Functional Medicine's Approach To Treating Children

by Mary-louise Condon

Functional Medicine approaches to treating children – assessing the root cause, triggers, mediators and addressing the core imbalances

Let be frank -  There is no single root cause

That’s kind of a broad overview of what I think the most likely contributing factors are to ADHD, mental health, obesity, skin disorders at this point in our understanding. We could think of it as a kind of gut–brain disorder really. That’s turning out to be true for a lot of behavioural and even psychiatric conditions like depression, ADHD, autism spectrum disorder.

The focus Dramatically Increase in Inflammation in Children IMMUNE system presenting with

ADHD  Autism

ALLERGY epidemic  - ASTHMA ,ECZEMA

DIABETES and metabolic syndrome

DEPRESSION / ANXIETY

Children - the big picture

1 Fortify and build up immune system. Asthma, pneumonia , tonsillitis , middle ear infection. So under-reacting or over reacting. Think deficiencies. Fix them early

2 Liver issues detox. Eczema,  psoriasis. Brings food intolerances and leaky gut, sleep issues constipation

3 Immune conditions. Viral support blisters through to EBV then progress to Autoimmune. Example -tonsillitis is the beginning of EBV and strep

It is time to give up on a single explanation and early intervention is critical

Functional medicine looking at the underlying causes - Not just symptoms.

Questions -

  1. Was the child born with deficiencies?
  2. Is the childs body getting what it needs to functional optimally now
  3. Is something getting into the childs body and brain which interferes with optimal function

Nutrient factors may include

  • Vitamins
  • Minerals
  • Essential fatty acids

Environmental factors may include

  • Diet
  • Sleep
  • Exposure
  • Emotional energy

Optimal nutrients are needed for various chemical pathways for optimal mitochondria functioning (energy for all cells) things that affect it are examples

  • Food sensitivities or Intolerances
  • Intestinal Dysbiosis (bacteria/yeast etc)
  • Oxidative Stress
  • Inflammation
  • Poor Mitochondria function
  • Poor absorption of nutrients
  • Excessive Histamine

ROOT Cause

  1. Look at Health TIME line: (use our timeline)
  2. DIET Poor VS optimal diet
  3. GUT dysregulation
  4. Environment
  5. Mineral and Vitamin imbalance, Heavy metals
  6. Hormones dysregulation Exercise/Sleep
  7. Mitochondrial support
  8. Genetic predisposition
  9. Early intervention matters

Comprehensive detailed History, physical exam, lab tests ( urine , stool , bloods , sweat and saliva)

POOR diet : Dietary Recommendations the obvious VS tailor diet

It appears that regardless of whether the diet is Mediterranean, Paleo, or vegetarian/vegan, the key issue is the quality of foods consumed. Any of these dietary approaches can be utilised to provide “a low glycemic load; high micronutrient, phytonutrient and fibre content; higher healthy fat diet” that contains:

  1. More vegetables and low-GI fruits. Eat high on the nutrient-density line. Unlimited: Green vegetables: all raw vegetables, non-starchy cooked vegetables, fresh fruit, beans/legumes.
  2. No packaged processed foods.
  3. Few or no white potatoes because they are high GL and also contain glycoalkaloids that are toxic in a dose-dependent manner. Limit daily: cooked starchy vegetables, whole grains, raw nuts and seeds
  4. No hydrogenated/trans fats.
  5. No refined and fewer grains.
  6. Small amounts of unrefined, minimally processed grains are recommended. If the patient is not wheat-sensitive, then examples would be sprouted grains and wheat berries. If the patient is gluten sensitive, gluten-free steel cut oats, quinoa, black or brown rice, millet, sorghum are recommended.

And, regardless, of which diet you—in consultation with your patient—choose, a wide assortment of biomarkers can be used to verify its efficacy. Key labs that should provide insight within 1 month: insulin sensitivity, hs-CRP, triglycerides, and homocysteine.

