Autism: Pathways To Recovery Workbook
Autism: Pathways To Recovery Workbook
Autism: Pathways To Recovery Workbook
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NRI
Neurological Research Institute, LLC
Amy Yasko
Ph.D., CTN, NHD, AMD, HHP, FAAIM
Autism:
Pathways to Recovery
Workbook
Discussion Group
www.ch3nutrigenomics.com
Disclaimer: The information is presented by independent medical experts whose sources of information include studies from the worlds medical and scientific literature, patient records and other clinical and anecdotal reports. The publisher, author and/or experts specifically cited in this publication are not responsible for any consequences, direct or indirect, resulting from any readers action(s). This booklet is not intended to be a substitute for consultation with a health care provider. You, the reader, are instructed to consult with your personal health care provider prior to acting on any suggestions contained herein. The purpose of this guide is to educate the reader. The material in this booklet is for informational purposes only and is not intended for the diagnosis or treatment of disease.
Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form or by any means (electronic, mechanical, photocopying, recording or otherwise), without the prior written permission of both the copyright owner and the above publisher of this book. The scanning, uploading, and distribution of this book via the Internet or via any other means without the permission of the publisher is illegal and punishable by law. Please purchase only authorized electronic editions and do not participate in or encourage electronic piracy of copyrightable materials. Your support of the authors rights is appreciated.
Third Edition ISBN: 978-1-4243-4321-8 Neurological Research Institute, LLC Bethel, Maine
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INTRODUCTION
My approach to Autism, as well as other chronic neurological issues, is somewhat different than others in these fields. I do not believe in telling you what to do. I believe that knowledge is power and that the more well informed you are about the process going on in the body, the better position you will be in to make informed choices as to supplementation and the path to health and wellness. For this reason I spend a lot of time talking about the why behind a choice or a suggestion, as well as looking at a great deal of biochemical test data to help you to learn how to monitor and follow your progress on this program. We also rely heavily on molecular biology to help guide you with the choices you make. The tools that we use are not meant to replace the need to consult with your doctor. They are meant instead to serve as additional tools to help you while you work in conjunction with the doctor of your choice. I believe that autism, as well as other chronic conditions are multi-factorial in nature, compromising an underlying genetic susceptibility with an infectious disease component as well as environmental toxins. I feel that it requires time and patience to slowly unravel the pieces of this complex puzzle for each individual. This is a marathon; it is not a sprint. I cannot promise any magic bullets; however, I do promise to be here to help you to understand the pieces of this puzzle. I am committed to pursuing any missing pieces we need, even if it is only needed to help a single child or one individual adult. This workbook is being provided as a beginners guide to the protocol. It is a step-by-step approach to help you begin the journey to take those important first steps in the marathon. It includes daily/weekly ideas on how to get started, suggestions to increase your knowledge base and links to encouragement and support you will need along the way. With love, hope, and a hug, Dr. Amy
Please take a deep breath and stop running as fast as you can. It is a marathon, not a sprint. It is okay to slow down and take your time. There is no prize for getting there first; we just have to get there!
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Contents
INTRODUCTION .............................................................................................................................................................. 4 WEEK 1 ........................................................................................................................................................................... 9 DAY 1: Discussion Group............................................................................................................................................ 9 DAY 2: Order Nutrigenomic Testing and Print Resources ....................................................................................... 10 DAY 3: ....................................................................................................................................................................... 12 Pathways Diagram ................................................................................................................................................ 12 DAY 4: What Brought You Here? .............................................................................................................................. 14 DAY 5: Evaluations .................................................................................................................................................... 15 DAY 6: Organization .................................................................................................................................................. 16 Approach #1 .......................................................................................................................................................... 16 Approach #2 .......................................................................................................................................................... 16 DAY 7: Excitotoxins .................................................................................................................................................. 17 WEEK 2 ......................................................................................................................................................................... 18 DAY 8: The Importance of the Diet ........................................................................................................................... 18 Web Resources ..................................................................................................................................................... 18 Print Resources ..................................................................................................................................................... 18 DAY 9: The Importance of Balancing GABA/Glutamate .......................................................................................... 19 DAY 10: Visualize Recovery ...................................................................................................................................... 22 DAY 11: Obtaining the Nutrigenomic Blood Sample ............................................................................................... 23 DAY 12: Resources ................................................................................................................................................... 24 DAY 13: Understanding Step 1 Support ................................................................................................................... 25 TOP STEP ONE SUPPLEMENTS/Nutritional Groundwork ...................................................................................... 25 DAY 14: ..................................................................................................................................................................... 27 Special Note .......................................................................................................................................................... 27 Supplement Brands ............................................................................................................................................... 27 Preferred Brands ................................................................................................................................................... 27 Community............................................................................................................................................................ 27 WEEK 3 ......................................................................................................................................................................... 28 DAY 15: Assessing Current Needs Based on Previous Testing................................................................................. 28 DAY 16: Biochemical Testing ................................................................................................................................... 30 Day 17: Biochemical Testing Option 1 or Option 2 ................................................................................................. 32 DAY 18: Autism: Pathways to Recovery ................................................................................................................... 34 DAY 19: Discussion Group Search Example .............................................................................................................. 34 5|Page
DAY 20: Positive Feedback........................................................................................................................................ 36 DAY 21: Implementing Step One Support ............................................................................................................... 37 Supplement Diary ................................................................................................................................................. 37 WEEK 4 ......................................................................................................................................................................... 38 DAYS 22-28: Transitioning From Another Protocol .................................................................................................. 38 Transition Supplement List ................................................................................................................................... 39 Instructions for Collecting Biochemical Tests ........................................................................................................... 40 Obtaining GI Profile Stool Sample ............................................................................................................................ 42 Gastrointestinal Function Profile (GI) example report ......................................................................................... 43 Obtaining Neurotransmitter Urine Sample .............................................................................................................. 44 Neurotransmitter example report ........................................................................................................................ 45 Obtaining Neopterin/Biopterin Urine Sample .......................................................................................................... 46 Neopterin/Biopterin Sample Report .................................................................................................................... 47 Obtaining MAP Sample ............................................................................................................................................. 48 Metabolic Analysis Profile (MAP) example report ............................................................................................... 49 Obtaining UAA Urine Sample.................................................................................................................................... 50 Urine Amino Acids (UAA) example report ............................................................................................................ 51 Obtaining CSA Stool Sample ..................................................................................................................................... 52 Comprehensive Stool Analysis (CSA) example report .......................................................................................... 53 Obtaining UTM/UEE Urine Sample ........................................................................................................................... 