Showing posts with label hypoxia. Show all posts
Showing posts with label hypoxia. Show all posts

Wednesday, October 19, 2011

Piracetam

Piracetam used to the be "in" drug for children with T21. And today, a lot of parents give their child Piracetam and believe that it helps him or her. Although I know some who saw no difference. Here is a brief overview on its purported benefits and then an article that talks about its use in the DS community as not properly supported through research. (I'm not one to wait for double blind studies on the actual DS population, but it would be nice to have.)  I've also included my notes as Jett has been taking it for a month and has shown huge improvement! Not knowing that I'd see such a huge improvement, I started Jett on Neuroprotek at around the same time, so I'm sorting through which benefits to attribute to P & which to attribute to NP.

Benefits

Piracetam is said to promote the flow of information (or messages) between the right and left hemisphere of the brain. Dean and Morgenthaler claim that it can enhance memory, language and learning abilities. It may also prevent memory loss and learning difficulties caused by trauma. By its action on the brain membranes it is also thought to prevent seizures. Finally it may be used for the treatment of myoclonus (uncontrolled muscle twitching or jerking) and for the treatment of Dyslexia.

Piracetam, a derivative of the neurotransmitter GABA, is a racetam a category of cognitive enhancers that includes aniracetam, pramiracetam, oxiracetam, and others. Cognitive enhancers are also called noötropics. Piracetams effects on both nerve cells and on blood may be explained by the fact that it alters the fluidity of membranes of cells. Such a change in fluidity would affect the function of various proteins that float in these membranes proteins such as ion channels in nerve cell membranes, and metabolic enzymes in mitochondrial membranes. Cell membrane fluidity would also affect the ability of blood cells to pass through small veins and capillaries.

For more information, please go to http://www.riverbendds.org/index.htm, click the Medical Series folder on the left hand side, then Supplements & Drugs, and then Piracetam.

Research:
- Epilepsy: Koskiniemi M, Van Vleymen B, Hakamies L, Lamusuo S, Taalas J. Piracetam relieves symptoms in progressive myoclonus epilepsy: a multicentre, randomised, double blind, crossover study comparing the efficacy and safety of three dosages of oral piracetam with placebo. J Neurol Neurosurg Psychiatry 1998 Mar;64(3):344-348.

- Aphasia: Kessler J, Thiel A, Karbe H, Heiss WD. Piracetam improves activated blood flow and facilitates rehabilitation of poststroke aphasic patients. Stroke 2000 Sep;31(9):2112-2116

- Dyslexia: - Wilsher CR, Bennett D, Chase CH et al. Piracetam and dyslexia: effects on reading tests. J Clin Psychopharmacol 1987 Aug;7(4):230-237. "Piracetam-treated children showed significant improvements in reading ability (Gray Oral Reading Test) and reading comprehension (Gilmore Oral Reading Test)."

Source
http://www.henryspink.org/smart_drugs.htm

Piracetam improves mitochondrial dysfunction following oxidative stress. 
British Journal of Pharmacology.
147(2):199-208, ... 2006. Peer-Reviewed Professional Journals
· Keil, U., et al.
Department of Pharmacology, University of Frankfurt, Frankfurt, Germany.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1615864/
Mitochondrial dysfunction including decrease of mitochondrial membrane potential and reduced ATP production represents a common final pathway of many conditions associated with oxidative stress, for example, hypoxia, hypoglycemia, and aging. Since the cognition-improving effects of the standard nootropic piracetam are usually more pronounced under such pathological conditions and young healthy animals usually benefit little by piracetam, the effect of piracetam on mitochondrial dysfunction following oxidative stress was investigated using PC12 cellsand dissociated brain cells of animals treated with piracetam.

Piracetam treatment at concentrations between 100 and 1000 muM improved mitochondrial membrane potential and ATP production of PC12 cells following oxidative stress induced by sodium nitroprusside (SNP) and serum deprivation. Under conditions of mild serum deprivation, piracetam (500 muM) induced a nearly complete recovery of mitochondrial membrane potential and ATP levels. Piracetam also reduced caspase 9 activity after SNP treatment. Piracetam treatment (100-500 mg kg(-1) daily) of mice was also associated with improved mitochondrial function in dissociated brain cells. Significant improvement was mainly seen in aged animals and only less in young animals. Moreover, the same treatment reduced antioxidant enzyme activities (superoxide dismutase, glutathione peroxidase, and glutathione reductase) in aged mouse brain only, which are elevated as an adaptive response to the increased oxidative stress with aging. In conclusion, therapeutically relevant in vitro and in vivo concentrations of piracetam are able to improve mitochondrial dysfunction associated with oxidative stress and/or aging. Mitochondrial stabilization and protection might be an important mechanism to explain many of piracetam's beneficial effects in elderly patients.
 

