A (3:22)

Let's start by the fact that pediatricians in general consider vitamins as an important add on, as they should, but they don't really differentiate any more than just these are the vitamins, and this is what the government has said they should be. And here is a multivitamin, pretty much that's actually a very weak way or poor way to go about it because, number one, we have to absorb the vitamins. And if things are happening in the gut, and I'll get back to that in a second, they might not be absorbed. Number two, all vitamins enter various, we call them pathways, ways into which they participate to help the body and the brain. But these processes most of the time require what they call enzymes, specialized proteins that do various tasks. And those enzymes may or may not be working properly. And as we all know, proteins are made from genes, and the genes might be silent, and if the genes even are not silent, the proteins might be made, might be malfunctioning. So we have to think of that. And then how does actually any vitamin get into the brain cells or the cells where it will actually participate? We don't talk about that either. And in most cases, these vitamins have to be acted upon by enzymes that require other molecules to be able to do their function. In other words, to create the active function form of the vitamins. So in the case of folic acid, about which we will discuss a lot, first of all, you have to get it from somewhere. It's available, of course, in nature, in green plants, et cetera, or at least in the United States, it is fortified in various foods, cereals, et cetera. Now, in nature, folic acid exists as folate. Even though folate and folic acid are actually interchangeable, the folic acid available for fortification or in vitamins is somewhat changed to make it more stable so that it might stay for a long time and people can get it off the shelf, you know, in a drugstore or wherever. But both folate from nature and folic acid in the synthetic form required to bind on the surface of cells, especially the brain cells, on specialized areas called receptors. And once they bind, then they can get inside. It's like a lock in a key. So the folate is the key, has to bind to the folate receptor and lock it again inside. Well, what has not been known and continues not to be known widely, is about 40% of children have antibodies, meaning proteins that our body made. And we usually think of the antibodies as the good guys. We have antibodies to fight disease. Well, in many cases the antibodies are not the good guys. And I'll give you an example unrelated to autism. But if those antibodies exist, they basically block the receptor. So folic acid, folate cannot just get in, period. So no matter how much you take, so it's not going to get in. And luckily there is a test called flat test, folate receptor autoantibody test, and it's available in many countries. And they will tell you if you've got antibodies, because if you've got antibodies taking folic acid or folate from green plants or whatever, it's useless. It's just not going to get inside. So let's say they got inside and then we'll talk about how to bypass the problem that has to be acted upon by a series of enzymes, the final enzyme of which is called mthfr. And as most genes, you have two alleles, so you have one good and one bad, or two goods or two bads. So we call them homozygous if it's two beds, heterozygous if you got two bads or one bad. So in that instance, the enzyme is kind of struggling to make active form of folic acid, which is called methylfolate, or sometimes L5MTHF, we call it. Why? Well, first of all, because it just doesn't work properly. It's like having a wagon with four wheels and two wheels are rusted, so the wagon just doesn't move. But there's an additional problem that in order to make the active form, you have to add groups that are called methyl groups to folic acid. So you're methylating the folic acid. But in many cases, again, as many as 30% of the people don't get enough folate with the methyl groups. Why? Because they're just not enough methyl groups. So you have a good enzyme that doesn't have what we call the substrate methyl to methyl groups to Methylate, and then you can have a beta enzyme that doesn't have the methyl groups, which makes it even worse. So in that case, we have to provide methyl groups and we'll talk about what are the such sources of methyl groups. And about 30 to 40% of the children have polymorphisms or mutations on the MTHFR enzyme. So they cannot actually produce the methyl, which is the active form. So the worsen.

C (9:01)

It's a double whammy when you say 30 to 40% of the children. So when it comes to MTHFR. Right. Which has at least been pretty widely studied, and it's one that, if anybody knows anything about, you know, potential issues, you know, people have probably heard of mthfr, and that's very relevant in my family. Right. I have the double mutation. My son has the single. But so what you're saying, though, is that in general, in the population, 30 to 40% of kids have at least one mutation, like hetero.

A (9:31)

That's correct.

C (9:33)

And that's for MTHFR, whether it's the A1298C or the C1677, that basically there's a mutation which, particularly if you're of Mediterranean descent, very common. Correct.

A (9:45)

Yeah. The C seems to be more involved than the A, but it depends on the publications, so it's hard to know. I just take it that any mutation is bad. I've got to bypass it somehow because I just don't know what is happening in any particular body.

