PANDAS, PROBIOTICS PROBLEMS AND AUTISM
One phenomenon that I have seen with a number of kids on the Autism spectrum–some kids aren’t necessarily classically diagnosed with Autism but who have the characteristics of something called PANDAS–is a condition in the body that is triggered by a streptococcal infection, specifically Group A Beta Hemolytic Strep. In this case, individuals develop obsessive compulsive behavior, sometimes tics, behavioral issues, weird or odd movements of the head or the eyes, side glancing, or different manifestations that usually come about after an infection, sometimes a sore throat. It can be a marked change in their behavior, social anxiety, anxiety in general and as mentioned before very, very severe forms of obsessive compulsive disorder.

Now there are certain individuals on the Autism spectrum who have this characteristic and there are also other people who develop obsessive compulsive behavior and tics etc, who also have PANDAS but are not Autistic. One of the things that is interesting is in many of the supplements that people take, specifically probiotics, there is a specific bacteria called streptococcus thermophilus that is a natural bacteria and is essentially listed as a beneficial bacterial for the digestive system and for our overall health. You also find it in some yogurt products as well. It’s reported that streptococcus thermophilus is entirely different than Group A Beta Hemolytic Strep as far as its protein structure and therefore should not be a contributing problem to the obsessive compulsive problems or the other manifestation of PANDAS. The problem is that has not always proved to be true. This basically means in many kids, whether they are on the Autism spectrum or not, just don’t seem to react very well to probiotics that have streptococcus thermophilus.

If you have a suspicion that your child has PANDAS or is likely a problem, check their probiotics. See if the probiotics that they are taking have streptococcus thermophilus. If it does, consider changing to a different probiotic. It doesn’t always fit, but often times it does.

I had a situation a couple of years ago where a patient who had PANDAS was successfully treated for it and was essentially in remission started a group of new supplements, and all of a sudden, started coming down with those PANDAS conditions again. Anxiety, tics, obsessive behavior. The parent didn’t realize that the streptococcus thermophilus was an issue until we recognized that that was likely a contributing factor. Just stopping that one supplement alone, his PANDAS symptoms, his OCD, his anxiety disappeared. I have seen that happen now with other kids and other people as well. So it is one of the things that I look at clinically is if streptococcus thermophilus is being used in a supplement, that is one thing I look to remove.

PANDAS

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• Autism Treatment – Helicobacter Pylori and Autism
• Autism Treatment – How to Successfully Work With a Biomedical Autism Doctor
• Autism Treatment–Specific Carbohydrate Diet (SCD)
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Microglia Activation–Brain Inflammation and Autism

Brain Inflammation, or neroulogical inflammation, with respects to Autism, has been the topic of a tremendous amount of research out of Johns Hopkins University and other research facilities. Emerging research shows that in Autism, there tends to be a higher prevalence of neuro-inflammatory markers likely affecting individuals on the Autism spectrum more adversely.

In short, there is a cell in the brain or a system in the brain called microglia. Microglia is a part of the immune system function of the brain and the central nervous system. In many individuals with Autism, there appears to be what’s called microglia activation where the microglia become activated, but don’t turn off. They can become activated from a virus or bacteria. They can become activated from a potential chemical reaction. There’s been some cases where it’s shown that certain vaccines may be a contributing factor to microglia activation.

When the system doesn’t turn off, it leads to chronic inflammation and essentially the destruction of what are called synapses. Synapses are the small spaces between nerve cells where neuro-chemicals are transferred from one nerve cell to the next as a communication link. So, we get a chemical reaction across the synapse creating an electrical chemical reaction in the corresponding nerve cell. So, anything that is going to affect the synapse will essentially affect chemical transportation from one brain region to the next and electrical impulse activation in the brain as well.

