Why All The Asthma, Allergies, ADHD and ASD?

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Our Canaries
Why All The Asthma, Allergies, ADHD and ASD? Autism One
Saturday, May 23, 2009 Chicago, IL
Nancy O’Hara, M.D. 150 Danbury Road Wilton, CT 06897 www.drohara.com
Excellence is the result of caring more than others think is wise, risking more than others think is safe, dreaming more than others think is practical and expecting more than others think is possible
Genetics Don’t Cause Epidemics
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Increases Over the Past 20 Years
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Autism:
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6000% Increase 400% increase 300% Increase 400% Increase 103% Increase
1/10,000 to 1/150 (Fombonne et al, JAACAP, 2001)
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ADHD: Asthma: Allergies: Diabetes:
7x increase in prescriptions (Swanson et al, Neuropsych Rev 2007)
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5 x increase in <5 year old (Bingley, 2007)
The Perfect Storm: Four Catastrophic Changes
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Toxin Proliferation
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Hydrocarbons Heavy metals Other (hormones, antibiotics, chemicals)
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Nutrition Deterioration Vaccination Rates Increased (3 -> 34) Ability to Detoxify Decreased
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Debilitation of Methylation and Sulphation
Toxins Inflammation
Oxidative Stress
Impaired Pieces of the Puzzle Glutathione and Sulfate
Toxins - Metals
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Mercury Lead Arsenic Other
Mercury Sources
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Vaccines (187.5 mcg mercury) Amalgams Fish Environmental
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Foundries (coal – burning) Medical/dental waste Fluorescent bulbs
Mercury – Amalgams
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Approximately 17mcg of mercury released from one amalgam daily (mostly from chewing) 8 amalgams ~ 136 mcg mercury vapor released daily 15 % (17mcg) absorbed daily Travels from blood to all organs and cells Mercury can concentrate in placenta during gestation and in fetuses (liver, kidney tissue) and infants (kidney, brain tissue) If >8 amalgams, statistically significant increase in autism 17 mcg/day absorbed by pregnant mother
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270 during pregnancy 4590 mcg during gestation
Mercury Fish
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6 oz (170 grams) flounder = 42.5 mcg Hg (0.6 mcg/kg for 70 kg man) 6 oz swordfish = 2.4 3 mcg/kg Most in swordfish, shark, tuna and sea bass Mercury affects fertility – Hong Kong study
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Subfertile (4.5 ppm) males had 40% more mercury than fertile (3.9 ppm) males Vegetarians – very low levels of mercury (0.38 ppm)
Texas autism rates, by school districts
Potential association between autism rates, environmental mercury other toxins in Texas
Palmer, et al., Health and Place, 12 (2006) 203–209
1990-1993
1998-2000
Autism rates
Palmer et al. Health & Place 12 (2006) 203–209
All Reporting Facilities, All Chemicals TRI-(1987-2002) Map shows 3,683 of 48,205 facilities reporting nationwide
On average, for each 1000 lb of environmentally released mercury, there was a 43% increase in the rate of special education services and a 61% increase in the rate of autism.
Chemicals-TRI
(Toxic Release Inventory)
Total toxicity
United Nations Environment Program Global Mercury Assessment, 2002
Lead
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Poisons developing nervous system Decrease in IQ (inverse correlation between IQ and blood levels at all ages (British Medical Journal 1996) Abortifacents
Lead Sources
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Metal Foundry Poorly regulated factories engaged in metal finishing, grid insertion, welding, casting Herbal Pills, cosmetics Cans, ceramics with lead solder Chili powder Cooking with Petroleum Toys painted with lead paint Exhaust emissions from leaded petrol Insecticides Lead pipes Burning of newspapers, batteries
Other Heavy Metals and Toxins
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Arsenic
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Pressured-treated wood Inorganic chickens (plus fed fish meal)
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Cadmium (industrial, incinerators) Antimony (flame retardants – Australia study: SIDS) Food additives
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MSG (neurotoxin) China study: 7 point decrease IQ in community with high fluoride levels
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Fluoride
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Toxins - Chemicals
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80,000 manmade chemicals Need 6,320 million tests to evaluate pairs 9 tested pesticides 7 of 9 found to be neurotoxins None have been banned
Chemicals
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PCBs/dioxins
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Disrupt thyroid and other hormonal loops Depress vitamin A Alter serotonin synthesis Impair cognition Depress IQ Increase preservative behavior in newborn monkeys fed levels commonly found in human BM (Rice, EnvRes, 1999)
Chemicals
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PDBE
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Flame retardant Endocrine effects Rocket fuel, fireworks Endocrine effects Carcinogens, neurotoxins
2003) (Vibera, ToxAppPharm,
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Perchlorates
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Pesticides and Herbicides
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Phthalates & Bisphenol A (BPA)
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Sources
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Plasticizers (#3 & #7) PVC Polycarbonate Food wrap
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High Correlation allergic rhinitis, eczema, asthma and house dust concentration of phthalates
Genetic Predisposition
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“Genes load the gun, environment pulls the trigger” (Sudhir Gupta, MD) Results in toxicities, nutritional deficits, infections, inflammation, immune dysfunction Epigenetics
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DNA of cell switched on/off -> profound function changes (Anway et al, Science, 2005)
Toxins Inflammation
Oxidative Stress
Impaired Pieces of the Puzzle Glutathione and Sulfate
Glutathione
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Detoxifies heavy metals and chemicals Antioxidant Preserve mitochondrial integrity and promotes ATP production Protects lining of gut Promotes normal T cell function
Toxins Inflammation
Oxidative Stress
Impaired Pieces of the Puzzle Glutathione and Sulfate
THE IMMUNE-GUT-BRAIN AXIS
Brain
Gut
Immune
Detoxification
Development of Mucosal Immunity
 
