Understanding The Rise In Autism And ADHD In Children

Introduction and guest background 0:00

Welcome back to ADHD, Autism and Chronic Disease Parenting Summit. I'm here with the fantastic doctor Emily Gutierrez, who is, a woman of many hats, pediatric nurse practitioner, functional medicine practitioner, clinical nutritionist, and a mental health specialist. I really appreciate you being here. Thank you so much for joining us. It's great to be here. Thank you. I'm looking forward to chatting. You know, it's a very, important topic to me. ADHD and autism, because the numbers have been rising and rising, and it's really staggering where we are in terms of statistics.

And I really do my best to always talk about what we can do to turn things around and to see some, some changes in the direction that we're going. But I'd love to hear from you and kind of what you're you're seeing and how the many hats that you wear, whether it's functional medicine, really differ from the traditional approach to what sometimes we see when it comes to ADHD or autism. Sure. Just as I was telling a family today, we have to reconceptualize what really autism is. And it's biological.

It's about inflammation. It's not this bad luck thing that happens to kids. I mean, you know, 20 years ago it was 1 in 10,000 and today it's 1 in 36. You know, our genes haven't changed that much. But what has changed is our environment and our environment is causing inflammation and physiological stress in our kiddos. And so when we shift what actually, the biological root causes are it changes our treatment tremendously.

Reframing autism and ADHD as inflammation 1:44

Yeah, definitely. And what do you think we should start because I you know for me all those things that you mentioned they really resonate with me. I think we oftentimes especially with autism, think of it more as something that that's just genetics. But I don't believe that's true as certainly genetics plays a part. But but the environment I think is a much bigger part than we really give it credit for. And so I think it is important to evaluate the lens that we're coming at for it, for ADHD and autism.

So where do you think we should start in terms of evaluation or how we think about this? Well, I think that genes do play a role. I mean, we know traditionally a chromosomal microarray and a fragile X should be kind of a rule out, but very little people have a positive chromosomal picture. But what we do know, some of these common variants, the gene loads the gun in the environment pulls the trigger. So starting with just figuring out where is the fire, where's the inflammation. What is this child have that they don't need in their body, and what are they missing to get to a better part of homeostasis that their brain inflammation can go down and their myelination can reach something that's more on a normal trajectory.

And when you work with with patients, is there some some key things that you'll be looking at first? Do you have like some favorite tests or are there things that that you'd be looking at that maybe parents can think about? Sure. I know we're trained that when you touch a child in, traditional pediatrics, there's only certain milestones that you're going to want to draw labs. But in functional medicine, I love labs because their information actually what's going on. So I always do a variety of labs and my new patients just even bloodwork the insurance will pay for.

You can look at how they're methylated through a homocysteine. You can look at some of their mineral and vitamin deficiencies. Often kids have omega three fatty acid deficiencies, problems with carnitine absorption. So there's a lot of clues that you get just from lab work. And it's actually very evidence based. If you search the peer reviewed literature. I just did a systematic review. We came up with 16 markers that have really good peer reviewed evidence for kids with autism, and ADHD. It's not quite autism.

You know, some people put ADHD on the spectrum of autism, just that really high and functioning.

Testing for nutritional and metabolic deficiencies 4:05

But we know there are absolutely core nutritional deficiencies in ADHD that's peer reviewed that we've seen over and over again. Iron, zinc, magnesium methylated B fatty acids. Phospholipids. So starting I mean I know parents don't want to get their little ones, you know, blood work, but it's a great marker to help. And it's also, you know, a lot of people can do blood work through their insurance. So it's not such a burden for cost. More functionally, I also look at like to look at things like organic acids, a gut study to really look at what the microbiome looks like, if there's dysbiosis, if there's anything that we really need to clean up or anything that we need to really replace in their little microbiomes, including inflammation from food.

And, you know, the gastroenterologist, they will believe a cow protecting. So even you can do a cow protect in through class. CPO some in the mainstream labs just to look at the very basic measurement of inflammation in the gut. And it will often be positive. And so when you're going through this again, I imagine it's similar for for me in function medicine. So you're thinking supplements are good. Bridge if you're finding some of these deficiencies and what else are you finding is a helpful kind of first steps in terms of treatment or support for for families who are going through this?

Well, the question is, is why does supplements work more in kids with autism and ADHD too? And I really like that when when you think about when your body is inflamed and there stress on it, we deplete our biochemical reserves faster. You know, if you're sick all the time, you're going to use up iron, you know, iron, you're going to be deficient in because you're growing. So you're kind of against the clock with that. So if you're not eating enough iron, but if you have an occult infection or you have an infection in your gut or in your blood, you're going to use iron quicker.