There isn’t just one thing that causes microglia activation, but it is something that should be on your radar. It is something to consider for your child on the Autism spectrum, something that may be a contributing factor to their overall condition. Whether you feel your child had a vaccine reaction, whether they had an infection at some point where things just never returned to normal, or they’ve had chronic immune problems throughout their life like food sensitivities, gut problems, etc, you could be looking at the potential for microglia activation.

microglia activation

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• Autism Treatment–Specific Carbohydrate Diet (SCD)
• Autism Treatment – Dietary Treatment Options for Autism Treatment
• Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and Autism
• Common “Typical” Signs of Autism
• Chronic Yeast Toxicity and Autism
• Autism Treatment – Chronic Stress and Autism

Behavior Changes

A number of factors can impact behavior in children with Autism, and working on resolving behavior changes means isolating some factors of the behavior. When is the behavior issue occurring? Is it occurring before going to school or in the morning or happening when your child gets home from school? Is it happening at school? In the therapy sessions? Before bedtime? Has there been some type of change in their daily routine?

I’ve often had kids who’ve had behavior changes because they’re in a classroom and a new child comes into the classroom that they either don’t like or they’re not getting along with or there is some type of conflict. It can even be a result of a new therapist or a new teacher.

Behavior changes can break down to something in their daily routine. Has there been some sort of change in their diet? Eating new foods or taking certain foods away that your child likes certainly can contribute to behavioral problems. Have you added a new supplement? Often times, changes in behavior occur when new supplements are added. Often times people will add too many supplements at one time instead of spacing them out every two to three days when introducing a new thing. Supplements sometimes can cause problems.

So you really have to be a detective in what is actually happening with your child and how long has that behavior change been occurring. Keep a journal on your child’s behavior changes to help you establish patterns. Has it been over a couple days or a couple weeks? Really try to piece together what may be going on, and keep in mind it may not be biomedical. It could be situational.

By the way, if it is something that might be tied to supplements, generally what I do is isolate which supplements have been added since the behavioral change started. Then, I recommend taking all of those new supplements out. Wait four to five days and see if the behavioral change shifts. Reintroduce those supplements one at a time, maybe sometimes at half a dose, and take implementation slower because just that change alone may be enough for your child to handle whatever new program you are putting them on.

Behavior Changes

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• Autism Treatment – Helicobacter Pylori and Autism
• Autism Treatment–Specific Carbohydrate Diet (SCD)
• Autism Treatment – Dietary Treatment Options for Autism Treatment
• Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and Autism
• Common “Typical” Signs of Autism
• Chronic Yeast Toxicity and Autism
• Autism Treatment – Chronic Stress and Autism

Helicobacter Pylori

Helicobacter Pylori, or what is called H. Pylori, is a bacteria that has been responsible for the development of stomach ulcers. We know that kids on the Autism spectrum seem to have a lot of gut problems, including bacterial imbalances, yeast problems, and digestive problems in general. Helicobacter Pylori typically tends to aggravate the stomach and alters stomach acid production which can affect digestive enzyme function in the small intestine. It leads to poor digestion and malabsorption, and can also be a trigger for food allergies or sensitivities. It can cause stomach pain, acid reflux, gastritis and overall discomfort in the upper intestinal area, particularly after eating.

There’s a number ways of testing for H. Pylori. The most common test is called an H. Pylori antibody test, where they look at antibodies, which are immune proteins that are generated by our immune system to the presence of an infection, whether it’s a bacteria or a virus. The most common antibody is called an IGG antibody to H. Pylori. The problem is that IGG is only indicative of exposure to H. Pylori, and doesn’t really give you any idea if there is an active infection, so with that test, you still have to correlate it to symptoms. Some labs will also do an IGA and an IGM antibody to H. Pylori, which often times you have to specifically request. Those are important because IGM is actually a marker of active immune activity or immune activity against an active infection. IGA is also part of the complex as well. IGA, IGM and IGG are the common bloodtests that are done for H. Pylori. There is also a breath test that can be done, but it’s difficult to do with kids, so its not frequently used. Some of the labs are doing stool testing for H. Pylori, and are looking for what are called antigen staining or an antigen test.

