New OAT for autistic teenager. Can you take a look and comment? Thanks.
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I’m getting great direction from the modules, so thanks, however it doesn’t hurt to get a direct expert opinion!
Intake Notes
Eric, 13 now. Has autism.
Autism, good and communicative up until 2, regressive.
ADHD, doesn’t focus well. Tries to speak but can’t. Has repetitive behaviors. Sensory issues. Verbal tics. Not interested in school. Poor fine motor skills. Can’t express feelings well. No activities he’s interested in.Doesn’t have rages, tantrums, etc. Pretty happy and calm. Does get moods where he’s really hyper, happy, laughing. Like he’s drunk.
Goes through periods where doesn’t sleep as well.
guafenosine for sleep at night. Was on high BP medicine to calm brain for a while.
Sometimes has constipation issues. Allergy test 4 years ago, poked finger. Slight allergy to gluten and eggs. Doesn’t like milk. Recently gluten free and seeing good results behaviorally.
Dr. Hartman,
A lot going on with this kid, and his OAT. This will likely be a thread of post to get all of the information. Here is my assessment though:-Definitely high yeast and high clostridia. These two things would be priority for treatment.
-His dopamine levels are high so there is going to be overstimulation of the sympathetics, and his quinolinic acid is high too driving possible NMDA receptor activity causing overstimulation as well.
-Oxalates are high too, partly from yeast, as well as food.
-What is real striking are his mitochondrial markers. There is definitely a mito issue with this child. Whether it is primary is hard to say as retesting in a few months will be necessary, but mito support is worthwhile.Let me ask you a few questions. Based on what we have gone over so far with the course modules, and from you past experience, what would be your approach at this point?
Sincerely,
Dr. WoellerWhat I would do is the following.
I’m a little behind in the modules, but I definitely saw the yeast/clostrida/mitochodrial problems on the OAT as well as related nutritional issues.
In module 2 I think you said addressing clostridia is first priority? And that we could address yeast concomitantly if it’s also present.
I thought addressing those first would be the appropriate approach. Anti-yeast & GFCF diet, biocidin (I am not a doctor and can’t prescribe meds), and probiotics.With the wide array of nutritional problems I would also include foundational nutrition, mitochondrial support such as ubiquinol, l-carnitine, or mitospectra. NADH?
At this point, since there is so much that could be done, I worry about overwhelming him and don’t know where to draw the line as far as initial treatment and progressing from there. Would you wait on 5-HTP until clostridia is taken care of?
I haven’t worked much with autistic kids yet, and a concern I have at this point is the logistics of getting him to take supplements and training the parents. I’ll give them the handouts that are pertinent.
I haven’t done the basic assessment form as this is an old contact who recently recontacted me. I’ll probably need to do that for better information. I imagine I’ll ask about oxalate symptoms (eye poking, self stimulation, right?) along with everything else to see if oxalate needs to be addressed even before clostridia, etc.
Thanks for all the wonderful information!
Nick
Nick,
Yes. Addressing the clostridia and yeast is priority number #1. I feel that the oxalate issue is important too, but the parents can work on this overtime and you can support the process with foundational supplements, i.e. mito support, calcium/mag citrate, probiotics. This case is actually a perfect situation for me to do a sample write-up on how to incorporate various strategies in a time efficient manner.You definitely want to avoid overwhelming the parents, and the child. A systematic approach is worthwhile. It is critical the parents get going with dietary intervention if they haven’t done so as it usually makes things go much easier. There are many layers to all of these interventions.
If okay with you I would like to take this lab and do a mock write-up for you (and everyone else). I can have Brian who supports the technical side of this site take out the child’s name, and then provide the lab and write-up as an example of who I would approach this situation – at least based on the objective information from the lab.
It may take me until later this week into next to get this done, but it could be very helpful.
Anything else you can tell me about this child? other supplements he is taking? can or cannot swallow capsules or tablets?
Sincerely,
Dr. WoellerP.S. I am going to assume this is a situation where we will use a botanical approach to yeast and clostridia, and I will set-up my mock program that way.
That would be absolutely wonderful if you did a mock writeup.
I don’t know if he is able to handle capsules or tablets… I can ask and let you know.
Yes, I’d like to do botanical unless you feel prescription would be significantly better option. I met a doctor in January who offered to write prescriptions for my clients as needed, but I assume that would introduce insurance and billing complications.
Thanks so much.
Nick
Nick,
I would try the botanical protocol first. Antibiotics can always be used if things don’t resolve, but I have seen good success with herbal remedies in these types of situations.Dr. Woeller
The mother says “he is picky when it comes to taking medicine and vitamins etc. But we have to try and see.”
Have you had a chance to look over this more fully and do the sample write up? I’m working with the parents and I plan to write up a protocol but I have been waiting to see what you come up with first.
Nicholas,
Yes. I finally had a chance to work on it yesterday and needed to get it edited. I am making it a handout for other attendees in the course. Will get it to you shortly.
Sincerely,
Dr. WoellerNicholas,
Here is the example program for the OAT you posted. Let me know if you have any questions. There is a lot going on with this case so I want to make sure it all makes sense. Feel free to download it and modify it to your liking.
Dr. WoellerThanks! It all makes sense. He is gluten free already, and in the protocol you mention low oxalate, so obviously that’s a dietary recommendation. Would you suggest also pushing for a casein free diet at this time? Or just start with this and approach that later? Thanks again.
Nicholas,
There is a lot going on with this case. I would advocated for dairy-free too because percentage wise it is a commonly a problem. Bring it up to the parents as the ideal approach, but with the understanding it can be something they work on in the near future since there are a lot of changes happening. You want them to have some success in all of this without being overwhelmed, but ultimately dairy-free should be on their radar in the near future.
Dr. WoellerNicholas,
There is a lot going on with this case. I would advocated for dairy-free too because percentage wise it is a commonly a problem. Bring it up to the parents as the ideal approach, but with the understanding it can be something they work on in the near future since there are a lot of changes happening. You want them to have some success in all of this without being overwhelmed, but ultimately dairy-free should be on their radar in the near future.
Dr. WoellerHi Dr Woeller,
We did a follow-up mOAT after using the protocol for about a month andarabinose went down from 96 to 64 (still high).
Hippuric went up from 300 to 444
2-Hydroxyphenylacetic went from normal to above range 0.03 – 0.47 H 0.90 0.90
4-Hydroxybenzoic also went from normal to above range
4-cresol went from 56 to 59
I attached the report. It seems the biocidin wasn’t killing the clostridia? Anything else you recommend? I am meeting with her and I’ll see how compliant she’s been.
Thanks
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