Breakthroughs in the Evaluation and Treatment of Autism
Dan Protocol

DAN! Protocol Video




Synopsis of the "DAN" Conference (Defeat Autism Now), presented by Dr. Bernard Rimland, Dr. Jon Pangborn, Dr. Sidney Baker and their colleagues. The DAN Conference was formed by Dr. Rimland to bring together the world's foremost doctors and scientist to form an effective protocol to treat Autism.


In the last few years parents that have followed the "DAN" protocol faithfully, in almost its entirety, their children have made great gains. It has been reported that a fifteen- year old non-verbal male started speaking after correcting some of the biochemical abnormalities. Another eighteen- year old young lady started speaking for the first time after her biochemical abnormalities were regulated. There is now a protocol that is so effective that it is claiming 85 percent improvement! When you balance a child or adult biochemically, all the other therapies work so much more easily, whether it's Applied Behavior Analysis (A.B.A.), Occupational Therapy (O.T.), Speech Therapy, etc. The person is happier, calmer and more focused. Very often, the person starts to retain what he is taught. There is now some evidence that the gains made from ABA are not sustained as the years go by. It is believed that if the biochemical problems are not corrected, the toxins will eventually take away the gains one makes with the other therapies in many cases. There are no promises, but if you don't try, you'll never know how far a person can go!

In Autism, the toxicities often are:

Mercury (and other heavy metals). Most Autistic children, genetically, cannot detoxify well. So when these heavy metals accumulate from vaccines in the form of Thimersol, (a preservative), in dental amalgams, in utero, from the mother's blood, seafood, water, etc., these children run into more trouble. Mercury toxicity creates a clinical picture very similar to Autism, even in adults.

Mercury binds to sulfur in cysteine, an amino acid present in many enzymes. There is solid evidence that one of these enzymes shuttles the innocent immune stem cells into the pathway Th1. In the absence of this enzyme, these cells get shuttled into the pathway Th2. The pathway Th1 converts the immune cells to fight viruses and yeasts. The pathway Th2 converts the immune cells to cause food allergies, asthma, eczema, and autoimmune diseases. Which pathway do you prefer? That is why, in Autistic kids, many have food intolerances and high yeast overgrowth. It might also be why many people believe that the predisposed infant cannot fight the measles virus in the MMR vaccine and ends up with Autism, days, weeks or months after the MMR vaccine (www.909shot.com) Evaluation and chelation (removal) of mercury and other heavy metals is a must. If the child has mercury dental amalgams, they must be removed ASAP!

An important finding is that about 85 percent of Autistic kids are high in Copper and low in Zinc. Furthermore, these kids are very low in an important protein call Metallothionein, or MT Protein. This MT Protein acts as a magnet to Mercury and protects the Autistic individual from further harm caused by mercury, among other important functions. This protocol claims that even older Autistic individuals can be helped, that great gains could still occur. Very often, parents of older Autistic children despair because it seems that there is nothing that can help these children. It seems that this particular protocol can help! Still, generally, the younger the child, the faster and more the improvements are. Also, the sooner that the casein and gluten free diets are started, the faster the progress is.

Food intolerances - because of toxins, maldigestion and abnormal gut flora, Autistic children develop the "leaky-gut" syndrome. Chains of amino acids (peptides) that are not supposed to leak through the bowel membranes into the bloodstream, do. This, in turn, sensitizes the body to these foods. Also, these peptides mimic eurotransmitters, so that they bind up the normal neurotransmitter receptor sites, affecting the development and function of the brain, adversely (This problem is metabolic and not just immunologic). The most common allergens and peptide sources are: casein (all dairy products), gluten (in wheat, barley, rye, oats), soy, and corn. Please note that eating one crouton is as bad as eating a whole loaf of bread. It has to be 99-100% avoidance. There are many hidden sources of gluten and casein. For instance, it is reported that McDonald's French fries are coated with gluten to keep the fries from clumping together, and yet this gluten does not show up in their product list.