54 Urine Toxic Metals (UTM) example report ........................................................................................................... 55 Urine Essential Elements (UEE) example report ................................................................................................... 56 Obtaining Fecal Toxic Stool Sample .......................................................................................................................... 57 Fecal Metals (FM) example report........................................................................................................................ 58 Obtaining Hair Elements Test Sample ...................................................................................................................... 59 Hair Elements (HE/HMT) example report ............................................................................................................. 60 WEEK 5 ......................................................................................................................................................................... 61 DAYS 29-35: Gut Protocol ........................................................................................................................................ 61 Gut Protocol .......................................................................................................................................................... 61 Gut Health Assessment ......................................................................................................................................... 61 Friendly Reminders ............................................................................................................................................... 63 WEEK 6 ......................................................................................................................................................................... 64 DAYS 36-42: Understanding Your Biochemical Test Results .................................................................................... 64 6|Page
Autism: Pathways to Recovery Workbook UTM/UEE .............................................................................................................................................................. 64 UAA ....................................................................................................................................................................... 65 HE/HMT................................................................................................................................................................. 65 WEEK 7 ......................................................................................................................................................................... 66 DAYS 43-49: Reflect, Regroup, and Review ............................................................................................................. 66 Visualize Recovery ................................................................................................................................................ 66 DVD Resources ...................................................................................................................................................... 68 WEEK 8 ......................................................................................................................................................................... 69 DAYS 50-56: Genetics .............................................................................................................................................. 69 COMT V158M, H62H, 61 (catechol-O-methyltransferase): .................................................................................. 69 VDR/Taq and VDR/Fok (vitamin D receptor): ....................................................................................................... 69 MAO A R297R (monamine oxidase A): ................................................................................................................. 70 ACAT 102 (acetyl coenzyme A acetyltransferase): ............................................................................................... 70 ACE (angiotensin converting enzyme): Considered for all No longer testing.................................................... 70 MTHFR A1298C, C677T, 3 (methylenetetrahydrofolate reductase): ................................................................... 70 MTR A2756G/MTRR A66G, H595Y, K350A, R415T, S257T, 11 (methionine synthase/ methionine synthase reductase): ............................................................................................................................................................ 70 BHMT 1,2,4,8 (betaine homocysteine methyltransferase): ................................................................................. 71 AHCY 1,2,19 (S adenosylhomocysteine hydrolase): ............................................................................................. 71 CBS C699T, A360A, N212N (cystathionine-beta-synthase): ................................................................................. 71 SHMT C1420T (serine hydroxymethyltransferase): .............................................................................................. 71 NOS D298E (nitric oxide synthase): ...................................................................................................................... 71 SUOX S370S (sulfite oxidase): ............................................................................................................................... 71 WEEK 9 ......................................................................................................................................................................... 72 DAYS 57-62: Assessing Detox and Current Needs Based on Follow up Testing ....................................................... 72 Recognizing Detox................................................................................................................................................. 72 Controlling Detox .................................................................................................................................................. 72 Urine Color ............................................................................................................................................................ 73 Graphing ............................................................................................................................................................... 73 Detox Diary ........................................................................................................................................................... 74 Resources .............................................................................................................................................................. 75 WEEK 10 ....................................................................................................................................................................... 76 DAYS 6370: Prioritizing and Supporting Mutations ................................................................................................ 76 First Priority Mutations ......................................................................................................................................... 76 7|Page
SHMT/ACAT .......................................................................................................................................................... 76 CBS ........................................................................................................................................................................ 76 Second Priority Mutations .................................................................................................................................... 77 Transitioning from Step 1 to Step 2 .......................................................................................................................... 78 Closing Remarks ........................................................................................................................................................ 79 Glossary & FAQ ............................................................................................................................................................ 80 Glossary .................................................................................................................................................................... 80 Frequently Asked Questions ..................................................................................................................................... 82 List of Excitotoxins ................................................................................................................................................ 83 Sources of MSG ..................................................................................................................................................... 83 Possible Sources of MSG ....................................................................................................................................... 83
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These forums are locked (locked icon on far left of each forum) which means that they are for information only and can only be edited by the moderator. Other forums have a page icon where one can post or respond to a question. Look through the forums listed on the log in page to find the best fit for your question, click to open that specific forum (Genetics, Supplements, etc). To post on an existing thread, click on that thread to open it. If no existing thread fits your needs, you can start a new thread by clicking on the New Topic button above and to the left of the existing thread list. This entire site may seem overwhelming. DO NOT PANIC. You can do this. It will take time to learn how to navigate through the forums, but over time, this Discussion Group will become your favorite resource in implementing the protocol and will keep you up-to-date with the most recent information.
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DAY 5: Evaluations
As you move through the program, it will be helpful to keep track of ongoing progress that you may have difficulty recognizing during stages of detox. The following links are suggested rating scales that may help you along the way. Dr. Amy feels that the following tools may be helpful for evaluating progress. Please choose one of the following to get a baseline assessment. Autism Treatment Evaluation Checklist (ATEC): http://www.autism.com/ari/atec/atec-online.htm The PDD Assessment Scale/Screening Questionnaire: http://childbrain.com/pddassess.html Childhood Autism Rating Scale (CARS): http://portal.wpspublish.com/portal/page?_pageid=53,69417&_dad=portal&_schema=PORTAL Date Test Performed Score / Rating Change in Score
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DAY 6: Organization
Having an organizational tool is vital. This marathon has a lot of information. To try to keep it all in your head would be overwhelming. Choose one of the following, use a combination of them, or create one of your own. The important thing is that you set up a system that works for you.
Approach #1
Get an AT-A-GLANCE month-by-month calendar book. Use this to plan the supplements for each week. Place a post-it on each month with what needs to be added/increased/reduced at some point in that month based on Dr. Amys comments on tests, and what protocol needs to be addressed, and to mark what days to do B12 (mega drops, nasal, injection, patch), charcoal flushes and EDTA baths. Also, use the calendar to plan when to run your Biochemical testing (see page 30 for information about testing, and page 32 for information on scheduling). Keep a separate running list of current supplements and doses organized by the time of day given (at breakfast, after school, at dinner and before bed). This can be a word document and updated each month. Keep a separate binder organized in the following manner: Testing - Copies of test results and Toxic Metals Test graphing. (Download files from Discussion Group/the Basics Forum) MPA (Methylation Pathway Analysis) - Genetic results with the supplements listed. Discussion/Chat Groups - Relevant posts, diagrams, supplements, and protocols printed from Discussion Group.
