This week on Less Stressed Life Podcast, I am joined by Dr. Emily Gutierrez. I am so excited to have Dr. Emily Gutierrez back this week to share her brilliance and fill a huge gap with neuropediatric nutrition. Last week she wowed me with her knowledge of PANDAS, and this week we are talking about autism. I ask lots of hard questions, and she fires back without batting an eye. I am thankful for her work!
KEY TAKEAWAYS:
GUEST SHARED HELPFUL TIPS ON:
ABOUT GUEST:
Dr. Emily Gutierrez is the chief scientific formulator and co-founder for Neuro Nutrients and has over a decade of clinical experience managing patients in her busy practice with Neuronutrition Associates, one of the first pediatric-focused functional medicine practices opened in the United States. Dr. Gutierrez received her doctorate from Johns Hopkins University with a focus in XX translational medicine as a doctor of nursing practice. She received her master's degree from the University of Texas at Austin and is board certified as a pediatric nurse practitioner. Dr. Gutierrez is also board certified through the Institute of Functional Medicine, board certified as a clinical nutritionist, and board certified as a primary care mental health specialist. In addition to actively managing patients in her private practice in Austin, Texas, she also is adjunct faculty at Johns Hopkins University where she lectures on integrative and functional medicine. Dr. Gutierrez has published in the peer reviewed literature multiple times, however one of her favorite accomplishments was publishing the first chapter on integrative and functional medicine in a textbook for primary care providers. Dr. Gutierrez continues to be an active researcher, writer, and speaker, and her passion for formulating science based nutrient compounds that met the strictest standards of quality and efficacy continue to be her favorite tool in managing patients.
WHERE TO FIND DR EMILY:
Website : Neuronutrients.com
WHERE TO FIND CHRISTA:
https://www.christabiegler.com/
On IG: instagram.com/anti.inflammatory.nutritionist/
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This week on Less Stressed Life Podcast, I am joined by Dr. Emily Gutierrez. I am so excited to have Dr. Emily Gutierrez back this week to share her brilliance and fill a huge gap with neuropediatric nutrition. Last week she wowed me with her knowledge of PANDAS, and this week we are talking about autism. I ask lots of hard questions, and she fires back without batting an eye. I am thankful for her work!
KEY TAKEAWAYS:
GUEST SHARED HELPFUL TIPS ON:
ABOUT GUEST:
Dr. Emily Gutierrez is the chief scientific formulator and co-founder for Neuro Nutrients and has over a decade of clinical experience managing patients in her busy practice with Neuronutrition Associates, one of the first pediatric-focused functional medicine practices opened in the United States. Dr. Gutierrez received her doctorate from Johns Hopkins University with a focus in XX translational medicine as a doctor of nursing practice. She received her master's degree from the University of Texas at Austin and is board certified as a pediatric nurse practitioner. Dr. Gutierrez is also board certified through the Institute of Functional Medicine, board certified as a clinical nutritionist, and board certified as a primary care mental health specialist. In addition to actively managing patients in her private practice in Austin, Texas, she also is adjunct faculty at Johns Hopkins University where she lectures on integrative and functional medicine. Dr. Gutierrez has published in the peer reviewed literature multiple times, however one of her favorite accomplishments was publishing the first chapter on integrative and functional medicine in a textbook for primary care providers. Dr. Gutierrez continues to be an active researcher, writer, and speaker, and her passion for formulating science based nutrient compounds that met the strictest standards of quality and efficacy continue to be her favorite tool in managing patients.
WHERE TO FIND DR EMILY:
Website : Neuronutrients.com
WHERE TO FIND CHRISTA:
https://www.christabiegler.com/
On IG: instagram.com/anti.inflammatory.nutritionist/
Shop our Favorites
Loving the podcast? Leave us a review and ENTER OUR GIVEAWAY NOW!
Sharing & reviewing this podcast is the BEST way to help us succeed with our mission to help integrate the best of East & West and empower you to raise the bar on your health story. Just go to https://reviewthispodcast.com/lessstressedlife
Have a question that you want to be answered on the Podcast? Submit it here: https://www.christabiegler.com/questions
Work Together: christabiegler.com/fss
Shop our Favorites:
Dr. Emily (00:00:00):
There are genes that contribute to autistic symptoms, and it's very multifactorial. We can't say that there's one gene that causes autism. Now there are some chal differences that can look like autism but are not actually autism. There's something else.
Christa (00:00:16):
Stress is the inflammation that robs us of life, energy, and happiness. Our typical solutions for gut health and hormone balance have let a lot of us down we're overmedicated and underserved at the less trust life. We are a community of health savvy women exploring solutions outside of our traditional western medicine toolbox in training to raise the bar and change our stories. Each week, our hope is that you leave our sessions inspired to learn, grow, and share these stories to raise the bar in your life and home.
Speaker 3 (00:00:58):
So I decided my word for 2023 is going to be connection. And something that feels so weird sometimes in podcasting is when you talk and you can't talk back to people. So I thought I would try having monthly calls with you, the community, to connect with you so you can register for the call every month. Every month there we update the page. And you do have to reregister every month. You don't automatically get the invite. And I change the topic every month. So what you have here on this episode is December's recording. So on this episode I did, why would you care about stool testing or gut testing and what's the difference between functional and conventional stool testing? And then I answered questions from people that were there. Now, I had of course, hiccups at the beginning cause sometimes links go out and they get disheveled by the internet.
(00:01:49):
And so I was a little flustered when I got started and then we got rolling. And I always love when people ask questions because then I can be actually the most helpful. So you can submit questions when you register and I'll answer them in the recording. You can always catch the recording if you can't catch it live. I try to keep it to 30 minutes. You can register for this monthly call by going to Krista bigler.com/community. So I hope you enjoy this little bonus episode. And maybe I'll leave and meet with you next month in January.
Christa (00:02:17):
All right, today on the Less Stress Life I have Dr. Emily Gutierrez, who is the Chief scientific formulator and co-founder of Neuro Nutrients and has over a decade of clinical experience managing patients in her busy practice with Neuronutrition Associates. One of the first pediatric focused functional medicine practices opened in the United States. Dr. Cutera received her doctorate from John Hopkins University with a focus in translational medicine as a doctor of nursing practice. She received her master's degree from the University of Texas at Austin and is a board certified as a pediatric nurse practitioner. She's also board certified through Institute of Functional Medicine and as a clinical nutritionist and as a primary care mental health specialist, which is a lot of things. In addition to actively managing patients in her private practice in Austin, Texas, she's also adjunct faculty at John Hopkins University, where she lectures on integrative and functional medicine. She's published peer review literature many times, but her favorite accomplishment is publishing the first chapter on integrative and functional medicine in a textbook. So it's an allopathic textbook for primary care providers. And she put the foot forward on integrative and functional medicine on that chapter. She is an active researcher, writer, and speaker. And her passion for formulating science-based nutrient compounds that meet the strictest standards of quality and efficacy continue to be her favorite tool in managing patients. Welcome, Dr. Emily.
Dr. Emily (00:03:32):
Well, thank you for having me.
Christa (00:03:34):
Yeah, having a lovely day. You're my second doctor Emily today. And you're the second like multi board certified. I'm like surrounded by geniuses today, which is lovely. And I I, it's my favorite. It's my favorite. Cause I've, if I can be learning, that's my jam. So I know last week we did an episode on pans and pandas and we're publishing these in sequence and that doesn't mean someone listened to that episode. So we'll give a little bit of background on your history, but I'll maybe ask it a little bit differently. Tell me about what translational medicine is.
