Big News!

Happy New Year everyone! After a full month without any posts, I feel like I’m seeing an old friend for the first time in while!

It’s good to be back and I have exciting news! Our clinic now offers in-office blood work. It is a wonderful tool for us to be able to help further evaluate our patients and so far it has been a raging success.  We’ve been able to catch things on patients that may have otherwise gone overlooked. Our ultimate goal is to help our patients be as healthy as they can.

We offer a wide range of services including chiropractic, nutritional counseling, dietary management, neurologic rehabilitation and, now, blood work done right in the office!  We are very excited.  Below is a video that discusses exactly how it works. We hope to have more and more “vlogs” (video blogs) so look for those this year!

I’ve listed below a complete list of the blood work that we can perform here in the office with our new Piccolo Xpress.  You may click each link to read more about that particular profile.  If you have any questions please let us know!

	Comprehensive Metabolic Panel (Waived) – ALB, ALP, ALT, AST, BUN, Ca, Cl–, CRE, GLU, K+, Na+, TBIL, tCO2, TP
	Basic Metabolic Panel (Waived) – BUN, Ca, Cl–, CRE, GLU, K+, Na+, tCO2
	Lipid Panel (Waived) – CHOL, CHOL/HDL*, HDL, LDL*,TRIG, VLDL*
	Lipid Panel Plus (Waived) – ALT, AST, CHOL, CHOL/HDL*, GLU, HDL, LDL*, TRIG, VLDL*
	Liver Panel Plus (Waived) – ALB, ALP, ALT, AMY, AST, GGT, TBIL, TP
	General Chemistry 6 (Waived) – ALT, AST, BUN, CRE, GGT, GLU
	General Chemistry 13 (Waived) – ALB, ALP, ALT, AMY, AST, BUN, Ca, CRE, GGT, GLU, TBIL, TP, UA
	Electrolyte Panel (Waived) – Cl–, K+, Na+, tCO2
	Kidney Check (Waived) – BUN, CRE
	Renal Panel (Waived) – ALB, BUN, Ca, Cl–, CRE, GLU, K+, Na+, PHOS, tCO2
	MetLyte 8 Panel (Waived) – BUN, CK, Cl–, CRE, GLU, K+, Na+, tCO2

Your 4 year old needs Ritalin Part II

Yesterday I wrote about how the American Academy of Pediatrics has changed the guidelines about how young (and old) a child could be diagnosed with ADHD. The new guidelines say that a child as young as 4 and as old as 18 may now be diagnosed with ADHD.

They went on to say that Ritalin and other drugs are good choices for treatment even for the youngest patients. To me this sounds like a terrible idea.

So what are some effective alternatives?

First and foremost, we must look at a child’s diet.  A healthy diet is a big key to helping a child regulate his brain function.  The problem in ADHD is that circuits in the brain that are responsible for attention, focus and other executive functions are under active.  That is precisely why most of the medications that exist are stimulants.  These stimulants speed up the processing in these brain regions and allow the child to function more normally.  The problem is that they carry serious side effect profiles, some of them very dangerous.

So where, exactly, does diet fit into this? Good question. First, each and every child must begin the day with breakfast. Food provides the fuel that the brain uses to do its job!  If there isn’t enough of the right kind of fuel, the child’s brain cannot function as well as it should.

And what is the right kind of food? Each child should begin the day with a source of protein and a little healthy sugar in the form of fruit.  This will provide ample amounts of fuel so your child can make it until his next meal at lunch.  Do not allow a child to eat sugary cereals or pop tarts or to skip breakfast.  Those types of fuel (or lack thereof) only set the child up for a crash in blood sugar which deprives the brain of the vital energy it needs.

The rest of the day should be roughly the same.  Be sure that your child eats protein and a fruit or vegetable every time he eats. Steer them away from sugary snacks and drinks.  They have a negative impact on brain function.

Balancing Neurotransmitters

A natural program to balance neurotransmitters in the brain is important. Neurotransmitters are specialized proteins that each nerve in the brain uses to communicate with its neighbors. The balance of them is important.  In ADHD the focus has been on the neurotransmitters called dopamine and norepineprhine.  Others, however, may play a role and include GABA, glutamate, PEA and serotonin to name a few.

