← Autism Parenting Secrets
Autism Parenting Secrets
Don’t Skip The FOUR PILLARS
01:01:47
Dr. Kurt Woeller joins the show to explain why so many parents chase the next breakthrough while overlooking the foundations that support lasting progress. He shares the Four Pillars framework he's refined over nearly three decades helping families navigate autism and other complex conditions. The secret this week is… Don’t Skip The FOUR PILLARS
Loading summary
Transcript38 lines
- [00:00]
A
When kids sort of jump into these therapies without any foundational support is often it causes problems, so it can cause hyperstimulation, hyperactivity, which can translate sometimes into aggression or self injurious behavior, sleeping problems, et cetera. So that's why the fundamental aspects of these four pillars is so necessary to always remember.
- [00:22]
B
If you're a parent of a child with autism, you are being called to rise with love, courage and clarity. This journey isn't easy and most parents aren't equipped, but you can be. This podcast is your invitation to rise higher because how you navigate matters. I'm Len, and this is Autism Parenting Secrets, where you become the parent your child needs now. Hello and welcome. If you're like most parents, you've spent lots of time researching the next therapy, the next treatment or breakthrough. And sometimes progress really isn't about about what to do next. Sometimes it's really about making sure the fundamentals are in place. First and today's guest is Dr. Kurt Wohler, an integrative and functional medicine physician, biomedical autism specialist, educator, author and chief medical officer of Mosaic diagnostics. For nearly 30 years, he's helped families and practitioners better understand the underlying factors that influence health and development. And despite all the advances he's witnessed, there's one principle he continues to emphasize again and again. The secret this week is don't skip the four pillars. Welcome, Dr. Waller.
- [01:36]
A
Hey, it's great to be here. Thanks for having me on.
- [01:39]
B
The thrill is all mine. And I know you have deep experience and have presented at conferences, and I know you really like to get your message out there. As we were thinking about the people who are listening and this concept of the four pillars, can you talk a little bit about how that evolved and why that's an area or at least a theme that you like to really emphasize for parents.
- [02:00]
A
The four pillar approach was something I developed many years ago, and it was really from being in clinical practice and seeing even at that time, you know, which you can go back 10, 15, 20, 30 years ago, it still didn't matter. It's still happening today. Is the tendency to want to jump into a therapy because it's kind of hot off the press, getting a lot of, you know, chatter online, although we didn't have online back then, but, you know, sort of the latest thing and which is fine and totally understandable. And there are certain therapies, you know, now right now we're currently in a cycle of everybody wants leucovorin, and that's fine. It certainly works for a lot of kids, not everybody. And what I realized was that when you do that and you sort of miss some of these foundational principles of biomedical intervention, you often don't get the long term results you're looking for. And what I started to recognize many years ago was that if you really don't focus on diet and have a good solid foundation on diet, healthy eating, whole food, real food diet, for example, it could be problematic because the things that either a child is consuming can interfere with other biochemical systems in the body. And so other therapies you might do may not necessarily work. We know that a lot of kids have, you know, ongoing gut problems too, and sometimes have limited, you know, nutritional intake from their diet. And so the four pillars really sort of grew out of this whole concept of we have to focus on diet. And that's a continuing focus. It's not just something you do for a weekend and then sort of move on. It's right. This is a foundational thing for all of our health. The other pillar, that's the first pillar, the second pillar is we know that many kids have nutritional deficiencies. And so it's looking at foundational nutrition beyond diet and using very foundational nutritional supplements, multivitamin, multiminerals, some essential fats to fill in those gaps nutritionally, to provide some support for kind of fundamental biochemistry. The other pillar, the third pillar, is gut function. If we have a child with faulty digestion, malabsorption, dysbiosis, well, you're not going to necessarily get a lot of nutrients in. And that also complicates the situation because the gut can also be a seat of toxins that adversely affect these kids. So we always have to think about the gut. And, you know, now that the discussions about the microbiome and the influence on the brain, and there's so much more research now than there's ever been. And then that fourth pillar is methylation. And if we look back at the history of research in autism, the fundamental aspects of methylation and methylation impairment play a big role in what's happening with a lot of these individuals as far as attention focusing, comprehension, language abilities, et cetera. And so these are not necessarily pillars that you sort of step through individually or move on from. These are foundational principles that are getting supported throughout a child's, you know, developmental years. And really these can be principles that are applied to just life in general. And I have found obviously, that when they are skipped, overlooked, not appreciated, you don't often get the results that we're looking for. With other types of interventions. And then there's also that fourth pillar or what I call the fifth box or whatever. And that is kind of everything else. Right. Other things that you might want to try, that could be hyperbaric oxygen therapy, that could be antiviral therapy, it could be stem cell therapy. These are kind of high ticket priced items. They can be effective. But if we're not establishing a foundation, those things often don't work or really work to that significant degree. So this principle has really, you know, is still consistent today. And it's a point that I try to emphasize to parents to remember to go back to those foundations.
- [06:24]
B
I love it because it just gives it more specificity to this concept of ensuring that an individual has a strong foundation before you try higher level order things. Right. So a lot of what you conveyed makes common sense really. Right. Where there's some key foundational areas that are likely relevant for any child. But then there's that fifth category that for a particular child there may be some foundational piece unique to them that needs to be addressed. Which is why this is never a one size fits all approach.
