Using Labs to Manage Using Labs to Manage Your Child’s Biomedical Your Child’s Biomedical Program and Interpret Program and Interpret

the Resultsthe Results

Tracy Ziemann PA-CTracy Ziemann PA-C

Sonja Hintz RNSonja Hintz RNTrue Health Medical CenterTrue Health Medical Center

Naperville, IL Naperville, IL

Goals for this PresentationGoals for this Presentation

Basic Laboratory Tests your general Basic Laboratory Tests your general practitioner can orderpractitioner can order

How do the lab findings present in my How do the lab findings present in my child’s behaviorchild’s behavior

Potential treatment options available for Potential treatment options available for abnormal results abnormal results

Build your foundationBuild your foundation Create your own History and Physical: Create your own History and Physical:

some- times a time line is helpful some- times a time line is helpful Review your:Review your:

Environment: Home, School and other Environment: Home, School and other places, what triggers are thereplaces, what triggers are there

Diet: texture, food choices, when your Diet: texture, food choices, when your child eatschild eats

Elimination: Are your Childs stool Elimination: Are your Childs stool frequent, or infrequent, what color and frequent, or infrequent, what color and odor do they have?odor do they have?

Gathering informationGathering information

When a doctor sees an autistic child there When a doctor sees an autistic child there is a need for the parent to relay the child's is a need for the parent to relay the child's physical conditionphysical condition

In the biomedical treatment of autism we In the biomedical treatment of autism we look at behaviors and the physical look at behaviors and the physical condition of the child to place them in condition of the child to place them in categorycategory

Basic initial testingBasic initial testing

BloodBlood CBC, CMPCBC, CMP TSH, Free T4TSH, Free T4 Iron, FerritinIron, Ferritin Lead, bloodLead, blood Copper (serum), Zinc (plasma)Copper (serum), Zinc (plasma) Ammonia, blood (Has to be sent Frozen)Ammonia, blood (Has to be sent Frozen) Immune system evaluation: IgG total and 4 Immune system evaluation: IgG total and 4

subclasses, IgA and 2 subclasses, total IgE and IgMsubclasses, IgA and 2 subclasses, total IgE and IgM

Additional Blood TestsAdditional Blood Tests

Viral Titers Viral Titers QUANTITATVE IgG:QUANTITATVE IgG:

CMVCMV EBVEBV HHV6HHV6 HSVHSV VaricellaVaricella MeaslesMeasles MumpsMumps RubellaRubella Hep. B surface AbHep. B surface Ab PolioPolio

Strep TitersStrep Titers ASO titer quantitativeASO titer quantitative AntiDNASE B Ab AntiDNASE B Ab

quantitativequantitative

Mitochondrial Tests:Mitochondrial Tests:

Blood Amino AcidsBlood Amino Acids

Carnitine PanelCarnitine Panel

Lactic Acid Lactic Acid

Pyruvate AcidPyruvate Acid

VirusesViruses

Physical PresentationPhysical Presentation ““Never sick”Never sick” ““Always sick”Always sick” Regression after illnessRegression after illness Poor eye contactPoor eye contact Improved eye contact with Improved eye contact with

a fevera fever Stimmy BehaviorStimmy Behavior

• Hand flappingHand flapping

• Sideways glancingSideways glancing

• Finger flickingFinger flicking

TreatmentsTreatments Olive leaf extractOlive leaf extract ElderberryElderberry Oil of OreganoOil of Oregano Herbs/Nutrients that Herbs/Nutrients that

support the immune support the immune systemsystem

Antiviral medications: Antiviral medications: ValtrexValtrex

High dose Vitamin AHigh dose Vitamin A HomeopathyHomeopathy EnzymesEnzymes

StrepStrep

Physical PresentationPhysical Presentation Poor eatingPoor eating Clearing the throatClearing the throat Swollen lymph glandsSwollen lymph glands Obsessive Obsessive

thoughts/behaviorthoughts/behavior SeizuresSeizures TicsTics Someone else in the Someone else in the

family has strepfamily has strep

TreatmentsTreatments Biofilm treatment esp if Biofilm treatment esp if

strep is found in the strep is found in the stoolstool

Antibiotics: ZithromaxAntibiotics: Zithromax ProbiodicsProbiodics Immune supportive Immune supportive

agents: IVIGagents: IVIG BerberineBerberine Golden SealGolden Seal Oregon grape rootOregon grape root