Dr. Emily (00:04:05):
Oh, that's such a great question. Okay, so first of all, there's two ways that you can get your doctorate in nursing. One is PhD. So you can have a PhD and become a doctor. And that's creating new knowledge. A DN P or a doctor of nursing practice. It's translational knowledge. So from bench to bedside, what we know, for example, we used to know that we should put our babies on their backs. So they didn't have the incidence of sids or sudden infant death syndrome went down. If you did that, we knew that for almost 30 years before actually it was a recommendation. So often what we know in science, as you know, sometimes it feels like drinking from a fire hose. We can know a lot of information and it becomes clearer and clear and clearer. But how we're translating it to the bedside or into patient care, there's a big gap. So my doctorate is all about the translational gap. How do we take from what we know to be true scientific efficacious into actually how we're practicing medicine?
Christa (00:05:09):
I don't know if you went back to, if you were going to school like just straight, or if you were working for a while in between going back for your doctorate
Dr. Emily (00:05:15):
Mm-hmm. <affirmative>. I worked in between all of my degrees. Definitely.
Christa (00:05:19):
And I remember from our conversation last week, you said, I hope I quote this right. You said, I felt woefully unprepared for my clients in Austin who were naturally minded, who wanted to know what essential oils to put on their child, or if they could alter their vaccine schedule. And you wanted to be helpful to them in collaborative to them, but you were like, Ooh, this was not in medical degree to deal with people like this. Right? Like it was a little different. And as a Texas girl, that was gonna be your home. So there wasn't gonna be a change in the people.
Dr. Emily (00:05:49):
Right. And you know, instead of avoiding these people or dreading these visits, you know, I had a choice. I'm either going to engage and jump in, or I'm just gonna be one of those people that kind of snicker and behind someone's back and kind of just dismiss everything they say as it's coming out of their mouth. And unfortunately, you'll find those providers, you know, someone knows science better than the provider. They know more about amino acid function and nutrition and all the things. And then, you know, they eerily come to their provider and wanna share and they're just shut down immediately. Mm-hmm. <affirmative>. And I didn't wanna be one of those providers. So I went on a journey to really teach myself and learn and, and find the resources to continue to learn. And I have all those degrees because I just love learning. I am a lifelong student and I will always continue to learn.
(00:06:41):
Sometimes that offers me a few letters behind my name, but this alphabet soup at this point, does it matter. But I just love to learn and, and I think the medical field, boy, we can learn so much from chiropractors and clinical nutritionist and osteopaths and naturopathic physicians. You know, there's kind of this, I'm a physician or I'm in this allopathic provider, so I am at the top of the food chain. And that's just bs. You know, we can all learn so much from each other. And when you realize that it, it sets you on a journey to learn from many different places.
Christa (00:07:17):
Yeah. Collaboration over competition is a great mantra. And you said about talking behind clients backs and dismissing them. I mean I, that was very much what it was like working conventionally for me. It was just how it was. It was just what was happening there. I think it's how people were removing themselves from like the seriousness of what was happening in the situation too sometimes. Mm-hmm. <affirmative>, it was like a, it was a buffering mechanism. It doesn't matter, but either way. Right. An inspirational
Dr. Emily (00:07:45):
<laugh>. Well, and just, it's just very egocentric too, you know, just because you've attained this certain educational milestone in your life, it doesn't mean that you know more or better than somebody else. Especially when it's a parent coming to you talking about their child. Because I always assume that the parent knows more. And if there's something that the parent's feeling very passionate about or wants to explore or has a gut feeling about, I'm gonna listen to that parent. Because if I don't, I mean everyone's in trouble.
Christa (00:08:12):
Mm-hmm. <affirmative>, that is part of evidence-based medicine, right? It's the research, it's the patient's experience and then it's your own historical and anti, like your other experiences from your, from your practice. From Yes. From from what you have. So I think we forget what that means sometimes. That's a nice little Venn diagram.
Dr. Emily (00:08:29):
Yeah. <laugh>, I like that Aven diagram. Nice.
Christa (00:08:33):
And then not to mention, when you like learning and you like challenges, which I'll say by the way, my friend Robin said this one time and I never got forgot. When you're shopping for a provider, look for someone who does like learning. Now that I think about it as you said that I was like, man, all my favorite providers love learning. That's what one of the women said this morning too. And I'm like, I see that all the time with those people. So it's a great asset, great trait to have to, to like learning cuz it means you're never done. But maybe it's also like where you want to help, as someone else said today, you know, you can help this person, but then you couldn't help this other person and so you just wanted to continue to help. So there's either a, a mixture of boredom from the stuff you were seeing all the time.
(00:09:10):
Or the person that was a little more complex is because you ended up with the more complex, interesting clients at this phase for sure. Mm-hmm. <affirmative> <laugh>. So, so your days are different and more, you know, just more. And we talked a little bit last time that if you have a more complex case, you can't just run through it like super fast. It just doesn't work. And so you don't do it like that anymore. You kind of, your day is set up. So it allows you to spend a little more time with a case, which is what is needed at that level. So, mm-hmm. <affirmative>, last time we talked about pandas. Today we're talking about autism, getting all the really wild, complex, debated, hotly debated diagnoses. And you did such a good job telling us all about pandas. So let's get into autism. So let's go 1 0 1. You know, with pandas, there's not an ICD 10 code, as you told us last week, there's symptoms, right? And there's like recognition of how you diagnose it. But autism has been around a little longer, I think. You know, or we know we've recognize it a little bit longer. So let's talk about the history of autism. Apparently it has jumped a lot in years, um, recent years. So how are you seeing that translate? And tell me about the diagnosis and just kinda like the 1 0 1 of autism police.
Dr. Emily (00:10:15):
Okay, well, there's a few people that can give the official diagnosis of autism for insurance purposes. So, and those people are, you know, child neurologist, child psychiatrist, developmental pediatricians. So when someone's trying to receive services or therapy, often dependent on how to strict your insurance, is you want a diagnosis for one of those three types of providers. Now, if you're in a small town in Texas or somewhere else, and your child's clearly, you know, if you get the diagnosis of autism from your pediatrician, it doesn't mean that they're not right. Are they not correctly diagnosing that child just for insurance? It might need to be someone else. There's a set of symptoms that happen that you start thinking about, is this child gonna meet the criteria for autism? So sometimes there's delays from the very beginning. So they didn't set up on time, they didn't start coing, they didn't start doing things like crossing midline.
(00:11:17):
They didn't start babbling. They didn't start crawling things that are delayed from the very beginning. And then more so than, not more than that delayed from the beginning. A lot of children have regression. So what that means is they're doing things, they're babbling, they're saying some words, they're very engaging, and then over a period, and it usually happens pretty quickly over a few weeks to a few months, they'll lose their milestones. So all of a sudden they were saying dadda. And then they don't say, you know, they don't say data, but might look at him. And then when he comes in the room, they might not even acknowledge he's there and have their like, kind of be trapped in their own world. They might be walking and stop walking. They might be, you know, language disappears in ways, things that they're able to do, even motor wise sometimes can disappear.
