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Month: July 2018

Autism Spectrum Disorder: the who, what, when, where, & why.

Posted on by Dana

ASD/ADD
ASD or autism spectrum disorder is a type of developmental disorder, which affects behavior and communication. Though patients suffering from autism may get diagnosed from the disorder at any age; but, it is considered a developmental disorder as its symptoms appear during the initial two years of a child’s life.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is a guide used in the diagnosis of mental disorders, states that people suffering from ASD have the following:

  • Difficulty with interaction and communication with other individuals
  • Repetitive behaviors and restricted interests
  • Symptoms, which hurt the ability of the person to function optimally at work, school and other walks of life

Causes of ASD
According to CDC (Centers for Disease Control and Prevention) at least 1 in 70 kids in the USA suffer from ASD (autism spectrum disorder), which is an alarming number.

Though, scientists suggest that aberrations in genes that act together with certain environmental factors as the causative factor of ASD; however, several studies have highlighted that neuroinflammatory processes play a more critical role in the causation of ASD. Over the last decade, intense research has been done to find out how exactly immune dysfunction alters brain function and causes autism.

According to a review published in the journal ‘Current opinion in neurology’, autoantibodies (antibodies that target tissues of your own body) targeting brain proteins have been found in both children suffering from autism and their mothers. The review further states that there is alteration in both humoral and cellular immunity in patients with autism. Moreover, in some patients with autism active inflammation in the central nervous system has been found (>60%).

Another review published in the journal ‘Immunology letters’ suggests that ASD is characterized by immune dysfunction. Symptoms of immune dysfunction present in ASD are neuroinflammation (inflammation in the nervous system), increased responses of T lymphocytes, presence of autoantibodies etc. Research is pointing at a reaction to foods in the child’s diet that may cross react with cerebellar proteins, diminishing brain development and executive function (cerebellum fires to the frontal cortex which is critical to behavioral control, mood and attention so anything generating inflammation in one area may create problems in others). These responses are associated with core symptoms of ASD including repetitive behaviors and impaired communication and poor social interactions. Hence, it can be suggested that the immune dysfunction present in ASD patients affects neurological processes and various aspects of neural development; thereby, resulting in changes in behavior and communication.

Another study published in the ‘journal of neuroinflammation’ found various biochemical compounds related to inflammation in the plasma of patients suffering from autism. These chemicals can change blood flow, impact nutrient utilization and impede “neuroplasticity”, or the process of neurons connecting and creating a healthy neuron-network.

Heavy Metal Exposure Raises the Risk of ASD
It has been found that exposure to heavy metals such as lead, copper, aluminum, cadmium and mercury at various stages of development of the child may raise the risk of ASD. Prenatal exposure to heavy metals can result in defective brain development of the fetus. Consuming fish, using aluminum cooking utensils and living nearby gasoline stations has been found to result in maternal exposure to toxins.

According to a study published in the journal ‘behavioral neurology’, environmental exposure of children to toxic heavy metals during their developmental period plays a vital role in the causation of autism. The exposure to these heavy metals may be prenatal or postnatal. Some of the possible sources of exposure to heavy metals include fertilizers, chemical products, building materials, industrial paints, fish (which has high amounts of mercury), dental fillings containing silver, and preservatives containing mercury (thiomersal) present in vaccines. Lead is present in the dirt found near roads or in paint on old houses. Children who eat paint chips or who have pica (an illness in which the child eat non-nutritious things such as paint or drywall) may get toxic levels of lead in their blood.

Females who have chronic heavy metal exposure and have accumulated high levels of heavy metals such as mercury in their body tissues and blood may pass these metals to their growing fetus or infants through breastfeeding.

Vaccinations as a Potential Source of Heavy Metal Exposure
It has been found that mercury present in the preservatives used in vaccines is also a potential source of heavy metal exposure for children. Moreover, vaccines given for measles, mumps and rubella or MMR that is given during early life is also correlated to the disorder.

Conclusion
The causative factors of autism or ASD remains controversial and elusive, but both environmental and genetic factors have been suggested. However, recent studies suggest that exposure to heavy metals during key phases of development of a child may play a vital role in the causation of ASD. Moreover, autism is a neuroinflammatory condition and not a genetic aberration, which results from immune dysfunction resulting from environmental factors such as heavy metal exposure. This is the most important point as many so called “Autism advocacy groups” would like to normalize the behavior found in kids suffering with autistic spectrum. There is no doubt many children grow into healthy, productive adults even with Autism but for others this condition rules their life and their parents’ lives. Instead of saying we have a new “normal”, functional medicine and functional neurology looks to the reasons why someone developed incorrectly, what inflammatory triggers they have and how we can rehabilitate the brain to improve function and create less dependence on medication.

