Brenen Hornstein Autism Research & Education

New Treatments

Mercury/Heavy Metal Detoxification
Vitamin A/Bethanecol
Oral Gamma Globulin

Mercury/Heavy Metal Detoxification

While mercury detoxification is not a "new" therapy, it is relatively new within the autism community and is something that we all will be hearing much more about. Dr. Cave and Dr. Holmes in Louisiana are reporting good results with heavy metal detoxification with their autistic patients. To learn more about mercury detoxification you can visit Dr. Holmes's web page.

Why would you even consider this treatment?
Dr. Stephen Edelson reported in a study the presence of one or more heavy metals in excess of reference ranges in 100% of autistic children tested. The toxic metal that seems to be the biggest problem is mercury. Mercury can cause a host of problems in our bodies. Mercury is known to cause brain damage and other neurological problems. Furthermore, mercury disrupts immune and enzyme system function. As a matter of fact, a recent article by Bernard, et al compared acute mercury poisoning with autism and found some very interesting results. Signs, symptoms, and laboratory tests of persons with mercury poisoning as compared with persons with autism were very similar. That being the case, is there a link here with the cause of autism? It would seem like a very plausible idea. See "My Theory" on the home page for more information about this link.

How would our children get such a poison in their bodies to begin with?
There are a number of different thoughts and each depends on whom you talk to. It is a fact that the amalgams in almost all of our mouths contain mercury. Many people believe that vapors, which are given off as the amalgams break down, are inhaled and therefore enter the system. The EPA (Environmental Protection Agency) considers mercury as a "Hazardous Material". One study found that mercury injected into pregnant rats concentrated in two areas. Almost half went to the rat's brain and about half went into the growing fetus. Thus, if a pregnant woman has amalgams that are giving off toxic vapors, then it would be very feasible that these vapors are affecting the unborn child. Mercury is also a pollutant that is now in our air, water, and soil that we can inhale or ingest. Lastly, and possibly the major cause of mercury in our children's systems would be from vaccines. Most vaccines, up until 2000-2001, contained a chemical known as Thimerosal, which is 49.6% mercury by weight. This chemical was, and is still used as a preservative. It was contained in the DPT, Hib, and Hepatitis B vaccines to name a few. The total amount of mercury that six-month-old babies received via these injections has exceeded the EPA safe limit. This is a very interesting and yet disturbing fact.

The FDA has "asked" the vaccine manufactures to stop producing childhood immunizations with mercury. Since there was not an order or mandate however, some vaccines still contain this toxic substance. If one were to vaccinate their child, it would be very wise to be certain that the vaccine the child receives is Thimerosal free. As such, the parent should insist on viewing the insert that comes with the vaccine to be sure the insert states "Thimerosal free". Some states are now suggesting that children get the Flu vaccine, which is not a "childhood vaccine". The Flu vaccine, and many others, still contains mercury.

Is there a test that can tell me if my child has this "heavy metal" problem?
Yes, you can test your child for heavy metals. Blood tests are generally used for acute poisoning which would not be the case for most of our children, unless of course your child was just vaccinated. Once the mercury enters the body it will work its way and bind to tissues and organs in a matter of weeks so a blood test even after a few months may not show any signs of mercury. Mercury can also be measured via hair, urine, and stool. There does not seem to be a consensus as to which method is the most accurate, but hair seems to be a good way to test if your child has this problem or not. If your child does have high levels of mercury and you choose to have it removed, urine tests will be used to determine how much mercury is leaving the child's body.

How do I remove mercury and other heavy metals from my child's body?
There is much controversy as to what is the best way to remove mercury. There are many different therapies that are used which are basically divided into two categories. Natural, or homeopathic, methods work slowly but have fewer side effects, while medication such as DMSA (Dimercaptosuccinic Acid), DMPS (Sodium Dimercaptopropanesul-fonate), and Lipoic Acid work much faster, but have more risks. Certainly for an acute case of mercury poisoning, medication would be the best treatment. For chronic cases, as many of our children seem to be, there is not yet a good answer as to which method is best.