(00:12:09):
And then it tends to be that they're going into this world that feels unreachable to parents not making eye contact, having stemming behaviors, like a lot of self soothing behaviors, a lot of rhythmic rocking, a lot of hand flapping, a lot of si, um, lining things up, just kind of regressed socially. And then some kids really at that point also become, uh, very aggressive or had a, have a lot of tantruming, a lot of crying. You know, everyone's journey to that place is a little different. But that's kind of the, the basics of it. And the regression happens typically around 12 months, I would say would be on the early side to, you know, two and a half would be more the late side. So one thing that parents can kind of take a deep breath for is if your child hasn't been diagnosed with autism after four years, the likelihood is they never will be. So that's a milestone a lot of parents are trying to get to. And the ones that we see is usually around the 12 months to two and a half years.
Christa (00:13:15):
Are there late diagnoses sometimes? I know you said they probably won't be, but is
Dr. Emily (00:13:19):
There, well, there's a lot of flippant diagnoses. So let's talk about the spectrum of autism because Yes, my question late diagnoses. Absolutely. I had a family member at 60 years diagnosed with autism. That's pretty late, right? It's being your sixties to get a diagnosis. Weird. So I think there's some casual throwing out, oh, he must be a little autistic. Or maybe they're on the spectrum. And yes, after four you can see the diagnosis of autism given, but it's usually in a very high functioning child. So it's not gonna be a child that's usually nonverbal, doesn't have skills, has a lot of the moderate to severe symptoms of autism. But it might be somebody that has some social awkwardness, maybe very severe adhd. In fact, at a time where you were starting to put ADHD on the autism spectrum as just being more high spectrum and there's not an ICD 10 code for Asperger's or high functioning autism, there aren't those codes. We, it's all still just autism, but the range of autism can be, you know, very, very mild to very, very severe. And then everything in between. Well,
Christa (00:14:30):
The sensory processing fit on this spectrum also.
Dr. Emily (00:14:33):
I don't think so. I wouldn't say a six year old with sensory processing disorder has autism. Mm-hmm. <affirmative>, however, their's sensory sensitivity, either being a sensory seeker or a sensory avoider. These kids needing PT OT therapies when they're very young, like two or three, you'll see a lot of that in the autism population. But you can have that in absence of autistic symptoms.
Christa (00:15:01):
Mm-hmm. <affirmative>. Okay. So I, would there be like a top five hallmark symptoms for autism? Or how do you start to, I know these are like more pretty significant, right? There's that regression, I think you said around 12 months, between 12 months and two and a half years you listed several symptoms, then they might get a diagnosis from their local provider, but for insurance reasons, they may need this official diagnosis. So they may have to drive hours to see the right provider. Mm-hmm. <affirmative>, would you say that in,
Dr. Emily (00:15:27):
Go ahead. In wait. A long, long time to get in to see those specialties. I learned from one of my very, my new very good friend who's a developmental pediatrician here in Austin. She was telling me, uh, a couple of weekends ago when we were at a autism conference that they only produced in the United States, uh, less than 20 developmental pediatricians a year. And so a developmental pediatrician is somebody that's pretty hard to access and get into and, and their wait list usually is at least six months or a year to get into most of them. Wow, that's really tough. It's tough. It's very challenging. And in the world of psychiatry, if you're a pediatric psychiatrist, we have less of those than regular too. So most of these kids are getting in to see neurology, first, pediatric neurology, and the pediatric neurologist, they might do additional testing when you go and see them, you can do something called an ados, which is, you know, a scoring system.
(00:16:26):
There's things that you can fill out and score and there's different testing as far as like more specialized testing. But you know, when someone is autistic and you've been doing this for a while, it's very clear and very easy to pick up on. Especially the more severe they are, the more nuanced they are and the more high functioning. There's some gray, and I think some people, you hear it all the time, the neurologists will say, oh well we're gonna go ahead and give you this diagnosis. So insurance will pay for your applied behavioral analysis therapy and aba or applied behavioral analysis therapy is the number one treatment in the allopathic world for autism. It's a certain type of therapy that helps kids to start to function and reengage.
Christa (00:17:12):
Well, let's talk about that since we're talking about the standard medical treatment already. So it is, was there a abbreviation for that?
Dr. Emily (00:17:20):
Aba. Aba. ABA therapy. All
Christa (00:17:24):
Right. So that's our standard of care is ABA therapy. Tell me a little bit more about ABA therapy where people have to, you brought up small town in Texas, um, small town in South Dakota, so I get that as well. But, so where are people going for ABA therapy or who does that? Where do kids access that?
Dr. Emily (00:17:38):
Well, you're gonna find ABA therapists all over the country. And ABA therapy can be very helpful for children on the spectrum. Especially, you know, to help them get into learning how to be potty trained and to learning how to, you know, sit and eat their food and how to engage and respond. I mean, ABA therapy can be very helpful. It's kind of like a specialized OT for autism. Mm-hmm. <affirmative>, if that makes sense. Mm-hmm. <affirmative>, there's some people that believe ABA is absolutely the only way to treat autism. And then there are other people that criticize ABA and say ABA really just creates parrots and these kids are automated but they don't know why they're doing what they're doing. And my personal bias with this is the longer that you are in ABA therapy, say if you're 16 years old, I do see a lot of parenting and I do see, you know, more moderate or severe kids doing things, but they don't actually know why they're doing them.
(00:18:38):
So I personally believe ABA has a place it's good to do early on, but then I like to see my patients graduating from ABA and doing other types of therapies if still needed, but not just the purely classic ABA model. Mm. There are, you know, occupational therapists that do a fusion and I really like that too. There's also another therapy in autism that not a lot of people know about, but I mean when you read about it and you investigate it, I think it's pretty interesting. It's called relationship development intervention. So it's about learning how,
Christa (00:19:13):
It sounds like it's for everybody.
Dr. Emily (00:19:15):
<laugh>. Yeah, very true. Very true. So it's, you know, for those people that are like, okay, I think we've gotten all, we're gonna get out of aba, but we still, our child isn't really engaged and a lot of people, they end up, it's just a social component is really the most challenging part for them, especially the more mild your child is. So going into some type of social therapy or relationship therapy is where I like to see a lot of my patients graduating too.
Christa (00:19:43):
Hmm. I have so many questions. A better hangout in standard medical treatment, though, that umbrella or cornerstone at the moment. So ABA therapy is probably gonna be delivered by an occupational therapist that has some specialized training. Am I catching that? Yeah,
Dr. Emily (00:19:57):
Well, so they have to be specialized trained in aba. Mm-hmm. <affirmative>. So these are therapists that actually have a master's degree and they are very, very specialized in this very specific therapy for autism. So it takes a while and it takes a lot of training.
Christa (00:20:14):
Yeah, I was just thinking about how this is handled in schools because you're well versed, the insurance loopholes there and I bet you have to have a diagnosis because usually with schools, I don't remember the terms for this, but you know, you get special adaptations that sometimes you, depending on the severity, you may have special person assigned to you. So it makes me curious about the training and the resources for schools because they're dealing with it most of the time, aside from parents.
Dr. Emily (00:20:40):
Yeah. And you're not gonna get, I don't know of any school systems in my view, not to say that they aren't out there and they don't exist that are offering ABA services in schools. When you have a pretty severe child, say he's moderate and he's two and a half years old. First of all, if your insurance doesn't pay for it, you gotta be really, really, really wealthy to afford it. Cause it is so incredibly expensive. That's why insurances are such a stickler about who gives the diagnosis. So, you know, some families could be, you know, paid 10 to $15,000 a month for ABA therapy if they don't have insurance covering it. It's very, very expensive. So if you're lucky enough to get your insurance to cover it, you also have to live in a town where there is access to it. So in small towns, I do have patients that are, you know, live an hour away from the, the closest ABA therapy center. So they'll either drive and do it a couple of times a week or they just won't do it at all cuz it's just, it's hard to access. And that's kind of the stickler with aba. Most kids that get ABA that are moderate to severe, you're gonna be doing 40 hours a week. So it's a full time job that they're doing ABA therapy.