If you are curious about how we can provide a deeper level of natural support to your child then please join us for our ADD/ADHD & Autistic spectrum lecture at Dr. Autoimmune in North Boulder this Wednesday, August 1 @ 6:00PM. Limited seating available so RSVP is required!

Looking forward to providing you with the info to let your family’s health soar!
Ian Hollaman, DC, MSc, IFMCP
References

  1. Farida El Baz Mohamed, Eman Ahmed Zaky, Adel Bassuoni El-Sayed, Reham Mohammed Elhossieny, Sally Soliman Zahra, Waleed Salah Eldin, Walaa Yousef, Youssef, Rania Abdelmgeed Khaled, Azza Mohamed Youssef. Assessment of Hair Aluminum, Lead, and Mercury in a sample of autistic Egyptian Children: Environmental Risk Factors of Heavy Metals in Autism. Behavioral Neurology. October 2015; 2015: 545674.
  2. Afaf El-Ansary, Laila Al-Ayadhi. Neuroinflammation in autism spectrum disorders. Journal of neuroinflammation. 2012; 9: 265.
  3. Exposure to heavy metals may increase risk of autism. Medicalnewstoday. Available at: https://www.medicalnewstoday.com/articles/317754.php Accessed July 20th
  4. Autism Spectrum Disorder. NationalInstituteofMentalHealth. Available at: https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml? Accessed July 20th
  5. Gamakaranage C. Heavy Metals and Autism. Journal of Heavy Metal Toxicity and Diseases. September 2016; 1:3.
  6. Charlotte Madore, Quentin Leyrolle, Chloe Lacabanne, Anouk Benmamar-Badel, Corinne Joffre, Agnes Nadjar, Sophie Laye. Neuroinflammation in Autism: Plausible Role of Maternal Inflammation, Dietary Omega 3 and Microbiota. Neural Plasticity. September 2016; 2016.
  7. Jennifer Mead, Paul Ashwood. Evidence supporting an altered immune response in ASD. Immunology letters. January 2015; 163(1): 49-55.
  8. Paula Goines, Judy Van de Water. The Immune System’s Role in the Biology of Autism. Current Opinion in Neurology. April 2010; 23(2): 111–117.

Autoimmune Diseases & the Infection Connection

Posted on by Dana

Viral Infections and Autoimmune Disease

Autoimmune disorders occur when the immune system malfunctions. That is, instead of helping protect you against infections; it attacks your own tissues and organs. Scientists are not clear on what exactly causes an autoimmune disorder; however, multiple factors like genetics, environment and triggers play a significant role.

One of the most under investigated triggers in western medicine is that certain infections such as viral infections coupled with high amount of stress. According to researcher’s, individuals who have suffered from certain infections are more prone to develop several kinds of autoimmune diseases. In fact, the strongest link to date has been found between infections and autoimmune disorders in scientific studies.

Understanding the Connection between Autoimmune Disease and Infection

A person suffering from an autoimmune condition has a malfunctioning immune system.   It does not recognize the healthy tissues of the body as self-tissues and start attacking them by producing an antibody referred to as an auto-antibody. This can vary from person to person and cause different tissues to be affected. One person may develop autoimmune thyroid while another person develops autoimmune Rheumatoid Arthritis. The ultimate challenge our immune system has is keeping our tissues identified and infectious triggers cordoned off and dealt with.

Since a similar kind of immune response is triggered by viral infections, it is suggested by some researchers that antibodies that are produced as a response to some infections may attack some of the normal cells of the body as they resemble the virus, which resulted in the infection (Mullerian mimicry). According to other researcher’s, viral infections may actually destroy or damage the immune system of a person resulting in autoimmune disease (Bystander effect).

What Research Says?

The idea that a connection exists between viral infection and autoimmune disease is supported by research. It has been shows that the encephalomyocarditis virus can trigger autoimmune myositis (smooth muscle disease) and Coxsackie B4 virus can trigger type 1 Diabetes Mellitus (Dairy protein are also closely correlated here).
It has been found in studies that EBV (Epstein Barr virus) is strongly associated with the development of multiple autoimmune disorders such as SLE (systemic lupus erythematosus), rheumatoid arthritis, antiphospholipid syndrome, Hashimoto’s, multiple sclerosis, giant cell arthritis, pemphigus vulgaris, polyarteritis nodosa and Wegener’s granulomatosis (glomerulonephritis). Similarly, cytomegalovirus or CMV is also associated with autoimmune diseases such as lupus and Hashimoto’s thyroiditis.

