regional seminars 2010 -biomedical treatments - dr. l...

Biomedical TreatmentsDr Lily Tomas

Mindd Regional Seminars 2010www.mindd.org

Mindd Regional Seminars 2010

Biomedical TreatmentsDr. Lily Tomas

What’s happening to our children?

� Incidence of Autism 1 : 160

� Incidence of Learning Difficulties 1: 6

� Incidence of Psychological Problems 1: 6

� Incidence of Asthma 1 : 8 (UK)

What’s happening to our children?

� Incidence of ADHD 10%

� Incidence of Allergy 20%

� Incidence of Eczema 10-20%

� Incidence of Dyslexia 10%

� Incidence of Dyspraxia 10%

Nutritional and Environmental

Factors

� Modern diet : Increased processed foods, refined carbohydrates, sugars, gluten and casein A1.

� Increased Omega 6 compared with Omega 3 essential fatty acids consumption

� Zinc, magnesium and selenium deficiencies in the soil

� Industrial waste recycled as chemical fertilisers

� Antibiotic and/or hormone use in farmed animals

.

Nutritional and Environmental

Factors

� Preservatives, additives, colourings in food

� Preservatives kill beneficial gut bacteria

� Increased use of antibiotics and toxic chemicals in our environment

� Use of toxic heavy metals – mercury, lead, cadmium, aluminium.



MINDD Foundation

� Bio-medical therapy of Metabolic, Immunological, Neurological, Digestive, Developmental disorders in children and adults.

� Non-profit health promotion trust consisting of doctors, integrative practitioners, patients and parents who recognise and appreciate the effectiveness of integrative treatment approaches for all diseases.

Biomedical Therapy

� Diseases do not suddenly appear overnight.

� State of Health……..Dysfunction……..Disease

� Biomedical Therapy involves recognising and treating cellular dysfunction.

� No cell can thrive without the presence of specific vitamins, minerals and amino acids.

� Nutritional Medicine = Biochemistry

Biomedical Therapy

4 Key Principles :

� Healing gastrointestinal system

� Dietary intervention

� Nutritional Supplementation

� Detoxification of chemicals and heavy metals.

Early Warning Signs� Difficult pregnancy and/or birth

� Gastrointestinal Problems : constipation, colic, reflux

� Difficulty sleeping

� Delayed Milestones- Retained Primitive reflexes

� Hypermobility and/or hypotonia

� Clumsiness/ Poor co-ordination/ Poor Hand writing/Poor at Sport

� Poor concentration

� Enuresis



Early Warning Signs� Skin rashes - eczema

� Reactions to vaccinations

� Speech regression

� Sensitivities – noises, lights

� Abnormal Behaviours- repetitive movements etc

� Learning Difficulties

� Lack of Imaginative Play

� Reduced Social Interaction

Examination� Observe abnormal behaviours

� General – pallor, size, head circumference

� Skin – eczema, goose flesh, red cheeks, peeling feet (yeast)

� Nails –white spots, ridges

� Eyes- peripheral gaze

� Tongue –twitchy, coated

� Abdomen – distended, tender, faecal impaction.

Healing Gastrointestinal System� Babies : Constipation, Reflux, Projectile Vomiting,

Mucusy stools, Colic,

� Children : Constipation, Diarrhoea, Distended Abdomen, Pressure on Abdomen, Abdominal pain, Excess burping, Excess flatulence

� Adults : IBS, Constipation, diarrhoea, Pellets, Pale floating stools, Bloated abdomen, Abdominal Pain, Excess burping, Excess flatulence, Reflux, indigestion, Nausea, Blood or Mucus in stools.

Gastrointestinal Health� 4 main reasons underlying these conditions:

� Intestinal dysbiosis, usually lack of probiotics +/- excess of bacteria, fungal organisms, parasites.

� Food Intolerances : “leaky gut”

� Lack of Digestive enzymes

� Alteration in the pH (acid/alkali) balance in stomach.

Intestinal dysbiosis• State of disordered bacterial ecology in the gut

• Gut becomes a source of toxicity rather than of nourishment.

• Generally due to an overgrowth of detrimental gut bacteria (Strep, Clostridia..) at the expense of beneficial gut bacteria (E. Coli)

• E. Coli makes most of our tryptophan.

• Strep makes large amounts of amines that can lead to brain fog and cognitive dysfunction.

Treating Intestinal Dysbiosis

� STEP 1 : REMOVE –Abnormal bacteria, toxins, allergens.

Identify and correct aggregating factors such as bacterial imbalances, IgGmediated food intolerances and other sources of inflammation

� STEP 2 : REPLACE –Enzymes and Digestive Factors

Promote a better environment for beneficial gut flora to break down food into nutrients.