Balance of good and bad flora Healthy gut flora:
  
Plays a crucial role in maturation of the immune system 70% immune system in gut (sIgA) Sub-optimal stimulation of the sIgA-dependent mucosal barrier function → increased frequency of: • allergies & asthma • autism • inflammatory mucosal disorders • Increased Risk of Systemic Inflammation
Dysbiosis
A state of imbalanced microbial ecology both bacterial & fungal that contributes to disease The overgrowth of micro-organisms of low intrinsic virulence induces disease
•
•
by altering the nutritional status and/or the immune response of the host
How does it all fit?
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Maternal presence of decreased Ω3 & increased Ω6, leads to increased inflammation Commensal flora cultivated over 1st 2 years of life provides the baseline for immune development Early introduction of solid foods, esp. grains and sugar alters flora Early vaccination stimulates TLRs (innate immune system) and exacerbates TH1/TH2 imbalance and dysregulation!
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What lies behind us and what lies before us are small matters compared to what lies within us.
How Does It All Fit? The Immune Load
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Pathogens Overload (viruses, bacteria, yeast) Antibiotic Use (depletion probiotics) Insufficient Nutrient Load (Poor diet, junk foods) Digestive enzyme deficiency (Lactose) Vaccination Excess Stress
How Does It All Fit? What Does It Mean
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Digestive impairment Inflammation, leaky gut Immune deficiency  greater susceptibility to dysbiosis, inflammation, and food sensitivities  further immune deficiency (vicious cycle) Yeast overgrowth, bacterial dysbiosis
Toxins Inflammation
Oxidative Stress
Impaired Pieces of the Puzzle Glutathione and Sulfate
Factors Contributing to Oxidative Stress
Inflammation Infection
Genes
ASD ADHD LD
Hormones
Environment
Timing
Gut Inflammation Brain Inflammation Immune dysfunction
Four Phases of Detoxification Abnormalities Found with Oxidative Stress
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Phase I – keeping toxins in gut to safely exit body (dysbiosis, impaired immunity, slow transit) Phase II – toxins moved from gut to liver and converted into water-soluble material; “make sticky” (antioxidants, silymarin) Phase III – Conjugate toxins with detoxifying nutrients (GSH, taurine, NAC) Phase IV – Alkalinity more efficient
What Can We Do?
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Reduce and Eliminate Further Exposure Efflux Existing Toxins (Detoxification) The Three R’s
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Remove (germs, allergens, toxins) Replenish (nutrients, good foods, probiotics) Repair (inflammation, malabsorption, methylation)
Reduce Further Toxins
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Remove Amalgam Fillings Reduce Seafood (tuna, shark, swordfish, sea bass) Eat Organic Chicken Filter Water Eliminate Pollutants Avoid Vaccination containing mercury (flu)
Avoid Further Toxins
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Avoid lead
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www.cehca.org www.leadcheck.com
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Avoid #3 (PVC), #6 (styrene) and #7 (BPA) plastics
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www.checnet.org
Enhance Output of Toxins
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Correct constipation – all stool is toxic Maintain good hydration/fiber intake Maintain alkalinity (diet, HC03) Exercise to sweat
Keep Your Faith in All Beautiful Things: In the sun when it is hidden, in the spring when it is gone.
What do we need to give to or get out of our children?
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Exercise/Activity Basic nutritional changes (change in diet..)
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Fresh, unprocessed, unrefined, unadulterated Varied and rotational (try to vary day to day) Non-allergenic (crave that which most sensitive to) Protein (every 4-5 hours) Vegetable juicing
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Organic (especially pears, apples, peppers, celery, strawberries,
What To Do?
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Treat Constipation At least 1 normal stool/day Mg Vitamin C Fiber Senna Diet changes
What To Do?
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Remove
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Junk food, sugar, and other empty calories
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Food additives – Artificial Sweeteners (Aspartame), MSG, Dyes, Preservatives, etc Raw animal food/unpasteurized food – risk of food-borne illness Food Sensitivities – yours and those of your affected child
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Instead of Gluten, consider quinoa, amaranth, millet, rice or other grains Instead of Casein, consider potato or almond milk
What To Do? Remove Germs  Bacteria (history of positive response to
antibiotics)
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Bacteria (history of positive response to
• • •
Virus
Monolaurin (Lauricidin) Valtrex Cyclovir (acyclovir, valacyclovir, famcyclovir, gancyclovir) Virastop Antifungal medication (Nystatin, Diflucan, Sporonox, Lamisil,
Nizorel)
•
•
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Fungus
•
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OTC (Citrus extract, caprylic acid, saccharomyces boulardii) Diet (not because yeast in our diets is infective…)
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Parasites (have to treat)
What To Do?
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REMOVE AMALGAMS – When? How?
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At least 3 to 6 months before conception while under the care of a competent/holistic Physician and Dentist PRE-Amalgam replacement regimen  Start at least 3-4 wks prior  Consider a good Probiotic, Glutathione, Vitamin C, Vitamin E, Milk thistle, B-Vitamins, Zinc, Magnesium, etc.  Consider taking Activated Charcoal 15 minutes before procedure starts (to help bind swallowed mercury and prevent circulation of the metal) AND immediately after the procedure POST-Amalgam replacement regimen  Continue at least 4 to 6 weeks after  As above plus… consider IV Vitamin C within 24 hours of procedure, double glutathione dose, amino acid complex (mercury may deplete or impair utilization of several amino acids, far infrared sauna therapy 3x/week
What To Do? Replenish and Support Digestion  Enzymes (speeds disassembly of
foods;