Similarly, it has been demonstrated in a study that patients who had active rheumatic arthritis (an autoimmune disorder) were found to be positive for Epstein-Barr virus infection. In fact, patients suffering from RA have higher anti-EBV antibodies levels in comparison to healthy controls. A history of EBV virus is significant if you know or think you may have an autoimmune disorder (did your doctor test all four antibody markers for EBV?).

How to Prevent Autoimmune Disorders?

Since a link has been established between viral infections and autoimmune disorders, it is important to prevent viral infections by using good hygiene and taking care of your immune system through sleep, exercise and supplementation. You can also take certain general measures to help protect yourself from infections. These measures include:

  • Washing your hands thoroughly and frequently using soap (not Triclosan!).
  • Consuming eatables that are handled in a hygienic manner.
  • Not getting in contact with contaminated surfaces and infected people.
  • Using practices of safe sex.
  • Coughing and sneezing into tissues that should be thrown afterwards.
  • Preventing mosquito and tick bites.

If you have developed a viral infection, then it is important to get a proper diagnosis, which involves evaluation by a doctor and for certain infections, getting appropriate blood tests. PCR (polymerase chain reaction) techniques are used to make multiple copies of the genetic material of the virus (and are standard in research but not necessarily medicine). The virus can be accurately and rapidly identified by the doctors using PCR techniques. Blood may be tested for antigens (viral proteins) or for antibodies to the virus.

So what natural products do we recommend for fighting viral infections?

  • Whole Beta Glucan – This is the cell wall fragments that come off probiotics and upregulates our immune system to fight more efficiently (https://www.xymogen.com/formulas/products/90)
  • N-Acetyl-Cysteine – This is an amino acid that has been shown to reduce the replication rate of viruses and also boosts glutathione, our master anti-oxidant (/130)
  • Vitamin C/Bioflavinoid Complex – Not just ascorbic acid here, get something that has flavonoids added or get VERY fresh fruit as the vitamin C is rapidly depleted with shelf life (/186)!
  • Astragalus – An amazing herb which has great adrenal benefits and can increase our natural ability to Lyse, or kill off viral particles (https://www.xymogen.com/assets/imageDisplay.ashx?productID=298&attachmentTypeID=1)
  • Echinacea – Wonderful immune modulating properties for autoimmune disease but rapidly upregulates our caspases, enzyme molecules which blow up viruses (Echinamed or wild harvested is best)
  • Selenium – Selenium is used by multiple enzymes that degrade infections and is critical for formation of glutathione (/124)
  • Olive Leaf Extract – One of the best for acute viral infections but this amazing extract contains high polyphenol concentrations to activate macrophages which gobble up viruses and present them to our antibody cells (/91).

It is equally important to reduce your stress levels and allow the immune system to fight the infection (I know this statement may stress you out ;-)!

Role of Stress in the Development of Autoimmune Disease

Apart from viral infections, stress is a major factor that plays a role in triggering and exacerbation of autoimmune disorders. Studies show that psychological stress can play a role in the exacerbation and maintenance of chronic inflammatory disorders including RA and psoriasis. Have you noticed the pattern of going through school, breaking up or moving and you get sick? Of course, this happens because we upregulate inflammatory molecules and hormones like cortisol which can overwhelm the immune system in the short term.

Stress causes up regulation of NF-Kb, predisposing patients to have greater severity and progression of disease. NF-Kb is a complex protein which controls DNA transcription (process of making copies of DNA), production of cytokines (molecules that help in communication of cells during immune responses) and survival of cells. It has been found in a study that repeated short term stress can increase the toxic response of UVB radiation and trichloroethylene (TCE) by up regulation of NF-kB expression.

What are ways to drop stress?

