Physical Health Profile of the Autistic Child strongly tends toward:

1. Gastrointestinal Abnormality
* Malabsorption (J. Autism/Childhood Schizo, 1971 1(1):48-62)
o freq. reports acholic stools, undigested fibers, positive Sudans.
o 85% of autistics meet criteria for malabsorption (B.Walsh, 500 pts)
* Maldigestion--elevated urinary peptides
o P Shattuck (Brain Dysfunct 1990; 3: 338-45 and 1991; 4: 323-4)
o KL Reicheldt (Develop Brain Dys 1994; 7: 71-85, and others)
o Z Sun and R Cade (Autism 1999; 3: 85-96 and 1999; 3: 67-83)
* Microbial Overgrowth--fungal, bacterial and viral
o William Shaw, Biological Basis of Autism and PDD, 1997.
o E Bolte on Clostridium (Med Hypoth, 1998; 51: 133-144)
o P Shattock and A Broughton IAG elevations
o W Walsh and W McGinnis pyrrole elevations
o Andrew Wakefield, Lancet 1998; 351: 637-4)
o TJ Borody, Center for Digestive Diseases, New S. Wales, Austral.
* Abnormal Intestinal Permeability
o P D'Eufemia (Acta Pediatr 1995; 85; 1076-9)
* G.I. Symptoms reported by parents: diarrhea, constipation, gas, belching, probing, visibly undigested food and need for rubs

2. Compromised Immunity
* Recurrent Infections
o Euro Child/Adolesc Psych, 1993:2(2):79-90
o J Autism Dev Disord 1987; 17(4): 585-94
* Abnormal Indices
o T-cell Deficiency (J Autism Child Schizo 7:49-55 1977)
o Reduced NK Cell Activity (J Ann Acad Chil Psyc 26: 333-35 '87)
o Low or absent IgA (Autism Develop Dis 16: 189-197 1986)
o Low C4B levels (Clin Exp Immunol 83: 438-440 1991)
* Skewed ("elevated") Viral Titers increasing grass-roots reports V Singh University of Michigan


3. Detoxification Weakness
* Phase II Depression (S. Edelson, DAN Conference Sept, 1997, and Toxicology and Industrial Health 14 (4): 553-563 1998)
o Sulphation low in 15 of 17 (mean 5 vs. nl 10-18)
o Glutathione Conjugation low in 14 of 17 (mean 0.55 vs 1.4-2.9)
o Glucuronidation low in 17 of 17 (mean 9.6 vs. 26.0-46.0)
o Glycine Conjugation low in 12 of 17 (15.4 vs. 30.0-53.0)
* Sulphation Deficit (Biol Psych 1; 46(3): 420-4, 1999)
* Peroxisomal Malfunction (P Kane, J of Orthomolec Med 1997; 12-4: 207-218 and 1999; 14-2: 103-109)
* Higher blood lead levels in Autism and documented response to EDTA Chelation (Am J Dis Chld 130: 47-48, 1976)
* Apparent temporal association autism onset and lead exposure (Clinical Pediatrics 27: 1; 41-44 1988)

4. Abnormal Nutritional Profile in Children with Autism
* Lower serum Magnesium than controls (Mary Coleman, The Autistic Syndromes 197-205, 1976)
* Lower RBC Magnesium than controls (J. Hayek, Brain Dysfunction, 1991)
* Low activated B6 (P5P) in 42%. Autistic group also higher in serum copper. (Nutr. and Beh 2:9-17, 1984)
* Low EGOT (functional B6) in 82% and all 12 subjects low in 4 amino acids (tyrosine, carnosine, lysine, hydroxylysine). Dietary analysis revealed below-RDA intakes in Zinc (12 of 12 subjects, Calcium (8 of 12), Vitamin D (9 of 12), Vitamin E (6 of 12) and Vitamin A (6 of 12) (G. Kotsanis, DAN Conf., Sept, 1996)
* B6 and Magnesium therapeutic efficacy--multiple positive studies (start with Am J Psych 1978; 135: 472-5)
* Low Derivative Omega-6 RBC Membrane Levels 50 of 50 autistics assayed through Kennedy Krieger had GLA and DGLA below mean. Low Omega-3 less common (may even be elevated) (J Orthomolecular Medicine Vol 12, No. 4, 1997)
* Low Methionine levels not uncommon (Observation by J. Pangborn)
* Below normal glutamine (14 of 14), high glutamate (8 of 14) (Invest Clin 1996 June; 37(2): 112-28)
* Higher Copper/Zinc ratios in autistic children. (J. Applied Nutrition 48: 110-118, 1997)
* Reduced sulphate conjugation and lower plasma sulphate in autistics. (Dev. Brain Dysfunct 1997; 10:40-43)
* B12 deficiency suggested by elevated urinary methylmalonic acid (Lancet 1998; 351: 637-41)
* Hypocalcinurics Improve with Calcium Supplementation Lower Hair Calcium in Autistics Reported (Dev Brain Dysfunct 1994; 7: 63-70)

