Tuesday, September 27, 2011

Why B12 & Folinic Acid for Down syndrome?

Studies suggest that an inadequate amount of vitamin B12 may be a risk factor for brain atrophy (shrinking) and possible cognitive impairment. Studies also show that individuals with Down syndrome commonly have low levels of B12 and Folic/Folinic Acid (or folate). In one study, typical seniors who took B12 supplements did a better job of holding cognitive declines at bay than placebo. Since the brain of a person with DS has similar qualities of a brain of an elderly person, we need to pay attention to studies about seniors. Supplementing with B12 and Folinic Acid also helps to normalize metabolism. 

Folic/Folinic Acid (or folate) is particularly important within our population since it is needed for the synthesis of DNA and RNA, which are the building blocks of cells. They also help prevent changes to the DNA that could lead to cancer such as leukemia, which our population is particularly susceptible to. It is also needed in both children and adults to be able to make normal red blood cells and prevent anemia. Specifically, B12 and Folinic Acid are used in a metabolic cycle called the SAM cycle.
 
Please visit Changing Minds Foundation's page on B12 and Down syndrome for more details.

Dr. Oz recently did a great show on B12, not specific to T21, but a nice overview: http://www.doctoroz.com/episode/americas-b12-deficiency 

Types of Folic Acid, Folinic Acid and Folates

Folic acid, actually, should be avoided in the DS population, those with the MTHFR variation (much more common in the DS and autism population and in mothers of children with DS) and older moms who want to have children. See   How to Prevent DS in Your Next Child in 60% of Moms for details as to why folic acid is difficult to process and properly use in our bodies. For this population, folic acid should be avoided in enriched foods such as breads and cereal as well.

Folinic acid also known as Calcium Folinate has been shown to have positive effects on children with DS whether or not they have the MTHFR variation.

Folate is a broad term, it may refer to Calcium Folinate, "naturally occuring folate" which may be folinic acid or could be a form of l-5-methylfolate. If it's not clear on the label, I'd contact the company to make sure of the source. 

Calcium Folinate has been shown to have positive effects on children with DS whether or not they have the MTHFR variation. It's not recommended for the typical population who has the MTHFR variation.

L-5-MTHFR, l-5-methyltetrahydrofolate, 5-methylfolate, etc. is the folate of choice for those with the MTHFR variation. (This is what I take. Jett has both DS and MTHFR so I give him both, just in case. Hopefully I'll eventually learn which is best but I'm covering my bases.)

For more info on types, see Cerebral folate deficiency in Down syndrome 

Dosage

B12
Birth to 2 years: 200-400mcg
Children 2- 12 years old: 400-1000mcg
Teen/Adults: 1000-2000mcg

Folinic Acid
Birth to 2 years: 200 mcg
Children 2- 12 years old: 400-800 mcg
Teen/Adults: 800-2000 mcg
 
For products, see the DS Day to Day Store
 
B12

Different children need different forms of B12. If your child has one or more of the MTHRF mutation, the methylcobalamin is preferable (40% of the typical population has this mutation. Jett does). With some kids, if you give the full dose the first day, it causes hyperactivity. If you see this happening, reduce the dose and slowly increase each day until you reach the full dose. If problems still occur with methylcobalamin, look into the hydoxocobalamin form (see healthy awareness article below).

B12 can be difficult to metabolize so you don't want to give it in food or have them shallow it. Instead, buy sublingual drops or mouth or nose spray or other easy to assimilate form. It also needs to be taken on an empty stomach, 
first thing in the morning works well. If your child still has low levels of B12, you can look into the B12 shots (watch out for extra ingredients in the shot, however).

Methylcobalamin B12 

B12 drops
This is what I use for myself. I just put the drops under my tongue first thing in the morning and try not to swallow, rather allow it to dissolve in my mouth.

B12 spray
This is what I use for Jett first thing in the morning. It sprays a fine film all over his mouth so that it's more likely to be absorbed in his mouth rather than to go down his throat.

More B12 Liquid versions


Designs for health super liquid folate

This one has BOTH good types of folinic/folate AND B12: Methyl Protect by Biogenesis Nutraceuticals

My stepson, with ASD, uses the sublingual lozenge that he sucks on while getting ready for school in the mornings. (I don't necessarily trust that he won't swallow the liquid and spray.)

Hydoxocobalamin B12
(The brand ProHealth has sorbitol in its tablets so I haven't included them in this list.)

sublingual drops $40
Revelation Health Hydroxo-B12
(I've sent them an email for their list of ingredients to see if this product can stay on this list.)

Sublingual spray $60 for 3 month supply
Blue Rock Holistics Hydroxade
(I've sent them an email for their list of ingredients to see if this product can stay on this list.)

Here's a great page that gives more information about the different forms of B12: http://www.healthyawareness.com/articles/about-vitamins-minerals/about-vitamin-b12.aspx

Calcium folinate

Source Naturals MegaFolinic™ -- 800 mcg - 120 Tablets

Kirkman's Folinic Acid

L-5MTHF

Metagenics FolaPro® -- 60 Tablets is the l-5MTHF type of folate.

