A guide to considering medical treatments for autism spectrum disorders (ASDs) for BC parents-
Naturopathic Physician/Associate Editor CAND Vital Link
111-611 Brookside Drive, Victoria, BC V9C 0C3
A guide to considering medical treatments for autism spectrum disorders
Treating ASDs are a marathon, not a sprint! Treating autism has been the most challenging --as well as rewarding-- part of my professional life. I have seen biomedical therapies work hand in hand with behavioral approaches many times, to help children with ASD break through the challenges of autism. With hard work and perseverance, sometimes miracles can happen! ~Dr. Marianne
Much of the current thinking about treating autism as a whole body condition has been carried out by
doctors and researchers working in conjunction with the Autism Research Institute (ARI) in San Diego, USA. Over the past 15-20 years, many of these doctors have spend considerable time and efforts deciphering many of the underlying medical problems that can contribute to ASDs, and sharing their findings with other physicians at conferences sponsored by Defeat Autism Now! (DAN!—now called ARI), Autism One, Autism Speaks, and Autism Canada. Many doctors affiliated with these groups use therapies popularized by books such as Children with Starving Brains, Healing the New Childhood Epidemics, and Healing and Preventing Autism. (References attached). With research and clinical guidelines advancing rapidly in this area, many clinicians follows an approach known as STEPS:
o Safety: has it been studied in children? o Tolerability: what are the side effects? o Efficacy: does it work?
o Price: how much will it cost? o Simplicity: how easy is it to do?
In BC, as of 2012 physicians who are trained and experienced in biomedical therapies for autism are
overwhelmingly naturopathic doctors (NDs) and incorporate many of naturopathic medicine’s unique
approaches to understanding and treating the whole person, as well as using the gentlest agents possible to bring about lasting improvements to your child’s health.
First visit: many of the things your autism biomedical practitioner will review at this visit will have to do
with eating , digestion and elimination, energy levels and sleep, typical behaviors (including social or
repetitive behaviours), and speech. This approach views autism as a dynamic and treatable disorder, rather
than a fixed set of symptoms that can only be controlled with medication.
An initial plan will usually include baseline testing and/or empirical (trial) treatments to resolve any digestive or biochemical problems may be underlying your child’s developmental or behavioral problems. Some tests that will be considered include:
o Stool testing: for digestion, or infection with yeasts, parasites or bacteria. o Food sensitivity testing: (IgE, IgG and/or IgA), to determine foods that may be contributing to
digestive problems such as inflammation or diarrhea,
o Organic acid testing: to help decipher biochemical imbalances in nutrients or hormones that
may be affecting your child’s functioning.
o Blood testing: to help rule out medical problems such as infections, anemia, hypothyroid, or
PANDAS (Pediatric Neurological Disorder Associated with Strep). Will often be done prior to this initial assessment as part of a conventional autism diagnosis.
Initial biomedical treatments: may include supplementation such as omega-3 fish oils, probiotics, high
antioxidant vitamins or minerals, Epsom salt baths, or digestive herbal medicines. A trial of a gluten-casein-soy-free diet (GFCF) will often be recommended, as there is now convincing empirical evidence from the ARI that these diets help many children with ASDs. Additionally, the importance of removing additives, preservatives, dyes, and antibiotics or hormones from your child’s diet will be discussed. Prescriptive ARI-studied therapies such as low dose naltrexone (LDN), topical glutathione, methyl B12 or acetyl-L-carnitine may also be considered.
Initial follow up: most autism biomedical doctors will ask for a follow up visit after a week or two to
review initial dietary, supplement or prescriptive protocols, and provide support and troubleshooting as needed. Your physician may also refer you to a nutritionist for further support on the GFCF or other special diets and may discuss supplementation for nutrients (such as calcium and magnesium) that may be lacking in children with either special diets or children who self-restrict their food intake. Often, lab or diagnostic results (such as EEGs) or other reports from other providers may be reviewed and discussed at this visit.