- [06:56]
A
Then you're seeing it today, right? There's a lot of parents that are like, I just want Leucovorin, I want to try Lugovorin. And they've not done any preliminary work. And you know, every once in a while you might get a positive hit where a child like, oh my gosh, there's some improvement in language or there's better eye contact, but usually it's not long lasting. It's usually not quite that profound. And you know, what also happens is when kids sort of jump into these therapies that without any foundational support is often it causes problems. So it can cause hyperstimulation, hyperactivity, which can translate sometimes into aggression or self injurious behavior, sleeping problems, et cetera. So that's why the fundamental aspects of these four pillars is so necessary to always remember. And we could talk about some of the components of these pillars and what is sort of involved and what's actually why focusing on these is so essential.
- [07:56]
B
I think that would definitely be useful. A lot of this is kind of obvious to me just because I've been doing this for a while. But again, for parents who are listening, you know, these concepts may be familiar, but I think a little bit more under the hood on each of them might be, might be useful. But I guess I just want to characterize or reinforce what you were saying where this concept of ensuring that people do not Skip the foundation. Right. To move on to other things. As you said, there's a lot of reasons why you wouldn't want to do that. It could make things worse. It could just make everything that you might be trying. It doesn't have a real good chance of success unless you have the basic building blocks in place. And I guess I look at it where it's about kind of get ready, get set, go. And to get ready is kind of just getting more awareness, which is why this podcast exists, why your podcast exists, so parents can get more information. And the get set piece of it, to me, all right, that's like setting the foundation and not skipping those steps. Because even though it's tempting to run out and do the latest because there's fomo, people want to take advantage of what's, what's not. This is where restraint really is a superpower. Hey, is my child set up for success? Do they have the basic building blocks? So you're saying that diet and food is super important, and then related to that, the concept of nutrient deficiencies. Right. We need the essential building blocks for the body to operate as it's intended, and then the gut, which I know there's a lot that you can include in there. And I was surprised when you talk about methylation only because when my son's journey started, and he's 19 now, you know, so 17 years ago, that's all we kept hearing was, it's MTHFR or methylation's the key. And of course, it's still important, but I think it's gotten less attention. It's kind of gotten lost in the other latest things that have come out, whether it's leucaborin stem cells, et cetera.
- [09:48]
A
You actually brought up. You mentioned it, the building blocks. You know, I mean, conceptually, it makes sense if you think about anything with regards to our health, if you're starting a new exercise regimen or you're trying to just improve your level of physical fitness or improve your diet. Right. There's always some foundational, fundamental things you have to do and be consistent with. So when we think about diet, right, There's. There is no one autism diet. In fact, I see the book behind you by Julie Matthews, which I recommend every parent buy. Even if you're an experienced parent and you've been doing this for a number of years, that book is still very, very, very valuable, because, again, there's no one autism diet. There is good overall whole food, real food diet, and just trying to improve the quality of food, but it's also about what types of food not to give. Right. Trying to remove some of the more toxic foods, the refined foods, the artificial colors, flavorings, et cetera. And every kid is going to be a little bit different in how they react. They don't all respond the exact same way. When you think about the fundamental aspects of dietary intervention and autism going back many years, even to the early days of the Defeat Autism now movement and through the work of the Autism Research Institute, which was headed up by Dr. Bernard Remlin, the gluten casein free diet was what was highly emphasized and for good reason. Because a good percentage of kids had positive response with eye contact awareness, sometimes improvements in communication, less hyperactivity. And you know, again, not Every, it's not 100% effective all the time, but it has a very good, high percentage of success. Good. 78% of the kids I've seen over the years when they remove dairy and remove gluten will have a positive effect like we just mentioned. And so, you know, you don't always, always know why it's doing what it's doing, for example, but it just tends to often be helpful. And so I always tend to talk about working off the percentages, things that typically have a good percentage, they can be worthwhile trying. But also there are other types of diets we know, Len. I mean, you know, if you have a child that has either confirmed or suspected inflammatory bowel disease, you know, the specific carbohydrate diet can be helpful. The GAPS diet can certainly be helpful. So the whole point is as best as possible. And it's a process that evolves over time. I don't expect parents to know exactly within a week all of what their child might be sensitive to, but it's moving in that direction to always be learning and always be looking to try to improve the health and quality of the food that our children are eating. And again also to try to as best as possible avoid certain types of food, processed foods, et cetera, that we know can be detrimental. And these things just take time to understand and become educated about. And so you start the process and the great book to get is the, the Autism. You know, I forget exactly the title of Julie's book. You can probably look behind you.
- [13:04]
B
Yeah, the Personalized Autism Nutrition.