C (10:02)

So 30 to 40% of kids may have an issue in this area with this particular.

A (10:08)

Correct, correct.

C (10:09)

But then separately, you started off talking about the frat test, and we're separately. People may have this antibody that. So really, there's these two kind of ways that we might be set up, and some people may have both. Right. That makes it a much bigger area

A (10:26)

if you have both. And that's where my colleague, Dr. Fry and his colleagues have published a lot. You have what we call global folate deficiency or global cerebral folate deficiency, then you really have a deficiency which might manifest in different ways. I mean, there are individuals who are not necessarily on the spectrum that do have folate deficiency, and they might have a lot of neurological problems, but not all fit into the category of the symptoms that are related with autism. So keeping your brain healthy is absolutely mandatory whether you've been diagnosed with a problem or not. For instance, as we have been identifying many cases of chronic Covid or long Covid individuals, they notoriously have brain fog. And when we started searching for either the antibodies or the mutations on the mthfr, it appears that many of them have the mutations as well. So it appears that a subgroup of the long COVID patients might be worse because they have mutations that no one actually identified. And they didn't have any problem before, except maybe they were not really multitasking, maybe they were not as fast as others. And now basically you hit the tip of the iceberg and you start searching as to why. So going back to the children of the spectrum, first of all, we use terms like precision medicine or personalized medicine, but really don't look for the problems. So three things that we have to absolutely look for before we start talking about how to actually help is number one, are they absorbing well? So if they have either full blown gluten enteropathy or if they have actually leaky gut syndrome, those individuals are just not absorbing properly. And if their bacteria in the gut are not functioning properly, or there's a mismatch between the good and the bad bacteria, then that would not allow them to absorb the vitamins very well, including the methyl groups that are required to eventually methylate and produce the active form. So first mandatory, I've got to know what's happening with the gut. And what I usually ask for is a stool analysis. Not for parasites, which of course anybody can do and we should be doing if there's a problem. But we look for secretory IgA, immunoglobulin A, because if there's a problem with the gut inflammation that if it is high it would be protective, if it is low it would be a problem. We look for total histamine that histamine might produce in the gut, which might indicate there's an allergic reaction in the gut. We look for calprotectin, a molecule that indicates inflammation of the gut, and eosinophilic cationic protein or eosinophilic neurotoxin A, which both of those are released from eosinophils cells in our blood, usually associated with allergic reactions, but also associated with parasites and inflammation, et cetera. That will tell me if I have to address the gut before I try to even help with increased amounts of folic acid. So then we have to do the gene analysis for the MTHFR to know if in fact there are polymorphisms and do the frat test as well. Now you can bypass all of that in a second, we'll explain that. But at least you have to know the results because the results will dictate how quote, unquote, aggressive we can be to intervene. I don't want to use the word treatment because this is not really treatment. We're just helping the body recovery. If you. So the first thing that my colleagues would do for good reason, is to use methyl folate or 5mThF, because that's the active form of folate produced inside the cells. What is not known is that when it's produced, of course, in the cells, it's inside the cells or it will act. But when we give it exogenously, how is it going to get inside the cells? Well, it still needs to bind to the receptors. So you've got antibodies against the receptors. Even the active form is not going to get in, so it's useless. And that is not being discussed at all. And most of my colleagues say, well, we'll give you methylfolate, I hope for the best. Well, how much methylfolate are you going to give if the antibodies are blocking?

C (15:09)

Right, because you could quadruple the dosage and it still won't matter. Right?

A (15:12)

