Woody McGinnis talk - Fatty-Acid Primer for Autistic Children

Fatty-Acid Primer for Autistic Children
Dr. Woody McGinnis

Providing the right amounts and proportions of needed nutritional oils can be very important to children with autism or other behavioral disorders. Irene (Vicky) Colquhoun, an English lay0erson with a severely hyperactive grandson, discovered over twenty years ago that hyperactive children tended to have physical signs of fatty-acid deficiency as well as abnormal behavior. She also determined that both their physical symptoms and behavior improved, often dramatically, with addition of certain oils to the diet. We now know the same is true in autistic children.

Basic Fatty-Acid Science
Fatty acids are exceedingly important to the function of cells, including nerve cells. Fatty acids are the primary building blocks for the cell membrane and the precursors for important chemical messengers called prostaglandins, which directly influence resistance to infection, allergic response and permeability of the intestinal membranes. Fatty acids named EPA DHA and GLA are particularly important. The average American diet provides only small quantities of these particular fatty acids, so the body must manufacture them from precursor fa5ts like corn oil or flax seed oil. In behavioral children the chemical co-factors needed for this manufacturing process – Zinc, Magnesium, Vitamin B6 low toxin levels – are often suboptimal, so just giving the precursor oils may not be enough to boost EPA, DHA, and GLA sufficiently. Further, the dietary intake of essential fatty acids may need to be higher in autistic children because of their tendency to malabsorb fats.

Understanding the Supplements
Regular fish oil is used to supplement EPA and DHA, and evening primrose oil to supplement GLA. Fish oil must be certifiably-free of contaminants such as mercury or PCB’s , and neither oil in acceptable if rancid to taste or smell. Refrigerated storage is best for these relatively fragile oils, which are prone to oxidation. To improve tolerance of these oils, it is desirable to quiet excess oxidative stress in the body by giving Vitamin C and Vitamin E for at least a few days before initiating the oils and on an ongoing basis thereafter. Cod liver oil and other fish liver oils are excellent sources of Vitamin A and Vitamin D, and also contain some EPA and DHA. Due to dosing limits on the amount of Vitamin A and D which can be given via these fish liver oils, regular fish oil is often needed in addition to fish liver oil in order to deliver enough EPA and DHA.

Many autistic children benefit from both fish oil (EPA, DHA) and evening primrose oil (GLA) in combination, but some children only need one or the other. Physical signs and symptoms, laboratory measurement of red blood cell membrane fatty acid levels and clinical response all help decide which oil(s) to select and how much to give. Generally, allergic symptoms (hay fever, asthma, eczema, food allergies) suggest potential benefit from more EPA. Dry hair, dry skin and phrynodermia (“chicken-skin” on back of upper arms or front of thighs) also suggest low EPA/DHA.

Frequent infections, leaky gut, growth delay or phyrroluria suggest the need for more GLA from evening primrose oil. DHA, the building block for nerve and retina cells, is found along with EPA in all commercially available fish oils. Children with low or lowish DHA levels definitely can benefit from extra DHA. However, in some persons clinically in need of EPA for allergy, DHA levels may be unexpectedly elevated, in which case use of one of the fish oils with a higher EPA to DHA ratio may be warranted.

Laboratory Measurement

Red-blood cell membrane fatty acid levels appear to most useful, and several laboratories perform this analysis. Levels take 3-4 months to re-equilibrate after oils have been newly introduced or dosages changed. The need for supplemental oils may change with other changes in the nutritional program, general health, size or age, so periodic re-testing can be most useful. Clinically, it is found that when it comes to key parameters (EPA, DHA, GLA levels), low-normal laboratory measurements should usually be treated as dietary deficiencies, to assure really robust status of these nutrients. Clinical presentation and individual response may outweigh actual laboratory numbers in judgments about giving oils. Some overlap exists in structural and functional roles of these fatty acids and clinical response to the. For example, as a rule-of-thumb, EPA should be considered the strongest anti-inflammatory fatty acid for most purposes, but GLA can also lesson (or sometimes increase) inflammation by different mechanisms.

Practical Approaches

Therapy with fish oil and /or evening primrose oil is approached without screening laboratory study by some clinicians. Children with significant allergies should probably be started with fish oil, once Vitamin C and E are on-board, working up to a dose of 200-500 mg. EPA daily. (Higher EPA should be avoided if any bleeding or excessive bruising tendencies exist.) In the allergic child, once allergic symptoms are improved with EPA from fish oil, evening primrose oil may be initiated at starting doses of 50-100 mg GLA daily, up to several hundred mg as tolerated. If allergies flare unacceptably, GLA may need to be reduced, at least temporarily. Infrequently, excessive evening primrose oil will potentiate hyperactivity, so only lower daily doses of 50-100 mg of GLA may be tolerated initially. Because the beneficial effect on gut and immune function can be great, tolerance for more GLA should be tested periodically. Tolerances for fish oil also vary individually and over time.

Children without a predominance of allergic symptoms may receive evening primrose oil first (once Vitamins C and E are on-board), and then fish oil. Occasionally, children will tolerate combined administration of balancing doses of EPA and GLA better than one-at-a-time introduction. As with administration of all the nutrients, careful observation for physical and behavioral effects, manipulation of single variables to assess tolerance, and good record keeping give best results. These oils should not be heated, but the evening primrose oil in particular is relatively bland in taste, and can be folded into cool or
cooling foods, or in the youngest or most reluctant children, even rubbed onto the skin for partial absorption.

What to Expect
Behavioral or physical effects of these oils may be quite noticeable in some cases within days, but generally take much longer to work, as cell membranes re-build, allergies lessen, intestines stop leaking and chronic infections subside. In autism, fish oil and evening primrose oil really are two of our strongest nutritional tools, and once rationally initiated, should only be discontinued for cause. A large number of autistic children have already benefited from fatty-acid supplementation, which may prove applicable to older individuals in the future.

Submitted by Karen from the autismandenzymes  Yahoo Group.