The Role of Inflammation and the Example of Autism
Autism is just an extreme example of what can go wrong with our brain. The same things happen in depression, Alzheimer's, or almost any psychiatric or neurological problem.
As the nature of disease gets uncovered, the common underlying roots of all illness become apparent. Autism and Alzheimer's are almost the same disease showing up at the opposite end of the age spectrum–the metabolism, biochemistry, and the causes all map over each other.
Martha Herbert, MD, PhD, a professor of neurology at Harvard, has put together a remarkable story of autism, which is like a hologram through which we can see the systemic nature of most illness. Her landmark paper, Autism: A Brain Disorder or a Disorder of the Brain?1 will change forever our thinking about mental and brain illness.
Dr. Herbert looked very carefully at autistic children's brains on MRI scans. She noticed their brains were bigger than those of children who did not have autism 2. The question that remained was why.
That's where Dr. Diana Vargas and her group from Johns Hopkins came in. They examined the brains on autopsy of eleven autistic children who had died3. They also looked at the spinal fluid of living autistic children. By examining and comparing these factors, they proved that these children's brains were swollen and inflamed, like a swollen ankle!
The short answer is allergens, toxins, infections, and nutritional deficiencies.
But where do problems like these come from and how do they affect the brain? Are they in the brain to begin with? Well, many times they may not be.
It has long been known not only that children with autism have misfiring and miswiring of their brain, but that 95 percent of autistic children have gastrointestinal problems and swollen bellies. It has also been noted that autistic children have frequent infections and allergies and have often had multiple courses of antibiotics. And according to the MIND Institute at University of California, Davis, more than 70 percent of children on the autism spectrum have altered immune function.
Most doctors assume these are annoying but secondary problems, meaning they have nothing to do with why autistic children's brains are not working properly or why their brains are swollen and inflamed.
But according to Dr. Herbert, the opposite seems to be true. These gut, immune, and toxicity problems are integrally related to and often the cause of what happens in the brain. In fact, she suggests that autism is really a systemic metabolic disorder that changes brain function. The brain and body function as a whole system. And multiple chronic, insidious triggers can throw the brain into chaos.
More than 60 percent of the immune system is in the digestive tract. When that key system of the body is thrown out of balance, the immune system is triggered and widespread systemic inflammation can often result.
We insult our digestive tract every day. We do everything to harm it and hardly anything to help it work as it was designed. We eat food low in fiber; high in sugar; and full of antibiotics, pesticides, and hormones; we drink alcohol and caffeine; we take antibiotics, acid-blocking medication, anti-inflammatory drugs, hormones, and steroids (all of which can inhibit proper gut function); we are under constant stress; and we are exposed to thousands of environmental toxins, all of which damage the gut.
These factors trigger widespread inflammation because our gut-immune system reacts to all the foreign proteins in food and the myriad of bugs and gets "angry" and inflamed.
So if inflammation starts in the belly (and so many autistic children have swollen bellies) and then spreads to the brain, it can literally lead to a swollen brain. And the effects can be disastrous.
Imagine the extraordinary beauty and dance of the brain where everything is exquisitely regulated. The timing and coordination of nerve cell firing and the amplitude (or volume) of the message has to be just right. Filters that modulate our sensory inputs must let in only the information we need. The activity of the brain must be exquisitely synchronized for us to be awake, alert, receptive, interactive, communicative, flexible, and happy.
But what if the signals start misfiring and the coordination and synchronization break down because of multiple metabolic disturbances such as ineffective enzymes or cell function due to insults from toxins, infections, allergens, or nutritional deficiencies?
This is the net effect of inflammation, whatever the original cause. It triggers a runaway cascade of damaging effects. All mental processing slows, neurotransmitters can't do their job, cell membranes don't function the way they were designed, cellular enzymes get hijacked or derailed, cells get trigged into a death spiral called apoptosis, and the delicate network of cellular connections and communications is interrupted and altered.
How does that show up? As autism or Alzheimer's or depression. It depends on the unique genetic makeup and environment of each individual person. In the children discussed above, the result of this inflammation is autism. In you it may be anything from a bad mood or dementia to hyperactivity and difficulty focusing.
Whatever the cause, at the end of the day we are all suffering from swollen brains.
These problems may not show up on the radar of conventional testing, but they wreak havoc in your body and your brain. We see this havoc as altered behavior, mood, and memory. It is precisely in these metabolic disturbances that we need to look at for answers.
Inflammation has enormous implications for treating autism and most "brain disorders." Our broken brains may be due to FIXABLE metabolic problems triggered by digestive imbalances, toxins, foods, allergens, and hidden infections and worsened by nutritional deficiencies.
Scientists are now asking the question why? Why do we find more mercury in autistic children? What is the effect of mercury on the brain? Why do these children have altered immune function? Why do they have more viral infections? Why do we find measles virus in the intestinal lining of these children and in their spinal fluid? What is the effect of giving babies nine immunizations at one doctor's visit or more than twenty-seven vaccinations by the time they are two years old? How do these all trigger inflammation and how does this cause autism?
Questions like these force us to ask how biology, brain, and behavior connect.
There Is No Gene for Autism: Looking at All the Causes
Researchers have been searching for the one autism gene or the one location in the brain that is damaged that leads to autism. Looking for these kinds of answers implies that the changes that cause autism (or other "brain disorders") are genetically hardwired and therefore treatment is hopeless.
But these researchers are looking in the wrong places for the source of the problem.
These same metabolic and environmental problems hold true for the one in six children with some type of developmental problem, the one in ten with ADHD, and the one in one hundred fifty with autism. Each of these may be problems related to underlying metabolic disorders and NOT the result of genetically hardwired diseases or damaged brains. It is all the same problem just showing up slightly differently in different kids.
Dr. Herbert suggests that many DIFFERENT CAUSES can lead to the SAME SYMPTOMS, namely the lack of language and social connection and the rigidity and inflexibility of behavior seen in children with autism, as well as many "behavioral" problems in children such as those with ADHD. A few common pathways result in the same symptoms from a host of different insults. There may be many "autisms," each caused by slightly different factors.
Rather than studying drugs that affect the brain to treat autism, the better path may be studying treatments that target inflammation, toxins, allergens, and infections or fixing biochemical train wrecks (like problems with methylation and sulfation) and gut problems.
Treating the gut, or giving B12, B6, and folate; omega-3 fats; vitamins A and D; or magnesium and zinc or eliminating gluten and casein from the diet or detoxifying mercury and lead from their little bodies may be the best way to get autistic children's brain connections working again.
Quite a notion! Treat the body, and heal the brain.
For more information on autism, please see Dr. Hyman's new book, The UltraMind Solution.
- Herbert M. Autism: A Brain Disorder or a Disorder of the Brain?,
Clinical Neuropsychiatry (2205 2, 6. 354-379).
- Herbert MR. Large brains in autism: the challenge of pervasive
abnormality. Neuroscientist. 2005 Oct;11(5):417-40. Review.
- Vargas DL, Nascimbene C, Krishnan C, Zimmerman AW, Pardo CA. Neuroglial
activation and neuroinflammation in the brain of patients with autism. Ann
Neurol. 2005 Jan;57(1):67-81. Erratum in: Ann Neurol. 2005 Feb;57(2):304.
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