One of the labs I use is called Biohealth Diagnostics and they have a panel called 401 which is a stool pathogen panel. When you add the H. Pylori component to it, it’s called the 401 H, it not only becomes a great test for parasites, looking for things like giardia, cryptosporidium, blastocystis hominis, entamoeba histolytica, but it also has a stool antigen test for H. Pylori and that if a stool antigen is present, it’s very good evidence that H. Pylori active infection is present. I often will do that, as an add-on stool test for kids on the autism spectrum to look for the presence of H. Pylori and also to look for the presence of other parasites that maybe missed by other stool tests. Those typically are the major tests that are done; the blood testing, the breath testing and the stool testing. The ones that are most common in the autism community would certainly be doing stool testing and the blood testing as well. I realize with some kids, it’s difficult to get blood, so again, if your doctors only gonna run H. Pylori IGG, in my experience that’s not going to be enough. Ask them to at least do the IGM, the IGA antibody and better than that, add a stool H. Pylori antigen test as well.

Helicobacter Pylori

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• Autism Treatment – Helicobacter Pylori and Autism
• Autism Treatment – How to Successfully Work With a Biomedical Autism Doctor
• Autism Treatment–Specific Carbohydrate Diet (SCD)
• Autism Treatment – Dietary Treatment Options for Autism Treatment
• Autism Treatment – Using Methylation Chemistry for Autism Treatment
• Autism Treatment – How Music Therapy Helps In Treating Autism

Let’s talk about something called Helicobacter pylori and Autism or H Pylori. H. Pylori is a bacteria that has been responsible for the development of stomach ulcers. We know that kids on the Autism spectrum seem to have a lot of gut problems, including bacterial imbalances, yeast problems, and digestive problems in general. So, they seem to have a greater susceptibility of these types of infections, as well as susceptibility of behavioral problems associated with these infections whether it’s self stimulatory behavior that is driven by yeast, or aggressive behavior that is exacerbated by the presence of clostridia bacteria.

Helicobacter Pylori found in children on the Autism Spectrum typically tends to aggravate the stomach and alters stomach acid production which can affect digestive enzyme function in the small intestine. It leads to poor digestion, malabsorption, and can trigger food allergies or food sensitivities. It can also lead to stomach pain, acid reflux, gastritis and overall discomfort in the upper intestinal area, particularly after eating.

A lot of kids will actually avoid meat because it’s just hard to digest, and that can be an indicator that Helicobacter Pylori may be a problem. So I want you to think about Helicobacter Pylori as another type of infection that may be affecting your child’s digestive system and affecting the way they digest food.

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• Autism Treatment – Dietary Treatment Options for Autism Treatment
• Autism Treatment – Using Methylation Chemistry for Autism Treatment
• Autism Treatment – How Music Therapy Helps In Treating Autism

Specific Carbohydrate Diet

Some children, particularly those with inflammatory bowel conditions, very weak immune systems, or the inability to eradicate opportunistic bacteria and yeast from their digestive system, often times will receive benefit from a more detailed autism treatment dietary program than just the gluten and casein-free diet. One such autism treatment program is called the Specific Carbohydrate Diet (SCD) as promoted by the late Elaine Gottschall, author of a groundbreaking book titled “Breaking the Vicious Cycle.” This diet is an extension of the gluten/casein-free diet (and soy-free diet) and has been a big boost health wise for many children on the autismspectrum.

I have seen the Specific Carbohydrate Diet work miracles with patients with digestive conditions such as Ulcerative Colitis or Chron’s Disease. Many children on the autism spectrum are suffering with a similar condition called Autistic Entereocolitis as described by Andrew Wakefield, M.D. Many more kids are suffering with undiagnosed bowel disorders that benefit from the Specific Carbohydrate Diet.

