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Episode 44
The Doctor's Farmacy: House Call

Autism: Getting To The Root Cause With Functional Medicine

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Rates of autism have skyrocketed over the years, from an estimated 1 child in 5,000 in the 1960s and 1970s to just 1 in 54 kids today. The diagnosis of autism can be shocking and difficult for parents and families which may leave them feeling isolated, alone, helpless, and hopeless, but it doesn’t have to be that way. While we don’t have all the answers, and more research is needed to identify and validate the causes and treatment of autism, there are new signs of hope. And there is no such thing as “autism.” Rather there are “autisms”—different patterns of biological dysfunction unique to each child that result in multiple insults to the brain that all manifest with symptoms we call autism. Like every condition or illness, the key is to dig into the layers and peel the onion to discover what is really happening. It is not usually one thing but a collection of insults, toxins and deficiencies piled on susceptible genetics that leads to autism.

In this episode, Dr. Hyman sits down with Dr. George Papaicolaou to discuss the Functional Medicine approach to treating children with autism. They also share specific patient stories that they have treated.

George Papanicolaou is a graduate of the Philadelphia College of Osteopathic Medicine and is Board Certified in Family Medicine from Abington Memorial Hospital. He is also an Institute for Functional Medicine Practitioner. Upon graduation from his residency he joined the Indian Health Service. He worked on the Navajo reservation for 4 years at the Chinle Comprehensive Medical Facility where he served as the Outpatient Department Coordinator. In 2000, he founded Cornerstone Family Practice in Rowley, MA. He practiced with a philosophy centered on personal relationships and treating the whole person, not just not the disease. He called that philosophy “Whole Life Wellness”. Over time as the healthcare system made it harder for patients to receive this kind of personal care Dr. Papanicolaou decided a change was needed. He began training in Functional Medicine through the Institute of Functional Medicine. In 2015, he established Cornerstone Personal Health – a practice dedicated entirely to Functional Medicine. Dr. Papanicolaou to join The UltraWellness Center in 2017.

This episode is sponsored by Athletic Greens and Better Help.

Athletic Greens is offering Doctor’s Farmacy listeners a full year supply of their Vitamin D3/K2 Liquid Formula free with your first purchase, plus 5 free travel packs. Just go to athleticgreens.com/hyman to take advantage of this great offer.

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In this conversation, Dr. Hyman and Dr. Papanicolaou discuss:

  • The significant rise in autism cases
  • Recent changes to environmental factors, including food and toxins
  • The role of inflammation in autism
  • Conventional vs functional medicine treatment of autism
  • Sleep and behavioral issues in children with autism
  • Autism, gut health, and mitochondrial dysfunction
  • Eliminating gluten and dairy

I hope you enjoyed this conversation as much as I did. Wishing you health and happiness,
Mark Hyman, MD
Mark Hyman, MD

Guest

 
Mark Hyman, MD

Mark Hyman, MD is the Founder and Director of The UltraWellness Center, the Head of Strategy and Innovation of Cleveland Clinic's Center for Functional Medicine, and a 13-time New York Times Bestselling author.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

 
Dr. George Papaicolaou

Dr. Papaicolaou is a graduate of the Philadelphia College of Osteopathic Medicine and is Board Certified in Family Medicine from Abington Memorial Hospital, Abington, Pennsylvania. He is also an Institute for Functional Medicine Certified Practitioner. Dr. Papnicolaou established his own practice: Cornerstone Personal Health dedicated to the Functional Medicine Model. Dr. Hyman invited him to bring his expertise and twenty years of experience to the UltraWellness team. He specializes in treating the root causes of many conditions including Neurodegenerative disorders, ADHD, PANDAS/PANS, gut and hormone health.

Show Notes

  1. New Science-Based Approaches to Treating Autism with Dr. Theresa Lyons
  2. A Functional Medicine Approach to Autism
  3. Improving Autism Spectrum Disorders (ASD): Does a Gluten and Dairy Free Diet Really Make a Difference?
  4. Dr. Elizabeth Boham on The Doctor’s Farmacy: How to Find the Real Cause of Your Disease and How to Fix It

Transcript

Dr. George Papanicolaou:
A lot of their behaviors become the focus, but those behaviors are really in response to the neuroinflammation that the child’s experiencing.

Dr. Mark Hyman:
Welcome to the Doctor’s Farmacy. I’m Dr. Mark Hyman, that’s Farmacy with an F, F-A-R-M-A-C-Y a place for conversations that matter. And today we’re going to have a very difficult conversation about autism, which is a diagnosis that is increasing at dramatic rates, from one in 1500 or more to up to one in 35 boys. I mean, it’s staggering and the question is, why? And today we’re going to talk about autism with none other than our favorite doctor at the UltraWellness Center, George Papanicolaou.

Dr. Mark Hyman:
He’s an extraordinary doc, one of my favorites and he’s just such a good man. And I’ve come to really respect him and honor him, and learn more about him every day. And not only is he a great doctor, but he’s a good human being, and I’m just happy to have to work with him. So welcome George.