Neurobiologix Methyl Folate with Activating Co factors
I haven't tried this yet, but it sounds good. It has both
5-methyltetrahydrofolate and folinic acid as well as niacinamide which helps with the symptoms you may get from using a lot of 5-MTHF. I did get the adverse symptoms when I first took l-5-MTHF and this product would have been nice to have then.

Seeking Health's l-5-mthf

Articles

Brain Takes Multiple Hits from Low B12 Levels
By Crystal Phend, Senior Staff Writer, MedPage Today

Published: September 26, 2011
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine.
Excerpts:
Low levels of vitamin B12 may contribute to cognitive problems for older adults in more than one way, according to a cross-sectional study…. 
...Note that previous studies have suggested that poor vitamin B12 status may be a risk factor for brain atrophy and possibly cognitive impairment.
Note that in this study, concentrations of vitamin B12–related markers (methylmalonate, cystathionine, homocysteine) were associated with global cognitive function and with total brain volume…. 
...Although her group's observational study couldn't say whether boosting B12 would prevent or reverse cognitive effects, a prior randomized trial demonstrated that high-dose B complex supplements could slow down brain atrophy in older adults.
In that study, dubbed VITACOG, supplements did a better job of holding cognitive declines at bay than placebo among those with high homocysteine levels.
"So at least from this one clinical trial it appears that [supplementation] may have some benefit," Morris argued.
Her group dug deeper into their Chicago Health and Aging Project (CHAP), measuring vitamin B12-related markers in relation to brain MRI and neuropsychological test results 4.6 years later in 121 residents of Chicago's South Side, ages 65 and older.
After adjustment for age, sex, education, race, and serum creatinine levels to control for renal function problems that could have an impact on homocysteine, all of the B12-related markers affected global cognitive scores….

..."You might be in the normal range, say in the low normal range, of vitamin B12 in your blood but still have evidence of insufficient vitamin B12 based on these biomarkers," she told MedPage Today….
Primary source: NeurologySource reference:Tangney CC, et al "Vitamin B12, cognition, and brain MRI measures: A cross-sectional examination" Neurology 2011; 77: 1276–1282.
Also:

Low Vitamin B12 Tied to Brain Atrophy, Cognitive Impairment


Study

Total blood mercury and serum measles antibodies in US children, NHANES
pubmed/21992842>
Gallagher CM, Smith DM, Meliker JR.
Sci Total Environ. 2011 Dec 1;410-411:65-71. Epub 2011 Oct 10.

Background: Environmental toxins, pathogens and host susceptibility cofactors may interact to contribute to disease. In vitro mercury exposure inhibited antiviral cytokines in human cells; however, little is known about the relationship between mercury and viruses in children. Children are susceptible to mercury toxicity; lower vitamin B-12 and folate levels and higher homocysteine levels may represent susceptibility cofactors.
This study aimed to evaluate associations between total blood mercury (Hg) and measles antibodies in children, and the influence of these susceptibility cofactors.

Design: Cross-sectional data on serum measles antibodies, Hg, homocysteine, methylmalonic acid (MMA, indicator of B-12 deficiency), and folate were obtained from the 2003--2004 NHANES for children aged 6--11 years with measles seropositivity (n=692). We used linear regression to evaluate relationships between measles antibodies and Hg, stratified by sex, MMA ?, folate b, and homocysteine?sample medians, adjusted for demographic, nutritional and environmental cofactors.

Results: Hg (range: 0.10--19.10 ?g/L) was inversely associated with measles antibodies (range: 1.00--28.24 units) in non-stratified analysis (n=692), yet positively associated among the subset of boys with higher MMA and lower folate (n=98). Among this subset with higher homocysteine levels (n=61), correlations were positive across all Hg quartiles relative to Q1 (Hg?0.20 ?g/L): Q2:?=6.60 (3.02, 10.19); Q3:?=8.49 (6.17, 10.81);
Q4 (HgN0.80 ?g/L):?=4.90 (2.12, 7.67) (ptrend=0.077).

Conclusion: Stratification by susceptibility cofactors revealed opposing directionality for correlations between Hg and measles antibodies, with positive effect estimates at lowest exposures only among boys with higher MMA, lower folate and higher homocysteine levels.


Related Posts


Folic Acid Cut Alzheimer's Risk by Half

Alzheimer's Disease & Down syndrome

Jett's Supplement List

Thyroid Issues & DS Go Hand in Hand

Which Multivitamin?

Anemia Causes & Cures

Natural Ways to Help with ADD

Cerebral folate deficiency in Down syndrome





Saturday, September 17, 2011

Reflux: Treating the Problem Not the Symptoms

Both Jett and Oliver had silent reflux and I didn't know it until Jett was 5 years old and Oliver 2 years old! Of course I feel terrible! Many of their symptoms I attributed to other things so they suffered, silently for years. Neither child has slept a full night through EVER -- but, last night -- they both slept through the night for the first time! 