The Specific Carbohydrate Diet (SCD) is not just a low carbohydrate diet, but instead is focused on removing certain grains such as wheat, barley, rye (same as the GF/CF diet), as well as rice, corn and other offending foods. The theory is that certain digestive enzymes that breakdown disaccharides (complex sugars) are missing (or are being blocked from reaching the food in the digestive system by excessive layers of intestinal mucus) in the child’s digestive system, making it difficult to digest these additional food sources. The lack of digestive function leads to chronic inflammation in the digestive system leading to gut wall deterioration. With the breakdown of the gut wall, food absorption is compromised leading to mineral, amino acid and vitamin imbalances, as well as immune dysfunction and the overgrowth of opportunistic infections such as yeast and bacteria.

The digestive system is the largest immune organ in the body and acts as the first line ofimmune defense against pathogens such as parasites, yeast, bacteria and intestinal exposed viruses. The loss of this immune response and the eventually breakdown of the gut wall can lead to systemic immune dysfunction and leaky gut. “Leaky gut” is analogous to a screen door on a submarine – “everything and anything can get through.” This means you lose the ability to keep the bad stuff from entering your blood stream. Increased toxins filtering into your child’s blood stream can activate systemic immune responses leading to local and systemic inflammation – including the brain. Celiac disease (which is a genetic disorder evidenced by the inability to digest gluten – specifically gliadin – containing grains) is an example of this where gluten proteins from food can adversely affect the brain.

To learn more about this autism treatment approach – the Specific Carbohydrate Diet -and the benefits it may have for your child visit – www.breakingtheviciouscycle.com

Specific Carbohydrate Diet

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Autism Treatment

There are a number of dietary interventions that are helpful for individuals on the autism-spectrum. These include the gluten and casein-free diet (GF/CF), the Specific Carbohydrate Diet (SCD), Low Oxalate Diet (LOD), Feingold, GAPS, and anti-candida. Deciding on which Autism Treatment diet is right for your child can be confusing. How do you know where to start? Which Autism Treatment protocol do I do? Which one is best? All of these are common questions, but sometimes difficult to answer. In my experience there, is no one diet that is right for every person – certainly not every autism-spectrum child. One size does not fit all. It is true that in the context of eating, the elimination of toxic foods such as processed grains, high fructose corn syrup, and trans fats is critical, and in doing so will go a long way in improving the health of your child. Let’s take a glance at one diet – The Body Ecology – as an Autism Treatment option.

Yeast is a major problem in autism. The biotoxins from yeast contribute to cognitive, behavioral and language difficulties. Working to reduce or eliminate yeast toxins is an important consideration for any person on the autism-spectrum. Autism Treatment programs such as the Body Ecology Diet help in attacking chronic yeast problems. Here is an overview of the Body Ecology Diet:

* Anti-candida diet by eliminating all fruits other than lemons, limes, dried cranberries, and black currant seed juice.
* Cultured vegetables which aide in proper digestion, normalizing intestinal beneficial bacteria levels and acid-alkaline balance.
* Using various kefir products which are a good source of protein.
* Using a wide variety of protein meats, vegetables, and certain non-gluten (gliadin) grains (quinoa, amaranth, millet and buckwheat).
* Vegetable juices for increased nutrient bioavailability.
* Proper food combining to reduce digestive problems such as bloating, gas, and yeast overgrowth, etc.

The benefits derived from the Body Ecology program are a reduction in yeast overgrowth (and other opportunistic intestinal “gut bugs” such as bacteria and parasites), reduced exposure to harmful sugars, proper digestion, stronger immune function and less food allergies.

The Body Ecology Diet is a good example of how a more whole food diet (with the incorporation of fresh fruits and vegetables, organic meats, and healthy grains), and the elimination of fast foods can have wide-sweeping positive effects on your child’s health by reducing many of the artificial food ingredients, sugars and toxic fats that plague so much of the typical American diet.