The levels of these neurotransmitters in the brain is important.  Levels that are too high or too low can cause the brain to function less than optimally.  In my office we measure these neurotransmitters in a urine test and have found them very helpful clinically.  If we find levels that are low, we can supplement to raise them.  For example, dopamine is raised by increasing dietary levels of tyrosine (or its derivatives) and serotonin is raised by increasing dietary levels of tryptophan (or its derivatives).  The process is relatively simple, but it is very effective. Through this process we are able to rebalance the neurotransmitter system and see improvements in behavior and attention.

Reprogram the brain

This sounds very much like something out of a science fiction movie, but it is all based in neurology.  In ADHD the brain is wired incorrectly.  The circuits that we want to work are not efficient enough to produce balanced brain function.  To change this we must provide a program of neurologic rehabilitation.  It can be done many ways, but in our office we use a combination of home exercises that include eye exercises, balance exercises, light and sound therapy and proprioceptive feedback with an in-offfice therapy called interactive metronome or IM.

IM was developed in the early 1990s and is used to help children with learning and developmental disorders as well as adult neuro rehabilitation patients. IM is a neuro-motor assessment & treatment tool used in therapy to improve the neurological processes of motor planning and sequencing.

The IM program provides a structured, goal-oriented process that challenges the patient to synchronize a range of hand and foot exercises to a precise computer-generated reference tone heard through headphones. The patient attempts to match the rhythmic beat with repetitive motor actions. A patented auditory-visual guidance system provides immediate feedback measured in milliseconds, and a score is provided.

Over the course of the treatment, patients learn to:

• Focus and attend for longer periods of time
• Increase physical endurance and stamina
• Filter out internal and external distractions
• Improve ability to monitor mental and physical actions as they are occurring
• Progressively improve coordinated performance.

I’ve used this program with many children and adults in my office and it works exceptionally well.  It is a great option for patients who have been diagnosed with ADHD and other learning disorders.

There are many options for parents with children with ADHD.  Medications are of course one of them, but there is no permanent benefit to taking them.  As a matter of fact, 50% of children who take medications will still need them as adults.  Rewiring the brain, dietary changes and rebalancing neurotransmitters has lasting and permanent effects.  In my opinion, it’s the best way to go.

Your 4 year old needs Ritalin

Unfortunately, your child’s pediatrician might agree.  The American Academy of Pediatrics recently changed the age at which children could be diagnosed with ADHD.  Now children as young as 4 and as old as 18 can be diagnosed with attention deficit hyperactivity disorder.  This diagnosis now also includes the old diagnosis of ADD, a term that is no longer used.

This change has led to fears that with more diagnoses there will be more drug therapies applied and perhaps some of these will be diagnosed incorrectly.  To me, these sound like legitimate fears.

The first problem I have is that the drugs approved for treating ADHD are dangerous and pose serious risks.  On top of that, they have only been approved to be used in children 6 and over.  No one has studied these medications on children younger.  This is a major problem. We cannot possibly know what these powerful stimulants can do to a developing brain.  These stimulants are, after all, a derivative of methamphetamine (basically speed!).

The guidelines are quick to point out that while Ritalin is an effective option, it should only be used once behavior modification has been tried unsuccessfully. The problem with that is I find many pediatricians are already too quick to write a prescription and move on to the next patient.  In a health care environment where most physicians are strapped for time as it is, they are unlikely to take the time to describe how to implement a program of behavioral modification and are much more likely to recommend something quick and easy like Ritalin.

A child that is just 4 years old is still developing.  Their brain is malleable and easily changed.  On one hand this is a good thing.  It means changes in their home life, behavioral modifications and therapeutic exercises have a great chance of working.  On the other hand it means the potential for negative change associated with medications is greater as well.

I see many children in my office for neurobehavioral disorders like ADHD.  I find I can recognize the hard signs in a 4 year of ADHD like breakdown in gait patterns, breakdown in eye movements or the persistence of primitive reflexes.  These are easily corrected with a program of brain rehabilitation and does not require dangerous stimulants.

These guidelines seem to be a way to open a new market for pharmaceutical sales.  As a matter of fact, the chairman of the committee who recommended the new guidelines, physician Mark Wolraich, is a periodic consultant to Eli Lilly,  Shire Plc, and other pharmaceutical companies. Eli Lilly and Shire hold exclusive U.S. patents for atomoxetine (brand name Strattera) and guanfacine (brand name INTUNIV), respectively, both of which the report recommends for treating ADHD in adolescents.