Still not going to work. And the worry there is that in cases where you have antibodies, we tend to recommend as much as 50 milligrams a day, 5, 0. But when you start reaching those levels, children become very hyperactive, at least in my book. So I've always been a proponent of starting low and slowly increasing as tolerated. And if we have the results, then of course, we can tailor it to the results. So what do we do if we cannot use the methylfolate, Someone has, let's say, the antibodies. So then we look at what is called folinic acid, not folic acid. Folinic acid, it's a natural form, different than folic acid, but it's got two benefits. One does not need the receptors to get inside the cells. It's taken up by a pump. And it does not eat the enzyme MTHFR either. It bypasses by going through a different pathway. Now, is it as effective as if the methylfolate were to get in? No. But if the methylfolate cannot get in, then we're stuck. Therefore, giving the folinic acid is very useful. And of course, if we knew the problem, then we'll actually give much more folinic acid. Now, there are different terms for folinic acid that are very confusing. So folinic acid, of course, is what it is. But when we make a product for the market, to keep it a little more stable, we make a salt of it, and therefore it is calcium folinate. So calcium folinate is folinic Acid with a little calcium added to it to make it a little more stable. Same thing. So both I and other colleagues and my good friend Richard Fry have been using calcium folignate for 20 years. This is not new. Until, of course, it was picked up by TikTok and then it was picked up by the secretary of health and others. And for some reason, they mentioned only leucovorine, which is a trade name for calcium folinate, Nothing more than that. Now, why they didn't say calcium folinate and they said leucovorin, I don't understand it because it's exactly the same thing. One is generic for the trade name. Now, when we usually say, take calcium folinate, and especially if you were to say, take leucovorin, and leucovorin is prescription because it comes at higher levels. So calcium folinate or folinic acid is available at less than 1 milligram, and we usually say micrograms. So it might be 400 micrograms, 500 micrograms, half a milligram. With prescription, either the generic form of calcium folignate or leucovorin comes as 5, 10, and 15 milligrams. Now, if you go with a prescription to an unsuspecting pharmacy, especially a local pharmacy, they might talk to someone, they'll say, do you have cancer? Do you have psoriasis? Why do you need that? And therefore, I have to remind everybody that a drug that we give for psoriatic arthritis, for sometimes lymphomas, is actually a drug called methotrexate. And methotrexate basically blocks the body from producing active folate because the cells need folate to multiply. Cancer cells multiply a lot. So one way to keep the cancer cells from multiplying is to deprive them from folate. But you cannot do this forever. And this is why we give, as an antidote once a week, calcium fulinator, leucovorin. So that's why a pharmacist might be confused. Why do you need leucovorin? We only use it as an antidote for cancer. So for anybody who's listening, don't worry if they don't understand it. That's what they've been taught, basically, in medicine. The other confusing issue that might come up is a physician might say, well, why do you need that? We only give it to reduce hormone homocysteine. What is that? Well, homocysteine is an independent risk factor for myocardial infarction, and the body needs folic acid to change the bad homocysteine to the inactive cysteine. And if you have polymorphisms like yourself, you should be watching out because the homocysteine level might be high and you don't want it to be high. Therefore, we would use leucovorin to make sure that we change the bad homocysteine to cysteine. So again, a family might hear, well, what's wrong with your heart? Why do you need leukovorin? So we just have to be cognizant and don't get scared. And all of a sudden one might have cancer or might have a heart problem, because that's what most physicians actually know. So going back, if we're going to shoot from the hip, I would say let's start with a little calcium folinate or folic acid, folignic acid, leucovorin, whatever. But make sure that we know we absorb properly. The MTHFR enzymes are not actually mutated and we don't have antibodies. If we have the others, then we absolutely have to go folinic acid or calcium folinate. So you might ask, well, should I be using both folinic acid and methylfolate? Well, nothing is absolute in medicine, and even if we have antibodies, that doesn't mean to say that all receptors are blocked. So in my book, it's safer to give both calcium folinate and methylfolate to make sure that we actually provide the brain with enough support, whatever the problem might be. And. And that's where the company Algonod made actually a product called vital folinic that has both calcium folinate and methylfolate in liquid form. So you can easily titrate it, depending how people are tolerant to it. So one drop contains about half a milligram of each, and then you can kind of keep on going, however many drops. And the good part of having anything in liquid is if you put it under the tongue, it becomes sublingual and it gets absorbed almost 100%. Otherwise, if it go through the stomach, the acid in the stomach is likely to basically destroy it, which is a problem with any vitamin or supplement that unless it is enteric coated, much of it will be destroyed through one passage in the stomach. And again, they don't tell us that. And we keep on increasing the doses to try to overcome that problem. Got it?

C (22:20)

No, I appreciate that expansive description and I think the delivery method is key. Right. Because sometimes, especially with these kids, if they have a gut that's imbalanced and you're Putting something in there. Then again, the odds of it doing what it's meant to do, which is why if it's more liposomal or something that's more direct on the tongue could be much more effective. But everything that you're painting, by the way, maybe it makes sense right now to talk about the fact that you are primarily a scientist, right? You're not a pediatrician, a functional medicine doctor. But you mentioned about the research you've done with Dr. Richard Fry, who is quite in demand now. So I think everything you're painting in terms of these options for a parent, yes, you can try to piece it together, but it just underscores the importance of find a practitioner who does have a perspective and experience in this space. Because it's never as simple as, oh, this is something that might be helpful. Let's just, you know, give it to your child and see what happens.