Autism Treatment

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There is a condition recognized in the biomedical field for autism and related disorders called PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections). This particular condition is caused by an immune reaction triggered by a toxin produced from a Group A Beta-Hemolytic Streptococcal infection. There are various strep bacteria that produce toxins as part of their infectious nature. Our immune system responds to them in an attempt to neutralize and eradicate these toxins. Unfortunately, in some individuals, this immune-toxin (aka. antibody-antigen complex) reaction creates immune complexes which are deposited in various tissues of the body. If these immune complexes land in the kidneys there is an immune reaction called post-streptococcal glomerulonephritis, in the heart it is called rheumatic fever, and in the brain PANDAS can ensue. This autoimmune reaction (self-directed immune reaction to body tissue) in PANDAS is directed to the Basal Ganglia area in the brain. The Basal Ganglia region of the brain when altered or damaged is associated with disorders such as obsessive-compulsiveness (OCD), strange body posturing/movements called chorea, and the typical TIC movements (quick jerking or vocal tics) associated with Tourette’s Syndrome. With obsessive-compulsive behavior anxiety is usually a major problem.

Some individuals on the autism-spectrum suffer with extreme anxiety, but without obsessive-compulsive behavior, while in others the OCD is severe. Even though PANDAS remains a controversial topic in medicine it is reported that PANDAS can cause or exacerbate Tics, Tourettes, and Obsessive-Compulsive Disorder. Approximately, 25% of individuals who have one or more of these conditions have what appears to be PANDAS.

Treatment options are limited, although certain biomedical autism treatments such as low dose naltrexone, dietary intervention such as the gluten and casein-free diet, and various supplements that support normal immune function such as Transfer Factor can be helpful in reducing the overall reactivity of the immune system, PANDAS remains a difficult condition to treat.

Antibiotic therapy has worked for some. I have seen clinically where a short course of antibiotics, such as 10 to 14 days of Keflex, Penicillin or Zithromax definitely helps, particularly with the OCD behaviors. Often times a prolonged course of weekly oral Zithromax has been helpful as suppressing the symptoms of PANDAS. In other situations more advanced biomedical therapies such as intravenous immunoglobulins (IVIG) are needed to short-circuit the autoimmune response. Plasmapheresis, which is a blood cleansing process performed to help diminish the immune-toxin reactions, has shown benefit for some individuals as well. Unfortunately, no treatment is 100% effective for everyone, and some people remain symptomatic even after medical intervention. Great Plains Laboratory – www.greatplainslaboratory.com carries a Streptococcal Panel which highlights immune reactions to strep. If positive this can then be correlated with behavioral and physical manifestations related to PANDAS to see if a treatment trial is indicated.

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• Autism Treatment – Helicobacter Pylori and Autism
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• Autism Treatment – Dietary Treatment Options for Autism Treatment
• Autism Treatment – Using Methylation Chemistry for Autism Treatment

Autism as a diagnosis is established based on specific observed behaviors. In addition, there are also various language problems and social interaction issues. No two autistic individuals, whether they are a child, teenager or adult, are exactly the same. Each individual had their own unique wants and desires. Biomedical autism treatments such as dietary changes, supplement therapy and others can help with many of the core autism problems.

Every person with autism has their own unique personality that manifests in a variety of ways. For example, one child can be affectionate, while another appears more aloof. The same thing can be seen with behaviors where one person can be quick to tantrum or be aggressive, while another is calm and non-assertive. There are many interventions that can be utilized to help such as behavioral therapy and autism biomedical treatments.

Language problems, including both receptive and expressive is a major problem in autism. Some individuals are mildly affected, while others have a complete loss of speech. Once again, biomedical autism treatments such as Methyl-B12, folinic acid and Respen-A therapy have helped many with language problems.

Listed below are some core signs of autism that you should be aware of. Even though the severity of symptoms varies from person to person, each person with autism will likely have some issue from each category:

Communication and Language

Lack in speech or limited language development.

Echolalia (as a stereotypical behavior). This sign of autism manifests as repeating something over and over such as a phrase from a video or movie.

Difficulty initiating or maintaining conversation.

Difficulty understanding the nuisances of communication such as humor or concern.

Note: In addition to speech therapy commonly which is commonly implemented for these problems, biomedical autism treatments can help with language development too. I have treated many children in my practice with significant language problems and seen very positive response. One child in particular went from 30 words to over 300 words in 3 weeks with the use of Methyl-B12 therapy.