- [13:07]
A
Nutrition plan. Yeah. So we can't get away from it. And I have, I, I've made many stories over the years, but I've seen kids programs be sabotaged by their diet, by the perception that, well, they deserve some ice cream once in a while, or, you know, they, you know, a little bit of gluten is not going to necessarily be harmful. And again, not. They don't, not all kids react the exact same way. But, but there's good reasons why that diet and others have been in existence is because there's a high percentage of sensitivity, immune sensitivity and chemical sensitivity to these foods that could be quite profound and, you know, negatively affecting you, these kids. So, I mean, that's just sort of pure and fundamental. The other thing about diet and trying to improve our nutritional intake through food as much as possible. Eating organic, you know, consuming non GMO foods is trying to also, you know, decrease exposure to various environmental chemicals. The glyphosate organophosphates, which we know are neurotoxic and damaging also to the microbiome, plays into some of the other things that we pick up in some of these other pillars. And of course, we're always trying to maximize nutrition because that then sort of bleeds over into pillar two, which is foundational nutrients. And the way I've explained this to families is that in an ideal world, all of us would get all of the nutrition we need through our food, but we don't live in that kind of world. And even though we may all try to purchase organic foods, et cetera, our soils are a little bit more depleted now. There's more environmental chemicals. Even on organic farms, you can't always control against pesticide drift and glyphosate exposure and these types of things. And so oftentimes we have to do some nutritional supplementation to fill in those gaps nutritionally. And again, that's a moving scale. It's not the exact same thing for everybody. But by and large, in the world of autism, and this is really backed up by a lot of the research that Jen Adams has done from Arizona State. Julie Matthews again was part of some of the research that he's done, her master's program there. And what, what Dr. Adams has found is that a wide, wide spectrum of kids, whether it's kids, teenagers or adults on the autism spectrum, have a number of nutritional deficiencies, whether that's vitamin D or certain B vitamins or certain, you know, essential fats, certain minerals, for example, can be depleted. And it makes perfect sense if your diet has been very limited because you're self selecting out certain foods. We know that some kids have such a high tendency to want to consume gluten and consume dairy, and that's kind of your main staple. You're not getting a diversity of nutrients and what Parents need to understand is that everything in our body, from, you know, the function of our heart to our digestive system to our immune system, to the ability to detoxify chemicals we come in contact with, our liver, our kidneys, to the function of our brain requires nutrition, and it requires the overall function of our cells. The energy systems that get produced within our cells are all dependent on the nutrition that we get from our diet. And when we are deficient in many of those nutrients, those systems don't work, or they don't work as well as they should. And that can translate into communication problems and behavioral problems and sleeping issues and digestive problems and immune system problems. So the best way forward that I have found is, again, it's providing that nutrition, filling in those gaps nutritionally. And so before you start stepping into the realm of, well, I want to do heavy metal detox, or I want to do stem cells, or I want to do this kind of thing, why not start providing the foundational aspects of nutritional support so that the sort of intrinsic biochemical systems that are sort of built within our biology have a better chance of working. And that's really the core concept, you know, of just foundational nutrients.
- [17:50]
B
I have an answer as to why not. Because it's hard, it takes time, it's inconvenient, it may not result in changes as rapidly as I, as the parent, want. And so again, I. And I've been there and took me a long time to really understand this.
- [18:05]
A
Yeah.
- [18:05]
B
So there is a why not that. You know, I think the opportunity is for anyone who's listening to really more deeply understand that this isn't kind of a skippable step if you do not have those building blocks, whether it's a. For a child or even for you as the adult, your body can't perform the functions it's designed to perform. And if it doesn't have certain nutrients, your body may try to steal, you know, where it can to get that. And there's so many downstream negative effects that can happen. So this is just proper for anyone that our current food system really doesn't have the nutrients that we would ideally like. And some supplementation is likely going to be needed because we really can't. Even if you're eating a clean diet, like, likely, you're gonna still need to supplement vitamin D, magnesium. There's a few that it's really hard for us to get. You know, maybe in the summer months, yes, if we're exposed more. But otherwise it's applicable for child and adults. And our. The Quality of the food that we're consuming in this country, really, it's not slightly worse than it was. It's. It's significantly depleted.
- [19:15]
A
I'm not necessarily advocating for things that are always easy. I'm just saying these are necessary. And this is not to guilt anybody or to make any judgment. It's. It's difficult. It's. It could be challenging. And, and every situation is a little bit different. I think what I'm really just trying to point out is, you know, is just trying to understand the importance of these concepts. And, you know, none of us are perfect every single day, right? With our diet, with taking supplements. What you try and look for is just more consistency and an awareness that as we continue to move forward, and the same thing applies with our kids, it's just trying to be, again, more consistent and aware of these concepts, because not being aware is certainly not helpful. But, yeah, I get it. I mean, giving supplements to some kids, some kids, as you know, I mean, they take them no problem. I mean, I have kids that all they do is drink water. And so it's very difficult to mix things in all these things in water. So that's a whole other level of discussion and nuance. But we know fundamentally that this is critical and important, just those principles. It is.
- [20:29]
B
And I guess I just want to accentuate one other thing that you mentioned where in this space it seems to me that the key is for a parent to get educated, to make decisions and to take actions and to do those actions with conviction because they feel like this is important for their child and they have maybe some data, some evidence. And this way, if you are, let's say, doing gluten free, then okay, if you are doing that, to do it. Well, because like you alluded to earlier, I was in this camp too, where it's like, okay, well, maybe we do it five days a week and on our weekends we have it. And, and if you, if you kind of do those kind of halfway actions, it's likely that you. You very well may be just wasting your time, right? Like, you may think that that's helping, but if something like gluten for a child is extremely inflammatory and basically toxic for that child, it's the. It's kryptonite for that child, then that's where, if you're going to do it, you just have to eliminate it. And to eliminate it five out of seven days, you know, you won't get the benefit. So that's where the key is really discerning what are those few Actions. You don't have to do a complicated diet in, you know, like scd necessarily. It comes down to what's happening with your child, what are, what's their kryptonite, what might help. And so it's really about not 20 actions in diet, but like what are the few moves. And for some families that might be just a pure organic diet, that's the big change they make because maybe for their child, pesticides, chemicals is the key, Kryptonite. But it's so wildly individualized, it's just half assed actions don't usually work. It's about doing something and maybe not perfectly, but really having more of a commitment in the actions that you're taking.
- [22:11]
A
That's absolutely true. Very smart and very well said. I like that. Kryptonite. I like that. You know, and really you're right. Every child might have different things that are kryptonite to them. And so really what I've recognized, and I'm sure you know this too, Len, is is that each parent has to become a detective into their child's specific autism and what is problematic for them and what's not necessarily problematic for them. But it's that conviction, it's that keen eye, it's that being really honest with yourself and your assessments of things. And that develops over time through education and experience. And this is a, a form of medicine, health care, whatever you want to call it, you know, intervention that requires commitment and it requires a parent to really become diligent and trying to become as, you know, educated as much as possible, fully understanding. Will never know everything because after 30 years, I'm still learning, I'm still humbled by how much I don't know. And every child I see, every new individual I see with autism is a new individual to me. And yeah, I look for patterns and yeah, there's consistencies and there's certain things, things trends over time, but still there's always something unique about every circumstance.