 

GUT: ADHD Like Behaviour / Mental Health / Food Intolerances

poor diet : Elimination Diet remove processed food, preservatives , salicylate, food colourings

What to look for : excitability, fidgeting, hyperactivity, impulsivity, irritability, lack of restraint, or Maybe absent-mindedness, difficulty focusing, forgetfulness, problem paying attention, or Mood swings like anger, anxiety, and boredom.

We know that there are some environmental factors that are contributing to this increase in ADHD. Which is interesting because if you look at conventional sources.

There actually is quite a bit of evidence that suggests that diet—at least indirectly—is a major contributing factor, as well as many other environmental factors. This is yet another example of where the conventional medical establishment is out of sync even with its own research, even with peer-reviewed published research over the past 10 to 20 years that has a lot to say about what some of the non-genetic causes of ADHD may be. I think that genetics are likely to play a relatively small role in these conditions, along with every other chronic condition. They certainly play a role in terms of predisposition, and we’re going to talk more about that in a little bit. But genes are not driving this condition, and that should be obvious given the dramatic increase just in the last eight years.

So what are the main causes of brain malfunction well you need to look at the GUT.

Why do we see Biome depletion

The biome depletion hypothesis suggests that alterations of the micro-biome are a consequence of our increasing hygiene and the resulting eradication of helminths, parasites, and other organisms that we co-evolved with over hundreds of thousands—if not millions of years—that help regulate and stabilise our immune system. And the loss of these organisms has been suggested to contribute to not only autoimmune conditions but also conditions like autism spectrum disorder and possibly ADHD because the microbiome works with the other legs of the stool, if you will, of the body to promote stability of the whole body’s ecosystem and immune function. The idea here is that changes to our environment disrupt the microbiome in a way that leads to a lack of immune competence. And that in turn affects the brain and can increase the risk of autoimmune disease, autism spectrum disorder, ADHD, and a whole bunch of other problems. Gut-Brian connection so clearly ADHD we should start with the gut.

Suggested Theory disturbances in the gut microbiota lead to increased production of a short-chain fatty acid called propionic acid. There are different short-chain fatty acids. There’s propionic acid, there’s butyrate, and they have different impacts. Butyrate is anti-inflammatory and immunoregulatory. It plays a role in supporting the immune system. Propionic acid, on the other hand, when it is found in excess, can alter metabolic and immune pathways, gene expression, and synaptic plasticity in a way that’s consistent with the findings of autism spectrum disorder and other brain disorders.

This is a very long list of possible contributing factors, but they would include things like:

Check for In GUT

    • enzyme deficiency
    • microbial imbalance
    • motility issues
    • detoxification abnormalities
    • intestinal permeability: Leaky GUT
    • inflammation
    • Oral health

GI MAP Gut microbiome.  We know that disrupted gut microbiome can cause a lot of adverse effects in the brain, and one of them that I mentioned was an increase in propionic acid. We want to identify potential issues like fungal overgrowth, parasites, bacterial pathogens, and SIBO and treat those. We want to make sure that the patient is consuming plenty of fermented foods and fermentable fibres. Prebiotic are way more important. Seen in Chronic acne and skin disorders, weight gain and adolescent mental health.

Short-chain fatty acids rebuild is a focus Specifically, we want to look at the balance of short-chain fatty acids—whether butyrate levels are low, which they often are in these kids, and propionic acid levels are high. (Which, by the way, are somewhat difficult to measure. we want to do things like all of the things that we talk about to fix the gut, powders and broth, nutrient-dense diet, fermented foods, etc., to shore up the gut flora and increase butyrate production. Specifically, prebiotics are important for promoting butyrate because they feed the beneficial bacteria that produce butyrate, like Bifidobacteria. Probiotics also can play a role, but I would say prebiotics are arguably more important in these cases as a way of increasing butyrate.