Removal of mercury from the body is known as chelation (pronounced key-lay-tion). Chelation is a process that can take a long time to occur. This is not a one-time treatment and is usually administered over many months or longer. Some of the natural ways this is done include vitamin therapy such as C and E, cilantro tea, sauna therapy, chlorella, and MSM. Medication has generally been given intravenously or orally. If the child is able to swallow capsules, the oral method may be the preferred mode of treatment. Kirkman Labs now offers all of the chelating products needed for this treatment if DMSA is the medication of choice. A prescription is required. Even if the child is unable to swallow a capsule, one can easily open the capsule and put the DMSA or other chelating support products into food or drink. The DMSA produced by Kirkman Labs is not pleasant tasting, but it is generally better then getting the product from a local pharmacist. One way that has worked for some, is to give the medication with food and break it down into many mouthfuls. Adding a little amount to a spoonful at a time may be best so the entire meal is not "bad tasting." Each child will have his or her best way to take the medication and therefore the best advice would be, "to do whatever works." The medication can be given intravenously, which of course is very traumatic for the child as well as the parent. Frequent injections are needed and this can be very unpleasant.

When the body begins chelation therapy, it is unable to differentiate between "good" and "bad" metals. Therefore, not only are toxic metals such as mercury, tin, arsenic and lead removed, but also zinc, which is already a deficient metal for most of our children, as well as other "good" metals. It is critical that chelation therapy be done only with direct supervision of an experienced doctor in these methods. Supplementation of "good" metals is a must.

Heavy metal detoxification treatments are constantly being updated and changed. The DAN protocols will most likely continue to change as they seek to improve results and decrease side effects. For the most updated protocol, see the Autism Research Institute. Kirkman Labs is creating new products every few months to aid in this treatment. Visit their web page to learn more.

Vitamin A/Bethanecol

The following description is based on listening to Dr. Mary Megson speak at the 1999 DAN Conference via an audiotape. I believe the information was very important and is on the cutting edge of research, but somehow was not received that way. I think the reason was that the presentation was somewhat difficult to follow. I was lucky to be able to listen to her speech three times prior to this writing and still do not understand everything that she presented. I have the utmost respect for Dr. Megson's work and appreciate this potentially ground breaking new treatment.

At the 1999 DAN conference Dr. Megson spoke of a "new" treatment she was trying with her autistic patients. It was explained that the symptoms of Vitamin A deficiency are Celiac disease, night blindness, diarrhea, and juvenile diabetes. Vitamin A is a critical component for the immune system. Vitamin A is needed to help "turn on" the T-cells. This vitamin is very important in eye function and in repairing epithelial cells. The epithelial cells line the gut and are in the liver to help detoxify the body. It is clear that autistic people in general have poor eye contact, GI problems, and have detoxifying problems, especially with heavy metals.

Dr. Megson educated the crowd in that there are basically two forms of Vitamin A. One form is called "trans" and the other is called "cis". The "trans" form is found in all baby formulas, milk, and although not found in fruits and vegetables, the carotene in the fruits and vegetables is metabolized into the trans form. The trans form of Vitamin A usually is called A-Palmitate.

The trans form of Vitamin A needs a very specific enzyme that sits on the tip of the microvilli in the small intestines to be absorbed. If these villi are damaged or this particular enzyme is not present than this form of Vitamin A cannot be absorbed. At least half of all autistic children have "damaged" GI tracts and some doctors believe that the number is more in the range of 85-95%. Therefore, no absorption of Vitamin A in the trans form is occurring in most of our children.

It was noted that in many countries, the measles virus is treated with IV Vitamin A since measles actually depletes a child's stores of this vital component. What happens when a "genetically predisposed" child that has a Vitamin A problem to begin with, receives an MMR vaccine? The stores of Vitamin A are used up and the cycle begins.

The cis form of vitamin A is found in liver, kidneys, milk fat (which is mostly removed now and A-Palmitate is added back), and cold-water fish. The cis form of Vitamin A is absorbed much easier than the trans form. Cod Liver Oil (CLO) is sold as a supplement for Vitamin A. Careful attention MUST be taken when supplementing Vitamin A because it is a fat-soluble vitamin and can be toxic if taken in too high of a dose. Dr. Megson stated the highest dose she had used was 5000 IU on a 10-year-old child. 5000 IU is the RDA. This is NOT a mega dose treatment.