Dr. George Papanicolaou:
Thank you Mark.

Dr. Mark Hyman:
Now, this is a tough topic. Autism has been increasing a topic of great controversy. There are all sorts of debates about what causes it, vaccinations … Not vaccinations, we’re not going to get into that today. But it’s a hot topic. And there’s no arguing with the fact that it is increasing. It is really increasing. And some say, “It’s just better counting and better assessments.” But not at the scale we’re seeing it. So why are we seeing such a rapid increase in autism?

Dr. George Papanicolaou:
Well, that’s the controversy. We’re not entirely sure why we’re seeing it. I mean, there are some thoughts about … One of the things I read is the major way of thinking about it in science today is that it’s 80% genetic and 20% environmental. Really when I read that statistic, I was really shocked. And so there’s definitely a genetic component to it, but it’s clear that the thing that changes, the thing that can improve that thing that can even lead to a child coming off the spectrum diagnosis, is changing those environmental inputs. So science may say it’s only 20%, but it’s a hundred percent of what works and that’s what counts.

Dr. Mark Hyman:
Just to stop you there. Because if you look at the data it’s pretty striking. In the 60s and 70s the rates of autism were about one in 5,000 kids. One in 5,000 kids. Now, it’s one in 54 kids.

Dr. George Papanicolaou:
It’s one in 54.

Dr. Mark Hyman:
And boys at a much higher rate.

Dr. George Papanicolaou:
One in 35 and and girls one in 145.

Dr. Mark Hyman:
It’s terrifying. And I can-

Dr. George Papanicolaou:
Can you imagine?

Dr. Mark Hyman:
[crosstalk 00:02:55] every year it’s getting worse and boys are four times more likely to be diagnosed. So, I get going from one in 5,000 to one in 2000 or one in 1000, but not one in 5,000 to one in 35 boys. That doesn’t make any sense as a genetic problem, because our genes don’t change that fast. But you know what’s changed? Our environment. So what are the real drivers and causes of autism?

Dr. George Papanicolaou:
Number one on my list-

Dr. Mark Hyman:
Because it’s not a random event.

Dr. George Papanicolaou:
No. It’s not random at all. And I think that as you just brought out, there’s just something more going on. I think pretty clear we’re suffering the effects of very modern society. And one of the things we have in our society that is really dangerous is the food that we feed ourselves. So it really starts with food that in many ways is toxic from the glyphosate that’s in it, and the GMO seeds that are used, that our food supply damages us. It’s information, as you’ve said so many times.

Dr. George Papanicolaou:
And not only does it have direct impact on our gut microbiome, but it has information that actually changes and can impact our genes. And so from one generation to the next, you can actually turn genes on that will impact the next generation and the generation after that. So food has a direct impact at our gut microbiome, has an inflammatory auto-immune impact and it has a genetic impact. So I would start with food followed by toxins, heavy metals.

Dr. Mark Hyman:
Yeah. Absolutely, heavy metals, pesticides, chemicals. Dr. Phil Landrigan, who’s an incredible scientist has really documented how the increase in toxic load in our society has really affected these kids. And they’re like the yellow Canary in the coal mine. The Canary was put in the coal mine with the coal miners. So when the Canary drops dead you know the air was bad and you had to get out of there.

Dr. George Papanicolaou:
Right.

Dr. Mark Hyman:
Well, these kids are genetically susceptible and we always say that genes load the gun, the environment pulls the trigger.

Dr. George Papanicolaou:
Yes.

Dr. Mark Hyman:
And what’s changed dramatically is our food supply. Not only have we added all these agrochemicals pesticides, herbicides, glyphosate is a microbiome destroyer, and now it’s on 70% of all crops. And it don’t only destroys the microbiome of the soil, but it destroys our own human microbiome, which is critical for our health. And 95% of artistic kids have gut issues, have real gut issues. Not only that, we’ve changed the kind of food we’re eating. For example, the gluten that we’re eating now is not the wheat that we ate, that our ancestors ate, it’s a hybridized form of wheat that has much higher levels of gliadin proteins, and much more likely to cause issues with kids.

Dr. Mark Hyman:
We’re born by C-section, we’re given antibiotics, we’re not breastfed. All these things tend to get these kids’ immune systems dysregulated. And one of the things we know about autism is that it’s an immune disorder. If you do an autopsy on these kids’ brains, they’re just riddled with inflammation. They actually done brain scans and they see these brains are bigger. Why? Because they’re swollen. And why are they swollen? It’s all the same things we think about in functional medicine that cause inflammation. It’s food, it’s food sensitivities, it’s toxins, it’s leaky gut, it’s all of these factors, allergens, microbes, infections, all these things are driving it.