Keeping in mind that acid reflux is because of LOW stomach acid and bacterial overgrowth, the cure is so simple. I just added a tablespoon of apple cider vinegar in their straw cups with lots of coconut water and a bit of stevia so it wasn't so sour. And they SLEPT THROUGH THE NIGHT!! I'll be adding a tablespoon of ACV in their drinks so that they can sip it throughout the day. Most people make sure their child drinks ACV an a hour before every meal. To address the overgrowth, probiotics are important. I list my favorites below. The last step is reducing carbohydrate intake. (See Get rid of GERD forever in 3 steps for details.)

Poor thyroid function is also a common reason for those with DS to have reflux. For Jett, his thyroid was properly treated so I had to go to the next steps. 


How did I miss this?

Jett's clues:
  • Displeasure when placed in a reclining position (One of his reflexes wasn't integrated so when I fixed that, he seemed fine on his back.)
  • Arching neck and back after eating (Most noticeable at restaurants because at home, I didn't think about "how it looks from the outside" as I did in a public.)
  • Poor sleeping habits – typically with frequent waking
  • Arching neck with head back during sleeping (Thought maybe it helped open his airways to breath better at night.)

Oliver's clues:

  • constant crying as a baby (attributed it to his PTSD)
  • irritability (PTSD)
  • frequent hiccups early on (the hospital said it was nothing--I thought maybe stress)
  • frequent waking (PTSD)
  • wanting to eat constantly because that helps soothe/decrease the pain (thought it was his mycoplasma infection or candida overgrowth)
  • Swallowing problems – gagging/choking/coughing (again, PTSD, was able to fix with an MNRI technique)
  • Arching neck and back during or after eating 
  • wanting to nurse all night long/ drink constantly because that helps soothe/decrease the pain (thought it was his PTSD)
  • occasional blood in his stool :(
What damage can reflux do?

In addition to wanting to get rid of the above symptoms, which are uncomfortable or downright painful, reflux can actually do some damage so it needs to be treated right away. Eventually it can cause inflammation and bleeding in the esophagus.  

Nutritional Ways to Treat Reflux  
 
As I mentioned, here's a great step by step guide.

And an excerpt from Weston. A. Price:  
Cultured foods and beverages will support the development of a healthy intestinal flora, and help break the candida cycle; these lactofermented foods will also supply enzymes to support digestion. Often, however, those suffering from acid reflux and related digestive problems find that they need additional help, especially at first. There are many fine probiotic and enzyme supplements that you can take to get you started in your healing journey.
Products Andi likes

Fermented foods are an easy way to add healthy microbes into your child's diet. Jett loves fermented ketchup, beet sauerkraut and raw goat keifer. Oliver like "salad" sauerkraut and coconut milk keifer and coconut or raw sheep's milk yogurt.  These are the enzymes and probiotics I like:
 
Enzymes 

Nutrivene Daily Enzymes
Digest Spectrum
TriEnza Enzymes

Probiotics

Prescript Assist

Nature's Way Primadophilus Reuteri

Dr. Mercola's Complete Probiotics

Get $10 off your first VitaCost vitamin order


Learn More


The following is by guest blogger, Kris Benson, mom to Chase, 9 months old who is doing very well. In fact, he started crawling on hands and knees at 7 months old! But Kris has also had to face many challenges that come with the diagnosis. One of which is reflux. Lucky for us, Kris has taken the time to share what she has learned in two informative blog posts. Oh, and she happens to be a professional writer! Be sure to check out part one: Reflux in Down syndrome.

Reflux is not CAUSED by excess stomach acid

Everyone associates reflux with excess stomach acid. And if that is the cause, then it makes sense that if you take medication to reduce stomach acid, you should reduce reflux. But it really only addresses the pain/discomfort associated with reflux.

A better way to think about this is reflux is (usually) CAUSED by the LES muscle not closing when it should. By reducing the stomach acid, you are not treating the cause of the reflux (failure of LES to close properly), but merely the consequence of reflux (stomach acid/food forced back into the esophagus). The reasoning for the antacid medication is that less stomach acid in esophagus = less pain and less chance of damage.

And that might be fine – if your child’s LES problem resolves quickly and everything starts working great. A short term reduction of stomach acid will most likely prevent the pain and damage caused by the reflux. However, the acid reduction may be causing more problems than it is preventing.

Low stomach acid is a problem too

At 3 months old, my son was diagnosed with “Silent Reflux” and put on Zantac with a TBD end date. When that stopped controlling his pain, they switched him to Prevacid and he has been on that for almost 6 months already with no end in sight. It seems to control his pain well and when it doesn’t, I have found that Mylanta and/or Mylicon treat his immediate pain.

