Summary: Do yourself a favor and look over this post about gut microbiome manipulation even if your interest in microbiome is not autism or Fecal Microbiota Transplant (FMT) because the microbiome can be manipulated many ways, FMT being only one way.DIET has a major impact on microbiome, and I’m surprised that there are only three clinical trials looking at diet and autism out of the 445 clinical trials looking at diet and microbiome(as of May 28, 2019). More surprising, there’s nearly300 clinical trailsnow going on that look at FMT impact to the microbiome for many of the diseases you guys have, like: IBS, T2D, MS, IBD, melanoma, cancer, depression, anxiety, obesity, metabolic syndrome, liver NAFLD, Alzheimer’s, Parkinson’s, Psoriatic Arthritis, food allergies, recurrent UTIs, Sarcoidosis, antibiotic resistance, Chronic Fatigue Syndrome, epilepsy, Sjogren’s, HIV, malnutrition…. Manipulation of the microbiome is being looked at because the microbiome is known to be altered in inflammatory ways for most all diseases, and it’s health determines your health. For autism for example, [Saghazadeh et al 2019] reported an increase in pro-inflammatory cytokines called IFN-γ, IL-1β, IL-6, and TNF-α. That’s the immune system gone rogue. Here’s the laundry list of pro-inflammatory cytokines that were found to have no significant alteration: IL-1α, IL-2, IL-2R, IL-3, IL-7, IL-8, IL-12, IL-12p40, IL-12p70, IL-15, IL-17, IL-18, IL-23, TBF-β, and TNFRI/II! Your disease will have some mix of pro-inflammatory cytokines going on and manipulating the microbiome can decrease demands on the immune system to send out these enforcers and positively affect disease state. I hope researchers include impact to cytokines in subsequent evaluation for microbiome studies. This post reports on [Kang et al 2019] which is a TWO year follow-up study of [Kang et al 2017], which was a small pilot trial that used an 8 week FMT intervention for 18 children with Autism Spectrum Disorder (ASD). They evaluated FMT impact toGI symptoms, behavior, and the gut microbiome. The conclusion of the 2019 follow-up study was that GI and behavior symptoms continued to increase or improve, and microbial diversity continued to increase and looked more similar to their donors based on16S ribosomal RNA (rRNA) microbiome sequencing, FOLLOWING the original Microbiota Transfer Therapy (MTT)intervention. Participants still had an average of a 58% reduction in GI symptoms and a 45% decrease in ASD symptomscompared to baseline. In addition, the parents of most participants reported a slow but steady improvement in core ASD symptoms during treatment and over the next two years., and that’s why the 2 year follow-up study was done. The study suggests that the recipients didn’t retain completely the donated microbiome, but rather retained some features of it such as increased overall diversity, and increase in some important microbes such as Bifidobacteria, Prevotella, and Desulfovibrio while finding a NEW state. The authors note that these encouraging observations demonstrate that “intensive MTT intervention is a promising therapy for treating children with ASD who have GI problems.” They recommended future research include double-blind, placebo-controlled randomized trials with a larger cohort. Read on to learn the power of microbiome manipulation, no matter what method(s) you employ! \O/
Summary: The article, [Handley, j.b.Handleyblog.com, April 2, 2018],is a must read for anyone interested in autism and/or autoimmune conditions including cognition, Alzheimer’s and other neurological concerns so prevalent in our times. Handley’s article will make you think twice about healthcareshots and the power of the microbiome to mitigate immune system damage and dsyfunctionality=&4=& for autism:=&5=&role of immune activation events for vaccines containing aluminum adjuvants (in utero via maternal vaccines, as well as post birth vaccinations=&6=&=&7=&[Mold et al 2018] As well, autism is strongly linked to gut dysbiosis thus Handley’s article addresses, autoimmune and neurological interested audiences listen up: That immune activating event(s) can cause gut dsybiosis, that aluminumis also found in the brains of neurological diseases including=&14=&aluminum in the brains of individuals who died of familial Alzheimer’s disease=&15=&mediating gut microbiome inflammation using diet.Leading light Alzheimer’s researcher[Exley 2017 Editorial] notes:“Alzheimer’s disease is not an inevitable consequence of aging in the absence of a brain burden of aluminum.” His editorial can be read here:Aluminum Should Now Be Considered a Primary Etiological Factor in Alzheimer’s DiseaseTruth be told, healing dietary tenets that I teach are baseline for the chronic disease mitigation, autoimmune and autism healing diets (SCD, GAPS, FODMAPs, etc), and there are anecdotally plenty that see benefit of microbiome dietary intervention. These diets remove dietary aluminum, and below I note where you’ll find it. I also give substitutions for baking powder which contains aluminum. Handley’s article also contains The Three Letters, sent in 2017 to caution American public health authorities, authored by three of the most important scientists in the field of aluminum adjuvant toxicity — Dr. Christopher Shaw of Canada, Dr. Chris Exley of England, and Dr. Romain Gherardi of France.Whether you are a parent, grandparent, or just someone trying to get their arms around the microbiome — diet — health link, Handley’s article is a great read. Accordingly, my post, focusing on autism, autoimmune, cognition, Alzheimer’s and other neurological concerns of our times, will only summarize a few pertinent salient points of Handley’s post.
How Aluminum Adjuvant in Vaccines Can Cause Autism
In sum, “Five clear, replicable, and related discoveries explaining how autism is triggered have formed an undeniably clear picture of autism’s causation, and possibly ways to alleviate the symptoms, too. Most of the research that has created this understanding has been published in the last 36 months, and largely from international scientists in the United Kingdom, Canada, France, Israel, and China… Published studies are showing that autism is caused by an immune activation event. The adjuvant in vaccines — aluminum adjuvant — can activate the brain’s immune system and is far more neurotoxic than previously realized — all the new science has been published in just the last few years. Aluminum can cause IL-6, the key cytokine implicated in autism. Chinese scientists — for the first time anywhere in the world — used a vaccine to trigger an immune activation event, and recorded elevated levels of IL-6 in rats… Vaccines, administered early and often, are igniting immune activation event after immune activation event. [Handley, j.b.Handleyblog.com, April 2, 2018]International Scientists Have Found Autism’s Cause. What will Americans do?