-ase)
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Mixed (helps kids with poor digestion) • Plant based (papaya and pineapple) • Peptidase specific (helps specific peptide digestion) Symptomatic (yeast die off) • Activated charcoal (mop up toxins)
•
What To Do?
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Replenish Probiotics
• • • •
•
• •
Promote growth of healthy flora Discourage pathogens Support digestion Produce SCFAs, reduce pH, synthesize vitamins Control inflammation and promote oral tolerance Encourage peristalsis Minimum of 10 billion CFU/day, often > 50 billion CFU/day
What To Do Fatty Acids and Immunity
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ESSENTIAL FATTY ACIDS (EFAs)
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DHA more important during pregnancy and breastfeeding periods (DHA is in breast milk, not std formulas) Associated with brain development, visual acuity and decreased inflammation Maternal DHA levels ↓ in 3rd T – 200 mg/day DHA increases level in mom, but need higher doses (~1000 mg/day) to also ↑ levels in infant. Take with antioxidant (Vit E) to prevent free radical damage Make sure product is pure
What To Do Fatty Acids in Childhood
Both DHA and EPA are important (any ratio of 33-66% DHA:EPA is recommended) Dosages need to be tailored in line with severity of the condition. Children 1-4 yrs 600-1800mg DHA/EPA per day Children 4-12 yrs 1000-3500mg DHA/EPA per day
What To Do Fatty Acid Status in ADHD
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Both conditions strongly correlate with low red blood cell membrane concentration of DHA,EPA,and GLA Lower levels of DHA and EPA also correlate with increased severity of conditions Stevens et al 1996 Forty one children with ADHD and associated learning disorders ( mainly dyslexia) were supplemented with 480mg DHA 186mg EPA and 96mg ALA for 10 weeks.
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Significant improvement found in:
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Four global scales of ADHD measurement Four out of seven sub-scales of the Comprehensive Parent Rating Scale Numerical but not significant improvement in two other scales
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What To Do? Replenish Nutrients
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Iron Magnesium Calcium Selenium Zinc Vitamins C, A, E, D, Bs
GIVE TMG MB12 shots Folinic acid ADD DPPIV AVOID CASEIN GIVE P5P REDUCED GLUTATHIONE
THERAPEUTIC T H INTERVENTIONS T H E
What To Do? Replenish Nutrients
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IRON
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Important in oxygen transportation, cell differentiation and heme/RBC function Associated with enzymes involved in energy production and metabolism. Also a cofactor in neurotransmitter synthesis. Low levels in infancy can be associated with↓ cognitive performance in teens (even if treated early) With deficiency – anemia, malabsorption, fatigue Take with Vitamin C to boost absorption Sources: liver, meat, seafood, spinach, kidney
What To Do? Replenish Nutrients
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CALCIUM
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Many women are deficient before pregnancy Reduces preeclampsia Vitamin D status is important in calcium absorption Important in bone health, enzyme activity, muscle contraction, neurotransmitter release, blood clotting Bone/tooth/muscle/nerve function; cell membrane permeability Deficiency causes rigidity, poor sleep, anxiety, teeth grinding Secondary deficiency Absorption vs taste Sources: tofu, green leafy vegetables
What To Do? Replenish Nutrients
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MAGNESIUM (Martineau et al, 1985)
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> 300 enzymatic functions; neuromuscular, neurotransmitters, BP Deficiency causes hyperactivity, anxiety, twitches, insomnia Sighing/salt craving/constipation ↓ magnesium associated with pre-eclampsia, pre-term delivery, and fetal growth retardation
