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  • Tony-Boggess

    Dr. Boggess (Medical Director)

    Dr. Tony Boggess is a Physical Medicine and Rehabilitation (PM&R) physician, speaker, and writer who specializes in Nutritional and... read more

Our approach to ASD & Mood problems


Dear Prospective Patient,

My team and I enthusiastically provide medical and therapy care to children and adults with Autism, AD(H)D, and other mood problems. We recognize the tremendous impact certain medical conditions have on the entire family and we approach these disorders according to the dictum: “Families that work together, heal together.” Our mission is to help the children and family members from a physical, physiological, and emotional perspective. Few conditions hinder the cohesiveness and spirit of family like significant mood or cognitive illness. Our goal is to support the entire family unit holistically.

We employ a wide variety of evidence based and complementary approaches, including:

  • Diagnostic testing for digestive problems, toxicity, and metabolic disorders
  • Medication tapering, transition to natural remedies, non-drug approach to mood and sleep
  • Neuro-immune, methylation, and detoxification support based on Nutrigenomic testing
  • Allergy assessment, bioenergetic techniques, customized diets (GFCF, SCD, LOD, GAPS Feingold)
  • In-home Hyperbaric Oxygen therapy, homeopathy, nutracueticals
  • Behavioral interventions, family coaching, psycho-nutraceuticals
  • Occupational/Speech therapy, interactive metronome, therapeutic listening, neurofeedback
  • Developmental testing, psychotherapy

We believe that by working as a team we will provide you and your family with the best care available.

 

Please consider these inspiring words!

“When things go wrong as they sometimes will;
When the road you’re trudging on seems all uphill;
When the funds are low, and the debts are high:
And you want to smile, but have to sigh;
When care is pressing you down a bit-
Rest if you must, but do not quit.
Success is failure turned inside out;
The silver tint of the clouds of doubt;
And you can never tell how close you are.
It may be near when it seems so far;
So stick to the fight when you’re hardest hit-
It’s when things go wrong that you must not quit.”

-Author Unknown

 

The Biomedical approach is not “one fits all”

Your child is unique, so we have to treat them that way. He/she has symptoms that can be life-limiting, impair social activities, proper development and can be a source of significant stress for other family members. He/she also has a unique characteristics and diagnostic findings that can guide clinical decisions and help to determine the very best strategies for testing, supplementation and dietary approaches.

  • Testing/Diagnostics
  • Supplementation
  • Restrictive Diets

While general statements can be made, the best way to treat children with mood and regulation problems is based on biomedical testing & observations.

Start with the Basics

Complete Blood Count (CBC) & Comprehensive Metabolic Panel (CMP) – here I’m checking for iron deficiency anemia, inflammation, low cholesterol, and basic liver and kidney function.

Cholesterol less than 145 mg/dl in neuro-typical children has been shown to increase defiance and irritability and increase the chances of school suspension by three-fold and supplementing children can be helpful with similar symptoms/behaviors.

*Zhang,J.,etal.,Association of serum cholesterol and history of school suspension among school-age children and adolescents in the United States. Am J Epidemiol, 2005. 161(7): p. 691-9.
*Aneja,A.andE.Tierney,Autism: the role of cholesterol in treatment. Int Rev Psychiatry, 2008. 20(2): p. 165-70.

Iron deficiency has been associated with inattention and lower IQ. Iron supplementation in children found to be low with deficit hyperactivity disorder (ADHD) leads to improvements compared to placebo. Iron supplementation in found to be low with autism leads to improvements in sleep.

*Konofal,E.,etal.,Iron deficiency in children with attention-deficit/hyperactivity disorder. Arch Pediatr Adolesc Med, 2004. 158(12): p. 1113-5.
*Lozoff,B.,etal., Long-lasting neural and behavioral effects of iron deficiency in infancy. Nutr Rev, 2006. 64(5 Pt 2): p. S34-43; discussion S72-91.
*Konofal,E.,etal.,Effects of iron supplementation on attention deficit hyperactivity disorder in children. Pediatr Neurol, 2008. 38(1): p. 20-6.
*Dosman,C.F.,etal.,Children with autism: effect of iron supplementation on sleep and ferritin. Pediatr Neurol, 2007. 36(3): p. 152-8.

