The Interwoven Global Epidemics of Mercury Toxicity and Autism

In October 2017, Robert F. Kennedy Jr. published an article on the website of the World Mercury Project about one of CONEM’s studies (1). Kennedy is the son of former New York senator and U.S. attorney general Robert F. Kennedy and nephew of former President John F. Kennedy. He is an attorney, environmental activist and syndicated talk radio host. 

The Interwoven Global Epidemics of Mercury Toxicity and Autism

Metals wreak havoc on living systems, including humans, animals and plants alike. RFK, Jr. discusses a new review article in Environmental Research and pulls together a wide body of literature with the aim of summing up current research and emerging trends about the global epidemics of toxicity and autism.

Reference

1. Bjørklund G, Dadar M, Mutter J, Aaseth J. The toxicology of mercury: Current research and emerging trends. Environ Res 2017; 159: 545-554.

 

What is Autism Spectrum Disorder?

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that can cause significant social, communication and behavioural challenges. This video explores the previous and updated diagnostic criteria for ASD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM). In 2013 was the new edition of this manual published (DSM-5). The DSM-5 redefined the autism spectrum to encompass the previous (DSM-IV-TR) diagnoses of autism, Asperger syndrome, pervasive developmental disorder not otherwise specified (PDD-NOS), and childhood disintegrative disorder. Autistic individuals are now placed on a continuum depending on the severity of their symptoms.

Digestive Enzyme Therapy: A Possible Option in Autism Spectrum Disorder

There is growing evidence for a gut-brain connection associated with autism spectrum disorder (ASD), which suggests a potential benefit for digestive enzyme therapy in autistic children (1). Working with an Egyptian team, Geir Bjørklund and collaborators performed a double-blind, randomized clinical trial on 101 children with ASD (82 boys and 19 girls) aged from 3 to 9 years (1). The autistic children were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision (DSM-IV-TR) diagnostic criteria. Structured interviews of at least one hour were first performed both with the parents and the children. In a later two hours session was the Childhood Autism Rating Scale (CARS) applied. After this, the children with ASD were randomized to receive digestive enzymes or placebo (1). It was found that autistic children that received digestive enzyme therapy for three months had significant improvement in emotional response, general impression autistic score, general behavior, and gastrointestinal symptoms. These results indicate that digestive enzyme therapy in the future may be a possible option in the treatment protocols for ASD (1).

The first author of the article, Khaled Saad, is Associate Professor of Pediatrics at Assiut University, Assiut, Egypt. Geir Bjørklund is the founder and president of the Council for Nutritional and Environmental Medicine (CONEM).

 

Reference

1. Saad K, Eltayeb AA, Mohamad IL, Al-Atram AA, Elserogy Y, Bjørklund G, El-Houfey AA, Nicholson B. A randomized, placebo-controlled trial of digestive enzymes in children with autism spectrum disorders. Clin Psychopharmacol Neurosci 2015; 13(2): 188-193.

 

Vitamin D Deficiency Correlates with Severity of Autism and Shows Improvement with Supplementation

Vitamin D deficiency has been previously reported in patients with autism spectrum disorder (ASD). However, the data on the relationship between vitamin D deficiency and the severity of ASD are limited. In collaboration with Egyptian researchers, Geir Bjørklund (2015) performed a case-controlled cross-sectional analysis on 122 children with ASD, to assess their vitamin D status compared to healthy control children and the relationship between the degree of vitamin D deficiency and the severity of ASD (1).

Fifty-seven percent of the patients with ASD in the study had vitamin D deficiency, and 30% had vitamin D insufficiency. The vitamin D levels in the children with severe ASD were significantly lower than those in children with mild/moderate ASD. It was found that the vitamin D levels had significant negative correlations with the Childhood Autism Rating Scale (CARS) scores (1).

106 children with low serum vitamin D levels (<30 ng/ml) then participated in an open-label trial of vitamin D supplementation. The patients were given 300 IU/kg/day (not to exceed 5000 IU/day) for three months. Eighty-three ASD patients completed three months of daily vitamin D treatment. 80.72% (67/83) of the children with ASD who received vitamin D3 treatment had significantly improved outcome, which was mainly in the sections of the Childhood Autism Rating Scale and aberrant behavior checklist subscales that measure behavior, stereotype, eye contact, and attention span (1). Of the 16 parameters measured, ten showed highly statistically significant improvements (see table below).