- [23:34]
B
And parents have the ability, you know, with curiosity, with commitment to figure this out. I guess one way I look at it is the right diet for your child is always an elimination diet. It's eliminating whatever might be toxic or inflammatory for them. Right. And, and that may change over time, you know, as they change as your understanding and maybe the data you have
- [23:55]
A
on your child may change.
- [23:56]
B
And again, I wish I could say, hey, I was one of those parents who really knew, knew this early on and my wife Cass took the lead on food brilliantly. I know in my mind it was something Where I didn't really want it to be true. I didn't want to do these changes because of the inconvenience. So I know what that's like. So it took me a while to really deeply appreciate this. But truly it's not a step to miss because again, there's nothing more fundamental or foundational than the food that somebody's eating. You know, sleep is right behind it. But you can't ignore the fact that the food that somebody's consuming has to have an impact on how they're presenting.
- [24:36]
A
Quick story. Years ago when I was in Southern California practicing, I had a family where they went on a gluten casing free diet. And another child was non verbal. A lot of self stimulatory behavior. I don't think he was self injurious. But the thing that really caused a lot of stress within the family was he would be up throughout the night, running up and down the hallway. So no one got any sleep, including him, until he finally collapsed. I don't know, four or five in the morning. And I'm like, okay, so start with, you know, a gluten casein for diet. And I forget now if we even did any basic supplements. So within a couple weeks, had a follow up and you know, the comment was, well, we don't see any difference in our son with the diet. I'm like, let's go through that. What's, what's happening? Well, there's no improvement in language and maybe he's got a little bit more eye contact, but we're not quite sure. And I said, well, anything else? And they go out. Yeah, he's no longer running up and down the hallways at night. I'm like, oh, so when did that stop? I was like, it stopped about a week ago. And so he's finally been sleeping more consistently now, which means we're getting some sleep, which we're certainly grateful for. I'm like, well, awesome. Okay, so let's, you know, let's move on to something else. And so the next console I got was the. They decided to. They didn't. The perception was, was that the diet wasn't helping. Okay. So they decided to go ahead and go back on gluten and casein. And the next consult I had, I'm like, well, how are things going? This is. Well, he's running up and down the hallways again. Right. Still there wasn't really much difference in his personality, his behavior. And I'm like, well, do you think it was the diet? I mean, I think that was the case. And so sure enough, that was, is, is what it was. I'm like, look, we don't always know what we're going to get. We might want some kind of change. We want the child to talk, we want them to stop hitting themselves, obviously, but we can't always know and we can't necessarily, you know, guide that process entirely. And so for that particular child, the gluten and casein was a trigger in his brain and nervous system to keep him awake and keep him running up and down the hallways all night long, which is dysfunctional and not healthy for anybody. And that's what they got. And the thing that I learned at that time, you've seen the symbol, right, of autism, a puzzle piece. It makes perfect sense in that everything, all of these things are different puzzle pieces to a child's puzzle. Some kids may be a five piece puzzle, others are 50, some are 500. And what we found and sort of looked at over the years with the different biochemical interventions is that there are certain puzzle pieces that tend to fit most kids puzzles good. And casein free diet is a puzzle piece that tends to fit most of their puzzles. It's not the whole puzzle, but it's a part of their puzzle. And sometimes the puzzle piece is a little bit bigger, meaning it has a little bit more of an impact. Sometimes it's a smaller piece. It may not necessarily fill all the gaps. But to your point, Len, in that many of these things are inflammatory, there's an inflammatory component that can get oxidative stress. These things pile up and they become barriers to progress. We're looking for building blocks to build up the foundations to try to help an individual move with regards to their health, their comprehension, their language, their interactions, their social abilities. Well, the other side of the equation is we can have negative building blocks that build a wall, that prevent progress. It's just another way of thinking of it. But I've seen a lot of those kinds of scenarios and that ultimately is, you know, taking it back to the fundamentals of diet can play out.