“…while the aluminium content of each of the 5 brains [of people with autism] was shockingly high it was the location of the aluminium in the brain tissue which served as the standout observation…The new evidence strongly suggests that aluminium is entering the brain in ASD [autism spectrum disorders] via pro-inflammatory cells which have become loaded up with aluminium in the blood and/or lymph, much as has been demonstrated for monocytes at injection sites for vaccines including aluminium adjuvants.”
A “monocyte” is a type of white blood cell, of which one form of monocyte is a “macrophage.” A macrophage can be thought of as the garbage man of the immune system, eating up foreign substances, cell debris, etc. As you will see in a moment, macrophages appear to be playing a critical and devastating role in triggering autism, serving to escort aluminum injected from a vaccine directly into the brain, where it can disrupt brain development and trigger autism.
How Much Aluminum is in Our Brains?
Here’s the evidence for aluminum in autism and Alzheimer’s brains.
For autism, [Mold et al 2018]:“Aluminium-selective fluorescence microscopy was used to identify aluminium in brain tissue in 10 [autism] donors. While aluminium was imaged associated with neurones it appeared to be present intracellularly in microglia-like cells and other inflammatorynon-neuronal cells in the meninges, vasculature, grey and white matter. The pre-eminence of intracellular aluminium associated with non-neuronal cells was a standout observation in autism brain tissue and may offer clues as to both the origin of the brain aluminium as well as a putative role in autism spectrum disorder.
SUMMARY: Bottom Line of this post:You want OFF the IBS diseasepan! WHY? Because — putting aside pain, bowel issues, and bloat — IBS can alter the brain size and function in the emotion and sensory processing areas when having it a long time along with early life stressors [Labus et al., 2017], it is associated with A LOT of diseases, and there are A LOT of surgeries performed inappropriately because of misdiagnosis or poor manangement of IBS! DISEASES that are associated with IBS — the listing is NOTcomprehensive — includes: Type 2 Diabetes, metabolic syndrome, fibromyalgia, chronic fatigue syndrome, IBD, CFS/ME, autism, anxiety, depression, MS, and Parkinson’s.Inappropriate SURGERIES occurring due to IBS misdiagnosis includes —appendectomy, cholecystectomy, ovarian, and hysterectomy. See below for All of those links.There are lots of ways to get off the IBS diseasespan! Learn in this post that it is YOUR choice: IBS, Microbiome, Fodmaps, Probiotics, Mindfulness-based stress reduction, Cognitive behavioral therapy works… or targeted drugs! Or not drugs — because of the poor efficacy of that current US standard of care: =&2=&“The physician should also emphasize the chronic nature of this syndrome [IBS]because nearly 75% of patients continue to have a diagnosis of IBS 5 years later.13” [Occhipinti et al., 2012].“Many different drugs have been suggested for IBS treatment, but their real benefits are very debatable.”[Bellini et al., 2014]. Don’t be surprised. In 2012, the FDA changed the endpoints of those drug studies to stop being only one endpoint because of how multi factorial IBS symptomolgy is, and the Bristol Stool Chart — defining what is a ‘normal BM’ (which you’ll learn in this post) — despite being around since 1997, is only now being validated, 2016! Contrast all this to the UK British Dietetic Association guidelines for IBS — low FODMAP diet is the second-line intervention[Catassi et al., 2017][McKenzie et al, 2016] [UK evidence-based practice guidelines for dietetic management of IBS in adults 2012 PDF])=&2=&as it helps about seventy-six percent of IBS patients [Magge et al., 2012][Bohn et al., 2015][Staudacher et al., 2011] and yet, it has come under attack with the current US standard of care still NOT recognizing the FODMAP diet (see this post). A rebuttal to all the rift recently published in 2017, authored by Monash University ressearchers, the creators of the FODMAP diet. See [Hill et al., 2017] To piggyback the diet fix, studies continue to find that probiotics might be something to think about for some cases of IBS — see [Whiteley, 2016]. Wondering about IBS and what early life stressors might mean? That group had more history of early life trauma(general trauma (31 items), physical (9 items), emotional (7 items), and sexual abuse (15 items))AND they hadlonger duration of IBS symptoms. [Labus et al., 2017]While we can’t change our early life stressors, there are lots of ways to tackle IBS using diet, probiotics, mindfulness-based stress reduction, cognitive behavioral therapy and targeted drugs — according to the Monash rebuttal [Labus et al., 2017]. Now you know! Protect brain size and function, avoid potentially needless surgery and improve your disease status by fixing IBS; LISTEN to your gut! Unbelievable… check out the global prevalence of IBS:
DON’T OVERLOOK THE COMMENT SECTION to this post, it adds STUDIES PUBLISHING AFTER I WROTE THIS POST!
IBS is not a condition to ignore.
Address it & Resolve it considering: Diet (Fodmaps or similar and probiotics), mindfulness, cognitive behavioral, and/or target drugs because…
Many diseases, including those crossing the blood-brain-barrier, are associated with the condition, and resolution of the IBS may help prevent or mitigate the disease,
There are a lot of inappropriate surgeries performed due to misdiagnosis (or poor management) of IBS, and
It alters the brain emotion and sensory processing areas for those having IBS long term with early life stressors.
Most people don’t even realize their symptoms are IBS — and yet IBS affects up to 10 to 25% of the population, and that has a large margin of error since few get counted via physician visits and the inclusion criteria differs. [Canavan et all., 2014]. I always recommend to jounal!
Links to the IBS Disease & SurgeryStatistics
Most are surprised to learn that many diseases have IBS associations. Just to put that into perspective, 30–50% of patients diagnosed with IBD [endoscopically in remission] also report IBS-type symptoms.3, 4, 5. [Ballou et al., 2017]. Check out the list of diseases having known IBS associations — it is not a comprehensive listing: Type 2 Diabetes “Given the higher prediabetes occurrence in IBS, IBS may indirectly indicate a higher risk of Type 2 Diabetes.”[Gulcan et al., 2009],metabolic syndrome “The findings suggest that the treatment of irritable bowel syndrome may be a potentially beneficial factor for the PREVENTION of metabolic syndrome.”[Guo et al., 2014],fibromyalgia (49% have IBS), chronic fatigue syndrome (51%), temporomandibular joint disorder (64%), and chronic pelvic pain (50%)[Heitkemper et al., 2015], IBD [Halpin et al., 2012], CFS/ME [Whiteley, 2017], autism [Navarro et al., 2016], anxiety and depression [Fond et al., 2014] see pdf here, Multiple Sclerosis [Marrie et al., 2015], and Parkinson’s[Mishima et al., 2017].
