| DAN conference notes |  |
| DAN conference notes |  |
Here are my notes from the recently concluded DAN Conference at Seattle. Ofcourse there is always something new, and for those parents visiting first time, something to promise hope for their child.
Like many of us going up to these conferences for the Nth time, I am looking for new explanations, new approaches, and new results. (These are my notes, not medical advice, it might help you decide which presentations to look at when they are available on the DAN website. This is based on my rough transcription, so any mistakes are my own).
A recurrent theme that resonated through the talks was the notion that oxidative stress and inflammation were central to autism. Energy transport, connectivity, neuronal synchrony, oxidative stress, toxicity, are all observed as abnormal in autism.
Dr Martha Herbert's talk was an enthralling overview of the systems perspective. It was interesting to see the progression of myelination through first two years of life. There was also a presentation on lower functional connectivity in the autism group. (functional connectivity is a measure of synchronization and coordination). Review of inflammation and oxidative stress (Vargas paper) - not confined to the brain. This might be an interesting paper to read: Rubenstein et al: Model of autism: increased ratio of excitation/inhibition in key neural systems.
The talk by Patrick Hanaway, MD emphasized the gut, and issues of the gut: LNH (lymphoid nodular hyperplasia). The animation of leaky gut (permeability), damaged villi and malabsorption was really impressive! He emphasized gut dysbiosys, probiotics, and normalizing mucosal health and hence immune function. His final message: Heal the gut... the mind will follow! (Cant disagree, but we all know how hard that is!)
J Pangborn, PhD, concentrated on DPP4 enzyme in particular. I always pick up new tips on DPP4. For example, too much Zn impairs DPP-4. So give Zn away from food. This is for people like me who give 50 mg each time! Also reminds me to run a stools test for fat absorption. Dr Sidney Baker is a yeast expert among other things. I think that yeast (candida) alone has caused most of us parents enough emotional stress that its worth understanding yeast. Yeast tortures when it lives, it tortures when it grows and tortures when it dies! On that topic of die-off Dr S.B. recommended activated charcoal with Welch's grape juice to mask the color. He suggests to begin with S. Boulardii (need to try that before jumping to flucanazole next time). Amphoteracin was another recommendation.
The next talks were on diets: Lisa Lewis on GFCF. Maureen McDonnell talked on SCD. (Missed Elaine Gotschall). I have had lot of difficulty with SCD. Hard to avoid the nut flours (which cause oxalate issues). One of the highlights of this conference for me was the LOD (lo oxalate diet). Its something that works in our case, but I just havent understood it completely, although I have eliminated the top hi oxalate foods. The break out session talk by Susan Owens and William Shaw was very interesting. There is a urine test in Dr Shaw's lab for oxalates (which is on my list of things to do) and Susan Owens elaborated on how oxalates get tied up in tissues. And oxalates could bind to mercury and get stored up in tissues (may be in the brain? its a scary thought that occured to me: can it harbor mercury in the brain that way?!) Calcium citrate was mentioned as the best form of calcium supplement from a lo-oxalate perspective. And VSL3 (the probiotic) is found to help. A lot of unanswered questions about oxalates and autism, but it is worth serious consideration.
Dr Kartzinel spoke on clinical treatment approaches: various blood works, Urine organic acids, stools tests, SAGE, etc. The constipation relief agents were useful: Benefiber, Fruiteze, Aloe, magnesium citrate (thats what i use), oxypowder etc. (Ive heard oxypowder is extremely powerful!) Try a Rice Protein powder for protein deficiency. Melatonin (I have been avoiding it) for sleep issues was recommended generally as safe.
J Furlong, ND, gave a talk on phytotherapy (plant based therapies). I had never heard a talk on this topic in a previous DAN, so it was interesting. For immune tuning he listed cats claw, stinging nettle, resveratrol, gingko biloba. (Resveratrol is one i use). He mentioned skullcap (scuttelaria) for glutamate toxicity. Enhancement of glutathione - milk thistle, which is on my regimen, and chlorella for toxin extraction. He mentioned that quality of the source is a big concern.
John Adams, PhD talked on EFAs. Autistic groups have less omega-3 fatty acids and normal omega-6s but generally in the population the ratio is not 1:1 anymore, since processing of food removes omega-3s. DHA is critical to brain development. (I have read about EFAs used in schizophrenia, so cant argue that its necessary to supplement). This is one of those talks that motivate me to force the smelly oils inside atleast for a couple of months after hearing the talk!
The highlights of the science talks were Jill James, PhD and Richard Deth, PhD. Jill James manages to teach biochemistry to a lay audience, and people like me who couldnt understand plain simple chemistry! Her talk focussed on chronic oxidative stress, and methylation issues in autism. She pointed out interesting ratios: methylation potential: SAM/SAH and redox potential: GSH/GSSG (antioxidant/oxidised forms of glutathione). Methylation is necessary for tissue specific gene expression, it is need to turn off gene expression. Glutathione helps with turning off viral replication. She differenciated acute oxidative stress and chronic oxidative stress. In acute oxidative stress, glutathione synthesis will be favored at the expense of methylation. I guess thats a quick fix response. In chronic oxidative stress both are decreased resulting in a vicious cycle, as seen in autism. There was more emphasis on genetics and DNA methylation, how methyl groups attach to bases. She discussed effects of DNA hypomethylation. Some SNPs in the methylation pathways were discussed comparing autistic groups to controls. However I guess no one denies the fact that an environmental trigger is necessary. Would be interesting to check parents' SNPs. Id bet my SNP list is worse than my child's in terms to susceptibilities.
