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UPDATE:  I would encourage all parents to read Book 3 and the paper I wrote on Redefining The Role Of Insulin:  Could It Play A Major Role In Metal Detoxification? especially (posted in full on my website)  for the critical issue of iron overload in these children.   Personally, I would NEVER give my child any supplement with iron.   Having researched these issues so much, I now consider iron almost as toxic as mercury in these children!   Read those critical papers and you'll know why (note:  "anemia" can be a sign of IRON OVERLOAD!).  There is also a great deal more provided on my website as far as "What I Would Have Done Differently, If Only I Had Known".   That link also addresses a lot of "dietary issues" parents need to be aware of... things I did not know at the time I wrote this section.

CHAPTER 11

Zachary’s Supplements

I read somewhere in my hours of research that it took three days for the body to eliminate casein (the dairy protein) and up to ten or eleven months to eliminate gluten from the body. It would actually be closer to twelve months before we saw the really huge improvements in Zachary.  This diet was going to be a challenge to say the least.

There were so many things that Zachary could no longer eat that I had to make a huge adjustment psychologically as to how I looked at nutrition.   The five food group thing was out.   Zachary could not eat most grains and those he could eat, he pretty well disliked all but one or two.   The same was true for fruits and vegetables.  He had never been big on them to start with and those he did like, he could not have due to the high phenol content.  So, my first problem was making sure he got all his necessary vitamins and minerals.   I found a company that specialized in dietary supplements (vitamins, minerals, etc.) for autistic children.   This company, Kirkman Labs, out of Wilsonville, Oregon, became my first tool in Zachary’s new diet.   All of their products were available without prescription and their salespeople were always willing to take the time to talk to you about the products.   From now on, Zachary would get his vitamins and minerals not from foods, but from supplements.   “Food” would only be a matter of calories from now on, calories to sustain activity each day.   It was very difficult psychologically to make this switch in how I looked at food…it was no longer a means of “nutrition” but rather just one of “caloric intake” to provide energy for the body.

Kirkman Labs was located in Wilsonville, Oregon (97070) and could be reached by phone at 800-245-8282 or 503-694-1600.   Their web site was at www.Kirkmanlabs.com.   According to their web site, Kirkman Labs has been in business since 1949.   Their web site states that they worked in conjunction with Dr. Rimland, the “father of autism research” in coming up with some of the supplements for autistic children.  Dr. Rimland had always stated he thought there was a biological link to autism.  If they had studied autism and done so much research on these products, I was not about to reinvent the wheel.  I was ready to try them.  This was the only company I had found that dealt specifically with producing nutritional supplements for children with autism or learning difficulties.

Why Kirkman Labs?

In researching autism, I found that gluten was sprayed on many things…including vitamins/supplements.  So, again, I had to assume all store bought vitamins contained gluten.   Unless supplements specifically stated on their label that they were “gluten-free” or “casein-free”, I had to assume they contained at least “gluten”.  Karyn Seroussi’s book noted that autistic children were affected by gluten and casein AT MOLECULAR LEVEL and so, even a minute amount of these proteins could have an adverse effect on these children.   Kirkman Labs’ products were gluten and casein free.  I found Kirkman Labs to be a “one stop shop” for Zachary’s supplements and thus, a tremendous time saver.  Also, Kirkman Labs provided an information sheet on pretty well all products they sold.  I have replicated some of these below.  Again, I was not looking to reinvent the wheel.  This company has been researching supplements and their impacts on autistic children for a few decades now...they knew a lot more about it than I did.  My only reason for providing their “information sheet data” was to provide what they had learned as “they state it”.   The research had already been done on how these products were used and how they helped these children.   Including the Kirkman Labs information sheets just made the writing of this particular section on Zachary’s diet easier and more efficient.  I did contact Kirkman Labs in order to obtain permission to use this information in my book.   They focused only on providing products for autistic children and others with learning disabilities and as such, I felt they would have a better understanding of Zachary’s needs than would most companies out there...and that saved a lot of valuable time!

In addition to providing the supplements below, I have indicated whether or not the product was maintained at room temperature or refrigerated and have provided an approximate annual cost for each product. 

