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Dr. Karen Harum, M.D. FAAP, Diplomate Neurodevelopmental Pediatrics has been treating special needs children for the past 20 years in her private practice.

“This user friendly, no nonsense guide is an irrefutable masterpiece of the secret recipe to achieving victory and success in the lives of these children and their families.”                                                          Sharon Morris, Founder of Vibrant Children

There are many books on this subject: thick, intensive, time consuming books. As a parent raising a child with AD/HD, we understand that you do not have the time to consolidate the magnitudes of information available- let alone, make sure it’s reliable,from a credible resource, and actually works.

We have done all the work for you. Dr. Harum’s : The ADD/ADHD 90 Day Healing Solution is a culmination of all the best practices she has accumulated over the past 2 decades of research and clinical practice. We have simplified the complexities of these developmental disorders into an easy to follow, checklist style e-book that allows caregivers, clinicians, teachers and parents the absolute best tools to get tangible, real and quick results.

Dr. Harum discusses these topics and much much more:

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If you have a child that has been diagnosed with AD/HD or if you suspect your child has AD/HD, this will be one of the best purchases of your life. An early and proper diagnosis is the MOST important tool to insure your child overcomes this developmental delay and thrives beyond all expectations as you equip them with all the tools needed to restore them. You are your child’s best advocate- They will succeed greatly with you as their coach.

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Healing Transformations in Autism (part 4): Cow derived casein: problems with cow’s milk

Niko experienced chronic upper respiratory infections for the first 4 years of his life, on rounds and rounds of antibiotic, some of which were injected.  He had also developed chronic belly pain, distention and behaviors that are sometimes autistic.  He is diagnosed with severe sensory processing disorder.

A therapist suggested that he discontinue cow’s milk, though there were no obvious signs of cow’s milk allergy. To Mom’s surprise, Niko improved significantly with this simple change in his diet.  His upper respiratory infections stopped, belly pain was reduced, and many of his ritualistic behaviors resolved.

Why does cow’s milk and the casein protein within it result in chronic inflammation, respiratory infections, abdominal pain, neonatal enterocolitis (Powell 1976) and even abnormal behaviors in some individuals? Although the answers remain murky, the scientific research is beginning to support what has been known clinically for decades.  (Jyonouchi, Sun and Itokazu 2002, Niebuhr et al. 2011, Kahn et al. 1987) (Vojdani et al. 2003)

Cow’s milk allergy is difficult to diagnose in children under 2 years using traditional skin prick testing for immediate hypersensitivity, or by measuring IgE antibody to the cow’s milk protein.  A different type of test known as Leukocyte activation studies are more likely to be positive in cases of true sensitivity because they can be activated by several different immune mechanisms and don’t rely on a reaction at the skin level. (Paddack et al. 2012) (Reichelt and Skjeldal 2006). This type of test will pick up sensitivities that traditional allergy testing cannot pick up. When sensitivities are present, one may experience vague symptoms of abdominal pain, vague signs of inflammation such as headache, swelling, and follicular eczema, and behaviors such as irritability, insensitivity to pain, hyperactivity and even mania.

Another problem with cow’s milk is the casein type of protein within the milk. This fascinating little protein has been widely studied for its role in all sorts of disease.  One mechanism of disease is this: Casein, along with some other dietary proteins, are sometimes morphed by the body’s chemistry into proteins that bind to the opiate receptors and behave a bit like morphine. This seems to be the mechanism by which casein can cause undesirable behaviors (Niebuhr et al. 2011, Jakobsson 1985). (Herrera-Marschitz et al. 1989) In fact, some recent epidemiologic studies suggest that an immune reaction to casein is related to the development of schizophrenia and bipolar disorder (Cade et al. 2000, Niebuhr et al. 2011) (Severance et al. 2010).

Autism Speaks is funding clinical research on this issue and results will soon be available to help us refine our ability to advise the right patients at the right time to begin a casein free diet or not.

Remember that if you choose to have your child on a cow’s milk free diet, you will need to add other dietary sources of calcium, including green leafy vegetables, almonds, blackstrap molasses and broccoli. Substituting almond milk for cow’s milk provides an excellent source of bio-available calcium.

References:

Cade, R., R. Privette, M. Fregly, N. Rowland, Z. Sun, V. Zele, H. Wagemaker & C. Edelstein (2000) Autism and Schizophrenia: Intestinal Disorders. Nutritional Neuroscience, 3, 57-72 ST  – Autism and Schizophrenia: Intestinal Disorders.

