Wednesday, 10 May 2017

Homeopathy and Autism - Part Two

The previous post outlined (probably with some errors) the basics of the diagnosis and causation of Austistic Spectrum Disorder (ASD). It also touched on the prognosis for those diagnosed. It raised questions about the competence of lay homeopaths in terms of their ability to diagnose ASD, whether their ideas about causation bear any relationship to reality and hinted at the ethics of offering treatment.

This post will examine the nature of homeopathic treatment of autism, in particular CEASE therapy.

Homeopathy Alone?
Something that is not generally clear from the various accounts of lay homeopaths treating autism is whether any other treatment is going on at the same time. Homeopaths are very willing to assign any improvement to their treatment (and conversely declare any set backs as "aggravation", etc). Proving causation is much more difficult and often impossible by looking at the individual.

It seems very unlikely that any carer of someone with ASD would rely on purely homeopathy for treatment and support. It could be argued that to do so would be neglect - in the sense of denying access to appropriate medical treatment and it can not be emphasised enough that the law does not recognise homeopathy as a form of medical treatment nor does it recognise lay homeopaths as having any status whatsoever. Relying on lay homeopathy as primary care for someone who can not give informed consent would be a cause for concern for Social Services if they become aware of it.

Conventional treatment is often multi-disciplinary. Many different types of professionals can become involved. Special education, speech therapy, psychological therapy, physiotherapy as well as medical treatment for conditions often associated with ASD. Social Services can often be involved. Gaining access to support, both financial and practical support can involve interaction with many agencies. The "system" can be difficult to navigate and often advocacy is helpful. It is the diagnosis of ASD and assessment of needs that opens the door to access to the above services. Whether medical and social care professionals would welcome a lay homeopath as part of a multi-disciplinary team is moot. It could depend on exactly what treatments are being offered and what advice is being given. It's also the case that such professionals do a duty to intervene if the treatment/advice causes harm.

Whilst compared to other "alternative" treatments such as hyperbaric chambers, chelation, chemical castration and bleach enemas homeopathy may seem a benign form of treatment. But as will be seen, some lay homeopaths other products in addition to homeopathic medicines. There is also a tendency in some to accept other alternative treatments uncritically even if they do not perform them themselves.

The case of Kerri Riveri is illuminating though. Ms Riveri promoted the use of bleach enemas as a cure for autism and ended up in court. She reached an agreement to cease promotion although unfortunately there is still plenty of her propaganda floating around on the internet. 

Parents?
Looking after an autistic child is not always easy. Whilst there are many positive stories, the media does not seem to have much interest in the difficulties parents can face and the negative psychological impact on them and siblings.

It is understood that some parents will turn to alternative treatments. They may already be sympathetic to them, or perhaps somewhat skeptical but will try them as "worth a punt" or even out of desperation when other treatments have failed. TEETH is an acronym which stands for "Tried Everything Else, Try Homeopathy".

The kind of desperation of drives someone to even consider dangerous, unethical and even illegal treatments is not so easy to understand. The kind of desperation that drives someone to try more and more of these treatments when one particular one fails is even harder to fathom. Or even try DIY treatments of such a nature.

1. CEASE Therapy
CEASE stands for "Complete Elimination of Autistic Spectrum Expression". The very name is problematic. It is very popular with homeopaths as this listing of "qualified practitioners" shows. CEASE therapy is the invention of the late Dr. Tinus Smits who died of cancer in 2010. Smits is an interesting character. He practiced as a lay homeopath before studying medicine. 

Smits made some extraordinary claims in this time about "cure". He also had some very strange ideas such as universal layers.

