Mercury Detoxification of Autistic Children

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Mercury Detoxification of Autistic Children: Consensus Position Paper - Part 3 http://www.mercola.com/2001/jun/2/mercury_autism3.htmPart 3 of 3 (Part 1 Part 2)Mineral supplements Because of poor nutrition (often due to idiosyncratic food preferences), poor absorption, and other, poorly understood factors, autistic children usually have numerous mineral deficiencies. Chief among these deficiencies is zinc. Zinc supplements should be given prior to, during and after detoxification therapy. Zinc given with DMSA will complex with it and will be more readily absorbed as a consequence29,30. Supplementation with 1 - 2 mg/kg/day of zinc is recommended (maximum of 50 mg/day unless guided by laboratory evidence of marked deficiency); more may be needed and plasma, erythrocyte or platelet zinc levels can be used to guide doses higher than this. Autistic children are also often deficient in selenium. Since this mineral is one of the few that can cause a significant toxicity if it is present in excess, caution should be exercised. In the absence of laboratory evidence of a profound deficiency, selenium supplementation should be limited to 1 - 4 mcg/kg/day. Magnesium, molybdenum, manganese, vanadium and chromium are all among the minerals that are deficient in autistic children; these can be supplied by a multi-mineral supplement. Be sure that this supplement does not contain copper. Copper is the one mineral that autistic children often have in excess and additional supplements will only worsen the excess. Vitamin supplements Although the conventional wisdom is that the "average American" receives all the vitamins and nutrients they require in a balanced diet, there are several reasons why this is not true in autistic children. First, autistic children rarely eat a balanced diet. They often have an extremely limited number of foods they will accept and these rarely encompass all of the major food groups. Additionally, some of the vitamins are anti-oxidants and are depleted in autistic children. Finally, many autistic children are deficient in vitamin B6, vitamin B12, folate and niacin, either from poor diet, poor absorption or both. Vitamin C: An important anti-oxidant, vitamin C can be a great benefit to autistic children. Since it is a water-soluble vitamin, it is rare to see true toxicity, although ascorbic acid crystals in the urine (and the potential for renal stones) will result from sustained use of extremely high doses. More commonly (and usually at doses over 2000 mg/day), gastrointestinal distress and diarrhea are the only side effects from vitamin C. Using the buffered preparation or vitamin C esters can significantly reduce the incidence of gastrointestinal side effects, as will dividing the dose. Vitamin C supplementation should start at 5 -10 mg/kg/day and gradually increase to tolerance. Some may tolerate and, in fact, need more than 50 mg/kg/day. Vitamin E: Another of the anti-oxidant vitamins, vitamin E has received more press lately than vitamin C. Since it is fat soluble, it can accumulate if given to excess. Dosing in the range of 2 - 4 12 mg/kg/day (3 - 6 IU/kg/day) is within safe limits. Mixed tocopherols are the preferred preparation. Many vitamin E supplements are prepared from soybeans and may be a problem in children who are sensitive to soy products. Since vitamin E is important in preventing fatty acid oxidation and peroxidation, more may be needed if the child is also receiving essential fatty acid supplements. Vitamin B6: Vitamin B6 can be found as B6 (pyridoxine), pyridoxal-5-phosphate (P5P), or a mixture of the two (rare). Up to 15 mg/kg/day of B6 or 3 mg/kg/day of pyridoxal-5-phosphate should be used (to a maximum of 500 mg B6 or 100 mg P5P). Be aware that many of the pyridoxal-5-phosphate preparations contain supplemental copper to prevent pyridoxal retinopathy in copper-deficient people. Since autistic children are typically high in copper, be sure to use a copper-free preparation. Other supplements Alpha-Lipoic acid: A dithiol fatty acid, alpha-lipoic acid is a native chelating agent but is also a powerful anti-oxidant. It has been extensively used in Germany to treat diabetic neuropathy with excellent results31. Its anti-oxidant effects may be particularly helpful in autistic children, since many of them show clear evidence of anti-oxidant depletion. Start with 1 - 3 mg/kg/day of alpha-lipoic acid and increase to 10 mg/kg/day as tolerated. Alphalipoic acid is a natural product of human cells and so has minimal toxicity; doses of up to 25 mg/kg/day given over more than three years have been studied in adults with no detectable toxicity32. There is a theoretical concern that alpha-lipoic acid may bind to DMSA and reduce the availability of both, but this has not been seen clinically. Another concern is that