In the past when people first learned of this program, I suggested that they make it a priority to spend time getting complete information before beginning to implement the protocol—and I have always applauded those who do this. But over a number of years, I’ve also seen that many more people want to begin right away. Whether they are addressing autism in their child or their own adult health issue triggered by neurological inflammation, many people feel a sense of urgency. I understand that, and that’s why I’ve designed the program so that you can begin the first step as you continue to inform yourself—as well as wait for your test results. Nutrigenomic test results take approximately eight weeks to come back from the lab, and we don’t want to waste that valuable time simply waiting when there are things that you can do right away, before knowing your own or your child’s specific mutations. What’s more, for financial reasons, many families who participate in the chat room on my website are not able to undertake Nutrigenomic testing from the outset. They’ve found that just following the first step of the program, detailed in this and the next chapters, brings improvement. Whatever your situation, there are many things that can be done to help your child or yourself today—and I urge you to begin now.
However, there is one caveat. You will see as you proceed through the program that I encourage people to undertake certain biochemical tests periodically, as this allows us to track progress, troubleshoot challenges, and appropriately transition to new supplements or steps in the program when the body is ready. These tests take out the guesswork. Accordingly, I often recommend that people undergo a few tests at baseline to determine the body’s status. The genetic results show lifelong health predispositions, while the biochemical tests show the current situation. For example, suppose your roof was made of substances that were projected to last eight to ten years. Before deciding on a roof repair after eight years, you might want to go up and assess the actual damage. Biochemical tests allow us to assess both health challenges, backsliding, and progress. You can undertake them prior to beginning Step One, during Step One, and/or prior to beginning Step Two. If you do the tests prior to beginning Step One, make sure you have gone off all supplements from prior programs for two weeks prior to baseline testing. Once you are on the program and adding the supplements I have suggested based on Nutrigenomics or other biochemical tests, then I want you to stay on all your supplements for any subsequent testing. List all the supplements you are taking along with the current biochemical test. On the website, you will find downloadable supplement forms you can fill out. The reason for baseline testing is to assess the biochemistry in the absence of supplementation. Once you’ve begun the individualized approach to supplementing based on Nutrigenomics (or other test results) then testing will reveal how well those supplements work in correcting imbalances in the various biochemical pathways.
UAA – Urinary Amino Acids from Doctor’s Data Inc. (or equivalent)
MAP – Metabolic Analysis Profile from Genova Diagnostics, OAT from Great Smokies (or equivalent)
CDSA/CSA – Complete Digestive Stool Analysis and/or Complete Stool Analysis from Doctor’s Data Inc. (or equivalent)
UTM/UEE – Urinary Toxic Metals/Essential Elements from Doctor’s Data Inc. (or equivalent)
If you wish, you can order the tests through my office at www.holisticheal.com. I comment only on test results (in conjunction with the Nutrigenomic tests) that are run through my office. You are also welcome to run tests yourself and through your practitioner, and if you send those results to my office, we will keep them in your file to make sure that our medical record on you or your child is complete.
The program consists of three basic steps:
The first step is basic preparation, which can be done by anyone—no matter what your SNPs, and whether you know them or not. In my view, almost anyone would benefit from many of the foundational recommendations in the first step.
In the first step, you will:
You can also think of Step One as what you do while you await your test results, which will allow you to then target support for your own or your child’s specific SNPs throughout the later steps of this program.
While continuing to follow many of the recommendations of Step One, you will move on to Step Two, in which you begin the process of detoxification. Detox consists of two parts:
I like to start by supplementing to bypass mutations, as this will often trigger a lower level of natural detoxification. Once this detoxification runs its course, then you can implement the metals program.
I will discuss supplementing based on the SNP analysis in great detail in the next chapter, but let me just briefly indicate that there are several mutations that need to be addressed first if test results reveal them.
At the outset of Step Two, when you receive your Nutrigenomic test results, you will learn exactly which SNPs are present (including the ACAT, SHMT, and CBS upregulations), as well as which supplements to use and which guidelines to follow to address the specific imbalances revealed by the test.
In Step Two, as you begin to slowly and gradually introduce the supplements customized to your own or your child’s SNPs, you or your child will naturally begin to detoxify. This occurs because supporting the methylation cycle makes detoxification more efficient.
In the second part of Step Two, if needed to complete the process of detoxification, you can step up detoxification with the metals program, which is designed to remove metals, bacteria, and viruses from the system.
Once sufficient detox has occurred via the Step Two process, which may take months or even longer, you can then begin Step Three, which helps the body remyelinate nerves and enhances nerve function. It takes time and commitment to halt and reverse the inflammatory process leading to neuron death. And no one really knows how long it takes to grow a new neuron. For years it was believed that it didn’t happen at all. Now we know that when an individual commits to this program and stays with it, it’s often possible to achieve incredible results. Remember, this is not a sprint, it’s a marathon.
How do we restore health and function as outlined in the steps? With herbs, vitamins, and antioxidants. People can wind up taking many supplements, sometimes as much as fifty or more, depending on the severity and number of imbalances in the individual. This may seem like a lot of supplements. However, neurological damage is cumulative. By the time it’s recognized, more than 50% of an individual’s neurons may have been damaged. Recently, I’ve formulated supplements that are compounded based on SNP results. Using them will reduce the number of supplements that are needed, thus streamlining the supplementation process.
