complementary and alternative medicine; medical therapies autism treatments
anti-fungal treatment for autistic spectrum disorders in children

Written and Maintained by Lewis Mehl-Madrona, M.D., Ph.D.

 


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Anti-fungal Treatment

We know that poor bowel ecology - common in autistic children - often promotes the overgrowth of fungi and other microbes. These microbes can be involved in autism, as fungal metabolites are often found in the urine of autistic children.

Many children with autism respond to anti-fungal treatment, and score high for yeast and anaerobic bacteria on such tests as the Comprehensive Digestive Stool Analysis test, available at the Great Plains Laboratory or Great Smokies Laboratory.

We also know that fungi can make hallucinogenic substances. LSD, for instance, is derived from ergot, and psilocybin from mushrooms. The theory that fungi are producing the compounds which are creating autistic behavior is not so far-fetched. Desmorphin, discussed earlier, is an hallucinogenic substance occuring more frequently among autistic children.

There is evidence that a form of yeast, candida albicans, may cause autism and may exacerbate many behavior and health problems in autistic individuals, especially those with late-onset autism.

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Candida or Yeast and Autism:

Some clinicians believe that autistic symptoms are made worse by the overgrowth of Candida albicans, a yest-like fungus present everywhere. Overgrowth is made possible by a dysfunctional immune system. A healthy immune system would keep the Candida in check.

The "leaky gut" theory of autism implies that withdrawing gut allergens and treating yeast overgrowth, should help the GI tract to return toward normal and autistic symptoms improve.

Many children afflicted with autism have had frequent ear infections as young children and have taken large amounts of antibiotics. These are thought to exagerate the yeast problem. Other possible contributors to Candida overgrowth are hormonal treatments; immunosuppresant drug therapy; exposure to herpes, chicken pox, or other "chronic" viruses; or exposure to chemicals that might upset the immune system. There is an increased probability, that a "general" environmental factor affecting our immune systems (i.e. ozone layer depletion, "toxic" chemicals, etc.) may be operative, affecting many children and adults.

Because it is impractical to expect anyone to stay on a totally yeast-free diet, ongoing medication, anti-fungal supplements, and avoidance of sugars are often used to control Candida. Even with the use of anti-fungal drugs, it is still important to limit sugar, because yeast grows 200 times faster in the presence of sugar.

If a potent anti-fungal such as Diflucan or Nizoral is used, it can be assumed that within 1 - 2 months most all of the yeast will die off. When Nizoral or Diflucan is used, some experts say that within 7- 12 days patients can experience "die off" symptoms. This consists of either a "sensitization" reaction to "products" released when the yeast is killed, or the release of "formaldehyde" like products or other potentially toxic derivatives during yeast death, that can contribute to negative symptoms in a patient, including hyperactivity, gastrointestinal distress, and irritability. Die-off usually lasts about 7-14 days and after that time the change in the child is reported as sometimes dramatic. If the die-off does not end in 14 - 17 days, the anti-fungal medication is usually changed.

If the treatment is successful for autistic children, usually eye-contact improves and the child seems more aware and less"foggy." Anecdotal reports claim that the frequency of inappropriate noises, teeth grinding, biting, hitting, hyperactivity, and aggressive behavior decreases. The child acts less silly and shows less inappropriate laughter.

The antifungals, Nizoral and Diflucan, are usually monitored with liver function tests drawn every 1-3 months, since these drugs can cause liver damage. Some physicians stop pharmacological antifungals at six months because of postulated effects on the adrenocortical axis. Then, some will switch to Amphotericin B, which has recently been licensed as an oral liquid in the United States, and can be legally compounded by pharmacies in the U.S.

If the antifungal therapy is stopped, and the body's immune system is still sub-optimal, the yeast is thought likely to return. Many believe treatment must be continued for 4 - 6 months to maintain gains obtained from yeast elimination. Stopping treatment after only one month is thought to allow yeast to return in perhaps even more resistant forms.

Probiotics for keeping healthy intestinal flora include:

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More About Candida albicans:

Candida albicans belongs to the yeast family and is a single-cell fungus. This form of yeast is located in various parts of the body including the digestive tract. Generally speaking, benign microbes limit the amount of yeast in the intestinal tract, and thus, keep the yeast under control. However, exposure to antibiotics, especially repeated exposure, can destroy these microbes. This can result in an overgrowth of candida albicans. When the yeast multiplies, it releases toxins in the body; and these toxins are known to impair the central nervous system and the immune system.

Some of the behavior problems which have been linked to an overgrowth of candida albicans include: confusion, hyperactivity, short attention span, lethargy, irritability, and aggression. Health problems can include: headaches, stomachaches, constipation, gas pains, fatigue, and depression. These problems are often worse during damp and/or muggy days and in moldy places. Additionally, exposure to perfumes and insecticides can worsen the condition.

Dr. William Shaw has been conducting important research on yeast and its effects on autistic individuals. He recently discovered unusual microbial metabolites in the urine of autistic children who responded remarkably well to anti-fungal treatments. Dr. Shaw and his colleagues observed a decrease in urinary organic acids as well as decreases in hyperactivity and self-stimulatory, stereotyped behavior; and increases in eye contact, vocalization, and concentration.