alpha-lipoic acid reduces the removal of methyl-mercury by glutathione, which is a reason why it should be given with DMSA. There is also evidence that alpha-lipoic acid reduces copper excretion33. Since DMSA increases copper excretion34 (it has been used to treat the copper intoxication of Wilson's disease35), this should not be a problem if alpha-lipoic acid is used with DMSA. A serious concern with alpha-lipoic acid is that it can facilitate the movement of mercury out of and into the cells. It can be very useful in mobilizing mercury from within the cells and making it available for DMSA to chelate. Without the DMSA to "grab" the mercury from lipoic acid, it may readily enter other tissues. Melatonin: The pineal hormone that helps to regulate the sleep/wake cycle, melatonin is also an anti-oxidant. It is relatively unique among natural anti-oxidants in that it is a terminal antioxidant: once oxidized, it cannot be reduced36. This characteristic means that melatonin cannot participate in destructive redox cycling, where an oxidized compound is reduced by oxidizing another compound. One study has found that neurons are protected from mercury damage by hormonal levels of melatonin37. Melatonin is also concentrated in the mitochondria and protects them from oxidative damage.38 Aside from its anti-oxidant properties, melatonin helps to regulate the sleep/wake cycle, which is often seriously deranged in autistic children. Its long-term use in institutionalized children has established its safety39.Doses of up to 0.1 mg/kg at bedtime should be adequate to help with sleep disturbances. Some clinicians have noted that smaller doses of melatonin (0.3 mg in adults) are just as effective for sleep and may cause fewer problems with nightmares and/or night terrors. A sustained release form of melatonin is currently under development and should help with those children who awaken four to six hours after the dose of melatonin. 13 Taurine: Taurine is a sulfur-containing amino acid which is important in the production of bile salts and, therefor, in the native excretion of toxins and absorption of fats and fat-soluble substances. Many autistic children are deficient in taurine and benefit from a supplementation of 250 - 500 mg/day. A maximum dose of 2 grams/day in adults and adult-sized children is recommended. Glutathione: Glutathione is the keystone of the cellular anti-oxidant system and is often deficient in autistic children. Despite numerous rodent studies that show good systemic absorption of oral glutathione, the two human studies looking at oral absorption have shown it to be nil40. In humans, oral glutathione is readily absorbed by the gut mucosa, repleting its glutathione supply; the mucosa then breaks down the remaining glutathione. This may explain why oral glutathione has been of help to autistic children even when there is apparently no systemic absorption. Given the gut dysfunction found in many autistic children, oral glutathione 250 - 500 mg/day may be of significant help. Supplements to be wary of Cysteine/cystine: As sulfur-containing amino acids (cystine is the dimer of cysteine), both can bind to and mobilize mercury. Like alpha-lipoic acid, cysteine and cystine may worsen mercury intoxication by spreading it to other tissues. Furthermore, cysteine and cystine are excellent culture media for the Candida genus of yeast and can promote or worsen intestinal candidiasis. In addition, many autistic children have high blood levels of cysteine. N-Acetyl-L-Cysteine (NAC): NAC should not be used initially or by itself with anyone suspected of having a significant body burden of mercury. Like alpha-lipoic acid, cysteine and cystine, NAC can bind with mercury and carry it across cell membranes. NAC is also a good culture medium for yeast, like its parent molecule, cysteine. Since many autistic children also have high cysteine levels, giving them NAC will only exacerbate this problem. NAC is often recommended because it can rapidly increase intracellular glutathione levels41,42. For that reason, it can be tremendously useful in treating the antioxidant deficiencies seen in so many autistic children. NAC should be used either in conjunction with DMSA or after mercury detoxification is well under way. In addition, NAC should be used with extreme caution in children with elevated cysteine levels. Chlorella/other algae: Often touted as an herbal remedy for mercury poisoning, chlorella has a great affinity for mercury and other heavy metals. Unfortunately, it will also readily extract mercury from the water it is grown in. Analysis of at least one specimen of commercially available chlorella has shown high levels of mercury. Other unicellular algae preparations are available on the market, advertised as a remedy for a variety of problems. They should also be viewed with caution, not only because of possible mercury content but also because of