IBS is complex and multifactorial. It is “a disruption of the so called “brain-gut axis” that determines changes in the digestive motility and secretion, visceral hypersensitivity, abnormalities of enteroendocrine and immune systems, genetic factors, infections, alterations of the intestinal microbiota and inflammation could play a role in IBS.” [Bellini et al., 2014].
IBS costs society in terms of medical and loss work absenteeism over $21 billion annually. [Canavan et al., 2014] As well, more women (60 to 65%) are affected then men[iffgd, 2016], and lots of inappropriate surgeries due to misdiagnosis occur for IBS suffers. Some examples include appendectomy, cholecystectomy — 2 to 3 x more likely, and ovarian and hysterectomy (twice as likely) occurs 45 to 55% more often in IBS then controls. [=&4=&] [iffgd 2016] [Corazziari et al., 2008].
AND What is a Normal BM?!?
Wondering if you have IBS?Well.. what does a normal BM look like? Use the Bristol Stool Chart (BSC) — see TWO versions on the above journal pic — a ‘NORMAL BM’ is rated 3 to 5!IT FIRST PUBLISHED 1997[Bristol Stool Chart 1997 PDF], BUT WAS ONLY VALIDATED FOR USE IN THE US IN 2016 BECAUSE IN IBS DRUG CLINICAL TRIALS, “There is little published evidence of efficacy for the most commonly used treatments. Thus, there is an urgent need to conduct clinical trials on existing and novel therapies.”See[Blake et al, 2016][Saps et al, 2016]. If still confused on what is ‘normal’, CHECK OUT A MODIFIED BSC VERSION AT [Lasch et al, 2016]. Honest… I am not making this up… validating the BSC in the US became a scramble because the[FDA Guidance, 2012}changed the “endpoints for clinical IBS trials since prior studies looked atone endpoint which can’t adequately report patient perspective of the complex IBS symptomology”!
The IBS Microbiome Study including early life stressors
Cohort: 29 IBS adult patients and 23 healthy controls. Yes, the small cohort is a limitation of the study but as the study concludes: “the correlations of abundance of certain microbial taxa with early adverse life events and with distinct brain structural changes previously reported in IBS suggest a possible role of gut microbes and their metabolites in the development and shaping of the gut-microbiota-brain axis early in life, confirming results from a previous study[10]... Identifying IBS subgroups based on gut microbiota, their related metabolomic profiles and corresponding brain signatures is likely to play an important role in optimizing therapies in IBS.”
Questionaires used for early life stressors:
For background, in mice, early maternal separation induced the brain differences with consequent symptoms similar to IBS[Palma et al., 2015]. Moving to humans, the microbiome/IBS study [Labus et al., 2017]used The Hospital Anxiety and Depression Scale [HADs][22],the Patient Health Questionnaire-15 [PHQ] for mood [23], and the Early Traumatic Inventory–Self Report (ETI-SR)[24] for histories of childhood traumatic and adverse life events that occurred before age 18 years old covering four domains: general trauma (31 items), physical (9 items), emotional (7 items), and sexual abuse (15 items)[24]. Detailson the ETI-SR are in the reference section at [Bremner et al., 2011].
The Catastrophizing subscale from the Coping Strategies Questionnaire assessed levels of catastrophizing[25].The degree to which subject viewed situations as stressful in the past month was measured by the Perceived Stress Scale[26].
Medication usage included any of the following: antispasmodic, laxatives, stool softener, fiber supplement, nonsteroidal anti-inflammatory drugs, aspirin, acetaminophen, thyroid medications, antihistamine, or proton pump inhibitors. [Note… PPIs have a disrupted microbiome — see this post. The significance is that drugs likely need further stratification when evaluating microbiome.]
Findings: The IBS microbiomes clustered into two subgroups with those having early childhood trauma clustering together. This trauma could be influencing how themicrobes in our gut interact with our brains as we grow, demonstrating a two-way street between the development of our nervous system and the microscopic residents of our digestive system.
One subgroup of IBS was indistinguishable from the healthy control cohort.
The other IBS subgroup differed and had an altered gut microbiota. As well, an area of the brain associated with pulling together the body’s sensory information was slightly bigger in this group. The front part of the insular cortex – an area associated with keeping certain body functions in balance as well as dealing with emotions and cognitive functions was slightly smaller as was the ventral prefrontal regions. This cohort also had more history of early life trauma based on a psychological evaluation called theEarly Traumatic Inventory–Self Report (ETI-SR) Inventory, and a longer duration of IBS symptoms. “A history of early life trauma has been shown to be associated with structural and functional brain changes and to alter gut microbial composition. It is possible that the signals the gut and its microbes get from the brain of an individual with a history of childhood trauma may lead to lifelong changes in the gut microbiome. These alterations in the gut microbiota may feed back into sensory brain regions, altering the sensitivity to gut stimuli, a hallmark of people with IBS.” — Gut microbes linked to brain structure in people with irritable bowel syndrome, May 2017 UCLA Newsroom article. It was postulated that “different kinds of bacteria in the gut could be producing chemicals that influence the brain’s development during childhood. Traumatic experiences early in life could affect the brain, which in turn influences the kinds of microbes that grow in the gut. These in turn could influence the brain’s development”.— Bacteria Could Be Responsible For Shifts in Brain Structure in People With IBS, ScienceAlert May 2017.