� STEP 3 : RE-INOCULATE – Prebiotics and Probiotics

� STEP 4 : REPAIR – Gut wall with appropriate Nutrients

L-Glutamine, Omega 3 EFA, Zinc, Saccharomyces Boulardii



Gastrointestinal Health� Role of Probiotics (Beneficial Gut Flora)

� Protection against foreign organisms – bacteria, fungi, parasites, viruses

� Health and Integrity of Gut

� Appropriate digestion and absorption of nutrients from food and supplements.

� Vitamin production (B vitamins, biotin, Vitamin K)

� Detoxification

� Immune system modulation

Healing Gastrointestinal System� Stool Culture – Conventional, Bioscreen, CDSA

� Probiotics – trial for 1 month

� Dietary Intervention� Milk and chocolate free diet -1 month

(Younger kids, Asthma, Eczema, recurrent ear and/or throat infections, Enuresis)

� Modified Food Elimination Regime:

(No gluten, sugars, preservatives, many different foods)

(Behavioural problems, Learning difficulties, Allergies)

Dietary intervention� Must address diet first as very difficult to assess the

effect of any further interventions if the child is eating a reactionary or “toxic” food on a regular basis.

� These can be “healthy” foods such as eggs, tomatoes, oranges, grains etc.

� Parent support groups – recipes, time to download.

Dietary Intervention � Gluten and Casein free

� GAPS Diet

� Gut Ecology Diet

� Specific Carbohydrate Diet

� Candida Diet

� Low Salicylate Diet

� Low Oxalate Diet

Gluten and Casein Free� Gluten………Glutomorphin

� Casein……….Casomorphin

� Large molecules that are difficult to digest

� Need DPPIV to break down these molecules

� Many children are deficient in this digestive enzyme.

� DPPIV impaired by heavy metals and organophosphates.

Gluten and Casein Free� Glutomorphin and casomorphin are similar in

structure to our endogenous endorphins.

� They flow through a “leaky gut”, cross the Blood Brain Barrier and act as opioids in the brain.

� Thus, they can profoundly influence our behaviourand this sets up a cycle of cravings for wheat and dairy in order to satisfy our internal drives.



Healing Gastrointestinal System� Once dietary triggers have been eliminated, aim is to

heal the gut:� Specific prebiotics and probiotics

� Continue any necessary dietary restrictions

� Judicious use of digestive enzymes

� Treat any pathological microorganisms

� Glutamine

� Zinc

� Essential Fatty Acids

� Aloe vera

� Slippery elm

Nutritional Supplementation� Commonly deficient nutrients :

� Probiotics

� Zinc

� Vitamin B6, B12, Folate

� Magnesium, Calcium, Selenium

� EPA/DHA Essential Fatty acids

� Vitamin A

� Essential amino acids – glutamine, taurine, tyrosine, methionine.

Neurotransmitters� Chemical messengers of the brain which are made

from essential amino acids and their co-factors (vitamins and minerals).

� Amino acids are derived from protein sources.

� Important neurotransmitters include:

Serotonin

Dopamine, Adrenaline, Noradrenaline

GABA

Histamine

Serotonin Pathway

Iron, Folate Vit. B6

Vit. C, Calcium Zinc

5 Hydroxy Serotonin

Tryptophan

Tryptophan Melatonin(from Food/ Supplement)

Vitamin B3

Dopamine PathwayIron, Folate Vit. B6

Vit. C

Tyrosine DOPA Dopamine(From Food/

Supplement) Vit. C

Copper

Adrenaline NorAdrenaline

Tyrosine� Precursor to Dopamine, Noradrenaline, Adrenaline

� These neurotransmitters have a role in many conditions such as depression, drug dependence, schizophrenia and ADHD.

� Tyrosine may also be used to enhance thyroid function

� Ritalin (Methylphenidate) is believed to work by partially influencing this dopamine pathway.

� Tyrosine 500mg can also be used as a calming agent up to 3 times daily as necessary as a natural alternative.



GABA PathwayVit. B6, Taurine

Zinc

Glutamine Glutamate GABA( From Food/

Supplement)

Glutathione

Glutamine� Related to the neurotransmitter, GABA, our primary

inhibitory neurotransmitter

� Therefore aids in mental anxiety and relaxation

� Glutamine 500mg-1000mgs coupled with co-nutrients

Zinc� White spots on nails, acne and other skin conditions,

stretch marks.

� Definite testing by plasma zinc level.

� 10:1 Zn:Copper ratio is ideal

� Primarily found in oysters

� Zinc is needed for the majority of protein binding reactions in the body.

Zinc� Essential component to create GABA

� Zinc is an essential component of metallothionein, a substance whose role is to naturally remove heavy metals from the body.