  • Stop pushing yourself constantly! Prioritizing and pulling back from some of life’s “TO DO’s”, can dramatically reduce your stress – Does it really have to get done?
  • Get 8 hours of sound sleep and shoot for a regular bed time and waking time.
  • Stop the caffeine! This vicious circle robs you of energy and can also promote lack of sleep and an abnormal circadian rhythm of cortisol; both linked to infections!
  • Exercise, exercise, exercise. I know this is not fun to think about since you may be fatigued, but there are few interventions like exercise that can have as dramatic an impact. Try this exercise; put your shoes in front of the door and leave them there. Every time you walk by and see those puppies they will call your name and I promise you that you won’t regret a short walk when you go outside!
  • Vacation – Seriously, when was the last time?
  • Supplementation can vary but a few of my favorites are:
    1. Phosphatidylserine – use topical as it is more cost effective
    2. Cortisolv (/510)
    3. Adrenal Manager (/397)
    4. Adrenaliv (/948)
    5. Optimag Neuro (Mag-Threonate) (/447)

To Conclude

Autoimmune disease are complex – from the symptoms you feel to achieving a proper diagnosis. Understanding your triggers such as possible infections and how you handle stress can be integral in your healing. Functional Medicine is an excellent way to address the underlying causes, nutritional needs, and support your body to help you control the disease rather than letting the disease control you. With the right care, you can let your health soar!

Yours in health,
Ian Hollaman DC, MSc, IFMCP
References

  1. Jean-Francois Bach. Infections and autoimmune diseases. Journal of Autoimmunity. 2005; 25:74-80.
  2. Barzilai, Y. Sherer, M. Ram, D. Izhaky, J.M. Anaya, Y. Shoenfeld. Epstein-Barr Virus and Cytomegalovirus in Autoimmune Diseases. Annals of the New York Academy of Sciences. August 2007; 1108(1):567-577.
  3. Kuusela E, Kouri VP, Olkkonen J, Koivuniemi R, Ayravainen L, Rajamaki K, Valleala H, Nordstrom D, Leirisalo-Repo M, Ainola M, Eklund KK. Serum Epstein-Barr virus DNA, detected by droplet digital PCR, correlates with disease activity in patients with rheumatoid arthritis. Clinical and experimental rheumatology. March 2018.
  4. Balandraud N, Roudier J, Roudier C. Epstein-Barr virus and rheumatoid arthritis. Autoimmunity reviews. July 2004; 3(5):362-7.
  5. https://www.msdmanuals.com/home/infections/overview-of-viral-infections/overview-of-viral-infections
  6. de Brouwer SJ, van Middendorp H, Stormink C, Kraaimaat FW, Sweep FC, de Jong EM, Schalkwijk J, Eijsbouts A, Donders AR, van de Kerkhof PC, van Riel PL, Evers AW. The psychophysiological stress response in psoriasis and rheumatoid arthritis. The British journal of dermatology. April 2014; 170(4):824-31.
  7. Ali F, Sultana S. Repeated short-term stress synergizes the ROS signaling through up regulation of NFkB and iNOS expression induced due to combined exposure of trichloroethylene and UVB rays. Molecular and cellular biochemistry. January 2012; 360(1-2):133-45.
  8. https://www.everydayhealth.com/autoimmune-disorders/understanding/are-autoimmune-diseases-caused-by-infections.aspx

I felt a great disturbance in the microbiome…

Posted on by Dana

Relationship between disturbance of microbiome and Hashimoto’s thyroiditis
What is Hashimoto’s Thyroiditis?

Hashimoto’s thyroiditis is an autoimmune disorder in which the immune system of the body attacks the thyroid gland, a gland which is located beneath the Adam’s apple in your neck. This gland forms a part of the endocrine system of the body which secretes various hormones to coordinate multiple functions of the human body.
Inflammation due to Hashimoto’s thyroiditis, which is also referred to as chronic lymphocytic thyroiditis, results in hypothyroidism. Hashimoto’s thyroiditis is the most common cause of hypothyroidism or underactive thyroid in the USA. It usually affects females in the middle age-group but it may occur in males and females of any age group and also in children.

What are the causes of Hashimoto’s thyroiditis?

Hashimoto’s thyroiditis is an autoimmune disease in which the immune system produces antibodies, which damage the thyroid gland. It is not clear what causes the immune system of the body to attack the thyroid gland. According to the belief of some scientists a bacterium or virus may trigger this response while according to others it may occur due to a genetic mutation. Ultimately like most autoimmune conditions it appears a triad of genetics, environment and triggers create a perfect storm with resulting tissue damage and symptoms (even if TSH is balanced within the normal range).

How is the thyroid affected by the microbiome?

There has been growing evidence that imbalances or dysbiosis of intestinal microbiome and over abundance of unfriendly bacteria in the gut can negatively affect functioning of thyroid gland and may even trigger autoimmune diseases including Hashimoto’s thyroiditis.

