Summary
- Prevalence rates of autism are rapidly increasing.
- Biochemical dysfunction and nutritional deficits are commonly found in autistic individuals.
- These inborn errors of metabolism, whether genetic or acquired, are further influenced by environmental stressors.
- Inborn errors of metabolism may be the result of vitamin deficiency, or the deficits may cause the biochemical errors.
- With nutritional and biochemical therapy, it is possible to enhance metabolism and reverse certain deficiencies in the body.
- As many of the problems (behavior, cognition and speech impediments for example) associate with autism are believed to be a result of these imbalances, by correcting these with tailored biochemical and nutritional therapy, it is the hope that the symptoms of autism will lessen, which has been shown, even to the point of losing the diagnosis of autism in some.
- Further research is needed to fully understand these process’s and to create screening tests and treatment guidelines. Learn more at Pfeiffer Treatment Center
Introduction
Prevention and early intervention of health problems are
valuable tools which must be promoted. They can be utilized with those at risk,
or exhibiting early warning signs and as such decrease the overall burden of
disease. As mental health problems, for example, such as autism, depression and anxiety
appear to be on the rise, especially among children and adolescents [1-5],
parents, teachers and general practitioners are in the optimal position to
utilize such tools which have been proven to be of benefit. Autism, once rare
with prevalence rates as low as 4 in every 10,000 individuals [6] is increasing
and now thought to occur in as many as 1 of 150 children. [7] These rapidly
increasing rates have highlighted the importance of finding adequate preventative
measures; over the past ten years, preventative medicine, including mental
health, has become a priority in terms or research, practice and policy. [8]
Environmental Role
It is widely accepted that human emotions and behavior have a
physiological basis [6]; a mere look at the massive amounts of antidepressant
medications which are prescribed to help people with emotional and behavioral
problems supports this view. However, the nature versus nurture debate goes on as scholars
continue to question whether humans inherit behavioral capacities (nature) or
acquire them through learning (nurture). Extremely complex psychological changes, such as self
awareness, memory, or emotion have been shown to be affected by stimulation or
damage to various parts of the brain. [9] This supports the notion that there
is a physiological basis to human behavior. At the same time, we know that
brain plasticity occurs even into adulthood as a result of human experiences;
furthermore, neurons and synapses which are not activated through experience,
generally do not survive. [10] This opens the door for nurture to play a role
in brain development and thus human behavior. Applying these new ideas and ways
of thinking to the research of Autism has led to an “explosion in the discovery
of ‘new’ inborn errors of metabolism”. [11] Taking into account the increase in
prevalence of autism as well as the lack of 100% concordance among monozygotic
twins [6], it becomes clearer that ASD while having genetic influences, also
has environmental influences.
Autistic Spectrum Disorder and Genetic Vulnerability
In children with Autism, genetic variations or mutations result in
differences among vulnerabilities to different environmental stressors and
exposures – this is widely acknowledged, not just in those with autism, but in
all humans. Particularly in those with autism, however, genetic variations and
vulnerabilities as well as increased parental age (resulting in increased
genetic mutations) have been identified as risk factors. [7] This supports the
notion that environment plays a role in Autism. Further risk factors that have
been identified include oxidative stress, neuro-inflammation, mitochondrial
dysfunction (all which can be affected by dietary factors, food contaminants,
air pollution, and heavy metals for example), as well as underlying biochemical
problems such as abnormal glutathione which is a very important antioxidant and
detoxifier in the body. [7]
Biochemistry
of Autism
Researchers are increasingly finding biochemical abnormalities among
children with Autism. For example these children typically show inborn errors
of metabolism leading to biochemical build-ups, depressed enzymatic function
and metabolism and poor elimination of toxins from the body. The end result of
such errors can be increased serum copper levels; depressed zinc; elevated
toxic metals (such as copper, lead and mercury); under-methylation – resulting
in poor synaptic connections; pyrrole disorders, depressed methionine; elevated
adenosine; low levels of selenium; low caeruloplasmin; and increased levels of free-radicals.