� For every heavy metal that is removed (eg. Copper, Mercury, Lead), 7 zinc molecules are required.

� Therefore, if we are zinc deficient, we cannot make metallothionein and we cannot remove heavy metals from the body.

Zinc Supplementation� Most absorbable form of zinc is picolinate.

� Dosages are extremely variable

� 35-50 mg elemental zinc at bedtime

� One can become zinc toxic – first sign that the body has had enough is short-term nausea.

Magnesium� Magnesium is needed in over 350 different body

enzyme reactions.

� Primary symptoms of deficiency : restlessness, restless legs, eyelid twitches, palpitations, feelings of tightness and cramps in the legs and feet, chocolate cravings, hyperactivity

� We need calcium to make our muscles contract and we need magnesium to make them relax.



Magnesium� Naturally found in seeds, nuts, chocolate…

� Usual supplementation dose for a magnesium deficient child is 175mg-350mg daily, usually for 3 months.

� 500mg Magnesium means eating

750g figs

750g chocolate

1.5kg steak

500g bread

1.25kg eggs

Vitamin B6� Preferably as Activated B6 – P5P

� Essential cofactor in many biochemical reactions in body, particularly neurotransmitters.

� Less than 5 years : 25-50mg

� More than 5 years : 50-100mg

� Can become toxic in high doses – pins and needles in peripheries.

Vitamin A� Found naturally in cod liver oil

� Dose : 2500-5000IU/day = 1 tsp cod liver oil

� Particularly important in hand/eye co-ordination

� Family history –night blindness

� G Protein defect

Essential Fatty Acids� Our brains are made of at least 70% fat.

� Omega 3 fatty acids are essential components of brain cell membranes.

� Humans cannot make their own Omega 3 Essential Fatty Acids!

� WE ARE WHAT WE EAT!

Essential Fatty Acids� Our change in diets (land animal fats and many

vegetables oils) from 4:1 to 16:1 Omega6: Omega 3 ratio.

� We cannot be ignorant of mercury and other toxins within our waters.

� Also necessary to be aware of tinned fish and the % EPA/DHA.

Essential Fatty Acids� Both EPA and DHA are essential but DHA is more

important than EPA in learning disorders.

� EFA levels can now be measured directly through blood tests performed in specialised laboratories.

� Clinical symptoms of EPA/DHA deficiency : dry skin, hair, goose flesh on upper arms.



Essential Fatty Acids� Dosages need to be tailored in line with the severity of

the condition.

� Children 1-4 years 600-1800mg EPA/DHA per day

� Children 4-12years 1000-3500mg EPA/DHA per day

� Adults 1000-9000mg EPA/DHA per day

Essential Fatty Acids

HOWEVER

� There is a subgroup of adults and children that may get worse from EPA/DHA supplementation.

� These are people who are deficient in arachidonicacid, an Omega 6 EFA – Evening Primrose Oil.

� These are people who produce and excrete kryptopyrroles in their urine.

Kryptopyrroles� Genetic disorder associated with abnormal

haemoglobin synthesis

� 10% general population

� Main symptoms : mood swings, anxiety, emotional meltdowns over minor triggers, pale skin, white spots on nails, poor tanning, poor dream recall, light, smell and sound sensitivities, tags on clothes, food/chemical allergies.

Kryptopyrroles� First discovered in late 1950s by Hoffer

� 1960’s : research on schizophrenics, “mentally retarded” and “disturbed” children and criminals

� 1970’s : Dr Carl Pfeiffer devised a simple quantitative urine test and demonstrated a reduction in kryptopyroles and clinical improvement with high doses of vitamin B6 and zinc.

� Testing by SAFE Laboratories in QLD.

Kryptopyrroluria� The formation of kryptopyrroles depletes the body of

zinc and Vitamin B6

� Zinc and Vitamin B6 necessary to produce serotonin and GABA

� Vitamin B6 necessary to produce dopamine, noradrenaline and histamine.

� Tend to do better on Omega 6 EFAs (evening primrose oil) rather then Omega 3 EFAs (fish oils) secondary to low levels of arachidonic acid.

Kryptopyrroles

� Pyridoxine-5-phosphate 50mg

� Pyridoxine 250mg

� Zinc 50mg

� Evening primrose oil

� Calmer, better focus, reduced sensitivities, fewer meltdowns.

