2005, Vol. 19(4)

Page 3 AUTISM RESEARCH REVIEW INTERNATIONAL Vol. 19, No.4, 2005 Guest Editorial: Jaquelyn McCandless, M.D. Clinical use of methyl-B12 in autism Dr. McCandless is a DAN! doctor who is in our afflicted children. We had been finding every three days is the optimal dose, volume, board-certified in psychiatry and neurology, more every day about how sulfhydryl (SH) reac- and frequency.) the grandmother of an autistic girl, and the tive metals such as mercury, lead, arsenic and 4) That the fat in the arm, abdomen, or author of Children with Starving Brains. cadmium appeared to be “triggers” for multiple thigh produces the same results as from the — disease symptoms in ASD. Dr. Deth’s studies fatty part of the buttocks. One of the most important treatment showed how thimerosal alters methionine Lowering the dose until side effects disap- modalities to come out of the strong focus synthesis activity with the potential to disrupt pear is a mistake, because the children with the on biomedical and metabolic aspects in au- normal development via its neurotoxic effect most side effects who stay with the course are tism in recent years is the use of injectable on DNA methylation and gene expression. the ones who make the most recovery. How- methylcobalamin, or methyl-B12. The evi- His studies lent tremendous credence to the ever, side effects must be dealt with. The most dence for transmethylation defects in autism importance of methylation disorders and their common are hyperactivity with or without disorders was already starting to accrue treatment in autism. increased stimming, changes in sleep pat- thanks to talented researchers helping us Prior to my DAN! presentation in Spring terns, and increased mouthing (not pica, to understand the basic science behind our 2005 I queried three of the more popular or eating of non-food item) of objects. clinical observation that certain treatments compounding pharmacies about the number Dr. Neubrander agrees that certain side ef- help these children. of autistic children for whom they were fects are an indication to stop this nutrient, In May 2002 my DAN! colleague providing the methyl-B12 injectables, such as an older child becoming uncontrol- and friend Dr. James Neubrander made and the total was 4500 children being given lable and potentially dangerous to others or the “accidental” discovery that showed injections two or three times per week at that side effects that are so disruptive that a child him methyl-B12’s profound effect on au- time. By now it is being used all over the can no longer function or learn. However, tism. Experimenting with different mem- United States and in many other countries. he encourages parents to continue as long bers of the cobalamin family, Dr. Neu- Methyl-B12 is estimated to be active and as a child can learn, attend to tasks, and stay brander was able to ascertain that the effective to some degree in 80-90% of ASD focused in a controlled situation no matter benefits of methylcobalamin far surpassed the children. Dr. Neubrander has an elegant Par- how much increased activity there may be cyanocobalamin and hydroxycobalmin forms ent Designed Report Form which helps par- at home when the child can just let loose. primarily used for autism prior to 2002. Since ents assess whether their child is a responder, Mouthing objects is a sign that previously every cell in the body expresses the folate/ downloadable for free from his website inactivated peripheral nerves are waking methionine cycle, defects in transmethylation www.drneubrander.com. He advises parents up and this represents a “positive negative” can affect vital biochemical reactions at many to make no changes in their child’s nutrient and a sign that the methyl-B12 is working. places in intermediary metabolism. program when adding the methyl-B12 for a Within two to six months the majority of At the 2003 Fall DAN! conference we period of five weeks to see how responses side effects diminish or disappear completely heard Jill James, Ph.D., discuss the impair- show its effect. Then he adds folinic acid and while the child continues to improve. ment in transulfuration and the resulting any other nutrients that testing has shown the Other caveats: Use a good compound- oxidative stress that occurs in ASD from child needs, as he agrees with the DAN! prini- ing pharmacy that can make the proper dose depletion of glutathione, the major intracel- ciple that these children need a multi-pronged as recommended by Dr. Neubrander. Do lular antioxidant essential for detoxification treatment approach. Though the parent form not pinch the fat for the injection. Inject as in the body. Her studies using certain nutri- looks for many possible responses, the narrow an angle as possible to avoid hitting ents showed a highly significant increase in primary ones for methyl-B12 are executive any muscle; pink urine means you injected plasma methionine, cysteine, and glutathione function, speech, language, socialization, and too deeply. The shots if given correctly are after only three weeks. emotion. However, Dr. Neubrander fears that seldom painful. There is no way if proper Dr. Paul Cutler, another DAN! practitioner, if parents only look for these signs, they may needles (BD 3/10 cc insulin syringe with an 8 had heard Dr. Neubrander’s initial methyl-B12 give up before adequately utilizing this treat- mm, 31-gauge needle, item #328438 only) and DAN! presentation in the fall of 2003, and ment, and he feels that if methyl-B12 is given injection technique are used that the sciatic nerve provided this nutrient to 8 of the 20 children in the right dosage, timing, and form, up to could be injured, even in the smallest baby. in Dr. James’ group. These 8 children contin- 94% of children will show benefit. There is no way to test who will be a respond- ued on this dietary schedule for 3-4 months Besides the myth that methyl-B12 only er to methyl-B12. Blood B12 levels are high- with the added injectable methyl-B12 and works in 30-40% of ASD children, other myths normal in almost all children documented to be results were even more positive, suggesting Dr. Neubrander would like to dispel are: responders. Though there may be a high level that methylation capacity and antioxidant po- 1) That this nutrient works better for in the blood, it is in an oxidized form that tential can be increased with obvious clinical younger children. cannot be reduced and recycled. Genomic benefits in ASD children. The dietary nu- 2) That oral, sublingual, transdermal, or testing is not yet advanced enough to reliably trients Dr. James showed as supportive of intramuscular routes are just as effective as the predict response, as these tests may miss the methionine synthesis were zinc; folinic acid; subcutaneous injections. (At the present time, majority of children who clinically respond betaine (TMG)–later seen as part of an al- a nasal spray has been introduced which has and should be treated. ternate pathway and helpful only for a small become popular with parents who do not want The only way to know if your child is one percentage of children; methyl-B12; and to give their children injections; many of us of the majority of autistic children who will choline. are testing to compare this with the tried and benefit from methyl-B12 is to use it. This This exciting presentation at the DAN! true subcutaneous route, and the jury is still is one of the important DAN! biomedical was followed by that of Richard Deth, Ph.D., out at this time.) interventions along with dietary restriction, who described his research showing the ef- 3) That the concentration of the methyl- nutrients, attaining gut health, detoxification, fects of thimerosal on methionine synthase B12 solution does not matter as long as the and immune enhancing strategies that are im- and emphasized the devastating role this neu- total dose remains the same. (Many tests have proving and even recovering more and more rotoxin can have in the disordered methylation shown that 25mg/ml injections at 64.5mcg/kg autistic children every day now. .

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