Environment:  Allergies and Toxin exposure. Even in the conventional world, they have recognised that toxic exposure is a contributor to adolescent health, and there’s certainly plenty of research to support that, so reducing exposure to toxins in food and in the environment in general and then implementing some safe detox and making sure the detox systems are working properly is very important. Water only, sweat often, aim for two stools a day and a whole food diet. Heavy metals. Any kid who’s dealing with ADHD, mental health and Immune dysregulation I would test them for heavy metals using an Oligoscan or urine test. Particularly mercury, arsenic, lead, and cadmium can be contributors, and unfortunately, high levels in kids are quite common. We would want to identify those and get those out if possible. Avoid Fluoride, filter water etc. EMF and screens: Biotoxins and MOULD

Mineral & Nutrient status. Energise patient first and correct sub optimal nutrients and vitamins. Oligoscan, Bloods, Urinary Organic acid test.  The first thing to look at, of course, would be nutrient status. That means ensuring a nutrient-dense diet, adequate amounts of zinc, copper, choline, B12, B6, iron, folate, vitamin A. Adequate vitamin D status is crucial and sometimes that can be achieved with diet, but in other cases supplementation will be necessary, or sun exposure. This is why a compounding pharmacy is a great start because it individualises doses and strengths. Thoughts?

    1. Methylation
    2. Pyrroles
    3. Anaemia
    4. Medication Nutrient Deficiencies (antipsychotics & antidepressants , Ritalin and alike, Roaccutane, antibiotics , asthma drugs). Study looked at low Vit D and omega three use to treat ADHD well
    5. Obesity brings fatty liver

Good detox and Hormone regulation

Medicines to avoid & Antibiotics. You want to reduce exposure to antibiotics as much as possible. AUS stats 40% of children aged 0-12 have had received at least one course) Panadol reduces the childs glutathione Livers first line defence that no good so avoid it. Medicines used like Ritalin have a place but they have a clear time frame in mind as long term use opens up a whole new set of other neurological disorders like depression

Diet. It may be worth trying, more specifically, above and beyond just a nutrient-dense diet, a GAPS maybe a ketogenic diet OR elimination diet , I think with ADHD you get a disrupted gut microbiota that’s producing these chemicals that affect brain function, and restricting carbohydrate and particularly starch can be very helpful in resetting the gut microbiota and reducing the production of these chemicals. To start on a paleo reset diet that removes all gluten and casein ( dairy ) is a great start.

Hormone dysregulation:

  • HPA axis. Another important factor would be to support the hypothalamic–pituitary–adrenal axis, HPA axis, often kind of referred to as the adrenals.
  1. Sleep Cycle : important with kids as well as adults, which means not getting too much exposure to light at night, not using their iPad in bed, for example, before they fall asleep, keeping the phone out of the room, making sure they get exposure to bright light during the day, not spending too much time indoors, melatonin at night is s great way to improve sleep quality and day time concentration.
  2. Stress management : helping them to find techniques like deep relaxation techniques or others that can help reduce stress. Kids are under a lot of stress, especially in this day and age, especially as they get into their teenage years. We often forget that that’s very important for kids as well as adults. Stress has been the biggest risk factor for mitochondrial dysfunction, which as I mentioned, is an issue in many of these cases. EXERCISE : Karate or marshall arts , trampoline.
  • Metabolic Disease & Obesity 
  • Thyroid Dysfunction: Learning difficulties, weight, Gut Motility
  • Oestrogen dominant
  • Autoimmune Disease
  • Substance abuse

Mitochondrial function= ENERGY We want look at other ways of improving mitochondrial function.

Certainly everything that I’ve mentioned so far is important for mitochondrial function. We also want to test for any infections that might be present and treat those, so that could be any viral infections or reactivated viral infections like Epstein-Barr, or tick-borne illnesses like Lyme, Bartonella or Babesia, if they’ve had exposure. Support Methylation possible but sometimes methyl donor supplementation may be required. In some cases, if addressing all of that, the mitochondrial function is still impaired, we might want to consider supplements like CoQ10, ubiquinol, PQQ, creatinine, L-carnitine, B-vitamins, all of these things, which are collectively referred to as a mitochondrial cocktail.

Genetic testing. Finally, it’s sometimes helpful to do more advanced genetic testing where you look at genes. Genomics, I should say, is really the best way of approaching it. Genetics looks at single genes and their function, but genomics looks at the relationship between all of the genes,

Epigentics effect on stress!!

Cheers,

 

Mary-louise Condon

BPharm ABAAHP

Back to Clean Blog