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Chromium
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Important for glucose control, insulin/liver function With deficiency – insulin resistance, Syndrome X, neuropathy
What To Do? Replenish Nutrients
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SELENIUM
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Important for proper fetal growth/development ↓ selenium has been associated with some SIDS cases Important for redox reactions, antioxidant With deficiency – immune dysfunction, cell fragility With excess – fatigue, brittle hair/nails, parasthesias Toxicity in high doses (> 1000 mcg/day) Sources: wheat germ, brazil nuts, oats With deficiency – poor detoxification, chemical sensitivity With excess – high uric acid, low copper, anemia

Molybdenum
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What To Do? Replenish Nutrients
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ZINC
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Important part of most enzymes, protein synthesis, cell growth, sensory function (taste, etc), and hormone and immune function (Sturniolo et al, 2001) > 200 enzymatic functions; in energy metabolism, protein, immunity, detox Acne, mouth sores, spots/lines on nails, pica, loss of smell, taste Deficiency causes language, attention and immune issues Best given alone, at night (piccolinate, acetate) Deficiency is teratogenic in rats, abnormal brain development seen in monkeys Ratio with copper; taste test Excess zinc can displace copper and ↓ copper can be harmful to fetus Sources: animal protein, seeds, nuts, beans
What To Do? Replenish Nutrients
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Vitamin C (ascorbic acid)
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Anti-oxidant, helps balance amino acids, hormone levels, important in collagen metabolism (critical for immune function, nerve transmission, carnitine) With deficiency – bruising, poor immune function, anxiety, depression (diarrhea with excess Sources: citrus, broccoli, brussel sprouts, peppers Anti-oxidant, incorporates into fatty part of cell membranes and helps protect cells from heavy metal/chemical damage, boost immunity and sulphation (glutathione and methylB12) With deficiency – jaundice, xs clotting, impaired reflexes Sources: seeds, nuts, polyunsaturated fatty acids
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Vitamin E
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What To Do? Replenish Nutrients
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VITAMIN D
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Important for calcium absorption ↓ associated with various chronic illnesses Daily sun exposure for 20 minutes should be enough to avoid extra oral supplementation beyond what is in the prenatal vitamins Sources: cod liver oil, salmon, herring, egg yolks Teratogenic (birth defects with > 10,000 IU/d – NEJM Study) Anti-oxidant, anti-viral, and immune regulation functions With deficiency – vision, immune dysfunction Sources: liver, carrot, dandelion root, kale
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Vitamin A
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What To Do? Replenish Nutrients
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B12 (COBALAMIN)
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Important in synthesis of DNA, RBC’s, and the myelin sheath (nerve transmission) Produced in gut by good flora – chronic antibiotic use decreases B12 levels Deficiency - decreased communication, anemia, memory loss, poor balance Methyl B12- SQ, IN, TD, oral; need adequate folate Sources: animal foods – liver, kidney, eggs, fish, cheese, meat Important for intracellular metabolism and DNA synthesis/repair 400 mcg/day associated with ↓ incidence of neural tube defects and pregnancy loss Sources: green leafy vegetables, asparagus, oranges,