First of all, it’s important to lay the groundwork for this program by putting some basic supports into place. In this book (and on my website) you will note that the suggested supplementation protocols are broken into categories. It is not necessary to take every supplement in every category. However, depending on the severity of an individual case of autism, you may find it necessary to use every supplement listed. Also keep in mind that it is possible that a child may be sensitive to an individual ingredient or supplement. It is best for this reason to add them slowly, allowing several days before progressing to new ones. Yes, it will take a while to introduce them all, but be calm and patient. Don’t feel you have to rush through the program. The Basic Supplement Support program is a good place to begin.
The suggested dosage of any individual supplement listed is usually 1⁄2 to 1 capsule or tablet, unless otherwise noted. This will be well below the dosage suggested on the labels of the bottles. The aim of this approach is to rebalance many different pathways in the body simultaneously. Picture the body as a system of roadways, and imagine that you are repairing the main roads, side roads, and back roads, all at the same time. To do all of this “road work” requires a small amount each of a large number of supplements traveling down multiple pathways and feedback systems to restore effective function.
In order to help to simplify and streamline the program I have recently formulated a series of new supplements that are customized and compounded to address specific SNP imbalances. These compounded formulas contain all of the individual components listed to help to bypass a specific SNP. When using the compounded formulas it is important to follow the dosing instructions, as the custom formulation has already taken into account the low doses of supplements and herbs that I like to use. Again, for the supplements formulated by SNP it is important to take the number of capsules or tablets listed on the label. You can slowly dose up, but ultimately, in order to have the proper amount of each ingredient, take the amount of capsules/tablets listed on the supplement bottle, rather than simply using only 1 or 1⁄2 of a capsule or tablet.
I recommend that you implement this program in conjunction with a healthcare practitioner.
|Neurological Health Formula
|Nerve Calm Inflammatory Pathway Support RNA||Vitamin D-3|
|Stress Foundation RNA||Cod liver oil|
|General Inflammatory Pathway Support RNA (if needed)||Super Digestive Enzymes (with each meal)|
|Bowel Inflammatory Pathway Support RNA as needed||OraAdren 80|
|Cytokine Inflammatory Pathway Support RNA (if needed)||ImmunoForte|
|Magnesium (citrate or drops)||OraKidney + Kidney Inflammatory Pathway Support RNA (a few times per week)|
|OraPancreas||OraLiv + Liver Support RNA (a few times per week)|
|Pycnogenol||Probiotics (several different types, rotated daily)|
|Grape seed extract||Basic mineral support such as BioNativus, Cell Food and/or individual minerals based on test results.|
|Branched chain amino acids (can be taken unless there is a maple syrup smell in the urine)|
Beginning in the next two chapters, and in the subsequent steps of the program, I’ll provide a number of lists of supplements like the one for Basic Support. Each list will be targeted to support proper functioning in a specific bodily area that we need to address. On day one, it’s not advisable to jump in and give your child or yourself, every supplement on the list. You should begin with a single supplement at a low dose, carefully monitoring how you or your child reacts to it. Other supplements can be added gradually one by one. Sometimes your child may not be ready to add in a new supplement, but he or she may be ready later on. Some supplements you may never add. Some children will benefit from a very narrow range of the appropriate supplements, while others may end up taking small quantities of them all. The important thing is for you and your practitioner to agree upon what works for your child.
Throughout all three steps of the program, you will continue using the supplements and diet you’ll learn about in this chapter and begin in Step One. Moreover, as you test key biochemical markers, which I consider essential, with each new round of test results you can further refine the program, adjusting your child’s intake depending on what these markers reveal. In most cases, wherever I offer supplement recommendations for specific areas of function, I also list the tests for those areas so that you and your practitioner can monitor results. Noticeable improvements in your child’s behavior, speech, and function, combined with test results of key biochemical markers will guide you and your health care practitioner so that you can decide when you need to adjust supplementation as well as when your child is ready for the next step.
Parents report that some children experience a temporary setback when they are detoxing and then resume their forward momentum after they have released more toxins. That’s why I always urge parents to introduce supplements slowly
with small doses—often a sprinkle is enough. That way you can see how your child reacts and modify doses accordingly.
Remember that natural herbs and the other ingredients found in supplements are gentler than prescription medications, so we can use different guidelines in taking them. For example, most physicians recommend that you take a complete course of antibiotics, rather than stopping prior to its completion. But the same cautions don’t apply to natural supplements. You are free to adjust as you go. In the chat room, you can connect with other parents who have long experience of this process and can answer many of your questions. Not only can they reassure you, but they can also guide you as you and your practitioner move your child through the program. I strongly encourage anyone using the program to join the chat room and take advantage of that resource.