- [28:49]
B
You could be inadvertently building a wall or maintaining a wall that doesn't need to be there. And again, I think this idea of avoiding inconvenient actions, I was there and I, and I've learned the hard way that over time to embrace the inconvenient because that's where most of the progress can, can happen if you can. And again, I appreciate parents who are maybe stretched, exhausted, not wanting to do something maybe as challenging as a special diet, you know, particularly and if they're dealing with a picky eater, et cetera, which is why to focus on this space and to take very targeted actions and maybe small moves at first, but just to go from wherever you are to something that's better for your child, a better diet to help them have more of the nutrients that they need, it's just such an important step. And sometimes you do need labs, you need some data. I mean, my son, particularly with, like, gluten and dairy, I would have fought tooth and nail against that because I'm Italian and, you know, basically I have diets based on those foods. And my son had ige allergies to both. So there was no optionality. If I didn't have that, I don't. I think I would have kicked him, screamed, and kind of really resisted that. But because he had the true allergies, I couldn't. And I think that was a blessing in disguise. So, again, for parents who are looking at what's the right move for their child, yes, it's very individualized. But again, if you get some data, there's definitely always something you can do to help the diet go from wherever it is to a better place that's more of a fit. And for your child to have those building blocks that are so essential, it's
- [30:26]
A
a great piece of advice. I mean, at Mosaic Diagnostics, we have the food IGG, you know, test, which helps to look for IGG reactivity, which does cause inflammation. It's not IgE. But even with that, and that's an important test to do, as Julie will allude in her book that you have on your bookshelf, they're, you know, you can't test for everything. You know, artificial colors, artificial flavors can have their own negative adverse influences. From a chemical standpoint, it's not really testable through a lab. These are just things that you see and behaviors you see improve when you start to remove these. These foods. So from a foundational nutritional standpoint, that people probably ask me, well, what does that mean? Well, usually when I talk about filling in the gaps nutritionally, it comes down to, you know, providing just a backdrop of a multivitamin mineral, some antioxidants, some essential fats, things that typically are often lacking in the diet, and again, kind of fill in those gaps nutritionally. So fundamentally, try to get as much quality as we can through our food supplement with foundational nutrients. And by the way, when we start improving the quality of our food, starting to remove foods that are pro inflammatory, starting to remove foods that are more artificial, in their ingredients, we automatically start benefiting our gut and start benefiting our microbiome, which takes us now into pillar three. I mentioned foundational nutrients and then I mentioned targeted nutrients. Well, the targeted nutrients in my view, become more utilized when you start doing testing and you're now have a specific target. You might have a mitochondrial deficit, you might have a toxin, you might have some oxidative stress markers, and you're using things to kind of target that imbalance. They're in addition to your foundational products that are just filling in those gaps nutritionally and, and they're in addition to your ongoing pursuit of a healthy, optimal diet from a gut standpoint. And this is well known, this has been well known for decades now, that autistic individuals tend to have a lot more imbalances in the gut, whether it's microbiome problems, overgrowth of Candida, overgrowth of other fungal organisms, bacterial imbalances, constipation, sometimes loose stools, cramping, bloating. There's a wide variety of gut problems. And this is a really a major area that we can do intervention with. I first got my start many years ago by learning how to do the organic acids test, which at that time was from Great Plains Laboratory, Great Plains Laboratory became Mosaic Diagnostics. And the organic acid test is a collection of different organic acid compounds that are measured through the urine that are reflective of underlying biochemical imbalances in the body, as well as compounds, chemicals, I. E. That get produced by opportunistic organisms within the digestive system. It's been well known, well established, that in autism, many of these individuals often have fungal problems. So they have high levels of yeast or candida, which are producing various compounds that adversely affect behavior, adversely affect brain and nervous system, they can affect comprehension, and they can interfere with language, et cetera. We also have bacterial compounds that get produced, and many of these come from clostridia bacteria. And many of these clostridia bacteria produce again, these microbial compounds that adversely affect the brain and nervous system as well. So there's a direct link in multiple ways between our gut and our brain. And this becomes a fundamental part that's part of that. That third pillar of my, you know, the four pillar approach is to constantly be aware of the potential of negative or imbalances that might be generated within the digestive system. And we do that first by doing assessments, doing testing. I always say to people, look, if you can only do one test and only afford one test upfront, in my opinion, it would be the organic acids test from Mosaic diagnostics because of the amount of information you get from it. And, you know, we start to work on the gut. You'll often when you start work to work on the gut, Len, as you know, you start to help other systems in the body. There is a direct link between the gut and the brain, and things that are happening in the gut often negatively affect what's happening in the brain and nervous system.
- [35:21]
B
That's not even debated anymore. Right. That there's a direct relationship. And as a parent, you know, you can't really fly blind to know what is going on in the gut. Sure, you can do pillars one and two and eat clean food and do a lot of other things, but to really understand what's going on, you do need some data. And yeah, the organic acids test, it's a urine test. It's been around for a while. It's very well respected, well, well researched. I know there's lots of tests that keep popping up. There's never an end of new testing that comes out, but this one really has stood the test of time as a very useful test. It'd be incomprehensible for a parent to look at it themselves. You need to be working with a practitioner who can help you interpret it, you know, and getting support from Mosaic. So I know a lot of those biomarkers, it's hard to even read, let alone pronounce, but it does give you an idea of what's going on. And for my son, I would never know that oxalates are a huge issue unless, you know, we had the data from that test. So there's a lot of clues and information that a parent can take in from that that then will inform what foods, what diet choices, and even the overall importance of how much time to focus on the diet piece and the nutrient deficiency piece.