Thyroid Function Tests: Many children with autism have clinical hypothyroidism, which can be the reason for some of the symptoms.

Ammonia and Lactic Acid –here I’m looking for mitochondrial dysfunction, especially if there is evidence of low muscle tone. In such case, symptoms can improve with supplements such as Coenzyme Q10/Ubiquinone, L-carnitine, etc.

Cysteine –a marker of impaired glutathione productions or excessive oxidative stress/toxicity

Lead – can cause autistic-type behaviors in some children and may prompt an intensive study of the child’s environment (home, daycare, outdoor areas)

Magnesium (RBC) low levels have been noted in some children with ADHD and Autism. Aggressive supplementation can be helpful to improve sleep, reduce autistic behaviors, decrease hyperactivity, and improve constipation.

*Mousain-Bosc,M.,etal., Improvement of neurobehavioral disorders in children supplemented with magnesium-vitamin B6. II. Pervasive developmental disorder-autism. Magnes Res, 2006. 19(1): p. 53-62.
*Starobrat-Hermelin, B. and T. Kozielec, The effects of magnesium physiological supplementation on hyperactivity in children with attention deficit hyperactivity disorder (ADHD). Positive response to magnesium oral loading test. Magnes Res, 1997. 10(2): p. 149-56.

Serum Testosterone – a small percentage of children with autism have elevated testosterone, which has been associated with aggressive behaviors.

*Geier, D.A. and M.R. Geier, A clinical trial of combined anti-androgen and anti-heavy metal therapy in autistic disorders. Neuro Endocrinol Lett, 2006. 27(6): p. 833-8.

Specialty Functional Tests

Urin Organic Acid Test (OAT) – especially with extensive gastrointestinal symptoms, this assays examines the urine for evidence of yeast, Clostridia bacteria, and other important factors like indirect nutritional factors and mitochondrial function.

Heavy metals & organic chemicals – provide direction for detoxification

Urine neopterin – provides a marker of inflammation and provides rationale for anti-inflammatory treatments.

Urine Nucleic Acid/Isoprostane – provides marker of oxidative stress inside/outside the cell; helpful for guiding antioxidant treatments.

Gastro-intestinal test if warranted may include

Comprehensive 3-Day stool analysis – a comprehensive, noninvasive diagnostic evaluation of the GI system looking at gut ecology, potential pathogens such as opportunistic bacteria, invasive yeast, parasites, inflammation and ability to digest and absorb nutrients.

Intestinal Permeability/Absorption Tests – the GI system is the rate-limiting step to convert all food into the products the body needs in order to be healthy, detox, and achieve optimal functionality. This test can help guide treatment when indicated.

Bacterial Overgrowth Breath Test – analyzes the fermentation products of bacteria in the small intestine. Helps to identify if populations of bacteria have become excessive in the upper GI tract, which may contribute to immune hyper-reactivity, nutritional deficiencies, and digestive problems often seen in children with ASD.

A WORD OF CAUTION:

While many test can be ordered without a physician, it is in your child’s best interest to work with a biomedical clinician who specializes in a biomedical approach. Regarding nutritional supplementation, it’s difficult to design a reasonable, cost effective biomedical protocol without proper observation. Most parents are confused by side effects versus adjustment reactions that goes along with the use of nutraceuticals and lack the needed background to have confidence their child is “a ship sailing in the right direction.” The end result being that unneeded supplements are given in happenstance fashion or the strategy is abandoned altogether and no improvements are realized.

The Biomedical process takes time and commitment and often leads to fundamental improvements, even complete resolution of symptoms can be achieved in some cases.

REMEMBER, AUTISM IS TREATABLE!

If you are currently working with a physician who is open to this form of treatment, I recommend showing him/her this information for further consideration. I am also happy to see you in my office in Ann Arbor or provide phone consultations under certain circumstances. Feel free to contact us.


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