GI Health MarkersGI Health Markers

Stool testingStool testing CDSACDSA CPP x3CPP x3 MicrobiologyMicrobiology

Urine organic acid test (OAT)Urine organic acid test (OAT) Great Plains lab- OATGreat Plains lab- OAT Metabolic Analysis Profile (MAP) Genova Metabolic Analysis Profile (MAP) Genova

diagnosticsdiagnostics

Yeast symptomsYeast symptoms

Giggly, inappropriate laughingGiggly, inappropriate laughing Foggy, spacey Foggy, spacey Change in bowel movements (foul/yeasty Change in bowel movements (foul/yeasty

smelling stools), gas, and bloated bellysmelling stools), gas, and bloated belly Yeasty rash/diaper rash, white coating on Yeasty rash/diaper rash, white coating on

tongue, red ring around the anus, ringworm, tongue, red ring around the anus, ringworm, cradle capcradle cap

Bedwetting or accidentsBedwetting or accidents Sleep disturbance or Night wakingSleep disturbance or Night waking Hyperactivity, hand flapping, toe walkingHyperactivity, hand flapping, toe walking Sugar cravingSugar craving

Treatment Treatment

Start a potent ProbioticStart a potent Probiotic Digestive EnzymesDigestive Enzymes Clean up the dietClean up the diet

Casein/Gluten freeCasein/Gluten freeLimit sugarLimit sugarConsider SCD and/or Low oxalateConsider SCD and/or Low oxalate

Support the gut and reduce inflammationSupport the gut and reduce inflammationVitamins/supplements, herbs, medicationsVitamins/supplements, herbs, medications

More Treatment options…More Treatment options… AntifungalsAntifungals

• Drugs Drugs Nystatin, Ampho BNystatin, Ampho B FluconazoleFluconazole ItraconazoleItraconazole KetoconazoleKetoconazole

• HerbalsHerbals BerberineBerberine Grapefruit Seed ExtractGrapefruit Seed Extract Oil of Oregano, Pau d’ArcoOil of Oregano, Pau d’Arco Garlic, SamentoGarlic, Samento

Homeopathy Homeopathy

Look OUT for “Die Off”Look OUT for “Die Off”

Loose stools, diarrheaLoose stools, diarrhea Behavior, irritabilityBehavior, irritability Head aches, head Head aches, head

bangingbanging FatigueFatigue Sleep disturbanceSleep disturbance RashesRashes

ParasitesParasites

What may What may keep you keep you and your and your child up child up at nightat night

Signs and Symptoms of ParasitesSigns and Symptoms of Parasites

Discomfort and bloating of stomachDiscomfort and bloating of stomach Itchy buttocks, night waking, fecal smearingItchy buttocks, night waking, fecal smearing Diarrhea and constipationDiarrhea and constipation Teeth grindingTeeth grinding Mal absorption of nutrients, pica, insatiable appetiteMal absorption of nutrients, pica, insatiable appetite AllergiesAllergies Behavior changes and/or aggression, worse at full moonBehavior changes and/or aggression, worse at full moon

PickingPicking BitingBiting RestlessnessRestlessness

Treatment for ParasitesTreatment for Parasites ProbioticsProbiotics HerbsHerbs

• WormwoodWormwood• Black walnutBlack walnut• Pumpkin seedsPumpkin seeds• CloveClove• Coconut oilCoconut oil

HomeopathyHomeopathy Antiparasitic medicationsAntiparasitic medications

• MetronidazoleMetronidazole• ParomomycinParomomycin

They don’t go They don’t go down without a down without a fight!!fight!!