Sometimes when people first see the supplement lists, they feel overwhelmed and ask me: “Why so many supplements?” Let me tell you, those of us who practice integrative health care did not set out with the intention to promote or provide supplements. However, many of us have found that not all supplements are made with the high standards necessary to produce successful results. That’s why, over many years of clinical practice, like many practitioners, I’ve come to see that it’s vital to use the proper tools to bring about real health changes. Quality supplements are crucial tools. Use good judgment in choosing your source of supplements. Please do not be guided simply by the price. The difference of a few dollars may mean the difference between a successful supplement program and one that is mediocre, I’ve heard parents say, “Oh, I’ve tried that before, it doesn’t work,” only to find that when they use a highquality version of that same supplement, it does in fact make a difference. In other cases, people followed the suggested protocols with great success, but obtained less favorable results when they switched to a different supplement brand, or to a supplement that was not stored properly. Supplement quality is therefore a key aspect of this program. Supplements are not regulated. As a result, quality can vary greatly. If not shipped or stored properly, just like fresh produce, some supplements can spoil. Consequently, in following the recommendations, it’s vital to use high-quality brands and know your source. This will assure that the product is fresh, rather than stale, and that it’s been stored and shipped properly.
Finally, this book contains my latest supplement recommendations. Many of these recommendations have remained constant over several years, but periodically I make modifications in order to keep my recommendations in step with both new scientific findings and my own clinical discoveries. Therefore, please do check the website regularly for these updates. One more thing you will notice is that certain of these foundational supplements are marked to indicate whether or not they are appropriate for people with specific SNPs. Accordingly, once you’ve gotten your Nutrigenomic test results, you may wish to revisit the lists, as you will have some new insight on which recommendations apply to (or may not be indicated for) your child.
In summary, rest assured that as you carefully work with diet, strengthen the body, balance key neurotransmitters, support processes that are blocked by mutation, and systematically detox the system, healing occurs.
My colleagues in scientific research and health practice often ask me how I came to develop this unique program. I regard this protocol as the outcome of my many years of training and research in molecular biology, combined with my training and clinical experience as a registered naturopath. My knowledge of these two fields enables me to have a unique, and I believe rare, cross-disciplinary perspective. Knowing different disciplines well helps me to think outside the box and see things that may not have occurred to others. Last, but perhaps most important, I am also a Mom writing to other parents. I want you to know that I understand the challenges in undertaking this kind of program and do everything in my power to make it as easy as possible for you to follow. My advice is to take it slow and take your time. You don’t have to run the marathon in one day.
Prior to bringing in nutrients via supplements, it’s vital to lay the right nutritional groundwork through diet. As I mentioned earlier, the basic principle of naturopathy is to give the body what it needs and remove from it whatever may be harmful. Foundational to that is diet. It’s common sense that if a child follows the program to a T while also consuming soda, candy, and junk food, he’s not going to progress as easily as he would if he were avoiding all harmful synthetic food additives and eating healthy whole foods, like fruit and vegetables. While I consider the supplements I recommend to be a form of food, because they supply essential nutrients, the baseline nutrients most of us get every day come from food, and for these children, we want that food to be of the highest quality.
Since there are so many capable nutritionists, doctors, and parents who provide terrific information about what your child should eat, I won’t discuss diet too extensively, except to touch on a few basics. Most parents are already familiar with these general dietary guidelines, but if by chance you aren’t, you can read this overview and delve into the topic further by accessing other sources. These include the gluten-free, casein-free (GF/CF) diet, and the PKU Diet from the University of Washington (http://depts.washington.edu/pku/diet.html). Also see Battling the MSG Myth, a cookbook by Debby Anglesey, www.msgmyth.com, and Excitotoxins: The Taste That Kills, by Russell Blaylock.
Going back to the naturopathic principle of bringing in supports and removing things the body doesn’t need or cannot handle, let’s consider what foods are harmful or hard to handle—especially for sensitive people—like many of the children on this program.
Compounds found in certain foods, especially gluten (found in wheat and other grains) and casein (in dairy), can be a problem for many children and adults, especially at the outset of this program, before it’s begun to rebalance their systems. If you are the parent of a child with autism, you are no doubt already aware of this. If not, please go online and search for information, products, and recipes for gluten-free/casein-free diets. In addition, there are other foods that can be problematic until the gut is in better balance. People sometimes report that they’re “allergic” to a food based on sensitivity shown through IgG testing. Frequently, reactions arise because a leaky gut allows foods to pass into the bloodstream, where they act as foreign substances and stimulate an IgG type reaction. As we work together to get the gut in better balance, these foods generally cease to be problematic. (The program for balancing the gut is in the next chapter.)
In many cases I’ve seen, the Bowel Inflammatory Pathway Support RNA helps to restore gut integrity. You can track improvement via an intestinal permeability test. However, when sensitivity testing reveals a positive IgE (as opposed to an IgG) reaction testing, that indicates a “true food allergy.” Avoid all foods to which you or your child has an IgE response.
Over the course of the program, one of our tasks will be optimizing digestive and immune function. As a result, over time some food sensitivities may decrease. But some will remain, requiring you to make sure that going forward, your child avoids specific foods and ingredients. As always, err on the side of caution. If you are concerned about your child’s reaction to a food, then simply do not allow them to ingest it.
Now, I’ll briefly highlight some other foods to look out for and eliminate if necessary.