A good resource is the Feingold diet. Also check on the websites that are in this synopsis. Again, just because your child does not go berserk after casein or gluten, it does not mean that they are O.K. with these substances; there is the problem of delayed hypersensitivities that symptoms do not show up until days later. Also, the byproducts of casein and gluten are toxic to the brain and will prevent your child from recovering as far as he or she should. Many DAN Doctors would not even enter a treatment agreement with you unless you agree to be serious about this diet! I know how hard this diet is; remember that I have a child on this horrible diet, too!

Yeast - because of the reasons mentioned previously, overgrowth of yeast happens in the majority of these kids. The byproducts of yeast overgrowth are toxic to the Autistic child. One must control yeast by diet (there are many books on yeast-free diets), anti-yeast medications (Diflucan, Nystatin, etc.) and pro-biotics (different strains of lactobacilli - some are tougher than others; some do not survive in the hostile environment of the gut). Remember that a normal IgG or IgM antibody test against Candida is not indicative of having no problems with yeast. The IgA test is the important one to see if there is yeast in the gut. There are excellent books on yeast-free diets. Most importantly, avoid sugar-laden foods!

In Autism, many children are picky eaters. Even if they are not, they often lack necessary enzymes and liver function to digest and absorb properly.

THE DEFICIENCIES FALL UNDER:

Vitamins
Essential fatty acids
Amino acids
Minerals
Enzymes and co-enzymes

There are many protocols, with many rationales. Dosages must be adjusted to a person's weight. This includes brand names with the supplements, just to be helpful, but there are many good companies, with many excellent products out there.Here is a list of good "off" brand supplements. If you are obtaining your supplements from other sources, make sure that they are casein and gluten free. If possible, they should be soy, corn and dye free as well. Different children will have different needs. Once you have the tests results, you will have to experiment with what works with the person. This list of supplements works well for many Autistic people.


The most important fact to remember is that different Autistic individuals responds to different treatments, our job is finding the treatment that makes a big difference!

TESTS NECESSARY TO DETERMINE TOXICITIES AND DEFICIENCIES

Hair analysis: The absence of mercury, in this test, does not indicate that your child's mercury level is normal. If you cannot detoxify Mercury, it will not show up excreted in your hair. Watch for elevated antimony, which can also be a problem for Autistics. Lead often shows up high in this test.

Elemental analysis: packed erythrocytes In many utistic individuals, this test shows high mercury, copper and antimony. This test would show mineral deficiencies, as well as high levels of metals.

24-hour urine elemental analysis: If this test is negative, it does not mean that the mercury is not high. In many cases, one would have to use a chelating agent to do a challenge test. In the challenge test, the chelating agent moves the mercury from the intracellular space into the extracellular space, so that it can be measured. If the individual is not toilet-trained, you might want to do a 6-hour or 12-hour urine test, instead.

Plasma amino acids: Most autistic people are deficient in many of the amino acids tested). They cannot digest well because of poor pancreatic and/or liver, biliary function. Often amino acid supplementation helps mental function. Many key enzymes cannot be produced in amino acid deficiencies. The 24-hour urinary amino acid works better than the plasma amino acid if the individual is toilet-trained.

C.D.S.A. (Comprehensive digestive stool analysis): Most autistic people have a very poor ability to absorb fat, hence, they are very deficient in vitamins A, D, E and beta-carotene. Many have lactobacillus levels in the bowels of zero. This test indicates what is happening to digestion and absorption. It would tell you how to repair the bowel condition and what is needed to help digestion.

Anti-Candida Antibody Test - IgA, IgG, IgM: Initially, these are usually very high in people with autism, with antifungal treatment, they can be normal. You need to monitor the yeast level every two or three years after treatment, as recurrence often happens, especially when you are chelating.

Food allergy test - IgE, IgG: In food allergies, the IgE mediated response is obvious - you get an immediate reaction like hives, itchy eyes or difficulty with breathing. With the IgG mediated response, it's a delayed reaction, so that you may not even get the stuffy nose or headache until three days later. Please note that food allergens change, so that it is a good idea to repeat this test every year or two. The food allergens act as toxins and would interfere with your child's mental functioning, etc. For instance, one child became toilet-trained, two weeks after the allergens were removed. (ImmunoLab does a good job on this test).

