Autism: A Nutraceutical ApproachDecember 2007
By Julius G. Goepp, MD
More than 60 years after it was first identified, the diagnosis and treatment of autism remain challenging. This severe disability is on the rise in the United States and other industrialized countries, with rates from two to five times what they were in 1990.1 This statistic has prompted many concerned parents, physicians, and other health care providers to characterize the dramatic increase in autism as an epidemic.2,3
Despite the widespread prevalence of autism, numerous theories regarding its causes are undergoing debate within the medical community. At this time, treatment options for the condition are varied, as physicians strive to develop a standardized, results-oriented protocol.
Research has revealed that specific nutrients may play a key role in managing autism. In this innovative report, we present the latest scientific studies in which nutritional therapies have demonstrated benefits in combating this stubborn disease.
The Epidemic of Autism
Today, more families than even before are affected by the devastating conditions of autism and its related disorders. These puzzling conditions manifest during early childhood, producing social separation or aloofness, language delays, and impaired socialization skills.3,4
Mainstream approaches such as pharmaceuticals have failed to effectively manage autism. In the words of noted autism researcher and integrative medicine advocate Parris Kidd, PhD, “Conventional medicine has largely failed autistic individuals and their families.”5
Possible Causes of Autism
The failure of conventional medicine to cure autism may arise from the complexity of the condition itself. Physicians and scientists are still debating the very cause of autism, which remains a subject of much controversy.
Emerging theories suggest that there may be no single, fundamental cause of autism, but that it may instead represent a cluster of factors involving genes, inflammation, impaired gastrointestinal health, increased oxidative stress, diminished ability to neutralize toxins, autoimmune processes, and decreased mitochondrial function.3,6-10 Other proposed triggers of autism include vaccine preservatives and food additives.5,11-13
Integrative Approaches to Autism
In the words of Parris Kidd, PhD, “Fortunately, because of unprecedented collaboration between activist parents, progressive physicians, researchers, and allied health workers, autism has emerged as a model of successful integrative medicine.”5
Several coordinated approaches to autism are emerging from the bewildering amount of information that has accumulated in the past decade. These approaches focus on:
Although all treatments for autism should be administered in partnership with skilled physicians and other health care professionals, certain basic steps that are known to be effective and safe should be started as early as possible.
Dietary Modification: Healing the Gut
The majority of children with autism have impaired gastrointestinal health.3 Since more than half of the immune system develops and resides in the gut, where it neutralizes infectious microbes, the consequences of poor gut health can be serious indeed. The gastrointestinal tract is also essential in digesting foods, absorbing nutrients, and preventing toxic agents from reaching the circulation—functions that may often be impaired in autistic individuals. Children with autism almost always require special attention to the status of their gut health to keep these essential processes in good working order.
Many experts now agree that the most important first step in the integrative management of autism is to heal the gut and restore its integrity, which provides natural resistance to toxins. Dietary modification should be the foundation of healing the gut. A relatively easy first step is to eliminate simple sugars such as sucrose and glucose, which can promote the growth of harmful bacteria, and to eliminate artificial sweeteners and food additives, which often contain chemicals that act as internal toxins.2,5 At the same time, nutritional experts advise increasing intake of fiber, protein, and organic foods, and eliminating highly allergenic foods, which often include soy, eggs, peanuts, and tomatoes.
Many parents have also seen a multitude of noticeable benefits in their autistic children upon starting a casein- and gluten-free diet. Some experts believe that this is one of the single most effective dietary interventions that can be made, as many autistic children are unable to properly break down these dietary proteins in their bodies.5,14-16 Gut healing may begin almost immediately when these proteins are eliminated, though it may take several months to see the full benefit.5 Even so, removal of both gluten and casein simultaneously from the diet can be extremely challenging for children and parents, so some experts recommend a two-phase process, first removing dairy products, and later eliminating gluten.17 Careful coordination with a physician and a nutritionist is essential during this period.
Also because gluten and casein are found in so many common foods, and because children with autism are often “picky eaters” to begin with,5 parents should offer nutrient supplementation right at the beginning of the new diet. Many dietary supplements also have an added benefit by providing nutrients that have antioxidant, anti-inflammatory, and detoxifying properties.
Dietary Supplements That May Benefit Autistic Disorders
Dietary supplements are helpful in autism by promoting gut health and by preventing or reducing the effects of oxidative stress and inflammatory agents. They can also support a child through the effects of a detoxification program aimed at eliminating heavy metals such as mercury, which some believe is also a risk factor for autism.
The rest of this article examines promising research involving the use of specific nutrients for managing autism. Those responsible for caring for autistic people should always work closely with a health care provider who understands nutritional supplementation and can guide specific dosing.
Incomplete digestion of dietary proteins, especially casein or gluten, produces small “peptide” molecules that many investigators believe may contribute to some of the symptoms of autism.8,18-20 In animals, these incompletely digested peptides have been reported to cross the blood-brain barrier, contributing to symptoms of social indifference.3 Digestive enzymes such as trypsin, chymotrypsin, and amylase can be given orally to assist with the complete breakdown of proteins and carbohydrates, preventing the accumulation of nervous system irritants.21 The plant-derived enzymes bromelain and papain are widely used for their anti-inflammatory effects, and may help correct the digestive problems that frequently accompany autism such as bloating, flatulence, abdominal cramping, and diarrhea.22 Scientists are still investigating whether supporting gastrointestinal health with digestive enzyme supplements may help to improve the neurobehavioral symptoms of autism.
A normal, healthy population of intestinal bacteria plays a key role in the body’s detoxification system for heavy metals and other external toxins. This process is especially crucial in autistic children, who may have faulty elimination or an overload of toxic exposures. The abnormal gut environment in autistic people caused by inflammation, poor absorption, and antibiotic overuse, however, can allow the overgrowth of harmful bacteria and yeasts, which can produce toxic molecules and oxidants. High-dose probiotics are recommended to restore the natural bacterial balance23 and promote integrity of the gut mucosa.24 The two most commonly used probiotic bacteria are Bifidobacteria and Lactobacilli.
Scientists in the United Kingdom studied gastrointestinal bacteria in 150 children with autism. They found a very high prevalence of the harmful bacteria clostridia in children affected by autism, while clostridia were not present in the children’s non-autistic siblings. The gut microorganism clostridia can produce damaging neurotoxins that may contribute to the pathogenesis of autism. Researchers are intently studying which type of probiotic bacteria may most effectively combat clostridia in the hope of developing a novel approach to treating autism.25