Christa (00:21:52):
Wow. Yes. And well how long do they usually do it for? Because you talked about sometimes a 16 year old child and then this parroting, so I'll, I'll classify that in a moment. But how long are they usually doing aba if you're doing it for that mu it's like a full immersion right there.
Dr. Emily (00:22:07):
It is a full immersion. I see kids doing ABA up to, you know, eight years old. Typically they're, you know, they start with a really intense period of time that they're doing like 40 hours and as they get better they have less hours. Maybe they'll go to 30 hours and then 20 hours and then we're going to ABA a couple of times a week. What I see in my experience is parents say, yeah, we did ABA for three or four years, now we're moving on to something else. Mm-hmm <affirmative>, that's what I see typically. But it depends on the ABA center and the therapist itself is, you know, maybe they believe that that child needs to do it until they're, you know, 16 or 17. I'm not sure. It's not the norm for me to see a teenager in ABA therapy, but I certainly have. Mm-hmm
Christa (00:22:53):
<affirmative>. Well this makes me think about the preval cuz I think where I would love you just wouldn't do this or you would see what other options you have, which we can get to. But what is the actual prevalence of autism?
Dr. Emily (00:23:05):
Well, it's changing all the time. It's changing all the time. So I think the prevalence now is one in 54 and there's more boys than girls. And as we look over time that number becomes lower and lower and lower. So, you know, one in several hundreds decades ago to every year as we are, we're doing an assessment of how many children in our population are autistic. Mm-hmm <affirmative>, that number increases and it's increased over time. Recently that had an increase with the cdc. It was another increase. I don't know if exactly it's one in 54, but it's around there. Sure. And it's always more more boys than girls typically. And when I have girls that are autistic, they're usually more severe.
Christa (00:23:49):
Hmm. Interesting. Mm-hmm <affirmative>. So did we cover rule outs and rule ends when a child is first diagnosed? Do you think before we kind of continue down treatment pathways?
Dr. Emily (00:23:58):
Sure. You know, one of the rule outs that a lot of neurologists and everybody's looking for first is, is there something else chal that's going on? Is this genetic in some way? Because right now, while we could argue that there are genes that contribute to autistic symptoms and it's very multifactorial, we can't say that there's one gene that causes autism. Now there are some chal differences that can look like autism but are not actually autism or something else. For example, I had a patient when he was 10 come to me, clearly had a lot of autistic symptoms and they had never done a chal microray because their pediatrician had diagnosed kid with autism. He had clear autistic symptoms. And so a chromosomal microray is, is kind of a basic genetic test, just making sure all your chromosomes look okay. And so I was beginning to work with this family and I said, well you know, we haven't got that done.
(00:24:53):
I think it's an important test to do so let's just mark it off our list. And we ordered it and the kid had fragile X and why that's important to know the child had fragile X versus this non-specific autism is because with fragile X you'll look forward and think okay, there's certain milestones that we can predict that you need to look at. Like you need an echo of the heart and you need to look at, you know, different milestones of these kids. Cuz we have a history of what that looks like. They have different needs over their lifetime. And what's even more important to me is for parent expectation because it's just like some kid with down syndrome, you know, chromosomes change, phenotypical expression. What that means is, you know, you can have low set ears, a big tongue wide forehead, you know, phenotypically are physically how you look.
(00:25:40):
There are differences because of your chromosomes. Well this might be sensational to say, but some kids on the spectrum can reverse their diagnosis. They can no longer have the diagnosis of autism. But if you have a kid with a chal issue, they're always gonna have that chal issue. Even though you can improve their function certainly, but they're never gonna change some of the characteristics of how they are set up. And I think that's an important expectations for parents. Cause if you have a child that's diagnosed, the first thing you're gonna think when you're doctor Googling is how am I gonna cure my kid? How am I get them to be normal? Mm-hmm.
Christa (00:26:16):
<affirmative>. Yeah. Because it's a, now your life is totally different.
Dr. Emily (00:26:20):
Yes. Forever. It's different forever in one way or the other. It's different forever. Mm-hmm <affirmative>. And another rule out is a lot of kids that are having developmental delay, um, well if they're not speaking you should do a hearing test number one. You know, especially if they've had chronic otitis media or ear infections. But you can damage your hearing from that in. There are some parents that are so afraid of antibiotics that they don't treat their kids ear infections. Mm-hmm. <affirmative>. And sometimes that can be, that can be a detriment to the child, even though I know we have to balance with, it also can be a detriment to a child to put 'em on, you know, 75 rounds of antibiotics for their ears. So if they're not speaking, if they have something called a apria, which is lack of speech, certainly you wanna get a hearing test.
(00:27:07):
And then there's a significant amount, I mean it's clinically significant, about 10 to 15% as a good estimation for these kids will also have seizures. And they're having seizures. They're not doing that tonic clinic, you know, where somebody falls on the ground and you get really scared that, you know, they're shaking and seizing, but they could have staring spells where they just wander off and you can't get their attention or when they're falling asleep. And the different phases of sleep are more vulnerable to have seizures so they could be seizing when they're sleeping. Mm. And a seizing brain isn't gonna be a well developing brain. So a lot of times the neurologist will do an an eeg, just a routine. They put the little helmet on their head and then the office, they just make sure that their neurons are firing is succinctly and they don't see any type of epileptic form activity where there's discharges in the, the reading that shouldn't be there.
Christa (00:28:00):
Man, lots of things here. So we talked about some rule out things. Is there any rule in things that we didn't cover
Dr. Emily (00:28:09):
Rule in? So it's really the, it's a clinical diagnosis because there's not like a a blood test that you can do. There's not a genetic test that you can do. You really rule it in based on their symptoms and that's how you get the diagnosis. Is that what you meant by rule ends?
Christa (00:28:27):
I think so. <laugh>. Mm-hmm. <affirmative>. All right. So we talked about diagnosis, we talked about standard care and kind of the gravity of that and how that could look a lot of different ways and how it may typically look depending on access. But then I think, and it makes sense if that's the gravity of the typical treatment and it's like, well that's it. That's all I got. Then it makes sense that people kind of start to look for other options and think there is usually options to improve things in other places. So. Yeah.
Dr. Emily (00:28:54):
Well it's so heartbreaking. It's so heartbreaking to me that there's so many parents out there that have no idea there's another option. It just honestly breaks my heart because you can improve symptoms without just having to go straight to antipsychotic medications. Mm-hmm <affirmative>. And for some of these kids, they're so aggressive that they're biting their parents, they're putting holes in the walls, they're eloping and running away. I mean you have to put 'em on medication to get them to be able to stay within the home. And there are severity of kids that are like that. And I'm not anti-medicine. Mm-hmm. <affirmative>, but I'm not anti, that's the only solution either. Mm-hmm <affirmative>. And you know, it's unfortunate that these parents don't know that there's another way that this is a biological, when you, you look at autism from a functional medicine view, it's a biological illness. And we have to do some detective A to figure out where is the fire? Just like in pans, where's the fire? Where's the system imbalance? What is stressing out the body that it shouldn't have? And what is it missing that it needs to function optimally?
Christa (00:30:00):
So what are the big pieces of this treatment pie that you're gonna assess and that you see as issues?