Some History of Piracetam and Down syndrome

Excerpt from a summary by Len Leshin, MD, FAAP
Full text:  http://www.ds-health.com/piracet.htm

Note: I'm not sure why, when Piracetam was tested, it didn't show impressive results. I do know that the parents in the study continued giving their child P. Why would they continue to pay for it and give it if they didn't see results? -Andi

Piracetam became a controversial topic in the mid-1990s when a parent group began advocating its use for Down syndrome. There was notable publicity due to two ABC news shows about it and internet advocacy on the part of the parent group. However, the company licensing it, UCB Pharma in Belgium, has discouraged its use in children with Down syndrome. In July 1998, UCB Pharma specifically denied all rumors that it will fund or has plans to fund any study with children with Down syndrome in the United States or elsewhere. Many advocates of its use in Down syndrome claim that UCB Pharma's reluctance stems more from economic motives than scientific; however, UCB Pharma has obtained "orphan drug" status for piracetam in the US, and is currently planning a controlled trial of piracetam and myoclonus in the US. If given approval by the FDA for myoclonus, UCB Pharma would have several years of exclusivity of the drug in the US.

I have listed below the studies that involve children with Down syndrome. I have a separate page for other research on piracetam.

Lobaugh NJ et al. Piracetam does not enhance cognitive abilities in moderate to high-functioning 7 to 13 year-old children with Down syndrome. Presented at the PAS/SPR meeting in San Francisco May 3, 1999; published in Archives of Ped and Adol Med, April 2001, 155(4):442-448.

"Piracetam, a drug reported to enhance cognitive performance in many neurobehavioural conditions, has become popular in the treatment of children with Down Syndrome (DS). However, reports of its efficacy in DS have been anecdotal, not from evidence-based studies. Some caregivers have noted no effect of piracetam, while others claim substantial improvement in cognitive functioning. To address the need for objective analysis, we conducted a double-blind placebo-controlled crossover study assessing the cognitive and behavioral effects of piracetam in children with DS. Patients and Study Design. Children with DS (n = 25, 13 males, 6.5 - 13 yrs) and their parents participated. The first phase of the study was a baseline cognitive assessment. Children were then randomly assigned to one of two four-month treatment arms: Piracetam. Placebo or Placebo. Piracetam. Children were retested at the end of the two treatment phases. Children received 80-100 mg/kg piracetam per day in capsules. Placebo was administered in the same manner. Test Battery. The test battery included 16 tasks assessing attention, learning, memory, verbal fluency, perceptual and spatial abilities, processing speed, fine motor skills, and executive function. Both standardized and experimental tasks were included. Secondary outcome measures were questionnaires completed by parents and teachers at each of the three phases. Results. Eighteen children (7 - 13 yrs) completed the study, 5 withdrew, and 2 could not complete the battery at baseline testing. The mean mental age for the final sample was 4.2 ± .7 years (Stanford Binet). The 16 tasks yielded 75 measures and the parent and teacher questionnaires had 80 and 24 items, respectively. Piracetam did not show significant effects over placebo on any outcome measure. All significant interactions (p's < 0.05) with drug order or the covariate were examined further to ensure drug effects were not being masked. That analysis did not alter the results. Piracetam administration was associated with CNS stimulatory effects: aggressiveness (n=4), agitation (n =3), sexual arousal, (including masturbation in public, n=2), irritability (n=1), and poor sleep (n=1). Conclusion. Piracetam has received a great deal of attention in the popular press purporting its efficacy in improving cognitive function in children with Down Syndrome. In this study, we were unable to substantiate these claims, even at doses associated with adverse effects. Neither cognitive nor behavioural measures demonstrated improvement under piracetam. Due to the serious adverse effects, it is unlikely that larger doses can be tolerated."
©1999 Pediatric Academic Societies

Fialho J Dromia and Piracetam: a useful association in the treatment of Down syndrome. Tempo Medico 30:944, 1977. (The original was published in Spanish; an English version was reprinted in a book whose specifics are unknown to me.) 26 children with DS between 3 months and 12 years were given Dromia (mixture of pyriglutine and 5-hydroxytryptophan) alone, and then a combination of Dromia and Piracetam. The children were then evaluated based on their muscle tone, motor development, mental development, speech, affective-social development, scholastic achievement and EEG trace. The author concludes that the combination of the two drugs caused an improvement in all aspects, but especially speech. There were no side effects noted. (Unfortunately, this is a terrible study. There were no controlled subjects, the investigator does not tell how he evaluated the above categories and does not say if the subjects, parents, or investigators were "blinded" as to which children were getting one or both drugs.)

An unpublished feasibility study was conducted in 1999 at the Kennedy Kriger Institute in Baltimore under the guidance of Dr. George Capone. Five school-aged children with DS were given piracetam and compared to five children with DS not on piracetam. The piracetam was given at 100 mg/kg body weight per day. After six months, the children were assessed for auditory verbal memory, auditory non-verbal memory, visual memory, and spatial working memory. There were no statistically significant differences in the two groups. It should be noted that this was a study that was set up more to prove to the NIH that the study was doable and deserving to be funded on a large-scale basis rather than to prove whether to not piracetam had any measurable effects. A lack of funds kept this study from being carried out to a point where the research could be published.

In 2002, Dr. Capone and his associates published their trial of piracetam on trisomy mice: The effects of piracetam on cognitive performance in a mouse model of Down's syndrome Physiology & Behavior 77: 403-409, 2002.