Richard Deth spoke of the connection between neuronal physical and electrical properties and biochemistry. As an electrical engineer, it's fascinating for me to see how neurons signal, synchronize and pass messages. He described the mechanism of oscillations, gamma waves and how they affect neuronal signalling. He even presented a simple electrical circuit model. He had a good picture on the domains of methionine synthase and how it participates in methylation. He described the difference in neuronal cells, and the role of methyl B12. He had an interesting slide on how after thimerosal exposure, cyanoB12 and hydroxyB12 are not able to activate methionine synthase, but methyl B12 still works. He had an interesting hypothesis on the molecular mechanism of "attention". This is fascinating but hard to cover in a post like this! One paper that might be interesting is: "Autistic Brains out of synch?" in Science, Vol 308, Jun 2005 by Wickelgren.
Marvin Boris, MD had a talk on the use of Actos as an immunomodulator. He introduced the topic of immune system (TH1->TH2) alteration in the ASD groups. There is a tendency towards pro-inflammatory cytokines which might activate autoimmune disorders and inflammation. He had slides on lab reports to evaluate the therapy. Responses to Actos included (in time 1-8 months) increased cognition, calmness, socialization, and decreased diarrhoea and aggression. He noted minor side-effects, including weight gain in 8% of the cases.
Jacquelyn Mc Candless, MD spoke about the use of LDN (Low dose Naltrexone) as an immunomodulator. In therapeutic use for this purpose, it is used in tiny doses compared to its use as an opiod antagonist for narcotic/alcohol addiction. She reported results of a first clinical study and noted increased sociability, mood, cognition and language. One minor effect noted was viral activation followed by benefits.
Dr Sidney Baker gave an eloquent presentation on individuality. He spoke at length on autistic kids being out of synch at various levels. He listed some super foods: pomegranate juice, green tea, acai, ginger, turmeric, blueberry etc. Some pills he mentioned are Vit D, Theanine, Selenium, Milk Thistle and Fish Oil concentrate. (His talk motivated me to take anti-oxidants and hi anti-oxidant diets more seriously. We have been chewing on Goji berry!). He mentioned this book as a must read: The China Report by Colin Campbell.
Andrew Wakefield, MD had an interesting presentation on gut issues, inflammation, and pictures of kids in pain. The message there was to re-iterate that chronic GI inflammation can cause brain and immune dysfunction.
Jacquelyn Mc Candless had another presentation on treating viral issues. (She has the Vit A protocol on her StarvingBrains website). Gut measels treatment regimen includes: diets, enzymes, methylation support, decrease heavy metals, anti-oxidants, liver support, anti-inflammatories and finally, Vit A protocol. She mentioned some natural anti-virals: Lauricidin (those pellets btw have to be swallowed, not chewed!), olive leaf extract, oil of oregano, grapefruit seed extract, protease ezymes (Virastop) and healthy lifestyle!!
There was an interesting detox panel discussion. Dr Quig who sees zillion Doctors Data reports had some interesting comments: (My impression on hearing the talk was that TD creams in general are not transdermal because they do not trans the dermal. I understood that suppositories and IV are generally more effective. However in light of comments below by the CEO of Doctors Data, this section is edited. Please see comments below for clarification). He mentioned that none of these really penetrate the blood brain barrier. They bind to extra-cellular toxins and draw them out by creating a concentration gradient. He also mentioned that CaEDTA is very effective for lead. He emphasized the need for pre and post provocation measurements. The doctors mentioned the protocols for IVs they use in their practices.
Kenneth Bock, MD talked about Autism, ADHD, Asthma and allergies under a common umbrella, the new childhood epidemics. (Although I would trade any of the others for autism!) He mentioned chronic inflammation as the primary causative factor underlying these disorders. The driving force for this may be infections, toxicity, food sensitivities, dysbiosis or combinations of those. Interesting numbers for the increases in past two decades: autism: 15 times, ADHD: 5 times, Asthma: 3 times, Allergies: 7 times. He has a new book coming out: Healing the new childhood epidemics: Autism, ADHD, allergies and asthma.
Dr Bradstreet talked on various markers and treatment based on these markers. (I did not attend this talk). This summary is from the slides. Immunological markers urinary neopterin and biopterin, intestinal permeability etc. Oxidative stress: Urine 8-OHG (The lab in paris that does the porphyrin test does this as well) and other blood tests. Heavy metals: urinary porphyrins and post challenge tests. Among emerging interventions is mild hyperbaric oxygen therapy. Mentions immune modifying drugs like IVIG, Spironolactone etc. Dr. Bradstreet had a separate discussion on hyperbarics. Apparently they served food and wine, but I was too busy listening to oxalates, I missed this one!