Dr. Emily (00:30:07):
When I look at autism, I always counsel parents that I look at it in four big buckets and the first bucket for trying to figure out why, why is there autism? Why is there symptoms of autism? It's just putting into context that genetic bucket, right? So there are the chromosomes that we need to look at, but then there's also genes and we're learning more and more about genes over time. So a lot of the neurologists and geneticists will say, Hey, that doesn't matter. It doesn't matter at all. But you probably know as much as I know, sometimes genes do matter. Like if you have a gene where you are not absorbing b6, there's actually B6 dependent seizures that you can be having. I mean that makes B6 really, really important to know. And that is genetically based. Some kids also have shank mutations, these are mutations and how the scaffolding of the neurons develop in the brain and they're not really communicating well because of their shank mutation in their genes. And what's beautiful about that is if you give them zinc, their shank works better. So these kids need very, very high doses of zinc. So we have a genetic bucket, everybody's gonna have genes. The epigenetically you can modulate to have better function within the body. Mm-hmm. <affirmative>. And that's a big piece. That's a big piece.
Christa (00:31:29):
Yeah. Those were really interesting ones. You went way beyond methylation. And I don't, for my people, which I'm not dealing with your people. For my people, sometimes genetics is a little overwhelming for them. And for them I can say, Hey, did your family history also have these signs? Well then you could probably support these things. But for you it's like a potentially a make or break situation where it's like, oh, I look at the genetics and it's a huge potential win or a gap you could fill in from a nutrient perspective. Do you validate if you're gonna do genetic testing, you see X, Y, Z, hey you may struggle with this, this and this. Do you follow with any nutrient testing? I think last week we talked about how there's a lot of limitations with nutrient testing sometimes. Like it's just, it cannot always be accurate all the time. Like there's just not great options.
Dr. Emily (00:32:15):
Yeah. It's not accurate all the time. And also it's sometimes hard to get on kids that are needle phobic and there are some parents that just absolutely will not have both parents go to the lab and strap their kids down and get a needle in their arm because it literally is inducing trauma. Yeah, yeah. Yeah. And I respect that. I do respect that. I think some testing is, is helpful. Like organic acids testing, I think that can be really helpful. You can see a lot of mitochondrial markers in there that I think are helpful. Mm-hmm. <affirmative>, I had a kid today that had a seizure you know, a couple of months ago out of the blue, normal typical kid, six years old, I did an O time. I think he has fatty acid oxidation very severely and I think Carine is a big deal for him.
(00:32:58):
And I wouldn't have known that really without doing those tests as well. Even though we know with adhd, Carine is one of the nutritional deficiencies that you will see in ADHD and in some of the population. We haven't done really robust studies on that yet. Yeah. We know for sure zinc and magnesium and methylated bees like your methylation, those are deficient in that population. So I think there, there are limitations to testing certainly, but I also think there's some utility from it for sure. Yeah. Right. And it's not a home run with everyone. Right. There's sometimes where I'll do genes for autism and I'm using INXS dna, uh, Dr. Sharon Houseman co-created that. She does a lot of work with the neurodegenerative space with like pearl motor and Bredesen. I love her testing. She has a mental wellness and neurodevelopmental panel and sometimes, you know, we'll do the basics.
(00:33:48):
Like we'll look at how their magnesium is and their b6 and their methylation. There's so much there. And then we'll do the autism panel and there's really nothing in it. You know, it's something that would be in a neurotypical kid too. Mm-hmm. <affirmative>. So sometimes it's a win just figuring out, it's really the basics of things that are stressing the child out. And sometimes it's, hey, here's the shank mutation, or oh, you've got a lot of problems with glutaminergic load in the brain, et cetera. But the other three buckets, you hit one of 'em, you know, one of them is . But here's the nuance in autism, sometimes children create antibodies towards how they absorb folate through the blood brain barrier into the brain. They have blocking and binding antibodies where they can't get folate into their brain. And that's a big deal. That is a big deal for some children. You'll see some clues, midline defects, like if you have lip and tongue tie, trouble breastfeeding, any type of like birthmark, any type of dimples on the sacrum, any type of closing of the spine that was abnormal. So folate abnormalities and growing children are a huge deal. And sometimes methyl folate isn't enough for them. You have to give them folic acid. Are you familiar with folic acid?
Christa (00:35:13):
I am. But let's talk about it because it's kind of confusing because someone could have heard that and thought you said folic acid, but you said folic acid and it's different and it's tricky. It's like a couple letters. So let's talk about the difference.
Dr. Emily (00:35:26):
Yes. In fact, I was talking to a pharmacy today, I did a little inservice before I got on with you. And one of the nutritionist said that they were like, wait a second, Emily, we're not supposed to get folic acid. Why you have folic acid in your products? And I'm like, well let's talk about it because folic acid is synthetic, right? So the government unfortunately is still pumping us into our food supply into pregnant women. But over 60% of the population cannot metabolize that synthetic form of folate. So then you have dihydro folates where, which are your plant folates. And then from there there's several steps and then you make folic acid. So folic acid is most important for repairing dna and from folic, that's one biochemical step before you make your methylated folate. And in growing children there's been studies to show if you give them high doses of folic acid, it can start to improve and resolve their symptoms of autism. For some kids, that's the key. For some, not for all, but for some,
Christa (00:36:26):
What's the high dose?
Dr. Emily (00:36:27):
25 milligrams twice a day. Got it. Mm-hmm.
Christa (00:36:30):
<affirmative>. Well that's cool. Research on that. Yay.
Dr. Emily (00:36:32):
Yes it is. It's Dr. Richard Fry's work. And there's also a company that does that. Actually you can do a blood test and look at those folate antibodies. It's called the folate receptor antibody test by ilads. You can do that test and see it. You know, there's so many tests that you can do once you have a child. I try to be really picky. Some parents are like, give me every test there is possible. It <laugh>,
Christa (00:36:56):
You know, whatever does right away necessarily well
Dr. Emily (00:36:59):
Brought, oh you beautifully said,
Christa (00:37:00):
You brought up, hey, sometimes it's a home run, sometimes it's, it's funny, I think we all do that. It's like, what could I possibly do? That's for me, I'm like what's the minimum amount of testing I can do for the maximum roi? And I think you have more opportunity for testing that's gonna give you roi. And I think the stakes are higher a lot, you know, the stakes are high here and that's reasonable. But I would say that everyone loves a test when it tells you the answer and no one likes the test, that doesn't tell you the answer. So people are like, oh, I'm so thankful I did that. Like yeah, cuz it gave you like key answers and that makes sense. It's just human, you know, it's no big deal. It's just human. And so sometimes, like you said, you did the autism panel, it didn't give you anything and the other neuro panel gave you a lot of great things. So it's like it is, there's an element of luck. You do your best <laugh> with being a great detective. Like what could potentially work, like you said, there are some symptomatic keys with the fa, like you went through multiple clinic like body signs and symptoms. Right. Of potential folic acid or or folate issues potentially. And by the way, the antibodies to Foley, isn't that fascinating? I wonder when we discovered that, is that the only test for that by IODs? And how much is that? I would guess that that would be expensive.
Dr. Emily (00:38:09):
Don't hold me to the fire here, but I think it's around $200. Okay. And yes, they're the only ones that have it on the market at this juncture. Just curious,
Christa (00:38:18):
Nuanced. Very nuanced.