So that's just one example of how these kids, you know, can benefit from vitamins because their body is trying to use them and they go through them more to get to homeostasis. So vitamins I think, you know, a child with autism needs a team. A child with ADHD needs a team. We need the, you know, accommodations in school. We need parents on the same page. You know, it's hard when the mom is like, we're going to give them 800 supplements, and the dad is like, no supplements at all. So the parents need to come together and agree on the plan.

And then we really need school to be on board and therapy for ADHD and autism. Like very different. And I think therapy looks different depending on what age you are. For example, in autism, I think ABA therapy can be important and helpful in the beginning, but I'm not so sure a 17 year old boy or child needs ABA therapy. I think over time, it becomes less important. So therapy kind of changes depending on where you are in the diagnosis and what your diagnosis is. But they're part of the therapeutic support.

So they need they still need their pediatricians. They need their functional people. They need their school, their need their therapy, and they need their family to support them through this journey. Definitely. And do you find it difficult to get supplements in to kids? Because I feel like, you know, that's always a big issue for parents, too, especially for kids with autism. They might have sensory concerns or, you know, they're just more picky.

Supplements, team support, and treatment priorities 7:24

So then sometimes getting supplement can be hard because, you know, they don't always taste the best. So what are what are your thoughts around that? Sure. Well, they're more picky a lot of times because they're more deficient in zinc. We know zinc can change your taste. And then if there's more of an autoimmune encephalopathy or there's infection that hasn't been cleared, they're going to kind of go through that inflammation in the brain, which makes them picky, to begin with. So you're right. It can be incredibly challenging.

I, you typically recommend vitamins that have been formulated for kids and with taste in mind that are highly palatable, that can be mixed easily or arranged. And if they don't swallow capsules, it just depends on the kids, because some of my kids, you know, if I prescribe them liquid, which is a high potency acid, some of them will just chew it. No problem, whereas other parents have to crush it up and put it in orange juice and syringe it in. But it can be challenging. Sometimes I'll do custom compounding or I'll send it into a pharmacy.

And they'll compound it into a liquid solution. But persistence gets you there. But that also comes to mind that, you know, you don't want to prescribe them everything just because you can. You kind of top tier it down. Like, you know, your omega three fatty acid is the most important. So let's work on getting that in first. And where can we mix it? How can we hide it? Or how can we syringe it in. And then you build from there. And so I mean you mentioned Omega. So what would it be? Your top supplements I usually recommend or that you use or that you see people being interested to buy.

What what are you seeing as kind of the trends for, for, you know, the first because like, just like you said, you know, for these kids might be hard to give them 20 supplements or, you know, nothing that you should even do that. But but you get to maybe start somewhere. So a couple sometimes can be helpful. So what are you seeing as like the first few that if somebody's parents like, well, you know, I do want to get started and I want to work with the practitioner. Like what company? You know, companies you like or products that you like.

Top couple. Yeah. Well, it's hard not to like my own company is number one, because I've formulated all of the, vitamins that are on our store. I created a line that definitely puts combinations into effect, in autism and, and, ADHD. A lot of times these kids have a problem with glutamate Gaba balance in the brain. So glutamate is excitatory, causes more stimming, agitation, irritability, sometimes sleeplessness, sometimes it's a big player in seizure disorders. So there are natural things that can lower glutamate.

Magnesium three and eight pure dioxane, five phosphate and acid tall. So I like products that lower glutamate. We make a calming support. Everything in it is intended to lower glutamate when we make it into powder and a capsule form, put a little bit of coconut sugar in it for palatability for those picky kids. And so I think that's really important, you know, and also tools for inflammation. We don't custom make an omega. We're on the hunt to do that. But you know an omega three fatty acid is typically very safe and can be effective for inflammation.

And our brains are more than half fat. I mean, our phospholipid layers are full of cholesterol and plasma allergens and phospholipids. And really the omega is really important. And most of our kids have lots of omega six because they're eating grains and they're eating things more inflammatory and vegetable oils, and they're lacking omega three fatty acids. So that's a good place to start. So omega is and lowering glutamate. And then of course we have to methylated the nervous system. So that take your kiddo is the more likely they are going to have deficiencies and B vitamins.