Nowadays, nutritionists and natural health doctors have alerted people to a growing list of substances in foods that many believe are harmful. Given that children with autism are often reactive and sensitive, it makes good sense to consider eliminating some or all of them from your child’s diet. Here is a quick overview that you can use to do your own research and make your own assessments:
When practitioners or nutritionists characterize any food, substance, or chemical as helpful or harmful, they base these determinations on what research and/or practice has revealed. How does that substance interact with bodily biochemistry? Where does it throw key bodily areas off? Or conversely, where does it help improve areas of functioning? Until we look more closely at children with autism to determine where and how their bodily biochemistry is imbalanced, we won’t come close to understanding these disorders, nor will we be able to treat them. However, there’s an upside. The upside is that the more we examine what’s going on, the better our ability to address it with precision. That’s what we’ll be doing throughout this program.
There are so many areas of dysfunction in children with autism that parents often feel overwhelmed and wonder where to begin. In the next section I’ll acquaint you with where I like people to begin—with a factor that I consider critical in this program. Addressing this common area of imbalance can and should be undertaken at the outset and continued throughout the entire program, through all of the steps.
In this section I’ll explain why I consider it so important to balance two key neurotransmitters—and let you know how to do it. What are neurotransmitters? They’re brain chemicals (usually amino acids, the substrates of protein) that communicate information throughout the brain and body, as well as relay signals between neurons. Neurotransmitters play a role in signaling the two halves of our autonomic nervous system—the sympathetic and parasympathetic systems, each of which helps perform a wide range of bodily functions. When one or both of them are out of balance, this imbalance can contribute to many symptoms. That is why treatments that balance neurotransmitter levels create significant improvement. Mood, energy levels, mental stability, resilience, speech, motor-skills, sleep, and hormonal function are just a few of the many functional areas closely tied to neurotransmitter balance.
We have two kinds of neurotransmitters, the excitatory (such as norepinephrine or glutamate), which stimulate, and the inhibitory (such as serotonin or GABA), which calm the brain to balance mood. Our biochemistry dictates that each paired set of neurotransmitters functions in a dynamic balance between excitation and inhibition. You can picture it as a kind of seesaw, with imbalances resulting when one side or the other becomes overactive.
When an excitatory neurotransmitter becomes overactive, its counterbalancing inhibitory partner becomes depleted. As a result, stimulation will increase, while relaxation decreases. Conversely, if the inhibitory partner is overly dominant, drowsiness, lethargy, or even depression may result. So the key is maintaining balance.
Some of the SNPs we cover on the Nutrigenomic test contribute to regulating neurotransmitter levels. At later steps of the program, this information is used to fine tune what’s needed by each individual to improve neurotransmitter balance. But there’s one key neurotransmitter pairing that seems to be vital for everyone, so that even without testing, most of the children I see benefit from my approach to balancing the paired neurotransmitters glutamate and GABA (gamma-amino-butyric acid).
Glutamate is one of the main excitatory neurotransmitters in the body. It’s particularly important for the children I see because adequate levels are essential for learning as well as short-term and long-term memory. Its complementary partner on the “seesaw” is GABA, a calming neurotransmitter essential for speech.
How does imbalance in this pair of neurotransmitters translate into autistic behaviors? On one side of the seesaw, high excitatory neurotransmission leads to stimulatory behavior, called stims, while on the low end of the seesaw, low levels of calming neurotransmission lead to lack of speech. In addition, high levels of glutamate can cause the nerves to fire, creating neurological inflammation and damage. This damage produces the symptoms we see in autism and other neurological conditions—as well as other symptoms I’ll highlight later.
Since glutamate is also the biochemical precursor to GABA, under normal conditions excess glutamate automatically converts to GABA. You experience this normal balancing act when your brain starts to hit overload, you find yourself getting sleepy, and tune out. But when for various reasons, the body can’t properly regulate glutamate, as often occurs in the children I see, glutamate can build up to toxic levels. This throws off the delicate balance between this pair of neurotransmitters, causing high levels of glutamate to accumulate while GABA levels remain exceedingly low. When the glutamate/GABA seesaws tips too far over to glutamate, it’s vital to reduce glutamate intake in order to restore balance and correct the health symptoms caused by high glutamate.
In his landmark book, Excitotoxins: The Taste that Kills (Health Press 1996). neurosurgeon Russell Blaylock characterized excitotoxins (glutamate and other amino acids widely used in processed foods) as well as their contribution to neurological damage. Even though his book was first published over a decade ago, many people remain unaware that MSG, aspartame, and other novel food ingredients contribute to health risks.
These ingredients are added to food by food scientists working for major processed food producers. The companies add these chemicals to processed foods because excitotoxins fool the brain into experiencing a particular food as tasty. Unfortunately, excitotoxins also raise levels of excitatory neurotransmitters, including glutamate, potentially causing nerve-cell death.
In addition, excess glutamate toxicity also has a negative impact on:
According to research and clinical practice, excess glutamate levels can contribute to a range of neurodegenerative diseases, including Alzheimer’s disease, Parkinson’s disease, Huntington’s chorea, stroke, multiple sclerosis, and ALS. That’s why managing glutamate levels is beneficial to both children and adults—and absolutely essential when the methylation cycle is not functioning optimally due to genetics. Although in my experience, most of the children benefit from lowering glutamate levels, you and your practitioner can make an individual determination for your child through lab tests or monitoring symptoms.