CBC and Differential, CHEM 25: This is just to make sure that the blood count is normal and that the liver and kidneys are working well enough to chelate, if necessary.

Serum ceruloplasmin and copper that need to be tested in acid etched test-tubes and plasma Zinc done in EDTA test-tubes- this is done before and after Zinc loading before the actual Metallothionein Promotion takes place.

All these tests are available through Great Smokies Lab, 1-800-522-4762, (except the anti-Candida antibody - that is from ImmunoSciences Lab). Test # 8 can be done in any lab at all. Your doctor can also consult a Great Smokies staff doctor to go over all the results and recommendations, once the results are back. Dr. Pangborn is one of the world's geniuses in Biochemistry; he consults for Great Smokies.

The other labs that are also excellent for these tests are:

Biocentre Lab

1-800-494-7785

ImmunoLab

1-800-231-9197

Immunosciences

1-800-950-4686

Meridian Valley Lab

1-253-859-8700

Metametrix

1-800-221-4640

Dr.'s Data Lab

1-800-323-2784



SUPPLEMENTS:

Transfer Factor: This can make substantial difference in having people become more sociable, co-operative, calm, having great eye-contact and more speech. Transfer factor is extracted from colostrum or blood. It can be given by injection or orally. Transfer factor may have anti-viral properties, so that if you have the flu, and you take 9 capsules a day for three days, you may shorten the natural course of the flu.


There are two commercial sources of oral Transfer Factor that we are aware of:

Chisolm's Lab (Phone: 1-800-664-1333)
This is a specific Transfer Factor against childhood flus, viruses, including MMR, DPT. At the present time, I recommend immune factor #4; they are supposed to be coming out with one specific to Autism soon.
Dosage: 1 cap/day. Dr. Bradstreet (www.gnd.org) had good results with this.

Life (Phone: 1-888-454-3374)
This is a non-specific Transfer Factor
You start with 1 capsule 2x 1 day, then 3x 1 day, up to 3 capsules 3x/day
Dr. Peter Bock had the kids maintain this dosage for 3 months, then backed off to 1 capsule, 3x/day for maintenance.

DANplex (Phone: 1-800-792-6670). This is a vitamin/mineral/amino acid nutritional supplement, compounded by Hopewell Pharmacy, under the recommendations of many of the DAN doctors. Some people prefer Super-NU- Thera from Kirkman's 1-800-245-8282. There is also a good tasting multi-nutrient-Brain Child from Michael Lange, 1-831-465-9405. Dr. N's formula is good, too.


Omega Brite (Phone: 1-800-383-2030). This is the best source of omega-3 and omega-6 essential fatty acids ("essential" means that the body cannot produce it from something else). These fatty acids are necessary for the maintenance of the cell membranes as well as cell-to-cell communication. Dr. Andrew Stoll has found that a dosage of 1 capsule, 3x/day, helped many Autistic people. When you are on this product, you don't need to continue with flaxseed oil or evening primrose oil.

Sphingolin (Ecological Formulas 1-800-888-4585). Many Autistic people have anti-myelin antibodies. You can do a specific blood test for this or just give a trial of this supplement. It is inexpensive and has no side effects that are known, at the proper dosage. The dose is a half a capsule a day, regardless of the person's size. Please note that you should not be on Sphingolin and Secretin at the same time.

Cod Liver Oil (Kirkman Labs 1-800-245-8282). Dr. Megson (www.megson.com) has done remarkable research on the necessity of obtaining vitamin A (the "cis" form) from cod liver oil. It turns out that most of the vitamin A (including vitamin A from beta-carotene), is in the "trans" form, a form that we cannot utilize. The "cis" and "trans" forms are mirror images of each other; the "cis" form works better on the human body. The dosage depends on the weight of the person..

There is also a good tasting, orange-flavored one called Dale Alexander's Cod Liver Oil, by Twinlabs, in many health food stores.