Word of Caution:       I never  gave vitamins with animal fats or oil of any type.   It

just  “flushes” the vitamins and wastes money.

Also, life is not perfect.   There were definitely days where I would forget to give Zachary his supplements...not often, but it did happen.   When that occurred, I would just get back on track with normal doses.    I  NEVER  “gave more” of a supplement than the recommended dose.   Just getting back

on track was the best thing to do.   At other times, I would purposely choose to give Zachary’s system a little break for maybe a week each two or three months. 

Finally, I found I HAD to use measuring spoons.   Estimating doses was difficult and I found that when I just estimated, I was more than likely “off”.   All of Zachary’s supplements were non-prescription, but still, they did get expensive and so I found it wise to measure accurately. 

Super Nu-Thera             

This was Zachary’s  “power-punch” vitamin, available in liquid or powder form.    Zachary did not like the taste of the liquid form even though I tried to hide it in foods/drinks.   It had always been very difficult to get Zachary to take anything...even fresh orange juice.  The powder form available in a capsule worked fine for him.   I found it easy enough to hide.  It also tasted better to him.  Anyway, these vitamins provided high doses of vitamins that were not properly absorbed by autistic children.  The chart below was replicated from the back of the Super Nu-Thera  450 gram dietary supplement powder container.   Especially noteworthy was the vitamin B-6 dose…it was 25,000% the normal daily value for vitamin B-6.   Vitamin B-1 and Vitamin B-2 were also very high doses.  Vitamin B was a key factor in neurological development.

With Zachary, we chose to introduce supplements slowly to see how he reacted to each one.   For the liquid vitamin, we found he had more difficult a time taking it orally and he seemed to develop more diarrhea than we would have thought.   We tried the liquid over and over and it got to the point that even a small amount was not well tolerated by his system.   The Super Nu-Thera 450 gram dietary supplement powder (chart below) he did not like due to the taste.    When I spoke to a representative at Kirkman Labs about the “taste” issue, she stated most kids were fine with it.    Luckily for me, the company had a third product and that one worked well for him…Nu-Thera Hypoallergenic Capsules.  I can not explain why that was, I just know that this was what we experienced. 

This particular product we kept at room temperature per the manufacturer.   We  allocated about $70.00 for a one year supply for a child four and under.  As Zachary ages, he may require a little more since body weight was a factor when determining proper dose.

Super Nu-Thera 450 gram dietary supplement powder :

As I stated earlier, Zachary did not like the taste of this particular powder, so, we went with the Nu-Thera Hypoallergenic Capsules.   I was able to pull the capsules apart and easily hide the supplement in his food/drinks.  The label on the back of the capsule product was as follows:

Nu-Thera with P5P

Contains P-5-P the active co-enzyme of vitamin B-6**

Serving Size: 2 capsules

The Vitamin B-6 was provided in the form one would have if it was already digested, as P-5-P, the active co-enzyme of vitamin B-6, and that was why it was not listed under “B-2” in the above label….so, Vitamin B-6 was still present in this product, it just appeared in a different form.

KIRKMAN LAB INFORMATION SHEET ON NU-THERA HYPOALLERGENIC CAPSULES STATED:

“Nu-Thera Hypoallergenic Formula is a condensed version of Super Nu-Thera which contains no fillers, sweeteners, flavorings or allergens.  This product is formulated for those individuals who are sensitive or have allergies to ingredients commonly used in the dietary supplement industry.  Individuals who are unable to use other Super Nu-Thera products due to sensitivities or reactions to certain ingredients will now have a suitable product to use to get the nutritional benefits without the fear of a reaction to ingredients.  Nu-Thera Hypoallergenic capsules have the following features:

*Capsule shell is made from plant cellulose, not animal gelatin like other products

*No fillers are used

*No flavorings are used

*No sweeteners are used

*No preservatives are added

*No colorings are present

*Only vegetable grade magnesium stearate is used as a lubricant

This product contains 50 mg. Of Pyridoxal 5 Phosphatet (P5P) and 100 mg. Of Magnesium from a glycinate-oxide blend.  In addition it contains condensed potencies of all of the other nutrients present in other Nu-Thera products.  The condensation of some of the potencies was required so as to fit all the nutrients in the small easy to swallow capsule. 