A deeper look into how glutamate works and interacts with brain biochemistry reveals why it’s a key factor in a disorder like autism.
Receptors are located on the surface of nerve cells. They function a bit like ”fishing poles” and each type has a specific task—to reel into the cell a specific neurochemical. As in fishing, a certain hook will catch certain kinds of fish. Glutamate receptors have hooks that pull in glutamate. However, these receptors can also pull in other excitatory neurotransmitters which thereby enter the cell. The following neurotransmitters are pulled into the cell via glutamate receptors:
More glutamate receptors will tend to pull in more excitatory neurotransmitters, causing higher levels of excitatory chemicals within each cell. In certain key studies, scientists found that individuals with autism had elevated excitatory neurotransmitter levels compared with non-autistic individuals. I suspect that people with autism may produce more receptors for glutamate and other related excitatory chemicals.
The Relationship between Glutamate and Calcium
Glutamate can bind to six different types of receptors located in the brain, including the NMDA receptor, which helps the body carry calcium into the nerves. The combination of glutamate and excessive calcium makes it impossible for the neurons (nerve cells) to rest. The neurons continue to fire without stopping, causing the release of inflammatory mediators, which trigger additional calcium influx. This ongoing firing process results in neural cell inflammation and the death of neurons. Magnesium can modulate the calcium flow, as can zinc. (However, zinc is a double-edged sword since it can also activate glutamate release via the non-NMDA glutamate receptors.)
As Dr. Mark Neveu, a former president of the National Foundation of Alternative Medicine, said when speaking of excitotoxin damage, “glutamate is the gun and calcium is the bullet”. This is the main reason that, on this program, I recommend caution in supplementing with calcium. Both limiting calcium intake and supplementing with magnesium and zinc can help maintain low to moderate calcium levels. This strikes a balance between maintaining necessary amounts for bone health without damaging the nerves.
As you can see, achieving the appropriate levels of key minerals is also foundational. The best way to assure that your supplement levels are adequate is to take a test called the Urine Essential Elements (UEE). This will help you precisely determine current levels as well as monitor your success following supplementation. In addition, you can do weekly, spot, toxic urine tests and follow up with a UEE every few months. To interpret lab results on the UEE, please consult your doctor. However, here are some general guidelines that I consider in evaluating a UEE:
With these basic guidelines, and after checking with your doctor, you can use the following supplements to help achieve the proper levels of key minerals.
Paradex or wormwood
Elevated calcium relative to magnesium on a UEE or UTM
Elevated calcium relative to magnesium on a red blood cell element test
Calcium and Magnesium citrates
Vitamins D & K
Bone Support RNA to support healthy bones but will not affect calcium per se
Calcium below the range of low-end normal on a urine essential elements test
Calcium below the range of low-end normal on an RBC element test
High level excretion of lead when checking urine calcium levels
Magnesium citrate or oxide
Copper: Cell Food and BioThyro for copper support if recommended on testing
Sodium : You can use Aerobic O7 + ATP Potassium: You can use Aerobic KO7 + ATP Phosphorus (complexed) + ATP
Elevated copper relative to zinc on a UAA or blood work
Low levels of ceruloplasmin on blood work
Red hair is an indicator, to be confirmed with a urine essential element test
Decreasing Elevated Copper in Copper/Zinc Ratio
Low Molybdenum on a UEE
Carnosine (low dose)
As always work with your health care practitioner.
Children with autistic type behavior have often been described as exceedingly intelligent, with a certain percentage considered to be “savants,” people with extraordinary mental ability in certain areas (such as an exceptional memory). Dr. J. Z Tsien and his collaborators have demonstrated a correlation between glutamate receptors and superior ability in learning and memory. However, his research indicated a significant downside: enhanced levels of glutamate were also correlated to an increased risk of stroke and seizure activity.
The takeaway from this study is that more highly intelligent people often have higher glutamate receptor activity. At the same time, higher receptor activity may make intelligent people more vulnerable to glutamate excess and nerve damage. That’s why the recommendations to address this issue by lowering glutamate levels can be used with:
Children with autism
Adults with neurological illnesses
People with a family history of such illnesses
Individuals with atrial fibrillation also seem to benefit from balancing glutamate and GABA.
In my view, lowering glutamate levels to prevent nerve damage is a sound preventive measure for nearly everyone.
How to do this? To restore balance, we first must decrease glutamate levels by limiting foods that contain glutamate. Simultaneously, we can increase GABA levels by following the supplement recommendations for supporting healthy GABA levels.
Other Factors That Tip the Balance
Controlling glutamate intake is vital, but other factors also play a part. One of these is the body’s ability to regulate glutamate and GABA, which can get thrown off all too easily in children with autism. Later steps in the program may help parents manage contributors to disregulation.