At 9 months, he is only 14 lbs, rarely hungry, doesn’t sleep through the night, has severe constipation, and feedings are a constant struggle. He only eats 4-5 oz at a time, so I have to fortify his breastmilk with powered formula and must continue the night feedings in order to get enough calories into him each day. He’s been diagnosed with failure to thrive twice (for both times the doctors upped his reflux medication and threatened us with a feeding tube, which is major surgery and just a band-aid – it does not treat the cause of the poor feeding at all – and often causes severe feeding aversion and other complications.)

I believe that it is actually the acid reducing medication my son is on that prevents him from being able to properly digest his food.

This is causing a cascade of problems:

· He’s not hungry often enough. If his food is not fully digested in a timely manner, then food stays in his stomach longer, making him feel full longer, so he’s usually just not hungry. That makes he doesn’t eat enough and every feeding becomes a struggle.

· Gas build up causes pain and reflux. This bad digestion also causes gases to build up in his stomach causing extreme bloating, cramping, and pain that is easily mistaken for reflux and can also help cause reflux. He is constantly trying to stretch his torso – throwing his head back and arching his back to try to relieve the pain. This makes feeding painful and increases feeding problems. It also makes him wake up frequently and not want to be placed on his stomach or back. He has started sleeping on his side because of this gas problem.

· Nutrient absorption is reduced. Once the improperly digested food does leave his stomach, nutrient absorption is reduced because they have not been released from the food. This adds to slow growth and insufficient nutrient levels and calorie uptake.

· Increases constipation. Also, the poorly broken down food takes longer to travel through the intestine, causing more water to be absorbed from it making my child “super” constipated. This makes the whole system backed up and he’s uncomfortable, starts “holding it” because it hurts to poop, and can cause even more problems.
All of these compounding problems result in a poorly functioning GI system that could be causing my son’s eating and growth problems.

Treating the Problem Not the Symptoms

I do not believe that he is still suffering from reflux, but rather low stomach acid that is causing symptoms that present like reflux. Even though he’s been on the Prevacid for so long, he still has some symptoms of reflux and I l have to treat occasionally with Mylanta. Interestingly, Mylanta is an antacid and anti-gas medication. I think that I may have been treating gas problems that have presented like reflux.
Over the past month, I have slowly weaned my son off of the Prevacid. He has been free of antacid medication for over a week now. I have added 1 tsp of Miralax 3x a day to treat his severe constipation and keep things going through his system more quickly. (Note: Kris doesn't use Miralax anymore, she uses Vitamin C, if necessary, see Constipation: Causes and Cures ). I have also added an increased dose of Nutrivene digestive enzymes – 1/2 to 3/4 capsule 2-3 times a day – to help him digest his food more completely and more quickly. 
He tends to get gas build up in his stomach extremely easily and quickly. I let him stretch out across my body when feeding and give him Mylicon as necessary. Just today, I was trying to figure out why his diaper seemed to be gigantic on him and realized it was because his bloated budda belly was finally gone!
He is starting to be hungrier more often and is eating more at each meal. I am hoping that this will lead to better sleep at night and more rapid weight gain and make him a happier and healthier boy in general.

Note: Overexpression of GABA, a common problem in people with DS, can cause reflux, both acid and nonacid in the esophagus.  Taking ginkgo to control overexpression of GABA may therefore help with reflux. See Ginkgo: The Hows and Whys for Down Syndrome for details. -Andi

Sources

http://www.webmd.com/heartburn-gerd/guide/complications-untreated-gerd

Related Posts
 


Reflux in Down syndrome

Guest blogger, Kris Benson, is mom to Chase, 9 months old. I first met them at a local (terrible) free annual clinic for children with Down syndrome. I spotted her adorable, bright-eyed one month old baby and immediately thought of Jett.
Chase is doing great, in fact, he started crawling on hands and knees at 7 months old!! But Kris has had to face many challenges that come with the diagnosis. One of which is reflux. Lucky for us, Kris has taken the time to share what she has learned in two informative blog posts. Oh, and did I mention that she's a professional writer? (Score!) Be sure to check out part two: Reflux: Treating the Problem Not the Symptoms.
What is Reflux?