Reviewing test results and treating for digestive problems: a recent consensus article on GI problems
in ASDs published in the journal Pediatrics argued that many children with ASDs and GI problems such as inflammation, food intolerances/sensitivities, or chronic diarrhea are at risk for problem behaviors. You and your biomedical doctor may consider treating these GI problems with anti-bacterial or anti-fungal medicines. These medicines may either be prescriptive items or natural health products (NHPs), including botanical medicines or blended homeopathic medicines. Additionally, digestive enzymes or similar NHPs
may be considered if testing indicates poor digestion of nutrients. Small bowel inflammation can also be treated effectively by botanical medicines or nutrient therapies.
Following up: working with your doctor for the long term
Considering treatments for heavy metals or solvents: many children with ASDs and related conditions
have impaired biochemical pathways in their cells and organs to remove toxic metals or solvents. As a
result, these substances may accumulate in the body and cause significant problems with brain and overall
body functions. Impaired cellular detoxification can be improved with the addition of nutritional anti-
oxidants in high doses, as well as NHP nutrient therapies such as methyl B12 and dimethylglycine (DMG).
Compounded topical glutathione is another therapy that has been shown to assist in cellular detoxification.
Many doctors who treat autism biomedically will consider formal detoxification therapies after digestive issues have been treated and resolved, in order not to place too great a burden on developing organs of elimination, including the liver, kidneys and digestive tract. Oral or topical chelation therapy may be carried out if heavy metals such as lead and mercury are present in elevated levels in urine or hair testing. These agents are being increasingly studies and include a variety of natural health or compounded products, including vitamin C, modified citrus pectin, DMPS, DMSA, or EDTA. Some NDs may add homeopathic drainage products, either as standalone agents, or adjunctively with more conventional chelating agents. Detoxification of solvents using amino acid therapy can also be assessed and considered.
Ongoing care: regular follow up visits are critical to continue improvements gained during initial
treatment for ASDs. Intestinal yeasts and parasites may recur and cause regressions in behavior or mood swings. Follow up testing of blood, stool or urine will help establish whether treatment protocols have been successful or need to be modified. Supplement ‘holidays’ may actually improve efficacy of nutrient therapies or help determine whether they are still helpful. Eliminated foods may be challenged to help determine if they can be re-introduced to the diet. New and emerging therapies such as nasal oxytocin (not yet approved for use by BC NDs), galantamine, neurofeedback, or hyperbaric oxygen (HBOT) can be considered.
Dr. Marianne Trevorrow, ND MA, holds degrees from McGill University, the University of Chicago, and Bastyr University, where she completed her ND in 2006. After a year of post-graduate research work in Nutrition and Anti- Aging Medicine, she moved to Victoria, BC, where she has been private practice since 2007. She is Board Certified in Chelation Therapy and Licensed to Prescribe Medications. Alongside her wellness focused general practice, she sees a variety of environmental and developmental disorders in children, including ADHD, autism spectrum disorders (ASDs), Down’s syndrome, asthma/allergies, and other chronic conditions. She is affiliated with Autism Canada and the Autism Research Institute, and is a frequent panellist and speaker on women’s health and pediatric environmental health and autism. She has published several articles in these areas for professional and general interest publications. She is also a director of the BC Naturopathic Association, and a peer reviewer for several biomedical journals including CANDVital Link. References:
Bock K, Stauth C. Healing the New Childhood Epidemics: Autism, ADHD, Asthma, and Allergies: The Groundbreaking Program for the 4-A Disorders. New York; Ballantine Books, 2008.
Herbert M, Weintraub K. The Autism Revolution: Whole Body Strategies for making life all that it can be. New York:
Jepson B, Johnson J. Changing the Course of Autism. Boulder, CO; Sentient Productions, 2007.
McCandless J. Children with Starving Brains: A Medical Treatment Guide for Autism Spectrum Disorder, 4th ed. Bramble
Rossignol D. Novel and emerging treatments for autism spectrum disorders: a systematic review. Annals of Clinical Psychiatry Vol 21, no. 4: November 2009; 213-236.
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