How does disregulation occur? Scientists are still trying to determine all the contributing factors. There are a few working theories currently being investigated. It appears that problems with the GAD enzyme, a pancreatic enzyme, may contribute to the disconnect, so that excess glutamate does not automatically signal a counterbalance of GABA. Several studies have found that the rubella virus (contained in the measles, mumps and rubella (MMR) vaccine) can cause the GAD enzyme to stop functioning properly. This may explain why children with autism who have received these shots may be more vulnerable to this imbalance.
Acute viral infection can lead to type I diabetes. In type I diabetes, the body makes antibodies against the GAD enzyme which may lessen its ability to balance the seesaw. Chronic viral infection may also contribute to problems with the GAD enzyme. If so, then addressing chronic viral infections as we do on this program could potentially help.
The GAD enzyme deploys vitamin B6 as a cofactor for its activity. Supplementation of vitamin B6 has long been standard in the DAN (Defeat Autism Now) treatment, pioneered by Dr. Bernard Rimland. B6 taken via supplements may help the GAD enzyme convert glutamate to GABA which helps to explain the success many have experienced in following the DAN protocol. Nutrigenomics can also tell us which individuals can most benefit from B6 supplementation and help determine when to add B6. As mentioned earlier in this chapter, at the outset of Step Two, if CBS mutations are present, I recommend addressing those early on before introducing a number of the other supplements. Since the use of B6 also increases CBS activity, it’s not an ideal supplement for those with particular CBS mutations (such as CBS C699T or CBS A360A). For this reason, it’s best to get CBS in better balance before adding B6. This is just one example of how Nutrigenomic information helps to introduce the right support in the right time sequence. I call this “layering.” Each child or adult is unique. While the basic need for glutamate and GABA balance applies to all, we can optimize health care and outcomes by accessing the Nutrigenomic profile to fine tune how and when we layer in supports, like supplements. There is also an interrelationship between glutamate and blood glucose levels.
Lowered ability to remove glutamate
Glutamate stimulates insulin release, which in turn lowers glucose. However, glucose regulates the removal of excess glutamate from the synapses. Therefore, a drop in blood glucose disrupts this removal process and allows the build up of toxic glutamate. In fact, hypoglycemia, or low calorie/ starvation conditions induce the release of glutamate and reduce the ability to remove excess levels of glutamate from the brain, making it essential to provide regular nourishment through meals and snacks to maintain consistent blood sugar levels throughout the day. In the next chapter, you will see how the Nutrigenomic profile provides invaluable information for regulating blood glucose levels because it measures a genetic variation called the “VDR/Fok.” Individuals who have the VDR/Fok mutations may be more susceptible to sugar imbalances. Knowing that susceptibility alerts us to the need for sufficient pancreatic support to address the glutamate/GABA balance as well as blood sugar issues. If after getting your test results, you learn that you or your child have that mutation, you may want to revisit the recommended pancreatic supports and increase them if needed.
In addition to neurological damage, glutamate and other excitotoxins contribute to other bodily symptoms. Glutamate prompts the body to release opioids to protect the brain from damage, contributing to the “spaciness” that some of the children experience. Elevated glutamate levels can also deplete glutathione, a major antioxidant that promotes healthy detoxification and prevents inflammation. With lowered glutathione, there will be an increased tendency toward leaky gut (or Irritable Bowel Syndrome). Since glutathione helps to protect neurons from damage, its depletion also results in nerve cell death. Glutamate excess can also contribute to insomnia, bedwetting, and problems with eye focus and making eye contact.
Inositol hexaphosphate (IP6)
Nerve Calm Inflammatory Pathway Support RNA
Cytokine Balance Inflammatory Pathway RNA
Advanced Joint Inflammatory Pathway Support RNA
A decrease in GABA levels on this neurotransmitter seesaw can cause a range of symptoms. In particular, GABA is a key to speech. (That’s why GABA is often used to help restore speech in stroke sufferers.) As a result, the return of language is often an outcome of balancing the glutamate/GABA seesaw.
How does this work? GABA is used by the brain to support sensory integration, helping us to tune in to the sounds we hear. With adequate GABA levels, we are able to dampen background sounds, so that it’s easier to distinguish the onset of a particular sound or word, which is how we recognize words and develop speech. With lowered GABA levels, spoken words sound like a long run-on sentence, rendering comprehension difficult. I always imagine that this is what these children hear until they get sufficient levels of GABA. In fact, often when they first recover language, their first communications will sound like a run-on sentence. That’s why children will understand better when parents speak slowly,with gaps between the words.
Decreased GABA levels also increase anxiety, something that many of the children, their parents, and even the practitioners working with them tend to experience. Dealing with autism creates tremendous stress.
Low GABA levels can also increase aggressive behavior, as well as decrease social behavior. Low GABA leads to decreased eye contact and difficulties in focusing. With some children, due to low levels of GABA, both eyes focus inward toward the nose, while other children may experience horizontal or vertical wavering of the eyes. Low GABA levels lead to decreased bowel function. It may seem counterintuitive that a calming neurotransmitter helps stimulate bowel activity, but GABA does indeed help the bowel to contract. In addition, GABA release may help to reduce the triggering of transient lower esophageal relaxations, decreasing gastroesophageal reflux (GERD). GABA is essential for proper intestinal motility.