Dr. Mark Hyman:
And we don’t approach autism in that way in this country. We don’t treat it as a systemic disorder. I always say that, is it a brain disorder or is it a disorder that affects the brain? Is it a systemic disorder that affects the brain? It is not a brain disorder. And the manifestations are in the brain. Right? But the actual causes are things we can do something about. I mean, I see this all the time George, it just makes me so heartbroken, when these parents get a child with autism, it gets diagnosed. And essentially what they’re told is, “Your child has autism, there’s really not much treatment. You can use what we call ABA, Behavioral Therapy and get ready for a difficult life. Get ready to put your kid in an institution someday, and we’re sorry.”

Dr. Mark Hyman:
That just is unconscionable in my mind, given the amount of science we now have about autism, about the inflammation, about how to treat these things. It’s just devastating these families, and yet they’re not given any pathway to help these kids improve the quality of their health of their life.

Dr. George Papanicolaou:
No, they’re given a pathway, but it’s limited pathway. It’s a pathway that you just mentioned, it’s using, Applied Behavioral Analytic therap, and that’s just to change the behavior. Right? Which is just a symptom of the neuroinflammation that the child is experiencing. A lot of their behaviors become the focus, but those behaviors are really in response to the neuroinflammation that the child’s experiencing.

Dr. George Papanicolaou:
And so one of the latest ways of trying to treat children with autism, is actually diagnosed them sooner, because data has shown that children with autism will do better socially if you treat them more intensively early on with these therapy, speech therapy, occupational therapy, physical therapy, and then Applied Behavioral Analytics. Therapeutic model by itself doesn’t work. That’s why I think-

Dr. Mark Hyman:
It helps them adjust a little bit. It’s been so crude.

Dr. George Papanicolaou:
Well, when I say it doesn’t work, it doesn’t give the mother that child that she knows that her child can be. A child that can interact, a child that can feel, a child that can fulfill all their neurologic capability. Those behavioral changes aren’t enough. And that’s why, as I’ve said to you before, I think every kid with autism should have a functional medicine workup, because we do look at the systemic impacts, the systemic causes of this brain disorder. And it’s in doing so that we’ve been able to see as many changes as we do in the children that we treat with autism here at the UltraWellness Center.

Dr. Mark Hyman:
It’s really true. I mean, I hate to say this because it sounds terrible, but I love seeing kids with autism because there’s so many things you can [crosstalk 00:09:04].

Dr. George Papanicolaou:
Absolutely.

Dr. Mark Hyman:
They almost all have immune dysregulation. They almost all have gut issues. Most have toxin lows that are high. Most of them have nutritional deficiencies. Many of them have mitochondrial issues, which are energy production. And these are all things that we know how to approach with a functional medicine approach.

Dr. George Papanicolaou:
And they’re not that hard to figure out or find in testing.

Dr. Mark Hyman:
No. And I’m not saying we can cure autism, although I’ve had cases of complete reversal which is dramatic. But we can improve the quality of their life, we can improve their functioning, we can improve their speech. I remember I met this one doctor who was an incredible physician, and he told me this incredible story of his son who was autistic. I’d written this book years ago called, The Ultra Mind Solution, which was about how to fix your broken brain by fixing your body first, by healing your body first. It was very clear to me that most brain disorders were systemic issues where there was imbalances in the body that affected the brain.

Dr. Mark Hyman:
When I talked about some of these cases of autism in the book, this doctor read the book and saw that I had recommended to get off of gluten and dairy. And we’re going to talk about why that’s important. And he said, he just tried it with his son who was five years old and hadn’t said a word his entire life. And he got him off gluten and dairy and in a short while later, the kid started talking, just started chatting in it. And he heard, he was learning language, he had receptive language, but he had no expressive language. And he just really started crying.

Dr. Mark Hyman:
And when I hear these stories, sometimes it’s that simple. Now, it’s not always that simple. But we know a methodology a really … A system of evaluating patients using the model of functional medicine. Understanding the body as a system and being able to map out where the imbalances and dysfunctions are and fix those and get these patients to get better.

Dr. George Papanicolaou:
And I think it’s important to know that it’s now been changed to the terminology autism spectrum disorder, because it’s not autism it’s autism’s. It’s a spectrum, every child is different. We have no protocol, but we know where to look. And every child’s going to have a puzzle, a complex pieces of puzzles that we’re going to have to put together that might be … It is different for every kid. One of the things that I do first when a family comes to me is, I let them talk and I let them tell me their story. And I listen because they haven’t been listened to for a long time.

Dr. George Papanicolaou:
Most of the families that come to me have not been heard, and they’ve been given tools that don’t work and they come discouraged and disappointed. And I can see the apprehension on their face of whether or not they’re going to be heard. One of the most important things I do is I make that connection with moms and dads and help them understand that they’ve come to a place that they’re going to be heard and that they’re going to be helped. And the things that seem to be two of the really hot buttons for parents are sleep and behavior and gut issues. Diarrhea, constipation, and then the behavior and the lack of sleep.

Dr. Mark Hyman:
What I want to underscore is that, in traditional medicine when you get a diagnosis of autism, it’s a brain disease and you need to use psychological tools to fix it. You use psychiatric drugs to suppress the symptoms, which they give them many psychotics and all kinds of stuff.

