GI Biology, Pathology,
and Treatment Strategies
Autism One Conference
Canada
October 2009
Sonja Hintz, R.N.
Anju Usman, M.D.
True Health Medical Center
Naperville, Illinois
What Defeat Autism Now
Doctors know about GI issues…
• Autism is a neuro-immune inflammatory
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condition affecting the gut and brain
Much of the inflammation originates in the gut
Many of the symptoms we call autistic, are
related to the gut
Treating the gut, is one of the most
successful biomedical interventions
Healing the Gut is the Key to success
What does the gut do for us?
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Protection/Barrier
Immune Protection
Provides Fuel/Nutrition
Transportation/Motility
Digestion (stomach, duodenum, jejunum)
– Fats
– Carbohydrates
– Protein
Absorption (ileum)
Waste Removal (colon)
The GI tract is our
first line of defense
against the outside
world.
• Absorptive surface of
the GI tract is 200
times larger than the
surface area of the
skin (400 square
meters)
GI Histology
100 trillion bacteria in
the gut
Early disruption of gut
flora, affects later
immune function,
potential allergies and
autoimmunity
Good flora protects us
from pathogens
Aids with digestion of
carbohydrates and fiber
to form SCFA which in
turn fuels enterocytes
Gut Microbiota
Human Microbiome Project
• 5yr/ $140 million effort to study and explore how the
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trillions of microscopic organisms in our bodies affect our
health.
Total microbial cells found in association with humans
may exceed the total number of cells making up the
human body by a factor of 10:1.
The total number of genes associated
with the human microbiome could
exceed the total number of human genes
by a factor of 100:1
Organisms expected to be found, bacteria
yeast, protazoa, parasites viruses,
bacteriophages
The Immune System in the Gut
GALT (gut-associated lymphoid tissue) with organized lymphoid
structures — Peyer's patches and isolated lymphoid follicles
The diffuse tissues of the lamina propria contain a large number
of immunoglobulin A (IgA)+ plasma cells, T and B cells,
macrophages, dendritic cells (DCs) and stromal cells (SCs)
The Gut/Brain/Immune Connection
The Vagus nerve inherently communicates with
the splenic nerve to suppress TNF alpha production
by macrophages in the spleen and modulate
immune function. (Dr. Rosas-Ballina)
• Parasympathetic
• Efferent or Motor
• Afferent or Sensory (80%)
• Back to the brain from the ear,
tongue, larynx, GI
• Dorsal Vagal Nucleus
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Motor to Pharynx, Larynx, GI..
• Releases ACh (acetylcholine)
• Nicotinic Receptors
• Muscarinic Receptors
Physiology and immunology of the cholinergic
anti-inflammatory pathway
J Clin Invest. 2007 Feb;117(2):289-96.
Tracey KJ.
• The nervous system, via an inflammatory reflex
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of the vagus nerve, can inhibit cytokine release
and thereby prevent tissue injury and death.
The efferent neural signaling pathway is termed
the cholinergic antiinflammatory pathway.
Cholinergic agonists inhibit cytokine synthesis
and protect against cytokine-mediated diseases.
Stimulation of the vagus nerve prevents the
damaging effects of cytokine
Gastrointestinal Dysfunction (literature)
• Maldigestion
– Decreased activity of digestive enzymes (Horvath,1999. Buie, 2004)
– High levels of opioid peptides found in urine of autistics. (Reichelt, 1997)
• Malabsorption
• Dysbiosis
– Dysbiosis or altered bowel flora (Rossenau, 2004)
– Clostridial overgrowth (Sandler, 2002)
– Persistent measles virus (Wakefield, Krigsman)
• Immune Dysregulation (allergy, autoimmunity, inflammation, deficiency)
– Autistic Enterocolitis, Lymphoid Hyperplasia (Wakefield, Krigsman, Balzola
– Increased intestinal permeability leading to food sensitivities
and autoimmunity (Vodjani, 2002)
– Increased pro-inflammatory cytokines – LP, TNF alpha, IFN gamma
(Ashwood, 2004)
– Proinflammatory response to dietary proteins (Jyonuchi, 2004)
– Low Secretory IgA (Gupta, 1996)
• Motility
– Gastroesophageal Reflux associated with aggressive behavior(Buie)
Gastrointestinal Dysfunction (experience)
• Maldigestion
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IgG Food Sensitivities (dairy, gluten, soy…)
Poor weight gain
Low Essential Amino Acids
Low Stomach Acid/Bloating
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Fat Soluble Vitamin Deficiencies
Essential Fatty Acid Deficiencies
Low weight and height
Dry-Bumpy Skin, Ear Wax Excess, Floating Stools
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Chronic Strep Issues
Chronic Anaerobic Overgrowth (clostridia sp.)