Digestive Enzymes: These help to break down the foods that the kids eat, into absorbable components. Most autistic people have very poor digestion. It is recommended to take EnZym-Aid (Kirkman's), with another enzyme, which contains lipase, (such as b, c or d below), to break down the fats since EnZym-Aid has no lipase in it.

EnZym-Aid (Kirkman's)
Phone: 1-800-245-8282

Plantizyme (Thorne's)
Phone: 1-800-228-1966

Megazyme (Whole Foods)
Creon - 10
Creon - 20 by prescription

Probiotics: This is to supply the body with "good" bacteria to keep down the yeast growth and to acquire many other health benefits from them. This is well explained in Dr. Sidney Baker's book. Remember, some lactobacilli do not survive the hostile environment of the unfriendly pH's in these children's intestines.

Lactobacillus sporogenes (Thorne) 1-800-228-1966 - This is a tougher form of lactobacillus since it is in the spore form.

Enterogenic concentrate (Preventhium)
Phone: 1-800-755-1327 (They often have phone problems)
Fax: 1-770-831-8610

Pro-Bio Gold (Kirkman's)
Phone: 1-800-245-8282

Cuturelle has the reputation that it can actually colonize in the gut. Many health food stores carry it.

Mineral Supplements

Citramin I or II (Thorne)
Phone: 1-800-228-1966

Trace minerals (Thorne)
Mineral supplementation is a must in chelation on the "off" days
Phone: 1-800-228-1966
It is also a good idea to add extra Zinc, as this mineral seems to be deficient in most Autistic kids. Zinc must be taken on an empty stomach, at bedtime, for best absorption.

<>D.M.G. (Kirkman's)
This helped 40% of the Autistic kids in Dr. Rimland's study. You may need higher doses than you think in order to have a great effect.
Phone: 1-800-245-8282
Fibre: Arabinex or Medibulk (Thorne) 1-800-228-1966. This is important for the health of the intestines as well as the survival of the lactobacilli.

Secretin This substance is helping a lot of Autistic kids, but not as many as originally thought. It is available in I.V., oral and skin patch forms. Again there is controversy as to whether the latter two forms work.

I.V. Glutathione: There have been some benefits with this therapy as far as calmness and getting rid of "tics" are concerned, as well as some acceleration in cognitive abilities. Of course, Glutathione is also available in oral and topical forms.

Metallothionein Promotion Therapy: This seems like a really exciting therapy with promising results. There is basically 2 phases to this protocol. The first phase is to increase the zinc and to decrease the copper. The second phase is to give the body the amino acids necessary to build the MT Protein. The MT Protein will then help the body heal and catch up in the necessary areas. Taurine interferes with Zinc absorption, so no Taurine on the days of Zinc Therapy.

A very exciting area is being researched at Harvard Mass. General Hospital where hundreds of Autistic kids are being endoscoped by Dr. Tim Buie. The findings are, that even in the absence of G.I. symptoms, there is inflammation of the gut. When the gut is given the appropriate therapies to heal, the Autistic symptoms greatly recede.

If you live outside the US, you might need to find the non toll-free number through a friend. In some cases, your friend might have to order it and ship it to you, as regulations may not permit shipping outside the country. This applies to all the toll free numbers mentioned.

Please remember that, if you introduce someone to a new supplement, it is not unusual for the them to experience some adverse effects for a short while. These effects may include hyperactivity, skin rashes and behavioral regressions. When this happens, it does not necessarily mean that you should discontinue the supplement, unless the adverse effects are dangerous, or persistent. Usually these side effects wear off in a few days. Please remember to start with a very low dose, even as low as a quarter capsule. If there are adverse effects, stay at this dose until the adverse effects are gone, then proceed to a slightly higher dose, etc. In addition, you may not see the beneficial effects of these supplements for a period of time. Also remember that just because a therapy did not work before, it does not mean that you should not re-visit that therapy at a later time, for instance, after you clean up the gut problem. Please consult your doctor about any adverse effects that persist or cause concern.