Are all CLO the same? There are only two brands that The BHARE Foundation currently knows of that have the "possible" desired cis form. Those include Kirkman and Twin Labs. With most CLO on the market, 1000 IU of CLO will contain 990 units of A-Palmitate and only 10 units of natural cis form. The BHARE Foundation is not certain the amounts in Twin Labs. Kirkman's CLO contains 100 IU of the cis form (10 times as much as most CLO). Also, the A-Palmitate is natural and not added synthetic like most on the market.

Dr. Megson believes once the Vitamin A stores are up, the body will begin to heal itself. She recommends a two-month supplementation, then begin the second "phase" of the treatment. This treatment must be under the direction of a Dr., preferably one that understands nutrition and autism.

The second step in this treatment is a drug called Bethanecol. Bethanecol, also known as Urecholine, has been used since the 1960's and is a relatively safe drug with minimal side effects.

Bethanecol has some very interesting actions that involve the gut. Before talking about the gut however, it is important to discuss the two "nervous systems" in the body. Each of us has a Sympathetic Nervous System (SNS) and a Parasympathetic Nervous System (PNS). The SNS "kicks in" when we are in a "fight or flight" situation. As cavemen, this system was very helpful in surviving an animal attack for example. The PNS is for "preservation of the species", meaning this system is used most of the time a person is living. This system is used for digestion and sexual function. When one system is "on" the other is "off". If the SNS is switched on because of a perceived threat, then the body reacts by increasing adrenaline flow. All of the functions needed to survive (high threshold for pain, need for acute hearing, smell, taste, touch, and sight) are instantly turned on. And also, the functions that are not needed for instant survival (digestion and sexual function) are turned off.

Bethanecol stimulates the PNS and promotes the utilization of Vitamin A in the cells. By doing this, many wonderful things can occur in the gut of our kids. Peristaltic motion is increased. This motion helps move food along the GI tract to be digested and also excreted. Furthermore, the PNS stimulates the pancreas to secrete enzymes (sound like something you may have heard of?), thus aiding digestion. The adrenaline flow is stopped and the person can "calm" down.

Sounds great in theory, but does it work?

At the time of this writing Dr. Megson has treated about 500 children using this protocol with results she describes as just as good if not better than secretin. Plus, there are long lasting results with much less risk to the child as well as much less cost to the parent. Early reports from some parents after the DAN meeting were that the Vitamin A treatment did not produce much in terms of improvements. This however, was prior to the introduction of the Bethanecol step in the treatment. Also, it is not known what type of Vitamin A these parents were using. If it were A-Palmitate, then certainly one would not expect any change to take place. Kirkman's CLO has been on the market since March, 2000 and they will be doing a double blind study soon, according to one of the owners at Kirkman. The Pfeiffer Treatment Center in Naperville, IL has begun this therapy as of March, 2000. They are not at this time doing a study, but The BHARE Foundation will be following this very closely and keep you posted on any details. According to The Pfeiffer Treatment Center, patients with one or more of the following symptoms may have the most to gain from this treatment: malabsorbtion, divergent gaze, speech delay, dry skin, poor social skills, night blindness, soft stools, and dry eyes.

Is Bethanecol safe?

Bethanecol has been used by millions of children with most reporting no side effects. Side effects that have been reported include diarrhea, frequent urination or enuresis, dilated pupils, abdominal cramps, nausea, increased salivation, increased sweating, flushing, and headache. There are contraindications for Bethanecol as well. Long-term use of Bethanecol in children has not been studied and therefore long-term effects are unknown.

This is a very complicated topic as are many in autism. If you feel this interpretation of treatment was not accurate please E-mail us and make any suggestions you may have.

Oral Gamma Globulin

Oral Gamma globulin is now being used as a possible alternative to IVIG therapy. Dr. Cindy Schneider is in the early stages of studying this potential new therapy. The ingredients in the oral Gamma globulin is the same as the IVIG, but it is simply kept as a solid powder and ingested as a capsule, instead of being infused from an IV.

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