Autism, Dysbiosis, & the Gut-Brain Axis – Book Club

This month’s book club is:

AUTISM, DYSBIOSIS, AND THE GUT-BRAIN AXIS

Dr. Alex Vasquez

Welcome to our first Book Club!  Thank you for voting on this month’s book.  If you’d like to vote for next month’s book, please join my email list here.

This month’s book is a technical book discussing some of the root-causes for autism behavior.  This book does not go into deep detail about treatments or specific supplements. This book really focuses on causes, root-causes, which is great because that’s what you want to address for your child. You don’t want to just give them a supplement to mask things. You want to get to the root cause and address that so that they don’t have that problem for the rest of their lives. 

The mechanisms discussed in this book relating to autism are:

  1. Neuroinflammation
  2. Neurotransmitter altering metabolites (especially p-cresol and HPHPA)
  3. Dysbiosis induced activation of the NLRP3 inflammasome 

Some of the interventions that they consider here in this book is Fecal Microbiota Transplant. Click here for a previous video about FMT.

The book also discusses vitamin D and it’s a common intervention. So this is one of the few therapies that this book talks about. And Vitamin D is very important. I have a 20-minute video on vitamin D.  A quote from the book is “Vitamin D is also one of the interventions we commonly use when we’re dealing with dysbiosis-induced disease.  The reasons include the fact that vitamin-D enhances immunity, so it helps to clear out some of those infections and colonization.”

It goes on to say that vitamin D is essential for antimicrobial peptides, as well as maintaining the integrity of the GI  mucosal lining, and anti-inflammatory effects. You can see those are all good things.

And many times children with autism have issues with inflammation in the broad sense and Vitamin D is really helping to have an anti-inflammatory effect, as well as its focus on the immune system, which for the majority of the body is in the gut.  These are also areas those with autism typically have challenges, health-wise.

Vitamin D is extremely important – universally. Your vitamin D levels should be monitored twice a year.  Get a blood test in winter and then spring-summer. You will change supplement levels throughout the year

The book goes on to talk about exercise a little bit. That is a great therapy. Exercise is great because there’s a variety of anti-inflammatory effects that you get from exercise. We all know that. So I’m not going to go into too much.

Many parents know when their kids get a lot of outdoor activity, a lot of exercise, they sleep better. There’s a reason why, biologically speaking, it’s not magic.

Here’s a very good quote from the book about what autism is.

“We now know that autism is a multifaceted disorder associated with gastrointestinal inflammation, nutritional deficiencies, multiple food allergies and intolerances, impairments in liver detoxification and resultant accumulation of xenobiotics, the majority of which have either neurotoxic or immunotoxic effects.

Thus, autism is not behavioral-disorder per se. Rather, it is a gastrointestinal, allergic, immunologic, toxicant, nutritional, environmental disorder and the behavioral cognitive abnormalities are symptoms of the underlying complex and interconnected pathophysiology.”

Many parents struggle with defining what autism really is.  And I have many clinicians who watch my videos, many different therapists. And I get that question often “What really is autism?”

And this is one definition from the book – I wouldn’t say it’s a perfect answer, but it gives a good picture of how “its not just one thing.”

There are a few things that really need to be addressed in detail to see the health improvement in a child. So this is a very good description of what autism is. If you have someone who is kind of struggling with the idea of what really is autism, what am I dealing with, what should I be looking at? This is a good book for someone who is technical and wants to answer those kinds of questions.

OK, so it talks a little bit about microbial metabolites and how they interfere with normal neural transmission, and that promotes psychosis and neurotoxicity. So this is important because: the gut is important and the microbes in the gut produce molecules and scientists, researchers, they call that metabolites.

So there are metabolites in the gut that are produced by different bacteria and a variety of different organisms in the gut. And they have an effect on our body. Right. 

So when someone is healthy and there’s no dysbiosis they have a great balance of beneficial bacteria that produce vitamins, such as vitamin B12 and K plus many more.