Chronic Small Bowel Bacterial Overgrowth (SBBO)
Chronic Yeast/Fungal Overgrowth
• Malabsorption
• Dysbiosis (fungal, bacterial, viral)
• Immune Dysregulation/Inflammation
– Behaviors, Stims, Sleep disorder, Posturing, Aggression, Self Injurious
• Motility
– Chronic Constipation, Reflux, Burping, Hypotonia
Measles Virus, Colitis, and ASD
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Mol Pathol. 2002 Apr;55(2):84-90.
Potential viral pathogenic mechanism for new variant
inflammatory bowel disease.
Uhlmann V, Martin CM, Sheils O, Pilkington L, Silva I, Killalea A, Murch SB, Walker-Smith J,
Thomson M, Wakefield AJ, O'Leary JJ.
form of inflammatory bowel disease (ileocolonic lymphonodular hyperplasia)
SeventyAhasnew
five
91 patients
a histologically
beenof
described
in a cohortwith
of children
with developmentalconfirmed
disorder. This study
investigates
thelymphonodular
presence of persistent hyperplasia
measles virus in the
intestinal
tissue of
diagnosis
of
ileal
and
enterocolitis
these patients (new variant inflammatory bowel disease) and a series of controls by
were positive
for measles virus in their intestinal tissue
molecular analysis.
compared with five of 70 control patients. Measles virus was
RESULTS: Seventy five of 91 patients with a histologically confirmed diagnosis of ileal
identified
within the
follicular
dendritic
cells
and
some virus in their
lymphonodular
hyperplasia
and enterocolitis
were
positive
for measles
intestinal tissue compared with five of 70 control patients. Measles virus was
lymphocytes
foci
reactive
hyperplasia.
identified in
within
the of
follicular
dendriticfollicular
cells and some
lymphocytes in foci of
reactive follicular hyperplasia. The copy number of measles virus ranged from one
to 300,00 copies/ng total RNA.
CONCLUSIONS:
The data confirm an association between the
presence of measles virus and gut pathology in children with
developmental disorder.
PMID: 11950955
Bacterial Co-infections and ASD
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J Neurosci Res. 2007 Apr;85(5):1143-8.
Evidence for Mycoplasma ssp., Chlamydia pneunomiae, and
human herpes virus-6 coinfections in the blood of patients with
autistic spectrum disorders.
Nicolson GL, Gan R, Nicolson NL, Haier J.
– We examined the blood of 48 patients from central and southern
California diagnosed with autistic spectrum disorders (ASD) by using
forensic polymerase chain reaction and found that a large subset
(28/48 or 58.3%) of patients showed evidence of Mycoplasma spp.
infections compared with two of 45 (4.7%) age-matched control
– We found that Mycoplasma-positive and -negative ASD patients had similar
percentages of C. pneumoniae and HHV-6 infections, suggesting that such
infections occur independently in ASD patients. Control subjects also had
low rates of C. pneumoniae (1/48 or 2.1%) and HHV-6 (4/48 or 8.3%)
infections, and there were no coinfections in control subjects.
– The results indicate that a large subset of ASD patients shows
evidence of bacterial and/or viral infections (odds ratio = 16.5, P <
0.001). The significance of these infections in ASD is discussed in
terms of appropriate treatment. (c) 2007 Wiley-Liss, Inc.
PMID:17265454
Propionic Acid, Dysbiosis and ASD
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Behav Brain Res. 2007 Jan 10;176(1):149-69. Epub 2006 Sep 1.
Neurobiological effects of intraventricular propionic acid in rats:
possible role of short chain fatty acids on the pathogenesis and
characteristics of autism spectrum disorders.
MacFabe DF
– PPA is a by-product of a subpopulation of human gut enterobacteria
and is a short chain fatty acid and an important intermediate of cellular
metabolism. Also a common food preservative.
– PPA produced reversible repetitive dystonic behaviours, hyperactivity,
turning behaviour, retropulsion, caudate spiking, and the progressive
development of limbic kindled seizures, suggesting that this compound
has central effects.
