Naturopathic Perspectiveon the Assessment and

Treatment ofLyme-Associated Autism

by Nicola McFadzean, ND

Autistic-spectrum disorders(ASD) affect one in 160 children inthe United States and up to one in 80in certain states.' Both complex andmulti-factorial, the myth of ASD asa genetic disorder with no effectivetreatment or cure is being debunkedby the biomedical community, whichis using special diets, nutritionalsupplementation, and detoxificationtherapies to treat the underlyingbiochemical imbalances thatperpetuate the behaviors oi ASDchildren.

Part of the investigation involvesan examination of the role ofinfectious agents in ASD. Certainly

viruses such as human herpesvirus 6, Epstein-Barr virus, andrubella have been discussed.'"* Morerecently, Borrelia burgdorferi, thespirochete bacteria responsible forLyme disease, has come under morecareful examination as a contributingfactor in autism. Borrelia burgdorferi(Bb) is primarily a tick-borneagent, although there is evidence oftransmission via mosquitoes, fleas,and lice.̂ ^ Originating in the town ofOld Lyme, Connecticut, Lyme diseaseis no longer the domain of NewEngland, with increasing numbers ofcases reported across the US.̂

Or. Nicola McFadzean received her Doctorate otNaturopalhic Medicine from Bastyr University in Seattle,Washington, having completed her Bachelor in HealthSciences (Naturopathy) in her native country of Australia.For the past three years, she has been in private practicein San Diego and Temecula, California, specializing inautistic-spectrum disorders and Lyme disease. She hostsher own radio show on Autism One Internet radio and hasdeveloped a preconception program to help parents withautistic children improve their own health and preventautism in future children. She is also on the physicianadvisory board for the Lyme-Induced Autism Foundation.More information on Dr McFadzean can be found atwww.drnicola.com.

Epidemiological studies investi-gating the link between Lyme diseaseand autism are underway."'' Thereis strong anecdotal evidence thatsome connection exists, based oninterviews with several doctors whopractice biomedical approaches toautism. Such doctors - doctors whobelong to Defeat Autism Now (DAN!),a domain of the Autism ResearchInstitute - who have tested for Lymedisease nationwide, report 50-90%of children test positive. Clearly,further studies are needed to gainmore objective and substantiateddata; however, at face value, rateslook frighteningly high.

The chaiienges facing assessmentand treatment of Lyme disease andautism are significant. Laboratorytesting for Lyme disease producesmany false-negatives, mostly due tothe ability of the Borrelia spirocheteto disable the immune system,dampening the antibody reactionsthat are measured on testing. Anewer IFA assay run by IGeneX isproving a high level of sensitivity,with specificity of 80%. Coupled withIgG and IgM Western Blots and a PCR,IGeneX provides a comprehensivepanel that assists with the diagnosisof Lyme.

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The bigger question is how totreat a child who bas tested positivefor Lyme disease. At the time ofwriting, there is contention betweentwo groups of physicians whowork with Lyme disease in general.The Infectious Disease Society ofAmerica (IDSA) recently publishedguidelines stating that short coursesof antibiotic therapy (three tofour weeks) are sufficient even forchronic Lyme disease; while theInternational Lyme and AssociatedDisease Society (ILADS) claims that,in some individuals, longer-term useof antibiotics Is warranted. Lymedisease treatment has become ahighly politicized arena.

Debates over these protocolsrelate to the Lyme population ingeneral, not specifically to pediatricsand certainly not to autistic children.The biomedical community involvedin autism treatment recognizesthat frequent courses of antibioticsin early childhood are a potentialcontributing factor to autism, givingrise to the preponderance of yeastovergrowth seen in the intestinaltracts of many ASD kids. Within thiscontext, it is almost impossible toconceive of treating autistic childreninfected with Borrelia burgdorferiwith antibiotics in any capacity.The need arises to find effectivetreatments that do not further taxthe already fragile systems of autisticchildren, but instead build themup and strengthen their immunecapabilities.

To date, there are several pioneersis the area of natural treatments forLyme disease, and it is inevitable thattheir protocols will be drawn uponfor guiding the treatment of Lymedisease in autistic children. Amongthem are the Chinese medicineprotocols of Dr. Qingcai Zhang'" andthe more Western herbal approach ofHarold Buhner." The Lyme-InducedAutism Foundation'^ held their firstthink tank in February 2007 in SanDiego, California, bringing togetherexperts in the fields of Lyme diseaseand ASD to collaborate and furtherdevelop safe and effective treatmentsfor individuals witb both diagnoses.

The approach to Lyme/autismtreatment must be three-tiered:first, to support the immune

system of the individual or "host"to strengthen their capacity tofight foreign invaders; second, toallow antimicrobials to reduce theinfectious load on the system; andthird, to address comorbid factorssuch as toxicity, nutrient imbalance,digestive dysfunction, and enzymaticdefects such as poor methylation.

The DAN! approach to autismtreatment already takes manyof these factors into account.

Immune support takes the formof both dietary intervention, suchas reducing food allergensrefined sugar consumption,specific supplementationsas monolaurin. olive leaf,transfer factor, to name just a few.Antimicrobials in autism treatmentmust be expanded to incorporate theBorrelia species. Current treatmentscenter largely around yeast control.

