BIOMEDICAL email: info@autismfile.

com

Dr. Dan Rossignol Dr. Irva Hertz-Picciotto Julie Matthews, CNC Dr. Amy Yasko Dr. Kenneth Bock

Please email your questions to: info@autismfile.com

Question 1 Risperdal is an atypical antipsychotic of environment, even when genetics is a major

We have a 47-year-old son who has
recently been diagnosed with Parkinson’s
disease and is being treated very
successfully with the lowest dosage of
Sinemet that is available.
There is no Parkinson’s disease in either
of our families. Has anyone with autism
had this same affliction? If so, is there any
reason?
Could Risperdal be a factor?
Look forward to your reply.
Response from
Dr. KenNETH A. Bock:
Parkinson’s disease is a neurodegenerative
disorder of unknown etiology (causation);
however, a confluence of genetic and
environmental factors is suspected. Similarly,
autism is a neurodevelopmental disorder
with a complex multifactorial causation, also
believed to be due to genetic susceptibility
coupled with environmental factors. In both
disorders, toxins are believed to play a role,
most likely coupled with an impaired ability to
detoxify these toxins. In Parkinson’s disease,
pesticides and herbicides are especially
believed to play a role, whereas in autism,
heavy metals and chemicals are suspected
contributory factors.
medication that is a dopamine antagonist. It
is used in autistic children to control certain
types of severe adverse behaviors, such as
agitation, rage, and aggression.
Its side effects (especially at higher doses)
do include Parkinson-like symptomatology,
such as stiff, rigid muscles, tremor, abnormal
movements, and impaired gait.
Question 2
They say the chance of identical twins
becoming autistic is 60%. Is this a genetic
condition?
Response from DR. Irva Hertz-
Picciotto
The statement is not accurate. The data
show that if one of two identical twins has
autism, then the chance that the other one
also has autism is between 60% and 90% in
studies conducted so far. This would be from
twin pairs that are not pre-selected for other
factors.
For comparison, the figure for fraternal
twins is lower: about 10% (if one has autism,
then about 10% of the time, the other twin
also will). In reality, even when two twins both
have the condition, the severity often varies
considerably, which supports the importance
factor.
Note also that if one child in a sibling pair
(two children with the same parents) has
autism, then the chances that a second child
also develops autism seems to be around 10%
(7% to 15% in well-conducted studies).
Of course, those statistics do not tell us
“how much of autism is due to genetics” or
“how much of autism is due to environmental
factors.”
Also, it is absolutely crucial to understand
that the percentages of cases “caused by
genetics” and “caused by environment” do not
sum to 100%. This is because most cases of
autism have multiple causes; i.e., not only are
there multiple causes across the population,
but also: for each person who develops
autism, there is a set of factors, all of which
were necessary, and together were sufficient
to cause brain development to go awry
resulting in the behavioral syndrome known
as autism. This set of sufficient causes might
be five genes and one environmental insult, or
vice versa, one gene and five environmental
exposures. Also critical will be the timing of
those exposures: the same exposure at 10
months of age may do nothing, but at one
week of age or at 3 months of gestation might
be quite damaging.

Disclaimer
Information is not provided as medical advice. Parents / patients should research all information given. Every person’s physiology is unique. All
information provided as a reply should be discussed with the patient’s personal physician and / or autism or other specialist appropriate to the
symptom(s) or body system(s) involved in their individual situation, who provides the patient with regular medical oversight, monitoring, and lab
testing, and who keeps up-to-date on the most recent research and interventions. Beginning any significant biomedical or other interventions
that may impact physiology or making changes to an established regimen should be discussed with the patient’s physician in advance.