"Piracetam is a nootropic agent that has been shown to improve cognitive performance in a number of animal model systems. Piracetam is reported to be used widely as a means of improving cognitive function in children with Down's syndrome (DS). In order to provide a preclinical assessment of the potential efficacy of piracetam, we examined the effects of a dose range of piracetam in the Ts65Dn mouse model of DS. Ts65Dn mice are trisomic for a region of mouse chromosome 16 with homology to human chromosome 21. Daily piracetam treatment at doses of 0, 75, 150, and 300 mg/kg ip was initiated in 6-week-old male Ts65Dn and euploid control mice. Following 4 weeks of treatment, mice were tested in the visible and hidden-platform components of the Morris water maze and were placed overnight in computerized activity chambers to assess effects on overall activity. Piracetam treatment was continued through the 4 weeks of testing. In control mice, 75 and 150 mg/kg/day piracetam improved performance in both the visible- and hidden-platform tasks. Although low doses of piracetam reduced search time in the visible-platform component in Ts65Dn mice, all piracetam doses prevented trial-related improvements in performance in Ts65Dn mice. The 300-mg/kg/day-piracetam dose was associated with a reversal of the nocturnal spontaneous hyperactivity in Ts65Dn. These data do not provide support for piracetam treatment for individuals with DS."

Advocates of piracetam have argued that choline must also be supplemented with piracetam to get any effect, thus explaining the results of the Toronto and Johns Hopkins studies. The main basis for this belief are the following studies:

Bartus RT et al. Profound effects of combining choline and piracetam on memory enhancement and cholinergic function in aged rats. Neurobiol Aging Summer;2(2):105-11, 1981. Rats given both choline and piracetam did better on a memory test than on choline or piracetam alone.
Platel A et al. Habituation of exploratory activity in mice: effects of combinations of piracetam and choline on memory processes. Pharmacol Biochem Behav 21(2):209-12, 1984. Mice did better on memory of their environment with the combination of choline and piracetam than on either separately.
Mosharrof AH & Petkov VD. Effects of citicholine and of the combination citicholine + piracetam on the memory. Acta Physiol Pharmacol Bulg 16(1):25-31, 1990. Mice did better with memory retention with the combination of citicholine and piracetam than the compounds separately.
Friedman E et al. Clincal Response to choline plus piracetam in senile dementia: relation to red-cell choline levels. New Eng J Med 1981 Jun 11; 304(24): 1490-1. This is actually a "letter" rather than a full paper, and consisted giving 10 patients with presenile dementia piracetam and choline for 7 days in a non-controlled study. 3 of the 10 had "marked improvement" cognitively, but no description of the cognitive tests or whether the testing was blinded is mentioned. The 3 who responded had higher choline red blood cell levels than the 7 who didn't respond.

However, other studies show a lack of usefulness of the combination:

Ennaceur A & Delacour J. Effect of combined or separate administration of piracetam and choline on learning and memory in the rat. Psychopharmacology 92(1):58-67, 1987. Rats given choline alone did better than rats given piracetam alone on memory test, and rats given piracetam and choline together did worse than the other groups.
Growdon JH et al. Piracetam combined with lecithin in the treatment of Alzheimer's disease. Neurobiol of Aging 7:269-276, 1986. Piracetam was administered alone or with lecithin (phosphatidylcholine) in a double-blinded test. No effect was seen, with or without lecithin, on cognition or memory test scores.
Corona GL et al. Clinical and biochemical responses to therapy in Alzheimer's disease and multi-infarct dementia. Eur. Arch. Psychiatr. Neurol. Sci. 239:79-86, 1989. Patients with either AD or multi-infarct dementia were given either piracetam or piracetam with choline. This was not paired with placebos. Despite biochemical changes, there was no change in memory performance.

It should be noted that the maker of piracetam, UCB Pharma, has never incorporated choline as part of any of its research on humans with Alzheimer's disease or myoclonus.

Products

NooRacetam (Piracetam) 800mg $17.95 plus $6 shipping


Dosage

75 mg per kilo per day is the recommended dosage.  Is recommended to take with choline. (Body Bio PC is the brand of choice.) May cause hyperactivity so you may need to avoid at night. Piracetam tastes bitter so if you have to break open the capsules, you'll need to be a little creative when giving it. Jett takes it fine with a chunk of banana and a little bit of honey. If I add fermented ketchup to a mashed vegetable such as acorn squash or avocado, it works as well.