A (23:19)

You made a very important point and let me expand on it if you wish. So for many years I was just doing research because I love research and because I always felt that through the findings of good research, we can help more people than we can do individually as physicians. However, there have been so many cases of complicated patients, complex problems, not necessarily in children, that it became almost impossible for individual physicians in different specialties to address them. Because medicine has moved towards super specialties. And unless specialists talk to each other, which hardly ever happens, patients go from one place to another. And by the time we see them, they've gone through 10, 20 physicians with as many potential interventions, many of which might not even, you know, be, be proper because they interact with each other. What do I mean to say by that? So I basically reactivated my license and I do see patients in Florida now after 30 years of having done it, because the demand is so high. So I'm not necessarily asking for more patients to see, but every third month, I apologize. Every third week of each month, at the clinic of the so called neuroimmune Medicine Clinic at Nova Southeastern University at Davie, Florida, I see patients on Tuesdays and Wednesdays with two wonderful nurse practitioners who themselves have a doctorate in integrative medicine. So the best comments we've gotten is that we listen. And that's what it is. You've got. We spent about an hour listening about all the issues, how they developed, et cetera. Then we talk about what labs might be required, and then we talk about intervention, because nothing really helps everybody the same way. And of course, the same is true with children. So I cannot physically see children myself because I'M not a pediatrician, but there are a few very good pediatricians that I would refer the children to, and we think the same way. So we bypass that problem. Now we actually started seeing teenager through the Department of Pediatrics, and I will kind of jump in as a consult, especially if it relates to also allergic like problems and things of that sort, which very often occur in children on the spectrum anyhow. And as you may know, in fact, I shouldn't say may know. I'm sure you know, many of the providers for children on the spectrum are not even pediatricians themselves. Some are family medicine, some are internal medicine, like I am. Some might be neurologists. The bottom line is you have to want to help and be willing to read and be up to date. And unfortunately, for many families, the only approach is take a little Abilify, take a little Risperdal and hope for the best. And we just don't search for anything more than that. And we should.

C (26:45)

Parents search out the right resources. Right. And you're right, it's not necessarily only pediatricians, although that's clearly where most parents are going to start.

A (26:53)

Of course, and they should. Except that we've heard so many times families will go to pediatrician, the child is three and a half having issues, and they'll say, oh, it's a boy, wait another year. That's kind of the typical answer that I've heard for so many families. And it shouldn't be that way. We should be much more cognizant of the fact that might be issues. On the other hand, we get a different set of questions, such as the one that I'm struggling with with one particular family. They've heard that stress during pregnancy might increase the risk, that, you know, allergies and autoimmune diseases may increase the risk. So the question is, you know, how do I deal with all of these issues to make sure that my child might not have a higher risk for developing autism? Well, obstetricians don't really discuss these issues because it's not in their domain. Allergies don't know what to do because they don't deal with such issues during pregnancy. Many of the drugs are rated by the government as safe or not safe during pregnancy, but no one knows anything about the vitamins or supplements. So there's a lot of a gray area where we could help people if we just paid more attention and did the appropriate studies, so to speak.

C (28:15)

Right, right. No, that makes sense. I'm delighted to know that you're actually providing consults now. So that's great. I'll include all the links in the show notes.

A (28:25)

Unfortunately, we cannot do it with telemedicine unless we have seen someone physically first.

C (28:31)

That was my next question. I know certain states have certain rules like that.

A (28:35)

Right, Right.

C (28:36)

So you could do consults, but in order to do that, you either need to live in the state or you need to travel for that first time.

A (28:43)

It is for the first time, yes. Now, I've identified some colleagues in various other states where they have actually licensed to do telemedicine in many other states, but they're mostly allergists. They're not in the domain that we are actually dealing with. So I still have not found receptive. Let's pull it. Colleagues who would be willing to dwell into this because, you know, it's complicated, it's time consuming, there are no good answers, there are no good treatments. So you're always walking on eggshells in terms of what you can do and what you should not do, how often you should be talking to someone, kind of, et cetera. But we need to. We need to.

C (29:27)

No, it's such a big piece of the puzzle is finding the right people, if you're a parent, to put on the team to provide advice to help guide you in terms of what data does it make sense to collect and once you get that data, what to do about it, what to do with it.

