Our Canaries

Why All The Asthma,

Allergies, ADHD and ASD?
Autism One
Saturday, May 23, 2009
Chicago, IL

Nancy O’Hara, M.D.

150 Danbury Road
Wilton, CT 06897
www.drohara.com
 Excellence is the result of caring more than others think is wise,
risking more than others think is safe, dreaming more than others
think is practical and expecting more than others think is possible
 Genetics Don’t Cause
Epidemics
 Increases Over the Past 20 Years
 Autism: 6000% Increase
 1/10,000 to 1/150 (Fombonne et al, JAACAP, 2001)
 ADHD: 400% increase
7x increase in prescriptions (Swanson et al, Neuropsych
Rev 2007)
 Asthma: 300% Increase
 Allergies: 400% Increase
 Diabetes: 103% Increase
5 x increase in <5 year old (Bingley, 2007)
 The Perfect Storm:
Four Catastrophic Changes
 Toxin Proliferation
 Hydrocarbons
 Heavy metals
 Other (hormones, antibiotics, chemicals)
 Nutrition Deterioration
 Vaccination Rates Increased (3 ->
34)
 Ability to Detoxify Decreased
 Debilitation of Methylation and
Sulphation
 Oxidative
Toxins Stress

Inflammation
Pieces of the Puzzle
Impaired
Glutathione
and Sulfate
 Toxins - Metals
 Mercury
 Lead
 Arsenic
 Other
 Mercury Sources
 Vaccines (187.5 mcg mercury)
 Amalgams
 Fish
 Environmental
 Foundries (coal – burning)
 Medical/dental waste
 Fluorescent bulbs
 Mercury – Amalgams
 Approximately 17mcg of mercury released from one
amalgam daily (mostly from chewing)
 8 amalgams ~ 136 mcg mercury vapor released daily
 15 % (17mcg) absorbed daily
 Travels from blood to all organs and cells
 Mercury can concentrate in placenta during gestation
and in fetuses (liver, kidney tissue) and infants (kidney,
brain tissue)
 If >8 amalgams, statistically significant increase in
autism
 17 mcg/day absorbed by pregnant mother
 270 during pregnancy
 4590 mcg during gestation
 Mercury Fish
 6 oz (170 grams) flounder = 42.5 mcg Hg
(0.6 mcg/kg for 70 kg man)
 6 oz swordfish = 2.4 3 mcg/kg
 Most in swordfish, shark, tuna and sea
bass
 Mercury affects fertility – Hong Kong study
 Subfertile (4.5 ppm) males had 40% more
mercury than fertile (3.9 ppm) males
 Vegetarians – very low levels of mercury (0.38
ppm)
Texas autism
rates, Potential association
by school between autism rates,
environmental mercury
districts other toxins in Texas
Palmer, et al., Health and Place, 12 (2006) 203–209

1990-1993 1998-2000
 On average, for each
1000 lb of
environmentally
Autism rates
released mercury, there
was a 43% increase in
the rate of special
education services and a
61% increase in the rate
of autism.
Palmer et al. Health & Place 12 (2006) 203–209

All Reporting Facilities, All Chemicals TRI-(1987-2002)

Map shows 3,683 of 48,205 facilities reporting nationwide

Chemicals-TRI Total toxicity

(Toxic Release Inventory)
United Nations Environment Program
Global Mercury Assessment, 2002
 Lead
 Poisons developing nervous system
 Decrease in IQ (inverse correlation
between IQ and blood levels at all
ages (British Medical Journal 1996)
 Abortifacents
 Lead Sources
 Metal Foundry
 Poorly regulated factories engaged in metal finishing, grid
insertion, welding, casting
 Herbal Pills, cosmetics
 Cans, ceramics with lead solder
 Chili powder
 Cooking with Petroleum
 Toys painted with lead paint
 Exhaust emissions from leaded petrol
 Insecticides
 Lead pipes
 Burning of newspapers, batteries
 Other Heavy Metals and
Toxins
 Arsenic
 Pressured-treated wood
 Inorganic chickens (plus fed fish meal)
 Cadmium (industrial, incinerators)
 Antimony (flame retardants – Australia study:
SIDS)
 Food additives
 MSG (neurotoxin)
 Fluoride
 China study: 7 point decrease IQ in community with high
fluoride levels
 Toxins - Chemicals
 80,000 manmade chemicals
 Need 6,320 million tests to evaluate
pairs
 9 tested pesticides
 7 of 9 found to be neurotoxins
 None have been banned
 Chemicals
 PCBs/dioxins
 Disrupt thyroid and other hormonal loops
 Depress vitamin A
 Alter serotonin synthesis
 Impair cognition
 Depress IQ
 Increase preservative behavior in newborn
monkeys fed levels commonly found in human
BM (Rice, EnvRes, 1999)
 Chemicals
 PDBE
 Flame retardant
 Endocrine effects
 Perchlorates
 Rocket fuel, fireworks
 Endocrine effects
 Pesticides and Herbicides
 Carcinogens, neurotoxins
(Vibera, ToxAppPharm,
2003)
 Phthalates & Bisphenol A
(BPA)
 Sources
 Plasticizers (#3 & #7)
 PVC
 Polycarbonate
 Food wrap
 High Correlation allergic rhinitis,
eczema, asthma and house dust
concentration of phthalates
 Genetic Predisposition
 “Genes load the gun, environment
pulls the trigger” (Sudhir Gupta, MD)
 Results in toxicities, nutritional
deficits, infections, inflammation,
immune dysfunction
 Epigenetics
 DNA of cell switched on/off -> profound
function changes (Anway et al, Science,
2005)
 Oxidative
Toxins Stress