Parents should not be fooled by these recent recommendations.  Parents should seek drug-free alternatives for their children if they believe that they have ADHD. We just don’t know what these medications can do to a young brain.

Sidney Crosby’s got a new weapon

Dr. Carrick and Sidney Crosby seated at a press conference.

If you follow the NHL at all, you know who Sidney Crosby is.  He is arguably the best hockey player in the world.  He is the face of the National Hockey league. He is not playing hockey at the moment.

At the beginning of this year, Crosby was leading the NHL in scoring.  His team was playing well and was expected to make a deep run into the playoffs. Then two hits sidelined his season and possibly his career.  These hits, which came just days apart from one another caused Crosby to have two concussions which he had a very difficult time recovering from.

His symptoms were so debilitating that he couldn’t watch TV, drive a car or even shop at the grocery store. He had post-concussive syndrome with a unique component.  His vestibular system was affected.

The vestibular system is basically our balance center.  It allows us to stay balanced in earth’s gravitational field.  It tells the muscles of our neck, back and eyes how to respond to changes in position without conscious intervention.  This is important because if we needed to think about staying balanced every time we changed position, we wouldn’t think about much else!  Without our vestibular system, you and I could not walk, run or play. And we definitely could not skate at the level Sidney Crosby is accustomed to!

Sidney Crosby’s progress was moving exceptionally slow.  It was so slow that people in the media began to question whether he would ever play hockey again. He had been seeing some of the most prominent neurologists and concussion experts in the world with little to show for it. Then, a chiropractor who works with many professional sports teams recommended that he go see Dr. Ted Carrick.

Dr. Carrick is a chiropractic neurologist and head of the Carrick Institute.  In addition to being a chiropractic neurologist, he has a Ph.D in neurology.  His focus is to help people functionally rehabilitate their brains when there has been injury.  The results he has achieved with Crosby are quite amazing.

What do I mean, functionally rehabilitate? The brain has many, many functions.  It is very powerful.  Even small changes in the way the brain processes, interprets and executes function can cause symptoms.  Despite this fact, when people have concussions they are told time is the only thing that can heal the brain.  They are given no advice on how to rehabilitate their brain.  We understand rehabilitation when someone sprains an ankle or tears and ACL.  Those patients are given aggressive rehab programs to strengthen and heal their ankle or knee.  Why wouldn’t we do this for someone with a brain injury?

This is what Dr. Carrick has done for Sidney Crosby and it is also what we do here in our clinic.  We use the same techniques that Dr. Carrick is using on Crosby to help patients in our office every day.  As a matter of fact, I have studied under Dr. Carrick and seen him lecture on these brilliant techniques many times.  It is quite amazing.

So what exactly do we do? We use many different therapies designed to re-educate the brain and help it to more efficiently process the information it receives.  If the information is processed correctly it can respond appropriately and that is when we begin to see symptoms of many brain disorders improve.  The types of therapies vary depending on what and where the problem lies in the brian.  But they range from eye exercises to sound and light therapy to balance exercises to general brain games.  The list really is endless.

Dr. Carrick is hopeful the Crosby will begin playing shortly.  The progress that Crosby has made with Dr. Carrick is astonishing, but it’s not a miracle, it’s neurology.  I’m glad this type of rehabilitation is getting a little mainstream media coverage.  In my opinion, it’s just the tip of the iceberg!

What’s that sound?

Image via Wikipedia

Tinnitus, or ringing in the ears, is an exceptionally common problem.  As many as 2 million Americans experience this on a daily basis.  It can range from very minor to annoying to debilitating.

Tinnitus is often associated with hearing loss.  Prolonged exposure to loud noises is the most common cause of hearing loss.  It is this loss of hearing that is actually causing the tinnitus.  Say what? Hearing loss actually causes people to hear sounds that don’t really exist? Yes!

People often describe tinnitus as ringing in the ears.  However, the list of sounds that are considered tinnitus is very long.  Other sounds that people might perceive include ticking, clicking, whooshing and buzzing to name a few.

Recent research, published online in the journal Proceedings of the National Academy of Sciences, suggest several new approaches to treatment, including retraining the brain, and new avenues for developing drugs to suppress the ringing.