A (29:42)

Right. And, you know, for better or worse, if you were to go to some of the sort of official sites, whatever that means, they indicate that, you know, 70% of autism is actually genetic. Well, that's not entirely correct, because if you really go deep into it, what it amounts to is that we're talking about genomics. Many genes might be more common in individuals with autism, but that doesn't mean that that gene caused autism. So, yes, there is some genetic, maybe predisposition or something. So that's why we talk more and more about epigenetics. Meaning, yes, we have the genes, and I probably have the genes myself, but in some individuals, these genes wake up and now they start causing problems. And that's where we are very interested and very active because I believe that environmental triggers, and I include stress as an environmental trigger, can actually participate to a very large extent. A study was published recently looking at mothers that had to actually move from one country to the other, whether they were seeking asylum or whatever reason. Just the stress of that was linked to higher chance of children have autistic traits. And we swim in stress, whether it's economic, political, personal, Social. We just don't deal with it. And the second that is very high in my mind is that about 80% of the children come hyperactive to begin with, regardless of the autistic traits. And as you know, hyperactivity is not part of the diagnosis of autism. Sensitivities are, but not hyperactivity. So we've got to figure out early on why a child is hyperactive, because the way we might address that could be very different, whether it's supplements or drugs or whatever. So the one thing, of course, that I do is request that in the gene analysis, we look for the genes that break down the neurotransmitters that are excitatory. So there would be epinephrine, norepinephrine, dopamine, you know, glutamine. If we don't break them down, that means they're high and they're going to actually put us into a flight or fight reaction, you know, all the time. If they're high, then we have ways of addressing them. But again, this is a different topic, you know, altogether.

C (32:26)

It's an important topic, though, because what you're alluding to, which is a constant theme on this show every week, it's about the idea that if you could focus more on what's at the root of what's going on with your child and address there. Right. As opposed to addressing the symptoms, so much more becomes possible.

A (32:43)

Absolutely, absolutely.

C (32:44)

And I think, I love that you brought up genetics, and that is the key concept. And really, simply put, right, we all have a genetic makeup. We may have a predisposition to certain. To being, let's say, hampered by certain stressors or toxins. And that's what we're talking about. There's a whole bunch of toxins out there that could be impacting you and your child.

A (33:06)

And.

C (33:07)

And while most people are familiar with, okay, chemicals, pesticides, heavy metals, electromagnetic fields, more so now mold, all these potential toxins, and what you're introducing is that stress itself can be a true toxin in our.

A (33:23)

Oh, my goodness. I'm writing an editorial for the New England Journal of Medicine these days. They might not accept it, but we always thought and taught that the mast cells involved in allergies mature at about two years of age. That's why if you go to an allergist, they're not going to do an allergy test because they say, well, the system is not mature enough yet. I'm going to see anything. Well, there are two papers published, one in Nature, the other in Science. Within the last year. Showing that the mast cells are actually mature in the developing fetus by the second trimester and they will respond to anything that the cross of the placenta. And that increases then the risk of a child being born with allergies, abdominal colicky pain and potentially autism, even though those publications were not talking about autism. So now we have to shift to much earlier as to when we should be paying attention before actually something develops or very early on neonatally so that we don't allow it to develop sort of, you know, full, full blown. And the one thing that has absolutely stunned me is a colleague of ours from, from Canada published many years ago that one, we call them short chain fatty acids. So propionic acid is made by bacteria in the gut. Here we induce propionic acid in the brain and mice will become literally, quote, unquote autistic. So we knew that from, I don't know, 50 years or so. And many other publications showed that propionic acid is neurotoxic. Now imagine someone who has a little leaky gut and the blood brain barrier is not working very well. So propionic acid now will get into the brain. They're going to have a problem. Well, what I didn't know that propionic acid is one of the most common preservatives in foods, drugs, supplements and cosmetics. So we're swallowing it every day. So if a child has a little leaky gut and a little, you know, blood brain barrier, you know, disruption, then we might be getting it from the food as well. But no one is linking that. So when I say environmental, I'm going way beyond just, you know, mold and heavy metals because we have all these others that we just don't pay attention to because someone said we're safe. Give you an example. A lot of people I hope are aware of glyphosate Roundup. So many studies have shown that Roundup is actually toxic to the brain. But many physicians and companies were relating back to a publication from 20 years ago that said glyphosate is safe. Well, two weeks ago the paper was retracted after 20 years. Okay, so there you go. Yet it's still available. So even though we're struggling to find connections, some connections are just looking us straight into our eyes. And yet we're not doing anything about it. I mean, technically a president can write an executive order and say that's it, no more Roundup and that's it. We'll be save. A lot of people believe me by just doing that. And so again, I'm not criticizing that the president has or has not done it. He's done a lot of other good things. I'm just saying some things are fairly simple. We know something is bad, just out with it. I remember when I was actually studying at Yale, as you know, both my MD and my PhD degree in pharmacology are from Yale. At that point, as, as you know, whenever we get an antihistamine, it will say antihistamine, then D. So Allegra D Zyrtec D. D stands for decongestant. Okay. Because it constricts the nasal blood vessels so you don't get runny nose, et cetera. So back then a paper was published out of Yale because then all the antihistamines had as a decongestant phenyl propanolamine. And the paper published, it was an epidemiological study and showed that only in women it was causing hemorrhagic stroke, so bleeding in the brain. Within one month it was taken off the market. So this is the kind of thing we need. It's causing problems. Here is the evidence. Out with it. And I'm sure there are other such. This is just an example I'm bringing up while we're struggling to make other connections which are much more difficult to prove. If you wish, sure.