But when there’s dysbiosis, so when things aren’t optimal in the gut, then this is where you can have neurotoxicity and psychosis. So this book specifically addresses HPHPA as well as p-cresol. And so both those metabolites, meaning those are molecules produced by bacteria, both of those metabolites block the conversion of dopamine and that leads to excess dopamine. Unfortunately, excess dopamine is neurotoxic.

This fact has been known for decades. And the classic antipsychotic drugs are also anti-dopamine.  So that means that they are blocking the dopamine receptors and that’s how they’re thought to provide their therapeutic benefit – we call that the mechanism of action. So this isn’t some new science that’s coming out. The dopamine levels are really important.

But again, for your child, you want to go to the root cause, you can certainly give some type of relief, with a drug, with a supplement that can help even-out the dopamine levels. But you want to go deeper than that for long term benefit. You really want to find out what the issue is. And what this book is saying is the issue is different bacteria in the gut that are producing certain metabolites that are causing the dopamine to be increased and therefore a change in someone’s behavior.

Let’s define dysbiosis.  This book has a really good 4-part definition of Dysbiosis

  1. Qualitatively more microbes. So sometimes microbes that are supposed to be in the large intestine, they kind of scooch up into the small intestine. That’s called SIBO, small intestinal bacterial overgrowth. That’s when you have too much bacteria going on and it’s starting to go in places that it shouldn’t, which is not good.
  2. More absorption of inflammatory and allergic producing molecules. In certain aspects of the gut, you can have increased permeability. It’s called in mainstream media, leaky gut. And so with a “leaky gut” inflammatory molecules that normally would be housed in your gut and excreted unfortunately go to places in the body where they should not be going.
  3. Qualitatively worse microbes. This is when you have pathogenic microbes. Pathogenic-fungus, pathogenic-bacteria, you have too much of the bad things and not enough of the good things. 
  4. You have adverse health effects. So these microbial imbalances, they’re important because it leads to overall health. There’s a lot that goes on with our gut, right? Our immune system is in our gut. So much is in our gut. And when we have these imbalances, then you can see health changes. And the research is starting to have more of that linear relationship – if this happens, then this happens.

OK, let’s talk about neuroinflammation a little bit. Neuroinflammation is something that children with autism deal with a lot. Neuroinflammation enhances glutamate, a neurotransmitter that also can reduce the levels of serotonin and melatonin. And melatonin – everyone hears that and they think sleep, right? Very, very true. But the author goes further and says, “I want you to think not simply of sleep, but also melatonin’s potent antioxidant effects and also its ability to help protect and maintain mitochondrial function.” 

This is so important to overall health. Again, neuroinflammation starts off with neurotransmitters being unbalanced and it affects melatonin, which then affects sleep and then has this downstream effect that leads to really poor quality of life. When a child’s not sleeping, the quality of life goes down very quickly for both the child and the parents. I’m happy to see here in this book how the author is very mindful of melatonin not being just about sleep because many doctors do not make this connection..

OK, next, the book talks about HPHPA, p-cresol & also propionic acid.

These are metabolites – molecules that are being produced in the gut by bacteria, fungus, and other organisms in the gut. And the three of them are microbial metabolites that, according to preclinical and experimental data, have the ability to contribute to neuropsychiatric dysfunction.

It’s important that these molecules are taken into account when you’re addressing your child’s health issues.

So let’s look specifically at elevated quinolinic acid.  And I’ll just read the section here about it:

“Quinolinic acid  is a potent excitatory neurotoxin elevated in Huntington’s disease, Alzheimer’s disease, ALS, depression, suicide, and other forms of neuroexcitation and neurodegeneration.”

High levels of quinolinic acid promote seizures and 20%-30% of those with autism have recurrent seizures, while up to 60% of those with autism have the silent form of seizures. 

And so seizures are certainly something to be addressed medically.  If your doctor can zero in on the cause being certain metabolites in the gut and give a simple protocol to have the gut be optimal, that’s definitely something worth pursuing.