Approach #2
Use a 3-ring binder with section separators and a 3-ring folder. The folder is for copies of test results. The binder is separated into several sections: Important, frequently referred to posts in the Basics and Getting Started sections from the Discussion Forum Nutrigenomic SectionResults and relevant posts Supplements SectionRelevant posts Supplements SectionCurrent supplements given and what comes next lists. (This is great information to have in an emergency if Mom and Dad are not available.the caregiver could pick this section up and move forward without difficulty because it contains a complete history of supplementation and reactions.) A section for each issue being or to be addressed (Step 1 supports, strep, clostridia, etc) Testing Sections - Each test has its own section: MAP, UAA, UTM, UEE, FM, CSA, etc 16 | P a g e
DAY 7: Excitotoxins
A very important piece of the puzzle is limiting excitotoxin damage. Dr. Amys paper, The Role of Excitotoxins in Autistic Type Behavior explains in detail the damage that excess excitotoxins can have on the body and how it relates to our behavior and health. Learning the importance of balancing GABA and glutamate and limiting calcium is essential to beginning the healing process. As Dr. Amy stated Excitotoxins will continue to damage more nerves and wreak more havoc in the body if they are not addressed. Therefore, the excitotoxin imbalance is the best place to start to put the pieces back together. Once excitotoxins are under control, it is easier to balance the rest of the body. Key Definitions: Excitotoxins A toxic molecule that stimulates nerve cells so much that they are damaged or killed. GABA A calming neurotransmitter that is essential for speech. Glutamate The main excitatory neurotransmitter in the body, that is essential for learning and for both short-term and long-term memory. Printed resources relating to excitotoxins include: Autism: Pathways to Recovery, Chapter 4 Neurological Inflammation and Putting It All Together DVDs (checkout webisodes on www.dramyyasko.com) Dr. Amys paper, The Role of Excitotoxins in Autistic Type Behavior o To read this go to www.dramyyasko.com o Click on Resources o Click on Books and Writings o Scroll down to The Role of Excitotoxins in Autistic Type Behavior
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When Glutamate is elevated we can see the following types of symptoms, please check any that you or your child may be experiencing:
Increased
Excitotoxin damage Opioid effects TNF alpha (leading to leaky gut) Acetylcholine Bladder contraction Strabismus Stims (self stimulatory behavior) Seizures
Decreased
Glutathione Sleep Eye contact Myelination
When GABA is low, we may observe the following symptoms, please check any that you or your child may be experiencing:
Increased
Anxiety Aggressive behavior
Decreased
Language/speech (particularly comprehension) remember that GABA puts the spaces between our words Social behavior Eye contact Bowel function (retention issues) 19 | P a g e
Increased Glutamate leads to increased Calcium flow into neurons, which causes nerve damage. Nerve damage leads to increased inflammation. If Glutamate and Calcium remain too high and this process of nerve damage is left unchecked, then cytoskeletal and membrane damage can also occur.
Evaluating Calcium levels and utilizing Vitamins D&K are important to re-establishing this balance as well. Vitamins D&K are fat-soluble vitamins and without a diet high in dark leafy greens, one would need to supplement on a daily basis. A Urine Essential Elements test should be done to establish baseline mineral levels. Controlling Calcium levels may be done by switching to Chamomile and/or Nettle supplementation rather than directly supplementing with Calcium. Increasing Magnesium relative to Calcium, using Zinc to limit Glutamate damage and watching Lithium, Iodine and Boron levels will all aid in reducing Glutamate levels and reversing the flow of Calcium into the neurons and back to the bones and teeth. If you have not already done so, start limiting excitotoxins and switch Calcium to natural forms. Refer to Addendum A that came in your test kit or download it from the Discussion Group/The Basics Forum, and the Autism: Pathways to Recovery book for the suggested forms of natural Calcium.
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Autism: Pathways to Recovery Workbook The following supplements should be used on a daily basis to increase GABA and reduce Glutamate.
Support for Glutamate/GABA Balance Nerve Calm RNA Comfort RNA Be Calm Spray (Glutamate/GABA Spray) Melatonin Sleep Spray Progesterone Cream GABA Pycnogenol Grape Seed Extract Valerian Root Jujube Lithium Orotate L-Theanine Taurine (not for CBS + or SUOX +) Protection from Excess Calcium MitoForce Compound Supplement CoEnzyme Q10 Spray GSH Caps Magnesium Chamomile Ayur Boswelia Vinpocetine Zinc Paradex Dong Quai Air Power Black Cohosh Prevagen 5 mg or less
Follow GABA/Glutamate levels with a Urine Amino Acid Test (UAA) every 3-6 months. Glutamate levels tend to increase with detox and increasing supplements may be necessary.
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I feel that if we all do our part, more and more people will be able to recover. My part is to share as much information as I can and to continue to uncover any missing pieces of the puzzle. Your part is to take advantage of the tools to understand the pieces that you need, and to find a doctor to work with you who is open to the process and will help to support you medically.
The following is a list of resources available: Autism: Pathways to Recovery book located on the CD you received with your Comprehensive Methylation Panel kit. Webisodes Series on www.dramyyasko.com/resources/webisodes o An individualized Approach: Introduction to The Yasko Protocol o Stress and Aggression o Membrane Fluidity o Methylation: Why you should be concerned, Part 1 o More Pieces to the Puzzle o Methylations & Mutations o And lots more! Genetic ByPass book located on the CD you received with your Comprehensive Methylation Panel kit. All the DVD are to be upload to the www.dramyyasko.com site as webisodes. Getting the information to you is what its all about. Also Dr. Amy has generously donated several copies of the DVD to the Sharing Circle Lending Library accessed through www.ch3nutrigenomics.com. Guidelines for utilizing the library can be found in the Sharing Circle Lending Library Forum. You may wish to read or view the following today: Autism: Pathways to Recovery - Read chapters 1-3 View the Webisodes on www.dramyyasko.com/resources/webisodes
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Supplement Brands
Please read labels on any supplements that you may have on hand or when purchasing supplements, beware of added fillers and sources of excitotoxins such as: Glutamate, Glutamine, Glutamic acid, Aspartate, Aspartame and Aspartic acid. There can be an issue in terms of purity and storage for certain brands of supplements. Source and storage conditions are very important. Think of supplements as fresh produce.
Preferred Brands
For information on Dr. Amys preferred brands of supplements visit: www.holisticheal.com
Community
Take some time today and read the New Members Forum (5th link from the top). For questions please post on the Discussion Group, and other members will be happy to help you.