My notes on Jett's experience with Piracetam

Day one
Age: 20 months  
Dosage: Jett weighs 19.8 lbs which is 8.98 kilos. So he'd get 673 mg per day. One capsule is 800 mg. So I will give him 1/2 a capsule (400) in the morning and 6 hours later, give him a third of a capsule (266) and see how it goes. But for day one, I'm giving him 1/3 of a capsule in the am and 1/3 in the afternoon.
He's not on Prozac at the moment and we ran out of LC and EGCG and have a full bottle of Piracetam that I haven't tried so... I'll let you know what I see...
I take 840 mg of choline a day and Jett still breastfeeds, so I am assuming that he is getting some choline 3 times a day. (I did look this up and a study supports the fact that breastfeeding woman who supplement with choline have higher choline content in their breast milk.)
Cognition test: I wrote 6 words on the magnadoodle, one at a time and showed him what they were in the room:  bean bag, chair, cow (a picture), shoe laces, stool and umbrella. (Bean bag, shoe laces and umbrella are brand new words. The others he has seen this week.) Sometimes he wanted to write them as well after I wrote them (I mean that he made me hold his hand and he wrote them with me). Then I immediately wrote each one again and asked him where they were. He got them all right. I called my husband and stepdaughter into the room and although he was distracted and "talking" to them, he got them all right again. He's taking a nap now, but I'll try again when he wakes up to see if he remembers.
He did remember when he woke up and remembered all but one (bean bag) the next night. This test only proves that Piracetam doesn't seem to hurt his cognition. I can't say he did this because of it.
I'm excited because he's not on Prozac, LC or EGCG. Just ginkgo and vitamins (and Piracetam). Hopefully we can afford LC and EGCG again soon. He's not been hyper at all and he actually crawled around the house and played a lot on his own (w/out being irritable--being happily independent). I did read a lot of books to him and did some Little Reader and magnadoodle, as I mentioned. When I do a lot of that, he seems to feel happier and more independent. If I don't spend a lot of time with "lessons" he gets really irritable and whines for me to read to him.
Obviously, it's caused no sleep issues so far because he's taking a nap now.

Day two
I noticed by day two on Piracetam that it doesn't support the eyes as well as: LC, Prozac & EGCG since his eyes are crossing very badly. (Shows that the communication between the brain and eyes are not doing well.) We've ordered LC (yeah!!!) and should expect it in 3-5 days. But, his language is coming along nicely. Usually, off LC, he either stops talking or really regresses language wise, but yesterday he said a bunch of words, actually repeated after me. (Unfortunately one was "shut up" (I did say PLEASE, first...) which of course he repeated like twenty times with enthusiasm. And then it was the first thing he said this morning. I said, "Good morning, Jett." and he smiled and said, "Shut up!" Hopefully people will think it's cute... like Ann Hathaway in Princess Diaries...
I did also add Neuroprotek which he took before w/no side effects.
I showed Jett colors, but he didn't get them all right. I'll try again another day. Maybe the concept is more difficult than words?

Day three
I'm upping the dose to 1/2 in morning and 1/3 in the afternoon. Ooops... Jett was fed the last dose of Piracetam at 7pm! So, he didn't sleep very well at all. He didn't fall asleep until 2 am. Once he fell asleep, he was fine though. So, it looks like it takes about 7 hours to get out of his system... We won't make that mistake again!

Day four and five
He turned 21 months old on Nov. 25, 2011. These past two days he has been playing independently for very long periods of time! And instead of sitting and going "ehhhhhh" when he wants me to read a book, he takes the book, crawls over to me and hands it to me to read. He also has been more interested in his bath time and has been taking an hour long bath and not wanting to get out. For the first time. (He's always enjoyed bath time, he's just more engaged and for a longer period of time.) So, it appears to me that he's more focused with a longer attention span on the Piracetam and NeuroProtek (NP has a lot of the same things as ginkgo, EGCG and curcumin, so I think it's more the Piracetam). Any one else notice that on Piracetam?

Day six
Saturday, Nov. 26, 2011 I had to work (2-4 a month) and there was a "miscommunication" so Jett got 1/2 a capsule of Piracetam at 10am and then another 1/2 at 1pm. (I fixed the small bowls of supps, but my husband got the times wrong--I didn't write it down for him this time.) He seemed fine though and Kenny said that he didn't "give him any trouble" which means that Jett did a lot of independent play, was in a good mood, ate well and took almost a 2-hour nap. :D

Day seven
Sunday, Nov. 27, 2011 My mother came over and had Jett outside for his 30 minutes of sun. While outside, Jett stood up and walked behind a rolling toy car! She said that he took three steps! I took him outside an hour later and he took five steps! So I got my husband and stepson to see and take a video. I'll get my husband to upload it soon and will provide a link here. I'm excited!! I would love for him to walk soon! (As part of the ND program, I haven't initiated much walking because crawling is so important for brain development. I don't know if my mother "put him up to this" or if he thought of trying to walk behind the toy on his own... I do wonder how long he's been able to do this. I don't really think I'm supposed to encourage him to walk like this...) He has taken a couple of steps forward on his own just in this week, so maybe it was his idea? The average age of a child w/DS who can walk 10 feet with a push toy is 22 months and 11 months for a typical child. Jett did walk about 5 feet today. I'm not sure how much Kenny recorded. I don't think it would hurt for me to try this again tomorrow.

Day eight
I played Little Math for the first time and he LOVED. He shouted with protest when it was over. They counted to five really fast and he shouted out "six"! So funny because no one taught him any of that! (There is a Readeez song that counts to 12 very fast so he probably learned it that way.) He did it twice more when my husband played it later on in the day, so it wasn't my imagination.