Dr. George Papanicolaou:
Antiseizure meds, antidepressants, anti [inaudible 00:12:54].

Dr. Mark Hyman:
Yeah. It’s terrible. And when these kids come in, if you take a good history you find so many other physical problems with these kids. Like you said, gut issues. 95% have gut issues. They have congestion rhinos, they’ve had earaches and ear infections and taken lots of antibiotics.

Dr. George Papanicolaou:
Eczma.

Dr. Mark Hyman:
They’ve had eczema. They have dry spots all over their skin, their hair, their scalp they might have dandruff. They have all these immune and gut issues, and it’s so well-described in the science. This is not stuff we’re just hypothesizing. This is really there, they’re documented. And then the question is, why are they ignored? Why do we ignore all these things which are clues? They’re like breadcrumbs that tell you what’s going on. Right? Or if the kids-

Dr. George Papanicolaou:
It’s shocking.

Dr. Mark Hyman:
It’s shocking to me.

Dr. George Papanicolaou:
It is shocking.

Dr. Mark Hyman:
And [inaudible 00:13:49] I want to just underscore what you say, which was so important George, is that, when you see someone with a disease like autism, they’re all treated uniformly. Okay, you have these descriptive behaviors, you have no expressive language, you’re socially disconnected, you have repetitive behaviors. It’s like if you look at the DSM five criteria which is a psychiatric manual, these are the criteria that you have to meet to meet the definition of autism. But there are a hundred ways to get to those symptoms.

Dr. Mark Hyman:
And there are a hundred different ways to treat these patients. And if you’ve seen one kid with autism you’ve one kid with autism. I mean, yes there are common themes and there are things you will do, but in each kid it’s different. Some kid it’s a mitochondrial issue, some kids it’s a heavy mental issue, some kid it’s a gut issue. It’s so different. Some kids have severe methylation issues and B vitamin issues. Some kids have other issues that really are related to infections that they … That are untreated.

Dr. George Papanicolaou:
And toxins.

Dr. Mark Hyman:
Yeah, and toxins. So, there’s really a [crosstalk 00:14:58] level.

Dr. George Papanicolaou:
Mitochondrial issues. Yeah

Dr. Mark Hyman:
Yeah. I mean, we had a professor from … Has trained at Harvard and Oxford, a pediatric neurologist who came to Cleveland Clinic, he did grand rounds, Husain [inaudible 00:15:06]. Who has done some incredibly nuanced research published in JAMA and major medical journals on mitochondrial dysfunction in these kids. Their brain can’t produce energy and they give them mitochondrial support, which is basically a supplement that we use to support the energy production.

Dr. George Papanicolaou:
And guess what happens?

Dr. Mark Hyman:
They get better.

Dr. George Papanicolaou:
You start to see immediate improvements.

Dr. Mark Hyman:
Hey everybody it’s Dr. Hyman, and thanks for tuning into the Doctor’s Farmacy. I hope you’re loving this podcast. It’s one of my favorite things to do and introduce to you to all the experts that I know and I love, and that I’ve learned so much from. And I want to tell you about something else I’m doing, which is called Mark’s Picks, it’s my weekly newsletter. And in it I share my favorite stuff, from foods to supplements, to gadgets, to tools, to enhance your health. It’s all the cool stuff that I use and that my team uses to optimize and enhance our health. And I’d love you to sign up for the weekly newsletter.

Dr. Mark Hyman:
I’ll only send it to you once a week on Fridays, nothing else I promise. And all you do is go to Dr. hyman.com\picks to sign up. That’s Dr. Hyman.com\picks, P-I-C-K-S and sign up for the newsletter. And I’ll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Now back to this week’s episode. So George Let’s go deep in, so if you have a kid comes in with autism, what’s the initial approach to evaluating these kids? How do you start to think about what’s going on? You do a deep history, right? What are you looking for in the history?

Dr. George Papanicolaou:
So in the history I’m looking for any familial history of autism just to make any neurodevelopment disorders. Then I’m looking specifically at a mom, what was her nutrition like when she went into pregnancy? What was her stress levels going into pregnancy? Getting a really good understanding of how she was in pregnancy. Because that has a big impact on the child.

Dr. Mark Hyman:
Yeah. Did she have feelings? Did she get vaccines with mercury in them? [crosstalk 00:17:09].

Dr. George Papanicolaou:
Exactly. Did she get antibiotics prenatally or antenatally which can impact the child’s microbiome. Because a lot of these kids, just as a quick aside, they come out of the womb with gut issues. They have diarrhea from day one. Then I want to know about what was the child’s early days like? Did they have feeding issues? Did they have hypotonia? Meaning that they were … They didn’t have the muscle tone that a baby should have. Did they meet developmental milestones?

Dr. Mark Hyman:
Did they have colic? Whether they have ear infections and antibiotics, did they have C-section births?

Dr. George Papanicolaou:
Did they get immunizations early in life? Hepatitis B vaccine can have some yeast proteins in it and that can maybe possibly sensitize a child to yeast and create some inflammatory processes early on.