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Lab Tests/other Indicators for Need to Reduce Calcium Elevated Calcium relative to Magnesium on a UEE Elevated Calcium relative to Magnesium on a red blood cell element test Stims Lab Tests Indicating a Need to Increase Calcium Calcium below the range of low-end normal on a UEE Calcium below the range of low-end normal on an RBC element test High level excretion of lead when checking urine Calcium levels Lab Tests and other Indications of a Need for Glutamate/GABA Balance Elevated: Glutamate, Glutamine, Glutamic acid, Aspartate, Aspartic acid, and Low GABA (gamma aminobutyric acid) on a Urine Amino Acid test (UAA) Low GABA on a Neurotransmitter test Elevated quinolinic or kynurenate on OAT/Metabolic test Seizures, stims, poor eye contact, aggressive behavior Lab Results and Other Indicators of High Ammonia Elevated Ammonia on a Urine Amino Acids test Lab Results and Other Indicators of a Need to Address Lithium High Lithium or very low Lithium on UEE Low Lithium or dumping of Lithium on HMT Aggression Lack of Cobalt on UEE in spite of high level B12 support MTR/MTRR + Status Please refer to Nutritional Supplement Addendum A that was included with your Nutrigenomic testing kit for specific organ supports indicated by previous testing. However, regardless of your level of need as determined in the checklist above, organ support is critical for anyone engaging in a detoxification protocol. It is important that all organs, even if there are no issues indicated, receive some level of support.
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Neurotransmitter Test Determines levels of Serotonin and Tryptamine and other important Neurotransmitters. Ordered within the CPR (see page 32). Turnaround time for processing is 7-10 days after file review date.
Neopterin/Biopterin Profile Determines current level of Neopterin and Biopterin in urine. Ordered within the CPR (see page 32). Turnaround time for processing is 7-10 days after file review date.
Metabolic Analysis Profile (MAP) Determines current level of methylation support, and gives a sense about gut microbes and Dopamine balance in respect to Norepinephrine. Ordered within the CPR (see page 32). Turnaround time for processing is 7-10 days after file review date.
Urine Amino Acids Test (UAA) Determines Ammonia, Taurine, Glutamate and other important Amino Acid levels. Repeated every 3 to 4 months or within the CPR (see page 32). Turnaround time for processing can take approximately 3 weeks or 7-10 days after file review date when ordered within the CPR bundle. Comprehensive Stool Analysis (CSA) Determines gut and bacterial issues. Ordered within the CPR (see page 32). Turnaround time for processing is 7-10 days after file review date.
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Autism: Pathways to Recovery Workbook Urine Toxic Metals Test (UTM) & Urine Essential Elements Test (UEE) Determines current level of detox and mineral levels. Repeated every 4-6 weeks (during times of heavy detox it is important to keep an eye on minerals as they can be depleted) or within the CPR (see page 32). Turnaround time for processing can take approximately 2 weeks or 7-10 days after file review date when ordered within the CPR bundle. Fecal Toxic Metals Test (FM) Determines current level of detox through the stools. Repeated as necessary or within the CPR (see page 32). Turnaround time for processing can take approximately 2 weeks or 7-10 days after file review date when ordered within the CPR bundle. Hair Elements Test (HE/HMT) Determines past/history of toxic metals excretions that you may have missed and Lithium levels. Repeated as necessary or within the CPR (see page 32). Turnaround time for processing can take approximately 2 weeks or 7-10 days after file review date when ordered within the CPR bundle. Urine Toxic Metals Test (UTM) Determines current level of detox. Done weekly, biweekly, or monthly depending on finances. Turnaround time for processing can take approximately 2 weeks.
The Preferred Supplement List form can be downloaded from the Discussion Group at www.ch3nutrigenomics.com/phpBB2/viewtopic.php?t=14153. If tests are ordered through HHI, please send your updated list to [email protected] or fax it to (207) 824-0975 when your samples are shipped. When ordering the CPR please contact [email protected] to schedule your file review date before obtaining any samples. Failure to do this may result in a delay of results, which will come by email 7-10 days after your file review date.
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Option 2: Order your UEE/UTM, UAA and HE/HMT from www.holisticheal.com These three tests can be ordered individually upon starting the protocol and may also need to be rerun every few months to assess levels especially during Step 2. 1. UTM/UEE: Reports on the essential elements (minerals) AND will include excreted metals as reported in a UTM. Getting a baseline on minerals at this point is necessary to continue with your Step 1 work of balancing the body. 2. UAA: Reports on the Amino Acids levels, including Taurine, Ammonia, and Glutamate etc. This test may be run every few months as needed to assess Amino Acid levels. 3. HE/HMT: Reports on essential elements and excreted metals. It helps to determine a past/history of toxic metal excretions which you may have missed and Lithium levels. Please note that the lab company analyzing your samples provides an auto-generated interpretation with the report. Dr. Amys analysis is personalized and is completed in conjunction with your current supplement list and personal history. Written feedback is provided to be considered in conjunction with your physician and is aligned with the scientific principles on which this protocol is based.
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3. Enter key word(s) for your search. If you also enter griffkoom in the author box, you will only get responses to your topic that originated from Dr. Amy or the moderator, Erin Griffin. *Note: Search for Keywords: You can use AND to define words which must be in the results, OR to define words which may be in the result and NOT to define words which should not be in the result. Use * as a wildcard for partial matches.
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Autism: Pathways to Recovery Workbook 4. Once you hit the search button at the bottom, you will receive all the responses containing the keyword(s) you have entered. You can also limit by Forum and Category, but most do not do this unless they are searching for a very specific post.
5. You can then select the posts that seem to relate closest in title to the issue you are experiencing. If more than 100 results return, you may wish to add an additional and or not to your search to further limit the results.
