Hello everyone. I am a little late on my post about our 10-week follow-up to Jaxon’s urine analysis. If you are joining me for the first time, my grandnephew was diagnosed with level 3 – severe autism last June. At the suggestion of his functional pediatrician, we tested Jaxon’s urine to see if his Serotonin, Gaba, and Dopamine were out of whack since he has bouts of aggressive behavior. We already tested his stool and found issues there which we are addressing. See Stool Testing – Part 1
You can find the results from the first urine analysis here when you click on this link. Urine Testing For A Child With Autism – Findings
Roughly ten weeks after the first urine analysis, we did a second test. We wanted to see if we made any progress with the new supplements we added.
Following are the results. While they aren’t what I hoped for, I cannot be too upset because I failed to follow the doctor’s instructions exactly regarding the supplements. This snafu on my part cost us valuable time, so now we have to essentially start over. Thankfully, the doctor is understanding and she gets it.
I decided to copy the wording directly from the test results so you can get a better understanding of what they look for in these urine analyses regarding children with autism. Please excuse the big words. I am still working to understand them myself.
The NeuroWellness Program And Your Patient
The object of the NeuroWellness Program is to help restore balance to the neuroendocrine system. One of the cornerstones of the NeuroWellness Program is to monitor neuroendocrine levels by retesting the patient throughout the rebalancing process. This can be a very effective way to guide individual therapy. The patient’s current laboratory values can be measured against previous results, allowing for imbalances to be more adequately addressed. Any Targeted Nutritional Therapy™ can be adjusted as results are compared. With each retest, the aim is to move the patient closer to achieving HPA axis balance and an improved sense of well-being.
*The patient indicated the use of a supplement that may influence results.
The patient has indicated AUTISM on the Questionnaire. As autism is one of the most heterogeneous of conditions, many neurotransmitter systems and their underlying genetics have been investigated. Though conclusions do not apply to every patient, several patterns have been identified. Central serotonergic hypofunction is a common finding. Serotonin is found to be elevated in platelets but deficient in the brain. In support of this finding, tryptophan depletion produces an increase of abnormal kinetic symptoms in autism. Low central SERT (serotonin transporter) binding is commonly found associated with impaired social cognition and repetitive behaviors.
Dopamine is also intimately involved, affecting nearly all the brain areas associated with autistic behavior. Genetic studies strongly implicate dopamine in autism’s etiology; however, its complexity prevents consensus regarding overall deficiency or excess in dopaminergic neurotransmission. Newer research on GI infections of Clostridia species implicate a role for this bacterium in the dopamine theory of autism.
Significantly elevated urinary levels of a marker for Clostridia, 3-(3-hydroxyphenyl)-3-hydroxypropionic acid (HPHPA), have been found in autism.
Metabolites of Clostridia are known to inhibit dopamine beta-hydroxylase, the enzyme responsible for changing dopamine into norepinephrine. This can result in elevated dopamine and reduced norepinephrine in at least some autistic populations. The dopamine metabolite homovanillic acid (HVA) is also often elevated in autistic patients, supporting this hypothesis. Treatment with antibiotics such as metronidazole and vancomycin against Clostridia species help eliminate these urinary metabolites with reported concomitant improvement in autistic symptoms.
Allergy is another consideration and may exacerbate autistic behavior. In a model of autistic mice with allergy, adding omega 3 PUFA restored deficiencies of both dopamine and serotonin and improved their impaired social behavior. Zinc deficiency has been found in autism as well. The reduced DAT transport found in patients was reversed by the addition of zinc, and it is suggested that the zinc: copper ratio may be a useful biomarker for the autistic spectrum.
GABA has consistently been found to be low in autism, which may allow glutamate-induced hyperexcitability. Synthesizing enzymes, binding sites, and receptor density for GABA are all reduced in various central locations. HPA axis imbalance has also been reported, particularly showing elevated androgens but lower DHEA. Balancing all neurotransmitters and HPA function may be useful, though intervention tolerability by the patient is of primary concern.
The patient indicated symptoms of ANXIETY, NERVOUSNESS, or IRRITABILITY, which are often the result of decreased inhibitory neurotransmission and/or excess excitatory neurotransmission. However, this patient has a normal serotonin level.
Additionally, in the presence of up-regulated adrenal function, anxiety, irritability, and/or nervousness may also be present. Therefore, consider assessing adrenal hormone levels. As mood concerns were noted with normal urinary levels of serotonin, it is possible that overall inhibitory function may be suboptimal, possibly due to low glycine and/or GABA levels. GABA and glycine function to promote calm and prevent over-excitation. As GABA is the primary inhibitory neurotransmitter, it can be thought of as “the great balancer” of the nervous system.
Also, serotonin often functions as a modulator of GABA activity.
Depletion of GABA alone may cause anxiety. Research also indicates that inositol and glycine supplementation may be beneficial for those suffering from anxiety, especially acute anxiety and panic disorders. Avoid supporting excitatory neurotransmitter function before restoring serotonin and GABA levels. When in excess, thyroid hormones may also generate feelings of nervousness, irritability, and anxiety for the patient. Therefore, consider a comprehensive thyroid hormone assessment.