But what's really confusing for a lot of providers and people that run bloodwork and they say, oh, your B12 is high and oh, your folic acid is high. We know now that high

Gut health, diet, and microbiome support 11:34

in the blood doesn't mean it's high in the cells or high in the brain. There's lots of autoimmunity from inflammation preventing the absorption of high methylated forms of folate into the brain. So you can always get felin acid. Not to be confused with folic acid, but for Winnik acid, you can always get that through the reduced folate carrier. And we're seeing more and more and more children with autism and ADHD having these binding and blocking antibodies to where you're not able to get methyl ated forms of fully into the brain.

So the treatment is you start to give them full clinic acid to rescue their cerebral holy deficiency. And this can be really important. Kids can start talking and become more aware. We've had a lot of success with this. That's awesome. And maybe circling back to you mentioned about gut health, going back to the gut health testing for a little bit. I think that's a very I mean, it's great to see it's becoming more popular. I think people are becoming more aware of how important gut health is. So if there are many gut health tests out there now that you can even do yourself at home or with a practitioner, which I think is great just to get some idea of what's going on there.

But what do you find really helpful for parents to kind of tune into in terms of, you know, if they do go get a gut health test or they're working with maybe a regular pediatrician that's willing to do it, but they're not really so familiar with functional medicine testing. What should be the big key is that maybe they would want to look at first. I think first and foremost, if you can, I mean, I prescribe antibiotics, probably, you know, I prescribe antibiotics all the time because I'm trying to clear infection and rebalance the body.

And a lot of times kids have a cult infection, meaning they don't have fever, cough or things, but you see it all over their microbiome or in their sinuses or in their blood. So I prescribe antibiotics and I think they're lifesaving. However, if you have an infant or a first year child that has an ear infection and you can do that, watch and wait and not do antibiotics within the first year of life, I think that's so helpful. Not all kids are going to get there. But first, I think that if you can try not to do it in the first year of life, it's very it's very impactful.

And then I think that, you know, we're feeding our kids just fake food packaged, processed non nutrient food from non nutrient soil. So that's really important is the diversity of the food. You're putting into your child's body is really important and full of pro and prebiotics. So they need those insoluble forms of fiber things from like cooked and cold potatoes and Hickman beans. So I think that first and foremost, the diversity of the diet is amazing. You would be surprised how many young, patients that I have that will eat sardines, even in pairs are just like, oh my gosh, I would never eat that.

They won't ever. So they don't even try. But you'll be amazed if you start with what what Doctor Sears says. Start with avocado and then go to salmon as your first foods. You know when you start. That way you can really develop the palate and get them real foods, and that helps to establish the microbiome. But when you get there, if you do a gut test, I mean, often you find bacterial overgrowth in the test. And then you have to understand, you know, what bacteria is a what is considered commensal where you don't really have to weed it out.

And then, you know, what are the good guys? What are the good bugs in there that you can work on increasing the good beneficial for to rebalance the homeostasis in the gut. I absolutely love above any other gut supplement period Immunol in I imu in Lin in a high dose. It's entire game. Are you familiar with it? Yeah, yeah, yeah. So I've prescribed in tarragon for years and years. And when we want to make a gut product, you better bet that's the first ingredient that's in there. And then I put some prebiotic fiber with it.

Inulin from chicory root, sun fiber, which is partially hydrolyzed sorghum. So some prebiotic fiber, because I don't know, I'd be curious. Your experience with probiotics, I don't find that they make that, you know, like serious change in the microbiome. Especially the older the child is, I think they can be beneficial, in different periods over time, depending on which one it is and how much you give and what the situation is. But, I really think what you're putting in your child's mouth or what they're putting in their mouth rather, is the most important thing to gut health.

Definitely. I think yeah, I've seen probiotics help a little bit sometimes. You know, it can be a good part of, you know, if you're trying to make a change on a different direction, that can be a nice part of that. But in the team of supplements or other things, but generally not on its own, is it going to make any major differences, or would it make sense that it would? Because just because you give someone a probiotic and they're still eating crappy food doesn't really change your environment.

So, I mean, you might be putting in a little bit of some good stuff, but that's not not really the big the big thing. So I agree, I mean, I think, you know, everything you said is really fantastic and I think very, very helpful for parents. I think it's a really good starting point.

