Aphthous Ulcers/Canker Sores, Gluten Sensitivity and Unmanageable Behavior
More than just Vitamin D: New Specifics On Vit D3
April 27, 2008Carlat and Amen: Naysayers and the SPECT process have some fallout
May 22, 2008Report from the Front: The Gluten-Celiac Question
Just in the office last week: An "acting out" child, smart, second grade, unable to respond to medications with two previous docs repeatedly adjusting meds to no avail.
She is depressed, suffering with ADD, emotionally up and down, diagnosed Bipolar, trials of atypicals [antipsychotics] and antiepileptics to no avail. – and she complained of canker sores.
This is what her mouth looked like: -and, yes, I did ask the important *number two question* regarding bowel frequency. Her response: "Every two or three days" Canker sores are often related to Gluten Sensitivity.
Since Gluten sensitivity, and it's downstream end point, Celiac, is genetic, I asked her mother the same question. Her response: "Switches from constipation to diarrhea since childhood."
And her Grandmother had joined for the evaluation, so I asked her as well – with the response: "Irritable Bowel Syndrome my whole life."
I ordered the LRA/ELISA ACT [see the description and research here under Immune Dysfunction Testing], and will keep you posted. Initial impression: pervasive genetically related bowel disorders across the family and with our patient – likely related to an immune dysregulation – likely gluten. The GS [Gluten Sensitivity] is likely contributing to the emotional volatility. Psych meds adjusted slightly downward, as she appeared too sedated with Risperdal.
Stay tuned, I will post the results, even if I didn't get this right.
7 Comments
[…] Disease 164. Ciguatera Neurotoxins 165. Adrenal Fatigue 166. Estrogen Dominance [PCOS, etc.] 167. IBS – Constipation, Diarrhea [Transit Time under 18 hr or over 24 hr] 168. Hashimoto’s Autoimmune […]
My son had a test done called genesight assureX. They collected his DNA. Are you familiar with this test? Is this something that would be helpful in understanding why he is responding this way to this med? Also, is there an alternative med, something like Risperdal that would help him? I do believe the Risperidal caused the tics. He had tics prior to meds but they were under control with the Intuniv until we introduced the Risperidal. That’s why I’m wondering if Kapvay might be more beneficial now? He might need a change? At any rate-I’m willing to do the tests that you recommend. I want to know if you are familiar with the genesight testing though?
Melissa,
Thanks again for your interest, and yes am familiar with genetic testing, and Assure RX. Those results would be helpful, I can go over them for you, but encourage you to investigate the other recommendations from my other reply here. Genetic testing can tell us a great deal, but without careful IgG even good genetic testing can leave you in the cold.
cp
Hello Dr. Parker,
I want to thank you for always being so reliable. I have been researching information for years for my son (10 yrs old) who has been diagnosed with a mood disorder-NOS . He appears to be a rapid cycler. He has been on Intuniv for 4 years. It initially helped with his irritability and anger, but he burned through it after two months thus having to increase it time and time again. He is now taking 5mg to help with his tics. We introduced Lamictal 150 mg in pm and 200 mg in am two years ago as a mood stabilizer. However, we are finding much difficulty in finding the right antipsychotic for him. We tried Abilify-with little relief, seroquel-caused tics and high blood pressure and little relief and recently Risperidal. He did WONDERFUL on Risperidal! His moods were regulated, his perseveration stopped, he was happy, focused and compliant. However, after three months he developed worsening facial tics. I want to add that over the summer we decreased the Intuniv because we did not want him on so many meds and were hopeful Lamictal and Risperidal were going to be sufficient for him. He was doing great as we slowly took away the Intuniv-but BOOM! One day-three months into Risperdal- he had tics worse than ever before. I was certain it was because we took away the Intuniv. We slowly added Intuniv back into his regimen and slowly decreased the Risperidal (.5mg 2x’s a day). Of course his irritability, ect came back in full force and we were at a loss. The tics subsided, and we couldn’t help but think what caused what? Did the decrease in Intuniv cause tics to return or was it the Risperidal? He did SO well on Risperidal that we were willing to re-introduce it at a lower dose .25 2x’s a day. So here we are, back at square one. We had to take away Risperdal as it is causing major tics that could lead to tardive dyskenisia which scares the hell out of me.
I’m at a loss. I don’t know what to do for our son. He is very sensitive to meds. I don’t like that he is on 5mg of Intuniv and feel like his tics are not under control with them anymore since Risperdal. I am wondering of Kapvay is a better option for him at this point. Also-what causes Risperidal to cause such horrible side effects? Too much dopamine? Is there another med out there like Risperdal that is a better option that will help with our concerns for him? Am I missing something?
Thank you for your wisdom and time Dr. Parker. I am hopeful you have some insight.
All the Best,
Melissa
Melissa,
I’ll tell you here what I would certainly tell myself if he/you were in my office and I had tried these very well thought out and reasonable approaches: Yes you/we are quite surely missing something. The antipsychotics, even the stimulants and antidepressants can all encourage tic disorder or EPS [extrapyramidal symptoms] which can look like tics.
At this point my best recommendations is always more comprehensive testing. I usually start with two, and if affordable, three: 1. TMA Tissue Mineral Analysis [only 51$ but loaded with information about sympathetic, parasympathetic, adrenal, thyroid dysregulations], 2. IgG Immunoglobulin G [cost 219$ – 97 foods helpful 80% of the time – follow the links in the description. 3. Urinary Neurotransmitters [about 325$, very helpful to asses next steps in balancing neurotransmitters.
We provide review and interpretation of these three helpful tests long distance see Services at the top of this page. An additional suggestion after understanding the underlying issues: Neurofeedback – often very helpful,
These complexity insights: more difficult, but provide better data and more predictability – not absolute predictability.
cp
Thanks,
Have been very successful with Dr Fine’s lab, great results, look forward to his book and would love to interview him here this year.
I like LRA/ELISA because of the multiple [307] antigens tested, and the cost is often somewhat reimbursable, and enterolab clients have trouble with insurance submission.
Easy link here, great company esp simply for wheat and milk:
http://www.enterolab.com
I always suggest doing the best test there, if you are going to do it, – saves money and is simply more comprehensive.
Thanks, I have mentioned them several times in the past.
cp
Are you familiar with Enterolab? They have developed a new test that can isolate anti-gliadin (gluten) IgA antibodies, anti-tissue transglutaminase IgA in stool samples, as well as the genetic tests for alleles that predispose to celiac and gluten sensitivity (they also test for sensitivity for some other common food sensitivities, as well as fecal fat malabsorption). I just had my son and I tested and we are positive for gluten, which didn’t surprise me, and casein, which did. Was very pleased with the lab and their tests.
http://www.enterolab.com
No affliation other than as a satified client.