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TOWNSEND LETTER - APRIL 2007

Assessment and Treatment of Lyme-Associated Antism

using medications such as Diflucanand Nystatin as well as manyeffective natural treatments, amongthem, oregano oil, caprylic acid, paud'arco, and garlic. Many children onthe autistic spectrum have bacterialimhalance in their gut also, requiringtreatment targeting Klebsiella,

well to the anti-bacterial herbs usedfor the Borrelia species.

Lyme disease and autismshare many of the underlyingsystemic imbalances that arisefrom infectious or toxic assaulton the body. Many patients witheither diagnosis show high levels

A diagnosis of Lyme disease can be significant for an individualon the autistic spectrum. Even if antibiotics are not the treatmentof choice, the infectious component must be addressed tooptimize the total treatment regimen.

Pseudomonas, Citrobacter, orClostridia. Again, berberine, oliveleaf, pau d'arco, caprylic acid, garlic,and oregano can be used quiteeffectively. Probiotics are a largepart of treatment, to recolonize thegut with healthy flora and preventthe predominance of unhealthymicrobes.

With Borrelia infection layeredon top of other yeast and hacterialinfections, more aggressive herbaltreatment must be initiated. Cat'sClaw, Andrographis, Polygonum(Japanese Knotweed), allicillin (theextract from garlic), and Coptis canbe used as anti-Borrelia treatments.Along with Borrelia. we often seeco-infections of Babesia, Bartonella,and Erlichia. Each co-infection mustbe addressed for comprehensivetreatment. Babesia, a parasite,can often be successfully treatedwith Artemesinin, an extract fromArtemesia or wormwood. The otherco-infections respond reasonably

of toxic metals such as lead andmercury. Elevated mold antibodiesare common, as well as methylationdefects that can be effectivelybalanced with methyicobalamintherapy administered nasally orintramuscularly. Along with thedysbiosis that is so common, foodallergies, gluten intolerance, anddietary peptide reactions alsoadversely affect the gut. Dietarymodifications are often necessaryto remove stressors that can worsensymptoms and have behavioralramifications.

A diagnosis of Lyme disease canbe significant for an individual on theautistic spectrum. Even if antibioticsare not the treatment of choice,the infectious component must beaddressed to optimize the totaltreatment regimen. Lyme disease maybe one piece of an already complexpuzzle. It is impossible to say atthis time how significant of a pieceit is - whether it may be a primary

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causative factor or simply anotherlayer of infection in a body with animmune system already compromisedby heavy viral, bacterial, fungal, andtoxic loads. Regardless, families withdual-diagnoses are coming out of thewoodwork. Mothers with fibromyalgiaare testing positive for Lyme, as aretheir autistic-spectrum children,indicating placental transfer of theinfection. Further treatment regimensmust be developed to address thetotality of causative factors, includingBorrelia and its co-infections. This isa potentially groundbreaking area inthe future biomedical treatment ofautistic-spectrum disorders.

Notes1. Changes in the Population o( Persons with

Autism and PDD, Dept Develop Services.California, Health and Human Services March1 1999.

2. Shi L, Fatemi SH, Sidwell RW, Patterson PH.Maternal influenza Infection causes markedhehavioral and pharmacological changes inthe ottsprinn- Journal of ^euroscience. January1.2003;23(l):297-302.

3. Llbbey JE, Sweeten TL. McMahon WM,Fujinami RS. Autistic disorder and viralinfections. 7/Veuroi;/ro/. 2005 Feb;ll(l):l-10.

4. Singh VK, Lin SX, Yang VC. Serologicalassociation of measles virus and humanherpe8virus-6 with brain autoantibudles inautism Clin Immunol Immunopathol. 1998Oct;89(l):105-8.

5. Teltow GJ. FournJer PV, Rawlings JA. isolatUinof Borrelia burgdorferi from arthropodscollected in Texas. Am J Trop Med Hyg. 1991May;44(5):469-74.

6. Zakovska A, Nejedia P, Holikova A, Dendis M.Positive findings of Borrelia hurndorferiin Culex(Culex) pipiens larvae in the surrounding ofBrno city determined hy the PCR method. AnnAgric Environ Med 2002:9(2);:^57-9.

7. ciesielski CA. Markowitz LE, Horsley R,Hightower AW. Russell H, Broome CV. Thegeographic distribution of Lyme disease inthe United States. Ann N YAcadSci 1988;539:283-8.

B. Fallon BM. Developmental delay and Lymedisease in children: An epidemiologlc study.Results unpublished at time of writing.

9. Funds are currently being raised for PhaseI study of 67 autistic children and controlsto determine percentage of children withautism that are infected with Borreliaburgdorferi. Principai Investigator Dr Torres.in association with Ihe Lyme Induced AutismFoundation (www.lymelnducedautlsm.com).

10. Zhang, QingCai, Lyme Disease and ModernCfiinese Medicine New York: SIno-MedResearch Institute; 2006.

U. Buhner, Stephen Harold. Healing Lyme: NaturalHealing And Prevention of Lyme Borreliosis AndIts Coinfections. Vermont: Raven Press; 2005.

12 The Lyme Induced Autism Foundation.Available at; www.lymeinducedautlsm.com.Accessed February L 2007.

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