– Biochemical analyses of brain homogenates from PPA treated rats
showed an increase in oxidative stress markers (e.g., lipid peroxidation
and protein carbonylation) and glutathione S-transferase activity
coupled with a decrease in glutathione and glutathione peroxidase.
– PPA treated rats revealed increased reactive astrogliosis (GFAP
immunoreactivity) and activated microglia (CD68 immunoreactivity)
suggestive of a neuroinflammatory process.
PMID: 16950524
Clostridia and ASD
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Clin Infect Dis. 2002 Sep 1;35(Suppl 1):S6-S16.
Gastrointestinal microflora studies in lateonset autism.
Finegold SM
– Some cases of late-onset (regressive) autism may involve
abnormal flora because oral vancomycin, which is poorly
absorbed, may lead to significant improvement in these children.
– The number of clostridial species found in the stools of children
with autism was greater than in the stools of control children.
– The most striking finding was total absence of non-spore-forming
anaerobes and microaerophilic bacteria from control children and
significant numbers of such bacteria from children with autism.
– These studies demonstrate significant alterations in the upper and
lower intestinal flora of children with late-onset autism and may
provide insights into the nature of this disorder.
Clostridia and ASD
• J Child Neurol. 2000 Jul;15(7):429-35. Links
Short-term benefit from oral vancomycin treatment of
regressive-onset autism
Sandler RH, Finegold SM, Bolte ER, Buchanan CP, Maxwell AP, Väisänen ML,
Nelson MN, Wexler HM.
– We speculated that, in a subgroup of children, disruption of indigenous
gut flora might promote colonization by one or more neurotoxin-producing
bacteria, contributing, at least in part, to their autistic symptomatology.
– Entry criteria included antecedent broad-spectrum antimicrobial exposure
followed by chronic persistent diarrhea, deterioration of previously
acquired skills, and then autistic features.
– Short-term improvement was noted using multiple pre- and post-therapy
evaluations. These included coded, paired videotapes scored by a clinical
psychologist blinded to treatment status; these noted improvement in 8 of
10 children studied. Unfortunately, these gains had largely waned at
follow-up.
– These results indicate that a possible gut flora-brain connection warrants
further investigation, as it might lead to greater pathophysiologic insight
and meaningful prevention or treatment in a subset of children with
autism.
PMID: 10921511
PANDAS
Pediatric Autoimmune Neuropsychiatric Disorder Associated
with Streptococcus
• Presence of obsessive-compulsive disorder and/or a
tic disorder
• Pediatric onset of symptoms
• Episodic course of symptom severity
• Association with group A Beta-hemolytic
streptococcal infection (a positive throat culture for
Strep or history of Scarlet Fever)
• Association with neurological abnormalities (motoric
hyperactivity, or adventitious movements, such as
choreiform movements)
• Diagnoses based on symptoms and High ASO and
AntiDNAse AB
Chronic Infectious Agents and
Chronic Disease Effects
• These agents create inflammation, free radicals
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and oxidative stress.
Some of these biologic agents produce
neurotoxins and excitotoxins and other toxic byproducts.
Some agents increase cell membrane
permeability.
Our body may produce antibodies to these
agents. These antibodies may cross react with
our own tissue creating an autoimmune reaction.
This is called molecular mimicry.
Chronic infections disrupt neurotransmitters
Impact of Oxidative Stress on Methionine Metabolism
Methionine
MAT
THF
SAM
MTase
MS
B12
BHMT
5-CH3THF
Betaine
Choline
THF: tetrahydrofolate
SAH
SAHH
Adenosine
Homocysteine
B6
B6
CBS
AK
AMP
ADA
Inosine
Cystathionine
Cysteine
Enzymes
Methylation of DNA, RNA,
Proteins, Catecholamines,
Phospholipids, Creatine
Glutathione
Transsulfuration
Pathway
GSSG
Basic Biomedical Strategy
• History and Physical Examination
• Laboratory Testing
• Clean Up
– Environmental Controls
– Dietary Interventions
– Address Gastrointestinal Health
• Foundational Nutrients
• Treat Underlying Immune Issues and
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Inflammation
Support Detoxification Pathways, esp.