The Vitamin C content of the Nu-Thera Hypoallergenic formula is less than recommended levels for autistic children, and it is therefore advised that additional supplementation be given.  Kirkman offers Vitamin C 250 mg. In the hypoallergenic line, plus a chewable Vitamin C product.  Other nutrients which have been reduced can also be supplemented such as Magnesium or Vitamin E if necessary, but even the condensed potencies are substantial enough for most individuals except for the Vitamin C.  When hyperactivity is a concern extra Magnesium supplementation could be necessary and when immune weakness is apparent, extra Vitamin E supplementation would be warranted.  Kirkman has both of these products in the hypoallergenic line as well”.

This product worked very well for Zachary.  It was important to note, however, that although I had not given him the powdered form (first of the two labels above) in several months, I recently tried it again (on November 13^th, 2001) and he took it just fine.  So, as with everything, it was often trial and error several times before Zachary accepted something new.  If there was one thing I had learned about being the parent of an autistic child it was that I became very “in tuned” with everything about my child’s behavior, down to very minute details that provided hints as to when I might be able to try again (i.e., change in texture preferences, etc. in other foods).  Since Zachary was put on Nu-Thera capsules, per the manufacturer’s recommendation, I also supplemented with Vitamin C and Magnesium.

Buffered Vitamin C Powder

Vitamin C helped the immune system.  Again, this product was one that remained at room temperature.   Zachary only needed to get ¼ teaspoon of this per day (powdered form was what I used) and it came in a 7 oz jar.  Kirkman Labs had capsules also for Vitamin C.     We allowed $25.00 or so for a one year supply.

KIRKMAN LAB INFORMATION SHEET ON VITAMIN C STATED:

“Many physicians are recommending very high doses of vitamin C for autistic patients especially those undergoing heavy metal detoxification.  Up to now Kirkman has offered two forms of vitamin C, chewable tablets and Hypoallergenic capsules both of them dosed at 250 mg.   With doctors now suggesting from one to three grams daily, the 250 mg dosage forms may not be convenient or practical.

Kirkman has therefore developed a buffered vitamin C powder which is very easy to administer and is great tasting.   Vitamin C is formulated with sodium, potassium and magnesium ascorbates to produce a buffered product which is very gentle on the stomach because the normal high acidity of ascorbic acid is counteracted by the ascorbates.  A small amount of sucralose and natural passion fruit is added to make the product taste great when dissolved in water or juice.  One quarter of a teaspoon supplies 1100 mg of vitamin C.

Vitamin C is the most popular vitamin supplement in the country.  The list of health conditions where Vitamin C has shown to be of value is indeed very long.  Vitamin C has some specific roles in autism, however, making it a necessary supplement in the nutritional treatment of autistic children.  Some of its key roles include:

                *Vitamin C boosts the immune system

                *Vitamin C inhibits Candida growth

                *Vitamin C promotes wound healing and gut healing

                *Vitamin C protects against toxins and allergens

                *Vitamin C inhibits certain viral activity”

Magnesium

Again, per the recommendation of the manufacturer of Super Nu-Thera, I did put Zachary on a magnesium supplement because he was quite “hyper” at times.    It did seem to help him although he still had “his days”, but then again, all children did.

This was another product that came in capsules and was maintained at room temperature.   We allowed $20.00 for a one year supply.  Like the vitamins, this product was not given with animal fats or any oils as that just “flushes” them from the system.

KIRKMAN LAB INFORMATION SHEET ON MAGNESIUM STATED:

“Magnesium is an essential mineral that is involved in many body functions as well as being a constituent of bones and teeth.  It is essential for element of cellular metabolism and is an enzyme activator.  Magnesium is extremely important in autism and other developmental disorders for the following reasons:

*Magnesium counteracts the side effects of high B-6 therapy

*Magnesium helps curb hyperactivity

*Magnesium relaxes nerve impulses and muscle contractions

*Magnesium helps prevent muscle spasms such as tremors or twitching

Dr. Bernard Rimland is the leader of Vitamin B-6 therapy in treating autism.  Dr. Rimland has concluded that supplementation with Magnesium along with the B-6 administration gave improved results.  Side effects of the B-6 such as irritability, sound sensitivity, hyperactivity, and bed wetting stopped when Magnesium was included.