Reflux occurs when the contents of the stomach go back up into the esophagus, which usually results in “spitting up” or more forceful vomiting. There is a ring of muscles, called the Lower Esophageal Sphincter (LES), located at the base of the esophagus and top of stomach that opens and closes to allow food to enter and stay in the stomach. Reflux can happen with this ring of muscles is either not developed enough or too loose to close completely (this is fairly common and explains why infants grow out of reflux) or the muscle opens to release gas after the meal and stomach contents are just ejected into the esophagus as well. Compounding the sphincter problem is that an infant has a shorter esophagus and is lying down more of the time.
Most babies have at least a little reflux within the first 1-3 months. It is more prevalent in preemies and, of course, in babies with DS (probably due to a higher likelihood of reduced tone and/or underdeveloped of the LES) Reflux usually goes away by itself anywhere from 6-12 months. But it can last longer. 
There are several kinds of reflux:
Gastroesophageal Reflux (GER): Most reflux is GER. Ranges from reflux material just entering the bottom of the esophagus to spitting up and projectile vomiting. 
Gastro-Esophageal Reflux Disease (GERD): GER becomes GERD when reflux causes troublesome symptoms and/or complications. Complications are considered to be failure to thrive, slow growth, feeding and/or oral aversions, esophagitis, Barrett’s Esophagus (lining of esophagus is permanently damaged – this is pretty uncommon) even chronic sinusitis, wheezing, pneumonia, and other respiratory problems. 
Extraesophageal Reflux (EER): When reflux reaches up into hypopharyx, nasopharyx, oropharynx, larynx, or trachea.
Laryngopharyngeal Reflux (LPR) (aka Silent Reflux): GER, EER, and/or GERD without the frequent spitting up/vomiting. Fewer symptoms present.
Doctors push for immediate use of antacids because they claim that chronic reflux can lead to contact ulcers, recurrent ear infections, scarring to throat and voice box, or even cancer called adenocarcinoma of the esophagus. This is not advisable.
Potential symptoms
A baby can have several, one, or maybe even none of these symptoms:
· Constant and/or sudden crying or colic-like symptoms
· Displeasure / pain when placed in a reclining position
· Arching neck and back during or after eating
· Irritability
· Wet burps or frequent hiccups
· Poor sleeping habits – typically with frequent waking
· Chronic hoarse voice
· Noisy breathing and possibly apnea
· Refusing food or accepting only a little despite being hungry OR wanting to eat constantly because that helps soothe/decrease the pain
· Food/oral aversions
· Swallowing problems – gagging/choking/coughing
· Repeated swallowing
· Spitting up and/or vomiting
· Post nasal drip
· Blood in stool
Things that might help control reflux
· Add a thickener like gluten free oatmeal to the bottle (if the milk is heavier/thicker, it might not reflux up into the esophagus as easily or as often).
· Feed the baby in a more upright position (ears above mouth).
· Reposition yourself and the baby to let the baby stretch out as much as possible when feeding (see picture) – not bent at the waist crunched in the crook of your arm.
· Feed baby smaller more frequent meals to avoid overstuffing the stomach making it easier for food to reflux out of it.
· Keep child upright (and calm!) for minimum 30 minutes after eating.
· Put child to sleep on left side.
· Put a wedge in the bed so child sleeps on an incline.
I have a wedge in my son’s crib and always start him off on it, but he inevitably slides down it until he is a crumpled ball at the bottom or ends up parallel to it. There is a wedge/sling combo that you can buy (I have seriously considered it, but never bought it) to keep the baby on the wedge. The website even notes that insurance may cover the cost of the item if ordered by a hospital or doctor.
You can also just buy the sling and elevate one end of your mattress: http://www.pollywogbaby.com/item--tucker-sling--CribSling.html
I have often fed my son while he’s lying on a wedge in his crib because he ate more and seemed more comfortable. Now that he’s older I position him so that his head is in the crook of my arm and his body stretches across my torso. It keeps him more upright and more stretched out.
Tests:
Reflux is frequently diagnosed just based on parental reports of symptoms, but there are a few tests to confirm:
Barium Swallow Study (aka Upper GI): They mix a small amount of barium into the child’s food/milk and feed it to him while taking a series of fluoroscopic x-rays over about 15 minutes to track the barium’s path. You can get a false negative during this test because your child has to be having the reflux during the test. My son had this done and they actually tracked the barium going back up the esophagus a little bit, so reflux was confirmed.
pH Monitoring: A thin tube is inserted through the nose into the esophagus and left there for 24 hours. The tube measures the amount of acid that reaches the esophagus and the frequency of the problem. This can help determine if any respiratory problems are triggered by reflux.
Upper Endoscopy: This test can reveal the extent of damage caused by reflux. A flexible tube with lights and a camera is inserted into the child’s mouth into the esophagus, stomach, and duodenum, which is the first part of the small intestine. The doctor can take biopsies at different locations. This is the test to confirm Barrett’s Esophagus.
Reflux Medications:
There are 3 classes of medications: Antacids, Histamine-2 (H2) receptor antagonists, and Proton pump inhibitors (PPI).
Antacids: Maalox and Mylanta. These work great for immediate but short-term relief of symptoms. These neutralize the acid in the stomach rapidly but only last a few hours. These are not advisable for infants and children.
H2 Blockers: Zantac (randitine), Tagamet (cimetidine), Pepcid (famotidine), and Axid (nizatidine). H2 signals the stomach to make acid. Therefore, blocking the H2 receptors in acid producing cells in the stomach blocks the production of stomach acid. This category of drugs works within one hour and only lasts up to 12 hours. Also, most babies develop an insensitivity to this drug anywhere between 2 weeks to a few months and it ceases to control the pain from reflux. 
PPI: Prevacid (lansoprazole), Nexium (esomeprazole), Prilosec (omeprazole), Aciphex (rabeprazole), and Protonix (pantoprazole). These reduce the production of acid in the stomach by acting on the cells in the stomach wall (called proton pumps) that make and release the acid. This is the newest category of reflux medication. It takes about 2 weeks to build up enough in your child’s system to be effective – the doctor will probably recommend staying on an antacid and/or H2 blocker until this kicks in. I believe lansoprazole is the only one that they give to infants, but not positive about that. 
Both the H2 blocker and the PPI medications require a prescription for a special compounded dosage for infants and needs to be refrigerated. There is a lot of debate that these medications become less effective after 2 weeks and they always write the prescription for a month. There is something called “Prevacid Fast Tabs” that you can get and dissolve yourself as needed, but according to my GI doctor, your child has to be over 16 lbs and my son is still nowhere near that.
***The H2 Blockers and PPI medications are very strong medications and you should never stop either cold turkey. It is necessary to wean off of these medications extremely slowly – over a month or more and always under the care of a doctor – because going off of either of there too quickly can cause a massive overproduction of acid which can be extremely painful and potentially damaging.***
Note: Overexpression of GABA, a common problem in people with DS, can cause reflux, both acid and nonacid in the esophagus.  Taking ginkgo to control overexpression of GABA may therefore help with reflux. See Ginkgo: The Hows and Whys for Down Syndrome for details. -Andi 
Nutritional Ways to Treat Reflux
Related Posts