Dr. Mark Hyman:
Yeah. I want to be clear about vaccines. I don’t think vaccines cause autism, I do think that there’s a whole field of vaccinomics, Mayo Clinic and others have departments of vaccinomics which it looks at the variability in responses. And we know that certain kids who are sick when often they get vaccines can have adverse immune responses. And we know that autism is an inflammatory disorder. So there is some something going on, but it is not the vaccines on autism.

Dr. George Papanicolaou:
There are many things that can trigger an immune response.

Dr. Mark Hyman:
Right. So I just want to be clear about that. I think that we do have to look at these bigger issues of what is driving the inflammation. And so you take that history and then we want to dive into the testing.

Dr. George Papanicolaou:
Right. One of the first tests that we do is we look at the gut microbiome. So we’re going to do a complete diagnostic stool evaluation, and we’re going to be looking for the things that you’ve mentioned. Candida which is a mold, is one of the major things that we typically will find in the gut. But we’re also looking for an imbalance of good and bad bacteria that can be caused by the nutrition that they had, nutrition that their mom had, any antibiotic use. We’re going to be looking for parasites. Kids can develop these parasites that can be autoimmune triggers and that will need to be eradicated. So the gut is the first place.

Dr. Mark Hyman:
Absolutely. And then we look at the immune markers. I’ve seen kids who have really high markers of inflamation-

Dr. George Papanicolaou:
Or really low.

Dr. Mark Hyman:
Like you would see in someone with colitis. I mean, because it’s sticky, smelly, mucusy, weird stools that are pasty and weird.

Dr. George Papanicolaou:
Yeah we see this really-

Dr. Mark Hyman:
Awful. And it’s telling you that there’s something’s rotten down there and you have to deal with it.

Dr. George Papanicolaou:
Yeah.

Dr. Mark Hyman:
And that causes leaky gut. Right?

Dr. George Papanicolaou:
And leaky gut. Leaky gut is just basically a part of almost every conversation when we’re talking about people in the functional medicine world they’re coming of. Any immune disorder or immune dysfunction. That’s the first place I looked because that’s one of the most … Commonly one of the most concerning areas for parents is, they’re just … They have stinky, smelly poops and I’m changing the diaper every day, all day. And can we do something about that? I know that that has to be part of the problem. And they’re right, it is.

Dr. Mark Hyman:
And 60% of the immune system’s in the gut and the gut and the brain are connected. And if you’re having a lot of toxic bugs in there, those toxic bugs produce metabolites that are toxic to the brain and can interfere with brain function.

Dr. George Papanicolaou:
Yeah. The next place that I’ll look will be at the … Looking at nutritional evaluation. Finding out specifically, are they getting all the nutrients they need for the mitochondria to function as well as they should?

Dr. Mark Hyman:
Yeah.

Dr. George Papanicolaou:
Because mitochondrial dysfunction has a huge role to play in how our brains are going to function and so we look there.

Dr. Mark Hyman:
It’s an energy deficit. These kids can’t make enough energy in their brains to work, and you can do testing like organic acids. Would you look at the mitochondrial function and you can look at the way you process energy and this is not a test you normally see at your regular doctor’s office.

Dr. George Papanicolaou:
No you don’t. And then we do heavy mental testing. Again, because a lot of these children may have difficulties with their toxification genes. They may not be able to detox as well. So the normal toxins that we’re all exposed to, they can’t process.

Dr. Mark Hyman:
That’s right.

Dr. George Papanicolaou:
So looking at their physiology of detoxification and also at their single nucleotide polymorphisms, there’s variations in genes that impact how well a enzyme is going to function. We look at those, because if we can identify some of those genes aren’t working well, that clues us in to what specific nutritional plan and targeted nutrients that they need.

Dr. Mark Hyman:
Yeah. And these kids often have genetic variations in the … Also the B vitamin genes that affect B12 and folate and B6. And they might need really high doses of certain nutrients. They might need special forms of these nutrients. And so these are things you really can understand by looking at their unique genetics.

Dr. George Papanicolaou:
Absolutely.

Dr. Mark Hyman:
The other thing obviously we look at is food sensitivities and food reactions. And there’s a couple in autism that are so common.

Dr. George Papanicolaou:
Gluten and dairy.

Dr. Mark Hyman:
Gluten and dairy.

Dr. George Papanicolaou:
Right off the bat, it’s gluten and dairy. And the reason why we focus so much on gluten and dairy, because they can … When they’re broken down, certain people will break them down into peptides called Caseomorphins and Gluteomorphins. And peptides are just small proteins, they’re usually 50 amino acids or shorter. These can actually cross the blood-brain barrier and they can have a deleterious effect on how the brain will function. They can actually impair cognition. They can impair neurotransmitter communication. So these-

Dr. Mark Hyman:
They’re just like little molecules of heroin running around in your brain and they make you spaced out. And one of these kids are-

Dr. George Papanicolaou:
They slow cognition.

Dr. Mark Hyman:
[crosstalk 00:22:59] can’t focus, can’t connect.

