I usually begin by testing the blood to determine allergies that could possibly trigger the immune system to react. Often autistic children come up allergic to a large number of foods, not necessarily because they are actually allergic, but rather because their immune systems are so “revved-up,” they react to everything.
This reaction may or may not occur as a traditional allergic reaction of asthma, a rash or hives. But what does occur is an immune mediated, abnormal “shut down” of blood flow in the brain that affect the language and social skills area of the brain and central nervous system function.
I generally start to improve the immune system by placing the patient on a diet free from dairy products, chocolate, and whole wheat. The reason for this is to help reduce the stress on the immune system. If dairy, chocolate and whole wheat are taken away, 96 - 98% of probable “food” allergies are alleviated. However, I do not believe that you can correct this condition by diet alone. If this were possible, parents (and physicians) by now, would have heard of multiple, “unbelievable” successes over the years. Reputable “institutions” would be conducting clinical trials to investigate the “successes.”
Since nutritional therapies have not resulted in cures, or even published reports of significantly improved cognitive function, it is illogical, in fact potentially detrimental, to put these children on extreme diets. However, sometimes these children put themselves on extreme diets by only eating a limited number of foods. I don’t think there are a lot of normal children who would be healthy on some of the diets these kids put themselves on.
For most of the children, all that is necessary is to eliminate the “main offenders” in their diets that will cause the immune system to react. It is not necessary to eliminate all wheat. Some doctors and homeopaths recommend the elimination of all gluten and wheat. I think these children show improvement because when they are put on a gluten / wheat free diet, they no longer eat whole wheat. Usually, all that is really needed is to eliminate whole wheat and other whole grains (due to allergenic potential) from the diet.
I do not normally focus on casein beyond eliminating the primary milk products. Because even though they may, in theory, play a slight role in the background, if the allergies overall are lowered, it will decrease the immune system firing off.
It does not matter if “allowed” processed products are used, as long as they do not appear to be a “trigger.” But, avoiding the “main” offenders is extremely important. Eliminating too many products from a child’s diet, increases the risk of disturbing a child’s metabolic balance, rather than helping to normalize it. (Note: Many supplements meant to compensate for the diet extremes, may in themselves have allergenic components, acting as negatives triggers to the immune system and the child overall. They may fail to be properly absorbed or contain dangerous impurities. Children may be at far greater risk from diet and “supplements” than any perceived risk from properly used pharmaceuticals.)
The G.I. tract is loaded with lymphocytes (white blood cells that fight infection and disease).Those lymphocytes communicate with the brain. What has always made sense and is “logical” is if the body is sensitive to milk protein and whole wheat protein, coming into the G.I. tract it could cause the immune system to fire.
As research evolved, it was found that milk and dairy can actually cause a microscopic blood loss in the intestine by a “reactive” inflammation of the bowel. It is interesting to note that most of the world’s populations get violently ill when given cow’s milk. Apparently, it’s not a normal human trait to digest the cow’s milk proteins.
Asian people have much healthier arteries than we do. One of the major assumptions for this is that they eat soy protein instead of dairy protein. Dairy is the number one source of cholesterol. The entire family can be helped indirectly if milk is eliminated from the meals. Parents often worry if their child is getting enough calcium. Soy and rice milk often have calcium and vitamins A and D added. However, if a child (girl or a boy) is eating a normal diet, they will get enough calcium.
In the teenage years, girl’s diets should be supplemented, if you’re not giving them a lot of dairy. But usually, this is not necessary in these first three or four months. As time goes on a calcium supplement may need to be added. Often I will suggest Tums®. Tums® are a very safe source of calcium for a child and they taste good. Inter-related is the fact that many children and adults who are sensitive to milk but still continue to drink milk products, often have iron stores that are low. Their Hgb. / Hct. are chronically on the low side of normal, even if they were not truly “anemic.” This is typically because of a microscopic blood loss occurring through this “inflamed” mucosa. If dairy and milk were eliminated from the diet, and then a biopsy of the intestine was done, the mucosa(the mucous membrane that lines a structure e.g. mouth and lips) would look normal. If milk and dairy were then reintroduced, the mucosa would look raw and inflamed. (Therefore, in approaching the idea of “leaky” gut, helping the body by removing negatives, is more important than “supplements” and nutritional “fixes.”)
As a pediatrician it has been fairly routine for me to see a child do well on formula (even a cow’s milk based one) for 12 months, but when the child is switched to real milk, the child experiences congestion, stuffiness, upset stomach, and a whole realm of symptoms not seen before. Whole protein, unprocessed food is much more allergenic and has a higher incidence of causing the immune system to react.