Herrera-Marschitz, M., L. Terenius, L. Grehn & U. Ungerstedt (1989) Rotational behaviour produced by intranigral injections of bovine and human beta-casomorphins in rats. Psychopharmacology (Berl), 99, 357-61.

Jakobsson, I. (1985) Unusual presentation of adverse reactions to cow”s milk proteins. Klin Padiatr, 197, 360-2.

Jyonouchi, H., S. Sun & N. D.-p. L.-e. Itokazu (2002) Innate immunity associated with inflammatory responses and cytokine production against common dietary proteins in patients with autism spectrum disorder. Neuropsychobiology., 46, 76-84 ST  – Innate immunity associated with inflammatory responses and cytokine production against common dietary proteins in patients with autism spectrum disorder.

Kahn, A., E. Rebuffat, D. Blum, G. Casimir, J. Duchateau, M. J. Mozin & R. Jost (1987) Difficulty in initiating and maintaining sleep associated with cow”s milk allergy in infants. Sleep, 10, 116-21.

Niebuhr, D. W., Y. Li, D. N. Cowan, N. S. Weber, J. A. Fisher, G. M. Ford & R. Yolken (2011) Association between bovine casein antibody and new onset schizophrenia among US military personnel. Schizophr Res, 128, 51-5.

Paddack, A., T. Gibbons, C. Smith, S. Patil & G. T. Richter (2012) Food hypersensitivity and otolaryngologic conditions in young children. Otolaryngol Head Neck Surg, 147, 215-20.

Powell, G. K. (1976) Enterocolitis in low-birth-weight infants associated with milk and soy protein intolerance. J Pediatr, 88, 840-4.

Reichelt, K. & O. D.-p. L.-e. Skjeldal (2006) IgA antibodies in Rett Syndrome. Autism, 10, 189-197 ST  – IgA antibodies in Rett Syndrome.

Severance, E. G., D. Dupont, F. B. Dickerson, C. R. Stallings, A. E. Origoni, B. Krivogorsky, S. Yang, W. Haasnoot & R. H. Yolken (2010) Immune activation by casein dietary antigens in bipolar disorder. Bipolar Disord, 12, 834-42.

Vojdani, A., J. Pangborn, E. Vojdani & E. D.-p. L.-e. Cooper (2003) Infections, toxic chemicals and dietary peptides binding to lymphocyte receptors and tissue enzymes are major instigators of autoimmunity in autism. Int J Immunopathol Pharmacol., 16, 189-199 ST  – Infections, toxic chemicals and dietary peptides binding to lymphocyte receptors and tissue enzymes are major instigators of autoimmunity in autism.

 

Autism & Mitochondrial Dysfunction

Today, I’m going to present a story of healing transformation of Ronnie, a child with autism and mitochondrial dysfunction. This series of blogs focuses on actual patients of mine and drives home the reality that developmental disorders are treatable and the brain has amazing potential for healing.

What is mitochondrial dysfunction and what does it have to do with autism? Mitochondrial disease as a recognized disorder only entered the medical literature < 30 years ago (Frye and Rossignol 2011). In this relatively short period of time, the clinical description of mitochondrial disorders has widened and we now appreciate the more subtle presentations of mitochondrial dysfunction. What do these tiny cellular structures do for us? They are the powerhouses of our cell, producing molecular energy to power up the cell’s natural functions. The actions of the mitochondria are not simple, but divided into several key functions(Croston 2001) (Chen).

Just like autism, not all mitochondrial disorders are genetic. Some develop over time and are caused by drug reactions and environmental toxins (Atchison and Hare 1994, Duewelhenke, Krut and Eysel 2007).

When one has a classic mitochondrial disorder, there is significant impairment in brain function. The more subtle manifestations may include seizures, regression of skills, developmental delay, migraines, weakness and specific nerve impairments (Frye and Rossignol 2011, Pinto, Pickrell and Moraes 2012). I presented a case of mitochondrial dysfunction in the series of blogs on the underlying causes of autism this fall.

I’m happy to report improvements in another 3 year old boy, named Ronnie, who has lately taken off with improvements in eye contact, language expression, language understanding, reduced anxiety improved weight gain. This little guy presented over a year ago with the classic elevations in lactate, pyruvate, alanine, increased oxygen free radicals, increased anion gap, intermittent increases in ammonia and in liver enzymes on his laboratory evaluation. Likewise, he presented with the classic features of developmental regression, low tone, poor weight gain, intestinal dysfunction, and difficulties in learning.

