April is Autism Awareness Month

Over 3.5 million Americans live with autism spectrum disorder. However, within the general public, there is only a limited recognition of the disorder.  The specifics of autism, including the impact that it can have on individuals, as well as their families and caregivers, is often not well understood, except by those who deal with it on a daily basis.

Autism is a complex disorder of brain development.  Each person affected by autism will experience differing types and severities of symptoms, and therefore, to reflect the varying degree it can affect an individual, the disorder is referred to as a spectrum. The overarching theme of the spectrum generally involves impaired communication skills, as well as a difficulty interacting socially.  While for some individuals this can result in complete lack of language, in others it may only involve difficulty making eye contact or holding a conversation.  Still, others may have motor coordination delays, difficulty reasoning and planning, repetitive behaviors, or physical health disturbances such as sleep and gastrointestinal issues.

Symptoms of autism generally present early in childhood, around the ages of two to three.  Lack of, or delay in language development, trouble developing peer relationships, and repetitive mannerisms are only a few of the early warning signs.  Some red flags may be spotted even earlier at the infant stage, such as lack of smiling or joyful expressions, and absence of gestures such as pointing or waving as the child approaches twelve months of age.

Not long ago, the cause of autism was a mystery.  Even today, science has yet to grasp a complete understanding of the disorder’s roots despite ongoing research. The most recent research suggests the disorder results from a combination of genetic mutations and differing environmental factors.  For instance, if a developing child already has a genetic mutation, environmental factors such as advanced parental age or complications during childbirth may possibly increase the child’s risk of developing the disorder.  More recent research has begun to examine the body’s own immune system and how it may play a role in brain development and maintenance.

Given that it is thought autism is largely a result of genetic mutations, it is not possible to prevent autism, per say.  However, steps can be taken to limit exposure to the environmental factors that are thought to possibly increase the risk of the disorder’s development. For instance, women who are pregnant or plan to become pregnant would be wise to avoid toxins such as air pollution, pesticides, some cosmetics, and others.  Additionally, some research shows proper prenatal diet, as well as adequate folic acid intake of at least 600mcg to 800mcg per day during pregnancy may lower the risk of autism development.

The demands of living with the disorder, and the burden of caring for someone afflicted by it, can be a major source of stress.  For individuals with milder forms of autism, the stigma of living with the disorder, and the lack of social competency associated with it, can be difficult.  For those on the spectrum with more significant disabilities, the lack of being able to live independently can weigh greatly on a family.  Parents must try to manage behavioral complications, plan for the future, and cope with a large financial burden, while siblings may feel a lack of attention or embarrassment.

No single treatment protocol is applicable to all individuals on the spectrum.  Because the disorder presents so uniquely in each individual, the treatment of that individual should be just as unique.  Treatment interventions can involve behavioral therapy, conventional medication to control behavior and underlying medical conditions associated with autism, or a combination of both.  Additionally, outside the arm of conventional medication, there exist some complementary and alternative treatments, often termed integrative medicine, that have begun to show promise in the field of autism.

One such alternative therapy approach targets methylation, the body’s process of altering proteins and genes, which thus leads to changing their behavior and expression. Essentially, methylation is required to build and repair all of the cells in our bodies.  Individuals on the spectrum often have faulty methylation pathways, thus leading to abnormal gene expression, as well as decreased production of powerful antioxidants like glutathione, which help to detoxify the body and prevent cellular damage.  Treatments with methylcobalamin, a form of vitamin B-12, and folinic acid are often given to improve this methylation process, as well as glutathione metabolism.  Additionally, glutathione itself may be given as well.  Treating methylation pathways and glutathione metabolism has shown promise in improving communication, language, and social skills, as well as cognition and responsiveness.

Oxytocin is another tool used in integrative medicine to potentially improve social bonding.  This hormone has been linked to social ties such as parent-child bonding.  Some research has shown that when administered as a nasal spray, oxytocin can potentially improve social, emotional, and behavioral problems.

Also in the alternative realm, research has begun to examine the roles certain proteins play in autism, such as gluten (found in wheat and other grains) casein (found in dairy products) and soy (derived from the soybean). It has been postulated that these proteins can lead to increased inflammation in the gastrointestinal tract, which may stimulate autoimmune responses and exacerbate the symptoms of the spectrum.  An elimination diet is sometimes initiated to completely eliminate the intake of these proteins from both foods and medications, with the hope this inflammatory response is reduced.

Finally, many supplements can be used to support the management of the spectrum. Omega-3 fatty acids can be used to support the development and function of the brain, possibly improving cognition and reasoning.  Melatonin may be used to help regulate sleep cycles, and probiotics may help to resolve gastrointestinal issues that are often present in individuals on the spectrum.

Alternative therapies such as methylcobalamin, glutathione, and oxytocin are not available through traditional pharmacies and instead must be custom compounded by speciality pharmacies such as Pine Pharmacy in Williamsville. Likewise, these pharmacies are also able to prepare medications to exclude gluten casein and soy, thereby easing adherence to elimination diets.  Generally, they will also specialize in supplements geared towards the spectrum disorder as well.

Clearly, autism spectrum is a unique disorder and modern medicine still has yet to fully grasp all of the intricacies of the disorder. However, the recognition of the disorder is expanding, and there is hope that advances continue to be made in the management of it.