Inflammation
Pieces of the Puzzle
Impaired
Glutathione
and Sulfate
 Glutathione
 Detoxifies heavy metals and
chemicals
 Antioxidant
 Preserve mitochondrial integrity and
promotes ATP production
 Protects lining of gut
 Promotes normal T cell function
 Oxidative
Toxins Stress

Inflammation
Pieces of the Puzzle
Impaired
Glutathione
and Sulfate
THE IMMUNE-GUT-BRAIN AXIS
Brain

Gut Immune

Detoxification
 Development of Mucosal
Immunity
 Balance of good and bad flora
 Healthy gut flora:
 Plays a crucial role in maturation of the immune
system
 70% immune system in gut (sIgA)
 Sub-optimal stimulation of the sIgA-dependent
mucosal barrier function → increased frequency
of:
• allergies & asthma
• autism
• inflammatory mucosal disorders
• Increased Risk of Systemic Inflammation
 Dysbiosis
A state of imbalanced microbial
ecology
both bacterial & fungal
that contributes to disease
The overgrowth of micro-organisms
of low intrinsic virulence induces
disease
• by altering the nutritional status
and/or
• the immune response of the host
 How does it all fit?
 Maternal presence of decreased Ω3 &
increased Ω6, leads to increased
inflammation
 Commensal flora cultivated over 1st 2
years of life provides the baseline for
immune development
 Early introduction of solid foods, esp.
grains and sugar alters flora
 Early vaccination stimulates TLRs (innate
immune system) and exacerbates
TH1/TH2 imbalance and dysregulation!
What lies behind us and what lies before us
are small matters compared to
what lies within us.
 How Does It All Fit?
The Immune Load
 Pathogens Overload (viruses,
bacteria, yeast)
 Antibiotic Use (depletion probiotics)
 Insufficient Nutrient Load (Poor diet,
junk foods)
 Digestive enzyme deficiency
(Lactose)
 Vaccination Excess
 Stress
 How Does It All Fit?
What Does It Mean
 Digestive impairment
 Inflammation, leaky gut
 Immune deficiency  greater
susceptibility to dysbiosis,
inflammation, and food
sensitivities  further immune
deficiency (vicious cycle)
 Yeast overgrowth, bacterial
dysbiosis
 Oxidative
Toxins Stress

Inflammation
Pieces of the Puzzle
Impaired
Glutathione
and Sulfate
Factors Contributing to Oxidative Stress

