Now that I have introduced the concept of the biomedical approach to autism, I want to talk a little bit about my five favorite tests for autistic-spectrum kids. Honestly, these tests would be useful for a huge subset of kids, with anything from eczema to migraines to ADHD to autism. These are the tests I most frequently run on new patients of mine to get good information and help shape their treatment. They are all available from The Great Plains Laboratory, which is a lab that specializes in testing to support the biomedical approach to autism.
In shaping the dietary modifications to help with autism, looking at hidden food sensitivities is key. We know that 80% of kids improve with the gluten and dairy-free diet, but what if a different food was causing an immune reaction, which can lead to inflammation in the gut and also the brain? The IgG food test is a finger stick test – sometimes we do it in the office, sometimes parents opt to do it themselves at home. This test looks at 95 different foods, and grades the reactivity from 0 to 6. It is extremely useful for determining what a child should be eating and should be avoiding.
(2) Gluten/ Casein Peptides Test
I have written an article on the peptides of gluten and casein, and how they can impact brain function. This urine test will actually measure whether those particular peptides (i.e. strings of amino acids in particular sequences) appear in that individual. We can establish from that that the child is not breaking down those peptides adequately, and knowing that those peptides can bind with opioid receptors in the brain and wreak havoc with cognition, emotions and behavior, it reaffirms the need for that particular child to be on the gluten and casein-free diet. Theoretically, if a child is already GFCF the peptide test should show up negative, so it’s not particularly useful for kids already on that diet. I do find it very useful when parents are uncertain about the diet and whether it would help their child, or whether they feel capable of implementing it, as it gives concrete evidence of the need for it and that can be a highly motivating factor.
This is a urine test that measures a host of different metabolites. Most important to me are the first two categories which are yeast and bacterial metabolites. This is where I get to see if Candida overgrowth is a problem, and how much of a problem it is. Stool tests are not always reliable for evaluating Candida issues, I find this urine test is so great because it quantifies the problem – if I see someone with an arabinose level of 40, then I know there’s a slight issue but not terrible; if the arabinose level is 150, we have some work to do. It’s also a great marker for tracking treatment as we see it coming down over time. This test also includes markers for glutathione status and detoxification, vitamins such as B5, B6 and C, fatty acid oxidation and krebs cycle metabolites. There is a condensed version called the Microbial Organic Acid Test that just does the yeast and bacterial markers, and that’s a good one for when there are budget constraints, or when we are retesting to see how anti-fungal treatment is working.
(4) Comprehensive Stool Analysis
I do not run this test on every child, since the Organic Acid Test is so useful at detecting yeast and Clostridia. However, the stool analysis does show a good number of other things. It will show the amount of beneficial flora found, the amount of unbalanced flora, and the amount of pathogenic flora. It can detect intestinal parasites, and also has several markers of inflammation and digestion, that can help indicate a need for digestive enzymes, butyrate, glutamine or other nutrients to help rebalance and heal the gut. I will encourage parents to do this test if their child’s digestive system is completely up the creek, as it can help us get a more complete picture of what is going on.
Hair testing has its pros and cons. I do not love it for heavy metal testing, other than in really young kids. I prefer a provoked urine test. I’ll write a separate post about that this week. The hair analysis can be helpful for finding certain nutrient deficiencies, however. I have seen many kids with really low lithium levels, and in these kids supplementing with nutritional lithium (not pharmaceutical lithium) can give benefits especially with having a calming effect on mood. We can see major imbalances in zinc and copper, and it can give us clues to the heavy metal status. It is important with hair testing to avoid contamination of the sample as much as possible. Luckily not many kids have hair dyes or hair products to worry about!
Great Plains does a great job of all of these tests, I love that they are really focussed on the needs to those on the autism spectrum. They also offer many tests that do not require a blood draw, making the whole testing process less traumatic for everyone! They also send a set of results directly to the parents (or whoever ordered the test) as well as the doctor, which to me reflects their desire to keep parents informed and empowered in their child’s health.
These are the tests I’ve come back to time and time again, and have found them to give so much great information. Without information we don’t know how to help a particular child, each one is unique and has their own set of balances and imbalances. The value in being able to assess the underlying imbalances cannot be understated – it is in correcting these imbalances that I have watched kids go from being diagnosed with autism to losing their diagnosis entirely and being considered neurotypical. Autism is treatable!!