Dimethylglycine  (DMG) and Trimethylglycine (TMG) are often used in helping to treat autism.  These compounds can cause hyperactivity in some individuals.  Magnesium can be helpful in this situation along with folic acid.

Signs and symptoms of magnesium deficiency include fatigue, mental confusion, heart disturbances, irritability, weakness, muscle spasms, loss of appetitie, insomnia,  and a feeling of weakness.  Cardiovascular disease can be triggered by inadequate magnesium.  Cardiac arrhythmias are often benefited by this mineral.

Kirkman’s Super Nu-Thera products contain Magnesium in the correct ratio to Vitamin B-6 for most individuals.  Some users have found that additional magnesium is necessary to curb hyperactivity and help in normal sleep patterns”.

TMG (Trimethyglycine) Liquid with Folic Acid and Vitamin B-12

Again, in researching autism, I found that Dr. Rimland and Kirkman Labs were very excited about this particular supplement.    It seemed to somehow help trigger language in autistic children.   I thought to myself, fine, I’ll try it.   I had nothing to lose.   Zachary had lost language and was now down to less than five words.   If this could somehow help to get him talking again, it was worth a try.   Again, I was not out to reinvent the wheel.  I figured if they got anything positive in autistic children from any of these supplements, I would give them a try.

This was another product that we kept at room temperature.   It was available in liquid, powder or capsule form.   We went with the liquid for Zachary.   We allowed approximately $60.00 for a one year supply.  

KIRKMAN LAB INFORMATION SHEET ON TMG WITH FOLIC ACID AND B-12 STATED:

“TMG is DMG with one more methyl group.  TMG stands for Trimethyl-glycine while DMG stands for Dimethylglycine.  

DMG is well known in the autistic community.  For many, it improves speech, behavior and energy.  Not many people however know about its “Big Brother” TMG.  In short, TMG provides several remarkable benefits and then becomes DMG!

TMG donates one methyl group (it has 3 methyl groups while DMG has 2) that reduces harmful homocysteins and increases beneficial seratonin by stimulating the production of a precursor called SAMe, which acts as a natural antidepressant by increasing the level of seratonin.  The remaining two methyl are DMG.  The liquid has a pleasant sweet taste and includes Folic Acid and Vitamin B12.

                                *All the advantages of DMG and more

                                *Increased seratonin levels

                                *Folic Acid and Vitamin B-12 included

                                *Casein and Gluten Free”

Another information sheet from Kirkman Labs provides more information on TMG.   It stated:

                Trimethyglycine

                (TMG)

                DMG’s big brother that does so much more….

                How is TMG Different from DMG?

                In simple terms TMG is DMG with one more methyl group.  TMG stands for Trimethyglycine while DMG stands for Dimethyglycine.

Dimethyglycine (DMG) is well known in the autistic community. …Not many people however know about its “Big Brother”, Trimethyglycine (TMG).  In short, TMG provides several remarkable benefits and then becomes DMG.

TMG donates one methyl group (it has 3 while DMG has 2) that reduces harmful homocysteins and increases beneficial seratonin by stimulating the production of a precursor called SAMe.  The remaining two methyl are DMG!!!  The formula is 250 mg of TMG will result in 125 mg of DMG.

What is Trimethyglycine (TMG)?

TMG is a naturally found chemical compound found in some foods.  It can be extracted from sugar beets in a very concentrated form.  The result is a 99% pure white crystallized powder with a distinctive taste.  It is mildly sweet with a mild aftertaste.

TMG is also known as glycine betaine.

What is the Benefit of TMG?

TMG is the newest and most effective methylation-enhancing compound.  Methylation is a natural process that makes new cells, creates natural antioxidants and breaks down harmful chemicals.

TMG converts one of these harmful chemicals, toxic homocysteine into methionine.  It also boosts the level of beneficial SAMe and then becomes DMG (Dimethyglycine).  It takes approximately 250 mg of TMG to naturally produce 125 mg of DMG.