Friday, September 16, 2011

Signs of Nutritional Deficiency

Here's a compilation of symptoms of nutritional distress. Lab tests also help with diagnosing deficiencies, but there are plenty of useful clinical indicators. Eye, hair, nail, mouth and skin symptoms are among the earliest outward warning signs of vitamin and mineral deficiencies.

The following list may help in diagnosing and treating these deficiencies. However, increased metabolic requirements for indicated deficiencies may persist for a long time after the outward symptoms have disappeared. Many listed symptoms may also be caused or aggravated by allergies and problems with the blood sugar and fat metabolism.

If you child has numerous symptoms, you may want to look into a multivitamin. If your child is on a multivitamin, you may want to look into reasons why s/he may not be absorbing the nutrients. If you suspect allergies, look to an NAET practitioner to find and clear the allergies. Perhaps adding enzymes or probiotics would help with digestion. The hyperlinks take you to the blog post or outside source on that particular nutrient or topic as it relates to Down syndrome (if possible).


Hands and nails

Cold hands - check thyroid, magnesium deficiency
Shaking hands - magnesium and vitamin B1 deficiencies (common with low blood sugar issues)
Arthritis - Boron and sulphur (MSM) deficiency

White spots on nails - almost any mineral deficiency but typically zinc
Ridges on nails - poor blood supply, zinc deficiency, vitamin A or a protein deficiency or kidney disorder
Soft or brittle nails - mineral deficiency, especially magnesium
Splitting, peeling or brittle nails- deficiency of vitamin A or Vitamin D3 it could also be due to poor circulation of blood or may be due to some thyroid problem. Sometimes Iron (Fe), calcium or protein deficiencies also have this symptoms.
Bitten nails - general mineral deficiency
Chewing hands - general mineral deficiency, particularly Iron (Fe) or zinc deficiency
Hang nails - Vitamin C, Folinic Acid, proteins
Nails curved upwards- Iron (Fe) or zinc deficiency
Nails curves downwards passing down the fingers- vitamin B12 deficiency. This may be also due to some disorder in the heart and liver or any kind of respiratory disorder.
Dark and spoon shaped nails- vitamin B12 deficiency or it may be due to anemia.
Flat nails- protein or Iron (Fe) deficiency or may be due to vitamin B12 deficiency.
Wide and square nails- hormonal imbalances.
Poor growth in nails- deficiency of zinc.

Numbness or tingling of the fingers- calcium deficiency

Many of the raw materials for nails are the same for bone and connective tissue so nail health reflects bone and connective tissue health.



Arms

Carpal tunnel syndromeVitamin B6 deficiency


Skin

Red cheeks- Dairy, wheat, gluten and other food / supplement sensitivities. Consider adrenal fatigue if flushing while eating. Vitamin C flush can help.
Tickling, itchy skin - (in DS, overexpression of GABA)- Gingko
Follicular hyperkeratosis (rough skin, especially on the heels)- Vitamin A deficiency
Spontaneous hemorrhages - lack of Vitamin C or Vitamin K
Dermatitis- calcium deficiency 
Dry skin- thyroid, iodine deficiency
Dry scaly skin with hair follicles plugged with coiled distorted hairs and a red halo - Vitamin C deficiency
Yellow/reddish brown palms - excessive beta carotene intake. But can be due to eating lots of colored vegetables.
Pimply rough skin at the back of the upper arms (chicken flesh) - essential fatty acid deficiency SCAD
Greasy red scaly skin of face and sides of nose - vitamin B2 deficiency
Seborrhoeic dermatitis around nose and an acne-like forehead rash - Vitamin B6 deficiency
White spots, especially on forearms - Vitamin D3 deficiency
Stretch marks - zinc deficiency. They are common in pregnancy not because the skin is stretched, but because demands for zinc are high.
Lack of sweating-
thyroid, iodine deficiency. Three to four weeks of iodine supplementation may reverse this symptom, allowing your body to sweat normally again.
Pale skin- - Folinic Acid/Folate deficiency, zinc deficiency