Dr. Emily (00:38:20):
Yes. And it was created for kids on the spectrum and you know, Dr. Fry did some work and he was tapping spines of kids on the spectrum and finding 'em that way and looking at actually instead of looking at fully in the serum but fully in the cerebral spinal fluid was seeing it low. Low in the CSF and high in the blood. So unfortunately a lot of providers will do it fully and they just look at it in the blood. Yeah. But it does not mean it's high in the brain or in the nervous system. It doesn't. That's tricky by seeing, seeing these antibodies sometimes you can say okay you have blocking or binding antibodies. I've never seen anybody with both because I do not think it's sustainable for life. And you know, the prediction is if you high dose folate them for six to 12 months, they should see improvements in their symptoms for certain. So
Christa (00:39:10):
It's a long timeline.
Dr. Emily (00:39:12):
It is. Oh you're
Christa (00:39:13):
Wrong. It's just like a little bit of time to wait. What's the soonest that they might see changes?
Dr. Emily (00:39:17):
Six weeks. Ok. Just like with other nutrients, you give a nutrient, you give a combination and you need to give it four weeks. There are a few things. Okay. For sure. Lubar kinase, you can see that and see increased energy after covid. Right? If you give it and has somebody has kind of a post covid coagulopathy, you can see their fatigue start to kind of melt away very quickly. That's an exception at lp you should probably see something within a couple of hours. Also, magnesium three and eight, there's definitely things that have an immediate return. Right. But, but some of these things don't. You have to give it time to see efficacy. Right. So no, that's with the folic acid, it's usually around six weeks that parents start seeing it. But when they do, they're like, okay, we have more eye contact. We've developed a word. When they see that progress, they're like, we're in, we're gonna do it. We're, you know, they're consistent because the payoff is so great.
Christa (00:40:13):
Oh totally. Okay. So we're going through the buckets. We went through genetic chal meth and then yet the second bucket is still mutilation and folate issues. Mm-hmm. <affirmative>. So very similar buckets and interesting, you know, it's a big deal. What's the next, what are the other buckets?
Dr. Emily (00:40:28):
So redox abnormalities. So people that have a lot of oxidative stress from some type of toxicity and it can be immunological toxicity, right? If they had a parent with chronic mold, chronic ly, if there's cmb, if there's infections. The immune system is a big part of redox stress, but also redox stress from toxicity. So you know, the people in my field that are treating autism are assumption and pretty much a general consensus is, is our planet and our food and our mothers are more toxic because of where we are today. And our infants are becoming more toxic. And for some people that don't make good detox chemicals mm-hmm. <affirmative> like glutathione or their transation pathway has a lot of mutations in it and they don't eat antioxidants and they have dysfunctional voiding, they become toxic maybe. And
Christa (00:41:22):
They don't urinate or have bowel movements or they don't sweat or something.
Dr. Emily (00:41:27):
Exactly. They stay and play on a screen and they eat for beige foods and they're constipated and their parents are using Roundup in the yard. Not to blame any parent, I shouldn't have said that cause it's not any parent's fault period that their kid is autistic. But some people are not mindful about toxicity because they don't believe they need to be.
Christa (00:41:48):
Right. This is, it's very challenging though because there would be no one, everyone's gonna do what they're doing. Like we're gonna do what, you know, and then when you, some have, when the stakes are high and something like this happens, then you're gonna maybe do everything you know? And so on the note of this bucket is, uh, I've gotta ask about the most common thing that comes up or parents looking for other stuff. And I think it just fits potentially under the big bucket degree is like, so what is the perspective? And like, yeah, I know this has been hotly debated, but I can't really leave an autism discussion without asking you where vaccines lied in the middle of this. Because people say like, Hey, this is what happened and like the next day my kid is not like that. Right. So where does that fall? And is it just part of toxic burden bucket? Is that where you'd
Dr. Emily (00:42:36):
Put it? I love it that you just said toxic burden. I love that. I love it because we're all in a continuum of health, right? Mm-hmm. <affirmative>. And we're, if it's zero to 10 and 10 is death and zero is perfect, you know what is the tipping point for regression of, of developmental symptoms? You have to have a burden before coming up to that point. And vaccines are meant to stress the immune system. That's part of the immune response. And I'm not anti-vaccine. Mm-hmm. <affirmative>, I support a delayed schedule. And there are some that I would skip and I wouldn't be true to myself or to these families if I sat here and said that there haven't been maybe 60 to 65% of my practice that the parents, they come to me and they say that their child regressed after vaccines. I've heard it over the last decade so many times.
(00:43:30):
And parents, when they tell me that they're afraid, they're afraid of what I'm gonna say. They're afraid of the judgment. They're afraid that they're not gonna have support and they're afraid they're gonna be ridiculed. Mm-hmm. <affirmative>. And in my experience it is correlative very much so. But I also think that not every child is autistic that has vaccines. So there's some type of burden that is not understandable. Now, I had a patient yesterday tell me that their child was sick and had a fever and their pediatrician went ahead with um, six vaccines. Mm-hmm. <affirmative> and the child regressed in within two weeks. They were autistic after that had all the autistic symptoms and were not typical before. And there is this, if your child is sick, absolutely do not get them a vaccine. Mm-hmm. <affirmative>. Absolutely not. It's, it does happen
Christa (00:44:16):
A lot. That's a good comment because that does happen a lot where I think it doesn't get, I mean I've, I've had clients talk to me about it, so <laugh> where they kind of just have to know better, right? Because they go in and they're like, Hey, you're due, so let's just do all these things. And it's like, well it's a lot, a lot of immune chaos at that moment.
Dr. Emily (00:44:32):
So, and do you know that that's how we're taught, that's how we're taught. I used to work with the Medicaid population when I first went into practice and mm-hmm. <affirmative>, some people would come in, they didn't have their vaccine records and, and what we're taught is they're coming into the clinic so vaccinate them, vaccinate if they don't have a card and they said that they've, it doesn't matter, just give 'em all the vaccines again. So it was this, they're in your care so you should vaccinate 'em when they're in front of you despite what their history is. Mm-hmm. <affirmative>. And I think that that's dangerous.
Christa (00:44:59):
Yeah. That's not do no harm.
Dr. Emily (00:45:00):
Dangerous. Yeah.
Christa (00:45:01):
Mm-hmm. <affirmative> that's tricky. Tricky cuz people can have strong opinions on either side, but toxic burden is a thing for sure. And you know, my history is skin stuff, which is a mechanism of elimination. And I didn't do my genetic, I didn't do my genetics early in my journey. Well maybe like a urine. So maybe for some people that's early, but like when I saw them and I understood my genetic predisposition for detoxification sucked. I was like, oh, well that is makes some sense. I'm not saying that's like the fit for everyone. A lot of times you can just look at your parents, why am I telling you this? Even though I don't think it's particularly relevant for like your, I think you have very specialized stuff. I say this because we all have toxic burden and so to me supporting toxic burden, elimination and supporting like put less in and support how we get it out is something we can all do and we should do.
(00:45:49):
And like, let's not rid of, like to me it seems so uneducated when people say, well you've got a liver, you're fine. It's like, uh, my nutrient potential is not that awesome. Right? Am I digesting and assimilating my nutrients? Am I getting all the nutrients in? It's like a full on factory down there trying to keep up <laugh>, you know? So, um, anyway, just thinking about what we can all do, right? Because prevention's the best step, right? Like let's prevent anything we can right. By reducing toxic burden. So genetic stuff, methylation stuff. Toxic burden. Sorry, go ahead.