As a chiropractic neurologist the above statement about retraining the brain got my attention.  This is something that is near and dear to the heart of all chiropractic neurologists.  We use techniques that retrain the brain every day.  We use these techniques to help people with a wide variety of conditions ranging from anxiety to muscular imbalances and pain.

Traditionally, patients with tinnitus are told the problem stems from damaged hair cells inside of the ear.  They are told it is these hair cells that are sending the wrong signals into the brain which interprets them as noise. Turns out, this is not true.

Because each hair cell is tuned to a different frequency, damaged or lost cells leave a gap in hearing, typically a specific frequency and anything higher in pitch.  It is this gap which causes problems for the brain.

Chiropractic neurologists have been saying for a very long time that ringing in the ears is actually brain based.  This new research supports this assertion. Below is information from coauthor of the recent study Shaowen Bao, adjunct assistant professor in the Helen Wills Neuroscience Institute at UC Berkeley

Experiments in the past few years have shown that the ringing doesn’t originate in the inner ear, though, but rather in regions of the brain — including the auditory cortex — that receives input from the ear.

Bao’s experiments in rats with induced hearing loss explain why the neurons in the auditory cortex generate these phantom perceptions. They showed that neurons that have lost sensory input from the ear become more excitable and fire spontaneously, primarily because these nerves have “homeostatic” mechanisms to keep their overall firing rate constant no matter what.

“With the loss of hearing, you have phantom sounds,” said Bao, who himself has tinnitus. In this respect, tinnitus resembles phantom limb pain experienced by many amputees. (From sciencedaily.com)

The neurons that have lost sensory input in the brain are the neurons that are responsible for the perceived noise that people hear.  These neurons have undergone a process called transneural degeneration.  To stabilize these neurons they need more input.  But because they cannot receive it from the hair cells in the ear that are damaged, other areas of the auditory cortex must take over.  This retraining of the brain takes time, but if performed diligently, the results can be phenomenal.

We know this is a possibility because the brain is plastic.  That is, it changes in response to the stress and environmental input it receives. When a finger is amputated, for example, the region of the brain receiving input from that finger may start handling input from neighboring fingers.

Drug therapy is aimed at increasing the levels of the neurotransmitter GABA in the brain.  GABA is the primary inhibitory neurotransmitter.  In order to slow down the firing rate of these over excited cells, we must increase the levels of this inhibitory neurotransmitter.  The good news is there are lots of natural therapies that work to raise GABA levels or drive GABA receptors in the brain.

One way is to use the amino acid taurine.  I use it frequently.  Another is a product called phenibut (Phen-i-bute).  It is a natural GABA derivative that crosses the blood brain barrier and binds to GABA receptors.  I also use this frequently in my practice. These supplements, however, I believe are temporary solutions.  The permanent solution is to retrain the brain.

Tinnitus is a complicated and elusive condition, but we appear to be headed in the right direction in terms of research.  Always remember, the brain holds the key!

Anxiety or Depression? Test the levels of your neurotransmitters to guide therapy.

Image via Wikipedia

Happy New Year!  A new era began at the Vreeland Clinic on January 1st this year.  Dr. Carrie and I would like to thank all of our friends and family for their well wishes.  We looked forward to continuing to serve the community for years to come!

Today I’d like to touch on something that has revolutionized the way I practice.

People come to me for many reasons.  Some people come to my clinic for weight loss or to get more energy.  Others for help with a chronic condition that hasn’t responded to traditional care.  Still others come to see me for a wide range of neurologic conditions.  These include things like Parkinson’s disease, multiple sclerosis, depression or anxiety.  It is the last two that I’d like to focus on today.

Anxiety and depression are extremely common in America.  Millions of Americans suffer from anxiety, depression or both.  These conditions may have many etiologies but one theory is a chemical imbalance in the brain.

Just what is this chemical imbalance?  When someone states that they have a chemical imbalance they are referring to an imbalance in the neurotransmitter system of the brain.  These neurotransmitters are really just proteins that each nerve in the brain uses to communicate with its neighbors.  Sometimes people can have too little of a certain neurotransmitter or too much of another.  This is problematic because it alters the way the brain functions.  It may cause anxiety and/or depression.

The pharmaceutical industry has figured that out and makes a large class of drugs that alters neurotransmitter function in the brain.  These are drugs like Prozac, Zoloft, Wellbutrin and Lorazepam to name a few.

