Biomedical Treatments for Autism

... a Rational Approach to Biomedical Treatments for Autism

As a genetic condition (90-95% according to most studies), any approach toward "external causes" should relate to the general effect of the treatment on the individual, and how this relates to autism.

Beyond the neurology, there are no biological differences between an autistic person and a neurotypical person. Specifically, there are no biochemical differences whatsoever. (i.e., autism is not a chemical imbalance.) Autistics have reported differences in sensitivities to particular drugs; however, this is a difference in sensitivity and response; there is no difference in the pharmacological effect itself. Any biological treatment must therefore have a direct analog to the same treatment of a neurotypcial person.

In evaluating a treatment:

1. The treatment should have a rational basis in science.
If it purports to be based in science, it should make sense in scientific terms.

2. It should not require belief in a conspiracy theory for the science to make sense.
One is far more likely to find a conspiracy with individual charlatan therapists because there is no unbroken chain between the charlatan, the charlatan's theories, and the charlatan's mark (patient or caretaker).

Private entities have a profit motive, and government generally follows their doctrine and researchers depend on both. Neither have the power to silence legitimate institutions from disclosing legitimate discoveries. Also consider that there are in fact organisations which would oppose any attempt to silence valid research.

3. It must be humane
Outside of the Judge Rotenberg Center, abusive treatments are considered a relic of history.

4. It should be in accord with the desires of the patient.
In many cases, the patient is not looking for an attempted "cure", but rather has the same goals as anyone else seeking a healthy lifestyle.

5. It should follow the medical requirement of "Do no harm."

6. It should have a rational relationship to medical necessity.
Chelation should correspond to a measurable excess in a specific toxin. For example, chelation for heavy metals or elements are indicated if the patient were exposed to excess Hg, Zn, Sn, As or the like. This would normally correspond to a measured excess in those materials or an observed excess. If one suspects an excess in a particular material, then the proper medical procedure is to test for that.

7. A choice of treatment should not depend on sales skill.


A Reasoned Approach

What does make sense is that an external factor can affect any human condition. Autistics do not consider themselves "broken" but if there is a stressful factor involved, then this should be addressed with a reasoned approach.

This is no different from other fields of study, whether they are politics, religion, faith (in the sense of a religious concept), science or of course medicine.


Biomedical and Environmental Treatments

The following are biomedical approaches which have a foundation in science:
Lactose intolerance
Lactose intolerance should not be confused with lactose allergy. Lactose allergy is relatively rare and would be indicated by typical allergic reaction symptoms, including anaphylactic shock, hives and similar allergic reactions. Lactose intolerance is similar to Fructose malabsorption in that the cause is inadequate absorption by the small intestine.

What it is - While no link between lactose intolerance and autism has been demonstrated, lactose intolerance affects a significant proportion of the population. Lactose intolerance is tested by invasive tests, by a non-invasive pre-prandial test involving a fasting routine, and by non-invasive correlations between symptoms and lactose intake. In Caucasians, it usually affects children older than age 5; earlier among other ethnicities.

Link with autism - Lactose intolerance relates to the ability of the small intestine to break down lactose into its component sugars, glucose and galactose. The ability of adult humans to digest milk is called "lactose persistence", a genetic trait. Lactose intolerance is caused by the absence of a lactase persistence allele, which has no relation to neurology.

Treatment - Besides deletion of milk (but typically not cultured dairy products), lactose-free milk is readily available at upscale and "mass-market" supermarkets.
As a lower cost alternative, lactase, an enzyme (created by a fungus, genus Aspergillus) which breaks down lactose into its component sugars, is readily available as a nutritional supplement. The supplement can be added to milk. If you find a fairly potent version, even small quantities (e.g., 1/4 capsule per gallon or 4-litre container), will curdle the milk within 2 days, so you may have to limit quantities. The curdled milk is yoghurt (with liquid), although with substantial liquid, so it is safe and healthy to drink and has a good taste. The curdled milk will not mix with coffee. (The lactase available at Whole Foods has sufficiently low potency for use at rates of 1 capsule/gallon.) Lactase has an effect of extending shelf life of milk, so it may be worth experimenting with it.