“Analysis of a person’s gut microbiota may become a routine screening test for people with IBS in clinical practice, and future, therapies such as certain diets[low FODMAPS perhaps [Occhipinti et al., 2012]] and probiotics may become personalized based on an individual’s gut microbial profile.”[Labus et al., 2017]
Diet (Fodmaps)
What are FODMAPs? FODMAPs are food substrates that are poorly absorbed and therefore fermentable by the gut microbiota. The acronym stands forFermentable Oligo-, di-, Monosaccharides And Polyols. FODMAP substrates are ubiquitous prebiotics in the diet that are difficult to digest for everyone, they are additive, and when in excess for your unique physiology, can cause digestive symptoms. “There is an accumulating body of evidence, based on observational and comparative studies, and on randomized-controlled trials that supports the notion that FODMAPs trigger gastrointestinal symptoms in patients with functional bowel disorders.”[Shepherd et al., 2013].
The FODMAP diet is not intended to be long-term therapy. From Monash University (the creator of the Low FODMAP diet): “A low FODMAP diet will reduce the intake of foods high in fibre and natural prebiotics, which in turn may impact of the growth of certain bacteria in the gut. This is why we advise against following a strict low FODMAP diet unnecessarily. Typically consume low FODMAP 2-6 weeks, then re-introduce FODMAPs in a deliberate process to learn tolerance levels using a FODMAP knowledgeable professional.” Source: Monash University, Dietary Fibre and natural prebiotics for gut health: FAQs.The below chart lists some prebiotic FODMAPs that beneficially feed the microbiome.
Source: Monash University, Dietary Fibre and natural prebiotics for gut health: FAQs,
The efficacy of the elimination phase of the low-FODMAP diet for overall gastrointestinal symptom relief in adult patients with IBS has been seen in randomized, controlled trials; a blinded, randomized, rechallenge study; and observational studies that have been reviewed in detail elsewhere3,4as well as in a meta-analysis.5These studies have shown that 50% to 86% of patients have a clinically meaningful response to the low-FODMAP diet. In contrast, the success of maintenance (the reintroduction phase of the diet) has been studied less (in only a few observational studies).6,7Due to the difficulties of designing an appropriately blinded, randomized, longer-term, interventional study, the evidence base for maintenance will likely remain less solid. [Hill et al,, 2017],
Figure out if it is Gluten or FODMAP Intolerance! The FODMAP gold standard of food intolerance testing (ie, food exclusion to achieve symptom resolution followed by gradual food reintroduction and subsequent symptom induction to identify tolerance)35is important because often gluten is not the dietary culprit contrary to many thinking otherwise. “Randomized studies have shown that there is a lack of gluten specificity in the induction of symptoms in the vast majority of patients with self-reported NCGS.32–34 Another trial of 36 patients experienced improvement in gastrointestinal symptoms when placed on a low-FODMAP diet during the run-in period, but none had repeatedly consistent exacerbation of symptoms specifically on ingestion of FODMAP-depleted gluten during the blinded rechallenge phases.31One logical interpretation of these studies is that the FODMAP reduction associated with avoidance of wheat, rye, and barley—all high in FODMAPs—led to partial response, and more extensive FODMAP restriction further improved that response.” See[Hill et al,, 2017] for reference links.
IBS, Food Intolerances, and SIBO.FODMAPS may work since 75.6%, 37.8% and 13.3% of [IBS] patients had fructose, lactose malabsorption or small intestinal bacterial overgrowth respectively. [de Roest et al 2013][Barrett et al., 2007].
Disease and FODMAPs — IBD. The FODMAP diet successfully manages over 86% of IBS/IBD patients, having partial (54%) or full (32%) efficacy. Satisfaction with dietary management was seen in 83 (70%) IBS patients and 24 (55%) IBD patients.Eighty-four percent of patients lived on a modified low FODMAP diet (LFD), where some foods rich in FODMAPs were reintroduced, and 16% followed the LFD by the book without deviations. WHEAT, DAIRY products, and ONIONS were the foods most often NOT reintroduced by patients. [Maagaard et al., 2016].
Disease and FODMAPs —Diabetes. The Joslin Diabetes Center, a teaching and research affiliate of Harvard Medical School, recommends trying FODMAP for diabetes!Have IBS [and Diabetes]? Try FODMAPs.
Genetic predisposition and IBS. There may be a subset of patients that are genetically predisposed to IBS due to mutations in the gene encoding the enzyme sucrase-isomaltase which is responsible for the digestion of small carbohydrates from sugars and starches called disaccharides. 15Phe is a common sucrase-isomaltase polymorphism. “A significant decrease in the enzymatic activity of sucrase-isomaltase would be compatible with poor carbohydrate digestion in the intestine, possibly leading to malabsorption and bowel symptoms,”Hassan Naim, PhD. [Henström et al,, 2016] and see this Healio article.
Fructose and children under 10 years age:“Children under the age of 10 years have a reduced capacity to absorb fructose. It would be important to assess whether young children with IBS are consuming a high-FODMAP diet with excessive amountsof fruit/fruit products, dairy/dairy products, and wheat/wheat products. Furthermore, it would also be important to assess whether normalizing—that is, limiting portions of fruit, dairy, and wheat to reduce dietary intake of FODMAPs—results in symptom resolution.” [Hill et al., 2017]
Probiotics — They Work Well for IBS!
The study. [Zhang et al., 2016] Meta analysis of 21 randomized controlled trials (RCTs) that compared many probiotics including different types of Lactobacillus acidophilusand Lactobacillus rhamnosus including VSL#3 with placebo.
Conclusion:“Probiotics are an effective pharmacological therapy in IBS patients. Single probiotics, a low dose, and a short treatment duration were more effective with respect to overall symptom response and quality of life.” Some probitoic(s) worked very well but we don’t know enough about which ones used under which circumstances because the authors did not analyze “the effects of individual probiotic species”.
Practically, Try many differentwhole food probiotics. You’ll find those in the refrigerated section, or try making your own and see how you feel — see my Pinterest Ferment Board for starters. Always start S—L—O—W! Here is the link for how I make SCD Yogurt – the FODMAP lactose is eliminated in this recipe since the long ferment time renders the yogurt lactose-free. Regarding the inflammatory casein protein, it is said that the recipe changes the protein to more digestible, but different milks can also be trialed to decrease the inflammatory nature of casein. If you find you still cannot tolerate yogurt, try non-dairy ferments such as those in the below pic. Note too: You should try those non-dairy ferments anyway because all ferments contain differing probiotic bacteria and more is better when it comes to talking microbiome diversity.
