Allergies and Autism, what are the options?

So many of the children we see at our office have issues other than just autism. Many children regress in the spring or in the fall. This is usually because of the increase of pollen triggering an allergic response and often in children on the spectrum — regression. So what options are out there?

I am including a comment we give to our patients as there are several choices available. This comment will discuss the various options as Dr. Neubrander views them and why he he picks LDA as a treatment for autism.

Dr. Neubrander’s comments to his patients:

When parent learn their child has a significant degree of environmental allergies (also called inhalant or airborne allergies), the parents are confronted with the question, “What’s the best way to help my child?”  The options parents have are to do nothing,  treat symptoms only, to desensitize with conventional allergy shots or by LDA shots. My bias is definitely to try to desensitize the child, either by conventional allergy shots, provocation/neutralization (P/N), serial endpoint titration (SET), or LDA shots rather than to just treat symptoms.

When one just treats the symptoms, it does nothing to get to the root of the problem and only gives short-term benefits. To desensitize gives long-term benefits and does get to the root of the problem. Provocation/neutralization or SET are hybrids between the two, conventional allergy shots and LDA. I have done all of these and for my ASD population, the best answer, relatively speaking and when speaking in accordance with these children’s fears and phobias and the need for repeated invasive treatment, is to opt for LDA.

Conventional allergy shots need to have a series of skin tests and then many desensitization shots over several years. This is definitely an invasive option that is usually not offered early by an allergist, and even more often not offered to young children. Provocation/neutralization or serial endpoint titration are also invasive and require a series of shots to diagnose the problem over several hours and often a couple of days. Treatment may then use shots or sublingual drops. LDA only needs to determine if allergies exist. Therefore, a simple blood test is adequate. The reason this is OK for LDA is because the treatment “generalizes” for types of allergenic stimuli. For conventional allergy shots, SET, or P/N, the treatment is a one-to-one treatment. You must test for a specific antigen, find the specific treatment dose, and then treat from the same vial, lot, and batch number. One tests for oak and treats for oak. The treatment will not “cross over” and treat for elm or maple or sycamore, etc. By contrast, LDA is able to determine one is sensitive to “tree pollens in general” and therefore desensitize to tree pollens in general, whether they come from New Jersey, Texas, or Oregon. Therefore, LDA offers current and future treatment for a great number of allergens that one is in contact with now, or may come in contact with in the future. This is not the case with any of the other types of desensitization.

For LDA to work “optimally”, it has been taught in the past that one needs to avoid certain things while having others in place. As I look back over my long history with LDA and its precursor, EPD, I see that many things we were taught as facts and absolutes are no longer the case. Rather than to go over such a list, let me make my point for today. In the past we have been taught to follow strict diets for LDA to work. We now know that LDA will work for most patients, specifically for this audience children on the spectrum, without having to be on the strict LDA diet. We have also been taught that patients should avoid taking many types of medications and supplements. What we have learned is that most patients do not have to be excessively strict with this as long as they continue to do the same thing as they were doing. We have learned that often it is just as much a “shock to the immune system” to stop something for a while and then restart it after being off for several days. Dr. Shrader, in personal communications with me on more than one occasion, has said that with LDA there is more to gain by doing it, even if we are not doing it perfectly (something we don’t know and change our minds about year after year) than to not do it at all. I have learned over the years that most of my patients who should not have had any results based on the “we gotta be perfect theory” which they couldn’t be on for a number of reasons did improve.

Therefore, because everything is relative when treating children with autism, and because it is rare for a parent to be perfect with anything they are doing, does that mean they shouldn’t try and scrap the whole thing? Take diet for example — there are almost always infractions so should one not do the diet? Take supplements for example — because a child cannot take everything all the time, or because a child cannot take much of what is recommended most of the time, does that mean one should quit? The obvious answer to both of these things is, “No!” So it is with LDA and “the things” that are taught for how to “make it perfect”. The rules and recommendations apply most to patients who are the most severely ill patients, e.g. those that see Dr. Shrader in New Mexico. For the rest of us, and from talking with other colleagues who give LDA to their patients, we do not want to be cavalier but at the same time we need to be practical with the ASD population and their families. The question arises, “What about vitamin C? If my child takes it, will it ruin the shot?” The answer is that it may blunt the total effectiveness of the shot somewhat, but definitely not make it to where the shot fails. The same can be said for the oils. If one wants, one can decrease the total amount of the supplements being taken by 1/2 or 1/8 for two to three days before up to two to three days after the shot if they have vitamin C or oils in them. However, I can say that if given according to the shot frequency schedule I have outlined for children on the spectrum, and if the shots are given for the full three years according to this schedule, and if one does not break the rules and “walk in the posies”, then the shots will still work for the vast majority of patients. Therefore it is my opinion, biased by years of successfully treating children on the spectrum, that the benefit of LDA, when compared to the other forms of therapy, even when not done perfectly, is a better option.


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