This methylation of TMG produces the following benefits:

1.                    TMG methylation lowers dangerous homocysteine levels, thus lowering the risk of heart disease and stroke.  Methylation is the primary process by which homocysteine is transformed into nontoxic compounds such as SAMe.

2.                    TMG methylation produces SAMe, which may have potent anti-aging effects, and has been shown to alleviate depression, remylenate nerve cells, improve Alzheimer’s and Parkinson’s disease patients, and protect against alcohol-induced liver injury.

3.                    Methylation protects DNA”.

I never used DMG at all since TMG was available by the time we figured out what was wrong with Zachary.   He has done well on TMG and takes it easily.

Folic Acid With B-12

The liquid folic acid needed to be refrigerated so we always had to keep that in mind when traveling.   We simply packed it on ice.    The dose was only ¼ teaspoon per day.   We allowed about $25.00 per year.

KIRKMAN LAB INFORMATION SHEET ON FOLIC ACID WITH B-12 STATED:

“Folic acid is a vital nutrient for all individuals and has recently been recognized by the US government as a necessary supplement to be included in everyone’s daily diet.  For children with autism this can be especially important because of their very often limited diets.  For those using DMG, Folic Acid is even more necessary because DMG can reduce the amount of folic acid in our body.

To offset the reduced folic acid Kirkman Labs has developed a pleasant tasting liquid combining Folic Acid and vitamin B12.  In most cases this will prevent or eliminate hyperactivity which is one symptom of folic acid deficiency.  Because folic acid can sometimes mask a vitamin B12 deficiency, vitamin B12 has been added to the product as well.

                *A fundamental nutrient required for good health

                *Casein and gluten free

                *Can eliminate hyperactivity created by the use of DMG

                *Pleasant tasting liquid can be used alone or with other beverages”

and still another Kirkman Lab fact sheet on Folic Acid and B12 stated:

“Folic Acid With B-12

A common B vitamin with amazing results for autistic children…now in a new liquid

Why Folic Acid is Important?

Folic acid produces many health benefits.  One of the most important to autistic children is the reduction in mitochondrial stress, common in these children.

Folic acid helps protect the chromosomes, is needed for the utilization of sugan and amino acids, promotes healthier skin, and helps protect against intestinal parasites and food poisoning.

What is Folic Acid?

Folic acid (also called folic acid or folacin) is a vitamin in the B group.  Foods rich in folic acid include grains, green vegetables (spinach, broccoli), meat (liver) and legumes (lentils and kidney beans).

Folic acid acts as a coenzyme (with vitamin B-12).  It also stimulates the formation of digestive acids.

Why Did not We Get Enough Folic Acid?

Although present in these foods, it is often difficult to obtain enough folic acid from diet alone.  Some 80 percent of Americans, especially children, are not getting enough.

What are we doing wrong?  For one thing, we aren’t eating enough vegetables.  In fact, if current USDA data is to be believed, the average American is lucky to get one serving of folic acid-rich fuits or vegetables a day.

Does Folic Acid Effect Emotional Health?

Our nervous system is very active and as the activity in the central nervous system increases the needs for folic acid increases.

Studies have linked low levels of folic acid with disturbances in behavior and other problems with nervous system functions.

In a review of folic acid in psychiatric disorders studies published between 1967 and 1992, the researchers concluded that low levels of folic acid is very common among individuals admitted to hospital for emotional behavior. 

In the studies it was concluded that the mental problems improved with folic acid supplementation.

In a recent study patients that had low levels of folic acid had the lowest scores for cognitive functions and when given supplements of folic acid greatly improved their scores in memory tests.

A recent study published in Medscape, Dr. Jonathan E. Alpert, MD, PhD, a medical researcher from the Harvard Medical School, discussed the relationship between folic acid and mental health.  He says in part:

                                ‘A relationship between folic acid and neuropsychiatric

                                disorders has been inferred from clinical observation

                                and from the enhanced understanding of the role of

                                folic acid in critical brain metabolic pathways.

                                Depressive symptoms are the most common

                                Neuropsychiatric manifestation of folic acid deficiency.