Potential reactions when Potential reactions when eliminating these pathogenseliminating these pathogens

SymptomsSymptoms Irritability, aggression, behavioral issuesIrritability, aggression, behavioral issues Increased stimming, hyperactivity, sleeplessnessIncreased stimming, hyperactivity, sleeplessness Skin rash, diaper rash, feverSkin rash, diaper rash, fever

Possible CausesPossible Causes Side effect of supplement or allergy to drugSide effect of supplement or allergy to drug Yeast or Bacterial Flare-up (Balancing act)Yeast or Bacterial Flare-up (Balancing act) Detox ReactionDetox Reaction = Too rapid of an effect leading to vitamin or = Too rapid of an effect leading to vitamin or

mineral deficiency, oxidative stress, liver or kidney stressmineral deficiency, oxidative stress, liver or kidney stress Die offDie off = Rapid death of gut bugs, leading to excess release of = Rapid death of gut bugs, leading to excess release of

toxins and subsequent liver or kidney stresstoxins and subsequent liver or kidney stress

Treatment ApproachTreatment Approach

Rate severity, if severe stop supplement, notify Rate severity, if severe stop supplement, notify physicianphysician

Treat with Activated charcoal/Bentonite clay and/or Treat with Activated charcoal/Bentonite clay and/or Alka Seltzer Gold, homeopathic remedy, if helpful Alka Seltzer Gold, homeopathic remedy, if helpful probably die off probably die off

Rule out dysbiosis, treat accordingly Rule out dysbiosis, treat accordingly Check ammonia levelCheck ammonia level Add Liver Support Add Liver Support

• Milk thistle, artichoke extract, dandelion rootMilk thistle, artichoke extract, dandelion root• Give at bedtimeGive at bedtime

Clostridia produce Clostridia produce toxins and toxins and enzymes that enzymes that create severe create severe gut inflammation gut inflammation and produce and produce watery diarrheawatery diarrhea

Clostridia issuesClostridia issues

SymptomsSymptoms AggressiveAggressive TemperTemper AgitationAgitation IrritableIrritable Very foul stoolsVery foul stools Mucus in stoolsMucus in stools Severe diarrhea Severe diarrhea

following antibiotic following antibiotic useuse

TreatmentTreatment Probiotics, High Probiotics, High

Potency single strainPotency single strain Sacchyromyces Sacchyromyces

BoulardiiBoulardii AntibioticsAntibiotics

• VancomycinVancomycin• Metronidazole Metronidazole

(Flagyl)(Flagyl) Immune modulatorsImmune modulators HomeopathicsHomeopathics HBOTHBOT

Evaluation of Heavy Metal ToxicityEvaluation of Heavy Metal Toxicity Provocative TestingProvocative Testing is often unconvincing in ASD due to is often unconvincing in ASD due to

impaired detoxification. impaired detoxification. Urine Toxics, Fecal ToxicsUrine Toxics, Fecal Toxics, and , and Hair AnalysisHair Analysis show show

excretion of toxic metals. We have no way to determine excretion of toxic metals. We have no way to determine total body burden.total body burden.

RBC Blood testingRBC Blood testing is a poor measure of chronic heavy is a poor measure of chronic heavy metal burden. However, blood may show acute metal burden. However, blood may show acute exposure.exposure.

There are no standards for diagnosing chronic toxicity.There are no standards for diagnosing chronic toxicity. There are no tests to determine body burden of metals. There are no tests to determine body burden of metals. Lead is a bone seeker and can only be measured in Lead is a bone seeker and can only be measured in

blood 12 hrs after exposure, therefore blood Pb is not an blood 12 hrs after exposure, therefore blood Pb is not an adequate indicator of low level chronic toxicity.adequate indicator of low level chronic toxicity.

Mercury has an affinity for fatty tissue and a developing Mercury has an affinity for fatty tissue and a developing brain, and is very rarely seen in blood.brain, and is very rarely seen in blood.

Urinary porphyrinUrinary porphyrin testing – promising. testing – promising.

Benefits of ChelationBenefits of Chelation

Better sleepBetter sleep Cognitive gainsCognitive gains Better speech and languageBetter speech and language Improved eye contactImproved eye contact Fine and gross motor improvementFine and gross motor improvement Better focus, attention, awarenessBetter focus, attention, awareness

IMPORTANT to continue to IMPORTANT to continue to monitor symptoms.monitor symptoms.

Labs can only help point us Labs can only help point us in the right direction. in the right direction.

Have Have courage courage

and follow and follow your own your own

path.path.

Thank You and Thank You and Good Luck on your JourneyGood Luck on your Journey