On an industrial level, a different enzyme, produced by yeast from the genus Kluyveromyces is used to produce lactose-free milk.
Cost - Lactose-free milk is approximately double the cost of regular milk. Cost estimates for lactase supplements are 18¢ / gallon, but the cost is apparently much less when using more potent varieties.

Recommendations - Reduced lactose milk is often beneficial, and can be beneficial to autistics by reducing digestive distress caused by lactose intolerance.

Artificial food coloring (avoidance)
What it is - Avoidance of artificial food coloring, or avoidance of artificial colors or avoidance of Red #40 (Allura Red), Blue #1 (Brilliant Blue) and Yellow #6, (Sunset Yellow), as well as Yellow #5 (Tartrazine), Red #3 (Erythrosine B), Blue #1 (Brilliant Blue), Blue #2 (Indigotine; Indigo Carmine), Green #3 (Fast Green; FCF)

Link with autism - Most literature links artificial food colors with causing ADHD, with little research directed to their effects on autism, although one observer noted sleep disturbances associated with one of the yellow food dyes. In a 2011 study, the FDA indicated, "For certain susceptible children with Attention Deficit/Hyperactivity Disorder and other problem behaviors, however, the data suggest that their condition may be exacerbated by exposure to a number of substances in food, including, but not limited to, synthetic color additives." Association between ADHD triggers and autism can be found here, here and here.

The Center for Science in the Public Interest has recommended that the FDA re view evidence linking synthetic food dyes to behavioral problems in children. The FDA reached no conclusive findings in a 20 11 interim report.

Many US manufacturers delete these colors in Europe, where they are permitted but must include a warning label. Unfortunately, these same manufacturers treat the US market as a third-world economy due to limited regulation.

Treatment - Deletion of artificial colors from food.

Cost - technically none, although food items with artificial colors are generally cheaper products, and are therefore likely to be lower in cost.

Recommendations - Read labels when purchasing food. As with any food product, one need not read the same label with each purchase. In some cases foods that are colored can be very apparent, such as an ice cream shop selling ice cream with green dyes.

Ask the school dietician about their policies on food colorings. A significant number ban artificial colors, for example, here, here, here, here and here.

Food Preservatives (avoidance)
(sodium benzoate and others)

What it is - This is in part linked to the food coloring issue, and the association by the Center for Science in the Public Interest associates the preservative sodium benzoate with sleep disturbances.

Link with autism - No direct connection, although sleep disturbances have implication on behaviour issues.

Treatment - Purchase of foods without preservatives.

Cost - "It depends." With a few exceptions, foods without preservatives do not cost more than the equivalent preserved item. Purchase of foods without preservatives generally means obtaining higher quality varieties, which often (but not always) results in increased cost.

Recommendations - Read labels when purchasing food.

Fluorescent Lighting
What it is - Fluorescent lighting has been identified with two effects:
1. Red-Blue pupillary flicker (pupillary flutter)
sometimes associated with old magnetically ballasted tubes which aggravates the condition, but this condition has been identified with compact fluorescent lamps which operate at higher frequencies.

2. Blue/ultraviolet sensitivity
These are two separate effects, although they may be interrelated.

Link with autism - Autistic adults frequently report sensitivity to fluorescent lights and characteristically avoid fluorescent lights.

More information is found at http://www.scn.org/autistics/fluorescents.html

Treatment - Discussed in the fluorescents.html article. Halogen and other incandescent lamps avoid all problems. It is possible that LEDs having low color temperature (3100°K or lower, preferably 2700°K or lower) may be effective. Some people have had good results with low color temperature fluorescent lights in multi-phosphor (high color rendering) design, including GE's Reveal fluorescents and compact fluorescents.

