AUTISM SPECTRUM DISORDER (ASD)

I am going to “stick my neck out” because I am so appalled by the widespread disease that is going to bankrupt us through medical costs. This presentation is to develop what I consider to be the direct cause of ASD. Some of this is from the hard won experience of a small group of physicians who have faced the challenges of sick chemistry affecting the growing brains of so many children. Before starting on that, however, I want to point out something that is well known already. The Japanese are the healthiest people in the world, but when they come to the U.S.A. they succumb to the same diseases as Americans. That must tell us that there is something wrong with the U.S. environment and that dietary mayhem that stalks vast numbers of people is an important part of this. I have seen hundreds of children within the autistic spectrum. The ones with ADD, ADHD and other similar diagnostic categories, like “variations on a symphonic theme”, are usually easy to treat with dietary correction and non caloric supplements. They are the high functioning group, whereas the children with autism are low functioning at the other end of the spectrum and are much harder to treat-- but they are treatable. First, let us look at the environment. We all know that our air, water and food are polluted with all kinds of chemicals and heavy metals. We invite our own collective disaster as we continue to damage our sensitive biological machinery. It is also obvious that we cannot change that, simply because industry creates our modern era of employment. The factor that is common to so many diseases, including ASD, is oxidative stress, so this demands a simple explanation. We, like the rest of the animal kingdom, consume oxygen in a process known as oxidation. This is complex chemistry and beyond the scope of an article like this, but it is governed by a simple fact: “not too little and not too much, the Yin and the Yang”. Too little oxidation is obvious, but many people have a little trouble with “too much”. The concept of free oxygen radicals has become fairly well known in health articles. The simplest explanation is that they might be compared with sparks that fly out from a fire that is burning briskly. Sparks are dangerous because they may spread the fire, so they have to be quenched. For example, a fireguard might be placed in front of an open hearth fire to prevent sparks setting fire to a carpet. The same principle applies to oxygen radicals; they have to be quenched also. The harder we work mentally or physically the more oxygen is consumed and the “metabolic fires have to burn more briskly”. This is where the “genius” of Mother Nature comes in. She invented chemical substances called antioxidants, many of which are derived from diet. It is important to note that antioxidants act as a team in the body for they might be compared with strands of wire that make up a fireguard. A single wire would not catch the sparks and a single antioxidant does not do the job of quenching oxygen radicals. It is simple to compare the oxidant chemicals with sparkplugs in a car: spark plugs ignite gasoline whereas oxidants in the body burn or “oxidize” protein, fat and carbohydrate, the equivalent of gasoline. Efficient oxidation is midway between “too little and too much”. This is essential to maintaining maximum efficiency of our cellular engines that are known as mitochondria. Thus, each of our body cells has its own energy budget, automatically adjusting or adapting to its required work load. I cannot imagine this wondrous process being coordinated without a computer and the limbic system and brainstem, that make up the lower more primitive parts of the brain, fulfill that function. Since this part of the brain is the most oxygen-demanding tissue in the body/brain combination, it is hardly surprising that it is the very first organ to “feel the oxidation pinch” if and when it occurs. But I have learned that a curious thing happens with mild oxidation deprivation. The computer becomes more irritable. Since this is the part of the brain that generates our emotional reflexes, an affected person becomes more emotional. The emotion itself (e.g. anger) is a normal reaction but becomes exaggerated and increased in volume. Children with ASD often have severe temper tantrums long after their normal incidence in infancy. They tend to be associated with some degree of violence such as kicking the wall. We know that mild to moderate oxidative inefficiency in brain occurs because giving air enriched with twenty percent carbon dioxide to patients who suffer panic attacks will initiate a panic attack. Such attacks are nothing more than fragmented fight-or-flight reflexes occurring without the threatened danger that normally initiates this survival reflex. The sympathetic arm of the autonomic (automatic) nervous system is activated too easily. If the oxidation mechanism becomes more severe and prolonged, the nervous control mechanisms begin to deteriorate and collapse. The prototype for this is the vitamin B1 deficiency disease beriberi. Now we must go back to ASD and the fundamental issue of oxidative stress. Published information in a medical journal has reported that neonatal jaundice and/or so called “colic” are in fact the first signs of oxidative stress. When I was speaking to an audience of parents of ASD children, I asked for a show of hands for the incidence of these two symptoms in their children. About two thirds of the parents responded for each of those observations. The next question that I asked was how many of these children had experienced ear infections and about the same number of parents raised their hands. Some of these children had received ear tubes and it is not as well known as it should be that they are not for drainage but to allow air (hence oxygen) into the middle ear cavity. Hence inefficienrt oxidative function enters into the underlying cause of ear infections. These symptoms are so common in the infancy of children that later become autistic that it would make sense to accept them as a potential warning of worse things to come later. To start nutrient supplements for infants with this kind of neonatal history would be, to my mind, absolutely mandatory. It is true that parents would never know if they have prevented ADD, ADHD or autism, because there is not an automatic incidence of brain dysfunction in every child with this clinical picture. It is, however, completely safe and can only do good, irrespective of the normal or potentially abnormal physiology. The only way that we would know whether such a preventive program would work would be by looking at public health statistics a few years later and see if the incidence of such problems has been shown to decrease. This would require a big change in the usual and customary pediatric approach. In our present state of knowledge, preventive nutrition is the only way that we can hope to reduce the incidence of ASD. If we wait until the dread diagnosis is made somewhere between the ages of eighteen months and four years, the treatment potential is much harder, much more expensive and prolonged. The old proverb that prevention is better than cure is, in this case, an imperative. The trouble is that mainstream medicine still has not caught up with the real meaning of the word “prevention”. Only a few pediatricians are aware of the vitally important ways in which Mother Nature exhibits her warnings. Even then, they must be able to recognize that oxidative stress can only be treated from a well rounded knowledge and experience of nutrient-based therapy. There are always plenty of calories in our diets. The tragedy is that the calorie-bearing foods are not being oxidized efficiently, particularly in brain. The ratio of calories to non-caloric nutrients is too high, producing an effect similar to a choked car engine. There is insufficient energy to power growth and function. Perhaps what really happens is that the “hard wiring” that must configure the adult brain becomes held back. Thus we see a child who has never completely broken through to adult status.

