Many thanks for your question about your client with autism and Myasthenia Gravis. I note you had undertaken an organic acids test. You do not mention what the key health symptoms are currently. You mention you have been working on the gut – was that because the client was demonstrating digestive symptoms? You also mentioned about calming the client down – is your client showing hyperactive behaviour or is very stressed and anxious? I note there are some yeast markers raised. I wonder if have considered running a more comprehensive stool test with parasitology to look at the bowel health in more detail?
If there are a number of microbial imbalances it would be important to focus on this prior to gut lining support.
Some of his symptoms may be more linked to Myasthenia gravis. This is an autoimmune disease that causes muscle weakness that worsens with activity and improves with rest. Normally, the neurotransmitter acetylcholine stimulates muscular contractions. In most patients with myasthenia gravis, the immune system produces antibodies that block the acetylcholine receptor in muscle cells. There are two specific issues to consider – Ten to fifteen percent of people with myasthenia gravis have a thymic tumor, and 50% have an increased number of cells in the thymus. Secondly, infection with the Epstein-Barr virus and inflammation may contribute to the development of myasthenia gravis.
On this basis it may be appropriate to consider viral screen testing. Typical intervention includes suppression of the immune system, usually with corticosteroids and non-steroidal drugs. In addition, acetylcholinesterase inhibitors, plasma exchange and intravenous immunoglobulin therapy are other therapies used for myasthenia gravis. Depending on your client’s symptoms will influence intervention. As muscle fatigue can make eating a difficult task, it is often recommend eating during periods when patients have more strength and eating 5–6 small meals throughout the day.
Being autoimmune you may wish to investigate addition aggravating foods with array 4 or array 10 from Cyrex. I note the client is also gluten free. People who have myasthenia gravis are often diagnosed with overactive or underactive thyroid disease so I agree thyroid testing would be important.
There are also a number of specific supplements that have been shown to be beneficial.
Vitamin D: A pilot study showed supplementation with vitamin D has beneficial effects on autoimmune response and may alleviate fatigue associated with myasthenia gravis.
Askmark H, Haggard L, Nygren I, Punga AR. Vitamin D deficiency in patients with myasthenia gravis and improvement of fatigue after supplementation of vitamin D3: a pilot study. European journal of neurology : the official journal of the European Federation of Neurological Societies. Dec 2012;19(12):1554-1560. https://tinyurl.com/y95ts7k5
Astragalus: Astragalus was found to be as effective as prednisone for reducing symptoms of myasthenia gravis.
Niu GH, Sun X, Zhang CM. [Effect of compound astragalus recipe on lymphocyte subset, immunoglobulin and complements in patients with myasthenia gravia]. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine / Zhongguo Zhong xi yi jie he xue hui, Zhongguo Zhong yi yan jiu yuan zhu ban. Apr 2009;29(4):305-308. https://tinyurl.com/y7h9t3pd
Creatine: An analysis of six randomized controlled trials in muscle diseases reported that patients who supplemented with creatine had a significant improvement in muscle strength versus placebo-treated patients.
Stout JR, Eckerson JM, May E, Coulter C, Bradley-Popovich GE. Effects of resistance exercise and creatine supplementation on myasthenia gravis: a case study. Medicine and science in sports and exercise. Jun 2001;33(6):869-872. https://tinyurl.com/y8k8xktz
Other nutrients with immune-modulating properties, include white peony, green tea, turmeric, etc.
Fish oil: Due to its anti-inflammatory and immune-modulating properties, fish oil may help with the underlying pathology of myasthenia gravis.
Maroon JC, Bost JW, Maroon A. Natural anti-inflammatory agents for pain relief. Surgical neurology international. 2010;1:80. https://tinyurl.com/y9gsums2
With regards to the potential yeast imbalance you could consider anti-microbials such as oregano and garlic. Include coconut oil in the diet daily as well and keep sugar content to a minimum. To modulate any inflammation in the gut you could also consider collagen which can be helpful for joint health and connective tissue as well. Vitamin D and A are also beneficial for gut lining support and immune modulation. Focus on an anti-inflammatory diet with plenty of oily fish, herbs, spices, colourful vegetables and starchy vegetables with gluten free grains if tolerated. I would also consider daily fermented foods and bone broth daily.
You ask specifically about vitamin C levels. While vitamin C may be important I would look more generally with this client and consider a multi. Depending on his diet you may wish to run a more comprehensive vitamin and mineral screen via blood testing through Biolab. A comprehensive stool test would provide you with more information about digestive function and whether this needs support.
You also ask about NT Factor – yes this may be beneficial, but it may be that based on his current signs and symptoms other supplements are more relevant at this stage.
The following supplements are suggested for you to consider in light of your relevant expertise and intimate understanding of the needs of your client or patient. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.
Garlic Plus (BRC) – take 1 with breakfast and dinner
ADP Oregano (BRC) – take 1 with each meal – https://tinyurl.com/hdjg9c5
Saccharomyces boulardii (ARG) – take 1 daily – https://tinyurl.com/z27sdwn
Gut Lining Support
Bio-D-Mulsion (not forte) (BRC) – 1 drop daily based on blood testing – https://tinyurl.com/yaoh6xeo
Arthred Collagen powder (ARG) – take 1tbsp breakfast and dinner – https://tinyurl.com/j2arfe4
Omega 3 fatty acids
Arctic Cod Liver Oil plain (NN) – take 1 tsp daily
NT Factor Phospholipids
NT Factor Energy Lipids Powder (ARG) – take 1 scoop daily – https://tinyurl.com/zhdwojx
Multi Vitammin & Mineral formula
Aqueous Multi-Plus (BRC) – take 1tsp daily – https://tinyurl.com/ztzxw7v
I hope this helps with your client
Registered Nutritional Therapist Helen Perks is collaborating with Clinical Education to bring you the first-ever Functional Medicine book club for Practitioners.
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