[12,13]
It has been suggested that Autism is a
condition of oxidative stress resulting in a build-up of harmful by-products in
the body, known as free-radicals. [7] Excessive
free-radicals in the body lead to the destruction of cells, proteins, and
essential fats; these harmful elements include oxygen free-radicals and ionized
metals such as mercury, lead and copper. [12,13] Increased oxidative
stress can be a result of weak immune function and inflammation, zinc
depletion, copper overload, under-methylation of cells, increases in toxic
metals, such as mercury, lead and cadmium, many food sensitivities, such as
gluten, and yeast overgrowth in the GI tract. [12,13] These are all common problems
found in children along the autistic spectrum. Walsh [12] states that
under-methylation is found in over 90% of children with an autism-spectrum
disorder (ASD) and that more than 99% of autistic individuals have been found
to have serious metal metabolism disorders; for example, increased copper and
decreased zinc are found all throughout the autistic spectrum of disorders.
Whether these underlying biochemical processes are the initial problem,
or instead, a result of damage by environmental stressors, may not yet be fully
understood. This does not however prevent us from understanding that
biochemical processes can be reversed by targeted nutritional interventions
aimed to balance these abnormalities. Furthermore, improvements seen have even
lead to the loss of diagnosis in some children with autism, further supporting
that brain wiring is susceptible to environmental changes – both inside and
outside of the body. Environmental stressors and exposures impact organisms in
a way that can be studied via markers of exposure, effect and susceptibility.
These effects can be on brain development, development of other organs and
systems, and physiological/biochemical processes in the body. [14]
Most
people diagnosed with ADHD, behavior disorders, autism, and depression, have
been shown to have biochemical imbalances which can have a negative effect on
neurotransmitter regulation and synthesis. [15] In
general, the chemical imbalances in those with autism tend to be more severe
than for those with ADHD, depression, violent behavior, schizophrenia and
bipolar disorder; females with autism tend to have more disordered chemistry
than males with autism. [6] Also, major biochemical differences have been demonstrated between the
general population and individuals with autism.
Putting this all together, it is important to think about the physiology
behind it. Serotonin and dopamine as well as many other neurotransmitters are
synthesized in the brain. Raw materials for this synthesis include: vitamins,
minerals and amino acids. Therefore, nutrient imbalances, be they genetic or
acquired, can result in brain chemistry dysfunction. [12,13] In this regard,
researchers found that GABA (a ‘calming’ neurotransmitter) synthesis requires
Zinc. GABA balances increases in norepinephrine, and so a deficiency in Zinc
relates to irritability, anxiety and violent behaviors. Serotonin synthesis
requires vitamin B6; Norepinephrine synthesis requires copper; and dopamine,
norepinephrine and serotonin levels are all affected by folate levels. One
might conclude then, that deficiencies in any of these required substrates would
lead to deficiencies in the end product. It is reasonable to assume that
supplementing with zinc, B6 and folate will help to minimize these
deficiencies. While the evidence is only slowly emerging, the trend is clear
and supports the use of nutritional, biochemical therapy for Autism.
In a recent study by Walsh, [12] copper
and zinc imbalances were demonstrated to impact neuronal
development, detoxification of heavy metals, and immune response among children
with autism, leading to abnormal behaviors, G.I. tract problems and heightened
sensitivities. Empirical studies on
vitamin therapy in individuals with autism report a favourable response to
vitamin treatment. Most families reported improvement following
nutrient therapy to normalize chemistry. Researchers have attributed the
advances seen in cognition, social behavior, and speech to enhanced development
of immature brain cells creating new and/or better synaptic connections. [12] It was further concluded that many symptoms and
traits seen commonly in autistic children have specific and direct biochemical
indications. These include: light and/or noise sensitivity being related to
pyrrole disorder; pollen and ragweed allergies are found with under-methylation
disorders; over-methylation disorders are related to artistic ability; reading
disorders commonly relate to vitamin B6 deficiencies; hyperactivity is related
to increased serum copper levels; low zinc produces white streaks on nails; and
fatty acid deficiency is related to very dry skin.
Conclusion
It is clear that
biochemical dysfunction and nutritional deficits are commonly found among
autistic children. Furthermore, these imbalances have been shown to be detrimental
to the development of abnormal behavioral development. By correcting
imbalances, trends are starting to emerge showing the benefits of such
treatment. These benefits found are not limited to those with autism. Other
disorders which have shown positive outcomes with biochemical therapy include:
behavioral disorders; ADHD; depression; bipolar disorder; schizophrenia; and
Alzheimer’s disease. While evidence does support the use of biochemical and
nutritional therapy for many mental health related problems, further studies
are still needed, including large randomized control trials to help: determine
most effective doses and ways to prevent toxic build-up; create adequate tests
to screen for these disorders and deficiencies which can be accessible to everyone;
and to help create guidelines for treating patients; as well as studies looking
at the long-term benefits of these treatments.
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