Social Engagement and Awkwardness

Poor eye contact, poor recognition of facial expressions or body posturing. Lack of social cues recognition

Decreased or absent interest in sharing enjoyment, i.e. playfulness with other people. Lack of humor appropriate for age.

Lack or diminished interest in developing friendships. Overall poor social engagement.
Empathy is lacking. Poor or complete lack of awareness for another person’s pain, desires, or ambitions. Rigid in thinking.

Needs constant order and structure.

Note: Many biomedical autism treatments such as Methyl-B12 therapy and/or the gluten/casein-free diet can help particularly with better eye contact and awareness of others.

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• Autism Treatment – Helicobacter Pylori and Autism
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• Autism Treatment – Dietary Treatment Options for Autism Treatment
• Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and Autism
• Chronic Yeast Toxicity and Autism
• Autism Treatment – Chronic Stress and Autism

The organic acid test is essential to analyze for yeast, and bacterial overgrowth. It is also helpful to assess the level of oxalate excretion, and other factors related to glutathione and antioxidant status, serotonin metabolism, quinolinic acid production (a marker for potential brain toxicity) as well as markers for in-born errors of metabolism including oxalate and amino acid dysfunction.

Case History Yeast and Pervasive Developmental Disorder (PDD-NOS)

Mark was one of my first ASD cases back in 1998. He was a 2 year old boy diagnosed with PPD-NOS (not otherwise specified). His development was typical of the history listed above. Multiple ear infections had led to repeated antibiotics for months on end. Loose stools were the norm as he struggled to maintain eye contact and learn in school. I ordered an Organic Acid Test (OAT) from Great Plains laboratory and discovered a massive amount of yeast metabolites – arabinose being the most common and quite elevated in Mark. Being new to biomedicine for autism all I knew (back in 1998) to do was make a recommendation for a gluten/casein-free diet and antifungal therapy. The anti-fungal medication was called Nystatin. Mark’s mother also implemented some basic supplements including a multi-vitamin and mineral, probiotics, and digestive enzymes.

After 18 months of continuous use of Nystatin, dietary modification and general nutritional support Mark was mainstreamed into regular school and continued to do well. His repeat OAT finally showed no yeast overgrowth. This case illustrated for me the powerful changes that could happen for an ASD child with basic dietary intervention and prolonged antifungal therapy.

Yeast has a tremendous effect on health. What are common in children with yeast overgrowth are behaviors that suggest dissociation, withdrawal, and aloofness. The most common behaviors that I see most commonly attributable to a yeast overgrowth problem are the following:

Poor eye contact.
Increased self-stimulatory behavior – fixating on spinning objects, odd hand movements including and finger-flicking in front of eyes.
Toe-walking.
Becoming withdrawn.
“Silly, goofy and/or giddy” – but this is not a behavior that involves other people. The child becomes silly, goofy and/or giddy to themselves. Parents will often describe that their child appears drunk.
Increased sugar craving.
Overall increased sensory seeking behavior, i.e. pressure

Other parents can describe more subtle differences, but those listed above are fairly common manifestations. What is most prevalent with “yeasty” behavior is a giddiness that mimics drugged or drunk behavior. When they are put on medications such as Nystatin or natural remedies, i.e. oregano oil, and/or grapefruit seed extract these behaviors improve.

Recommended Reading

• Autism Treatment
• Autism Treatment – Pandas, Probiotic Problems and Autism
• Autism Treatment – Autism Research and Brain Inflammation | microglia activation
• Autism Treatment – Behavior Changes in Treating Autism
• Helicobacter Pylori and Autism – What Tests to Perfom
• Autism Treatment – Helicobacter Pylori and Autism
• Autism Treatment–Specific Carbohydrate Diet (SCD)
• Autism Treatment – Dietary Treatment Options for Autism Treatment
• Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and Autism
• Common “Typical” Signs of Autism
• Autism Treatment – Chronic Stress and Autism