Immunology, Gastroenterology and Autism

The Salisbury Autism Support group's conference, held in October, was, as usual, fascinating. Nutritionist, Beryl Paton, reports on it for us.

Anne Cunningham lectures students at Sunderland University about the human immune system, whose main task is to recognise danger - and destroy it. There are many different ways that this can be achieved - and many ‘fail safe' mechanisms.

Dr Cunningham told us about the huge concentrations of immune cells in the gut and the lungs, two of the areas of the body (along with the skin) where we are most likely to be exposed to danger. These cells mount an inflammatory response as a first line of defence.
She took us on a whistle-stop tour of the different immune cells which can multiply rapidly to deal with an emergency, and which circulate round the body in the bloodstream. These cells can destroy invading bacteria and viruses. (For visual illustration see Dr Cunningham's riveting website at

She also described the antibodies circulating in the blood plasma, which retain a memory of specific disease organisms so that the appropriate defence cells can be mobilised rapidly once the invader is recognised. Vaccines are given to help create these antibodies to specific diseases.
However, she also emphasised the individual nature of each person's body and immune response - a subject raised again at the plenary session at the end of the conference with reference to our present ‘'one-fits-all' vaccination programme for babies.

Dr. Natasha Campbell-McBride talked about the syndrome that she has christened GAPS - Gut And Psychology Syndrome.

In her clinic she sees children with autism, ADHD, dyslexia, dyspraxia, learning difficulties, behavioural and social problems or a mixture of all of these. She feels that they are vulnerable, if untreated, to psychoses as adults and may develop substance abuse, depression,obsessive/compulsive disorder, bipolar disorder disease or schizophrenia. She maintains that there is a bio-chemical background to every illness. (Remember - schizophrenia used to be associated with coeliac disease.) The patients that she sees are physically unhealthy:

• They have digestive problems.
• Allergies are very common.
• Asthma and eczema are common in infants.
• Malnutrition is present because they don't digest and absorb food properly.
• Bed-wetting is common, often into adulthood.
• Thrush is very common and it is difficult to diagnose in the gut.
• There is often chronic cystitis with regular infections.
• There may also be viruses: cyto-megalovirus, herpes and measles.
• There is an overgrowth of abnormal gut flora and a dearth of good gut flora.

Gut flora
Gut flora are essential for cell regeneration, detoxification, immune system modulation, digestion, absorption and synthesis of vitamins - especially B vitamins. Good gut flora are especially vulnerable to broad-spectrum antibiotics, allowing an overgrowth of candida and clostridia, which can produce neurotoxins and alter sulphate levels by ‘'eating' sulphur (see Dr Hinder’s talk below).

The gut/brain connection
The gut can become a major source of toxicity, producing brain altering substances such as acetaldehyde and alcohol, dermorphin and deltorphin, gluteomorphin and casomorphin and clostridia neurotoxins. These can be identified by testing the urine for organic acids.

A typical scenario in her clinic involves a mother who has gut dysbiosis herself (probably encouraged by oral contraceptives) so her baby does not develop normal gut flora (especially if not breast-fed).

The baby may then become immune compromised and get ear infections for which it is given antibiotics which further damage the gut flora. Vaccinations and poor weaning diet may add to the problems and the result is gut dysbiosis in the child. The gut then produces toxicity instead of nourishment which reaches the brain via the bloodstream.

Key treatments
• Re-establishment of a normal gut flora.
• Diet with no starches or sugars. Ample carbohydrate is obtained from fruit and vegetables.
• Fresh meat (not preserved), ripe fruit, nuts, seeds, eggs, and animal fats to help control cravings.
• No processed food (it feeds abnormal flora).
• Nutritional deficiencies should be addressed with easily absorbed supplements including a probiotic, cod-liver oil, essential fatty acids, multivitamins/mineral/amino acid liquid, digestive enzymes with hydrochloric acid and pepsin.
• Detoxification - best achieved by fresh juices twice-daily.
• Bone and meat broth and raw cabbage juice help increase stomach acid and improve digestion.

Dr Steve Hinder is a consultant psychiatrist specialising in learning disabilities and autism.

He is quite certain that diet modification and nutritional supplements can be extremely helpful - despite his medical colleagues’ reluctance to accept this.

He noted biological markers in autism, such as increased platelet serotonin (giving low levels of serotonin in the brain) and decreased levels of sulphate which is vital for detoxification.

Both autistic children and those with learning difficulties have low sulphate levels but increased cysteine, which should be converted to sulphate in the body. This indicates a problem with the enzyme phenolsulphotransferase (PST) which enables this conversion. Sulphate levels can be increased by soaking in a warm bath with Epsom salts several times a week and by taking glucosamine sulphate.

The detoxification of paracetamol (the painkiller used in Calpol) uses up a lot of sulphate and Steve recommends using Nurofen instead. It may also be helpful to cut out high phenol foods (citrus, vinegar, tomatoes and apples) as phenols use a lot of sulphate in their detoxification.

Opiate excess theory
The 'opiate excess' theory likens autistic behaviour to that of people who have taken opiates.

Gluten and casein in the diet convert to opiates in the gut where they are normally broken down. If the gut is leaky (lack of sulphate attached to the lining of the gut may contribute to this) the opiates may ‘leak’ into the bloodstream and thence into the brain. The theory would seem to be supported by the fact that Naltrexone, used medically to counteract opiate overdose, can modify severe self-injurious behaviour in people with autism.

A gluten-free/casein-free diet will help about 40% of children; another 30% may not respond obviously but will react to reintroduction. Total elimination is needed for most children. Steven recommends starting with casein then moving on to gluten. Both usually need to be eliminated.
Children who respond to the diet have frequently either craved or avoided gluten and casein containing foods. Sometimes there are withdrawal symptoms which temporarily worsen behaviour. Trial, error and perseverance are essential, together with the recognition that each child is different.

Other approaches
Candida (commonly found) is treated with Nystatin and/or caprylic acid and garlic. A low sugar diet is needed and good quality probiotics should be given. A 'die off' reaction may occur.

Essential fatty acids can be extremely helpful, especially the Omega 3s with extra EPA. Zinc is needed for the body to be able to utilise them properly. Cod liver oil may also be useful for its vitamin A content.

Other useful supplements include high-dose B6 and magnesium, TMG, digestive enzymes, multivitamins, minerals and glutamine which helps to heal the gut.

The elimination of all food additives including MSG and aspartame is advisable.

It should also be remembered that many treatments work synergistically so it is worth continuing to experiment with such interventions both with children and with adults.
The only drugs that Steve regularly uses are Nystatin and anticonvulsant drugs where needed for epilepsy.

Epilepsy & Vaccination
The afternoon plenary session addressed questions on epilepsy and vaccines.

Dr Campbell McBride felt there should be some prevaccination testing to identify vulnerable children, and that children from atopic or immune compromised families, or with siblings with ASD, should not be vaccinated until they were much older.
She also felt that toxicity could exacerbate epilepsy and that the need for drugs might be less if a good detoxification programme was followed.

Both Dr Hinder and Paul Shattock (who chaired the conference) warned that anti-convulsant drugs should not be discontinued without advice from the child's neurologist as recurrence of epilepsy had been seen when a patient had been accidentally exposed to previously excluded foods. Paul Shattock felt it might be a good idea for a small maintenance dose of anti-convulsant drugs to be continued indefinitely to guard against this.

More information from Autism Support Salisbury
also for Paul Shattock's extremely helpful Sunderland protocol:


Click here for more general articles on autism

First Published in 2005

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