Mouth and gums

Pale fissured tongue - Iron (Fe) deficiency
Sore painful fissured tongue - vitamin B3 deficiency
Sore burning tongue and lips and peeling of lips - vitamin B2 deficiency
Swollen tongue with lateral teeth indentations - food intolerance. Also myxoedema - see Hypothyroidism.
Painful sore tongue with a smooth appearance - Folinic Acid
/Folate deficiency
Tender, swollen tongue - Folinic Acid /Folate deficiency
Angular cheilosis (splits in lips) - vitamin B2 deficiency, thrush
Gum disease and pyorrhoea - Co Q 10 deficiency, Folinic Acid
/Folate deficiency.
Bleeding gums - Vitamin C deficiency, K2 deficiency

Crusty, dry skin on corners of mouth- B2 or B3 deficiency
Dry mouth - iodine deficiency in Salivary glands = inability to produce saliva, producing dry mouth
Cancer sores- Folinic Acid/Folate deficiency


Eyes

Bags under eyes - thyroid, allergies or food intolerances
Bitot's spots, foamy patches on conjunctiva - vitamin A
Bloodshot eyes - treatment: boric acid for fungus infection, blue light
Blurred vision - vitamins B2, B6, pantothenic acid B5
Bulging eyes - vitamin E, nicotinamide, iodine, hyperthyroid
Cataracts (lens becomes opaque) - vitamins B2, Vitamin C, E, antioxidants (avoid lactose), chronium deficiency or excess free radicals
Blue eyes and blond hair are often seen in hyperactive male children - zinc , magnesium, Vitamin B6 and essential fatty acids deficiencies
Blue eyes and premature grey hair - vitamin B12 deficiency - a feature of pernicious Anemia
Color-blindness - vitamin A
Conjunctivitis - vitamins A, B2, Vitamin C (B6, zinc)
Cross-eyes - vitamin E, Vitamin C, B1, (allergy testing & look into heavy metals)
Dark spots in front of the eyes - vitamins B6, Vitamin C, zinc (liver problems)
Dim vision (amblyopia) - vitamins B1, B2, Vitamin C, B12 (allergy testing)
Dark rings under eyes - low Iron (Fe)
Dry, hard eyes (xerophthalmia) - vitamin A
Farsightedness (hyperopia) - magnesium, potassium, MSM
Glaucoma - magnesium, Vitamin C (B2, B1,salt)
Hemorrhaging in the back of the eye (retinitis) - vitamin B6, zinc, bioflavonoids (also magnesium, Vitamin C, B2, B12, E, pantothenate)
Infected, ulcerating eyes (keratomalacia) - vitamin A (Vitamin C, B2, B6, zinc, blue light, boric acid)
Itching, burning, watery, sandy eyes - vitamin B2
Macular degeneration - vitamins A, B2, B6, magnesium, zinc, antioxidants, bioflavonoids, esp. lutein & zeaxanthin, Gingko, bilberry, eyebright, MSM, EFA
Near-sightedness (myopia) - chromium, Vitamin C, E, Vitamin D3, calcium (proteins, avoid sugars)
Night blindness (nyctalopia) - Vitamin A, (B2, B6, zinc)
Red blood vessels in the sclera - vitamin B2
Retinal detachment - zinc, vitamins B6, B2, Vitamin C, E, A
Sensitive eyes, fear of strong light (photophobia) - vitamins B2, A, magnesium deficiency
Tics of eyelids - magnesium, vitamins B2, B6, zinc
Poor eye growth and refractive development - (in DS, overexpression of GABA) Gingko 

Poor retina development - Gingko, Vitamin C


Nose

Nasal polyps- salicylate sensitivity, catarrh, sinusitis, history of removal of Ts and As for good clinical reasons, milk intolerance
Blocked nose with red wine- molybdenum deficiency
Greasy red scaly skin of face and sides of nose- vitamin B2 deficiency
Seborrhoeic dermatitis around nose and an acne like forehead rash - Vitamin B6 deficiency
Red nose- check for mycoplasma infection