Dr. George Papanicolaou:
They have an opiod like effect. I have mothers say to me, “I can’t take them off gluten because it makes everything worse.”

Dr. Mark Hyman:
Yeah, it will.

Dr. George Papanicolaou:
And you just have to really-

Dr. Mark Hyman:
Batten down the hatches, lock the cabinets, lock the fridge.

Dr. George Papanicolaou:
It’s really.

Dr. Mark Hyman:
It’s true, it’s really true. And the gluten also causes a leaky gut too.

Dr. George Papanicolaou:
Yeah. So you just-

Dr. Mark Hyman:
On top these you get more inflammation, more reactions. And the dairy has an interesting effect as well. In a subset of these autistic kids, there is these folate receptor blocking antibodies that are caused by dairy. So when you eat dairy, your body creates an antibody against the dairy, but it binds to the Folate receptor. Now Folate is one of the most important nutrients to create neurotransmitters and make your brain work.

Dr. Mark Hyman:
And when you can’t get Folate working your entire cycle of what we call methylation, which is the vitamin cycle is blocked and your entire cycle of detoxification is blocked. Because they’re like cogwheels, they wheel together.

Dr. George Papanicolaou:
They work well together. Yeah.

Dr. Mark Hyman:
And they don’t work. And that’s why these kids can’t detoxify, they can’t make neuro-transmitters, they can’t function.

Dr. George Papanicolaou:
And it has a huge impact on energy production in mitochondria as well.

Dr. Mark Hyman:
Yeah. And getting these people off dairy and then boosting up the special form of folate called methylfolate, these kids can really pop up and come alert. There’s not like one treatment for autism. Right?

Dr. George Papanicolaou:
No.

Dr. Mark Hyman:
This kid might do well with no dairy and a high dose of methylfolate. Another kid might need to fix their gut. It might be a gluten issue. Another kid might be a mitochondrial problem. And so you have to dig into this. And this is the beauty of functional medicine is, we don’t treat all patients the same. We look at them as individuals, we look at real personalized medicine, personalized nutrition, and we do very sophisticated diagnostics, which allow us to really map out what’s going on with these kids.

Dr. Mark Hyman:
So you go wait a minute, if there is actually lab tests that help us identify and map out what’s disordered in these kids biology, why aren’t pediatric neurologists doing this? Why aren’t pediatric psychiatrist doing this? It makes me crazy. I am sorry, it makes me crazy. Because after treating literally hundreds of these kids with everything from dyslexia, to ADD, to autism, to behavioral issues, it’s all the same stuff. Different things are going on in different kids, but it’s all the same approach. It creates a really deep dive to help these kids.

Dr. George Papanicolaou:
Right. So it is a deep dive and it’s a comprehensive approach. And so once we’ve looked at the gut, once we’ve looked at basic nutrition, once we’ve looked at some of the more intricacies intricate nutrition and deficiencies that might impact the mitochondria, we look at toxins. We look at genes, we look specifically at genes of detoxification inflammation. And there’s very important methylation genes that are responsible for so much, including detoxification and energy production in the mitochondria.

Dr. George Papanicolaou:
Once we looked at all of that then we start … And then we look at immune markers. We do look at markers for immune function, that will help us understand if a patient’s immune system is hypervigilant or whether it’s so tired, it’s depressed. So, as we said before, we do the stool testing. And one of those markers in the gut that we looked at to get a sense of what the immune system is doing, is Secretory IgA or SIgA. And it’s not uncommon for-

Dr. Mark Hyman:
That’s an antibody-

Dr. George Papanicolaou:
It’s antibody.

Dr. Mark Hyman:
That has made a first line of defense in our guts against infection, right?

Dr. George Papanicolaou:
Yeah. But sometimes by the time I see these kids, their immune systems have been working so hard for so long, that they’re not able to produce this antibody. And that is an indicator that they have a significant amount of immune dysfunction, and that becomes a focal point for how we’re going to treat them.

Dr. Mark Hyman:
That’s right. And I think we also look at nutrient levels, because there’s a lot of nutrient levels that are really low in these kids. omega-3 fats and zinc and magnesium.

Dr. George Papanicolaou:
Vitamin A and vitamin D.

Dr. Mark Hyman:
And vitamin A and vitamin D and omega-3 fats and B12 and folate and B6.

Dr. George Papanicolaou:
B vitamins, yeah.

Dr. Mark Hyman:
Often some really simple interventions, you can make profound differences in these kids. We also treat the gut aggressively in these kids with lots of probiotics and things to really help the guton enzyme. So it’s a lot of work and it’s a lot of work for the parents. It’s often costly, unfortunately, insurance doesn’t cover this yet, although hopefully it will. I mean, you think of the cost upfront of doing a few thousand dollars worth of diagnostics versus the entire lifetime of support services and institutionalized care. I mean, it’s really a bargain.

Dr. George Papanicolaou:
It’s a no brainer.