Early intervention, toxins, and closing remarks 16:50

To think about some of these things, especially when you, you get into a medical system that sometimes just says, well, this is how it is. And, you know, I guess, go get your idea, maybe a therapy and that's that. When there is actually a lot more that you can do and you're not necessarily or probably should do these things on your own, that's where you get a good functional medicine practitioner or a good integrative practitioner who is well versed in whatever the condition, whether it's autism, ADHD and work through it, even if it's only a couple of visits.

Just to kind of put things into the right direction and really see what's going on in the body. So you can be a little bit more targeted, can be very helpful and beneficial for a lot, a lot of patients. I've seen it, and I know you've seen it in many practice rooms that I've spoken to. You have have seen it. So I think it's great what you're doing. And, you know, you're really helping a lot of families and that's really great sounds. The supplements are fantastic, so I think that's awesome. But maybe you can tell people again, you know, where to find you a little bit more about your, your supplements.

And then again, thanks for being here. Thank you. I will encourage, parents that the earlier the intervention, the better the outcome. And I think that has to do with a lot of things like myelination and how much myelination, you know, in those first few years of development is so important. And when that process of pruning comes down, you know, we know in neurodevelopment there's this aberrant thing that happens. It's not this normal pruning, but nobody really asks the question why. And my question why is it's likely because of inflammation and the stress on the astrocytes and the oligodendrocytes and how we're wrapping myelin.

And if we backup, backup, backup, it all comes down to neuroinflammation. So how can we take out what our little babies and children don't need? And how can we replace what they're missing to give them the best chance to get there? And, you know, supplements can play a big role. They can be very, very helpful. But you're right. I mean, changing the diet, changing the environment, it's just so multifactorial. And unfortunately, what our what our kiddos are being, treated with and told in the allopathic paradigm is, hey, you know, we're really good at this diagnosis stuff, right?

We're really good at it. And I really believe we're good at diagnosing early, especially autism and ADHD. But the treatment is still name it and blame it. Like here's your diagnosis and here's your pill. And a lot of people fail. I mean, with ADHD the first thing that they give them is a stimulant. And you know, some people can have benefit from it. And then other people can have a little bit of benefit. And over time they become anorexic. They become more nutritionally deficient. They're not sleeping and they become irritable.

And we're giving our kids methamphetamines at a very early age, which there is some data to say that if you take stimulants early in life, you are more likely to have basal ganglia disorders later in life. And nobody really kind of highlights that data. So I don't want to blame or shame any parent if they're giving them stimulants and it's working. But what I don't understand is why don't we go back and say, oh, well, kids with ADHD are typically deficient in zinc. They need fatty acids. They often don't have magnesium.

Why can't we do that assessment? First try to rebalance them their nutritional biochemistry. Give it you know what the studies give it, which is at least 12 weeks to work. And then after that period of time, if you're still really having trouble, you know, you might feel better as a parent saying, well, I tried something for a little bit of time and it didn't seem to really be that helpful. So I'm going to go ahead and try a medication. Just think, our first line is is not really getting it to the why.

It's just saying, hey, we're really good at diagnosing this. And I'm proud of the American Academy of Pediatrics because a few years ago they put out a position statement saying toxicity is a big deal and it's a big deal for our kids, and it's a big deal in autism. And we need to start really evaluating where the toxins are coming from. So it's kind of the first peek into that allopathic world and then saying, hey, there might be a root cause, but we need to start looking at as our world becomes more toxic, because certainly our genes aren't changing that fast.

To have the incidence of autism and ADHD come along. I mean, back, you know, in the 80s, it was like 1% of kids have ADHD. Today it's at least 10% of kids have ADHD. So you can find me at Neuro Nutrients. That's our supplement company. I do make an ADHD supplement that has it's like it's like you're multivitamin for a child with ADHD. It covers all the gaps. But you will have to add in omega three fatty acid. I almost added one to it. There's one dry powder omega three. But man, it makes those capsules stink.

So I decided it wasn't worth it. So you got to add an omega to it. My medical practice is neuro Nutrition Associates. We're in Austin, Texas. On neuro nutrients. I have a place where it says podcasts and blogs, and there's some information under there. So, also Instagram. I do our Instagram. I'm not really great at Instagram, but I try to only post things that are like, really relevant. Like, you know, when I first tasted my first Purdue chicken nugget, I was like, this is so amazing. And so I posted that.

So, you know, nice information, authentic, always coming for me. I'll post on Instagram as well. I love it. Well, well thank you for being here and thanks for being a part of the Raise and Healthier Kids Summit. And thank you everyone for listening. I really appreciate it. And we'll see you guys in the next episode. Awesome. Thank you.