Methylation and Sulfation
Address Mitochondrial Dysfunction
Heavy Metal Detoxification
History - Gastrointestinal
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History of Colic, Reflux
Frequent Antibiotics
Dairy Intolerance, Sugar Cravings
Frequent Otitis Media or Sinusitis
History of Thrush, Severe Diaper Rash
Poorly Formed Stools, Odd Color, Consistency,
Odor, Mucus, “Soft Serve”
Undigested Food in Stools, Floating Stools
Constipation, Chronic Diarrhea, Both
Abdominal Distention, Gassiness
Abnormal Posturing
Self Injurious Behavior, Aggression
Poor Sleeping Habits
Physical
• Poor growth – height, weight, head circumference
• Pale skin, spider veins, long eye lashes
• Skin- rash, sand paper skin, eczema, warts, acne
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molluscum contagiosum, red anal ring
Dilated pupils, lack of eye contact, divergent gaze,
poor visual tracking, squinting
Allergic shiners, Nasal crease, Mouth breathing
Nails – spots, ridges, fungus
Coated tongue or thrush, mouth ulcers, cracked lips
Enlarged tonsils
Lymphadenopathy
Spleen tenderness
Abdominal bloating
Hypotonia, W-sitting, Flabby muscles, Strabismus
Ligamentous laxity (double jointed)
Signs of precocious puberty- facial hair, pubic hair
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Clean up the Child’s Diet
• Casein-free/Gluten-free/Soy-free Diet Trial for 3-6 months.
• Avoid sugar and refined starch, high fiber diet, maximize
antioxidants, cruciferous veggies, turmeric, garlic…
• Limit processed and preserved foods; organic is best.
• Avoid excitotoxins (ex. Caffeine, MSG, NutraSweet, red/yellow food dyes,
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nitrites, sulfites, glutamates, preservatives).
Limit intake of phenolics (apples, grapes, strawberries).
Limit sources of Copper (chocolate, shellfish, tap water, artificial food dyes).
Drink plenty of clean filtered water.
Eliminate seafood.
Begin meals with raw fruits and veggies.
Add good fats (cold pressed, hexane-free) – oils, nuts, seeds.
Avoid hydrogenated, trans-fats, fried or heated fats.
Buy hormone-free, antibiotic-free, organic, GMO-free especially
animal products such as eggs, meat and dairy.
Add fermented foods (coconut kefir, cabbage, kombucha).
Dietary Detours
CF/GF Diet
Persistent Gut Issues
Hyperactivity/Stimming
Specific
Carbohydrate
Diet
Avoid Excitotoxins
Body Ecology
Diet
Low Phenolic/Feingold
Diet
Low Oxalate
Diet
Low Copper Diet
Elimination/Rotation
Diet
Elimination/Rotation
Diet
Opioid Peptides
• Casein/gluten peptides are broken down by the
enzyme DPPIV(dipeptidyl dipeptidase 4). This
enzyme can be disabled by toxic metals and yeast.
• These peptides act as false neurotransmitters,
creating problems with behavior, focus, attention,
mood regulation, and processing info. Other
symptoms include high pain tolerance, dilated pupils,
addiction to dairy and gluten products.
• High levels of opioid peptides (gliadorphin and
caseomorphine) found in urine of autistics. (Reichelt,
1997)
• Casein-free, Gluten-free diet may be an effective
intervention (Whiteley,1999)
Specific Carbohydrate Diet
Elaine Gottschall BA, M.Sc.
• The allowed carbohydrates are monosaccharides and have a single
molecule structure that allow them to be easily absorbed by the
intestine wall.
• Complex carbohydrates which are disaccharides (double molecules)
and polysaccharides (chain molecules) are not allowed.
• Complex carbohydrates that are not easily digested feed harmful
bacteria in our intestines causing them to overgrow producing by
products and inflaming the intestine wall.
• “The diet works by starving out these bacteria and restoring the
balance of bacteria in our gut.”
www.breakingtheviciouscycle.info/beginners
www.pecanbread.com
Celiac Disease Presenting as Autism
Stephen J. Genuis, MD, and Thomas P. Bouchard, BSc
Gluten-restricted diets have become increasingly popular among parents
seeking treatment for children diagnosed with autism. Some of the reported
response to celiac diets in children with autism may be related to
amelioration of nutritional deficiency resulting from undiagnosed gluten
sensitivity and consequent malabsorption. A case is presented of a 5-year
old boy diagnosed with severe autism at a specialty clinic for autistic
spectrum disorders. After initial investigation suggested underlying celiac
disease and varied nutrient deficiencies, a gluten-free diet was instituted
along with dietary and supplemental measures to secure nutritional
sufficiency. The patient’s gastrointestinal symptoms rapidly resolved, and
signs and symptoms suggestive of autism progressively abated. This case
is an example of a common malabsorption syndrome associated with
central nervous system dysfunction and suggests that in some contexts,
nutritional deficiency may be a determinant of developmental delay. It is
recommended that all children with neurodevelopmental problems be
assessed for nutritional deficiency and malabsorption syndromes.