C (38:03)

No, but you're 100% right. There's a lot that can be done where the evidence is there. And I have to be optimistic that if any administration might take action swiftly, given RFK Jr. In that role. There's a lot of reason for optimism. But there's a lot that is out there that is holding back. Forget about the diagnosis. There is a lot of stressors that are out there. There's a lot of interests that continue this more toxic soup that we're in. But again, with greater awareness. There's a lot that can be done. And again, it's because of curious people like you who keep trying to promote that greater enhanced awareness. Because again, once you're aware, there's so much that you can do to play better defense. And I know you just recently published a paper. Can you talk a little bit about where your science currently is focusing?

A (38:52)

Right, right. So I'll tell you about a paper and about what we're doing science wise. So the paper with two colleagues, but we'll probably have a different session about all of this. But I think it's an important paper because it addresses how small amounts of various toxins in the gut might have added an effect and eventually detrimental effect to the brain. So we don't have to be looking for a full blown infection or full blown leaky gut or whatever else might be going on. Because the mast cells exist in the gut and they're affected by small amounts of toxins and then they release molecules that travel to the brain and they open up the blood brain barrier. So now other toxic molecules from the gut can get into the brain. So it's important not just to be measuring, as we say, sometimes gut microbiota, because the number of organisms might still be the same. Some papers say they're about the same in autism, some papers maybe say some bad bacteria have raised their ugly head. You know, the literature is all over the place, but they don't measure what comes out of this bacteria because we might have, as I say about mast cell, you might have 100 mast cells and they're just quiet. You might have one mast cell that is behaving and still causing problems. Can we measure what is being released? That's why it's important to be measuring certain things in stool samples, because that is telling us what is happening right there in the gut. And as you know, we have some of the good bacteria are the bifidobacteria because they break down histamine. So I'm always a proponent of giving probiotics with bifidobacteria, for instance, to make sure that they balance out whatever else might be happening. Because the good bacteria make butyrate, and butyrate counterbalances propionic acid. So butyric acid counterbalances propionic acid. So there are ways to start healing the brain by starting the gut, for instance, but not by taking horrendous actions. Because I'm sure you've heard we're talking about transplant or micro biome, you know, from one person to the other to fix the gut, et cetera. Well, that has only worked basically in a contingency called C. Difficile colitis. It hasn't really worked in anything else. And as I said, the number of bacteria might still be the same. It's what causes them to actually be activated and release the molecules we shouldn't be having kind of in our gut. So coming back now to the folic acid, even though we absolutely need folic acid for brain cells, and as I'm sure all your listeners know, it was added to fortified foods because it had been associated lack of folic acid had been associated with spina bifida. It was the spinal cord was not closing properly. And I'm glad they discovered that and they're putting folic acid in. But there's been a number of families where I asked actually the mothers who were about to become pregnant if they have ever been tested for either antibodies to the receptor mthfr and said no one told us anything. That is a critical period because the mother needs the folic acid to take it to the child who is developing in the womb. So it's not important only to do the frat test and the MTHFR later, after the child was born. It should be done in the mother, because if the mother has antibodies and if the mother has MTHFR mutations, she will not be able to absorb the folic acid. Therefore, the growing fetus is not going to have the folic acid. In other words, if this is present, we should be giving calcium folinate to the pregnant mothers once we know if they have these problems. That's why I said we should shift the equation much earlier in life than after the children are born. Yep.