1.1 Advice to Parents
Some of the more questionable advice on the website is reproduced below.
Avoid the use of the microwave for all food and drinks; avoid also as much as possible plastic containers and packages.
No reason is given for avoiding the use of microwave ovens. Microwave cooking doesn't make food toxic or anything like that in itself. Depending on the foodstuff, microwave cooking can preserve more nutrients than conventional cooking. Again, depending on the foodstuff, it can result in the production of fewer toxic compounds vs conventional cooking. Plastics? Bisphenol A has been implicated in certain health problems and has been banned in the EU for certain purposes.
Make sure your child is well grounded to the earth. Static electricity may give rise to both emotional/mental disorders and physical complaints. Synthetic clothing, insulating shoes (rubber or plastic soles) and synthetic floor coverings should therefore be avoided. If possible, have your child walk around barefoot. Eliminate all electric appliances in the bedroom such as electric alarm clocks, TV, computers or audio equipment. Turn of Wi-Fi during the night (and day).
The sensation of static electricity could be problematic. It could act as a trigger for a meltdown. But to claim it causes other disorders and physical complaints is a stretch to say the least. This feels very much like electro-sensitivity nonsense. It would not be a surprise if some CEASE practitioners sell anti-electrosmog devices.
Avoid antibiotics since they impair intestinal flora and consequently increase underlying problems. In case of infection, opt for naturopathic solutions.
Whilst it is true that antibiotics do impair intestinal flora and may aggravate gastro-intestinal issues, in the UK, antibiotics are not prescribed on a whim. Not treating infection can, in some cases, lead to death. Infection is does require medical treatment and "naturopathic solutions" are not that.
Give the two different types of Vitamins C. Both are available in tablets or capsules and as powder. The rule is that in case of diarrhea the dose should be lowered a little bit until the diarrhea disappears (bowel tolerance dose). This is without danger; only patients with haemochromatosis should avoid extra vitamin C, because vitamin C stimulates iron absorption. The general rule is not more than 1000 mg per year of age. So a child four years old can be given 4000 mg a day divided over three doses a day. That means three times an ascorbate of 1000mg and 3 times ascorbyl palmitate of 500mg (which is 3x 200mg of vitamin C). That makes 3600 mg per day. For children 6 years and older the maximum dose I advise is 6 grams a day, which is generally enough to attain our goal.
Ah, good old megadoses of Vitamin C, the staple of orthomolecular medicine. Claimed to be many things, including a clue for cancer. Whilst vitamin C is essential to health, megadoses have not been shown to have any benefit. Giving a child diarrhoea is hardly a good idea and even if the dose reduced, it does beg the question as whether it increases the likelihood of diarrhoea due to other factors.
Then make an appointment with a CEASE therapist. Autism is a serious disease that can be treated successfully, but even if I have given give you a lot of information about its treatment here and in my book Autism Beyond Despair, it needs professional help. Otherwise you will ultimately be disappointed and not get the results you hoped to achieve. You child is too precious to treat yourself.
A spectacularly bogus claim. It must also be remembered that UK lay homeopaths are not considered medical professionals in law.

1.2 Stages of CEASE Therapy Treatment
The first is detoxification using isopathic homeopathic medicines. This is a strange concept. On one hand, it could be understood as the ultimate extrapolation of "like cures like" but it contradicts the concept of "direction of cure". Many homeopaths do not use isopathy.
  • One of the important factors in the development of autism is without a doubt the administration of many vaccines at a very early age. In the Netherlands, vaccines mainly contain aluminium hydroxide, formaldehyde, protein pollutions and the actual vaccines themselves, viral, bacterial or toxins, sometimes also mercury. In children with malfunctioning detoxifying systems (metallothionein deficiency) this can lead to serious side effects of which autism is merely one. The rise of epilepsy, asthma, eczema, behavioural disorders, developmental disorders and many other post-vaccination symptoms is possibly caused by similar factors. In the United States the enormous increase in autism cases (from 1:180.000 to 1:180) coincides with the introduction of the MMR and subsequently the Hepatitis-B vaccine which is administered at birth. 
  • The immune system consists of two important parts, the humoral and the cellular defence. Vaccinations cause there to be a shift from cellular to humoral defence which leads to a weakening of the immune system. A zinc deficiency can lead to a similar shift. 
  • All autistic children should be detoxified using the homeopathically diluted remedies of the vaccines that have been administered to the child. 
  • Autistic children should never again be vaccinated!
Here we see the unevidenced claim that vaccines cause autism. The claim that there has been an enormous increase in cases is made as well. The general consensus is that there has been no underlying increase in actual cases, rather the categorisation has changed. It is worth pointing out that in the UK, none of the isopathic "vaccine" remedies are licensed medicines. As such, there are questions over the legality of supply to UK lay homeopaths. 

How the supposed shift from cellular to humoral immunity leads to a weakening of the immune system is not clear. Nor does it make much sense.

The advice that autistic children should be never be vaccinated again presents a considerable health risk, not just on an individual level but also to public health. Whilst it is possible that an autistic child may not be able to be vaccinated this will because of factors other than autism - allergy or immunosuppression. It can depend on the vaccine.

The next stage is "orthomolecular support" which seems to involve megadoses of vitamin C and Omega-3 supplementation.

Much is made of Metallothionein. Metallothionein are a family of proteins that are believed to play the roles of removing heavy metals from the body and also reducing oxidative stress. Some suggest that autism is caused by heavy metal toxicity. Mercury in the form of thiomersal is often implicated but there is no evidence that it causes autism The same is true for mercury amalgam fillings. Smits posits that issues in the function of Metallothionein that could be responsible for autism. It is also posited that the ratio of copper to zinc is indicative of autism. Mention is made of aluminium compounds but it is unclear whether Metallothionein has any role in removing aluminium from the body.

The website makes mention of research done at a Pfeiffer Treatment Center. This organisation has been the subject of various complaints and law suits. 
Unusual levels of Metallothionen activity have been found in some types of cancer. Defects in Metallothionein function may cause certain cancers. There is also evidence raised levels can create resistance to chemotherapy drugs.