Ears

Excessive ear wax production- essential fatty acid deficiency

Hair

White hair- magnesium deficiency

Dry scaly skin with hair follicles plugged with coiled distorted hairs and a red halo - Vitamin C deficiency
Blond hair and blue eyes are often seen in hyperactive male children -zinc , magnesium, Vitamin B6 and essential fatty acids deficiencies
Premature grey hair - Folinic Acid/Folate deficiency
Premature grey hair and blue eyes - vitamin B12 deficiency - a feature of pernicious Anemia 
Hair loss - thyroid, Iron (Fe), biotin, zinc and essential fatty acid deficiencies (must measure serum ferritin to check iron stores)
Hair loss, dandruff, eczema, excessive ear wax production, poor wound healing, excessive thirst (especially in hyperactive children), pre-menstrual symptoms of any sort - essential fatty acid deficiency

Neck

Goiter, thyroid swelling - iodine deficiency (check thyroid)


Legs

Tender calf muscles - magnesium or zinc deficiency
Brisk knee reflexes - magnesium deficiency
Restless legs - mineral deficiency, tendency to be acidic - see Acid-Alkali balance, magnesium deficiency
Muscle cramps- calcium or potassium deficiency




Feet

Cold feet- thyroid

Stomach

Stomach upset (in DS, overexpression of GABA)- Gingko, need probiotics
Constipation- thyroid, also see post on constipation 

Constipation, bloating, IBS- Folinic Acid/Folate deficiency
Persistent diarrhea leading to fatigue - zinc deficiency, magnesium and potassium deficiencies
Poor appetite- calcium or zinc deficiency B-12 can help

Persistent Runny stool- zinc deficiency

Central Nervous system (Brain)

Sleepiness, drowsiness, sedative (in DS, overexpression of GABA)- Gingko 
Reduced alertness and lowered IQ- iodine deficiency


Airway Epithelium
 

Excess mucous; decreases smooth muscle tone (in DS, overexpression of GABA)- Gingko


Bladder

Inhibitions of urination with increases in bladder capacity (in DS, overexpression of GABA)- Gingko
Strong smelling urine- look to too much ammonia, butyrate and TMG can help


Liver

Acts as an inhibitory signal for hepatic cell proliferation (in DS, overexpression of GABA)- Gingko
Needs detox- milk thistle


Lungs

Shortness of breath (in DS, overexpression of GABA)- Gingko


Esophagus

Reflux- check thyroid, (in DS, overexpression of GABA)- Gingko
apple cider vinegar works well
Laryngeal motorneurons- decreases laryngeal moror neurons, inhibits Adductor and abductor- (in DS, overexpression of GABA)- Gingko


Muscle

Decreased muscle tone- thyroid, Gingko
Muscle cramps- magnesium or calcium deficiency
Muscle nodules- iodine deficiency
Scar tissue-
zinc or iodine deficiency
Muscle fibrosis- iodine deficiency 
Fibromyalgia- iodine deficiency (among other things)


Sleep
 
increase NREM/ Decrease REM (in DS, overexpression of GABA)- Gingko 
restless sleep- magnesium or zinc deficiency, also look to tryptophan
night terrors-
zinc deficiency
thoughts won't stop- try ashwagandha poor dream recall - Vitamin B6 deficiency, zinc deficiency

Growth
 
Slow growth- thyroid


Behavior
 
Chewing hands/clothes- general mineral deficiency such as magnesium or zinc
Walking in circles- bacopa works to stop this
Anger/violence/defiance/immoral or criminal activity- mycoplasma infection


Issues of nutritional relevance
 
Poor healing - zinc deficiency 
Blood sugar swings with obvious low blood sugar episodes - chronium deficiency
Pre-menstrual syndrome - progesterone, magnesium, zinc and essential fatty acid deficiencies
Glandular fever - inadequate liver detoxification mechanisms
Sensory symptoms - B12, B1, magnesium deficiencies
Mental symptoms - B12 deficiency
Parkinsonism/Multiple sclerosis - glutathione deficiency
Cervical dysplasia - Vitamin B6 and Folinic Acid deficiency, papilloma/wart virus. Heals well with DMSO on the end of a tampax
Arthritis - Boron and sulphur (MSM) deficiency
Measles - Vitamin A deficiency
Many diuretics cause magnesium and potassium deficiencies
Hypertension - magnesium deficiency
Dysphagia - magnesium deficiency
Sensitivity to light - magnesium deficiency
Osteoporosis - magnesium or calcium deficiency
PET - magnesium deficiency
Frequent colds - zinc and Vitamin C deficiencies
Infertility, miscarriages and premature labor - zinc deficiency
Poor sense of smell and taste - zinc deficiency
The contraceptive pill and HRT can cause an increase in copper levels and zinc, magnesium and Vitamin B6 deficiencies
Bowel cancer - selenium deficiency
Mercury amalgams in teeth - selenium and glutathione deficiencies
Cardiomyopathies (Keshan Disease) - selenium deficiency
Heart attacks - vitamin E deficiency (Shute brothers)
Vegans - vitamin B12, zinc and (iron) Fe deficiencies
Gastrectomy - vitamin B12 and HCI (stomach acid) deficiencies
Diabetic peripheral neuropathy - vitamin B12 deficiency
Persistent infections - Vitamin C and zinc deficiencies

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