Dr. Mark Hyman:
It’s a bargain and no brainer, but it is a real cost. And often families can’t afford it, which just breaks my heart. But there’s a lot of stuff that you can do on your own. And I think a lot of these things we’re talking about are lifestyle nutrition. And I think you want to share … Maybe share a case or so, and I’ll share some of my cases.

Dr. George Papanicolaou:
Sure. There’s a boy that came to me, he was like four and a half, his name was Johnny. Mom and dad brought him in to see me. He was actually a delightful little boy, but he had all the hallmarks of autism. And he had very little progress working with his pediatrician. And the mom had somehow come across functional medicine, saw a video and they had not done too much to this point. And so it was really exciting. I remember reviewing the chart thinking, I am so excited to be working with them because just by reading the chart, there seems to be a lot that we can do.

Dr. George Papanicolaou:
So the main things that they brought him in with was that he had a lot of gut issues, a lot of bloating, a lot of distension, a lot of diarrhea. He also had eczema and he had all of the behavioral characteristics of autism, and he had difficulty with sleep. Those were the main characteristics. He was not socializing well at, at four and a half, he was not at reading level. A lot of difficulty with language, social cuing did not … He was socially isolated, withdrawing from kids oftentimes. And when he was around kids, oftentimes he would misread cues, lose his temper, hit and bite.

Dr. George Papanicolaou:
And so it was very difficult for the family to really engage socially with other families and go places. Of course, sitting with them the first time is usually a lot of tears and there’s a lot of listening. And so I was happy at the end of the visit when mom just said, “Thank you.” She just said, “Thank you for listening, because I really for the first time think we’re going to get help.” Now he’s like four and a half years old, and they’ve been going to their docs for a long time. So that was a really, really good start, to give them hope. So after that first visit, the things that we really have done is we’ve given them. They’re going to get all that testing done.

Dr. George Papanicolaou:
But knowing that he had gut issues one of the first things I did was saying, “We’re going to put him on a gluten-free dairy-free diet. We’re going to take out some of the other potential inflammatory products like eggs and soy and yeast. And we want no sugars, no processed carbs.” That is a lot. Just starting there with an autistic child is giving a family a huge task. And so I don’t want to do too much. Particularly these children have a lot of sensory issues, so they will have texture issues, they may have swallowing issues. So giving them a huge number of supplements is not something that we can do. But at the first visit, they get a nutritional plan as I’ve outlined there.

Dr. George Papanicolaou:
And generally, depending on what’s going on, I’ll start a probiotic. And I usually will start with a high potency probiotic and potentially a digestive enzyme, to really start to help get that gut functioning in a way that will be helpful. So nutrition and gut issues, and I also put them on a multiple vitamin because generally these kids have very limited diets. So their nutrients and their vitamin intake is going to be limited. So we put them on a robust multiple vitamin and some additional mitochondrial support. And that’s how we started.

Dr. Mark Hyman:
Well, how did he do?

Dr. George Papanicolaou:
So, in eight weeks he came back and they had a hard time with the nutrition plan, but they were able to take out most of his gluten and dairy. And they noticed immediately that a lot of his bloating started to go away after meals. And his diarrhea started to decrease. They’re very happy, and his eczema began to clear up. So, just there they were thrilled. So then when we went over all of This testing, he did have genes that indicated that he had a fully receptor antibody that was positive. So he’s making folate receptor antibodies.

Dr. George Papanicolaou:
And he had genes that made it difficult for him to use foliate in the first place. So we added methylfolate to his plan and we also added … He was also very low in vitamin D. So we added in vitamin D and vitamin A. And three months later, it wasn’t even three months, was it three months? Yeah, three months later, mom indicated that his eczema has gone and they were able to really expand. He was almost totally dairy-free and gluten-free. He was taking the vitamin D the vitamin A, he was taking the additional methylated folate. And his eczema was gone, his bloated had stopped.

Dr. George Papanicolaou:
With the high dose probiotics they noticed that his diarrhea had almost completely resolved having more formed movements, but multiple in the day. And his speech therapist indicated that he had made strides in his language acquisition.

Dr. Mark Hyman:
Yeah. It’s pretty amazing. And I just … It reminds me of-

Dr. George Papanicolaou:
That was at six months, Mark. And we weren’t even done.

Dr. Mark Hyman:
And you keep working through the layers, it’s like layers, you start with the simple stuff and the diet and the nutritional sport, but there’s one of those layers. And it reminds me a kid I saw, but he was 20 … Maybe he was two and a half years old. Right? And he was diagnosed at 22 months with autism, with regressive autism. And he was fine and then he got sick, and his mother was told, “Nothing we can do just use behavioral therapy.” And his mother was not willing to take that at face value and came to see me. And I’m like, “Look…” This is her early on.

Dr. Mark Hyman:
And I said, “Look, I can’t promise you that I can do anything to help your son. But we do know that this is a systemic disorder. We do know that it’s inflammation in the brain. We do know there’s issues around gut and toxins. We know there’s issues around mitochondria, let’s … And nutritional factors. So let’s just take a look.” And we looked under the hood and we saw an array of problems that were so easy to treat really. I mean, he had the worst gut issues, stinky, smelly, sticky, poop. He had severe, we call it dysbiosis, which is imbalances in the bacteria in his gut. He had 28 food sensitivities, gluten and dairy antibodies were really high.