C (43:01)

Well, that's where we might be in an environment now where that's more likely to happen, where we look at what's happening, what might help these kids who have challenges now and take that and then work on prevention. And how do you actually take this knowledge and set up these future generations for the greater ability to thrive in what's going to likely be still a very toxic environment?

A (43:24)

I would urge every mother who's likely to get pregnant and who is pregnant to be tested both for the antibodies and the MTHFR mutations. And if they're present, my God, they should get either just folic acid or folic acid together with methylfolate, which is exactly what this vital folinic actually has.

C (43:46)

All right, great. Well, Dr. Theo, yes, we can continue, but we'll save it for. For another conversation in the future. And as always, I really appreciate you sharing your perspective. Is there one final message you'd like to just leave with our listeners, something that you think would be really useful for them to really keep top of mind?

A (44:03)

Well, number one, to keep on searching as they do. Number two, to absolutely request that their health providers do both the antibody and the MTHFR test. And number three, that adding calcium folinate and or with methylfolate is important, but probably most important than all is to know what to expect. Because the studies with methylfolate or calcium folinate were very significant with language development. They did not actually show that all the other aspects of autism necessarily improve as quickly as the language. So when someone or some people said leucovorin treats autism. I think it was such a bad way of presenting the evidence. It does not treat autism. It helps with language development, it helps to keep the brain healthy. But it would require much more understanding to make sure that we address or improve all the other symptoms associated with autism. And even though this is not a parting comment, a paper was published a few months ago in Nature Communications where they looked, I think out of Princeton University, where they looked at both the autistic traits and the makeup of the genome, and they separated autism in four different, somewhat different categories from what we knew until now. I'm not going to go into it now. We can go into it some other time. But it's a step forward in the sense that in the worst case scenario, there were more of one bundle of genes associated. So maybe. But that was only about 10% of the cases, or 15, maybe at the most. So for about 10, 15% of the cases, there seems to be some strong association between the presence of some genes or the altered gene makeup. But again, even though it's important because it starts doing such associations, I want to stress for those who might have heard about the paper or read the paper, there was only about 15% of those who are really severe that seem to make sense to be linked to certain particular genes. Okay, got it.

C (46:37)

No, thank you for sharing that. And again, I think that the whole conversation we've had has covered a lot of different aspects. And yes, it can be overwhelming, but at the same time, all this overwhelm and all this information ultimately leads to a clear understanding of what's happening potentially with your child. And again, where to aim. And if you can, absolutely, you can get to that point. There's lots of options, as you pointed out, some of them that might really help you not to treat any condition, but just to meet your child where they are, to get to the root of what is manifesting as these symptoms that we put a label on. And if you approach it that way, again, you can get better and better at aiming and focusing your energy in the most productive areas. So as always, Dr. Theo, what you have, what you've teed up, is extremely helpful. I appreciate it. And we'll look forward to having you on again down the road.

A (47:27)

Thank you, Len. Thank you. I congratulate you for all the work you do. And at some point, maybe you can bring a few people together, whether it's Uzna, Richard, myself, et cetera. We've got to kind of at least give a more concerted approach to the basics, not to the complicated cases. But we should all agree that here are some of the basics. You have nothing to lose. Let's at least get those done. Two, three tests, three, four things you can do. And then you can expand into other things. Because many times I see colleagues jumping into the extreme without having paid attention to the basics. That might take care of most of the problem, if not all of it.

C (48:16)

Yeah, that actually gets to the theme of the conversation I had last year with Dr. Richard Fry when he was on, which is it is about there's some foundational moves, some things to do early on.

A (48:25)

That's a good point. Foundational moves. That's a good one.

C (48:28)

I think everyone can kind of agree and I think that is slowly emerging. But again, for parents listening, yes, there's foundational work.

A (48:34)

I hope so.

C (48:35)

And data you can get again to maybe get to some of those more precise things you can do. But you can't ignore the importance of the guide as an example, as a key foundational area to focus on. And again, there's a few other power moves to make. But yeah, we'll look forward to continuing this dialogue down the road. And again, thank you so much, Dr. Thiel.

A (48:53)

Thank you, Len.

B (48:54)

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 elevatehowyounavigate.com

A (49:09)

Sam.