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Supplement Diary
Date Supplement Given Dosage Reactions
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Knowledge Empowers
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Test Type
1. GI Profile 2. Neurotransmitter 3. Neopterin/Biopterin Profile 4. Metabolic Acid Profile (MAP) 5. Urine Amino Acid (UAA) 6. Comprehensive Stool Analysis (CSA) 7. Urine Toxic Metals & Essentials Elements (UTM/UEE) 8. Fecal Metals (FM)
9. Hair Elements (HE/HMT) Please contact [email protected] schedule your file review date before obtaining any samples for the CPR. Failure to do this may delay your results. Dr. Amy prefers that you stay on ALL supplements for testing, unless specifically instructed on previous testing. Start collecting your samples in the order above at least 30 days before your file review date. Please note that random samples for each test are recommended (i.e. different stool samples for the FM, CSA and GI profile) and the collecting process can take 1-2 weeks. Different samples are also suggested for the MAP and UAA. In the past, Dr. Amy has preferred both being run on the same urine sample. This is no longer the case. Basic instructions for each of the above tests can be found on the next few pages. For more comprehensive suggestions, please refer to the Discussion Group/The Basics Forum post entitled, Tips on Testing. If your child is not potty trained or you are having difficulty obtaining a sample, please refer to Discussion Group/Basics Forum, post entitled Ideas for Collecting Urine. Please download the preferred supplement list format from the Discussion Group/Basics Forum, entitled Methylation Pathway Analysis/Supp by Mutations list-Download. Once your first sample is obtained and shipped, it is important to send the one page summary of where you are and what your biggest concerns are to [email protected] Previous tests ordered from outside Dr. Amy's office may be sent for inclusion in your file as a background reference, but they will not be commented upon. Please complete the supplement list reflecting supplementation at the time of testing. Note the date of testing and send it via fax (207) 824-0975 or email [email protected] on the day of shipping your first sample. This will allow ample time for it to be placed in your chart for Dr. Amys reference when commenting on testing. Results and suggestions for consideration should arrive by email from Kelly 7-10 days after your file review date. Please note that the lab company analyzing your samples provides an auto-generated interpretation with the report. Dr. Amy's analysis is personalized and is completed in conjunction with your current supplement list and personal history. Written feedback is provided, to be considered in conjunction with your physician, and is aligned with the scientific principles on which this protocol is based. 40 | P a g e
Option 2:
Test Type
1. Urine Toxic Metals & Essentials Elements (UTM/UEE) 2. Urine Amino Acid (UAA) 3. Hair Elements (HE/HMT)
Dr. Amy prefers spot/random urines for the UTM/UEE test as opposed to the 24-hour collection. She prefers the later afternoon urines, but if it is easier to collect a morning or overnight urine, that is fine too. Try to follow the diet restrictions as best you can by eliminating fish and shellfish for one week prior to obtaining your sample. Dr. Amy prefers the first morning urine/void for the UAA as opposed to the 24-hour, unless otherwise instructed on previous testing. Your sample is required to be frozen for a minimum of 6 hours before shipping. Cut samples of hair as close to the scalp as possible from the back of the head and collect the suggested amount for the HE/HMT. Fill out the paperwork and ship according to the package instructions. The invoice is only partially filled out and the test is already paid for. You still need to provide the following info: name, date, time of collection, height, and weight. You will also need to sign and date the release. If your child is not potty trained or you are having difficulty obtaining a sample, please refer to Discussion Group/Basics Forum, post entitled Ideas for Collecting Urine. Please download the preferred supplement list format from the Discussion Group/Basics Forum, entitled Methylation Pathway Analysis/Supp by Mutations list-Download Complete the UAA list on page 4 reflecting supplementation at the time of testing. Note the date of testing and send it via fax at (207) 824-0975 or email [email protected] on the day of shipping your samples. This will allow ample time for it to be placed in your chart for Dr. Amys reference when commenting on testing. Test results and Dr. Amys comments will come by email from [email protected]. Please add this email address as a safe sender in your email filter so that you can receive email from Kelly without difficulty. The turnaround time is approximately 2-3 weeks depending on the lab processing time and Dr. Amys schedule. If this is your first test and you have not received your test comments after 3 weeks please contact the office to make sure your email address is correct. Please note that the lab company analyzing your samples provides an auto-generated interpretation with the report. Dr. Amy's analysis is personalized and is completed in conjunction with your current supplement list and personal history. Written feedback is provided, to be considered in conjunction with your physician, and is aligned with the scientific principles on which this protocol is based.
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Fill out all paperwork and ship according to the package instructions. The invoice is only partially filled out and the test is already paid for. You will need to provide the following info: name, address, date of birth, date, wake up time, time of collection, height, and weight. You will also need to sign and date the release.
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Vial and ice pack must be frozen. Ship according to the package instructions. The invoice is only partially filled out and the test is already paid for. You still need to provide the following info: name, date, time of collection, height, and weight. You will need to sign and date the release.
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Gut Protocol
With respect to the gut, as with all aspects of this protocol, there is no one size fits all approach. Sometimes it is difficult to know where to start with support, and there is no easy answer that fits all cases. On the Discussion Group/The Basics Forum you will find the COMPREHENSIVE GUT PROTOCOL. It is a compilation of suggestions for overall gut health, taking biochemical testing and Nutrigenomics into account. As always, work closely with your physician. Below is a brief summary of Dr. Amys Comprehensive Gut Protocol: While it is lengthy and extensive, you will find that everyone needs some of the basic tools, while others need more extensive supports. There are many tools suggested, some you may not have even heard of, but periodic biochemical testing (CSA and GI Profile as needed) will help narrow down the necessary supports. The idea is to stay in control of the non-ideal organisms. During times of heavy detox you may need to rely on more tools and supports. The three arms of the gut protocol: 1. Bacterial/Aluminum detox and pH balance 2. Probiotics and overall gastrointestinal environment 3. Specifically targeted bacteria (Strep, Clostridia, Staph, H.pylori, Ecoli etc.)
High DHPPA on a MAP or OAT High Suberic on a MAP or OAT Lab Tests indicating a need to address yeast imbalances: Elevated arabinose on OAT/Metabolic test, CONFIRM with CSA /GI Profile Presence of yeast on CSA/GI Profile Low gut pH, CONFIRM with CSA/GI Profile Lab Tests indicating a need to address parasites: Parasites on a CSA/GI Profile Lab Tests indicating a need to address Helicobacter: Helicobacter test Presence of blood on a CSA Low Manganese on UEE or HE/HMT test in spite of supplementation Very High Suberic on MAP Extreme swings in CSA/GI profile Stool PH High Asparate Or high Tryptamine on Neurotransmitter Excretion of Bismuth on a FM in the absence of supplementation Consistent Cadmium excretion on a UTM and FM Signs of ketosis on a MAP Normal to high excretion of Arginine on UAA, when all other Amino Acids (except Taurine) are low Low PS on a UAA regardless of having all suggested supports in place High 5HIAA or Indole acetic acid on a MAP High Taurine on UAA in the absence of a CBS +, OR in spite of sufficient CBS RNA/Ammonia RNA
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Friendly Reminders
It is important that you do the following as you continue on your path to wellness: Continue layering Step 1 supports and documenting in your supplement diary. Visit the Discussion Group and read Dr. Amys Recent Posts and New Findings Forum for updates in this continuously evolving protocol. While you wait for your test results, also continue to implement Step one support. Please refer to the Discussion Group, the Autism: Pathways to Recovery book pages 75-84 and Addendum A on the CD in your Nutrigenomics test kit. Continue collecting test samples if applicable. Please utilize this space to indicate any other gut health symptoms or issues:
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The following are general preferred ranges. Suggestions are individually tailored based on genetics, previous testing in the file, current supplementation, and fluctuations in urine Creatinine.