- [36:33]
A
You know, it's interesting with regards to testing, and I just thought of something. When you're talking about organic acid testing, and best not to just avoid it or assume something's not there, a lot of times when it comes to things that you're being exposed to, the only way to know what you're being exposed to is to test so that you have an idea. And when it comes to the organic acid test, again, we go back to the. The individual aspects of autism, there are no two individuals exactly the same. And a lot of times we do an organic acid test and find a lot of imbalances. But there are times I do an organic acid test and don't find many Imbalances. And sometimes that could be looked. Looked upon as being a negative. I look upon it as well. That's a positive. Now there's less things we have to worry about or less things we have to be concerned about. So a negative test is oftentimes just as beneficial as a positive test. We can check off what isn't a problem. And yeah, it takes some detective work and it takes time, but that also is viable. I actually do a lot of consulting with practitioners, and a lot of times they'll get disappointed. I'm like, oh, I did this test on a patient and nothing showed up. I'm like, great, okay, now you can move on to something else. You don't have to worry about the X, Y and Z that isn't there. Yeah, we have to do more investigation. So these are fundamental. And again, there's a lot of testing. We could talk for hours about the different types of tests available within just this particular space. But fundamentally, from a gut standpoint, the organic acid test is important. That could be complemented with a comprehensive digestive stool test as well that looks at levels of bacteria, it looks at parasites, looks at markers of inflammation. Certainly beneficial and helpful. It complements the organic acid test. We mentioned the food IgG test, which looks at food sensitivity. Well, as you probably found with your child. Right. They have a lot of IGE reactivity. Well, that can manifest sometimes as gut problems and also allergic reactions systemically. So it's something else that contributes to the inflammatory load. But what I want parents to understand is that what's happening in the gut, good and bad, have an influence. And when we have a lot of overgrowth of these fungal organisms and we have overgrowth of some of these opportunistic bacterial infections, they create chemicals. And although these chemicals may be natural to them, they often are detrimental to us. There are certain compounds that get produced that interfere with specific points of biochemical influence, particularly energy production in the mitochondria, which can greatly affect the brain or nervous system. Some of these compounds can create immune system imbalances. Some of them are neurotoxic. There's a particular compound, two of them, actually, you pick up on the organic acid test. One is called HPHPA. Another one is called 4 Creosol. Well, both of these compounds get produced by different types of Clostridia bacteria, and they have a lot of negative chemical impacts in the brain and nervous system. They're not good. They're never good to have, you know, hanging around at a high level. Not in all, but in Some kids, I've seen them be contributing factors to aggressive and self injurious behavior, sometimes increasing the tendency to anxiety or just becoming impulsive and overly stressed. Those are behavioral aspects fundamentally from a chemical standpoint. They can have toxic influences on the way the nerve cells communicate. And the long term effects of these are certainly not good. They're not necessarily 100% unique to autism. Some of these compounds can be seen and negatively influence people with other types of mental health conditions, some neurodegenerative conditions as well. But the only way you can detect them is through the organic acid test. So that's a test that should not be skipped in my experience.
- [40:42]
B
I would concur, at least from my perspective. And it is something that maybe you get the test and you see some outliers and maybe you see some things that seem fine, but periodically to check in because things can evolve, things can change. And I just know at one point I did do an organic acids test and I also did the same test running it through, through Quest, I think because they have something that they would call an organic acids test, doing the same testing, a lot of the same biomarkers. But I think that's where the testing company is really key. Because the art of this are the ranges. And sometimes if you run through like a Quest, you might get the same biomarkers, but the acceptable ranges they provide are like, basically I got an entirely clean report for my son through the standard testing companies at a very different result from, from Mosaic. And again, I think the, the key is the specialization and the research behind the tests. And what are those ranges? There's an art to this.
- [41:39]
A
Not all organic acid tests are the same. They don't all have the same markers. Usually within a hospital system or a standard lab like Quest. Most of their organic acids they're, they're testing for are linked to what are called inborn errors of metabolism, which are kind of rare genetic metabolic diseases. So most organic acids have those minimal markers. But when you get into specialty labs like Mosaic, there's many other markers on there that you don't get through a Quest or a LabCorp. So they're not, they're not all the same. The name's the same, but they're not necessarily the exact same profile. So you're going to get much more actionable information through a Mosaic organic acid test than you would say running and doing it through Quest. And Quest is a fine lab. It's just that their organic acid test is not as robust.
- [42:34]
B
And that's my point. It may have the same name, but it's a wildly different product because I'm a big fan. Hey, if you can get things covered through insurance and run it through, fantastic. Ultimately, though, as a parent, you have a certain amount of resources. If you're going to invest in testing, you want to make sure that you're. You're doing something that's likely to reveal the clues that you're looking for. And so again, where you, where you spend your. Your resources is key. And having a good urine test, blood test, stool test, you know, you don't have to do every test out there, but to kind of get. Invest in a few tests to get some really important clues, because the gut's just too important to not get some information about what's really going on in that very complex ecosystem.
- [43:17]
A
Pillar three becomes foundational. It becomes something you come back to because none of us live in isolation, none of us live in a bubble. So we're constantly exposed to our environment. We're eating food, we're drinking water, so we come in contact with new things. So our ecosystem of our gut never stays the exact same. And so you have to come back and say, well, is it optimal still? Let me repeat. An organic acid test or a stool test. If there's problems, we can't just necessarily check the box and move on. So that becomes, again, like diet, like foundational nutrients, like gut function, it's always in the backdrop, it's always in the background. It's part of our foundation. And then that translates or transfers or overlaps, if you will, over to this methylation pillar. And why I incorporated that was going back many years. And you're probably familiar with the seminal paper by Dr. Jill James on methylation impairment and oxidative stress. And what they found in that paper, what they found essentially, when looking at different biomarkers, was the kids with autism tended to have certain biomarkers that are linked to their methylation folate cycle that were imbalanced. That basically showed that there was an impairment in these biochemical systems that could be contributing factors to some of their problems. Again, that could be eye contact, that could be awareness, that could be behavior, et cetera. And they also had a lot of oxidative stress. So what do these terms mean? Right? What, what is methylation? What is oxidative stress? We throw these words around, but, you know, sometimes we don't define what they are. And the process of methylation is a fundamental chemical reaction in our body. A methyl group is a carbon with three hydrogens, and that methyl group is linked to a lot of different chemicals in our body. And our body methylates by attaching or transferring a methyl group or 2 or 3, depending on the reaction, to have some sort of influence on downstream effects. So for an example, we will methylate certain nucleotides in our DNA to try to turn off DNA's potential for being transcribed. So it has a regulatory influence on what could be transcribed and what cannot be transcribed from a genetic level. We don't want our DNA constantly available