Intro: Health psychology and gastroenterology have become increasingly aligned over the last several decades because: “There is strong evidence that cognitive behavioral therapy; hypnotherapy; and mindfulness-based therapy directlytarget physiological processes by reducing arousal of the autonomic nervous system, decreasing the stress-response, and even reducing inflammation. This physiologic effect is largely due to the so-called brain-gut axis, which explains in part the common gastrointestinal consequences of stress and anxiety. Although the brain-gut axis is particularly important in the treatment of IBS [and ALL diseases having IBS associations], it is also relevant among patients with IBD, especially when considering the increased likelihood of an IBD flare in the context of chronic stress.84, 85” [Ballou et al., 2017].
Summary: The 2014 1st International Symposium on the Microbiome in Health and Disease with a Special Focus on Autism brought out anecdotal parent findings that autism symptoms improved or worsened on antibiotics. Baylor College of Medicine study in conjunction with Texas Children’s Hospital, is now investigating those findings! If you have an autistic child, consider enrolling now before they are sick, so you have a test kit if prescribed an antibiotic over the next two years. You would send microbiome samples pre and post the antibiotic. Those are to be evaluated for changes to behavior and the microbiome — the bacteria, yeasts and fungi that also inhabit the gut, as well as examining metabolites (small chemical molecules) found in the GI tract. The study is free to participants and fully paid for by N of One: Autism Research Foundation which is founded by John Rodakis, the father of an autistic son who experienced symptom improvement due to an antibiotic dose Thanksgiving 2012. Participate if you can to increase understanding of Antibiotics, Autism Symptoms which at present, has a gap in the published autism research. This initial data may more effectively sub-type autism and develop and deliver more effective microbial-based interventions.
Autistic children’s microbiome metabolites (the exhaust of the gut microbiota) differs compared to children without autism.
Several studies have reported significantly higher oral antibiotic use in children with autism versus typical children (6, 14–17). Antibiotics cause collateral damage to the microbiome. From the 2016 review, The effects of antibiotics on the microbiome throughout development and alternative approaches for therapeutic modulation: The use of antibiotics heavily disrupts the ecology of the human microbiome (i.e., the collection of cells, genes, and metabolites from the bacteria, eukaryotes, and viruses that inhabit the human body). A dysbiotic microbiome may not perform vital functions such as nutrient supply, vitamin production, and protection from pathogens [3].Dysbiosis of the microbiome has been associated with a large number of health problems and causally implicated in metabolic, immunological, and developmental disorders, as well as susceptibility to development of infectious diseases [4–11].
SUMMARY: IBD CAM “Probiotics, Special Diets [SCD], and Complementary Therapies: We Know Patients Want Them, So What Do We Tell Them?“was presented at the Dec. 2014 Advances in IBD conference, by Dr. Sandra Kim, MD, who noted, “SO CERTAINLY THERE IS SOME PROMISE IN AT LEAST THINKING ABOUT THIS.” Now that’s a first!!! At least one conventional doctor is encouraging her peers to seriously educate themselves about IBD CAM, LDN, probiotics, SCD… and Integrative Medicine and to ask their patients if they are interested in them, using them and if so, what do they use, and to actively seek funding for further study of them! And… Dr. Kim has disclosure of conflicting interests — Speaker: Nestle Nutrition, Abbott Laboratories and Consultant: AbbVie Pharmaceuticals!
That title (no joking) says it all now, doesn’t it? But no worries… the conference presentations have always questioned protocols such as the presentation: Should We Change How We Position Biologics in UC?
Dr. Kim is a pediatric gastroenterologist; her continuing medical education presentation was fifteen minutes. No time was left for questions; no surprise there.
Bottom line: there really is disease activity indices improvement and mucosal healing taking place with these modalities.
You can watch Dr. Kim’s Presentation in the below YouTube: “Probiotics, Special Diets, and Complementary Therapies: We Know Patients Want Them, So What Do We Tell Them?” Probiotics, Special Diets, and Complementary Therapies:
Dr. Kim addressedten CAM and Integrative Medicine practices havinganti-inflammatory impact and/or decreased disease activity indices on the gut function as it relates to IBD, although it should similarly relate to other gut dysbiosis and may be worth your time to Google research such.
Dr. Kim concluded saying she personally, with patients:
Goes through the medications,
Goes through the nutrition,
Then she is open and up front asking patients if they are interested in different types of integrative medicine practices, or CAMs, and if so, what sorts of practices or supplements they are utilizing. She stressed to: LISTEN WITHOUT JUDGEMENT as there is a perception that physicians believe in only the Westernized medicine and judge, and for this reason, often she thinks the families are NOT upfront in the non-Western practices they are doing. She always says it isbest to know what patients are thinking!!! I honestly don’t think they would like to know, at times, strictly my opinion.
She thinks physicians should:
Understand the literature or they are not credible.
Know how the literature talks about the practice; is it used as primary or adjunct therapy.
Know what the benefits and potential downsize is.
Treatments she discussed are:
Artemisiaor wormwood found to have a 65 to 80% improvement of disease activity indices; that was better than Remicade,
HMPL found to have beneficial clinical response but not remission at 8 weeks; thought to exert anti=inflammatory effects due to TNF, IL-1β, and NF-kB pathways.
Curcumin plus 5-ASA had 5% relapse versus 5-ASA alone which had a 21% relapse.
Cannabis helped with symptoms but was a greater predictor of progression to surgery (OR 5.03).
LDNimproved disease activity indices for Crohn’s.
Probiotics. The below images also include #7—Prebiotics and #8—SCD. Dr. Kim acknowledged FMT but decided to not discuss it in this presentation.
Probiotics: Potential butyrate producers. Some efficacy in pouchitis and UC but not Crohn’s. VSL#3 helped post operative surgery Crohn’s.