� Improvement expectation: 1-3 months



Detoxification�Remove all potential toxic triggers :

� Abnormal gut micro-organisms(Stool M/C/S, CDSA, Bioscreen)

� Foods(Elimination diets, IgG Food Sensitivity)

� Environmental chemicals(ALCAT Testing)

� Heavy metals.(Blood levels, Hair mineral analysis)

Detoxification� Spectrum of Detoxification : Gentle….Powerful

� Whole foods and Herbs :Chlorella, Coriander, Keffir, Coconut oil, fermented foods, fresh vegetable juices, Spirulina, Seaweed

� Alkalinisation

� Homeopathy

� Epsom salts baths

� Clay baths

Detoxification� Herbal liver support regimes

� Footsies +/- coriander oil

� Nutrients : Vitamin C, Zinc, Vitamin E, Manganese

� Metallothionein Promotion-glutathione, selenium, serine, lysine, alanine, glycine, threonine, proline, aspartic acid, asparagine, glutamic acid, methionine, glutamine, isoleucine, valine.

� Chelating agents : DMSA, DMPS, EDTA

Case Study� 6 year old boy diagnosed ADHD, difficulties at school

with both peers and teachers.

� Birth history-unremarkable

� Breast-fed to 1 year

� Family history – mother had PND

� Baby-mild eczema

� Immunisation history – UTD, no reactions

� Milestones - on time

Case Study� Young child – recurrent tonsillitis requiring multiple

courses of antibiotics, difficulty sleeping.

� Daycare – first noted that his behaviour was impulsive, easy temper tantrums.

� Kindergarten – poor concentration, hitting other children

� GP referral to paediatrician – diagnosed ADHD. Ritalin offered but parents declined, preferring to try other alternatives first.

Case Study� On examination – fidgety ++, poor eye contact

� Skin – mild eczema

� Nails- white marks ++, tongue twitchy, coated

� Cardiovascular/Respiratory systems – NAD

� Gastrointestinal- distended abdomen, not tender

� Closer history taking – bowel motion once every 2-3 days. Behaviour markedly worse before bowel motion.



Case Study� First Impressions – constipated (unable to

eliminate toxins and unable to absorb nutrients well)

� He was likely to be deficient in probiotics (due to his multiple courses of antibiotics), deficient in zinc (white dots) and magnesium (twitchy tongue, restlessness)

Case Study� Stool culture x 3 M/C/S + O/C/P

� Probiotic commenced.

� Milk and chocolate free diet

� Review in 1 month

Review after 1 month� Stool culture clear

� Bowels much improved.

� Eczema had settled down.

� Less congested nasally.

� Behaviour was unchanged.

� Remain off dairy. As bowels have improved, add magnesium 250mg elemental daily.

� Birthday party in the next month…digestive enzymes given as a “band-aid”. No further dietary changes.

Review after 6 weeks� Teacher and parents had noticed that his behaviour

was calmer with less tantrum outbursts.

� “Still a long way to go”

� Parents ready to commit to further diet modification.

� Mum noticed there were less sugar/chocolate cravings

� Sugar, preservative, additive free – 6 weeks

� Continue probiotics and magnesium for a total of 3 months.

� Add zinc at night : 1mL in 100mL water/juice

Review after further 6 weeks� Behaviour continued to improve.

� Compliant with all supplements.

� Parents decided to continue the sugar, preservative, additive free diet.

� Concerned regarding calcium intake…may slowly start to reintroduce dairy, separately.

� Probiotics and magnesium were trialed at half-dose.

Earlier appointment� After 1 month, sudden deterioration in mood swings,

anger outbursts and anxiety.

� Teachers were concerned; Ritalin was again suggested.

� No obvious psychological triggers

� Had undergone a growth spurt, requiring more zinc.

� Urinary kryptopyrroles test ordered, with review after results.

� Tyrosine 500mg up to 3 times daily in meantime.



Review after results� Significant change in behaviour with tyrosine.

� Went away for weekend to visit relatives and forgot tyrosine, with obvious deterioration of behaviour.

� Kryptopyrrole result : 54 (<10, normal)

� Pyrrole Primer recommended, building to twice daily. � Zinc picolinate 50mg

� Vitamin B6 250mg

� Pyridoxal 5 Phosphate 25mg

� Previous zinc supplement was ceased. Magnesium and probiotics were continued.

� Review after 6 weeks.

Review after 6 weeks� Dramatic improvement in behaviour.

� Started to remember his dreams.

� After first 2 weeks, no need for extra tyrosine.

� Bowels still functioning well on half-dose probiotics. Trial without magnesium.

� Main problem with dairy- milkshakes. Yoghurt and most cheeses were OK in small amounts.

� Sugar, additive, preservative free diet was continued.

Follow-up� After 3 months of pyrrole primer, dose has been

successfully reduced to 1 day.

� Aim is to stop this completely.

� Parents were told to “stress-dose” with extra zinc in times of stress, growth spurts or illness.

Thankyou.

regional seminars 2010 -biomedical treatments - dr. l...

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