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 BIOMEDICAL
Note that there will likely be not only risk
factors but also protective factors in the
environment.
Once we get a better handle on those
environmental factors, we will be able to
intervene to lessen the severity and possibly
even prevent autism from developing, in at
least some children.
I hope this is helpful to you.
Question 3
My child has increased gut permeability. He
is 4 years old and has suffered in the past
with constipation and diarrhea. Is DMSA
chelation therapy advisable?
Response from Dr. Dan Rossignol:
You did not list if your child has autism, but
I am assuming that this is the case. Increased
gut permeability has been described is a subset
of children with autism [1] and is probably
indicative of underlying gastrointestinal
inflammation, which is also relatively common
in autism [2, 3]. Therefore, I suggest you
focus on treatments for the underlying
gastrointestinal problems. Before even
contemplating any form of chelation therapy,
you need to perform some testing to determine
if chelation is even necessary, such as
measuring markers of heavy metal toxicity (e.g.,
blood lead level, perhaps urinary porphyrin
levels). Furthermore, performing chelation
without having gastrointestinal inflammation
under control could worsen the inflammatory
problems. Work with your physician to
determine if chelation is even advisable,
and, if so, make sure that gastrointestinal
inflammation is first treated adequately.
144 THE AUTISM FILE | www.autismfile.com | info@autismfile.com REPRINTED WITH PERMISSION © THE AUTISM FILE
Question 4
My daughter has elevated mercury and lead
in her hair analysis report. I have heard
that CaEDTA is better at pulling out lead
and DMSA is better at pulling out mercury.
Which one and do you feel I should go with
and why?
Response from Dr. Dan Rossignol:
What you describe is concerning because
elevated mercury and lead in the hair is
consistent with recent exposure. Hair grows
at about 1 cm per month, so it depends how
long the hair was that you sent off for testing,
but if it was several cm long, then there has
been exposure to lead and mercury within the
past several months. The MOST important
step to take in this situation is to identify
the source of the mercury and lead, which
means testing for these metals around the
house, and then performing remediation. You
would also be wise to measure blood levels,
as this is a marker of recent exposure as well.
You also need to work with a physician who
is experienced with chelation if you decide
to pursue that route, as chelation is only
advisable under certain situations, and if
evidence of toxicity has been met. Calcium
EDTA is more effective at removing lead,
and DMSA is effective in removing both lead
and mercury, but again, you need to work
with your physician before planning on going
forward with chelation.
Question 5
Can all-natural products such as Goji and
GoChi help alleviate some of the symptoms
of autism?
Response from Dr. Dan Rossignol:
Multiple studies have demonstrated that
oxidative stress is a problem in some
individuals with autism [1, 2], and this
has been associated with regression [3].
Antioxidants including vitamin C [4],
L-carnosine [5], methylcobalamin [6],
melatonin [7], carnitine [8], zinc [9], and
pycnogenol [10] have been shown to improve
symptoms in some individuals with autism
and attention-deficit hyperactivity disorder
in double-blind, placebo-controlled studies.
Goji and GoChi appear to have antioxidant
properties and, therefore, may be beneficial,
although I am unaware of any studies
published to date on the use of these in
autism. Therefore, I would suggest first using
antioxidants that have been proven to be
effective in double-blind placebo-controlled
studies.
Question 6
Is there a correlation between children
having an MTHFR mutation and
seizures? My son has one of the MTHFR
polymorphisms and has started having
seizures. Also, might it make a difference
as to whether the seizures would have
started if he hadn’t been subject to
mercury toxicity? In other words, how
many of these factors singly or combined
would precipitate seizures? Understanding
that every child is unique and medical
attention is called for if a child begins
having seizures,are there other factors
such as nutrient deficiencies, testosterone
levels, or anything else that might be
considered?
Response from Dr. Amy Yasko:
In terms of seizure activity, there are a
number of factors that I have found to
increase the incidence of seizures. First,
lack of B-12 can be a major factor. There
are some longer posts on my chat group
about this topic, but the bottom line is that
when we have significant MTR and MTRR
mutations and not enough B-12 support,
we can see increased seizure activity. This
gets me to the second point which creates a
bit of a catch 22...When we have high level
detox of metals, such as mercury, lead, and
especially aluminum, that can also increase
the incidence of seizures. Using B-12
support can trigger detox. So, this is why it
is a bit of a catch 22. When we have MTR
and MTRR mutations we look to support
with B-12, and the B-12 can be helpful in
lowering seizure activity. However, at the
same time, the increased B-12 can trigger
detox which can increase seizure activity.
It is often not until the excretion of toxins
has progressed to lower the body burden
that we can see the positive effects of B-12
support on reducing seizure activity. Finally,
the level of excitotoxins in the system can
also contribute to seizure activity. So, we’re
looking at eliminating any added glutamine,
glutamate, aspartate, aspartame, including
these derivatives as complexed with minerals,
for instance, looking to eliminate magnesium
aspartate or supplements as “amino acid
chelates,” as those will also include glutamate
and aspartate. I also look to reduce the
amount of calcium, as calcium in conjunction
with glutamate can increase excitotoxin
activity and may increase seizure activity.
Looking to balance the glutamate with GABA,
theanine, low dose lithium, magnesium, and
low dose zinc may be useful, as well as other
supplements that I have talked about in the
past.
ISSUE 30 2009