Another great read on F. prausnitzii and IBD is Among Trillions of Microbes in the Gut, a Few Are Special as it suggests perhaps F. prausnitzii, part of the clostridial clusters, that do the opposite of CDiff in a gut —they keep the gut barrier tight and healthy, and they soothe the immune system… In East Asian populations the gene variants associated with IBD differ from the gene variants in European populations. Yet the same bacterial species—F. prausnitzii—was reduced in the guts of those in whom the disease developed. This suggested that whereas different genetic vulnerabilities might underlie the disorder, the path to disease was similar: a loss of anti-inflammatory microbes from the gut. And although Sokol suspects that other good bacteria besides F. prausnitzii exist, this similarity hinted at a potential one-size-fits-all remedy for Crohn’s and possibly other inflammatory disorders: restoration of peacekeeping microbes.
Prebioticsdid not help significantly in changing typical probiotic strains like bifidobacteria or F. prausnitzii. But see above study for SCD study that did show this change for IBD-Crohn’s.
SCD (1 year consumption, individual patients are charted):
Stan Cohen, 2014 JPGN study: disease activity indices and endoscopic for mucosal healing showed improvement in PCDAI as well as Lewis Scores (measurement of mucosal healing when undergoing capsule endoscopy.)
Also Suskind 2014 JPGN study from Seattle Childrens found significant improvement in multiple parameters including albumin and hemoglobins.
Acupuncture in IBD: improved sense of well being.
Hypnosis for IBD:one 50 minute session had mucosal and serum inflammation markers decrease.
“SO CERTAINLY THERE IS SOME PROMISE IN AT LEAST THINKING ABOUT THIS,” -Dr. Kim
While I am happy she included SCD, I am disappointed that she missed a lot of the studies.
Nutrition as Medicine in the past has been a holistic approach by those wanting to avoid medication side effects. Limited studies have been conducted and most are outside the US. There is a surprising overlap of IBD and IBS symptoms. The FODMAPS diet seriously helps over 70% of IBS and has decent research behind it. See the post, IBS: FODMAPS, STOMACH MICROBIOME & RIFAXIMIN ANTIBIOTIC TREATMENT, SERIOUSLY?!? Not surprising, many of the SCD type diets used for IBD have FODMAP overlaps. At times I think this is the concept that keeps diet management of IBD within reach, but it is hampered by the need for conventional physician’s to recant the knee jerk reaction, “Diet has nothing to do with it [IBD]” that patients hear again and again. And patients need to realize that as in Type 1 Diabetes control, diet management may not be a negotiable concept. What is sad is the lack of physician understanding that eating SCD is not that difficult, even on the road, once you learn and understand the rationale for its tenets and how to practically implement SCD.
SUMMARY: Roundup on your yard means runoff in your garden, from you or your neighbors use. It’s ubiquitous in the restaurant and grocery food chain hidden in ingredients: corn, soybeans, canola, and cottonseed oil, and meat from alfalfa-corn-soy eating animals and their other byproducts. It’s found in our urine and breast-milk and cattle’s tissues: intestine, liver, muscle, spleen, kidney, and bone .
What’s the harm of eating ubiquitous glyphosate? Dr. Stephanie Seneff asserts that the glyphosate and disease link is: autism, diabetes, Alzheimer’s, and the gmo intestinal gut having related digestive system disorders leading to disease… In simpleton, glyphosate exposure impairs detox pathways through the microbiome including the liver’s P450 enzymes. Toxins taken onboard are not sufficiently eliminated from the body. Gyphosate kills beneficial gut bacteria allowing pathogens to grow; it interferes with the synthesis of amino acids including methionine which leads to shortages in critical neurotransmitters and folate; it chelates (removes) important minerals like iron, cobalt, manganese, and much more.
Summary: It is time to share what a successful professional autism dietary intervention program can look like for autism management.
“Special Diets and Nutrition For Autism: Why They’re Cost Effective,” is such an interesting read from Judy Converse MPH RD LD, a registered dietitian since 1989, who then self taught herself, beginning in 1996, diet impact for her son’s growth, feeding, and developmental challenges at birth. She then expanded training to learn biomedical intervention for autism, becoming a DAN practitioner, and ultimately provided instruction in nutrition for Autism Research Institute, US Autism and Aspergers Assocation, National Autism Association, and many others. She has lectured for many local and national audiences about the profound impact nutrition and a healthy gut have on the developing brain as well as authoringthree books and created the first web-interface accredited learning module for health care providers on nutrition and autism in 2007.
Actually, there is a lot of science on the success of dietary intervention for autism:
Readers of my work are no stranger to the published science and ongoing studies looking at the food – autism interactions. Some of the latest of such are summarized in posts:
SCD in 20 children ages 2-6 years with gastrointestinal problems that have been diagnosed with autism.Enrollment is now closed; they will eat a SCD diet for 16 weeks (all food is provided) and blood, stool, and questionnaires will be obtained. The contact for more information on this study is intake@johnson-center or call 512.732.8400.
Performing a retrospective study of 600 children with a diagnosis of autism, ages 2-21 years, who were seen on an outpatient basis at the Nutrition Clinic at Thoughtful House Center for Children in 2009. The will compare the intake of calories, carbohydrates, protein, fat, vitamins, and minerals from food at baseline and follow-up dietary consultations and assessments. The prevalence of dietary inadequacy of these nutrients in this patient population diagnosed with failure to thrive (FTT) will also be evaluated. Enrollment is now closed.
This prospective treatment study is enrolling up to 50 children, ages 2-21 years, diagnosed with ASD with documented evidence of ileitis, colitis, and/or duodenitis, and lymphoid nodular hyperplasia. They are evaluating the tolerability and efficacy of an Elemental Diet in the amelioration of gastrointestinal symptoms by conducting a prospective open trial of administering a nutritionally adequate elemental diet in this patient population. They will quantify symptomatic changes in GI presentation as well as quantify anthropometric and biochemical changes. Enrollment is now closed.
