Autism: another gut hunch

Paul Shattock's article (WDDTY vol 11 no 6) says that autism is "all in the gut" due to the "inadequacy of the enzymes ordinarily responsible for" the breakdown of food.

It is interesting to note that secretin, the drug of the moment for autistic spectrum disordered (ASD) children, also acts on the gut. Secretin acts to encourage the production of antacid to neutralise the acid juices coming from the stomach to the duodenum so that enzymes can degrade food to make it ready for absorption in the small intestine. These digestive enzymes have a maximum function at fairly specific alkaline levels. However, the stomach needs to be very acid for its enzymes to start degrading protein, and to work on metals and B12 so that they are appropriately presented to the small intestine.

This means that the usual variation in stomach acid production needs to be managed in some way in the small intestine to avoid having a devastating effect on the function of the enzymes there, which would result in an inappropriate presentation of nutrients for digestion. This is true for low or high stomach acid.

I had become frustrated working with ASD children because of their frequent refusal to eliminate casein and gluten from their diet, so I decided to look at their problems slightly differently.

The relationship between stomach acid levels and the proper function of the small intestine led me to divide a group of 12 ASD children and adolescents into: a potentially high stomach acid (aggressive and hungry types) group; a low stomach acid group (switched off and not hungry types); and an ADHD (hyperactive type) group. Instead of secretin, the high acid children were given calcium carbonate. The low acid children were given ascorbic acid (vitamin C) or iron with multivitamins. The ADHD children were given combined fish and seed oils.

The high acid children were given P5P (pyridoxal 5-phosphate) and no B6 (hydrochloride form) or B12, and the low acid children were given low levels of multivitamins and minerals (often as ascorbates) with or without additional iron.

I encouraged all the parents to try to avoid gluten and casein without much success. Nine of 12 children have now made dramatic progress, two made good progress and one made no progress. All but the ascorbic acid group showed excellent improvement, at least in their behaviour, within 24 hours to three months of starting the supplements. Nevertheless, the ascorbic acid group made the same improvement over 18 to 24 months. As an example of just how successful this approach has been, two of those who showed excellent improvement are now talking, socialising and functioning at an average level in their basic skills despite having been very low/non responders four years ago.

I would recommend that parents of ASD children consider: the possibility of inappropriate levels of stomach acid as well as the inadequacy of digestive enzymes and secretin; and giving iron supplements if the mother had done well when given iron for anaemia at some time in her life, but had not been given it during pregnancy.

In the book Nutritional Medicine (by Drs S. Davies and A. Stewart, Pan Books, 1987: 60), it is stated that "abnormalities of the gastrointestinal tract, including too little stomach acid, have long been observed in iron deficiency anaemia".

!ANatalie Firman

Natalie Firman is a chartered educational psychologist and nutritional consultant (e-mail: n.a.firman@btinternet.com). Harald Gaier is on holiday this month.