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Autism/PDD - Deciding Which Tests to Do |
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It’s a balancing act weighing the expense of tests with their usefulness in improving symptoms. In general, the more abnormal the results, the greater the chance for improvements after implementing therapies. Keep in mind that one approach never fits all cases, and we’re available for consultation. The following recommendations are not meant to take the place of sound medical advice from a doctor. (A doctor’s signature is necessary to do the following tests though not necessary to order and have the sample transport containers sent to you.)
Initial Testing RecommendationsOrganic Acids Test - Virtually all specimens from children with autism or PDD have one or more abnormal Organic Acid compounds, due to abnormal levels of yeast and other gastrointestinal bacteria. These compounds can affect, among other things, neurological functioning, vitamin utilization, energy level, intestinal wall integrity, hormone utilization, and muscle function. In addition to identification of excessive levels of GI yeast or bacteria, the test also reveals nutritional or antioxidant deficiencies, inborn errors of metabolism, amino or fatty acid problems, exposure to solvent toxins, indications of possible diabetic conditions, deficiencies of B or C vitamins, and unusual levels of neurotransmitters. Yeast Culture and Sensitivity - This test should be done in combination with the organic acid test to get the most accurate reading for yeast and bacteria overgrowth. By doing both of these tests you will have all the evidence your doctor needs to help you treat this problem. The urine organic acid test is the most accurate measure of yeast, which can sometimes be overlooked in the stool test. Yeast can sometimes attach to the intestinal lining and will not be eliminated in the stool. In some cases, the sections of stool where the yeast is present are not the sections that are collected and sent in to be analyzed. Generally, however, the stool test is an accurate test. The greatest benefit of the stool test is the sensitivity portion of the test, which will tell you which antifungal agents your intestinal yeast will respond best to. Food Allergy - The impact of food allergies on behavior can be astounding, and cravings are very often, for the same foods that cause allergic reactions. And, those foods may play a role in abnormal levels of GI organisms. We have two panels available; one that tests for 96 foods, and another that tests for 10 of the most common foods people are allergic to. We recommend doing one of these two panels. It is best to have the full panel done. However, the 10 food panel is good for those who have limited resources, or for those who do not want to wait until the yeast problem is under control to see what food allergies they have. Immune Deficiency Panel - Numerous papers document inadequate immune functioning in this many populations, increasing the vulnerability to bacterial/viral/fungal infections. In particular, yeast is well-documented as suppressing the immune system. So, if there is an excessive yeast population, it increases the likelihood of an inadequate immune response, in turn, increasing the probability of more infections and more yeast. Our panel is designed specifically for this patient population; for instance, levels of zinc, and specific immune proteins like IgA and subclasses of IgG, are often inadequate. Peptide Testing for Milk and Wheat - In most cases people that have food allergies to milk and wheat, also have problems with peptides from milk and wheat interacting with their brain and causing an opiate-like affect. However, there are some people that may not show a food allergy to milk or wheat, but have the peptide problem and vice versa so it is a good idea to have both the peptide and food allergy testing done. If you prefer to have only one of the tests run, we recommend the food allergy testing since it can be assumed that the majority of people who have food allergies to casein and gluten also have the peptide problem. The peptide test is also a urine test and thus may be more convenient.
Metals (blood, hair or urine) - Hair is useful for the detection of toxic metals such as lead, aluminum, mercury, and cadmium. Lead may be found in dirt near roads and is commonly present in paint from older houses. Children with pica or who eat paint chips may develop toxic lead levels. Cadmium is used in batteries, steel-belted tires, and plastics. The clear plastics used to cover foods may be a source of cadmium and it is also found in cigarette smoke. Mercury is used in batteries, dental amalgam, vacuum pumps, valves, and seals. High amounts of mercury from the dental fillings of the cremated deceased have caused contamination of the surrounding neighborhoods. Arsenic is high in seafood and may also be found in animals fed arsenic in their feed. Arsenic is also present in wood preservatives, fungicides, herbicides, corrosion inhibitors, and in lead and copper alloys. Children with autism may respond favorably to removal of toxic metals. Children with autism as a group also have low values of essential elements like calcium, potassium, zinc, and magnesium. Treatment of heavy metal exposure usually involves the removal of the heavy metal source and/or treatment with chelating agents.