Assess bone mineral density status for 80 boys, ages 4-8 years, diagnosed with autism or neurotypical controls. This study will determine if bone mineral density is correlated with: nutritional status, vitamin and mineral levels, symptomatic GI presentation, and antropometric measurements. Enrollment is now closed. Slide Source: biomeonboardawareness.com
Collaborating institutions include:
The Johnson Center for Child Health & Development : Research
Another study, Gastrointestinal abnormalities in children with autistic disorder”, Horvath, et al, 1999, for 36 participants: 25 (69.4%) had Grade I or II reflux esophagitis, 15 had chronic gastritis, & 24 had chronic duodenitis. Additionally the number of Paneth’s cells in the duodenal crypts was significantly elevated in autistic children compared with non-autistic control subjects, and low intestinal carbohydrate digestive enzyme activity was reported in 21 of 36 children (58.3%), although there was no abnormality found in pancreatic function and 75% of the autistic children (27/36) had an increased pancreatico-biliary fluid output after intravenous secretin administration.
And this most recent post, “2 AUTISM STUDIES ARE SEEKING PARTICIPANTS: MICROBIOME & CONSTIP,” which shares a new food study, funded by Autism Speaks, looks are remedying chronic constipation and the effects on autism symptoms (and another study noted on this post looks at the microbiome).
My favorite autism researcher, Paul Whiteley, is also a member of ScanBrit, which was/is a meeting of minds between the group he works with and other research groups based in Denmark and Norway, who want to experimentally examine the question of whether a diet devoid of foods containing gluten and casein might be able to impact on the presentation of autism in children. This post on his blog entitled “Autism and the GFCF diet: ScanBrit episode 2″ speaks to what seems to be working for many autism and notes“These preliminary observations on potential best responder characteristics to a gluten- and casein-free diet for children with autismrequire independent replication” “That sentence, taken from a recent (pre-print) publication I was very peripherally involved in writing, isprobably the most important thing to take from the paper by Lennart Pedersen and colleagues* and certainly is a message that I would be very keen to promote.”
Last, Whiteley authors two blogs: Questioning Answers is where he describes and discusses various research into autism spectrum and related conditions.Gutness Gracious Me is where he discusses various gastrointestinal research. Nuff said there about how important this expert feels diet is to autism management.
You’ve seen the slide belowbut it bears repeating here as it demonstrates the success of eliminating certain food groups for autism:
“Autism – Part 4: Digestive Function”,Dr. Nicholas Anhorn, BSc, ND. http://www.ndaccess.com/MonctonNaturopathic/Page_Detail.asp?PageID=22&CommentID=20
Despite all the above… diet intervention for autism, in 2014, is still NOT recommended mainstream, which is incredible realizing that 1 in sixty-eight US children have autism (with prevalence increasing alarmingly)
Slide Source: biomeonboardawareness.com
This 2014 paper, Practice Parameter for the Assessment and Treatment of Children and Adolescents With Autism Spectrum Disorder continues to NOT recommend dietary intervention for autism (despite noting that 90% of parents use complementary and alternative medicine for such) and instead focused on teachers, behavorial psychologists, and speech and language pathologists support. The rationale was (see the paper for the actual citations):
“Although most alternative or complementary treatment approaches have very limited empirical support for their use in children with ASD, they are commonly pursued by families.155 It is important that the clinician be able to discuss these treatments with parents, recognizing the motivation for parents to seek all possible treatments. In most instances, these treatments have little or no proved benefit but also have little risk.7 In a few instances, the treatment has been repeatedly shown not to work (e.g., intravenous infusion of secretin156 and oral vitamin B6 and magnesium157[rct]), or randomized controlled evidence does not support its use (e.g., the gluten-free, casein-free diet,158 ω-3 fatty acids,159 and oral human immunoglobulin).160[rct] Some treatments have greater potential risk to the child directly (e.g., mortality and morbidity associated with chelation161[cs]) or from side effects owing to contaminants in “natural” compounds or indirectly (e.g., by diverting financial or psychosocial resources). For a detailed review of alternative treatments, see Jacobson et al.162 and Levy and Hyman.163 Although more controlled studies of these treatments are needed, it is important that the family be able to voice their questions to health care providers. Families may be guided to the growing body of work on evidence-based treatments in autism.164 “
It’s happening! Cancer and autism is leading the way… “Medicine will soon rely on a kind of global Internet-of-DNA which doctors will be able to search on Goggle’s cloud platform. “Our bird’s eye view is that if I were to get lung cancer in the future, doctors are going to sequence my genome and my tumor’s genome, and then query them against a database of 50 million other genomes. The result will be ‘Hey, here’s the drug that will work best for you.’ ”“
Autism, Crowd Sourcing and Google Cloud Platform
Advancements in genome sequencing will permit Autism Speaks, to sequence the whole genomes of 10,000 people in families affected by autism and to share the results with researchers around the world on the Google Cloud Platform.
Data from 2014 show one in 68 children in the US have autism; the prevalence has alarmingly increased (see the CNN article, Autism rates now 1 in 68 U.S. children: CDC. Additionally, the number of children with autism varies widely by community, from 1 in 175 children in areas of Alabama, to 1 in 45 children in areas of New Jersey. Autism is a group of disorders, it is tangled in genetic and environmental factors causing the disorder, and diet can be used to positively impact symptoms for many (see the post, FOOD MANAGING IBD & AUTISM: THE STUDIES and check out the slides below for more details):
The Autism Speaks effort is called MSSNG; the dropped vowels are meant to show all the things about autism that no one has yet observed.
The cloud sequencing data effort is sort of like digitizing a DNA library. It is crowd sourcing for autism answers. My readers understand this principle well as many sequencing centers are busy collecting samples from around the world to analyze the composition of the gut microbiome of all peoples with the goal of correlating microbiome to health and disease states (see “The American Gut project“, “Ubiome“, and “23AndMe“.)
“The explosion of data is happening as labs adopt new, even faster equipment for decoding DNA. For instance, the Broad Institute in Cambridge, Massachusetts, said that during the month of October it decoded the equivalent of one human genome every 32 minutes. That translated to about 200 terabytes of raw data.”
“We saw biologists moving from studying one genome at a time to studying millions,” says David Glazer, the software engineer who led the effort and was previously head of platform engineering for Google+, the social network. “The opportunity is how to apply breakthroughs in data technology to help with this transition.”