FOLATE
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What To Do? Replenish Nutrients
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B1 (thiamine)
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Part of an enzyme essential for energy production, carbohydrate metabolism, and nerve cell function Deficiency can cause ataxia, enuresis, sensory loss) Sources: brown rice, sunflower seeds, peanuts Important in energy production and regeneration of glutathione Deficiency can cause mouth fissures, photophobia Sources: organ meats, almonds, mushrooms, whole grains
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B2 (riboflavin)
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B3
 
Important for energy production and regulation of blood sugar, antioxidant mechanisms, and detoxification reactions Sources: organ meats, eggs, fish, peanuts
What To Do? Replenish Nutrients
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B5 (pantothenic acid)
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B6 (PYRIDOXINE; P5P)

Deficiency can cause toe walking, grinding, restlessness, insomnia Important in immune function (antibody formation), protein formation, nerve transmission, and RBC and prostaglandin formation Deficiency can cause immune dysfunction, anemia, sensory issues, tantrums) Sources: whole grains, legumes, bananas, seeds, nuts, sprouts Deficiency leads to poor communication Give with folate to decrease hyperactivity
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B15 (DMG/TMG)
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Repair

Oxidative Stress
•
Antioxidants do not work alone (more like rungs of a ladder; vitamins A, C, D, E, glutathione, pycnogenol)
   
Gut (germs, enzymes, clean out) Immune -EFAs Hormonal Detoxification
You gain strength, courage and confidence by every experience in which you really stop to look fear in the face…. You must do the thing you think you cannot do. -Eleanor Roosevelt
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Breast is BEST! ∀ ↑ Production of beneficial Bifidobacter in 1st year Delay introduction of solid foods, minimizing or avoiding wheat & milk, support flora Infants with a family history of atopic allergy who received a Lactobacillus probiotic had a 50%  in atopy @ 2yo
How does it all fit? Fostering A Healthy Environment
Fostering A Healthy Environment
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Foods Start soon after 6 months (some studies show that waiting too long after that increases the incidence of allergies, etc)
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Good options for first foods are avocado, fruits and vegetables Avoid any foods that siblings or parents are sensitive to

Fostering A Healthy Environment

Vaccines
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Consider modified schedule –separate all vaccines in time (gives child’s immune system more time to develop) Always use Thimerosal free vaccines Avoid Flu shots unless necessary Avoid vaccines during pregnancy Support with antioxidants (Glutathione, Vitamin C, A, E) Keep children on nutrient-rich diets Do not give to sick kids (fever, cold, on antibiotics, etc)
Follow those who seek the truth but flee from those who have found it. Yaclav Havel
Basic biomedical interventions
 
HEAL THE GUT Avoid what harms
   
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Gluten? Casein? Additives? Toxins? Nutrients (MVI) Probiotics Omega 3 EFAs

Give what heals
  
FIX METABOLIC PROBLEMS  Additional Vitamins/Minerals  Magnesium  Calcium  Iron  Antioxidants  Vitamins A, C, D, E  Anti-inflammatories  Pycnogenol  Detoxification  Sweat
What Is It That My Child Needs:
  
To Get To Get Rid Of My Courage
“Courage does not always roar. Sometimes it is the quiet voice at the end of the day saying, “I will try again tomorrow.”