There are many safe methods to treat yeast overgrowth, such as taking nutritional supplements which replenish the intestinal tract with 'good' microbes (e.g., acidophilus) and/or taking anti-fungal medications (e.g., Nystatin, Ketoconosal, Diflucan). It is also recommended that the person be placed on a special diet, low in sugar and other foods on which yeasts thrive. Interestingly, if the candida albicans is causing health and behavior problems, a person will often become quite ill for a few days after receiving a treatment to kill the excess yeast. The yeast is destroyed and the debris is circulated through the body until it is excreted. Thus, a person who displays negative behaviors soon after receiving treatment for candida albicans (the Herxheimer reaction) is likely to have a good prognosis.

Please note: treatment for candida albicans infrequently results in a cure for autism. However, if the person is suffering from this problem, his/her health and behavior should improve following the therapy.

(Excerpted from: The Candida Yeast-Autism Connection, written by Stephen M. Edelson, Ph.D. at the Center for the Study of Autism, Salem, Oregon)

There are 30 or 40 strains of candida, and some are very resistant to treatment. Nystatin, quite possibly the safe prescription drug on the market, will work on the weakest candida strains. Ketoconosal (Nizerol) is a stronger drug, but much more likely to have adverse side effects. Diet is at least as important as drugs in treating candida. There are also non-prescription substances that have anti-candida effects, such as acidophilus, caprylic acid, garlic oil, colloidal silver, and other readily available substances, some of which have been used to treat candida for hundreds of years.

The Autism Research Institute distributes an information packet on candida (yeast) and autism: Candida (Yeast) and Autism: Basic information and questionnaire for parents whose child might have yeast-caused (antibiotic effect) autism.

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Candida-caused autism?:

"Candida albicans is a yeast-like fungus which inhabits almost all humans. It lives on the moist dark mucous membranes which line the mouth, vagina and intestinal tract. Ordinarily it exists only in small colonies, prevented from growing too rapidly by the human host's immune system, and by competition from other microorganisms in and on the body's mucous membranes. When something happens to upset this delicate natural balance, candida can grow rapidly and aggressively, causing many unpleasant symptoms to the host. Some of the symptoms are widely known and acknowledged. Vaginal yeast infections, primarily caused by candida, present the most common case in point. Thrush, the white yeast infection of the mouth and tongue which is common in infants, is another well-known example of candida overgrowth.

In recent years a minority of physicians have begun to try to persuade their colleagues, and the public, that candida may present consequences far more devastating to human well-being than vaginitis and thrush. They cite Japanese studies showing that candida is able to produce toxins which cause severe long-term disruption of the immune system and may also attack the brain. In extreme cases, they claim, severe disorders, totally resistant to conventional treatment, can occur as a result of candidiasis. These include depression, schizophrenia and, in some cases, autism.

It is much too early to reach a firm conclusion, but, based on the weight of the information gathered to date, it seems to me highly probable that a small, but significant, proportion of children diagnosed as autistic are in fact victims of a severe candida infection. I further believe that if the candida infection were successfully treated in these few cases - much easier said than done - the symptoms of autism would show dramatic improvement.

When the Los Angeles Times published a long, syndicated article about [ a child whose autistic behavior and symptoms were greatly reduced by anti-fungal treatment] in 1983, the Mayos, and the Institute for Child Behavior Research, which was mentioned in the article, began receiving letters and phone calls from parents of autistic children throughout the country. It seems that there are many autistic children whose problems started soon after long-term antibiotic therapy, or whose mothers had chronic yeast infections which they had passed along to the infants. How many of these might in fact be caused by candidiasis? No one knows.

William G. Crook, the well-known pediatric allergist of Knoxville, Tennessee, has mentioned several similar cases in his book The Yeast Connection and in his lectures. Cecil Bradley (one of Duffy Mayo's physicians) recently told me that he has seen eight "autistic" children who respond favorably to anti-candida drugs and diet treatment.

ICBR has been gathering information on the possible link between autism and candida since 1966, when our first research assistant, Dale Meyer, noticed that thrush seemed to be mentioned unusually often in the letters and questionnaires sent to us by parents. I am fairly well convinced that there is a connection and that perhaps 5% to 10% of autistic children - those given many courses of antibiotics, or born with thrush or afflicted with thrush soon after birth - will improve when properly treated for candida. However, there is no consensus among physicians on the candida/autism linkage.

Judging from contacts with several hundred parents over the past few years, only about one physician in 20 or 30 will give serious consideration to the possibility that treating candida may alleviate the symptoms of autism. Most physicians regard concern with candida as just another fad, soon to be forgotten. I wish they were right, but I don't think they are."

Bernard Rimland, Ph.D.
Autism Research
4182 Adams Avenue
San Diego, CA 92116

(For the full text of the editorial, please see: Candida-caused autism?

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Disclaimer:

"The opinions and analyses expressed herein are those of Dr. Lewis Mehl-Madrona and his colleagues at the Center for Complementary Medicine of the University of Pittsburgh Medical Center, but do not necessarily represent official policy or opinion of the University of Pittsburgh Medical Center."


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