Clinical trials will span 3 years and are now filling if you are interested. Please share this information on Facebook, Twitter, Pinterest… so that others can participate. While this research might be a decade or so behind what parents know, it’s two decades ahead of our GP and many autism treatment facilities, so it’s needed, it’s important, and I’m very grateful to hear about it.
Data from 2014 show one in 68 children have autism; the prevalence has alarmingly increased. Additionally, the number of children with autism varies widely by community, from 1 in 175 children in areas of Alabama, to 1 in 45 children in areas of New Jersey. Check out the slides at the end of this post for more details.
Slide Source: biomeonboardawareness.com
The First Study is an Autism Microbiome Study
Dr. James Versalovic and his team of Baylor College of Medicine, a world pioneer in the study of the human microbiome, will study changes in the microbiome that relate to autism symptoms and GI problems. They will also look for signs of metabolic disturbances in the children participating in the study.
“This study determines whether there are important differences in the microbiome of individuals with ASD and whether these differences are specific to ASD and GI problems. It will also help us understand possible metabolic differences specific to ASD and GI problems… , this knowledge will be critical in determining how to tailor future treatments, including probiotics,” comments Paul Wang, Autism Speaks senior vice president and head of medical research.
The study will enroll 375 children, ages 4 through 12, at three sites:
Texas Children’s Hospital/Baylor College of Medicine, Houston;
University of Texas Southwestern Medical Center, Dallas; and
For comparison and analysis, children will fall into five groups:
those affected by autism and GI problems,
those with autism and no GI problems,
those with GI problems but not autism,
those with neither autism nor GI disorders, and
the unaffected siblings of children who have autism.
Click here to receive more information when the study opens for enrollment.
This study will nicely piggyback the 2014 YouTube:“The Potential Role of Gut Microbes To Correct Microbiome Imbalance in Autism,” presented at the 2014 annual meeting of the American Society for Microbiology, which provides more evidence that bacteria in the gut is linked to autism. Both Dae Wook Kang, Arizona State University and Lita Proctor, National Human Genome Research Institute, NIH, discuss the potential role of gut microbes, diet, and autism. Proctor says,“We are redefining what a pathogen is (disease causing bacterium)… we need to add the microbiome imbalance causes pathogenic behavior (disease causing).”
Kang et al found that children with autism have significantly different concentrations for 7 of the 50 compounds they identified, of certain bacterial-produced chemicals, called metabolites, in their feces compared to children without ASD.“Most of the seven metabolites could play a role in the brain, working as neurotransmitters or controlling neurotransmitter biosynthesis,” says Kang. “We suspect that gut microbes may alter levels of neurotransmitter-related metabolites affecting gut-to-brain communication and/or altering brain function… Gut microorganisms are thought to play a major role in the brain, affecting mood, anxiety, and pain. Now we are seeing they may play a role in development as well.”
SUMMARY: Anytime food choices turns around chronic disease with studies that prove such, that should be an eye opener! Implementing principles of such diets should be considered for anyone wanting to prevent or manage chronic disease.This post presents studies for Food Managing IBD & AUTISM, where dietaryprotocols achieved remission and management (with reduction, if not elimination of medication) for autoimmune IBD , or positively altered the course of autism.
HOW? Diet can optimize (or modulate) the gut microbiome which is the source of 80 – 85 percent of our immunity:
So too does Natasha Campbell-McBride, MD, noting multiple times “85% of the body’s immune system can be found in the gut,“ (seehere),Her book,“Gut and Psychology Syndrome,” is followed by countless numbers managing autism thorough the GAPS diet which is based on SCD. Her bio: MD, Master of Medical Sciences in Neurology and Master of Medical Sciences in Human Nutrition.
More on the“1st International Symposium on the Microbiome in Health and Disease with a Special Focus on Autism,”July 2014: “the microbiome refers to the constellation of enteric bacteria that create an organ system that makes up 80% of our immune system... Scientists are diligently working to understand how xenobacteria and commensual bacteria communicate and interact to influence health and how alterations in populations of bacterial species may alter host health and contribute to chronic disease. “The goals of this incredible conference are to: “bring together a world renowned group of experts to present their work on the microbiome in health and disease with a special focus on Autism. Researchers hope to consolidate this information into a formative discussion aimed at designing a clinical trial that can elucidate pathophysiological mechanisms related to the microbiome in Autism and possibly promote new treatment strategies to address core underlying biological alterations through targeted treatment approaches aimed at manipulating the microbiome.” Further details of this conference are discussed below in the “AUTISM AND IBD MICROBIOME SHIFTS ARE NOW INDISPUTABLE“ Section.
Still wondering about this huge 80 to 85% gut immunity rate? Watch this video presentation to appreciate the role of your gut mucosa, which is the largest and most dynamic immunological environment of the body. Realize we now know that many diseases have altered microbiomes, not just the focus of this post (IBD and autism).
You’ve discovered the key cells and molecular players involved in gut immunohomeostasis and disease: the crypts, Tcells, dendritic cells (regulators of innate and adaptive immunity by acquiring, processing, and presenting antigens to T cells), antigens, tolerogenic activation (tolerogenic cells induce regulatory Tcells), anti-inflammatory response, Tregs (specialized T cells that exert immunosuppressive function), IL-10, tumor necrosis factor, and neutraphils just to name a few!
WHY AM I HIGHLIGHTING AUTISM AND IBD FOOD STUDIES?
First, MANY are affected and MANY are children that are put on medications (usually lifelong). That actually is a double whammy considering the fetal impact due to drug exposure once these children reach child-bearing age. SCD (and GAPS which is based on SCD) heals the gut and studies presented below support medication reduction and/or medication elimination.
Second, any parent would want to know that dietary options exist to manage such. Interestingly, it is well known that a high prevalence of food sensitivities exist in Crohn’s Disease patients, and enteral nutrition is not only the first-line of therapy in Japan, but a known research method used to place the majority of Crohn’s patients into remission. Lastly, I should note, the legal system precludes your doctor from sharing diet alternatives since this is not the legal “standard of care” which your doctor must adhere to. Ok… I’m done wearing my attorney hat.
Bottom line: there really is disease activity indices improvement and mucosal healing taking place with these modalities.