THE PLACEBO EFFECT

Placebo, from the Latin, meaning “I shall be pleasing, acceptable” is defined in Webster as a substance having no pharmacological effect but given to placate a patient who supposes it to be a medicine”. It is also defined as “a pharmacologically inactive substance or a sham procedure administered as a control in testing the effect of a drug or course of action”. An unusual use of the word is “the vespers for the office of the dead”. The placebo effect is defined in Webster as “a reaction to a placebo manifested by a lessening of the symptoms, or the production of anticipated side effects.
The use of a placebo in medicine implies the use of doctor/patient fraud and it is not surprising that the ethics have been questioned. The point of this presentation is to discuss what, if anything, is known about its mechanism. It is clear that if we knew this and how to turn it on in the mind/body relationship of sick people, it would automatically disqualify a huge section of modern medicine. I have so often been told that an unusual observation of improved wellbeing in a patient is “only a placebo effect” as though the observation is itself fraudulent. Yes, we dismiss its potential importance out of hand without thinking about how it works.
A six million dollar study involved comparison of the effects of a pharmaceutical drug used for treatment of depression with that of St John’s Wort, also used for depression. The study was “controlled” by using a third arm with a placebo. The results must have been mystifying to the investigators. The drug and the herbal remedy were about even but the placebo did better than both of them.
This must indeed remind us that the personal approach of a physician to a patient may make a huge difference to the outcome of the illness. There is an opposite effect of a placebo (a nocebo) that can actually do harm, purely by suggestion, as in producing anticipated side effects, or perhaps even hasten death. Thus, when a physician says to his patient,” I am sorry to tell you that you have cancer” it may be by itself a deterrent to recovery, since many people believe that cancer is inevitably fatal. Although this has long been known as “bedside manner”, I am aware that modern scientific medicine too often neglects this vitally important function of a physician, or any person that works in the health field.
The mechanism is still unknown but it is to the credit of Professor Ingvar at the Karolinska Institute that it is being studied. It has long seemed to me to be related to how hypnosis works, since that can have far reaching physical and mental effects. There is an apocryphal story of a young native in Africa who crossed the witch doctor who cursed him while shaking a “magic” bone in front of him. The young man began to lose weight and move toward death. A Western clinic in the vicinity tried to cure him, but failed. The witch doctor was then asked if he would remove the curse. He agreed “for a consideration” and he shook the same bone in the face of his victim, announcing his removal of the curse. The young man promptly recovered.
Mary Baker Eddy was paralysed in her youth. Her father had to carry her everywhere. She sought treatment from Mesmer who was treating people with magnets and she recovered. Later on she relapsed and began reading the New Testament, whereupon she recovered again. She concluded that her recovery was in the hands of Jesus and founded the Church of Christian Science. The cathedral in Boston represents a remarkable success story.
All of this must make us think seriously about the action of the brain/body in maintaining health and the induction of disease. It has seemed to me that the only thing that really matters for the “placebo effect” is the complete and indelible faith of a sick patient in a process that promises cure. A “faith healer” only requires the faith of his patient and he must inject his infallibility through his own belief in his “special” power. It is of considerable interest that Christ said to his patients “Go, thy faith hath made thee whole”.
I was once a pediatric oncologist, a physician that treats cancer. I had a child with a Wilms tumor of the kidney, one of the highly malignant cancers in children. It had metastasized to the abdominal cavity and she was in the state of cachexia that was the herald of death. I told the mother that I had nothing that could possibly touch her severe state. Her answer was simply “If God will not work through you I will find someone who will”. She took the child to Oral Roberts who “laid on his hands”. The tumors vanished and she became healthy again. I had an annual letter from the family doctor for several years, telling me of her complete recovery.
A 6-year old child had a malignant tumor in his cheek that was completely resistant to all available treatment. His father asked if he could bring a faith healer into the hospital and I agreed. His family, unknown to me, were also seeking treatment in Detroit. One day when leaving Cleveland, the car hit a guard-rail and rolled down an incline killing everyone but my patient. He was adopted by an aunt who gave him a lot of TLC. A short time later the child walked into the room to show his aunt something in his hand. He told her that he had found it in his mouth. She had the presence of mind to take it to a pathologist who reported that it was indeed the tumor and that it was necrotic, meaning that the cells were all dead. A miracle is a remarkable event for which we have no explanation. As soon as a mechanism is found for the event, it ceases to be a miracle. We would all benefit from a discovery of the mechanism of this much scorned placebo effect!
The effect cannot be forced on anyone; it must come from the brain of the person in whom it operates. Religion, if used properly in inducing a faith in God, is the ideal method of acquiring a mechanism that transcends self. To me, it seems that any ritual that might be loosely called religiosity, is quite useless unless it has true meaning for an individual practicing it. As a physician, I am only too well aware that my “success” in helping a patient might be attributed to the patient. The only thing that I do is to apply nutrients to recruit cellular energy so that healing can begin within the brain/body. But the body is merely a chassis that carries the brain and the healing process must be guided by that complex organ. Perhaps “energy medicine” has discovered at least part of the mechanism that turns on the placebo effect. Its safety and relative cheapness will eventually make the public force it to become mainstream.