Dr. Mark Hyman:
So he had severe leaky gut. And he also had lots of nutritional deficiencies. Right? He had magnesium, zinc, manganese, vitamin A, vitamin B12, vitamin D, omega-3 fats all were very low. We just tested them. And these are all essential for brain function, for immune function, for so many things. And he was loaded with toxins. We did levels of toxins in his blood, which had a high aluminum and lead. His hair had antimony and arsenic, and he had low levels of the most important detoxifying compound in his body, glutathione. And he also had other things we talked about the mitochondrial issues on the testing.

Dr. George Papanicolaou:
He had everything.

Dr. Mark Hyman:
He had methylation problems. So these kids often don’t have one thing it’s just a biochemical train wreck. Right? And using functional medicine, you begin to tease it apart, and you order the therapies to start with the simplest stuff. You change the diet, you fix the gut, you get the nutrient levels up, you start to deal with mitochondrial function. You start then deal with the toxic load. You boost up the methylation. And we did all of those things. We found just for general B12 shots, which overrode some of these biochemical pathways allowed him to start detoxifying.

Dr. Mark Hyman:
He was starting to have eye contact, started connecting, started not being in his world. I mean, when I first met him, he was just in the room staring into a space, looked like he was on a heroine trip or a psychedelic adventure, completely in his own world, wordless, no speech. And over time we worked through all these issues like peeling the onion and it doesn’t happen with every kid. But we’re really diligent. And it took a lot of work. The parents were really diligent about doing the things that they need to do. We took away the gluten and the food allergens. We got rid of the dysbiosis and the bad bugs and the fungus in his gut. We actually help replenish his gut with probiotics and enzymes.

Dr. Mark Hyman:
We gave him all the minerals and nutrients he needed and the omega-3 fats. We got his mitochondria working. We started detoxifying him. And over a number of years, he went from being completely locked in to a normal kid. Now, I’m not saying using this approach, we can take care and cure all case of autism. But this was a miracle case. But honestly, over many decades of doing this, we can help. Whether it’s a 50% improvement, a 25% improvement, a 75% improvement, complete resolution, we see all that.

Dr. George Papanicolaou:
Yeah. And I would say, I have not seen a child with autism that I was not able to help in some way.

Dr. Mark Hyman:
If people are listening, this is … We’re in a crisis of our children’s brains. I mean, one in six children today have some type of neurodevelopmental disorder. One in six, that’s a lot of kids. And it’s dyslexia, it’s ADD, it’s learning difficulties, it’s autism spectrum issues. I mean, it’s a lot of kids. And we just are so in the dark ages in traditional medicine about this. And we have really advanced this field and functional medicine and see miracles all the time.

Dr. Mark Hyman:
And it’s just heartbreaking for me that parents don’t have access to this, they don’t know how to find their way to practitioners who can help. And that’s really why we’re here at the UltraWellness Center, why I established this 15 years ago and why it’s so satisfying practicing this medicine, because we do see real change.

Dr. George Papanicolaou:
We do.

Dr. Mark Hyman:
We’re in this moment where everything’s changing.

Dr. George Papanicolaou:
Drastically.

Dr. Mark Hyman:
We’re seeing the opening up of the mind around autism to understand that it really is a biological disorder, it’s not a mental disorder.

Dr. George Papanicolaou:
If we can’t look at these numbers, if we can’t look at going from … In 1970, it was estimated one in 10,000 kids would have autism to one in 54. If we can’t look from 1970 to 2020, and we can’t say there is something significantly wrong with our environment today, just based on looking at this number and the brain is the Canary in the coal mine.

Dr. George Papanicolaou:
Because we’re talking about autism, but the adult brain is under siege too, because we know that Alzheimer’s is now epidemic level. I’m just saying these numbers and looking at autism is a really … It’s a wake-up call for all of us to understand we really need to pay attention to the toxicity of our environment and our food.

Dr. Mark Hyman:
Yeah, absolutely. And I think what you’re saying is so important. These kids are the Canary in the coal mine. They’re warning sign for all of us to pay attention that our food supply, our environment and our way of life has got to change. And I’m just so grateful to George for you being here at the UltraWellness Center. If you’ve been listening to this podcast and you know someone with autism or on the spectrum, are you struggling in your family with this or your friends, please share this podcast with them, because it’ll help them understand that there is a way.

Dr. Mark Hyman:
And we’re here at the UltraWellness Center, we’ve got a great team of practitioners who’ve been doing this for a very long time, and we just love seeing these kids. So, please share this podcast with them and know that there is hope. And of course, leave a comment. How have you helped your kids with using these approaches? What has worked, what hasn’t worked? And then of course, subscribe wherever you get your podcasts so you can listen to Doctors Farmacy. And we’ll see you next week on the Doctor’s Farmacy.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

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