Amino Acids - Helpful in assessing causes and treatments for lethargy, muscle weakness, vitamin deficiency, protein intolerance, vomiting, kidney stones, inborn errors of metabolism, and seizures. Since many of these symptoms are caused, or worsened, by elevated levels of GI yeast/bacteria, we recommend that Amino Acid testing follow Organic Acid testing and treatment (if indicated) for GI organisms. The Organic Acid test includes some indicators of inborn errors of metabolism. Essential Fatty Acids - Deficiencies of essential fatty acids are associated with hair loss, dry or peeling skin, diarrhea, eczema, fatigue, aggression, dry brittle hair, eating disorders, excessive thirst, gallstones, growth impairment, immune deficiency, hyperactivity, and impaired wound healing. Essential fatty acids can be deficient due to inadequate dietary intake, diarrhea, loose stools, inadequate production of pancreatic enzymes, or inadequate production or secretion of bile or bile salts. The pattern usually observed in children with autism is deficiency of omega-3 fatty acids, especially alpha-linolenic acid with elevations of arachidonic acid and trans fatty acids. Arachidonic acid is extremely important since it is converted to the regulatory substances called prostaglandins. Grains and meats from grain-fed animals may be very high in arachidonic acid. Trans fatty acids are unnatural fatty acids produced by hydrogenating unsaturated fatty acids. Trans fatty acids may be especially harmful when alpha-linolenic acid is deficient. Trans fatty acids may affect neuronal fluidity by virtue of different dimensions compared to cis fatty acids. Trans fatty acids are high in foods like French fries, potato chips, margarine, cookies, and cake.
Inhalants (Comprehensive or Basic) IgE - Particularly useful when allergies to inhalants, such as dust, molds, and pollens are suspected; blood tests have improved considerably over the years, and are especially helpful with individuals who would have difficulty complying with skin testing or have skin rashes; to save time; or for very young children. May also be considerably cheaper than skin testing. Follow-up Testing RecommendationsOrganic Acids Test - It is helpful to re-test about 4-6 months after the start of treatment, mainly to refine the treatment. If the original test demonstrated undesirable levels of GI microbial metabolites exclusively, then the less comprehensive microbial panel will suffice. The microbial panel measures only 20 of the 62 compounds in the full organic acid profile. Yeast Culture and Sensitivity - When redoing the organic acid test or microbial panel it is a good idea to redo this test as well to see if any of the sensitivities have changed after treating the yeast. In some cases yeast can develop resistance to antifungals after being exposed to them. Retest 3-6 months or as needed for treatment directed by your doctor. Comprehensive Food Allergy Panel - If you did the comprehensive food panel first, when the yeast was present, you should follow up with this test again to see what food allergies are still present. A lot of times food allergies may disappear when the yeast problem is taken care of.
Frequently Asked Questions about Autism/PDD TestingPlease remember that general questions about all our tests are answered in our testing FAQ, information about payment is available on our insurance and payment page, and questions about specific tests are usually answered on the page about that test. (See the test listing in the lefthand menu bar.) Yeast QuestionsIf my child has no external signs of yeast such as thrush or anal or genital rashes, could he still have a yeast problem? Yes. In many cases, a behavioral abnormality is the only clue to an underlying yeast overgrowth. Could an intermittent low-grade fever be a symptom of yeast infection? Fever often accompanies yeast infection of the blood stream, which is termed "systemic yeast infection." To test for yeast in the blood, you need to have a yeast culture and/or yeast antibody tests on the blood. The patient may also have an intestinal yeast overgrowth. My child has a white coating of the mouth. Could this be a yeast problem? Yes. One of the most common yeast in the intestine is Candida albicans. "Albicans" is a Latin word for white, and a white coating of the tongue may very well be Candida. My child has a yeast infection in the genital or anal area. Does this indicate a yeast overgrowth of the intestinal tract? Yes, it could very likely indicate such an overgrowth, but it is impossible to know for sure without testing to confirm it. My child has urinary tract infections or a vaginal yeast infections. Could the microorganisms in the urinary tract affect the test results? Microorganisms might contaminate the sample and lead to erroneous results if the urine stands too long at room temperature. Consider stool testing as an alternative in this case. Can I test my infant, who is having frequent ear infections, to see if s/he is developing abnormal yeast products? Yes. We provide tape-on bags to collect urine samples from infants or children who are not potty-trained. Simply check the box next to "Include a tape-on sample collection bag..." on your test order form. My child has a large number of food allergies. Could this be related to the yeast problem? When should I get food allergies tested? Yes, food allergies can be related to a yeast problem. Yeast can exist in two forms: a floating single cell form or a colony form. When yeast form colonies, they secrete enzymes such as phospholipase and