UTM/UEE
The first page of your results will contain the toxic heavy metal levels being excreted from the body. While many other professionals look solely at Mercury or Lead, Dr. Amy looks at all the metals and their relationship to each other and the Essential Elements/Minerals. At this time any metals showing would be considered a positive In the presence of high Lead, she may suggest Calcium supports In the presence of high Cadmium, she may suggest Helicobacter supports
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Autism: Pathways to Recovery Workbook The second page of your UTM/UEE results will contain the Essential Elements/Mineral levels. Midrange for Sodium, Phosphorous, Potassium, Chromium, and Boron Midrange Lithium Low to Normal range for Calcium, but lesser than Magnesium High to Normal range for Magnesium, but greater than Calcium Normal range for Zinc, but lesser than Magnesium and greater than Copper Low to Normal range for Copper, but lesser than Zinc Normal to High range for Manganese, Molybdenum, Selenium, Sulfur and Strontium Low to Normal range for Vanadium High range for Cobalt (indicator of B12 levels) No detectable levels for Iron
UAA
The 3 page Urine Amino Acids test report contains levels of GABA, Glutamate, Ammonia, Taurine, and other important Amino Acids. Dr. Amy makes suggestions for consideration based on the levels of Amino Acids and their relationship to each other. Midrange to High GABA (gamma aminobutyric acid), greater than Glutamate Low to Mid range Glutamate, Glutamine, Glutamic acid, lesser than GABA Low to Mid range Ammonia Low to Mid range Taurine Mid range Methionine, Lysine, Threonine, Isoleucine, Leucine, Valine, Phenylalanine, Tryptophan, and Arginine Low range of normal for Cysteine Midrange Citrulline and Phosphoethanolamine Low to Mid range Aspartate, Aspartic Acid, Glycine, Beta-alanine, Homocysteine, Ornithine, Methionine Sulfoxide, Anserine, Carnosine, Methylhistidine and Histidine
HE/HMT
The results will contain the toxic heavy metal levels being excreted from the body. While many other professionals look solely at Mercury or Lead, Dr. Amy looks at all the metals and their relationship to each other and the Essential Elements/Minerals. At this time any metals showing would be considered a positive In the presence of high Lead, she may suggest Calcium supports In the presence of high Cadmium, she may suggest Helicobacter supports Mid to High range of Lithium Low to Mid range Iron and Potassium Mid range Rubidium
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Visualize Recovery
Please take some time and think about or make a list of what recovery means to you and those you love. Take a deep breath. Relax. Close your eyes. Visualize yourself/your recovered child.
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What are things you can do with recovery that you cannot do now?
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Envision the life changes for you and your entire family.
Continue adding in Step 1 supports and any additions/changes recommended on testing so far. If you are seeing signs of detox, dont forget to take a toxic metals test. DVD Resources Take time to watch some more of the DVDs or view Webisodes at www.dramyyasko.com/resources/webisodes/. The suggested order is as follows: o An individualized Approach: Introduction to The Yasko Protocol o Stress and Aggression o Membrane Fluidity o Methylation: Why you should be concerned, Part 1 o More Pieces to the Puzzle o Methylations & Mutations 68 | P a g e
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MAO A R297R (monamine oxidase A): Mao A is involved in the breakdown of serotonin in the body. Like dopamine, serotonin is another neurotransmitter in the body. It is involved with mood, and imbalances in serotonin levels have been associated with depression, aggression, anxiety, and OCD behavior. Since Mao A is inherited with the X chromosome and is considered a dependent trait it may not show standard inheritance characteristics in males. Since the X chromosome in males can only come from the mother, this means that the fathers Mao A mutations (or lack thereof) does not play a role in his sons Mao A status. For females, since one X chromosome is inherited from each parent, the genetics tend to reflect the Mao A status of both parents. ACAT 102 (acetyl coenzyme A acetyltransferase): ACAT plays a role in cholesterol and other lipid balance in the body, helping to prevent the accumulation of excess cholesterol in certain parts of the cells in the body. ACAT is also involved in energy generation in the body. It is involved in helping to allow protein, fats and carbohydrates from food to be converted into an energy form that can be used by your body. In addition, lack of ACAT may also cause a depletion of B12, which is needed for the long route around the methylation cycle. ACE (angiotensin converting enzyme): Considered for all No longer testing The support for ACE should be considered for all as most individuals have the ACE deletion and many of the supports are suggested for basic nutritional support. Changes can occur that affect the activity of the ACE gene that can lead to elevated blood pressure. In animal studies imbalances in this pathway were also correlated with increased anxiety and decreases in learning and memory. Increased ACE activity can also throw off the essential mineral balance in the system due to decreased excretion of sodium in the urine and increased excretion of potassium in the urine. This reaction is also tied to the stress response such that situations of chronic stress can result in additional sodium retention and increased potassium excretion. This excess potassium is excreted provided that the kidneys are functioning properly. In the event that kidney function is compromised, it can lead to the retention of potassium in the body. ACE is a deletion, it is not a SNP. As a consequence it does not associate in the same manner that the other single nucleotide polymorphisms (SNP) on this panel do, so the inheritance pattern of the ACE deletion may not distribute in the same manner as single base changes. MTHFR A1298C, C677T, 3 (methylenetetrahydrofolate reductase): The MTHFR gene product is at a critical point in the methylation cycle. It helps to pull homocysteine into the cycle, serving to aid in keeping the levels in a normal healthy range. Several mutations in the MTHFR gene have been well characterized as increasing the risk of heart disease, as well as cancer, and may play a role in the level of the neurotransmitters serotonin and dopamine. MTR A2756G/MTRR A66G, H595Y, K350A, R415T, S257T, 11 (methionine synthase/ methionine synthase reductase): These two gene products work together to regenerate and utilize B12 for the critical long way around the methylation pathway, helping to convert homocysteine to methionine. High levels of homocysteine have been implicated as risk factors in a number of health conditions including heart disease as well as Alzheimers disease. As is the case for COMT and VDR /Taq, the MTR and MTRR composite status is also important. Mutations in MTR can increase the activity of this gene product so that it leads to a greater need for B12 as the enzyme is using up B12 at a faster rate. Conversely, recent publications suggest that the A66G mutation in MTRR decreases the activity of the enzyme. Regardless of which theory is correct, over activity depleting the cycle of B12 or lack of activity impairing the function of the methylation cycle at that point, the net result is the same in terms of suggestions for supplementation. 70 | P a g e