to constantly be copied and replicated. So we have to have some regulatory control, and that's what methylation does within the DNA genome. Methylation also can turn on certain neurotransmitters and turn off other chemicals. So it acts like a light switch, so to speak. Turn things on, turn things off. So it has a regulatory influence. And what's happening and what has been shown in autism is that there are certain points within this methylation cycle, certain key steps that are either being negatively influenced because of genetic variance from, for example, like you mentioned, mthfr, there's another enzyme, methionine synthase, or the methylation system is being impacted negatively by outside influences. It could be environmental chemicals or are negatively impacting the function of the methylation cycle. Maybe we have certain nutritional deficiencies, like we mentioned before, certain B vitamin deficiencies can negatively impact the methylation cycle. And these systems don't work in isolation. Right. They're fundamental to how our cells, how our energy systems, how our brain, nervous system, how our immune system functions. And when Jill James discovered that there was measurable things that are often out of balance in autism, it gave great insight into why some of the early treatments of B6 or. Or vitamin B12 or folic acid, for example, was actually having some positive influence. Because if you follow the biochemistry, you go, oh, aha. That's why it's working. Okay. It's kind of helping to work in this particular area. And it's a fundamental aspect of what's happening in autism. It's not unique to autism. In fact, methylation impairment is something that's seen in Alzheimer's disease, is seen in certain neurodegenerative conditions, it's seen in certain mental health conditions. Methylation impairment can impact cardiovascular health and other metabolic influences too. It just has such a fundamental importance in the autism world that it's one of those things that we have to pay attention to. And fortunately, we have some really great interventions to try to positively influence it. But again, it's not separate from everything we've been talking about, because if our diet is lousy, okay, that can negatively affect the methylation cycle. If we're not getting foundational nutrients, well, the methylation cycle works off of many of these foundational nutrients. So again, when I come back and talk about foundational nutrients, try to fill in those gaps. Nutritionally, you're almost automatically providing some support for this particular system. If we have gut infections, if we have fungal infections, Candida, for example. Candida produces a certain chemical that's known to inhibit the methylation cycle. If we're being exposed to organophosphates, being exposed to glyphosate, being exposed to heavy metals, et cetera, none of us can get away from these things 100%. But they too can have a negative influence. So the whole point is to try to provide as much support along the way so that when you step in and you're starting to do more targeted treatment for methylation impairment, you have a potential of having a greater influence. And I'll stop there. If you have any response, we can expand on that. I know it's a lot, Len, if you have any comments, but. And I could talk a little about what oxidative stress is and how the methylation cycle is connected to the folate cycle and where that even plays in today with the discussion of Leukovorin. Yeah, this is a really important thing for people to understand.
- [49:53]
B
Let's complete the loop with oxidative stress. And again, I think a couple weeks ago when this episode comes out, in prior weeks, I've had John Slattery and Dr. John Gitanis from Meadowhealth, and I know they're focusing on, especially, at least initially, ensuring that for people who want to go down the Leucavoran road, especially road, especially if it's a fit for their child, like, if that's a key root cause, then they're trying to make it easier. And I know you've been involved with them in terms of making it easier for parents to access something like the organic acids test. So if you could talk a little bit about that. And yeah, let's complete the loop on the key part of oxidative stress.
- [50:31]
A
I look at these things. If you look at, like, the biochemical charts for these things, the images, you think of a wheel, right? So the methylation cycle is a wheel. Our folate cycle is as a. As a wheel, and they overlap. They connect. Okay. And so they have. They have a relationship. They communicate with each other, they support each other, and then one other thing that's attached to it. There's multiple but the other one is this thing of glutathione production. And glutathione is a very important antioxidant chemical in our body. It has. Plays a fundamental role in our liver for detoxification purposes. It acts as an antioxidant in many of our cells to protect our cells against oxidative stress. Oxidative stress is essentially just some type of an oxygen compound that gets reactive. It wants to grab onto electrons to sort of stabilize itself and make itself happy. And so think of it like causing rust, okay? The oxidation. If you scrape off the metal on your old bumper, it rusts, basically an oxidative reaction, just cause rust in the body. But too much oxidation, too much oxidative stress is. Is. It interferes with the fundamental, you know, sequencing of this biochemistry. So again, the methylation cycle, supports the glutathione cycle, supports the folate cycle. You had mentioned mthfr, and that's a very important enzyme, actually. And what MTHFR does is it helps to make a certain form of folate called L methylfolate and. Or some people call it active folate, but we'll call it active folate for now. What that form of folate does is it assists in the methylation cycle. It helps to convert. Convert something called homocysteine into methionine. And that is really fundamental to get the methylation cycle to spin and to become functional. And MTHFR is actually dependent on the presence of riboflavin, so vitamin B2. So if we have a riboflavin deficiency because we've had a faulty diet for many years, that MTHFR is not going to work that great. Add on top of it, a lot of the autistic kids have genetic variants in their MTHFR that just decrease the function of it anywhere between probably 30 to 40 to 60%. So add on top of that the genetic influence and a lack of B2, now all of a sudden, your function of MTHFR becomes even more compromised. There's an enzyme that actually connects the methylation cycle in the folate cycle called methionine synthase. And basically, people just need to think of that as like, it's an enzymatic bridge. It's a connecting point between those two cycles. And why that's important is that particular enzyme is very vulnerable to poisons, chemicals, metals, alcohol, acetaldehyde, which we actually can form through alcohol. Candida produces acetaldehyde, aluminum, mercury, lead. All of these things can negatively impact the methionine synthase. And it Shuts it down, and it basically greatly impacts the spinning of that methylation cycle. If we're lacking in glutathione, if we're lacking in antioxidants, well, that negatively impacts that methionine synthase as well. And so this is why it comes back to starting to understand about our environment. If we're being exposed to a lot of chemicals that we don't, can't detoxify, can't neutralize, if we're eating a lousy diet, we're not getting the nutrition, we've got a lot of gut toxins, all of that stuff can converge at that critical point, that connecting point between the methylation and the folate cycle. And one of the fundamental treatments that has been around for years has tended to kind of gotten forgotten about a little bit is methyl B12 or methylcobalamin, specifically in the subcutaneous injection form. The methylcobalamin, the injection form really still is sort of the gold standard for methylcobalamin therapy. The father of methylcobalamin therapy, at least in my view, was Dr. James Neubrander, who, semi retired, probably overseen 100,000 different injections throughout his career. And it's one of those fundamental interventions in autism that oftentimes really moves the needle as far as eye contact, communication, awareness, improvements in sleep, improvements in academic performance, sometimes a generation of language. And it greatly complements the influence of folinic acid or leucovorin as well. They often complement each other. So it's a wonderful treatment. And the reason I say it's often overlooked is because, again, like a lot of things, as time goes on, people are focusing on the latest and greatest and often forgetting about where we came from. And that there have been these innovative treatments that have been well established years ago, but, you know, they're not necessarily the new sexy thing, but they're fundamental.