Although the patient did not indicate any concerns that are typically related to excitatory system deficiencies on the questionnaire, symptoms such as apathy, lethargy, lack of focus, poor memory, low libido, depression with exhaustion, decreased stamina and fatigue can be associated with deficiencies in this system. Consider reassessing the patient’s neurotransmitter levels should these symptoms arise.
Jaxon’s Urine Results February 2023
Serotonin / Current 246.1 Previous 315.0 / Reference range 91.7 – 472.3 ug/g Cr
GABA / Current 235.8 Previous 236.7 / Reference Range 130.8 – 736.1 ug/g Cr
Dopamine / Current 636.7 Previous 758.9 / Reference Range 224.2 – 847.7 ug/g Cr
Norepinephrine / Current 52.8 Previous 70.3 / Reference Range 15.6 – 100.3 ug/g Cr
Epinephrine / Current 17.8 Previous 17.9 / Reference Range 2.7 – 49.7 ug/g Cr
Glutamate / Current 10.2 Previous 10.6 / Reference Range 2.8 – 28.1 mg/g Cr
PEA / Current 11.7 Previous 13.7 / Reference Range 1.5 – 30.3 mcg/g Cr
Norepi/Epi Ratio / Current 3.0 Previous 3.9 / Reference Range <13
Creatinine / Current 69.5 Previous 42.4. Creatinine is used to calculate results and is not to be used diagnostically.
What are we looking for?
Decreased GABA levels/activity in the brain leads to anxiety, depression, insomnia, and mood disorders. GABA is a natural brain relaxant. In the rest of the body, GABA plays a myriad of important protective roles. It modulates the adrenal response to stress by acting as the gatekeeper of norepinephrine and epinephrine release (catecholamines responsible for the adrenaline surge). GABA is synthesized from the excitatory neurotransmitter glutamate in a process that requires vitamin B6 as a cofactor.
Dopamine – high levels are linked to attention deficit hyperactivity disorder (ADHD), binge eating, and addiction. It is also linked to being more competitive, aggressive, and having poor impulse control.
“PEA” stands for phenylethylamine. It is a hormone-like substance that is naturally produced in the brain and body and serves as a biomarker for ADHD. It has stimulating effects. It can improve mood, increase attention and energy, and promote a feeling of well-being.
Serotonin balances out the excessive excitatory neurotransmitter effects. All of the neurotransmitters require a healthy, noninflamed, nonleaking gut to remain balanced.
Revised Treatment Plan
1. Continue ProbioMax® Sb DF – 1 capsule once daily.
2. Continue Vitamin D3 drops – 3 single drops by mouth once daily (3000 IU)
3. Continue Mary Ruths multivitamin gummies daily
4. Continue Nordic Naturals DHA Jr. Liquid Omega – give 1 full teaspoon (1060 total omega 3’s) once daily
5. Increase NeuroScience GABATrex 100 mg chewable tablets to 1 tablet TWICE daily (L-Theanine)
6. Increase NeuroScience Alpha GABA capsules to 1 capsule TWICE daily.
7. Begin Thorne Labs Pharma GABA 100 mg capsules – give 1 capsule once daily
8. To ensure adequate hydration he needs to drink at least 1/2 his body weight in ounces of water per day.
9. Discontinue L-Glutamine for now until his dopamine level has normalized
10. Restart Calm PRT – 1 capsule once daily for 30 days then STOP.
You are now up to date on where we are with trying to get some of his levels under control, mainly the dopamine, serotonin, and GABA. If there’s one thing I know – this is no quick fix. This race is a marathon and not a sprint. Oh, how I wish some days it worked faster for his sake and ours.
There is so much to learn about the specifics of autism. One thing I am learning is there are not a lot of functional medicine doctors. Sadly, they seem to be the ones who focus on the bigger picture in lieu of one specific area like specialists.
When I think about the number of children affected by autism, my heart breaks. There has to be, just has to be a common denominator to all this. Autism isn’t contained in the United States. Children in other countries are affected by autism too.
In the year 2000, the CDC says there were 1 in 150 children diagnosed with an autism spectrum disorder.
In the year 2018, the CDC says there were 1 in 44 children diagnosed with an autism spectrum disorder.
I could not find stats for 2020 or 2022 yet. Most likely because the focus shifted to covid. But I bet it’s lower than 1 in 44, more like down in the 30s now.
I will close with this thought – there are not enough specialists for all the children affected by autism. The teachers have not been trained to deal with these students. There are not enough specialists in the medical field to help diagnose children. There are not enough trained therapists to help families with therapy.
By all accounts, autism is not going away any time soon. We need more people trained on how to diagnose, treat, and manage children on the spectrum, and we need them now.
If you pray, please pray more and more people will seek to understand children on the autism spectrum and seek medical knowledge, and therapy degrees so these children and families get more help.
Until next time…