the potential for contamination with toxic dinoflagellates.Note from Dr. Mercola: This information on chlorella is seriously flawed. It is based on a small study done by Doctor's Data. They NEVER demonstrated increased absorption of mercury from the chlorella, only that mercury was present in the chlorella. Since hundreds of tons of mercury are deposited into the oceans every year, this is not surprising. However, what the investigators failed to account for was that the binding coefficient of chlorella to mercury is far in excess of its potential to release mercury into the body. It only ABSORBS mercury it does NOT release it into the body.The other issue of potential for contamination with toxic dinoflagellates is only true for blue green algae and NOT for chlorella since chlorella is a cultured product and is NOT contaminated.Concurrent testing Since DMSA has been reported to cause elevations in hepatic transaminases, serum ALT and AST should be monitored during therapy. Likewise, white cell and platelet counts should be followed. Both elevation of liver enzymes and bone marrow suppression are dose-related and 14 have been, to date, completely reversible. Also, review of the literature indicates that, while some patients are more sensitive, sensitivity appears to remain constant. This would suggest that patients who tolerate DMSA well initially will rarely, if ever, develop sensitivity later in therapy. Complete blood count (CBC) with platelet count and liver enzymes should be checked after the first or second cycle and, assuming no abnormalities are found, rechecked periodically while therapy continues. If elevated liver enzymes or depressed cell counts are found, the DMSA should be stopped and the laboratory tests followed until the values return to baseline. If the abnormalities were not too severe and they return to baseline promptly, the DMSA can be resumed at a lower dose with careful monitoring. Urine metal analysis for mercury and other toxic metals may help direct the duration of therapy. The optimum time for collecting the urine specimen is after the second dose of the cycle and within six hours of the last dose of the cycle. Timed specimens are best, but may not be practical in children who are not toilet-trained. When a 24-hour specimen is not possible, 12- or 6-hour specimens are completely acceptable. In children who are continent at night, the first morning urine represents an 8-hour collection, on average. Random or spot urine specimens are problematic, as they may miss the time of peak excretion, especially when DMSA is given every eight hours. One way to overcome this problem is to obtain two or more random specimens and combine them. This will "average" the mercury excretion over several samples. The best time to get a spot urine sample is two to four hours after a dose. Some practitioners have found stool mercury analysis to be helpful, as much of the mercury excreted with alpha-lipoic acid will be found in the bile. The major limitation to stool mercury is that the stool contains both mercury excreted in the bile as well as any mercury ingested in the diet and not absorbed. Without knowing the amount of mercury in the diet, it is impossible to accurately interpret stool mercury levels. The best way to use stool mercury levels is to obtain a level before treatment. Assuming that the dietary mercury remains relatively constant, this will provide a baseline for subsequent measurements. End-of-treatment indications If one could assume that the benefits seen in autistic children were exclusively due to mercury detoxification, then treatment could stop when mercury excretion dropped below detectable limits. Since this may not be the sole mechanism of action, the decision to end treatment needs to be based on both laboratory and clinical evidence. One obvious indication to stop treatment is when improvement ceases. Halt therapy when the child reaches a "plateau" and watch for any indication of regression. Some parents and practitioners may want to continue treatment for a few months after reaching a "plateau" in the hopes that a small amount of additional progress may occur. Also, the possibility of a "false plateau" due to illness or other stress should be considered. Obviously, if the child shows no significant progress during therapy or experiences regression, this would be another indication to stop treatment. Keep in mind that a significant number of autistic children will undergo some degree of regression during initial treatment with DMSA while later experiencing significant gains. If intestinal dysbiosis is not adequately treated prior to 15 starting DMSA, any improvement from the DMSA may be masked when the intestinal dysbiosis worsens on exposure to a rich culture medium. A number of children have shown significant improvement while taking the DMSA, which regresses when they stop, even for the "rest period" of each cycle. These children need to be dealt with on a case-by-case basis, since there is insufficient clinical experience so far to recommend a course of action. Disclaimers:1. The therapies outlined in this monograph should not be used except by and under the supervision of a physician. 