Day 11/Dec. 1:
Jett's finally back on curcumin. Yeah! He said five recognizable words in front of the speech therapist today. I figure that's pretty good for an hour, right? (Horse was one.)  His walking is progressing as well. And he learned to read the names of some of his instruments: drum, tambourine, morocco and xylophone as well as shake and beat. He was very excited to learn these & would play each one when I wrote the name. He also loves to dance, bounce and shake. He wouldn't vocalize for "sing" but he did sway his arms from side to side and looked toward the computer where I play pandora.com (music).
When I wrote "together" he laced his hands together. I only showed him that word once a couple of days ago. But it's one of his favorite words, so it makes sense that he learned it immediately. When I wrote "chair" he pointed to the chair closest to him then he also pointed to the chair that was on the other side of him. These chairs look very different so he does understand what a chair is and not just the chair I showed him first. He remembered all the old words except bean bag--again! It's not a word we use a lot so maybe that's why? We worked on shapes yesterday and colors the day before but he didn't seem to either get them or be too interested so I didn't check today to see if he magically got them. I know that he knows star, though because he's said it a couple of times and will point to one.
Some meaningful words he said today were: Jett, yes, eyes, "S", "Ah" (for A-apple), "kuh" for book (upon request), "zzz" for buzz, shapes... that's all I can think of off the top of my head. He jibber jabbers constantly so I forget to remember all the stuff he says. His favorite book today is Mr. Brown Can Moo, Can You? He was having fun tonight pretending to read it out loud. He made a lot of noises but they didn't exactly match the word. I'll have to teach him those words tomorrow--he'll love that!
Oh, we did Little Reader in Chinese and he freaked out. He hated it! He rolled off my lap onto the floor he was so disturbed by it. I think it's because it was all too foreign to him and he LOVES reading English so much that it was not a pleasant experience. I'll have to try again later--once he's got a good grasp of the English language. (Learning another language is really good for the brain.)
I gave him the Piracetam a little after 5 so he fell asleep about an hour late (midnight). I have to remember that he won't fall asleep until 7 hours after the last dose -- so no later than 4pm.

Dec. 4
Discovered for sure that he knows and will verbally say ten letters of the alphabet. He says the sound, not the letter name. When I read the alphabet to him, I say "wuh" instead of "double-u", etc. He knows A, C, E, O, P, S, T, W, X and Z. (I found out the next day that he knew M as well.)
Yesterday, he spontaneously gave me a hug for the first time and my mother said he hugged her too. This afternoon, when he was supposed to be napping, he spontaneously gave me like 5 kisses on my nose. He never initiated kisses and hugs before. But he recently started to give me kisses from afar by making the smack sound.
Yesterday I also noticed that he put a lid on a container which I don't think he's done before.

Dec. 11
Okay, so now Jett can put in a puzzle piece for the first time. (It was the Melissa & Doug farm sound puzzle of the sheep.) And he wanted to put the shapes into the shape sorter, but was having difficulty so he had me come over. I set it up so he could succeed better (less choice of shapes, at the right side where the correct shape hole is, etc.) and he was able to do it better and better! He put them in himself! (He's not great at it yet, but he understood the concept and was interested and tried and did it!)
Yesterday, he spontaneously said, "A B C" while playing in the bathtub and my husband parroted him and then Jett said, "D!" He's started singing (ba, ba, ba) and has been singing with the Readeez version of the alphabet song. (I mean that he tries to, he can't actually sing the alphabet song.) I can tell that his brain is more organized... He went around and gathered all the parts of his floatable xylophone where each musical bar is on its own colored puzzle piece. So, he's picking through his toys and brings me a pile of his xylophone and says "together" (his version of the word) so that I will put it together for him! (Then he immediately ripped them apart so I'd do it again.)
He did something similar last night, he sorted out the red puzzle pieces from only one puzzle and just brought those to me.
I was unhanging socks that were dry and I dropped each one on his head as if it were raining socks and then I rolled the matching ones together into "sock balls." So he gathered the sock balls and we played catch for a while and then he gathered them and carried them all through his crawl tube and went back and got the ones he dropped, etc. And played with them for a good while, very creatively!
All this type of play is NEW NEW NEW! I don't know if it's the Piracetam or the NAET or what, but I'm loving this burst of amazing cognitive progress!
And his mood... he is smiling much more and seems to be an all around happier kid! His eyes are doing great as well. Very little crossing. Yes, we are still doing the neurodevelopmental exercises for his eyes. I'll have to ask around and see what other moms have seen in their child on Piracetam.
He also has been reading--out loud--words that I haven't specifically taught him, from his books. Like in the Hide and Squeak book, he read: Pup and the Mr. Brown book, he read: Hoo, Buzz, Pop, Klopp, Boom, and Grum... In a pig book, he read splash and like three other words. And in other books, I see him react to the words before I say them. Like a Barney books says pat your head and he's already doing it before I read it out loud.

