A (10:31)
Well, that's so true. And in the old days, if you wanted to make the diagnosis that leucovorin would be helpful is you'd have to do a spinal tap to see if they have a cerebral folate deficiency or do the antibodies testing for it, or just write the prescription, give it a try and see if the kid gets better. It is just vitamin B, as in Bravo 9. And I saw, and I have patients just like, I'm sure you've been hearing questions. Oh, well, we want, we want that 50 milligrams of. And it's like, whoa, that's a huge dose. We don't start. And it's like when they talk about that, are they talking about a 2 year old? Are they talking about 5 year old? Notice they never mention ages or weights when they talk about when people go, we're using 80 milligrams a day. How big is your kid? That's a lot. So I think one of the things that we have to understand is I always start with a small dose and work my way up, dial in the dose for that particular child. More is not necessarily better. So I have kids where if I started them, say at 20 milligrams of something, and since we're talking about Lucavor, we could just use that. But If I start 20 milligrams of something and the kid gets irritable and cranky and mom says, I'm never using that again, throws it away. Oh, I may have started too high. Maybe we should start at a lower dose. Nope, nope. Dad says, no more of that stuff. So I missed the window. So there's what we call a therapeutic window. And for example, a glass or two of wine is wonderful, but a bottle is too much. There is a window of something that really works well. Okay. And you have to find that. And sometimes a lot of time what I do is I creep into that window because one child's window is here and another child's here. But if I started here, that's way too much. Okay, So I start low and I titrate or dial in the dose for that child moving up relatively quickly. But I don't want to blow them out of the water because these kids will become irritable, they'll have problems sleeping, they'll start screaming, they'll start stimming more because I'm overstimulating the brain with something in this case like leucovorin. So in fact, I had that this week as your listeners probably can imagine. Oh, well, we want 50 milligrams of such and such. I said, no, you're wrong, doctor, we don't do that here. We'll start with 15 or 10 and work our way up and say I'll make it there, but give me some credit here. But you have a very well informed, very intelligent audience right now. So I know they've heard about this. So from what they've heard already, I know they've heard gluten free, dairy free. So I'm going to assume in our base model, if you will, our base child, who comes in a four year old with autism, who's stimming, walking on their toes, not sleeping great. And we are already gluten free, dairy free. But we're constipated. So I'm going to put them on something to help them move their stools. Now we'll step into some controversial areas, but we're going to talk about it anyway. If the child is super picky, I mean, can smell a molecule off, I'll use Miralax, colorless, odorless and tasteless. And I can hear the people going, oh, but you know, it's just fraught with all these dangers and it's poison, it's polyethylene glycol and stuff. And I'll sit there and say, okay, great, you sit in this chair and tell this set of parents what to give this kid who won't take anything and is constipated up to his eyeballs. Because everything else for constipation has a taste profile and they taste this stuff, they smell this stuff and obviously if they see you put something in their drink, it's over. Okay, so we have to work now. I have kids. Oh, he'll take anything, he'll take anything. Oh, then I'll use a magnesium product or something like that. But they they have some funky flavors to it. Oh, but he takes everything. He doesn't care. Then I'll use the more natural things that I can. He won't eat anything but chocolate. That's all he eats. Doctors chocolate. Well, I'll use chocolate flavored excise. Oh, but you'll become addicted to it or whatever. The kid's going to end up in the hospital and have an emergency decompression of his bowels if he doesn't move his poop. And you're worried about what? So I have to work with the individual temperaments of the parents too. Temperaments of the child. And from that, pick what I need from my tool chest to help that child immediately. Then we can get the child to be more flexible and be more apt to take other. Oh, he's now doing smoothies. Wonderful. I can hide anything in a smoothie, but I'll tell you stuff. I can hide things in Coca Cola. He just drinks soda. Now the doctor captain will say, oh, he should not drink soda. It's got high fructose corn syrup, it's got this and then it's sugar load. He should never have that. On the other hand, it may be the only way I can get supplements into him or the game's over, it's a no go. Because I know there's people out there. We can put them on their skin and they'll go into transdermally. I haven't seen that. I haven't seen the improvement because I'm a clinical physician, which means that if I do something, I expect to see results. For example, child's not sleeping, I give melatonin. What do I want to hear? The next day I email the office, he slept great. He did not sleep great. Then I'll increase the dose. So when I do things for language, when I do things for constipation, when I do things for hyperactivity, when I. There are certain things I do, like vitamin D. Everybody in your group knows now vitamin D is so important, but nobody ever calls me up and thanks me because I put their kid on vitamin D and he's so much better. It works behind the scenes. Great for health, great for mood, great for a lot of things. But behaviors from autism, not going to help. Okay, so that's the approach. So I've got this little guy, he's gluten free, dairy free, he's constipated, he is not picky. I'll use magnesium citrate. It comes usually in a green or white bottle at the pharmacy. And I'LL have to of course, come up with the right dose for the age. So I can't unfortunately give to your audience the doses Dr. Jury uses because obviously it's going to be different for a 2 year old than it'll be for a 12 year old. I have kids who have this functional. They just can't move their bowels. They can't move their bowels at all. And it's a real problem for them. And we have to figure that out. Sometimes we have to send them to the gastroenterologist for biopsies to see if the nerve plexus of the colon are intact or not. It's called Hirschsprung's disease. So there are different various degrees of how involved I have to get. Sometimes I just put them on a little bit of Miralax and they're moving their bowels every day. They clean themselves out, they fill the toilet and oh, Doc, he's so much calmer and he's not aggressive, he's not violent, he's just beautiful. And there was a stool issue problem with stool accumulating in the bowels. And I know that your listeners have heard this. I'm just going to remind them they tend to grow bacteria and yeast and those affect behaviors targeted again. So I would love to use caprylic acid, garlic, oregano to help mitigate the growth of these bad bacteria and or yeast. Problem is, who wants to take a teaspoon of oregano and put it into apple juice? They won't drink it. They can swallow a capsule. That's a different story. But they won't. So now I have to use a real medication. And again, we try not to, but the kids limit us. They love yummy. Ibuprofen, Motrin, never Tylenol. But to take them to take curcumin, which is an anti inflammatory, that's a tough sell in any drink or beverage. So we gotta be mindful when we talk about supplements and not to have your parents pull their hair out because the kid won't take it. He won't take it. He won't take it. And you can disguise it, but you know that's the first thing I do. What does your child drink? He drinks only water. Oh boy, I'm in trouble. And will he drink any water? Oh no, it has to be Fuji water. If I try and use any other water, he will not drink it. She goes, I even take the other water and put it in a Fuji bottle. He knows he won't drink it. That's going to Be a tough one for me. Okay. Because he's a great counterfeit to detecting. In other words, some of these kids have a hyper smell. They can smell things, they can hear things. Some kids, they taste stuff. And man, you can discern the difference between Dasani water and Fuji water and reject one. My parents out there say, well, I can taste the difference between Dasani and Fuji. Yeah, but would you not drink it? No.