The truth is, there is not as bad an allergic reaction out of a processed product. When a food is processed, the protein structure is changed. So a child that might go berserk on milk… may not have a reaction to “processed” cheese. When the protein structure is changed, the food will not give as large an allergenic reaction.
Products from the health food stores are not necessarily the best for autistic children because they are less processed and more pure. They have a lot of whole wheat and grains. For these kids, the cheapest white bread (without milk, whole wheat, or whey) is often the best choice.
To illustrate how peculiar the immune system is, when parents seen the results of the food test come back, a routine phone call is, “How come you did not say ‘no eggs’?” You’ll almost always see egg white and egg yolk with very high numbers, and yet I will usually say “ignore it.” The reason being, unless a child has eczema where yolk or egg are triggering off a skin reaction, for some reason the immune pathway fired off by eggs doesn’t seem to play a role in what we are talking about in the brain. I rarely have to worry about taking a child off of eggs, even though you may have this “huge reaction” on the food “screen.” This illustrates how parents need to become aware of what doctors have known and “fought” about for years, there is no “perfect” food test / screen, results must always be interpreted in their clinical context. Too often, parents are being “guided” by interpretation of food and metabolic screens that do not have the capability to do what the parents wish. Many mistakes are potential being made, that may be “metabolically” and physiologically hurting these children.
Although processed food might give a lesser reaction, the importance of avoiding allergens cannot be stressed enough. In the beginning, it is especially important to avoid foods that might trigger the immune system. If the immune system is triggered, the body is affected for a minimum of a week to ten days (or longer). So it’s necessary to be particularly strict at the start of the treatment, when the goal is to cool down the immune system.
If it comes down to choosing a food (cheat) with milk or sugar, choose the sugar. From the sugar the child may get hyper for a few hours, but it wears out of their body relatively quickly. From milk protein or other allergens, the immune system can be affected for up to two - three weeks. However since sugar feeds yeast, it is a good practice to minimize sugars in general.
It is also important to encourage the children to eat more protein. This will help balance out their own amino acids, which in turn will help alleviate some of their problems. All these children need protein. It is also necessary to restrict the starches. Healthy breakfasts, lunches and dinners should be served.
Sometimes this process of restoring the immune system to normal can be very deceptive. The child is doing extremely well, and appears almost well or “cured” to a parent, when everything suddenly falls apart.
A child may appear to be well, but unless the body has shut off this process, they still have a reactive, volatile immune system in the background. Even if a child is functioning at a extremely high level, a child should not be regarded as “cured”, unless the immune system has truly returned to normal.
While a few rare children will actually outgrow this process, especially if you have taken steps to help normalize their bodies; realistically, it will probably take the advent and usage of new drugs that are immune modulators, to truly shut-off their dysregulated immune system.
This treatment needs to be thought of on a continuum. The closer the child gets to normal, the better the chance that the body may shut off this process. But unless you’ve gone that last little step, unless this process shuts off, it must be assumed that the immune system is still volatile and potentially reactive.
The only principle I have continued to find logical over the years, is the idea that I’m trying to just help a child “normalize” their body (and brain). Can I help them balance out their body? If I can change the diet, their own body can help balance itself. There continues to be no evidence in these children of any pre-existing, built-in enzyme or metabolic defect. Therefore, by focusing on the overall intake, encouraging more protein, less starch, a child’s body will help balance out and replace needed amino acids ( the building blocks of the body) and other nutrients.
With rare exceptions, I will never say don’t do something if you truly see a child do better and it’s safe, but in most cases I have found that you can get to the right point if you just think of it as cool down the body’s immune system, help “safely” where medically and nutritionally possible, and extremely important, avoid offenders or triggers. If a child is doing better and their allergy test said they were not allergic to apple, but you give them a drink of apple juice and the child is bouncing off the walls, it doesn’t matter what the test said, that child should not have apple juice. And this is the way parents have to work with their own child.
Until new immune modulators are tested and ready for use with patients, I regard each step of treatment as an attempt to help “cool-down” the immune system, and help the body “adjust” itself in a healthier manner. While the principles are becoming very consistent, each child (his/her body and brain) must be “individualized.”
Michael J. Goldberg M.D., F.A.A.P.
Avalar Medical Group, Inc.
5620 Wilbur Avenue, Suite 318
Tarzana, Claifornia 91356
Telephone (818) 343-1010
Fax (818) 343-6585
Pediatrics & Young Adults
ADHD/ADD-Learning Disabilities,
Immune Dysfunction Autism
Source: allergens