Inflammation
Infection

ASD
Genes ADHD Environment
LD

Hormones
Gut Inflammation
Timing Brain Inflammation
Immune dysfunction
 Four Phases of Detoxification
Abnormalities Found with
Oxidative Stress
 Phase I – keeping toxins in gut to safely
exit body (dysbiosis, impaired immunity,
slow transit)
 Phase II – toxins moved from gut to liver
and converted into water-soluble material;
“make sticky” (antioxidants, silymarin)
 Phase III – Conjugate toxins with
detoxifying nutrients (GSH, taurine, NAC)
 Phase IV – Alkalinity more efficient
 What Can We Do?
 Reduce and Eliminate Further
Exposure
 Efflux Existing Toxins (Detoxification)
 The Three R’s
 Remove (germs, allergens, toxins)
 Replenish (nutrients, good foods,
probiotics)
 Repair (inflammation, malabsorption,
methylation)
 Reduce Further Toxins
 Remove Amalgam Fillings
 Reduce Seafood (tuna, shark,
swordfish, sea bass)
 Eat Organic Chicken
 Filter Water
 Eliminate Pollutants
 Avoid Vaccination containing
mercury (flu)
 Avoid Further Toxins
 Avoid lead
 www.cehca.org
 www.leadcheck.com
 Avoid #3 (PVC), #6 (styrene) and #7
(BPA) plastics
 www.checnet.org
 Enhance Output of Toxins
 Correct constipation – all stool is
toxic
 Maintain good hydration/fiber intake
 Maintain alkalinity (diet, HC03)
 Exercise to sweat
Keep Your Faith in All Beautiful Things:
In the sun when it is hidden, in the
spring when it is gone.
What do we need to give to or
get out of our children?
 Exercise/Activity
 Basic nutritional changes (change in
diet..)
 Fresh, unprocessed, unrefined, unadulterated
 Varied and rotational (try to vary day to day)
 Non-allergenic (crave that which most sensitive
to)
 Protein (every 4-5 hours)
 Vegetable juicing
 Organic (especially pears, apples,
peppers, celery, strawberries,
 What To Do?
 Treat Constipation
 At least 1 normal stool/day
 Mg
 Vitamin C
 Fiber
 Senna
 Diet changes
 What To Do?
 Remove
 Junk food, sugar, and other empty calories
 Food additives – Artificial Sweeteners
(Aspartame), MSG, Dyes, Preservatives, etc
 Raw animal food/unpasteurized food – risk of
food-borne illness
 Food Sensitivities – yours and those of your
affected child
 Instead of Gluten, consider quinoa, amaranth, millet, rice or
other grains
 Instead of Casein, consider potato or almond milk
 What To Do?
Remove Germs
 Bacteria (history of positive response to
Bacteria (history of positive response to
antibiotics)
 Virus
• Monolaurin (Lauricidin)
• Valtrex
• Cyclovir (acyclovir, valacyclovir, famcyclovir,
gancyclovir)
• Virastop
 Fungus
• Antifungal medication (Nystatin, Diflucan, Sporonox, Lamisil,
Nizorel)
• OTC (Citrus extract, caprylic acid, saccharomyces
boulardii)
• Diet (not because yeast in our diets is infective…)
 Parasites (have to treat)
 What To Do?
 REMOVE AMALGAMS – When? How?
 At least 3 to 6 months before conception while under
the care of a competent/holistic Physician and Dentist
 PRE-Amalgam replacement regimen
 Start at least 3-4 wks prior
 Consider a good Probiotic, Glutathione, Vitamin C,
Vitamin E, Milk thistle, B-Vitamins, Zinc, Magnesium,
etc.
 Consider taking Activated Charcoal 15 minutes
before procedure starts (to help bind swallowed
mercury and prevent circulation of the metal) AND
immediately after the procedure
 POST-Amalgam replacement regimen
 Continue at least 4 to 6 weeks after
 As above plus… consider IV Vitamin C within 24
hours of procedure, double glutathione dose, amino
acid complex (mercury may deplete or impair
utilization of several amino acids, far infrared sauna
therapy 3x/week
 What To Do?
Replenish and Support
Digestion
 Enzymes (speeds disassembly of

foods;
 -ase)
• Mixed (helps kids with poor
digestion)
• Plant based (papaya and pineapple)

• Peptidase specific (helps specific

peptide digestion)
 Symptomatic (yeast die off)
• Activated charcoal (mop up toxins)
 What To Do?
 Replenish Probiotics
• Promote growth of healthy flora
• Discourage pathogens
• Support digestion
• Produce SCFAs, reduce pH, synthesize
vitamins
• Control inflammation and promote
oral tolerance
• Encourage peristalsis
• Minimum of 10 billion CFU/day, often
> 50 billion CFU/day
 What To Do
Fatty Acids and Immunity
 ESSENTIAL FATTY ACIDS (EFAs)
 DHA more important during pregnancy and
breastfeeding periods (DHA is in breast milk,
not std formulas)
 Associated with brain development, visual
acuity and decreased inflammation
 Maternal DHA levels ↓ in 3rd T – 200 mg/day
DHA increases level in mom, but need higher
doses (~1000 mg/day) to also ↑ levels in
infant.
 Take with antioxidant (Vit E) to prevent free
radical damage
 Make sure product is pure
 What To Do
Fatty Acids in Childhood
Both DHA and EPA are important (any
ratio of 33-66% DHA:EPA is
recommended)

Dosages need to be tailored in line with

severity of the condition.