Autism: Pathways to Recovery Workbook BHMT 1,2,4,8 (betaine homocysteine methyltransferase): The product of this gene is central to the short cut through the methylation cycle, again helping to convert homocysteine to methionine. The activity of this gene product can be affected by stress, by cortisol levels and may play a role in ADD/ADHD by affecting norepinephrine levels. AHCY 1,2,19 (S adenosylhomocysteine hydrolase): The various mutations in AHCY may affect levels of homocysteine as well as ammonia in the body. CBS C699T, A360A, N212N (cystathionine-beta-synthase): The CBS enzyme basically acts as a gate between homocysteine and the downstream portion of the pathway that generates ammonia in the body. The types of CBS mutations that are identified on this SNP panel cause this CBS gate to be left open, this open gate is not a neutral situation. The open gate can allow support that is added for the rest of the methylation pathway to be depleted, including any B12 that is used to address MTR and MTRR mutations. While there are some positive end products that are generated via the downstream portion of the pathway such as glutathione and taurine, there are also negative byproducts such as excess ammonia and sulfites. By virtue of increased CBS activity, these sulfur groups that were complexed as part of the methylation cycle can now be released into the system as sulfites which are toxic to the body and put an additional burden on the SUOX gene product. SHMT C1420T (serine hydroxymethyltransferase): This gene product helps to shift the emphasis of the methylation cycle toward the building blocks needed for new DNA synthesis and away from the processing of homocysteine to methionine. While DNA building blocks are important, mutations which affect the ability to regulate this gene product and interfere with the delicate balance of the methylation cycle may cause accumulations in homocysteine as well as imbalances in other intermediates in the body. NOS D298E (nitric oxide synthase): The NOS enzyme plays a role in ammonia detoxification as part of the urea cycle. Individuals who are NOS + + have reduced activity of this enzyme. NOS mutations can have additive effects with CBS up regulations due to the increased ammonia that is generated by the CBS up regulations. SUOX S370S (sulfite oxidase): This gene product helps to detoxify sulfites in the body. Sulfites are generated as a natural byproduct of the methylation cycle as well as ingested from foods we eat. Sulfites are sulfur based preservatives that are used to prevent or reduce discoloration of light-colored fruits and vegetables, prevent black spots on shrimp and lobster, inhibit the growth of microorganisms in fermented foods (e.g. wine), condition dough, and maintain the stability and potency of certain medications. Sulfites can also be used to bleach food starches, to prevent rust and scale in boiler water that is used to steam food, and even in the production of cellophane for food packaging. The FDA estimates that one out of a hundred people is sulfite-sensitive, and five percent of those also suffer from asthma. A person can develop sulfite sensitivity at any point in life. Because many reactions have been reported, the FDA requires the presence of sulfites in processed foods to be declared on the label. Scientists have not pinpointed the smallest concentration of sulfites needed to trigger a reaction in a sulfite-sensitive person. Difficulty in breathing is the most common symptom reported by sulfite-sensitive people. Sulfites give off the gas sulfur dioxide, which can cause irritation in the lungs, and cause a severe asthma attack for those who suffer from asthma. Responses in the sulfite-sensitive person can vary. Sulfites can cause chest tightness, nausea, hives and in rare cases more severe allergic reactions. Mutations in SUOX may be a risk factor for certain types of cancer, including leukemia. 71 | P a g e
WEEK 9 DAYS 57-62: Assessing Detox and Current Needs Based on Follow up Testing
As you continue to add in Step 1 supports, including minerals, you may start to see changes. If so, it is recommended to do a UTM, HE/HMT, or FM. This will give you an idea if you are detoxing. Along the way, keep checking the Cobalt levels on UEEs. In addition, watch for the rise and fall of creatinine as well. For some it may take a year just to get the basic supports on board and tolerated, and for others it may be a quick process. Remember that there is no right or wrong way just what works for you, your family and your physician. It is not a quick process but, chances are you will enjoy every positive step forward--both large and small! Many need to keep an extra Toxic Metals kit on hand in the likelihood of detox, but even if you do not have a kit on hand, you can still collect and store some samples. Please see the Tips on Testing post in the Basics Forum of the Discussion Group for more information on storage options.
Recognizing Detox
Detox has many faces. It may be an increase in hyperactivity, increased stimming, recurrence of old obsessions, increases in OCD behaviors, less language or effective use of language, rashes, fever, cold like symptoms, increased difficulty with going to sleep etc. Some may even become lethargic, or they just do not feel well. Any behavior or feeling that is considered "out of the ordinary" for you or your child or even an increase in certain behaviors/symptoms may be considered as possible detox. One way to confirm your suspicions is to send a toxic metals test (UTM, HE/HMT, or FMT).
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Urine Color
During this time, it can be very helpful to monitor creatinine on a daily basis and note the color, smell and appearance. In this way, you can "see" what has been changing inside you or your child's body and that these changes are producing the less than desirable behaviors or performance. There are creatinine test strips you can buy and use at home. One less expensive way is to collect urine in Dixie cups or small vials. Note the date and time on each strip and use them as you would picking out paint colors. Some have even referred to the changes to the color of beer (Stout vs Pale Ale). Also, if you have some urine left over from your UTM samples, freeze it and write the actual creatinine on them when it comes back from the lab.
Graphing
Graphing the hair, urine and fecal toxic tests is an additional way to monitor your progress. Templates for these can be found in the Basics Forum on the Discussion Group. The following are graphing examples where one can see the rise and fall of a particular metal and ultimately see the bell shaped curve.
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At this point in the protocol there may be some big changes. Maybe you are seeing improvements, or even experiencing symptoms of detox. Take some time to reflect on where you are right now.
Use the chart below to document changes and behaviors you think might be attributable to detox.
Detox Diary
Date Detox Symptoms Toxic Metals Test Sent Suspected Trigger (Dietary Infraction, Supplement Addition, etc.) Adjustments Made
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Resources
Take some time today to view more of Dr. Amys resources and Webisode Series at www.dramyyasko.com. The following is a suggested order: An individualized Approach: Introduction to The Yasko Protocol Stress and Aggression Membrane Fluidity Methylation: Why you should be concerned, Part 1 More Pieces to the Puzzle Methylations & Mutations Continue Reading Autism: Pathways to Recovery
Spend some time on the Discussion Group reading new posts, also the "Positive Feedback" Forum.