Neurotransmitters are broken down into two categories – they are either excitatory or inhibitory.  That means they either tell the brain to go or tell the brain to stop.  The complexities of the neurotransmitter system are extensive and there is much more to it than “go” and “stop” but that basic principle holds true in most cases.

Examples of neurotransmitters include serotonin, GABA, epinephrine, norepinephrine, glutamate and dopamine.  Serotonin and GABA are inhibitory while epinephrine, norepinephrine, glutamate and dopamine are excitatory.

If you have anxiety and depression often times an imbalance exists in the levels of these neurotransmitters.

For example, high levels of glutamate may cause anxiety or seizures.  Low levels of GABA may cause anxiety.  Low levels of serotonin may cause depression.  Same goes for norepinephrine.

So how do you tell which neurotransmitters are low or which are too high?

Measuring Neurotransmitters

Measuring your neurotransmitters with a urine test is the best way to estimate your levels of neurotransmitters.  We do this routinely in our office for many patients.  It is incredibly insightful and directs our care for patients with anxiety, depression and many other conditions.

The measurement of neurotransmitters in the urine has been around for many years.  I’ve read studies dating to the 1960’s of scientists using similar methods to evaluate neurotransmitter levels.

Until relatively recently, perhaps the last 10-15 years, it has not been used frequently in clinical practice.  Now, through specialized laboratories, it is available to the general public and it is very affordable.

The knock on urinary neurotransmitter testing is that it does not correlate with brain levels of these hormones because the urine test is in fact testing whole body levels of neurotransmitters.

The very neurotransmitters that exist in our brain to make us happy exist outside the brain to serve the body in other ways.  So, yes, it is true that checking urinary neurotransmitter levels is technically a check of the entire body’s store of neurotransmitters.  But, through hundreds of thousands of tests these specialized labs have shown with high correlation that when neurotransmitter levels are abnormal certain psychiatric and neurological conditions are much more common.

Clinically, I have seen an almost one to one correlation in my patients with certain conditions an alteration in their neurotransmitter system.

The lab that I use will test all of the basic neurotransmitters plus a slew of metabolites of these neurotransmitters.  It provides a wonderful window into the neurological system.

If I find that serotonin is low, I supplement with something called 5-HTP.  If dopamine is low, I like to use L-tyrosine or an herb called mucuna pruriens.  The list can go on and on.

Once someone has been on a program for 6-8 weeks we recheck their neurotransmitter profile to gauge our therapy and adjust it if necessary.  We find that once a person’s profile returns to normal, their symptoms resolve.

If you have anxiety or depression, consider seeking out someone who does this kind of testing to improve your outcomes.  The brain is incredibly complex.  It never hurts to have a little extra information to guide your therapy.

Chiropractic saves 40% on care for low back pain.

Image via Wikipedia

My blogs generally focus on nutrition and other topics that relate to health.  That is the main focus of my practice.  But as a chiropractor by training I still see some patients that want just that – chiropractic.  I enjoy those patients because I feel as if it gets me back to my roots, so to speak.

Recently I came across a study that was just too good not to share with all of you.  It was about low back pain, its costs to patients and insurance carriers, and how starting your care with a chiropractor can save an astonishing 40%!  This is big news in this day and age with health care costs skyrocketing.  The medical profession and insurance companies should take notice and stop putting so many road blocks in the way of getting quality chiropractic care for people.

The new study showed that people who initiated care for low back pain with chiropractors saved an average of 40% over people who initiated care with a medical doctor.

The study collected data from 85,000 Blue Cross Blue Shield beneficiaries.  It concluded that insurance companies that restrict access the chiropractic will likely end up paying more for care.  This is precisely what insurance companies should be trying not to do.

The study was published in the December 2010 issue of the Journal of Manipulative and Physiological Therapeutics. It looked at Blue Cross Blue Shield of Tennessee over a two year span.  The people in the study had open access to medical doctors and doctors of chiropractic through self-referral.  There were no limits applied to the number of MD or DC visits and no differences in co-pays.

The study showed that people who started their care with a chiropractor instead of a medical doctor saved their insurance company almost 40%.  They calculated that would save BCBS of Tennessee $2.3 million annually.

I’m not one to listen to the insurance companies crying poor.  This story isn’t about saving insurance companies more money.  The point is that chiropractic has been shown to be more effective than conservative medical care and this study shows that it is also more cost effective.  Considering 85% of people will experience back pain in their life time and in a time when health care costs are on the national stage, this story should be front and center.