ARI parent survey for therapeutic responses by autistic children:

• 50% improved with Zinc (6% worsened)
• 49% improved with Vitamin C
• 46% improved with Magnesium and B6 (5% worsened)
• 58% improved with Calcium (Later survey 42%)

Physical Health Profile in ADHD

1. Gastrointestinal Abnormality

• Colicky Infants and Older Children Diarrhea-Prone (V Colquhoun HACSG, Sussex UK 1987)
• Severe Stomach Aches (Am J Clin Nutr 1995; 62:761-8)
• Elevated Stool Creosols (Lancet 7.12.85)
• Ileal Lymphoid Nodular Hyperplasia (Lancet, July 18, 1998)
• Urinary Peptide Elevations-P. Shattock and A. Broughton
• Urinary Organic Acids Elevations- W. Shaw
• IAG Elevations-A. Broughton
• Parasitosis 67%-M. Lyon and J. Cline

2. Compromised Immunity

• More Infections and Antibiotics (Am J Clin Nutr 1995; 62: 761-8)
• Low Complement C4B (J Am Acad Child Adolesc Psych 1995; 34(8): 1009-14)

3. Detoxification Weakness

• Low-Level Lead Exposure Induces Hyperactivity in Rats (Science 182(116): 1022-1024
• Marked Improvement in 7 of 13 Chelated for "Non-Toxic" Lead Levels (A J Psych 1976 133(10): 1155-1158)
• Neonatal and Maternal Hair Lead Predict LD at Age 6 (Lancet 2:285 1987)
• Hair Lead Levels Correlate with Teacher-Rated and Physician-Diagnosed ADHD (Arch Environ Hlth 1996; 51(3): 214-20)
• Striking Chelation Results in 50 Vancouver Children (Turning Lead into Gold, paperback, Nancy Hallaway and Ziggert Strauts 1996)