Child Neurol OnlineFirst, published on June 29, 2009
Low Oxalate Diet (LOD)
Susan Owen BS
• Oxalates are abundant in many plant foods
• When the gut is inflamed or becomes permeable
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excess oxalate from foods can be absorbed
When present in high amounts can lead to oxidative
damage, depletion of glutathione, and inflammation
Excess oxalates form crystals after binding with
calcium
Symptoms include: Pain, Burning, Frequent
Urination, Eye Poking, Family history of Kidney
Stones, Vulvodynia
Avoid High Oxalate Foods
– Spinach, Greens, Nuts, Soy, Beets
Avoid Calcium and High Doses of Vitamin C
Food additives and hyperactive behavior in 3-yearold and 8/9-year-old children in the community: a
randomized, double-blinded, placebo-controlled trial
• The Lancet 2007
• examined the effect of artificial coloring and preservatives on
hyperactive behavior in children. After consuming an additive-free
diet for six weeks, the children were given either a placebo beverage
or one containing a mix of additives in two-week intervals. In the
additive group, hyperactive behaviors increased.
• the study caused many pediatricians to rethink their skepticism about
a link between diet and A.D.H.D. “The overall findings of the
study are clear and require that even we skeptics, who
have long doubted parental claims of the effects of
various foods on the behavior of their children, admit we
might have been wrong,” reported a February issue of AAP
Grand Rounds, a publication of the American Academy of Pediatrics.
Excitotoxins - Glutamate
• Anti- Glutamates
• Glutamates
– Monosodium
Glutamate (MSG)
– Hydrolyzed Protein
– Modified Food Starch
– Natural Flavors
– Peas, Mushrooms,
Tomatoes
– Parmesan Cheese
– Protein
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Pycnogenol
Rosemary, Lemon Balm
Skull Cap, Chamomile
Magnesium
Taurine
GABA
L- Theanine
Vitamin K
Lithium
Namenda (drug)
Minocycline (antibiotic)
Excitotoxins = Substances that cause an excess of excitatory
neurotransmission in the brain. If inhibitory neurotransmission is
lacking, the excess excitation may lead to neuronal death.
Neuronal death leads to chronic inflammation in the brain.
Lab Options for Gut Issues
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Urine Organic Acids Test (OATS, MAP)
Stool Microbiology
Stool Mycology
Stool Parasitology
IgG/IgE Food/Mold Antibody Panel
Celiac Panel, Carnitine level, Vit D25 OH, retinol
Fecal Fat
Breath Test for Fructose Malabsorption
Inflammatory Markers (ESR, CRP, histamine,
calprotectin,…)
• Ammonia - blood,urine
• IBD Serology (prometheus testing)
• Endoscopy, Colonoscopy if necessary
General Treatment Strategies
• Address Maldigestion – Add Digestive Enzymes
• Address Malabsorption
– Add Probiotics, Essential Fats
– Address Fat Soluble Vitamin Deficiencies
– Add Lipase
• Address Dysbiosis
• Diagnose and Treat Immune Dysregulation
– Address Food Hypersensitivities
– Treat Immunodeficiencies
– Treat Chronic Inflammation
• Address Motility/Constipation
Clean up the Child’s Gut
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Daily bowel movements are a goal.
Add digestive enzymes with meals.
Start high potency probiotics.
Start treatment for dysbiosis.
Address constipation.
Check for high ammonia, treat accordingly
If persistent symptoms:
– Eliminate disaccharides from diet for 3-6 months
• Specific Carbohydrate Diet
– Consider referral to knowledgeable GI specialist
– Consider trial of IV or nasal Secretin
– Add anti-inflammatory agents.
Keep close eye on gut during any detox regimen.
Acute regression most likely due to gut issues.
Constipation has got to go!