So next time you have back pain, make sure you see a chiropractor first.  Not only is it more effective, it will save you money!

1 in 100 Children have Autism…Find Out Why

My recent studies have focused very much on vitamin D and all of its wonderful benefits.  A quick perusal of the other articles on our blog will confirm this!  Recently, I came across information that was too good not to share with all of you.  A link between Autism and vitamin D deficiency has been established.  As some of you know, we see many children at The Vreeland Clinic for interventions with autism.  We provide nutritional and neurological rehabilitation programs to further assist in the development of the brains of these children.  In this article I would like to share with you groundbreaking information regarding vitamin D and autism.

Autism now affects 1 in 100 children in the U.S.

Autism statistics are staggering.  Twenty-five years ago an autism diagnosis was a 1 in 10,000 chance.  Today, 1 in 100 children will be diagnosed with autism.  Many researchers point to the increase in diagnosis as nothing more than more accurate methods and increased awareness.  They believe that the number was always about 1 in 100, but it was not reported.  Although there is some truth to more accurate diagnosis, it does not account for such a meteoric rise.  What’s more likely is that there has been some change in our environment over the last 20 to 25 years that, in combination with a more accurate system of diagnosis, has caused the number of autistic children to rise to epidemic proportions.

Autism involves poor social and verbal functioning accompanied by a host of other issues that range from poor digestion to fixed and repetitive behaviors.  Also included in the Autistic Spectrum Disorders is a series of problems with fine or gross motor control, all of which can have a devastating effect on a family.  The range is so broad in fact that many scientists and healthcare professionals often do not agree on a diagnosis.  What is presently known is that this condition can cause subtle developmental delays or profound issues that can require long-term care is specialized facilities.  The dichotomy is obvious, but there seems to be a link between the two.  This link is vitamin D.

There are many proposed causes of autism.  Most agree that there is some genetic predisposition.  This has been suggested because of the increased frequency of autism that tends to occur in families and in studies of identical twins.  Although there is a genetic link, it is also accepted that some environmental trigger must occur to cause autism.  The majority of scientists have come to a consensus that identifies both genetic and environmental factors as being relevant in the cause of autism.  Many theories have focused on environmental toxins, especially heavy metals, as a culprit in autism.  Another theory is low levels of vitamin D during pregnancy and infancy.

Many times when speaking about autism people are very confused by the recent rise in autism diagnoses.  Most times,

A link between Autism and vitamin D deficiency has been found

people rightly point out that a purely genetic theory makes no sense because our genes certainly are not any different than they were 20 years ago.  They also make the point that our environment, while different, is not significantly different than it was 20 years ago.  If both of these previous statements are true, and I believe they are, then what could possibly be causing the rise in the diagnosis of autism?  Dr. John Cannell, a leading researcher in vitamin D has a theory.  He agrees that genetically we are the same today as we were 20 years ago and that the environment, while altered, is not so significantly altered to cause an epidemic of autism.  He argues that our behavior with regard to our environment has changed.  He states that these changes have had an effect on our nervous systems that can and does account for a rapid rise in autism diagnoses.

Our understanding of what vitamin D does in our body has exploded in recent years.  Although most physicians know that vitamin D is critical for healthy bones, most do not know about its other benefits.  Vitamin D is critical for a healthy heart.  It has been shown that it is critical in preventing many forms of cancer.  We know that it regulates the immune system by keeping it prepared but also keeping it from overreacting.  Vitamin D is a potent anti-inflammatory.  It has also been shown that the active form of vitamin D, called calcitriol, is an important neurosteroid hormone.  A neurosteroid hormone is a compound that is extremely important for brain development and behavior.  Calcitriol is a potent neurosteroid that controls brain cell growth and acts on brain cells from the time of conception.  Recent research has suggested that vitamin D offers “neuroprotection, antiepileptic effects [antiseizure effects], immunomodulation, impact on several brain neurotransmitter systems and hormones as well as regulation of behaviors.”  The last statement makes it very obvious that vitamin D is critical for pregnant mothers, newborns and children alike.