Dec. 17
We have contact! Eye contact, that is! I didn't realize what little eye contact Jett had before, but today, he really held my gaze. Because of this, he parrots more--both verbally and "gesticularly." I'm rather animated with my hand movements when I talk and I see him copying me. Too funny. I always thought he was engaged, but the change has been amazing.
Also new--I had noticed that when I pointed, Jett looked at my finger or the end of my finger and not at the object to which I was pointing. This is significant because studies show that children who can follow where you point learn better. Jett just started looking at the object! I try this everyday so I can tell you that this is the first time he's done it!

Dec. 18
I've readded TriEnza enzymes to help w/Jett's bowel movements. Because of the uncomfortable nature of getting his stomach in order, he was very clingy and irritable all day and night. He had 2 BMs in one day--1 BM a week is "normal" for him, so this will take some time for him to adjust.
As I learn more about Neuroprotek, I'm thinking that I need to attribute all the elimination of Jett's borderline Autistic tendencies on it rather than the Piracetam. I don't know how much of the P to attribute the speech and cognitive advances, but I am quite pleased so far!

March 24
Jett's been off P and only on NP for months and he's still doing great! I'm going to reintroduce P along with BodyBio PC soon and see if I observe a difference. He's 24 months and has been putting together the Melissa and Doug stacking puzzle, the M & D wooden puzzles with the little red knobs, reading words out loud like "helicopter, enterprise, happiness" and has been repeating two-three words at a time instead of just one. He's also been playing appropriately with cars and has been showing me things (new behavior). He recently starting following my point to far away objects instead of just looking at the end of my finger. And now he points himself. Last week he pointed excitedly to a flock of birds flying overhead and said, "Birds! Birds!" He didn't point to anything except for things up close until about 3 weeks ago. (This is another autistic tendency that is going away.) And just today, he called out to a boy on a bicycle as he rode by. So, he's wanting to be more social. And the past two weeks he's been memorizing songs including "Itsy Bitsy Spider" and the ABC song. He hasn't gotten it perfect yet, but he's having fun with it. And he's been playing with stuffed animals and dolls--brand new behavior as well!

Related Posts

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Thursday, March 31, 2011

Anemia Causes & Cures

Iron is very important because it is responsible for transporting oxygen to muscles and organs, including your brain. But don't supplement your child with Down syndrome iron unless your child's blood tests show low iron. (And even then, I'd give these strategies a good try before adding an iron supplement.)

Iron and Down Syndrome (from Down Syndrome: What You CAN Do edited by Kim & Qadoshyah Fish)

Iron is a “double-edged” sword. It is very important for life and growth, but it can also cause serious problems in children with DS. Do not give your child additional iron unless s/he has proven iron deficiency anemia. Iron increases the Fenton reaction and thus lipid peroxidation. It also aids in oxidative stress and damage. Oxidative stress is already increased in DS. [More detailed explanation follows in the article below by Ginger Houston-Ludlam.] Additionally, excess iron is often stored in the brain and may contribute to long-term CNS (central nervous system) dysfunction.
So, supplementing with iron just in case is not advised. See Biochemistry 101: Iron by Ginger Houston-Ludlam for more details on iron problems in the DS population. 

What about eating food high in iron? No, with our kid's immature digestive system, that does not guarantee adequate iron absorption.

What can you do to safely increase iron levels?

Rule out/treat
Astro-esophageal reflux, Celiac Disease, hypothyroidism and hypoxia -- all of which has an effect on the body's ability to process iron. (More info below in excerpts from Down Syndrome: What You CAN Do.)
 
The International Journal for Vitamin and Nutrition Research has published multiple studies supporting the supplementation of vitamin C with dietary iron to increase the bioavailability of non-heme iron. The amount of absorption is directly proportionate to the amount of vitamin C taken.

So before you supplement with iron, look to vitamin C to help the body better assimilate the iron that it is getting. Foods rich in vitamin C such as papaya, orange, cantaloupe, broccoli, brussel sprouts, raw green peppers, grapefruit, strawberries, etc. can be as effective as meat meals in improving iron absorption. (Go easy on the broccoli and brussels sprouts because they can mess with thyroid function.) Read: Vitamin C to find out how best to use Vitamin C supplements.

"In one of the earliest human studies, adult subjects maintained on vitamin A deficient diets developed anemia despite adequate iron intake. The anemia responded to vitamin A but not to iron supplementation…..Vitamin A supplementation of deficient children resulted in a significant increase in hemoglobin, hematocrit, and serum iron." http://www.ilsi.org/.../IVACG_vitA_iron_interactions.pdf  A word of caution: kids with DS have difficulty with vitamin A supplementation if they thyroid is not properly supported. Avoid the forms of retinal and beta carotene. Instead, look to getting vitamin A through fish oils.


Folate/folic acid and or B12 deficiency also can be a factor in production and/or function of red blood cells which can lead to anemia. See "Red blood cells and DS" below.