• May mask as
diarrhea
• Check a KUB xray
• If it takes greater
than 24 hrs to pass
charcoal or beets,
consider motility
issues
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Magnesium citrate
Buffered Vitamin C
Increased fiber/fluids
Avoid opiate peptides
Massage, Rebounding
Senna
Polyethylene glycol
Suppositories or
Enemas if needed
Cholinergic Agents
– Urecholine
– Phosphatidyl Choline
Treating Dysbiosis/Co-infections
• Clostridia
• Yeast
• Bacteria and Strep
• Parasites
• Viruses
Clostridia
produce toxins
and enzymes
that create
severe gut
inflammation
and produce
watery
diarrhea
Clostridia Issues
Symptoms
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Aggressive
OCD
Temper
Agitation
Irritable
Very foul stools
Mucus in stools
Severe diarrhea following
antibiotic use
Treatment
– Probiotics, High Potency
single strain
– Sacchyromyces Boulardii
– Antibiotics
• Vancomycin
• Metronidazole (Flagyl)
– Herbals
– Immune modulators
– Homeopathics
– HBOT
– Carnitine
Yeast Issues
Symptoms
– Spacey
– Foggy thinking
– Inappropriate
laughter
– Sugar cravings
– Poor sleep
– Frequent diaper rash
– Frequent urination
– History of frequent
antibiotics
Treatment Options
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Limit carbs, sugar, yeast
Probiotics
Sacchromyces Boulardii
Zinc, Molybdenum
Antifungals
• Drugs
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Nystatin, Ampho B
Fluconazole
Itraconazole
Ketoconazole
• Herbals
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Berberine
Grapefruit Seed Extract
Oil of Oregano, Pau d’Arco
Garlic, Samento, …
– Enzymes
– Homeopathics
Strep Issues
Symptoms
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Ritualistic
Repetitive
Verbal tics
Obsessive
Compulsive
Verbal stims
Frequent strep
infections
– Frequent bacterial
infections
Treatment Options
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Probiotics
Alkalinization
Xylitol
Antibacterial Herbs
• Goldenseal
• Neem
• Berberine
– Immune modulators
• Oral Immunoglobulins
• Transfer Factors
• Colostrum
• Mushroom Extracts
• Beta Glycans
• Plant Sterols
– Drugs
• Penicillin
• Zithromax
– Homeopathics
Parasites
Symptoms
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Bizarre Behavior
Insatiable Appetite
Aggressive
Worse at full moon
Picking, biting, licking,
itching, grinding
– Fecal smearing
– Restlessness
Treatment
– Probiotics
– Antiparasitic Drugs
• Flagyl
• Paromomycin
• Mebendazole
• Alinia
– Natural Remedies
• Wormwood(artemesia)
• Black Walnut
• Pumpkin Seeds
• Clove
• Coconut Oil
– Homeopathics
• Combo remedies
Viral Issues
Symptoms
– Easy Fatigue
– Visual Issues
• Squinting
• Divergent Gaze
• Poor Eye Contact
– Cold sores
– Warts
– History of Regression
after MMR or other live
viruses
Treatment Options
– Antiviral Agents
• Olive Leaf Extract, Elderberry
• Caprylic Acid
• High Dose Vitamin A
– Antiviral Drugs
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Acyclovir
Valacyclovir
Famvir
Imunovir
– Immune Support
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Low Dose Naltrexone
Red. Glutathione
Zinc
Immune Modulators
Anti-inflammatory Agents
• Herbs
– Boswellia, Green Tea, Nettles, Slippery Elm, Cat’s Claw,
DGLicorice, Aloe, Ginger, Garlic, Echinacea, Ginseng, …
• Bioflavinoids (carotenoids, catechins)
– Curcumin, Hesperidin, Pycnogenol, Quercetin and Rutin.
• Antioxidant rich fruits and veggies, and nutrients
– Glutathione
• Omega 3 and Omega 6(DGLA) EFAs
• Sulfates help to seal a leaky gut- Epsom Salts Baths, …
• Cholinergic agonists
– Phosphatidyl Choline, Phosphatidyl Serine, Galantamine, Nicotinic
Acid
• Meds
– Singulair, Actos, Celebrex…
Aggarwal, B.B. and K.B. Harikumar, Potential therapeutic effects of curcumin, the anti-inflammatory agent, against neurodegenerative, cardiovascular, pulmonary, metabolic,
autoimmune and neoplastic diseases. Int J Biochem Cell Biol, 2009. 41(1): p. 40-59.
Additional Sources of Information
• Autism: Effective Biomedical Treatments, Pangborn and
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Baker
Healing the New Childhood Epidemics, Ken Bock, MD
Children with Starving Brains, Jaquelyn McCandless MD
Special Diets for Special Kids, Lisa Lewis
Changing the Course of Autism, B. Jepson MD and Jane
Johnson
Nourishing Hope, Julie Matthews
Nourishing Traditions, Sally Fallon
Thank You.