The thyroid majorly produces the hormone T4 which is the inactive form and it requires to be converted to the active form T3 before it can be used by the body cells. 20% of T4 hormone is activated or converted to T3 in the intestines by the friendly bacteria present there. Imbalance in gut microbiome will affect the active hormone available for use by the cells, resulting in a state of low thyroid or hypothyroidism.

One of the main roles of friendly bacteria present in the gut is of strengthening the walls of the intestines, protecting it against pathogenic organisms and preventing the occurrence of leaky gut. When that barrier is not present large food particles and foreign matter pass out of intestines into your body starting a response by the cells of the immune system. Presence of prolonged immune response in the body can trigger production of antibodies against healthy cells and tissues resulting in autoimmune disorders such as Hashimoto’s thyroiditis.

When the intestinal microbiome is imbalanced, long-term damage and inflammation may occur in the body, which may result in production of cortisol (the stress hormone) by the adrenal glands. Over time, excessive cortisol may suppress the function of thyroid gland, reduce the quantity of hormones secreted by the thyroid and also inhibit the conversion of inactive T4 to its active form T3.

A study published in the journal Biomedicine and pharmacotherapy demonstrated that patients with Hashimoto’s thyroiditis have intestinal microbial dysbiosis and they showed an increased growth of the harmful bacteria E. coli. Another study published in discovery medicine concludes that dysbiosis in the gut may result in autoimmunity that may lead to Hashimoto’s thyroiditis.

How can we determine there is a problem with the microbiome?

Stool testing (I prefer a 3 day collection from Drs Data) can pick up on both functional and pathologic changes. It can tell us about inflammation, absorption and whether there is a healthy microbial balance. Pre and post stool testing is one of the most important tests in functional medicine because we have as much as 70% of our immune system in the gut! Treatment can be customized with the information found in this lab and it many times can pinpoint the trigger creating the autoimmune storm.

How to restore your intestinal and microbial health?

Prebiotics are the foods on which your gut bacteria thrive. Prebiotics such as bananas, garlic and onions contain dietary fiber and nutrients to feed intestinal bacteria and release by products of metabolism such as short chain fatty acids which help in maintaining health and preventing disease. Some of the prebiotic foods are:

  • Garlic
  • Onion
  • Jicama
  • Asparagus
  • Artichokes (Jerusalem)
  • Bananas
  • Pulses (beans, lentils, chickpeas etc.)
  • Fermented dairy & Ghee (butyric acid)

Probiotics are a kind of good bacteria, which on administration will keep your intestine healthy. They may be present in certain fermented foods that contain active live bacterial cultures such as yogurt.

Eating a diet rich in prebiotics and probiotics with live cultures plays a vital role in maintaining the balance of your gut flora. You can also eat fermented foods like kimchee, kefir, sauerkraut and kombucha as they contain live microbes and help in improving the health of the intestinal microbiome. Ensure that you get fermented foods with live cultures and not foods that are pasteurized.

Let Your Gut Soar,
Ian Hollaman, DC, MSc, IFMCP

References

  1. Ishaq HM, Mohammad IS, Guo H, Shahzad M, Hou, YJ, Ma C, Naseem Z, Wu X, Shi P, Xu J. Molecular estimation of alteration in intestinal microbial composition in Hashimoto’s thyroiditis patients. Biomedicine & pharmacotherapy. November 2017; 95:865-874.
  2. Hashimoto’s Disease. 2018. Available at: https://www.mayoclinic.org/diseases-conditions/hashimotos-disease/symptoms-causes/syc-20351855. Accessed June 29, 2108.
  3. What your gut bacteria need to thrive with Hashimoto’s. 2018. Functionalhealthnews. Available at: http://functionalhealthnews.com/2017/08/what-your-gut-bacteria-need-to-thrive-with-hashimotos/. Accessed June 29, 2018.
  4. The role of fermented foods & probiotics in gut health. Ignitenutritionca. Available at: https://ignitenutrition.ca/blog/fermented-foods-probiotics-help-gut-health/. Accessed June 29, 2018.
  5. Does the gut microbiota trigger Hashimoto’s thyroiditis? Discoverymedicine. Available at: http://www.discoverymedicine.com/Kouki-Mori/2012/11/27/does-the-gut-microbiota-trigger-hashimotos-thyroiditis/. Accessed June 29, 2018.
  6. Dysbiosis and thyroid dysfunction. All roads lead to the microbiome. Hypothyroidmom. Available at: https://hypothyroidmom.com/dysbiosis-and-thyroid-dysfunction-all-roads-lead-to-the-microbiome/. Accessed June 29, 2018.
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