Cost - sometimes nominal but in other cases, high electricity costs (halogen and incandescent), or bulb costs (higher quality fluorescent bulbs are often costly. The Philips L Prize LED had cost $50 for the 940 lumen bulb, although as of Nov-2012, Home Depot was selling them for $30.)

Recommendations - Attempt to identify fluorescent sensitivities and reduce exposure to fluorescent lighting in study areas.

High color temperature lighting (avoidance)
(see above, under Fluorescent Lighting.

What it is - Selection of lighting at colour temperatures at 4100°K or less; preferably 3000°K or less.

Multiple Chemical Sensitivity (MCS; avoidance)
What it is - The body develops a sensitivity or allergic reaction to environmental toxins, typically to synthetic chemicals.

Link with autism - No direct effect, but may interact with sensitivities by autistics.

Treatment - Avoid environmental chemicals. Store volatile chemicals outdoors and avoid scented products. Remove carpeting.

Organic Food
What it is - Food produced without synthetic pesticides and without most synthetic chemicals. The purpose is to avoid exposures to these chemical products.

Link with autism - No direct effect, but there is a possibility that pesticides and other chemicals may have effects on behaviour and neurological response. Some of these chemicals may interact with sensitivities by autistics.

Treatment - "Buy organic!"

Cost - Costs vary, but expect a 20% to 50% premium on most items. A side benefit is better flavour from a number of products.

Recommendations - "Buy organic!"

MSG and Excitotoxins (avoidance)
What it is - Excitotoxins cause various effects including migraines, headaches, restlessness, drowsiness and other neurological disturbances.

Link with autism - None direct.

Treatment - Avoidance. Look for "MSG" and its analogs, including "natural flavor" (US) and disodium guanylate. Avoid aspertame

Cost - MSG is often used as a substitute for more costly ingredients, so equivalent products without MSG would be more costly for that reason. Aspertame is sometimes used as a low-cost sweetener.

Recommendations - It is best to avoid MSG and its analogs and to avoid artificial sweeteners.

Gluten-Free Diet
What it is - Elimination of gluten from the diet. Gluten consist primarily of wheat (including kamut and spelt), barley, rye, malts and triticale.

Link with autism - None, but if the individual is celiac (sensitive or allergic to gluten), that can cause discomfort, which in turn can affect behaviour.

Treatment - First identify or diagnose if the person is celiac. If not, then there is no advantage to a celiac diet.

Cost - Gluten-free alternatives are typically twice the cost of wheat-based equivalents, but considerably more than some of the cheaper wheat products.

Recommendations - Diagnose before acting.

Vitamins, Mega-dose Vitamins and Supplements


What it is - Use of vitamins and supplements. The approach varies, but includes:
  • standard multivitamins and 1/2-dose multivitamins and nutritional supplements intended to augment multivitamins
  • megavitamins
  • supplements not part of an established recommendation but described in popular literature (e.g., echinacea).


Link with autism - None, but various vitamin deficiencies have been associated with behaviour issues in popular literature. Deficiencies in specific vitamins and minerals can result in food cravings which are often (mis-)translated as sugar cravings and the like.

Treatment - This can range from supplements to meet formal "minimum daily requirements (MDR)" (or meeting part of the MDR), to mega-vitamin dosage.

Cost - Cost of vitamins.

Risks - Some vitamins should be taken with a meal to avoid indigestion. Some vitamins taken in excess of formal recommendations can be toxic, although others merely produce expensive urine.

Recommendations - Check for potential side-effects when departing from formal recommendations.

Bogus Treatments and "Voodoo Science"

Some of these are discussed under Hoax Causes of Autism and Hoax Treatments for Autism. As with most quack medicine, these include bogus science, combined with conspiracy theories (many of which require very broad international cooperation for the conspiracy to work).

Voodoo belongs in a Voodoo ceremony (or perhaps spirit healing if one is so-inclined). It should not be part of a science-based medical treatment program.