 

Parameter  P Value (* highly statistically significant)
Relating to people <0.001*
Emotional Response <0.001*
Imitation <0.001*
Body use 0.01*
Object use 0.01*
Adaption to change 0.004*
Listening response 0.01*
Taste, smell, touch 0.1
Visual response 0.003*
Fear 0.13
Verbal communication 0.3
Activity level 0.32
Non-verbal communication 0.2
Intellectual response 0.1
General impression <0.001*
Total CARS score <.001*

 

The researchers concluded that as vitamin D is inexpensive, readily available and safe it may have beneficial effects in ASD patients, particularly when the final serum level is more than 40 ng/ml (1). It should be noted that these results were achieved after only three months of vitamin D supplementation. In a condition that is often present at birth and lasts a lifetime, this is a highly significant finding and should be fully explored immediately.

The first author of the study, Khaled Saad, is Associate Professor of Pediatrics at Assiut University, Assiut, Egypt. Geir Bjørklund is founder and president of the Council for Nutritional and Environmental Medicine (CONEM). Also, one of the coauthors is John Cannell, MD. He is the founder of the Vitamin D Council in San Luis Obispo, California, United States. The study is registered in UMIN Clinical Trials Registry: UMIN000016770.

 

Reference

1. Saad K, Abdel-rahman AA, Elserogy YM, Al-Atram AA, Cannell JJ, Bjørklund G et al. Vitamin D Status in Autism Spectrum Disorders and the Efficacy of Vitamin D Supplementation in Autistic Children. Nutr Neurosci. Article first published online: 15 Apr 2015. DOI: http://dx.doi.org/10.1179/1476830515Y.0000000019.

 

Serum Zinc and Copper Levels in Autistic Children

NeuroReport 25 (15) 2014In collaboration with Chinese researchers, Geir Bjørklund investigated the serum levels of zinc (Zn) and copper (Cu) in 60 Chinese children with autism (48 boys, 12 girls) and a control group of 60 healthy sex-matched and age-matched individuals. The researchers also evaluated the severity of autism using the Childhood Autism Rating Scale (CARS) score. The mean serum Zn levels and Zn/Cu ratio in the study were significantly lower in the autistic children compared with the control group (P<0.001). At the same time were the serum Cu levels significantly higher in the autistic children compared with the control group (P<0.001). It was in the study found a significant negative association between the Zn/Cu ratio and CARS scores (r=-0.345, P=0.007). 

The original article is published in NeuroReport (2014; 25 (15): 1216–1220). Bjørklund is founder and president of Council for Nutritional and Environmental Medicine (CONEM).

 

Si-Ou Li, Jia-Liang Wang, Geir Bjørklund, Wei-Na Zhao, and Chang-Hao Yin

Serum copper and zinc levels in individuals with autism spectrum disorders

Neuroreport 2014; 25 (15): 1216-1220

 

ABSTRACT

Trace elements play a critical role in the pathogenesis of autism spectrum disorders (ASD). The aim of this study was to investigate the serum levels of zinc (Zn) and copper (Cu) in Chinese children with ASD. Sixty patients (48 males, 12 females) diagnosed with ASD and 60 healthy sex-matched and age-matched control participants were assessed for serum Zn and Cu content at admission. The severity of ASD was also evaluated using the Childhood Autism Rating Scale (CARS) score. The results indicated that the mean serum Zn levels and Zn/Cu ratio were significantly lower in children with ASD compared with normal cases (P<0.001, respectively), whereas serum Cu levels were significantly higher (P<0.001). There was a significant negative association between Zn/Cu and CARS scores (r=-0.345, P=0.007). On the basis of the receiver operating characteristic curve, the optimal cut-off value of serum levels of Zn/Cu as an indicator for an auxiliary diagnosis of autism was projected to be 0.665, which yielded a sensitivity of 90.0% and a specificity of 91.7%; the area under the curve was 0.968 (95% confidence interval, 0.943-0.993). In conclusion, these results suggested an association between serum levels of Zn and Cu and ASD among Chinese patients, and the Zn/Cu ratio could be considered a biomarker of ASD.