To start, I needed to support Ronnie’s intestinal dysfunction by adding enzymes and healthy bacteria to his gut. His diet became very complicated due to his need for lots of calories, and his refusals to eat. Reducing belly pain and improving sleep were of top priority in helping this family.

And just as with the previous case presented, we began to support Ronnie’s mitochondria specifically with the vitamins and co-factors that the mitochondria use regularly to produce molecular energy. These include coQ10, high levels of B vitamins, medium chain triglycerides in the diet, specific anti-oxidant vitamins like vitamin C and E, and carnitine (Frye and Rossignol 2011).

Dietary prescriptions play a big role in the treatment of mitochondrial disorders. For example, if there are problems with the fat metabolism portion of the mitochondria, then fats are not going to be metabolized well for energy production. If there are problems with glucose metabolism, then alternate energy can be supplied with dietary ketones.

And importantly, if other organs are not powered up to adequately fulfill their functions, those organ systems must also be supported. For example, the immune system and the thyroid gland are often in need of various supportive treatments.

Some specific recommendations excerpted from the previous blog on www.vibrantchildren.com are listed here:

I support the electron transport chain within the mitochondria with antioxidants, the most notable being reduced L-glutathione. I use alpha lipoic acid to focus the anti-oxidant activity in the brain. Vit E is an important modulator of mitochondrial function and NADH can provide reducing substances to balance the oxidation.

It’s very important that these kids avoid physical stress on their metabolism – treat high fevers, avoid dehydration and calorie deprivation due to vomiting.

I will often add acetyl-Lcarnitine to assist the mitochondria with importing fats and deriving energy from fatty acid nutrients. Coconut oil can be metabolized by the mitochondria more easily, and can more readily form ketones, which are an alternative energy source for brain cells that cannot readily acquire other forms of molecular energy (Chen) http://www.biocarta.com/pathfiles.

Extra virgin olive oil (EVOO) is enriched in polyphenols and can increase the body’s stores of glutathione, a potent anti-oxidant. EVOO has been shown to improve age-related learning and memory problems in a mouse model of Alzheimer’s Disease (Farr et al. 2012).

Anti-oxidant herbals include flavonoids such as quercetin, rutin, luteolin, pycnogenol, etc. These compounds can reduce the oxidant stresses created by inflammation, vitamin and nutrient deficiencies, chronic infections, toxicities…and more. (Theoharides, Asadi and Panagiotidou 2012)

It’s also important to reduce or eliminate any compounds associated with mitochondrial injury: toxic metals, the anti-seizure medication valproate (blocks carnitine metabolism), and some antibiotics (ciprofloxacin). Just a note that valproate is used commonly to stabilize mood and treat seizures in some individuals with autism, yet should be avoided in those with mitochondrial weaknesses.

Ronnie’s parents have worked extremely hard to follow the recommendations that followed his extensive biochemical testing – and they have been successful. He is playing, exchanging information, singing songs, growing and more importantly, he seems very happy to be himself!

Atchison, W. & M. D.-P. L.-E. Hare (1994) Mechanisms of Metylmercury-induced neurotoxicity. FASEB J, 8, 622-629 ST
Chen, N. D.-B. L.-E. Mitochondrial Carnitine Palmitoyltransferase (CPT) System. BioCarta, 1 ST – Mitochondrial Carnitine Palmitoyltransferase (CPT) System.
Croston, G. D.-P. L.-E. (2001) The Citric Acid Cycle. BioCarta, 1 ST – The Citric Acid Cycle.
Duewelhenke, N., O. Krut & P. D.-P. L.-E. Eysel (2007) Influence on mitochondria and cytotoxicity of different antibiotics administered in high concentrations on primary human osteoblasts and cell lines. Antimicrob Agents Chemother, 51, 54-63 ST – Influence on mitochondria and cytotoxicity of different antibiotics administered in high concentrations on primary human osteoblasts and cell lines.
Frye, R. E. & D. A. Rossignol (2011) Mitochondrial dysfunction can connect the diverse medical symptoms associated with autism spectrum disorders. Pediatr Res, 69, 41R-7R.
Pinto, M., A. M. Pickrell & C. T. Moraes (2012) Regional susceptibilities to mitochondrial dysfunctions in the CNS. Biol Chem, 393, 275-81.

Join us for our next free live webinar on December 13, Thursday at 12 N. Register for this webinar on autism at www.vibrantchildren.com