Dr. Emily (00:46:21):
And it's interesting because parents that have kids with eczema and I'll just think it's bad luck, you know, it's just bad luck. They just develop eczema. It was gonna happen. They had eczema when they were little. If they don't think of it in terms of this is an organ system that's stressed and detoxification's a big part of
Christa (00:46:38):
It. I know you've brought up something before the parents, they're, they're afraid to be critical. I mean there's so much, we're all, we're so emotional before anything else. And so I actually don't put eczema as like an advertising point very loudly out there because you know, it's really important. Believe me, I, I had it all over my face and my neck. But it's a vanity metric and it like affects how you care about your day. I mean it's, it's important one, I'm not saying it's right or wrong. I'm, I have the same feelings anyone else who would have it on their face or on their body. But you have to know it's internal and external, right? <affirmative>. So it's not just, it's not just external, it's internally as well. Mm-hmm <affirmative>. So toxic burden bucket, what's the last bucket?
Dr. Emily (00:47:16):
The mitochondrial bucket. And it plays into all the other ones, right? Because if you have a toy issues, you know, your cells are junked up with debris, you're gonna end up stressing out your mitochondria. And a lot of children on the spectrum have problems with mitochondrial energy. So in our skin we barely have any mitochondria in our brain and skeletal muscle tissue. We have thousands of mitochondria within the cells and they're organized that produce energy. But they're very, they're sensitive in a way. They have to have all these co-factors. Like they have to have carine and fatty acids and their methylation and they have to have co-enzyme Q 10. And a lot of these kids have toxicity and dysfunction in their mitochondria. So they have mitochondria dysfunction, not mitochondria disease. Mm-hmm <affirmative>. So that's a big clarifying point because the disease is more of the genetic. They're seeing the geneticist, they're on extreme medications for it, but you can have dysfunction and not have disease. These are the kids that don't wanna play, don't have a lot of stamina, have low tone, aren't developing alongside their peers. And it may not be just one of the bucket, but a little bit of everything in each bucket. Mm-hmm <affirmative>. So that's why the assessment is so complex because it's not typically one thing. It's typically one thing is the main driver, but you have multiple things that are also working against it.
Christa (00:48:44):
So I would say testing wise, there's not like insane awesome. Like there's all kinds of things that will help lend to understanding that toxic burden bucket. But there's not just like one little thing to help you assess total box toxic burden. And in the note of mitochondria, as we look at these four buckets for autism, which are I think fairly specialized, but yet we can make connections for other things. Like we can all support <laugh> toxic burden, we can all support mitochondria. But this is like, again, stakes are higher. I can really see why the OAT test. So an organic acid test is a urine test and it gives you all these nutrients and mitochondrial markers, et cetera. And Great Plains Lab who is kind of like, I think the OG oat test they have, they have done so much work with like autism and spectrum and all types of things. And I can see why because they're checking so many boxes. That test is checking a lot of boxes for that particular case or that particular profile or clients. Is there other testing that you like to assess mitochondrial function? Well
Dr. Emily (00:49:46):
The same people that do the frat testing do something called a mito swab. So instead of going to have to go get a muscle biopsy, you can do a little swab and it'll come back with your complex chains on which ones, sometimes they're overactive complex chains and there's, there are some that are underactive if we don't do any testing at all. If I were gonna tell you what these children need the most that are on the spectrum. They need folic acid, they need methylation support, they need high dose omegas, they need glutathione, they need carnitine and they need cones on q1. That's what most of them need. And you can can pretty much do that and not do one test period and you should see some improvement because you're supporting their methylation, you're supporting their mitochondria, you're supporting their antioxidants, you're supporting their fatty acid oxidation. I know you're
Christa (00:50:42):
Talking cause you've got glutathione which is supporting, if you know it's a master antiox then in the liver. Right?
Dr. Emily (00:50:47):
Exactly.
Christa (00:50:48):
Carine CO U 10 cetera. Like those are mitochondrial nutrients. The lennic acid, we talked about high dose omegas we talked about last week being a neuro like reduced neuroinflammation for sure. If not other systemic inflammation. At least four or five grams. That's four to 5,000 milligrams still standing for this conversation. Mm-hmm <affirmative> and then methylation support. To me, this can mean lots of things. So what do you wanna say about methylation support?
Dr. Emily (00:51:12):
I think that we have to be mindful of the co-factors in methylation. Mm-hmm <affirmative>, there's a lot of products out there that have B12 and folate. They have methyl folate in them. They don't have folic acid for kids. Which, you know, there was also a study in the elderly population for neurodegeneration that they give folic acid over six weeks and saw an improvement in IQ for the older population. So folic acid is not just for young children, it's just especially important in young children. So B12 too. Some of some kids on the spectrum do better. Not with oral b12 but with transdermal or B12 injections. Riboflavin is really important and often forgotten in uh, supplements. And of course modulation of glutamate is probably a other thing that is, that I'm constantly working at. So GABA is really inhibitory for the brain calmness. It causes kind of the down regulation, the sleepiness, the calmness and glutamate causes excited ability more stemming, more agitation, more irritability, more anxiety.
(00:52:16):
And there are things nutraceutical that you can modulate with glutamate, like magnesium 3 0 8 and endo and altheine. So there's also drugs that can be really helpful, like amantadine or memantine. We often use those in autism, especially if there's a lot of irritability and they can work so, so well. So there is a bucket, there's kind of the basics that we talked about and then there's the nuance depending on how the child is presenting. Mm-hmm <affirmative>, there's a lot of ocd. You know, I like to use a lot of in acetyl cystine cuz it can work so beautifully if there's more agitation or stemming and stuff. Sometimes we do use medicines. Mm-hmm <affirmative>. If a child isn't sleeping, then there are some medicines that are non-addictive that can help them sleep. So it just depends on the function of the child, what we'll end up using. But you don't always have to do testing.
(00:53:10):
But when my patients come to see me, they want the data and I'm happy to show them the data and then it can really guide what we do and how we do it and what process we do it. That's another thing. The process of how you treat a child is also important. And I think the first step that everyone needs to be mindful about is lowering inflammation. Like how do we get the inflammation out of their space? Is it in their environment? Is it in their food? Is it their immune system is overactive and we need to downregulate it? Like how do we address inflammation? You have to go there first. And honestly, part of that is the hardest journey for parents cuz it asks them to have a complete lifestyle change on what they're doing or where they're living or what house they're living in or how they're feeding their child or, and then that's a reflection of how they're feeding themselves. So lowering inflammation is absolutely critical. And first,
Christa (00:54:04):
And it doesn't fit in one sentence, does it? There's a lot of opportunities for inflammation reduction. You gave a lot of examples, you touched on a lot of CORs of that. So I wanna be mindful of your time. I do have like, I wanna, you talked about those nutrients and the things that would be helpful for anyone. Nic, acid, methylation support, high doses, omega, glutathione, Carine, cocuten, b12, topical, internal. How about kids that don't wanna take anything that don't wanna take things, you know, and I know you've kind of like, I think you've dealt with this in practice, so you've kind of developed mm-hmm. <affirmative>. So if, if you have time, I wanna talk about how you kind of developed something and the gaps that you saw in the marketplace and how that's working. Because I like to hear how things are working and then if you have a moment, I wouldn't mind hearing about what are things parents can do right now in their own home. But tell me about how you get supplements into kids and how that's working.