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SHMT/ACAT
The reason you want to look at SHMT and ACAT support as starting points, if they are issues, is that we tend to see more dysbiotic and imbalanced flora associated with these mutations. Until we get the flora in better balance, we risk the problem of retention of toxic metals by the microbes. If we have an MTHFR A1298C mutation, BH4 and aluminum issue, we may have trouble moving ahead with this mutation and gaining on the aluminum excretion and mitochondrial issues, if we have not addressed the general gut environment by looking at SHMT and ACAT support. It is fine to layer in some B12 support early on and then later look at really supporting B12 in a big way after you have addressed some of these other mutations. You can look at B12 Mega Drops, B12 gum, B12 patch or the Get B12 spray at any point, and then layer in the much larger amounts of B12 (multiple routes/multiple sources) once you have dealt with some of the other mutations such as the SHMT, ACAT and CBS. Remember that the level of B12 in the system can also affect the gut environment. So if there are a number of MTR/MTRR mutations, higher doses of B12 are needed. B12 gradually layered in over time is important for the gut environment as well as support for the methylation cycle. Consider addressing these first if you/your child has these mutations or any of the following test results: Elevated Iron on a UEE SCFA Imbalances on a CSA/GI Profile Suberic, beta hydroxyl methylglutaric acid, or other ketone and fatty acid metabolites Imbalances on a MAP Severe gut issues Muscle weakness (which can be related to aluminum retention)
CBS
Start the ammonia program for CBS based on UAA results. The full ammonia protocol is listed in the Basics Forum, post entitled Ammonia Protocol CBS. The Ammonia/CBS Protocol is a set of supplement suggestions designed to address biochemical issues associated with CBS + individuals. The level of support is determined by your individual mutations as detailed in the Methylation Pathway Analysis and Urine Amino Acid biochemical test results. There is potential for each supplement to add in a layer of detox. It is suggested that you start LOW and SLOW with all recommendations, including the reduction of protein in the diet. If you see regressions in behavior, speech, etc., be sure to take a UTM. 76 | P a g e
Autism: Pathways to Recovery Workbook Please note that Ammonia supports may also be needed for NOS and SUOX mutations.
For More information on each mutation and priority, please read the Autism: Pathway to Recovery book Chapter 6, The Genetic Bypass book on the CD you received that came in your test kit, and refer to the Genetics Forum on the Discussion Group.
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Closing Remarks
I like the idea of looking for the next mile marker along the way rather than simply concentrating on the finish line. I think that sometimes it is easy to feel discouraged that you have not reached the finish line yet, but if we can all concentrate on how far we have come, rather than how far left to go, I believe that it makes the journey more enjoyable and easier to travel. It is another way of living in the moment, rather than always living for the future and the what ifs. When I used to do a lot more counseling in my private practice I would tell people that I wanted them to get rid of the would haves, could haves and what ifs. What is done is done, where we are is where we are. Live in the moment, concentrate on the moment, be the best you can be each and every day and you will not have regrets. We do need to learn from the past and look toward the future, but that is different than living with regrets or living for the future. I like the idea of focusing on the mile markers as we pass them, and trying to appreciate and enjoy the run along the way! I hope that this workbook will be helpful in getting you started.
Dr.Amy
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Autism: Pathways to Recovery Workbook MPA: Methylation Pathway Analysis. Test to determine genetic mutations to be addressed and includes lists of supplementation suggested for each mutation. Myelination: The wrapping around nerves. The change or maturation of certain nerve cells whereby a layer of myelin forms around the axons which allows the nerve impulses to travel faster. Neurotransmitter Test: Determines levels of Serotonin and Tryptamine and other important Neurotransmitters. Ordered within the CPR. OCD: Obsessive Compulsive Disorder Organ Supports: for liver, kidneys, pancreas and adrenals. Supplement lists found on Discussion Forum, Basics Section and Addendum A. PM: Private message on the Discussion Group. At the bottom left of each post is a button marked PM which allows you to send a private message to the author of that post. To view PMs sent to you, go to the top of the page, look below Dr. Amys Discussion Group and youll find You have X new messages. Click there and your private mailbox will open. SNP: (Pronounced snip) is a small genetic variation within a persons DNA sequence. UAA: Urine Amino Acids test. Shows levels of amino acids, especially important for identifying Ammonia, Taurine and GABA/Glutamate. UTM: Urine Toxic Metals test to see which metals are being detoxed and in what quantity. Also reports Creatinine (processed through the kidneys). UTM & UEE: Urine Toxic Metals test AND Urine Essential Elements, measuring mineral levels.
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Q: Why do all the HHI RNAs list the same ingredients? A: The specifics of each isolated RNA product are so complex and lengthy that they cannot be listed on the small bottles. Therefore each RNA product is labeled with the proprietary blend statement.
Q: How do I know if its detox? A: When in doubt its best to run a UTM, FM, or HE/HMT. Detox has many faces. It may be an increase in hyperactivity, increased stimming, recurrence of old obsessions, increases in OCD behaviors, rashes, fever, cold like symptoms, increased difficulty with going to sleep and many other issues. Some may even become lethargic because they just dont feel well.
Q: What do I do if detox gets to be more than I can handle? A: Increase the calming supplements and RNAs, pull out or reduce the detoxing supplement(s) until detox subsides to a tolerable level or until you are back to a calm place.
Q: Do I still give supplements when I or my child is sick? Which ones? A: This is a personal choice. Increasing the calming supplements and RNAs may be helpful. You may choose to continue the detox provokers at the same or lower dose, or stop them completely. There is no magic answer for this one. You are the expert on yourself or your child and are in the best position to determine which approach is most tolerable for your situation.
Q: Will Dr. Amy answer my question on the Discussion Forum? A: Most questions will be answered by Veteran members. A few posts are selected each week, at the discretion of the moderator, and sent to Dr. Amy.
Q: How and when do I contact the office? A: For office related questions please contact the office. You will find addresses on the contact page at the beginning of this workbook. For questions regarding the protocol itself and all other questions please use the Discussion Group. 82 | P a g e
List of Excitotoxins
monosodium glutamate seasoning(s) NutraSweet/Aspartame caseinate malted barley flour soy protein glutamate seasoned salt hydrolyzed protein disodium guanylate malt extract soy protein concentrate natural flavor(s) dough conditioners hydrolyzed vegetable protein disodium inosinate malt flavoring(s) soy protein isolate natural flavoring(s) yeast extract hydrolyzed plant protein disodium caseinate malted barley/barley malt soy extract maltodextrin soy sauce hydrolyzed oat flour autolyzed yeast malted anything autolyzed yeast extract carrageenan autolyzed anything hydrolyze anything bouillon texture protein broth gelatin stock sodium caseinate soup base guar gum vegetable gum spice(s) komb extract smoke flavoring(s) ajinomoto calcium caseinate whey protein concentrate plant protein extract lcysteine chicken/pork/beef flavoring whey protein chicken/pork/beef base whey protein isolate
Sources of MSG
Hydrolyzed Protein or Hydrolyzed Oat Flour Sodium Caseinate or Calcium Caseinate Autolyzed Yeast or Yeast Extract Gelatin Glutamic Acid Monosodium Glutamate
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