GENERAL POINTERS TO CHELATION

Make sure the autistic person is balanced nutritionally - i.e. amino acids, vitamins, minerals etc., before chelation. If the individual is very out of balance, chelation may lead to seizures (especially if the person is low in magnesium or taurine)

Take mineral supplements on the days of chelation..

In dosing of the DMSA or DMPS, chelating agents, remember to "go low" and to "go slow"!

Make sure you have a knowledgeable doctor supervising the chelation - what blood parameters to monitor etc. Dr. Rimland's institute, Autism Research Institute, has a list of doctors who are familiar with the DAN protocol. Phone: (1-619-281-7165).


There are three agents for chelation of mercury:

DMPS (Heyl is the purest brand) oral, I.V. or I.M.

DMSA (Chemet, Succimer). (Kirkman makes a very palatable form) oral.

DMSA with ALA (alpha lipoic acid) oral.

There are many chelation protocols, please consult either the web site of the Autism Research Institute www.autism.com/ari. Most chelation is done orally; some doctors implement the oral chelation with I.M. shots of DMPS.

Please note that most of the information from this DAN Conference (including the Autistic child's underlying inability to detoxify, deficiency states and toxicity and the treatments as discussed), is not yet widely accepted by the medical profession. The conventional medical community takes a very long time to embrace and accept new ideas. Don't be surprised if your doctor regards this information with skepticism. You may need to find a DAN Doctor or a doctor who is open-minded enough to supervise the testing and treatment with you.


USEFUL RESOURCES:

Dr. Sidney Baker's Book, "Detoxification and Healing" ISBN 0-87983-709-8 Publisher: Keats Publishing Inc. This book is easy to read and is very important to understanding Autism, or how to stay healthy yourself. In addition, Dr. Baker's web site is a very valuable source of information on Autism and healing. www.sbakermd.com

DAN Protocol: $25.00 Explanation of all of this material, more accurately and more scientifically. Phone: 619-281-7165 (Autism Research Institute). www.autism.com/ari

"Children with Starving Brains", by Jacquelyn McCandless M.D. A book that every Autistic child's parent should read and study ISBN 1-883647-09-6. It is a well-written book on the DAN protocol.

Another very informative web site is www.rxforautism.com

Web sites for casein and gluten free diets are: www.gfcfdiet.com www.gfcfkids.com and www.missroben.com

Dr. Megson at the Pediatric and Adolescent Ability Center www.megson.com

Valuable information on mercury can be found on the following sites: http://altcorp.com/autism.htm : http://www.house.gov/reform/hearings/healthcare/00.07.18/index.htm : http://www.cureautismnow.org/sciwatch/invest.cfm.

The DAN doctors and scientists now believe that Autism is a biochemical disease that can be helped greatly through much effort and persistence.


Remember, the lesson is in the journey, not in the destination.

There is significant evidence that the measles virus, in the form of the vaccination, MMR and other virus's, plays an important role, in the etiology of Autism. Viral Information


There are other more "in depth" tests as well, among them are:

Intestinal permeability
Detoxification profile
Vitamin profile
Essential fatty acids profile
All the tests for different antibodies, and immunoglobulins
This Metallothionein Promotion Therapy is claiming excellent results and bears watching and trying.


When the test results for the plasma or urinary amino acids are back, and you know what amino acids are necessary, a good compounding pharmacist is College Pharmacy (Colorado), Phone: 1-800-888-9358.

Don't be afraid to do some of the tests or take some of the tests yourself. Remember that there is a genetic component to Autism so that the defects might be present, but to a slighter degree, in other members of the family. Also, don't forget that Autism is just a part of a spectrum that includes A.D.D., A.D.H.D., obsessive-compulsive disorder, manic- depressive disorder etc. Many members of the family feel and perform so much better on the diets and some of the supplements that these kids are on. You might want to have your mercury dental amalgams replaced. There is a Dental Materials Compatibility Test by Clifford Labs, (1-719-550-000), to find out which amalgams will not be toxic to you, in the long run.