4. Abnormal Nutritional Profile In ADHD

• Zinc Deficiency
  • Lower urinary, serum, nail and hair zinc than controls plus quick drop in serum and salivary zinc with double-blind tartrazine. United Kingdom. (J Nutr Med 1:51-57, 1990)
  • Plasma, erthrocytes, urine and hair lower than controls. Poland (Psychiatr Pol 28(3):345-53 1994)
  • Zinc deficiency in attention-deficit hyperactivity disorder. Israel. (Biol Psychiatry 40(12):1308-10 1996)
  • Serum zinc--and free fatty acids--lower. Turkey. (J Child Psychol Psychiatry 37(2):225-7 1996)
  • In vitro study demonstrates decreased loss of fatty acids from mesenteric phospholipids with perfusion of physiological zinc. Canada. (Can J Physiol Pharmacol 68(7): 903-907 1990)
• Fatty Acid Deficiency
  • Lower serum DHA, DGLA and AA in hyperactives than controls. (Clin Pediatr 26(8):406-411 1987)
  • Double-blind administration of evening primrose oil to a subgroup of prior study was associated with improved parent ratings for Attention and Excess Motor Activity compared to placebo. (J Abn Child Psychol 15(1): 75-9 1987)
  • Evening Primrose oil (GLA) 1 gram/day improved 53 of 79 hyperactive children selected as a subgroup on the basis of mood swings. The most striking improvement was noted in children with sleep disorders, crying spells and family history of alcohol or bipolar. (Muriel Blackburn, Crawley Hospital, Sussex , U.K.)
  • Lower plasma DHA, EPA and AA, and lower RBC AA in ADHD than controls (Am J Clin Nutr 62: 761-8 1995)
  • (Same group above correlated greater tendency to behavioral problems with lower total plasma Omega-3, more colds and antibiotics with lower total Omega-6. Physiology and Behavior Vol 59, Nos. 4/5 915-920 1996)
  • Zinc and Evening Primrose Oil the mainstay for thousands of successes claimed by the HACSG, Sussex England (Personal Communication, Vicky Colquhoun 1997)
• Magnesium Deficiency
  • Magnesium deficiency measured in 95% of 116 Polish children with ADHD: 78% low hair, 59% low RBC's, 34% low serum. (Magnesium Research 10(2): 143-148 1997)
  • Double-blind adminstration of 200 mg elemental magnesium per day to 25 of the above group produced measurable decrease in hyperactivity over 6 months compared to control. (Magnesium Research 10(2): 149-156 1997)
• Iron Deficiency
  • Preliminary study showed improved behavior in nonanemic hyper-actives given 5 mg/kg/day of Iron for 30 days, with significant increase in serum ferritin. (Neuropsychobiology 1997; 35(4):178-80)
  • Lower Iron plasma, RBC, Urine and Hair levels in 50 Hyperactives (Psychiatr Pol 1994; 28(3): 343-53)
• Calcium Deficiency
  • Plasma, RBC, urine and hair Calcium in 50 hyperactive Polish children lower than controls. (Psychiatry Pol 1994; 28(3):
• B6 in ADHD
  • B6 to hyperactives with low serotonin levels resulted in normal serotonin levels and behavior. (Pediatrics 55: 437-41, 1975)
  • B6 to 6 hyperactives with low serotonin levels increased serotonin and reduced hyperactivity better than Ritalin in double blind cross-over. Benefit carried over into the following placebo period, but not with Ritalin. (Biol Psychiatry 14(5):741-51 1979)
  • Significant subgroup of patients with ADHD (and Autism) found to have pyrroluria by Bill Walsh (Pfeiffer Treatment Center, Napperville, IL) and Hugh Riordan (BioCenter, Wichita KS). Good clinical track record for response to generous B6 and Zinc in thousands of pyrroluric patients. (Walsh also finds Biotin very useful in "slender malabsorber group")
• B12 in ADHD
  • Elevated urinary methylmalonic acid and early reports of response to oral B12 from John Linnell, research director at The Children's Medical Charity, U.K. Some reports of response to B12 shots.

Emerging Possibilities

• VITAMIN A HYPOTHESIS- M Megson
• CALCIUM DYSREGULATION HYPOTHESIS-W McGinnis

Interventional Strategies for Behavioral Children

1. OPTIMIZE NUTRITION
* Low Glycemic
* Big Breakfast, Protein First, Frequent Meals
* Good Fats
* No Excitotoxins
* Organic as Possible
* Plenty of Fiber
* Careful with the Copper
* Baseline CBC, UA, Thyroid
* Urinary pyrrole
* RBC Fatty Acid Analysis
* Hair Mineral Analysis/Other Mineral Studies
* (PHF)

Start with these incrementally, continue until proven otherwise:
* Zinc with Manganese
* B6 (and/or P-5-P) with Magnesium
* Calcium
* Vitamins C and E

Then Address Fatty Acids
* Evening Primrose for GLA (Careful Seizures or Asthma)
* Cod Liver Oil (Provides Vit A and D plus EPA/DHA)
* Fish Oil or Neuromins for additional Omega 3

Other: B12, Biotin, Taurine, MSM, Folate, DMG, Amino Acids, Mb, Fe


2. ADDRESS OVERGROWTHS AND GUT CARE
* O&P at a bare minimum
* Urinary Organic Acids
* Nystatin/Oral Amphotericin/Diflucan/Cranberry/Grapefruit Seed
* Reconsider NSAIDS
* Fiber/FOS/Glutamine/Glucosamine
* Pentosan Polysulphate ("Elmiron")?
* Re-populate bowel with probiotics
* Creon or other digestive enzymes


3. ADDRESS FOOD INTOLERANCES
* Urinary Peptides
* IgG food antibody blood testing
* Address lactose, phenolic and high-arabinose intolerance