"Avoiding phytates and oxalates may help. These can interfere with iron absorption from the gut, but the research is not conclusive on this subject. Phytates are found in bran and whole grains. Oxalates are high in nut and nut butters, beets and beet greens, tea, strawberries, gelatin, rhubarb, spinach, chocolate and wheat bran. Most of these foods are the very substance of a vegetarian diet." --
Joanne Larsen, Ask the Dietitian http://www.dietitian.com/iron.html (When I added green tea extract to Jett's supplementation, his iron went from 24 to 11. Not sure if there is a direct correlation, but something to consider.)

Avoiding milk could also solve the problem. According to
Joanne Larsen, Ask the Dietitian http://www.dietitian.com/iron.html: "A diet high in milk or milk products can increase iron deficiency because these are high protein, low iron foods. Soy beverages are high in iron (also iron fortified infant soy formulas)." But soy should be avoided for our kids because it interferes with thyroid function. Better alternatives would be flaxseed milk or coconut milk. (Almond milk is high in phytates or oxalates so wouldn't be a good choice either.)
Longvida Curcumin and Green Tea Extract can chelate iron, so consider that when supplementing.
 
 
Symptoms


Weakness, a haggard look, fatigue, lack of energy, tired looking eyes, shortness of breath, dull and poor memory, headache, premature wrinkles and dizziness on exertion are some of the indications of anemia.
Symptoms of iron deficiency anemia include fatigue, pale skin, weakness, shortness of breath, headache, dizziness or lightheadedness, cold hands and feet, irritability, tongue inflammation or soreness, brittle nails, fast heartbeat, and poor appetite

Normal Range

The normal range of ferritin in children increases as they age. In children between the ages of 1 and 5 years, the normal range is 6 to 24 ng/mL. But, 20 is optimal. In children between 5 and 9 years of age, the normal range increases to 10 to 55 ng/mL. These levels continue to increase into adulthood, at which point they can be up to 200 ng/mL.


For iron and iron enhancing products, see the DS Day to Day amazon Store.

Instead of iron supplements, you may want to try these first:

Liquid chlorophyll by World Organics. ($6-7) It does not contain Fe, but because the chlorophyll molecule is similar to hemoglobin, it can quickly, raise the Fe level
(much less than the standard 6 weeks for Fe supplements).

Organic Black Strap Molasses (see below for detailed info)
Organic/Grass Fed Beef Liver


Supplemental Sources of Iron

If your child is iron deficient and your doctor advises supplementation, here's info about the different kinds. 


Important: Iron supplements should not be taken within four hours of thyroid medication or else the thyroid medications will not work properly.

Iron Bisglycinate, is a non constipating iron supplement. Brands include

Solgar Gentle Iron
Solgar Chelated Iron
Now Foods Iron
Floradix 
The absorption rate of Floradix (liquid iron gluconate) is twenty-five per cent compared to solid iron tablets that have an absorption rate of two to ten per cent. Floradix provides maximum absorption by using the most highly absorbable form of iron, iron gluconate. Floradix also contains B vitamins and vitamin C to enhance absorption, herbal extracts to increase digestion, and fruit juices to ensure proper stomach acidity. So it is non-constipating. But it does have high natural sugar content with 5g of sugars per serving.

Spatone
Spatone costs $19.95
for a 28-sachet box. If your total order exceeds $50, there is free shipping and handling. If your total order is less than $50, there will be a $7.95 charge added.

Unfortunately, iron supplements such as Spatone often cause constipation. To offset that side effect, take a look at the post: http://dsdaytoday.blogspot.com/2011/10/constipation-causes-and-cures.html and drink plenty of water.


Increasing Iron Through Diet

From HealthCastle.com


Absorption of iron from food is influenced by multiple factors. One important factor being the form of the iron. Heme Iron, found in animal sources, is highly available for absorption. Non-heme iron on the other hand, found in vegetable sources, is less available. Iron rich foods of an iron rich diet are listed below:
Iron Rich Foods containing Heme Iron

Excellent Sources:

  • Clams
  • Pork Liver
  • Oysters
  • Chicken Liver
  • Mussels
  • Beef Liver
Good Sources:
  • Beef
  • Shrimp
  • Sardines
  • Turkey

Iron Rich Foods containing Non-Heme Iron

Excellent Sources:

  • Enriched breakfast cereals (to be avoided because of added synthetic folic acid)
  • Cooked beans and lentils (make sure they are soaked before cooking)
  • Pumpkin seeds
  • Black strap Molasses

Good Sources:

  • Canned beans (avoid canned goods because of aluminum, if you must, only use cans from Eden organic, they use BPA free lining)
  • Baked potato with skin
  • Enriched pasta
  • Canned asparagus
The absorption of Non-heme iron can be improved when a source of heme iron is consumed in the same meal. In addition, the iron absorption-enhancing foods can also increase the absorption of non-heme iron. While some food items can enhance iron absorption, some can inhibit or interfere iron absorption. Avoid pairing these iron-inhibiting foods when you're eating the iron-rich foods in the same meal.

Red blood cells and DS

from The Guide to Good Health for Teens and Adults with Down Syndrome by Brian Chicoine M.D. & Dennis McGuire Ph.D:

"Abnormal lab Results- MCV One lab test in which results are commonly elevated in people with DS is the MCV....if red blood cells are released from the bone marrow before they mature, the cells will be larger and the MCV will be elevated.