All right, so moving right along, talking a little bit more about propionic acid, a metabolite produced in the gut.

There are three ways that this author is proposing propionic acid interferes with health:

1. Propionic acid is produced by gastrointestinal bacteria, especially those bacteria in the notoriously neurotoxic clostridium group.

2. Propionic acid is a fatty acid that becomes integrated into the cell membranes of neurons and into the membranes of mitochondria. This alteration in the structure of neurons and mitochondria leads to their impairments. Again, this is not something that you want to go on, for the long-term in your child’s body.

3.According to animal studies, propionic acid promotes neuroinflammation, which is also a known characteristic of autism. 

Alright, let’s now talk a little bit about Microbiota Transfer Therapy (MTT) or also fecal-microbiota transplant(FMT),on FMT: 

I have a detailed video about Fecal Transplant.

There’s two groundbreaking studies in autism with FMT. This book just briefly discusses it and says about how autism symptoms improve significantly and remained improved at eight weeks after the treatment ended.

Now, I have had clients whose children have had FMT’s. It doesn’t resolve everything but certainly resolves some things. But please don’t think of it as a magic bullet. It’s not. And if you read the research on FMT’s in autism, you’ll see that there are also nonresponders. So not everyone with autism responds to FMT.

All right. Let’s talk about glyphosate. The model proposed here in the book is that the herbicide glyphosate causes Clostridial dysbiosis, leading to excess gastrointestinal production of HPHPA and p-cresol, leading to dopamine psychosis, neurotoxicity, and mitochondrial dysfunction. This book proposes a rational line of biological plausibility. 

Sometimes parents, even clinicians, wonder, “Well, how does autism progress? How does this all fit together?” So, here the book proposes:

1. Antibiotic exposure – glyphosate herbicide which is in most of our food and much of our water.  And what happens is it functions as an antibiotic within our own gut. So we eat food that has this herbicide in it and our gut microbiota changes. 

Sometimes parents are questioning “How is this happening? My child wasn’t on antibiotics!”

Glyphosate, which is in the majority of the food we eat, acts as an antibiotic in our gut and kills off beneficial bacteria therefore allowing the growth of opportunistic pathogens.

2. Second we have gastrointestinal dysbiosis with mind-altering metabolites. And this happens especially with clostridia and the metabolites HPHPA and p-cresol.

3. And the third step we have altered behavior and cognition

So in the body, you have all these different changes going on and so many molecules are not at their optimal levels. Right? So what are you going to see? You’re going to see altered behavior, altered cognition. And many times that’s when a diagnosis of autism is made. An autism diagnosis is based on observation and this is the time when behavior and cognition begin to change.  So if you’re waiting and waiting and waiting, then you finally see these behaviors – it’s because a few steps before, a lot of things were not optimal.

Here’s a quote from the book:

“The mainstream medical perspective that autism is a genetic disorder of behavior is selectively illogical, ignoring its exponential increase, which cannot be of genetic origin. Ignorant, selectively failing to integrate biological information and self-serving keeping children dependent on drugs, therapies and the issues your child has with autism.” 

AUTISM, DYSBIOSIS, AND THE GUT-BRAIN AXISDr. Alex Vasquez

With autism, you don’t want to just necessarily focus on just behavior because there are many different biological reasons as to why your child has that behavior and it’s important to really get at the root cause of what’s going on.

The book also says, “The fact is very clear that all of us, especially today’s children, are exposed to an absurdly unregulated and invisible mixture of neurotoxins and mitochondrial toxins that promote what I call metabolic fragility and that promotes various disease states.” 

It’s very true. Our world today is very different than it was 10, 20, 30 years ago.  

Every single thing that was discussed here in the book about dysbiosis, all of that can be addressed. And definitely, this is a good book if you’re looking to have more understanding of some biological reasons for certain autism behaviors.

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