Dr. Emily (00:54:51):
It's not an easy task for everyone to take a supplement for certain. So you have to be mindful about how they smell. If they can swallow a capsule, what size that capsule is and how they taste. If it's a powder formulation in my super, super picky, difficult kids sometimes, and it's not perfect cause transdermal vitamins don't always absorb. Well, sometimes I'll go to the pharmacy, compound it into lotion and parents will rub it on the skin. And that's the only way that child is gonna take a nutrient. Otherwise I like to group combinations that have the ingredients they're efficacious for what the intended purpose of that product is. Mm-hmm. <affirmative>, like we have a calming support and if you are trying to lower that glutaminergic load, I'd put things in that like a nos, sotol and altheine and passion flower and the types of magnesium that calm the brain and the body down.
(00:55:48):
I put them because all of those individually can work, but they're synergy when you put them together. Mm-hmm. <affirmative>. So also it's a bulky, you know, an OSLs bulky. Right. If you wanna do the, the dose for OC D might say, oh that's 17 capsules twice a day and you're not gonna get an adult to do that, especially not an autistic child. So a lot of parents, you know, will tell 'em to open up a capsule and dump it and hide it in their food or drink. One thing that parents do often that's a mistake is they'll, they'll make a smoothie and then they'll blend all their supplements in it. Agree. Like, don't do that. You have to fold in afterwards gently. Yeah.
Christa (00:56:27):
So, well plus you're leav so much behind, I think like if they don't mm-hmm <affirmative> and then you're also potentially, I like to be clear, I like to encourage us to be clear about it and maybe everyone's got their own thing, so no judgment if you wanna do it your way. But I would suggest let's not try to lie to them and say this is your normal smoothie and then put things in it and then the kid won't eat the smoothie and that was their biggest source of nutrients also. So
Dr. Emily (00:56:50):
Like good point. I
Christa (00:56:52):
Have issues with that where it's like it's gonna, and also what's gonna get left behind there, like are we actually getting it? Can we instead I like suggest if we're gonna do liquids or powder, I'm like, but we might put it into a special kind of juice or a homemade something, something interesting. You know, I, I sometimes have people make this homemade elderberry juice because of the corset 10 and other things that for my client population. But I'm like, we're gonna have a purple juice <laugh> and it doesn't always taste perfect and you try to sweeten it. I know you put like you just alluded to, but people may not have known and you created this calming support for, I think it's called neuronutrition. You can tell me what it's called, but do you have Neuro nutrient? Neuro nutrient. So do you have the combo of folic acid and methylation support in glutathione, carine, and cocuten in a combo for autism?
Dr. Emily (00:57:33):
Not yet. Not yet. I have a good methylation support over the counter in this neuro nutrient line that I put in the baby is smallest capsule you've ever seen. It's size three. So if your child can attempt to swallow a, a capsule, I mean they're not gonna be intimidated by the size of it for sure. But if not, you know, B vitamins don't taste bad. Mm-hmm <affirmative>, it's other things like tyrosine and glutathione that tastes terrible. Mm-hmm.
Christa (00:57:58):
<affirmative> I know have thoughts about glutathione. I do not think it tastes terrible. It's that funny
Dr. Emily (00:58:03):
Person
Christa (00:58:04):
In the world that says that honestly, maybe
Dr. Emily (00:58:06):
It says quick
Christa (00:58:07):
Silver puts a min, a citrus over it or something. I'm like, I dunno. It doesn't taste like low farts to me. It
Dr. Emily (00:58:12):
Tastes, I think, I think quilt is a good, they have a lemon, a lemon one, right? Yeah. Yeah. And I think they do, I think they do a pretty good job of, of disguising the taste of it. But there's some other ones that Right. But I always remind people if it doesn't taste horrible, it's not active. Mm-hmm. <affirmative>, you know, it's just not glutathione. You cannot take that sulfurous rotten egg True taste outta it. Yeah. And it be active at all.
Christa (00:58:34):
So it's coming. You're doing a combination product maybe in the future, <laugh>?
Dr. Emily (00:58:38):
Yeah, I'm definitely thinking about it. I'm definitely thinking about it right now. We have something to support attention, something to support mood as far as like anxiety and depression. And then we have the calming support. We have a good multivitamin, some, an acetyl cystine. So we have a good line as far as it comes to, to autism. We don't have all of those combinations of one quite yet, but it is something few,
Christa (00:59:03):
About a few months. <laugh>. Just
Dr. Emily (00:59:05):
Kidding,
Christa (00:59:05):
Kidding. <laugh>. Maybe by the time this comes out.
Dr. Emily (00:59:08):
<laugh> kidding. Maybe 2023.
Christa (00:59:09):
Just kidding. I know how hard that is. It might take me like a year minimum to formulate that. Well if I may ask this last question, because I do think it's an important one. People wanna know, what can I do at home right now with my environment, with diet, et cetera, and then that's it.
Dr. Emily (00:59:24):
Okay. Here's a big challenge. So I love dairy, I love the way it tastes. I love cheese. I love so many things about dairy, but dairy also is one of the most inflammatory foods in our diet, as you know. And when it comes to kids on the spectrum, some of those folate receptor antibodies that we were talking about, it's molecular mimicry from people that are making antibodies to dairy. Mm-hmm. <affirmative> so often you can take dairy out of the diet and they've proven an autism that being on a dairy free diet can improve autistic symptoms because you're clearing out the antibodies and that takes time. You know, don't fall prey to the, I took dairy outta my kids for a week and nothing happened. It takes time. Three months I would say would be minimum to do it, but in the autism world, if you don't have any testing, if you're not working with a functional medicine provider, the two foods that you should eliminate from your child's diet is glu dairy. Hands down without question.
Christa (01:00:24):
There is colors and glutamate in the diet add to the glutamate load in the body that you're trying to
Dr. Emily (01:00:32):
Absolutely monosodium glutamate. Absolutely. And you know, some people don't convert glutamine very well, so they get agitated when you put it into the gut. Mm-hmm. <affirmative>. So, absolutely. Yes. And it's hard because if your child eats four foods and they all are gluten and dairy based, you have some work to do and it's gonna be a struggle, but you'll get your child there. I don't have, I've never had any child that just completely refused to eat. A hundred percent. And I wanna encourage parents that you are not responsible for what your kid eats. You are responsible for what you provide your child to eat. So whether they eat it or not, you have to walk away. But over time, if they just know you're not gonna feed 'em, you know, McDonald's chicken nuggets or you know, even a healthier chicken nugget because you're trying to eliminate one or two of those food sources, they're gonna eventually eat what you do provide. Cause kids get hungry and then they'll change. Mm-hmm. <affirmative>, they'll change. But it takes, it takes work and it takes a struggle and it takes a commitment. But if there's nothing else you can do, lower the two most likely sources of inflammation in that child and it's through their food. Mm-hmm.
Christa (01:01:39):
<affirmative>. Well, there's a lot here. You know, this is like a two parter <laugh>, but where can people find you online
Dr. Emily (01:01:45):
So they can find me? I'm on Instagram with Neuronutrition Associates. I'm on Instagram with neuro nutrients and with both of those companies we have a website as well. So you can find me in both places.
Christa (01:01:56):
Perfect. Thank you so much for the work that you do. Look forward to seeing that autism supplement <laugh>. Yeah, they'll order the calming supplement after this. Cause I said, when you told me the ingredients last week I had to go to another appointment, I was like, oh, sounds like anyone could use that. I'm gonna go try that out.
Dr. Emily (01:02:12):
Yeah, go. Good. Well let me know how it goes.
Christa (01:02:15):
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