In answer to your question about MTHFR
mutations and seizure activity: I have not
seen a direct relationship between the
two. If the MTHFR mutation has allowed
for decreased methylation cycle activity,
and that decreased activity has allowed
for increased toxin accumulation, then
indirectly the MTHFR may be increasing
seizure activity by virtue of the increased
toxin burden on the system. If we are talking
about MTHFR A1298C mutations, we will
frequently see those individuals as having
more issues with aluminum toxicity, which
may indirectly contribute to increased
seizure activity as compared to those who
are MTHFR C677T. Also, MTR and MTRR
mutations, particularly those that I consider
more severe, and the attendant need for
B-12 may also be indirectly related to seizure
activity.
Question 7
I hear that glutathione is commonly
depleted in autism and is poorly absorbed
as a supplement. How best can I, through
foods consumed, elevate glutathione
levels in my child?
Response from Julie Matthews, CNC:
Glutathione, an important antioxidant, is
used for detoxification, immune function, and
intestinal integrity. Vitamins A, C, and E, zinc,
selenium, and carotenes enhance immune
response and “spare” glutathione--look for
foods rich in these antioxidants. Asparagus,
watermelon, broccoli, garlic, onion, and,
particularly, whey protein (however, it’s not
References for Question 3:
1. D’Eufemia P, Celli M, Finocchiaro R, Pacifico
L, Viozzi L, Zaccagnini M, Cardi E, Giardini O:
Abnormal intestinal permeability in children with
autism. Acta Paediatr 1996, 85(9):1076-1079.
2. Ashwood P, Anthony A, Pellicer AA, Torrente
F, Walker-Smith JA, Wakefield AJ: Intestinal
lymphocyte populations in children with
regressive autism: evidence for extensive
mucosal immunopathology. J Clin Immunol 2003,
23(6):504-517.
3. Torrente F, Anthony A, Heuschkel RB, Thomson
MA, Ashwood P, Murch SH: Focal-enhanced
gastritis in regressive autism with features
distinct from Crohn’s and Helicobacter pylori
gastritis. Am J Gastroenterol 2004, 99(4):598-
605.
ISSUE 30 2009 REPRINTED WITH PERMISSION © THE AUTISM FILE info@autismfile.com | www.autismfile.com | THE AUTISM FILE
email: info@autismfile.com
casein-free) are good sources of glutathione.
Methionine, betaine, and choline enhance
liver function and increase the levels of
glutathione. Methionine is found in meat,
fish, sesame seeds, Brazil nuts, spinach, and
potatoes. Betaine is found in beets, spinach,
and broccoli. Egg yolk and liver contain
choline.
Question 8
Can you help me with my son who is
permanently constipated? He can go for
five days without passing a stool. I need
to keep sugar out of his diet because he
has Candida. He also can’t have wheat or
casein.
Response from Julie Matthews, CNC:
There are a couple aspects to constipation-
-avoid the things that can contribute to
inflammation and microbial imbalance, and
add substances that help with constipation.
I’m assuming that he is avoiding gluten,
as well as wheat -- if not, remove gluten,
as well. As far as food goes, also consider
other food sensitivities such as soy, corn,
eggs or other possible intolerances that can
create inflammation in the gut. Candida and
dysbiosis can cause constipation, consider the
Specific Carbohydrate Diet or other diet that
avoids complex starches and/or sugars to
starve out any harmful microbes.
Make sure the simple steps are covered