That’s why along with controlling glutamate, to help to create balance, many find it helpful to supplement directly with GABA as well as other natural substances such as valerian root, which indirectly helps to support GABA levels.
In looking over the recommendations of useful supplements for GABA/glutamate balance, please note that in a few instances, I’ve noted how the supplements can be further fine tuned once you have your test results. If you don’t yet have your results, please use the supplements recommended for everyone.
Branched chain amino acids (use only products that contain leucine/ileucine/ valine—but discontinue immediately if urine smells like maple syrup)
Grape seed extract
Nerve Calm Inflammatory Pathway Support RNA
Lithium orotate (depending on levels on urine essential elements test)
Sublingual GABA/ glycine
In addition, after you’ve gotten your test results, you can revisit the following additional supports in balancing GABA and glutamate, which build upon knowing your mutations.
Progesterone cream (Best for ACE+/ MAOA+)
Sublingual methylcobalamin (B12)—Only use following Nutrigenomic testing if recommended
Sublingual cyanocobalamine—Useful for all unless contraindicated by test results
Sublingual hydroxycobalamin—Useful for all unless contraindicated by test results
Hydroxy B12 Oral Spray—Useful for all unless contraindicated by test results Liposomal B12 Taurine (depending on urine AA test levels—not for CBS + or SUOX + -) Theanine (Best for COMT V158M –)
Monocyte support RNA as additional supplementation if seizures are an issue
Elevated levels of glutamate, glutamine, glutamic acid , aspartate, and/OR aspartic acid on a Urine Amino Acid test (UAA)
Low GABA (gamma aminobutyric acid) on a UAA
Low GABA (gamma aminobutyric acid) on a neurotransmitter test
Elevated quinolinic or kynurenic on OAT/metabolic test
Stims Poor eye contact
For all of the reasons I’ve discussed, it’s vital to avoid all foods (and nutritional supplements) that contain (or prompt the body to create) glutamate, glutamic acid, aspartate, and/or aspartic acid and cysteine. All forms of these various amino acids act as excitotoxins. In addition, it’s best for a time to limit calcium intake to acceptable sources at low to moderate levels, by using herb and food sources of calcium that maintain healthy bone without producing too many calcium “bullets.” Unless you exclusively eat a diet of healthy whole plant foods and grains, you will have to learn to read labels to discover which foods contain excitotoxins. (A list of common ingredient names can be found below.) Once they begin to read labels, many parents are shocked to realize how widespread these ingredients are. Don’t be surprised if they show up in foods you have served your children all along!
What should you look for?
I recommend eliminating both glutamate and aspartate from your child’s diet, because in the cells, glutamate can be made from aspartate, and vice versa. Both glutamate and aspartate are widely used as food additives, the two most common being MSG (monosodium glutamate) and aspartame. Later in this chapter, you will find lists of ingredients to be avoided, as well as lists of the types of products in which these harmful ingredients are most commonly found.
Finding Excitotoxins Hiding in Plain Sight
Most food prepared by major fast-food chains contains MSG.
Molasses, sugar beet and cane contain MSG.
MSG and Aspartame (NutraSweet) are found in everything from soups, sauces, and juice to frozen entrees, candy, cigarettes, and anything with seasonings (e.g., potato chips, meat, ice cream).
Binders and fillers for medications, nutrients, and supplements, both prescription and non-prescription, and some fluids administered intravenously in hospitals may contain MSG.
According to the manufacturer, Varivax-Merck chicken pox vaccine (Varicella Virus Live) contains L-monosodium glutamate and hydrolyzed gelatin, both of which contain processed free glutamic acid.
MSG is used as a plant “growth enhancer” (AuxiGro) sprayed on growing crops. AuxiGro Plant Metabolic Primer contains 29.2% by weight, pharmaceutical grade, L-glutamic acid.
Both glutamate and aspartate occur naturally in many foods, such as proteinrich foods, wheat gluten, hydrolyzed yeast, and milk casein. You can see why a grilled-cheese sandwich should probably not be on the menu of most children with autism. Many parents encourage their children to drink smoothies, but beware of the protein powder you use. The process of making protein powder releases glutamate.
Some recommend that children with autism eat high protein diets. While the amino acids that make up protein are necessary for normal brain function, most protein rich foods contain high levels of glutamate and aspartate which is why I don’t recommend high protein diets for this population. Further, high-protein diets force the body into a state of cannibalism called metabolic acidosis, in which blood levels become so acidic that the body starts feeding on muscle tissue for nutrients. What’s more, the breakdown of protein generates ammonia. Many children with autism have elevated ammonia levels, yet another reason for them to avoid high-protein diets. Instead, a low to moderate amount of protein is best. One exception is phenol-sensitive individuals, who have been advised to follow the PKU (phenylalanine-free) diet, which entails restricting all protein-rich foods since they contain a phenolic amino acid.
Many nutritional supplements contain glutamine (or glutamic acid), because it helps restore gut health and integrity. However, glutamine is readily converted to glutamate, so I counsel parents to read supplement labels and avoid products containing glutamine.
