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CC: Signs of Early Autism, Developmental regression, and Delays. Need for Nutritional Support, Suspected heavy metal detox.
Zack was 2.5 years old when he was brought in with concerns of chronic loose stool since six months of age, developmental regression, and early signs of autism.
Throughout Zack's infancy, he had been developing normally, hitting growth and height milestones on time, meeting developmental targets when expected, and eating a diverse array of foods, overall a happy toddler.
At 18 months, the patient received his 4th dose of the DTaP vaccine, Varicella-Zoster, and the flu shot. Within 1 hour, he spiked a low-grade fever that lasted 24 hours, accompanied by a fussy demeanor. Over the next few weeks, mom and dad began to notice a regression in Zack's vocabulary, which had previously been around 30 words, as well as a loss of recognition of his name and less responsive to parents, social, and vocabulary cues overall.
Additional History
The patient was full term, mom had a healthy pregnancy, and did not take antibiotics or medication during pregnancy except a DTaP vaccine in her second trimester. The patient was delivered vaginally, breastfed till 22 months, and co-slept with parents until 24 months.
Since six months of age, bowel movements have been a loose, oatmeal consistency, foul-smelling, very light brown/tan color, and always containing undigested food particles. The patient would frequently have post-meal bloating accompanied by him pushing his hands or toys into his belly for counter pressure.
Patient's Current Diet
At the time Zack presented, he was eating peanut butter/sun butter/tahini and jelly on white bread, scrambled eggs, chicken nuggets, toast with cream cheese, cashew and almond milk, beef sticks, and fruit- bananas, strawberries, red grapes. He was drinking very little water, less than 2 oz on some days, due to no desire to drink, but his parents could get him to drink apple juice.
Initial Lab Work
GI MAP Stool Panel
Alletess Food Sensitivity Panel
Lab Analysis
Digestion
Zack's lab results point out three main things contributing to his ongoing loose stool.
- Patients' diet was high in level 1 and 3 food sensitivities, contributing to an ongoing state of inflammation in the gut and contributing to leaky gut.
- High in dysbiotic bacteria
- Low in beneficial bacteria, chiefly Akkermansia muciniphila
Interventions
Nutritional Support
- ½ tsp cod liver oil 1x daily with meals for a total of 1,000 mg combined DHA/EPA to address lack of fatty acid intake
- Transition Zack to a gluten and dairy-free diet while weaning out known food sensitivities (40 days for level 1 and 120 days for level 3).
Detox
Due to moms' vaccine exposure during pregnancy, followed by patients' developmental and behavioral regression following his 18 month round of vaccines, it was highly suspected that the patient's detox capabilities were limited. Supporting these pathways through diet and homeopathic interventions is gentle and effective in helping the body effectively eliminate this toxin burden.
- Homeopathic detox support began with one dose of thuja 30c in office followed by one dose of homeopathic DTaP 30c preparation taken two pellets every other day for one week, then follow-up.
- Mother was also instructed to begin giving the patient detox baths 3x weekly: Epsom salt, magnesium flakes, box baking soda, pink Himalayan sea salt, and bentonite clay.
Gut Support
- Due to the high level of dysbiotic overgrowth, antimicrobial foods were recommended 2x daily in the form of bone broth cooked with oregano, thyme, ginger, garlic, thyme, and coconut oil stirred into puree and smoothies. Honey was used as the only sweetener while avoiding sugar.
- At least one fruit and vegetable with each meal.
- Fermented foods 1x daily.
- Patient was also instructed to eat foods that encouraged the growth of akkermansia and other beneficial bacteria by mixing ¼ tsp acacia powder with diluted 100% cranberry, pomegranate, or concord grape juice diluted with water.
- Kids Digest by Enzymatica was recommended with each meal for two months while doing an elimination diet to reduce the load on the gastric tract and increase nutrient absorption.
1 Week Follow Up
The patient had committed to a full gluten and dairy-free diet and successfully brought in a fermented food 1x daily while bringing one fruit and vegetable in every meal. Parents were very happy to report that five days into treatment, Zach started using previously regressed vocabulary words and was improving eye contact and direct response to his name. His bowel movements had improved consistency and reduced foul smell.
Continued Intervention
- Homeopathic DTaP 30c 1x weekly till two-month follow-up. Continue diet recommendations and supplemental support.
2 Month Follow Up
Since beginning treatment, parents, speech therapists, and developmental psychologists were all very impressed with patients' verbal and developmental advancements.
He was having daily bowel movements that were well formed, had little to no undigested food in it, and was no longer associated with a foul smell. Parents noticed bloating only after eating a lot of fermented fruit- his new favorite food- but he was no longer pushing toys or his hands into his stomach, indicating less abdominal discomfort overall.
His diet had expanded overall to include a much more diverse array of foods while committing to gluten and dairy avoidance, as well as drinking 4-10 oz of water daily.
Continued Intervention
- 3 Months Post Elimination Diet: Since the patient had been doing so well during the elimination period, we began to reintroduce and challenge level 1 foods previously identified on the food sensitivity panel.
- Continued digestive enzyme support, essential fatty acid support, and began introducing a Pediatric Vitamin/Mineral base powder to account for any nutritional deficiencies.
- Weekly chiropractic adjustments were also recommended for ongoing nervous system support.
6 Month Follow Up Lab Work
Follow Up Lab Analysis
A Follow-up stool panel indicated a robust improvement to the patient's overall microbiota by reducing dysbiotic and potentially pathogenic strains while improving the diversity of beneficial commensal bacteria, which was achieved through baseline supplemental and dietary interventions alone.
The patient was successfully able to return a majority of previously intolerant foods back into his diet. However, dairy, wheat/gluten, artificial food coloring/dyes were avoided while maintaining optimal bowel movements and digestive function. This indicated that a temporary avoidance of previously intolerance foods allowed immune system regulation to return and maintain a hospitable environment for the host microbiota.
The gut-brain axis connection is evidently seen by the patient continuing to see improved behavioral and cognition processing while treating chiefly the patient's gut and digestive dysfunction.
The main changes noted were improved speech and vocabulary diversity, eye contact and responsiveness to emotions expressed by others, shorter duration and frequency of temper tantrums, and improved interactions with his sister, family, and other children.
Summary
This case is an excellent example of the powerful connection between the gastrointestinal microbiota and the influence it has on the gut-brain relationship.
Nutrition is the baseline approach for microbiota support as well as detox support.
Supporting detoxification aided heavily in these results by allowing the patients' body to eliminate offending agents that were taxing his nervous system and would have likely contributed to further toxin burden in the future.
Through direct modification of microbiome diversity and the resulting benefit to gut lining health, we were able to see improved neurological responses more consistent with a developing toddler.
Other Articles That May Interest You
A Functional Medicine Approach to Detox
A Functional Medicine Approach to Food Sensitivities: Testing and Treatment
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