proteases that break down the lining of the intestinal tract in order to attach the yeast colony to the intestinal wall. The holes made by the yeast produce a condition called "leaky guy syndrome" in which large undigested food molecules are absorbed into the bloodstream and elicit food allergies. Once the underlying yeast problem is controlled, the holes in the intestinal wall will heal. Then less undigested food gets into the blood and the number of food allergies will drop. Will the use of Nystatin interact adversely with other medications a patient is taking? Nystatin is not absorbed from the intestinal tract in an appreciable quantity unless extremely larger doses are used. Therefore, there are no adverse reactions with drugs such as anti-seziure medications, antidepressants (such as Prozac or Elavil) or other medications. If you use antifungals that are absorbed from the intestinal tracts (such as Lamisil, Sporonox, Diflucan and Nizoral), then drug interactions must always be considered. It's important to be aware that other drugs used simultaneously may be more potent or make the antifungal drug more potent when these latter drugs are used. What about starting out all of these therapies at the same time? We recommend that the antifungal therapy precede the allergy and gluten/casein testing, since the yeast may be making the situation worse. As far as supplements such as SuperNuthera and DMG, we recommend that they be tried 2 months before or after the antifungal therapy so that you can know which therapies have been the most beneficial. If you do everything simultaneously, you won't be able to say which therapy is most helpful. Could there be adverse reactions to the food colors and flavors in Nystatin? Yes, that is a possibility. If that is the case, then you may have to use the pure Nystatin powder and disguise it in food. One way to disguise it might be to combine it with Stevia, a sweetener that cannot be utilized by the yeast. Stevia is available in most large health food stores. What kind of changes might I expect with the antifungal drug therapy? Results are highly variable but the most usual improvement noted is increased focus and concentration. Other improvements may include increased and clearer vocalization, less spinning, decrease in aggressive or self-abusive behavior like head-banging, better sleep pattern, increased socialization and better eye contact. Antifungal therapy does not appear to help individuals with normal or marginally elevated yeast metabolites. Ultimately, antifungal therapy is not a cure for autism by itself, but can significantly improve the life of the individual with autism and their family. Miscellaneous QuestionsMy child only eats bread, cereal or pasta. How can I change his diet without starving my child? Many parents have reported that their children may refuse the altered diet for three or four days, then give in and eat the new foods. However, it would be wise to consult your physician before starting the diet. A short time without eating is not harmful to most children, but might be significant if your child has a special medical problem like diabetes. What foods have Lactobacillus acidophilus in them? Yogurt is high in Lactobacillus acidophilus. The unflavored or plain kind is more highly recommended than flavored, because yeast may grow in the kind with fruit on the bottom. Some milk now also has acidophilus added. Just read the labels. What about the use of "Sara's diet" and the reported sensitivity to vitamin A and carotenes? What can you tell me about your organic acid test and this diet? At this time, the organic acid test is not useful in predicting whether or not a person will respond favorably to Sara's diet. Currently there is no known biochemical basis for this diet. Where can I get dimethylglycine? New Beginnings Nutritionals http://www.nbnus.com Where can I get various antifungal supplements such as caprylic acid, MCT oil, grapefruit seed extract or garlic extract? All of these supplements can be obtained in health food stores or from mail order companies. The does for children are usually not specified with these products, and the yeast die-off reaction is usually just as severe as with prescription drugs. The main benefits of prescription drugs are the additional quality control measures required for these products and the availability of pediatric guidelines. What side effects may be associated with the use of Flagyl or oral Vancomycin to control the overgrowth of Clostridia in the intestinal tract? The main side effects of Flagyl or Vanocmycin are probably due to the release of bacterial toxins as the Clostridia and other bacteria die. Side effects may be very severe and usually last from 2-10 days. A child should be under close medical supervision while on this drug. Side effects may include severe diarrhea, heart palpitations, extreme lethargy and fever with drenching sweats. A child should not start both the Flagyl/Vancomycin and antifungal therapy simultaneously because the combined die-off reaction may be too severe. Both Flagyl and Vancomycin will kill the friendly bacteria and it is very important to start Lactobacillus acidophilus as soon as the Flagyl/Vancomycin therapy stops or there will be a recurrence of the Clostridia or a yeast overgrowth. It is OK to continue Nystatin during Flagyl/Vancomycin therapy. Just don't start the antifungal and antibacterial therapies simultaneously.
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Last Updated:12/05/2005
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