clean up diet!!  Excitotoxins, MSG, potatoes, tomatoes, egg plant, corn syrup, hydrolized vegetable proteins, colors and additives.  (Sweet potatoes are OK – different family)
  • Taurine 1000 to 3000 mg daily
  • GABA 500-1000 mg daily
  • Zinc 10-20 mg / Calcium 500-700 mg (3 to 1 on calcium to magnesium) / Magnesium 250 mg -  combination

• Metals Toxicity:
  • Most ASD kids - 75% exposed to metal toxicity because of vaccines
  • Exposure could also come from
    • Air
    • Food
    • Drink
    • Trans-placental
    • Vaccines
    • RhoGam
  • Under reporting to VAERS is extreme
  • Vaccine Safety Data has been manipulated to reduce finding in phase 1 study
  • Need to link vaccine component to markers and disease implied (autoimmune and HG toxicity).  No prior studies designed to detect autoimmune disease.
  • Sorting out multiple variables
    
     
• What is in vaccines?
  • Mercury
  • Aluminum
  • Molecular mimicry (Mylein basic protein)
  • Crude toxoids
  • Live viruses
  • Antibiotics  (Neomycin)
  • Planned TH2 Excess provocation
  • Lowest common denominator thinking – only thing not individualized in our medical community
    
     
• Institutional thinking NEEDS to change so policies of national health will change.
  
   
• Toxicity metals
  • Binding sulfur groups
  • Loose enzymes
    
     
• Lead Toxicity
  • GI system
  • Brain and CNS
  • Lower intelligence
  • Growth retardation
  • Hearing loss
  • Behavioral changes
    
     
• Mercury Toxicity
  • CNS
  • Neuro-phych problems
  • Irritability, insomnia, depression, emotional instability
  • Antibiotic resistance
  • Visual processing errors
  • Educational challenges
    
     
• Siblings may not have autism, but they are affected somehow. Most likely metal toxicity
  
   
• Treatment of Mercury Toxicity
  • DMSA – FDA approved for children 1 and higher
  • DMSA – oral product (keep in freezer)
  • Best test:  Blood Elemental Analysis
  • Natural pathic: NDF Plus and Metal Free, PCARX
  • Likes NDF Plus or DMSA bests
  • Selenium can be used to chelate and cross the blood brain barrier
  • Do proper supplement load:  Vitamin C, Selenium, Zinc are crucial – Epsom salt baths and Glutothione (IV And transdermal) are important.
  • DMSA can create yeast issues – NDF Plus is best for kids that cannot tolerate DMSA or have yeast issues.
  • DMSA reactions – 2/3rds of the group do very very well.
    • Kid is fine – could not tell during dosing – day 5 good
    • Kid is just out of control – stims are off the roof – day 5 kid blossoms incredibly
    • Kids autistic symptoms go away.  Go off DMSA – autistic symptoms come back
    • Kids get no reaction

• NOTE:  On ALA, some kids bonk and causes more harm than good.  Biochemistry has not been worked out enough. ALA can cross the blood brain barrier – but then that means that can let other toxins in.
• Offending metals:
  • Mercury
  • Tin
  • Aluminum
  • Cadnium
  • Lead
  • Antimony

Prevent Toxicity

• Eat no fish.  Farm raised and fish in the sea = toxic period. Mahi Mahi is the only fish to eat – it has a shorter life span – one year.
• No amalgams – go porcelain
• No vaccines with mercury / thimersol
• Sealant vs. fluoride to protect teeth

• Heavy metals – got work to do first:
  • Go GFCF first
  • Get supplements going
    • So now they will feel better, be ready for metals out
  • Start DMSA first (50-200 mg – 3 days on / 11 days off).  Watch carefully for yeast.  Take time off so the body can re-group.
  • Go to NDF Plus if DMSA is not tolerated

NOTE:

All the ASD children are a delicate combination of issues that need to be handled carefully and individually. What does not work for one child may be wonderful for another child.   Not one treatment protocol will work for all children.

 

PAGE OPTIONS

• Printer Friendly Page