- [55:55]
B
They're also not very easy. Much easier to give a supplement, an MB12 supplement, than an injection. I didn't enjoy doing that at all and didn't stick with it for very long because of that. But again, if there's efficacy, if it's a better. And I know the form of MB12 is important, let alone the delivery method, but again, that's where across all these actions, there's going to be some inconvenient actions, which if you're going to take those actions, just being really clear on how it fits in, why you're doing it. I know that sounds so obvious, but there were so many things I was adding to my son's smoothie. I had no clue why I was doing it. And so again, just greater clarity with what you're doing and how it fits in. That's the key. And these four pillars, as you very eloquently described, they're all super important, they're all interrelated. And again, you don't have to throw the book at everything in these four spaces. It's just discerning what are the most powerful actions you can take for your child to ensure that they're all addressed in some way.
- [56:55]
A
You know, it's interesting about the methyl B12, the sub Q injections. And you're right, it can be challenging in some kids. But over the years I've actually had kids where it was the parents preference to do that because they had more struggle in trying to get them to take oral supplements. You have to become that detective for your child and what it's going to, you know, be most suitable for them. Your family dynamics, the consistency over time. What I can say with regards to the methyl B12 in the subcutaneous injection is my experience. Even still today, it's, I still view it as sort of the gold standard way of doing methyl B12. That's not to diminish that other forms can't be effective because they can't. You, whether it's a nasal spray, whether it's a, a sublingual drops of methyl B12, they all can be helpful. We're always trying to look for the thing that maybe has the greatest percentage of being most impactful. And again, you kind of work the percentages. You know, 70, 80% of the kids do really well with methyl B12 injections. But we have to have different options. We can't just be solely reliant on one form because to your point, like with, with your family and your son, it wasn't something you do consistently and that's okay. It's just being honest about it and say, okay, what else do we have?
- [58:16]
B
No doubt, no doubt. Well, hey, I thought this is, this has been a dynamite, expansive conversation. I mean, these four pillars are so important. I really appreciate this discussion. Is there anything as you're thinking about a parent who's listening, is there anything that you think would just be really helpful for them to like more deeply understand or a mistake to avoid? I mean, you've worked with so many families. Anything else that you'd like to share that you think could be helpful?
- [58:41]
A
So I have a website called Autism Recovery System. It used to be called Autism Action Plan, but that website is A membership website so people can join that website. And my people from all over the world who are part of that website, they can post questions to me if they like. But as part of that website is a course and it's called Autism Biomed Essentials. It's a six module course that goes through these four pillars and you know, good in good detail and what we've been discussing here, the importance of it and then it starts to expand into other areas as well. So it's a good foundational educational platform for parents who are still kind of grasping some of this that is accessible through that website. And they can always reach out to me with questions as well. The other thing is for parents to, you know, attend some conferences to become more familiar. So we've got the Autism Health Conference in, in San Diego every year. There's also Maps. So you know, the medical academy, Pediatric special needs, they're adding a parent component depending on where you are in the country. And you probably have other resources to lend that, you know, as far as some other conferences and I do a ton. I mean I have so many videos and things I've created over the years that are just available online through YouTube or Vimeo. You can just type in my name. I've created a lot of, lot of material out there. And the biggest thing I want for parents to understand that there is help and there is hope and there is so much you can do to help your child and even beyond just biomedical intervention. I think that the Spellers documentary was, I think is really important to look at. I just read another book recently, you know, on the Speller's method and there's other methods out there, but just to understand, to keep educating yourself, keep learning, keep asking questions, interact, you know, reach out to parents such as yourself, reach out to other parents who had maybe more experience or insight. But to be hopeful that there is so much you can do to help your loved one with autism. I just feel honored to be part of that process and have been involved for the past 30 years.
- [60:56]
B
That's great. And yeah, everything that you mentioned we'll include in the show notes all those links to the course that you mentioned. And yes, conferences are a great way for parents to learn. I'll include links for those as well. Documenting Hope also is having a conference this year in November, so. So yeah, no, Dr. Kurt, this has been fantastic and really appreciate you taking this amount of time to really go deep on these concepts. They are truly foundational and I really appreciate you sharing your perspective.
- [61:24]
A
I appreciate being here. Thanks so much.
- [61:26]
B
Your child needs you. Running on all cylinders now and the fastest way to rise is with personalized one on one support. Get started today go to elevate how you now navigate dot com.