Children 1-4 yrs 600-1800mg

DHA/EPA per day
Children 4-12 yrs 1000-3500mg
DHA/EPA per day
 What To Do
Fatty Acid Status in ADHD
 Both conditions strongly correlate with low red blood cell
membrane concentration of DHA,EPA,and GLA
 Lower levels of DHA and EPA also correlate with increased
severity of conditions Stevens et al 1996
 Forty one children with ADHD and associated learning
disorders ( mainly dyslexia) were supplemented with
480mg DHA 186mg EPA and 96mg ALA for 10 weeks.

Significant improvement found in:

 Four global scales of ADHD measurement

 Four out of seven sub-scales of the Comprehensive Parent
Rating Scale
 Numerical but not significant improvement in two other
scales
 What To Do?
Replenish Nutrients
 Iron
 Magnesium
 Calcium
 Selenium
 Zinc
 Vitamins C, A, E, D, Bs
 GIVE TMG

MB12 shots

Folinic acid ADD DPPIV

AVOID CASEIN

GIVE P5P
REDUCED THERAPEUTIC
T
GLUTATHIONE H
INTERVENTIONS
T
H
E
 What To Do?
Replenish Nutrients
 IRON
 Important in oxygen transportation, cell
differentiation and heme/RBC function
 Associated with enzymes involved in energy
production and metabolism. Also a cofactor in
neurotransmitter synthesis.
 Low levels in infancy can be associated with↓
cognitive performance in teens (even if treated
early)
 With deficiency – anemia, malabsorption,
fatigue
 Take with Vitamin C to boost absorption
 Sources: liver, meat, seafood, spinach, kidney
 What To Do?
Replenish Nutrients
 CALCIUM
 Many women are deficient before pregnancy
 Reduces preeclampsia
 Vitamin D status is important in calcium absorption
 Important in bone health, enzyme activity, muscle
contraction, neurotransmitter release, blood clotting
 Bone/tooth/muscle/nerve function; cell membrane
permeability
 Deficiency causes rigidity, poor sleep, anxiety, teeth
grinding
 Secondary deficiency
 Absorption vs taste
 Sources: tofu, green leafy vegetables
 What To Do?
Replenish Nutrients

 MAGNESIUM (Martineau et al, 1985)

 > 300 enzymatic functions; neuromuscular,
neurotransmitters, BP
 Deficiency causes hyperactivity, anxiety, twitches,
insomnia
 Sighing/salt craving/constipation
 ↓ magnesium associated with pre-eclampsia, pre-term
delivery, and fetal growth retardation
 Chromium
 Important for glucose control, insulin/liver function
 With deficiency – insulin resistance, Syndrome X,
neuropathy
 What To Do?
Replenish Nutrients
 SELENIUM
 Important for proper fetal growth/development
 ↓ selenium has been associated with some SIDS cases
 Important for redox reactions, antioxidant
 With deficiency – immune dysfunction, cell fragility
 With excess – fatigue, brittle hair/nails, parasthesias
 Toxicity in high doses (> 1000 mcg/day)
 Sources: wheat germ, brazil nuts, oats
 Molybdenum
 With deficiency – poor detoxification, chemical
sensitivity
 With excess – high uric acid, low copper, anemia
 What To Do?
Replenish Nutrients
 ZINC
 Important part of most enzymes, protein synthesis, cell
growth, sensory function (taste, etc), and hormone and
immune function (Sturniolo et al, 2001)
 > 200 enzymatic functions; in energy metabolism, protein,
immunity, detox
 Acne, mouth sores, spots/lines on nails, pica, loss of smell,
taste
 Deficiency causes language, attention and immune issues
 Best given alone, at night (piccolinate, acetate)
 Deficiency is teratogenic in rats, abnormal brain development
seen in monkeys
 Ratio with copper; taste test
 Excess zinc can displace copper and ↓ copper can be harmful
to fetus
 Sources: animal protein, seeds, nuts, beans
 What To Do?
Replenish Nutrients
 Vitamin C (ascorbic acid)
 Anti-oxidant, helps balance amino acids, hormone levels,
important in collagen metabolism (critical for immune
function, nerve transmission, carnitine)
 With deficiency – bruising, poor immune function,
anxiety, depression (diarrhea with excess
 Sources: citrus, broccoli, brussel sprouts, peppers
 Vitamin E
 Anti-oxidant, incorporates into fatty part of cell
membranes and helps protect cells from heavy
metal/chemical damage, boost immunity and sulphation
(glutathione and methylB12)
 With deficiency – jaundice, xs clotting, impaired reflexes
 Sources: seeds, nuts, polyunsaturated fatty acids
 What To Do?
Replenish Nutrients
 VITAMIN D
 Important for calcium absorption
 ↓ associated with various chronic illnesses
 Daily sun exposure for 20 minutes should be enough to
avoid extra oral supplementation beyond what is in the
prenatal vitamins
 Sources: cod liver oil, salmon, herring, egg yolks
 Vitamin A
 Teratogenic (birth defects with > 10,000 IU/d – NEJM
Study)
 Anti-oxidant, anti-viral, and immune regulation functions
 With deficiency – vision, immune dysfunction
 Sources: liver, carrot, dandelion root, kale
 What To Do?
Replenish Nutrients