The question remains, however.  What could have possibly changed so greatly in the past 20 years that it would account for the rapid rise in autistic cases?  Dr. Cannell believes it is a simple answer.  He believes that in an effort to reduce our risk for skin cancer we have created a very serious deficiency in vitamin D.  Remember, it is through the sun’s UV rays that most of our vitamin D is produced in the body.  By lathering up with sunscreen every time we go out side, we block those UV rays from ever reaching our skin, thus preventing synthesis of the all important vitamin D.  Dr. Cannell also believes that because we have become a much more sedentary society that we do not get outside nearly as much as we used to.  And is this so hard to believe?  Twenty years ago marks the real beginning of home video game systems.  Cable television was still in its infancy 20 years ago.  The iPod did not exist and hand held electronic games were not nearly as popular and complex as they are today.  So this, in combination with sunscreen, creates a dangerous, yet easily overlooked scenario.

Our unfounded fear of the sun has lead to an epidemic of low vitamin D levels - even in sunny climates.

So what evidence links autism with vitamin D deficiency?  Is it more that just a coincidence?  Calcitriol acts as a molecular switch in brain tissue that turns on favorable genes that facilitate brain development.  In fact, there are about 1,000 genes already known that are targets of calcitriol.  Vitamin D is unique in that is it the only vitamin that relies on the sun for its production rather than dietary intake.  Because pregnant women are getting into the sun less and less they require more and more to be taken orally.  Unfortunately, the prenatal vitamins that most women take are far too low in vitamin D to be of any benefit.  From an evolutionary perspective, our bodies are not used to getting the majority of our vitamin D from a pill.  It is used to getting massive amount from the sun.  The skin’s production of vitamin D is far more effective than ingesting it orally.  Take the following into consideration; in just 10-40 minutes of sunbathing by a fair skinned adult about 20,000 IUs of vitamin D will be produced over the next 24 hours.  It is important to note that the FDA claims 400 IUs per day through diet is sufficient for health.  There is quite a difference between 20,000 and 400.  Now consider this; in order to get 20,000 IUs from diet, one would have to drink 200 glasses of milk or take 50 prenatal multivitamins.  Obviously neither of those is a viable option.

Dr. Cannell points out that people have been avoiding the sun for the past 20 years.  It is exactly in the last 20 years that we have noticed a rapid rise in the diagnosis of autism.  Now, just because the rise in autism parallels a decrease in sun exposure in industrialized nations does not necessarily mean it is a cause and effect relationship.  There are other astounding biochemical reasons this theory makes sense.  A very large amount of animal studies have shown just how crucial calcitriol is to brain health.  In rats, it has been shown that the offspring of vitamin D deficient mothers had abnormal cell growth, structure and functions in their brains and alterations in learning and memory.  A group of French researchers found that 36 important brain proteins are disrupted when vitamin D is deficient during fetal development.  We discussed earlier that vitamin D is a potent anti-inflammatory.  Often in autism, children have problems with immune function similar to those affected by vitamin D – including increased inflammatory cytokine levels.  These high levels of inflammatory cytokines cause oxidative stress in the brain and are known to cause cognitive impairment.  Vitamin D reduces this oxidative stress on the brain.  Calcitriol also helps increase levels of glutathione in the brain.  Glutathione is a critical antioxidant for detoxification.  This may explain the link between heavy metals and autism.  Without the calcitriol, children cannot actively detoxify the small amounts of heavy metals that accumulate in their body on a daily basis.  In time, this results in a toxic load that retards brain development.  As we can see, there are many reasons why vitamin D is important for proper brain function.  It serves to regulate nerve cell growth, it regulates protein structure, it regulates the immune system and it regulates oxidative stress that may damage brain cells.

So now the question is, how much vitamin D do I need?  This is a good question.  Most people cannot obtain enough vitamin D through diet.  Ideally, a good blood level of vitamin D is 50-60 ng/mL.  This can be measured through a simple test.  In order to get to that number most people will have to supplement their diet with a quality form of vitamin D.  Generally speaking, we start adults on at least 2,000 – 4,000 IUs per day and recheck the levels in 2-3 months.  Recent research indicates that even that might not be enough (remember we are told the standard for Americans for adequate health is 400 IUs).  Children over 1 year of age can safely take at least 1,000 IUs but we usually start at 800 IUs and check the levels in 2-3 months.  Vitamin D is very safe to take and as a matter of fact, the risk of not having enough far out weighs the risk of vitamin D toxicity.  In fact, if vitamin D is taken responsibly, the risk of toxicity is virtually zero.  Should you have any questions regarding vitamin D supplementation, please contact you health care professional and talk to them about vitamin D.