                                Conversely, borderline low or deficient serum or red

                                Blood cell folic acid levels have been detected in 15% to

                                38% of adults diagnosed with depressive disorders.

                                Recently, low folic acid levels have been linked to

                                Poorer antidepressant response to selective seratonin

                                Reuptake  inhibitors.  Factors contributing to low

                                serum folic acid levels among depressed patients as well

                                as the circumstances under which folic acid and its

                                derivatives may have a role in antidepressant

                                pharmacotherapy must be further clarified.

                                [Medscape Mental Health 2(1), 1997. ^c 1997 Medscape, Inc.]

Is It Better to Get Folic Acid From Food or Supplements?

Folic Acid is one of the few nutrients that are better absorbed in its synthetic form.  The reason?  Dietary folic acid is a complicated molecule that must be broken down by

enzymes in the gastrointestinal tract.  Anything that interferes with those enzymes;

whether it is age, illness, or the action of other nutrients; can interfere with folic acid

absorption.

Why You Should Take B-12 if you are Taking Large Doses of Folic Acid?

Folic acid should be taken with Vitamin B12 to prevent the folic acid from masking a B12 deficiency.

Calcium Supplement With Vitamin D

Since autistic children can not tolerate casein, found in cow’s milk, I put Zachary on a calcium supplement, again, developed by Kirkman Labs specifically for children like Zachary just to make sure his bones were getting enough of it.  This product was kept at room temperature.    We allowed approximately $30.00 for an annual supply.

KIRKMAN LAB INFORMATION SHEET ON CALCIUM POWDER WITH VITAMIN D STATED:

“Many individuals with autism do not get enough calcium in their diet.  This is especially true if they are on a dairy free diet.  This shortage of calcium is a problem because calcium is essential for good health.

Apart from being a major constituent of bones and teeth, calcium is crucial for nerve conduction, muscle contraction, heartbeat, blood coagulation, and the production of energy and maintenance of immune function. 

Calcium deficiency in children can cause rickets, bone deformities and growth retardation.  Low calcium intake also contributes to high blood pressure, osteoporosis and colon cancer.

Kirkman’s Calcium with vitamin D is available in a pleasant tasting powder that is partially absorbed in the mouth (the mouth contains many small blood vessels close to the surface and calcium is absorbed directly into the blood stream) as well as in the small intestine.  The great taste of Kirkman’s Calcium Powder with Vitamin D is a result of using the calcium carbonate form of calcium.  No other form of calcium is as good tasting and easy for children to accept.

Kirkman’s Calcium with vitamin D can also be used in cooking and baking.  It has been successfully incorporated into cookies, pancakes, muffins and other baked goods.”

Yet another information sheet from Kirkman Labs stated:

“Why is Calcium Important?

Many individuals with autism do not get enough calcium in their diet.  This is especially true if they are on a dairy free diet (gluten and casein free).  This shortage in calcium is a problem because it is essential to our health.

It is the most abundant mineral in the body.  It makes up 1.5 to 2 percent of the total body weight.  Our bones contain 99% of the body weight of calcium.

Our Body Will Take the Calcium it Needs by “Eating Our Bones”

When dietary calcium is insufficient or serum calcium levels drop, the body takes calcium from bones.  That can leave them weak and prone to fracture.  “Eating our bones” as a source of calcium, rather than getting it from the diet can have devastating consequences.  Once bone loss has occurred it cannot be restored.  Prevention is the key.

Typical American Diet Causes Calcium Deficiency

The typical American diet consists of processed foods, carbonated soft drinks, caffeine, high protein, sugar and excessive salt consumption.  This interferes with calcium and can result in very low calcium levels in the body.

How Much Calcium is Necessary for Us to Take?

Many researchers suggest that to stay healthy the average body, before the age of 24 (man or woman), needs up to 1200 mg of calcium daily.

It is very difficult to get enough calcium in a normal diet.  This is especially true if the person is cutting down on the consumption of dairy products, which is the best source of calcium.  In order to get enough calcium you would need to drink 3-4 glasses of milk a day or eat four pounds of broccoli a day.  Below is a table of the calcium content of popular foods.  (milligram abbreviated is mg)