2. This is not a "stand-alone" protocol and must be preceded by correction of intestinal dysbiosis and nutritional deficiencies. 3. These therapies may not help all autistic children and may potentially make some autistic children significantly worse. Even those children who will ultimately benefit from these therapies may show transient deterioration during treatment. 4. The drugs and nutritional supplements discussed in this monograph, with the exception of DMSA (Succimer, Chemet®), antibiotics and antifungals, are not approved by the United States Food and Drug Administration (USFDA). DMSA is currently approved by the USFDA only for lead poisoning.5. The quality and purity of drugs and supplements that are not FDA approved will vary with different suppliers. All such drugs and nutritional supplements mentioned are allowed by the USFDA, but it does not guarantee their safety, purity or effectiveness. 6. The theories and medical models on which these therapies are based are not universally accepted in the medical community and are being vigorously studied by a number of researchers. The clinical evidence supporting these therapies is compelling but no wellcontrolled outcome studies have yet been performed; the evidence is largely based on clinical experience at this point. 7. The theories and therapies discussed in this monograph are subject to change without notice if significant clinical or research data indicates a need for change. Disclaimers for medical practitioners: 1. Attempting mercury or other heavy metal detoxification before the patient's underlying gastrointestinal and nutritional problems are corrected will likely be disappointing to you and to the patient's family. 2. The dosing of the drugs and nutritional supplements in this monograph is within the limits supported by the majority of the peer-reviewed literature published as of January 2001. The maximum limits should be exceeded only if you have good reasons to do so. 3. At the present, it is impossible to determine which patients will benefit from these therapies with great accuracy. Some patients who seem to be perfect candidates will have no improvement and others who seem to have little to recommend the therapy will show marked improvement4. The treatment of autism is in a state of continual flux. 16 Disclaimers for parents and family members: 1. Many families are treating their autistic children with therapies similar to those listed in this monograph without involving a physician or other health care provider. That most of them do so without any adverse consequences is a testament to the safety of the drugs and supplements used. However, DMSA and some of the supplements present a small but nonzero risk of serious side effects. Life, in general, is a series of risks; the risk of serious side effects can be reduced by careful medical monitoring during treatment. 2. Not every physician is able or willing to carry out the therapies described in this monograph. Have a frank and open discussion with your physician or other medical practitioner before embarking on these treatments. 3. Despite miraculous case reports heard on the grapevine and on the Internet, these therapies will not work for every autistic person. Even those who do improve may have slow or incremental improvement4. In general, younger patients appear to respond more quickly than older patients, but this has not yet been adequately investigated.Autism Research InstituteReferencesBack to Part 2Related Articles:Mercury Amalgam Detoxification or Detox Protocol Return to Table of Contents #225

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One of the safest and effective means to detox anyone from almost

anything, is to start bathing for 30 minutes max. in a tub of hot water[

as hot as you are comfortably] you put one ounce of the miracle -ll soap

and one ounce of the m-ll neutralizer in the tub, get in and just

soak....with the first bath, leave the water in the tub over night and see

what came out of you !! Everything in the water has been transmuted and

you can pour the bath water on plants,shrubs, trees, garden.......the

nutrition part of the autism problem can also be safely dealt with by

putting the neutralizer [water] into and on whatever they will eat and

drink! One of the unique features of the neutralizer is that in frequency,

every vitamin, mineral , amino acids have been imprinted in the

water!!!! Kraig

******

Kraig and Shirley Carroll ... in the woods of SE Kentucky

http://www.thehavens.com/

thehavens

606-376-3363

 

 

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