Mercury
1957 Mercury "Turnpike Cruiser"
1957 Mercury car
If mercury were a cause of autism, it would be possible to identify elevated levels in autistics. This would be extremely easy to research, since the research on elevated mercury among various populations already exists.
Vaccines - thimerosal
The "anti-vaxers" have identified thimerosal, a mercury-based preservative and claimed it is the cause of the "autism epidemic". No evidence has been found for a thimerosal-autism link, but why bother with "scientific evidence" when promoting a conspiracy theory.

In the US, Europe and a few other affluent countries, thiomersal is no longer used as a preservative in routine childhood vaccination schedules, with the exception of some tetanus and influenza inoculations. Thiomersal is still used in antitoxins for pit viper, coral snake, and black widow venom.

Recommendations - If it is desired to avoid thiomersal, avoid multidose injectable vaccines. It is also possible to select influenza vaccines without thiomersal, including the nasal inhalant type.

Dental Amalgam
Mercury is also a component of dental amalgam (amalgam means mercury alloy).

Link with autism - None; association with autism disproved, but metallic fillings may be subject to sensitivies.

Treatment - Using composite (ceramic and epoxy) fillings

Cost - Composite fillings are either the same cost or 20% more than amalgam. Gold fillings are typically at least twice the cost of amalgam, but less costly in the long run because of their durability.

Recommendations - If you are trying to avoid amalgam, request composite fillings for primary teeth; composite or gold for adult teeth.
Vaccines - reaction to immunization
Never let facts get in the way of a good conspiracy theory! With thimerosal no longer a factor, the anti-vaxers have claimed that the actual intended immune response to vaccines causes autism. (I'm not making this **** up!) This can be convincing because autism is often diagnosed at about the age of childhood vaccinations. Of course coincidence does not equate to causation (well, except in conspiracy theories). Considering that immunizations are often accompanied by mild illness (malaise), it is easy to make the association. The problem is that immunizations have been documented to not have any association with autism.

Of course concepts such as "scientific documentation" have no legitimate place in a conspiracy theory.

Recommendations - Ignore it. It's bogus.

Chelation
The concept is that autism is caused by an (undocumented) excess of heavy metals. Never mind that the first step in a diagnosis of heavy metal poisoning is ... let's see ... oh, a bona fide diagnosis of heavy metal poisoning.

The normal process of the body slowly expels heavy metals over time, so incidental exposure to heavy metals do not result in permanent accumulation in the body.

After the step of skipping a proper medical diagnosis of heavy metal poisoning, chelation materials such as EDTA are administered, often invasively.

Recommendations - EDTA belongs in cheap salad dressing; not in children. If heavy metal poisoning is suspected, obtain the opinion of a qualified physician.

Bleach enemas (a.k.a., "MMS - Miracle Mineral Solution")
I'm not making this **** up! The concept is that autism is caused by an unbleached colon. I'm waiting for the Nobel Prize in medicine to be awarded to the genius who came up with this one.
 
'Clorox Healthcare' logo 2-pack Clorox bleach in
squirt bottles The Clorox Company and Clorox Healthcare does not endorse or support the use of their products in bleach enemas.
(Clorox Healthcare sells products for cleaning and disinfecting healthcare surfaces and medical equipment.)
 
This is the brainchild of one Kerri Rivera (not a physician, obviously), who claims the bleach cleans intestinal parasites.

Microflora in the colon are an essential part of the digestive process. If an imbalance in the microflora occurs (e.g., as a result of antibiotic treatment), probiotics are used to help restore intestinal microflora.

Recommendations - "Bleach should not go there!"

If you suspect intestinal parasites, take a stool sample to a veterinarian I mean take a stool sample to a doctor. If parasites are indicated, the doctor can prescribe an actual antiparasitic suitable for the identified parasite (e.g., Ivermectin).

Inserting bleach up there (bleach, pool disinfectant, "MMS", "Miracle Mineral Solution", etc) would result in animal cruelty charges if done to a domestic animal. If done to a human, it is child abuse. If you become aware of anyone attempting this, please report this to your jurisdictions' department of Child Protective Services. This is indefensible.