Metallothionen is not found on the high street. It can be ordered via internet vendors but it does not appear to be widely sold. It would seem more likely zinc supplementation is involved, given that proteins do not cross the gut membrane - proteins are broken down into amino acids by digestive enzymes. Zinc is an important trace element and deficiency is a problem. Zinc supplementation is unlikely to cause toxicity in itself but it is known to be associated with iron and copper deficiency - both are important trace elements too. 

The website contains a lot on intestinal disorders and cites leaky gut. The prevalence of gastro-intestinal problems in people with autism compared to the general population is unknown. 
  • Approximately 85% of autistic children experience intestinal and assimilation disorders.
No citation is given for this figure. "Leaky gut" can for the most part be considered an invention of CAM. Further mention is made of "candida overgrowth". Candidiasis is a genuine condition and can be very serious but it has also become a staple of bogus CAM treatments. Although the website does not mention it, it is known that some homeopaths believe in pleomorphism. It is said that microbes can turn into other forms of microbes and eventually cancer. There is a virus becomes bacteria becomes fungus becomes cancer route apparently. There is also germ theory denialism

Metallothionen is mentioned again and the claim is made that it kills Candida. There is no evidence for this. Indeed, Candida produces its own Metallathionen as do many other life forms.

1.3 Successful Cases
Upon reading, this section of the website doesn't really back up the claim that homeopathy can cure autism. Compelling evidence it is not. Pure anecdote and it is easy to see how credit is taken for improvements that are likely to have nothing to do with the CEASE treatment.

1.4 ASA Ruling
The Advertising Standards Authority (ASA) issued a ruling against Teddington Homeopathy. They failed to comply and were placed on the Non-compliant Advertisers list. It is clear that they have no intention of complying. The next step could be referral to Trading Standards who may prosecute although there are other routes that could force compliance. Melissa Wakeling is a member of the Alliance of Registered Homeopaths (ARH). Their Code of Ethics makes it clear that -
36 All advertising must be published in a way that conforms to the law and to the guidance issued in the British Code of Advertising Practice. 
The ASA ruling does set a precedent for advertising of CEASE therapy in the UK and to some degree in the rest of the EU.

2. Non-specific
Not all UK lay homeopaths who claim to treat autism are CEASE practitioners. However, whilst they sometimes cite influences, their websites do not given the impression of a set methodology. Having said that, there are often similarities with CEASE therapy. Rather list all the variations, a handful of examples are given.

Mike Andrews uses hair analysis which has been discredited and vendors are notorious for selling expensive supplements. Andrews clearly believes that heavy metal toxicity is implicated in ASD. An example "treatment" regime is -
  • a constitutional remedy
  • a vaccine or heavy metal detox remedy
  • remedies to strengthen the gastrointestinal system
  • remedies to strengthen eliminative pathways.
Supplementation seems to be involved as well. Zinc, vitamin C and Epsom Salt are mentioned. Lay homeopaths do seem very keen on giving laxatives to children, possibly in the name of "detox".

Alan Freestone does use CEASE but also uses - 
  • Isopathy (giving a person the substance that caused their illness back in homeopathic potency)
  • Classical Homeopathy
  • Homeopathic Bowel Nosodes. It is my belief that these remedies will prove to be an important part of the autism recovery process in the future. They have incredible potential to heal damaged bowels and neurological symptoms such as rage and anxiety.
  • Biochemical Tissue Salts. Autistic people often have problems assimilating nutrients due to their compromised GIT (gastrointestinal tract). These remedies can help their bodies assimilate more effectively.
Bowel nosodes? Ultimately, they are made from faeces. Freestone goes onto say -
These methods can effectively work alongside conventional medication & other treatments such as Bio-medical intervention, GAPS diet, osteopathy, cranial-sacral therapy, Traditional Chinese Medicine, chelation and so on.
Many homeopaths also recommend restrictive diets. Many ASD children have restricted diets as a result of dislike of certain foods. Getting them, for example, to eat vegetables can be difficult to say the least. The mouth-feel of certain food stuffs can be highly unpleasant, not to mention the taste. To be fair, if ASD is co-morbid with certain GI problems, certain restrictive diets can result in an improvement of GI symptoms, leading to a decrease in distress but this not the same thing as treating ASD.

3. Secretin
There was a vogue for secretin as a treatment for autism years back. Research revealed that it had no effect. Secretin was difficult to get hold of and some homeopath came up with the idea of producing a homeopathic version. This would seem to violate the principles of homeopathy but it is not an isolated case. There was even a trial which contains the following -
As to why homoeopathy has been less successful than anticipated, the results indicate a clear reason. Each meal that a child consumes acts as a maintaining cause for their symptoms and as such a block to individually chosen treatment.
Ainsworths, Helios and Freemans offer it. Again, these are not registered homeopathic medicines and are treated as unlicensed medicines and there are questions about the legal supply to lay homeopaths.

It is not clear whether any UK lay homeopaths currently use homeopathic secretin.

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