I want to reassure you that it’s neither possible nor advisable to limit every single molecule of excitotoxins, as we do need low levels of glutamate. However, it is necessary to avoid excessive intake in order to stop the inflammatory process that glutamate and other excitotoxins trigger. To help our nerves function, we need the stimulatory activity provided by the glutamate receptor. What we want to avoid is excessive stimulation.
Hydrolyzed protein or hydrolyzed oat flour
Sodium caseinate or calcium caseinate
Autolyzed yeast or yeast extract
Ajinomoto Autolyzed anything Autolyzed yeast Autolyzed yeast extract Bouillon Broth Calcium caseinate Carrageenan (or vegetable gum) Caseinate Chicken/pork/beef “base” Chicken/pork/beef “flavoring” Disodium caseinate Disodium guanylate Disodium inosinate
Dough conditioner(s) Gelatin Glutamate Guar gum Hydrolyzed anything Hydrolyzed oat flour Hydrolyzed plant protein Hydrolyzed protein Hydrolyzed vegetable protein Kombu extract
Malt extract Malt flavoring(s) Malted anything Malted barely flour
Malted barley/barley malt Maltodextrin Meat flavorings (chicken, beef etc.) Monosodium glutamate Natural flavor(s) Natural flavoring(s) Nutrasweet/aspartame Plant protein extract 1-cysteine Seasoned salt Seasoning(s) or spices Smoke flavoring(s) Sodium caseinate Soup base Soy extract
Soy protein concentrate
Soy protein isolate
Spice mixes that contain glutamate or MSG as an ingredient
Stock Textured protein Vegetable gum Whey protein Whey protein concentrate Whey protein isolate Yeast extract
Remember to always read labels. Product contents can change at any time at the company’s discretion. Clearly, you can’t always avoid everything on the list below. But you can regard these foods and ingredients with suspicion, as they have been known to cause problems. Even if you do not eliminate them entirely, once you are aware of these concerns you can pay special attention after you or your child have eaten a potentially troublesome food and notice if there is an immediate negative reaction (within the next twenty-four hours.) On the other hand, we don’t always get the immediate certainty conferred by a quick reaction to a food. More often, there is a long term cumulative effect, making it harder to trace the various factors contributing to an illness or symptom.
To understand how this works, first visualize a measuring cup as a metaphor for what is going on within us that we cannot see. Although this cup is empty at first, the cup gets a little fuller each time we eat foods that contain glutamate or MSG. Over time, the contents creep up to the top until the cup overflows. Like a human body, the overflowing cup can no longer contain or manage the accumulation of toxins to which it has been exposed. When the body can no longer manage, it responds with an illness or symptom. That’s why I counsel people to moderate their food intake of excitotoxic ingredients. That will prevent the cup from overflowing. I offer this long list of problematic foods not because I expect you to absolutely avoid every single item on it, but because with awareness, you can and should monitor your and your child’s intake of foods that damage the nerves.
Anything enzyme modified Anything fermented Anything protein fortified Anything ultra-pasteurized Anything vitamin enriched Anything with corn syrup added Anything with milk solids Baked goods from bakeries Barbeque sauce
Certain brands of cold cuts/hot dogs
Body builder protein mixes
Bottled spaghetti sauce
Boullion (any kind)
Canned and smoked tuna, oysters, clams
Canned soups (certain brands) Canned refried beans
Canned, frozen, or dry entrees and potpies
Caramel flavoring/coloring Catsup Cereals Chili sauce Chocolates/Candy bars
Citric acid (when processed from corn)
Cornstarch Corn chips (certain brands) Dough conditioners Dry milk or whey powder Egg substitutes Flavored chips (certain brands) Flavored teas, sodas Flour Flowing agents Fresh and frozen pizza
Fresh produce sprayed with Auxigro—instead choose organically grown produce
Fried chicken from fast food sources
Frostings and fillings Gelatin Gravy Master Instant soup mixes/Stocks Kombu extract
Many salad dressings/Croutons
Most salty, powdered dry food mixes
Salted peanuts (certain brands)
Powdered soup and sauce mixes (certain brands)
Processed cheese spread Ramen noodles
Restaurant gravy from food service cans
Restaurant soups made from food service Soup base
Sausages/Processed meats/Cold cuts
Skim, 1%, 2%, non-fat, or dry milk
Some bagged salads and vegetables Some peanut butters Some spices Soy sauce
Supermarket turkey & chicken (injected)
Tofu and other fermented soy products
Tomato sauce/Stewed tomatoes
Whipped cream topping substitutes
Worcestershire sauce Xanthan gum/other “gums”
Some parents opt to have their children take tests that measure neurotransmitter levels in order to precisely determine glutamate and GABA levels. Since these tests are costly, I don’t recommend them that often. The bottom line is that once glutamate reaches a certain level, neurological damage has already occurred. To avoid getting to that point, the goal is to limit the amount of glutamate that comes into the body every day. As you learn the sources of glutamate and aspartate, you can make informed choices about limiting intake. The aim is to keep excitotoxins to a minimum; you will never avoid them completely.
Transitioning to proper nutrition and getting glutamate under control are foundational to this program, but I don’t underestimate the challenge. Please seek out the techniques and approaches that work for your child and family, and remember that this is a marathon, not a sprint.