Leuprorelin (INN) or leuprolide acetate (USAN)
Promoted as "Lupron protocol" - chemical castration.

Leuprorelin has been administered to sex offenders as a "chemical castration" drug, to enable them to control otherwise irresistible impulses to commit sex crimes. The original conjecture, promoted by anti-vaxer Mark Geier, is that autism is caused by mercury, which binds irreversibly to testosterone.

Recommendations - Mark Geier had his license to practice medicine suspended in at least four states and his son David Geier has been charged with practice without a license. Stay away!


Unorthodox Treatments Unsuitable for Other Reasons
There are a few autism treatments which are not used for reasons other than lack of efficacy or scientific basis:

Medical Marijuana (MMJ)
Marijuana would be the most widely used autism treatment if one includes recreational use of cannabis. Extracting from statistics for the general population and including recreational use, that would be 1,500,000 in the US, 178,000 in Canada, 210,000 in the UK, 87,000 in Australia and 30,000 (nearly 100%) in Jamaica.

Treatment with MMJ is considered unorthodox for three reasons:
1.   The use of marijuana as a medical treatment is unorthodox, and remains illegal in most jurisdictions.
2.   There is insufficient documentation as to the efficacy of marijuana in autism treatment.
3.   It is highly unlikely that one could find a qualified professional who can supervise the use of marijuana for autism-related therapy. The use of hallucinogen process drugs for gestalt therapy is not accepted psychiatric practice.
More Information - More information on the use of medical marijuana is readily available on the web.

Recommendations - Regular use of marijuana by children and adolescents has been shown to slow brain development, so MMJ is not a panacea for treatment of children and youth. For adults, observe local practice in law enforcement; i.e., "Be careful out there."

LSD-25
The political issues on this one dwarf those of medical marijuana, but this is the only biomedical treatment for autism that has documented support in peer-reviewed academic, research and professional articles. (further information at Kathleen Seidel's page on LSD Studies With Autistic Children)

That does not mean that the data is not deeply flawed. The techniques by Lauretta Bender at the time appear to have involved several violations of the Nurenberg Protocols (as stated in The Nurenberg War Crimes Trials). There were a few others involved in LSD-25 experiments including the infamous Ivar Lovaas.

An additional issue was the attempt by Bender and others to attempt to use a maintenance dose, which doesn't fit the pharmacological model of LSD.

The experiments were discontinued with a termination of production in 1965 by manufacturer Sandoz Pharmaceuticals, so data is sparse, as is commercial availability of medical grade LSD.

A well-known alternative approach to structured "maintenance dose" treatment was the form of self-medication as famously described by Timothy Leary. Self-dosed medical use was overshadowed by recreational use; however, this technique offers a form of self-help.

Recommendations - Not practical because of lack of treatment protocols, lack of properly assayed dosages and general issues regarding legality of use. Professional or (preferably) peer support would be advisible should LSD therapy become a practicality.

Conclusion

If looking for a holistic or alternative treatment for autism, start with accepted holistic or alternative approaches. If the "treatment" extends beyond what you would expect to see on the shelves of a health food store and used for its intended purpose, it should not be used on a human.

Looking at this another way, any treatment should take into account the fact that there are no detectable biological differences between an autistic (or any other human) and typical humans, and therefore no reason to expect that a biomedical treatment would have a different effect attributable to a person's neurology.

If the treatment does not make sense or is embarrassing to discuss, there is a reason.



Drugs and other Treatments including descriptions of medical marijuana and the early LSD-25 studies using non-consenting children
Hoax Causes of Autism
Hoax Treatments for Autism
Disguised Eugenics Research Promoted as Autism Fundraising - If you think you are contributing to an "Autism" charity, but the only connection is that autism makes an excellent genetic research model.
Homeschooling and the Spectrum
back to Relationships index

First posted 09-Sep-12. Last revised 10-3-2013.

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