Vision Therapy For ADHD.

I recently came across an article in the NY Times that speaks of using vision therapy to correct problems in children like learning disabilities and ADHD.  The article explores the divide that exists between what mainstream medical practitioners think and optometrists think when it comes to vision therapy.  Most of the health practitioners who practice vision therapy for leaning disabilities happen to be optometrists.

Behavioral optometry, as it is called when optometrists focus on these types of conditions, is a growing field within optometry.  This is similar to my own chiropractic profession in which regulated subspecialties like neurology, radiology and nutrition have emerged over the last 20 years or so.  Behavioral optometrists use eye exercises to improve conditions such as ADHD, Autism, learning disabilities and even neck pain.

Mainstream medicine, of course, finds this abhorrently offensive because it does not fit into their own paradigm of drug therapy.  To them, everything that can be known is known and anything ‘outside the box’ is without a doubt wrong and probably dangerous.  As a matter of fact, they will often tell you if you seek these treatments the practitioners offering it are ‘quacks’ and are out to steal your money.  This may sound harsh, but it is not an exaggeration.  I have heard it many times from my patients who were unsuccessfully lobbied by their primary care doctors to stop seeing me for their treatments.

Eye exercises along with other modalities is something that we use with regularity to treat children with a range of conditions that includes ADHD, Autism and other learning disabilities.  It is extremely successful.  Many doctors will say that there is no scientific research that shows it works.  Takes this quote for instance.

“It has no validity,” says Marshall Keys, a Rockville, Md., pediatric and adolescent ophthalmologist who is an outspoken critic of vision therapy.

Dr. Keys clearly has not picked up a neurology text in a very long time. The fact that they eyes and the brain act as virtually one entity is well known.  If they eyes do not work properly the brain cannot process information correctly.  If the brain is not working properly it cannot control the eyes.  The connection is easy to understand.  Try this simple demostration:

Stand up and put your feet together and with your eyes open look up at the ceiling and roll your head in several circles.  Now repeat this with your eyes closed.  It was much easier to stand and roll your head in circles with your eyes open wasn’t it?  You felt more stable with your eyes open.  Why?  Because you depend very heavily on your eyes for your sense of balance.  When you close your eyes you rely solely on the information coming from your inner ear and the receptors in the joints of your legs and spine.  Without the input from your eyes, your brain finds it slightly more difficult to process information.  Now extrapolate this to reading, writing, attention, etc.  Is it not easy to see that if you had an issue with your eyes or your brain that these tasks might be difficult to perform?

I do take exception to one thing in behavioral optometry.  They tend to attribute everything to a problem with the eyes.  While this is the case many times, just as many cases are problems in the brain.  I have seen many children with learning disabilities and sometimes the problem is with the eyes and sometimes it’s in the brain.  The treatments, however, are similar.  You must retrain the eyes or the brain.  To do so eye exercises, light therapy, sound therapy, vestibular therapy, cognitive visualization and balance exercises are applied to name a few.  This, when applied correctly and specifically, corrects the underlying issue.  It is really very amazing.

The brain is an amazing environment, but it is not perfect.  It makes mistakes and can under function just like other parts of the body.  When this happens it needs to be rehabilitated.  This rehabilitation is a simple process, but often requires months to be effective.  This is because of the very nature of the brain.  While it is malleable, it resists change.  A perfect example is trying to master a new skill.  You can’t master it overnight.  It takes many hours of repetition before the skill has been mastered.  Rehabilitating the brain is similar.  Exercises must be done over and over again in order to reap the rewards and see benefit in the end.  People are often frustrated at the pace of therapy, but are extremely pleased with the overall results.  You wouldn’t expect to be able to run a marathon after training for a month would you? The brain is very similar to a muscle.  It must be trained and maintained to function at its very best.  When it isn’t working well, training is the only way to fix it.

If you have a child that is having trouble in school have someone who is trained in functional neurology examine them.  A great website with a list of doctors is www.acnb.org.  They have a doctor locator in which you can put your address and zip code in and find all of the doctors within a defined radius.  If you ask your pediatrician for advice, your child will end up on drugs that have dangerous, even lethal side effects with no prospect of producing any permanent benefits.  Functional brain rehabilitation is the only way to permanently change the function of a child’s brain.