B12 (COBALAMIN)
 Important in synthesis of DNA, RBC’s, and the myelin
sheath (nerve transmission)
 Produced in gut by good flora – chronic antibiotic use
decreases B12 levels
 Deficiency - decreased communication, anemia, memory
loss, poor balance
 Methyl B12- SQ, IN, TD, oral; need adequate folate
 Sources: animal foods – liver, kidney, eggs, fish, cheese,
meat
 FOLATE
 Important for intracellular metabolism and DNA
synthesis/repair
 400 mcg/day associated with ↓ incidence of neural tube
defects and pregnancy loss
 Sources: green leafy vegetables, asparagus, oranges,
 What To Do?
Replenish Nutrients
 B1 (thiamine)
 Part of an enzyme essential for energy
production, carbohydrate metabolism, and nerve
cell function
 Deficiency can cause ataxia, enuresis, sensory loss)
 Sources: brown rice, sunflower seeds, peanuts
 B2 (riboflavin)
 Important in energy production and regeneration
of glutathione
 Deficiency can cause mouth fissures, photophobia
 Sources: organ meats, almonds, mushrooms,
whole grains
 B3
 Important for energy production and regulation of
blood sugar, antioxidant mechanisms, and
detoxification reactions
 Sources: organ meats, eggs, fish, peanuts
 What To Do?
Replenish Nutrients
 B5 (pantothenic acid)
 Deficiency can cause toe walking, grinding, restlessness,
insomnia
 B6 (PYRIDOXINE; P5P)
 Important in immune function (antibody formation),
protein formation, nerve transmission, and RBC and
prostaglandin formation
 Deficiency can cause immune dysfunction, anemia,
sensory issues, tantrums)
 Sources: whole grains, legumes, bananas, seeds, nuts,
sprouts
 B15 (DMG/TMG)
 Deficiency leads to poor communication
 Give with folate to decrease hyperactivity
 Repair
 Oxidative Stress
• Antioxidants do not work alone (more
like rungs of a ladder; vitamins A, C, D,
E, glutathione, pycnogenol)
 Gut (germs, enzymes, clean out)
 Immune -EFAs
 Hormonal
 Detoxification
You gain strength, courage and confidence by
every experience in which you really stop to
look fear in the face…. You must do the thing
you think you cannot do.
-Eleanor Roosevelt
 How does it all fit?
Fostering A Healthy
Environment
 Breast is BEST!
∀ ↑ Production of beneficial Bifidobacter

in 1st year
 Delay introduction of solid foods,
minimizing or avoiding wheat & milk,
support flora
 Infants with a family history of atopic
allergy who received a Lactobacillus
probiotic had a 50%  in atopy @ 2yo
 Fostering A Healthy
Environment
 Foods
Start soon after 6 months (some
studies show that waiting too long
after that increases the incidence of
allergies, etc)
 Good options for first foods are avocado,
fruits and vegetables
 Avoid any foods that siblings or parents
are sensitive to

 Fostering A Healthy
Environment
 Vaccines
 Consider modified schedule –separate all
vaccines in time (gives child’s immune system
more time to develop)
 Always use Thimerosal free vaccines
 Avoid Flu shots unless necessary
 Avoid vaccines during pregnancy
 Support with antioxidants (Glutathione, Vitamin
C, A, E)
 Keep children on nutrient-rich diets
 Do not give to sick kids (fever, cold, on
antibiotics, etc)
Follow those who seek the truth but
flee from those who have found it.
Yaclav Havel
 Basic biomedical
interventions
FIX METABOLIC PROBLEMS
HEAL THE GUT


 Additional
 Avoid what harms Vitamins/Minerals
 Magnesium
 Gluten?  Calcium
 Casein?  Iron

 Additives?  Antioxidants

 Vitamins A, C, D, E
 Toxins?
 Anti-inflammatories
 Give what heals  Pycnogenol

 Detoxification
 Nutrients (MVI)
 Sweat
 Probiotics
 Omega 3 EFAs
 What Is It That My Child
Needs:
 To Get
 To Get Rid Of
 My Courage
 “Courage does not always roar.
Sometimes it is the quiet voice at the
end of the day saying,
“I will try again tomorrow.”