first -- consume fiber through fresh fruits
and vegetables, and drink adequate water.
Fermented foods such as yogurt and kefir
(dairy or non-dairy), raw sauerkraut, and
References for Question 5:
1. James, SJ, et al., Metabolic endophenotype and
related genotypes are associated with oxidative
stress in children with autism. Am J Med Genet B
Neuropsychiatr Genet, 2006. 141(8): p. 947-56.
2. Chauhan, A and Chauhan, V, Oxidative stress in
autism. Pathophysiology, 2006. 13(3):
p. 171-81.
3. Chauhan, A, et al., Oxidative stress in autism:
increased lipid peroxidation and reduced serum
levels of ceruloplasmin and transferrin--the
antioxidant proteins. Life Sci, 2004. 75(21):
p. 2539-49.
4. Dolske, MC, et al., A preliminary trial of ascorbic
acid as supplemental therapy for autism. Prog
Neuropsychopharmacol Biol Psychiatry, 1993.
17(5): p. 765-74.
5. Chez, MG, et al., Double-blind, placebo-
controlled study of L-carnosine supplementation
in children with autistic spectrum disorders.
J Child Neurol, 2002. 17(11): p. 833-7.
kombucha supply good bacteria that help
with peristalsis (keeps the bowels moving),
reduce inflammation, and support a healthy
intestinal tract. Additionally, simmer prunes
in apple juice, and have your child eat
the prunes and drink the juice. Consider
magnesium or vitamin C supplementation,
both “loosen” stool. Simmer or steep flax
seeds (not SCD-compliant) in water, strain
and consume the liquid. Be sure to work with
a physician that can view this from a medical
perspective to make sure there isn’t anything
medical going on.
Question 9
Can you recommend good foods to feed
my son who has ADD, I really need to help
his memory as he is suffering at school.
Response from Julie Matthews, CNC:
First, avoid all artificial colors, flavors and
preservatives, as well as MSG (monosodium
glutamate, autolyzed yeast, hydrolyzed
vegetable protein)--this is crucial. Avoid
trans-fats such as partially hydrogenated
oil, and consume healthy fats such as cod
liver oil, olive oil, coconut oil, animal fats,
and nuts. Make sure your child has a well-
balanced breakfast including protein and
fat before school, such as eggs or a sausage
patty. Choline, the precursor to acetylcholine,
which is important for memory, can be found
in egg yolks, nuts and seeds (particularly
peanuts), liver, meat, milk products (if
not dairy-free), fresh fruit, and vegetables
(especially broccoli, cabbage, cauliflower,
beets, asparagus, and tomatoes).
6. James, SJ, et al., Efficacy of methylcobalamin
and folinic acid treatment on glutathione redox
status in children with autism. Am J Clin Nutr,
2009. 89: p. 1-6.
7. Garstang, J and Wallis, M, Randomized
controlled trial of melatonin for children with
autistic spectrum disorders and sleep problems.
Child Care Health Dev, 2006. 32(5): p. 585-9.
8. Van Oudheusden, LJ and Scholte, HR, Efficacy
of carnitine in the treatment of children
with attention-deficit hyperactivity disorder.
Prostaglandins Leukot Essent Fatty Acids, 2002.
67(1): p. 33-8.
9. Bilici, M, et al., Double-blind, placebo-controlled
study of zinc sulfate in the treatment of
attention deficit hyperactivity disorder. Prog
Neuropsychopharmacol Biol Psychiatry, 2004.
28(1): p. 181-90.
10. Trebaticka, J, et al., Treatment of ADHD with
French maritime pine bark extract, Pycnogenol.
Eur Child Adolesc Psychiatry, 2006. 15(6): p.
329-35.
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