It is thought that red blood cells are often released early from the bone marrow of people with DS. One theory is that rbcs die more quickly in people with DS so less mature cells are released in order to replace them. Another theory is that there is an abnormality in folic acid metabolism in people with DS that may lead to larger rbcs.

An elevated MCV is generally not considered an abnormality that requires additional assessment in a person with DS so long as he has a normal blood count (hemoglobin and hematocrit) (that is, he is not anemic)......"
------

Anemia Home Remedies: Best Natural Cures


If anemia is diagnosed and no other disease is associated with it, then the following home remedies for anemia may be useful:

Figs
Eat four dried figs daily for a month and continue thereafter for another month if results are to your satisfaction.


Citrus Fruit
Due to high Vitamin C content, eat one orange or tangerine daily.


Beets
Beets are very a potent treatment for anemia. Beet juice is full of natural minerals like potassium, phosphorus, calcium, sulfur, iodine, iron and copper. It also contains vitamins B1, B2, B6, niacin, and vitamin P. Beets are very helpful in curing anemia. Beet juice contains potassium, phosphorus, calcium, sulphur, iodine, iron, copper, carbohydrates, protein, fat, vitamins B1, B2, B6, niacin, and vitamin P. With their high iron content, beets help in the formation of red blood cells.

Cabbage
Drink 1/2 glass of white cabbage juice on an empty stomach twice daily.

Lettuce
Eat 100 gm lettuce twice daily, chew well.

Spinach
Eat various preparations made of spinach daily or extract 1/2 cup of spinach juice for daily consumption.


 
Astro-esophageal reflux and Anemia 
 from the book, Down Syndrome, What You CAN Do:
This occurs when food that had already passed into the stomach and beyond comes back up into the Esophagus and may be vomited up. Most healthy people experience this from time to time. It is more common in babies because their food is liquid and therefore more easily brought back they spend less of their time upright the muscle at the top of the stomach that should prevent this is not yet well established. Some also have a hiatus hernia where the top part of the stomach is pushed just above the diaphragm into the chest. Babies with Down syndrome are more likely to have reflux, probably because the muscles of the stomach and esophagus that work to push food along seem to work less effectively. Symptoms may be very mild and merely a nuisance. Simple measures mentioned above may help. However, vomiting may be considerable and the child may not gain weight. In addition, the acid contents of the stomach irritate the lower esophagus causing discomfort, and sometimes bleeding from the esophageal wall. This can cause anemia. In these cases, medical treatment is necessary. Several different kinds of medicine are used, often in combination. They work in a number of ways - by preventing the stomach contents flowing back, by neutralizing the stomach acid and by improving the gastrointestinal motility. Very occasionally, these measures won't be sufficient and an operation to tighten up the junction between the esophagus and stomach will be necessary.
--------

Celiac Disease
 
from Down Syndrome, What You CAN Do
This is a condition in which the bowels are unable to absorb particular nutrients from food. This can cause the body to run short of some nutrients, and the stools to be abnormal. Possible malabsorption of a number of different vitamins and minerals has been described in Down syndrome from time to time. However, the evidence for this is inconsistent and whether the malabsorption leads to any health problems is uncertain.

There is, however, one important type of malabsorption that is more common in Down syndrome called Celiac Disease. In this, the body develops an allergy to part of a protein called gluten, which is found in wheat and some other cereal grains. Symptoms include poor growth, abnormal stools (diarrhea, frothy, foul smelling or bulky stools are typical), swollen stomach, tiredness and irritability. Anemia may also result. Special blood tests are available which may help with diagnosis, but a jejunal biopsy may be necessary. In this test a small tube is swallowed, and a sample of the wall of the jejunum is removed for examination under a microscope. Treatment is by special diet excluding gluten. This should he supervised by a dietitian....

Thyroid & Anemia

from Down Syndrome, What You CAN Do
The adverse effects of abnormal thyroid function are well-known. An under active thyroid gland leads to cognitive impairment, increased risk of coronary artery heart disease from hypercholesterolemia (14), dry skin, constipation, and anemia.

Folic Acid

from Down Syndrome, What You CAN Do
Folic Acid is particularly important in the population of people with Down syndrome. It is needed for the synthesis of DNA and RNA, which are the building blocks of cells. Folic Acid also helps prevent changes to the DNA that could lead to cancer. It is also needed in both children and adults to be able to make normal red blood cells and prevent anemia. Read about the best types of folic acid for the DS population:  Why B12 & Folinic Acid

Piracetam and Hypoxia
from Down Syndrome, What You CAN Do
Hypoxia is a condition of low oxygen levels in the tissues. Hypoxia can be caused by lack of oxygen in the air (hypobaric or high-altitude conditions), decreased oxygen carrying capacity of the blood (anemia or carbon monoxide toxicity), by impaired circulation (ischemia, heart attacks, blood clots, etc.), or other causes.

For decades piracetam has been studied as an anti-hypoxia agent. This may have special application to DS due to developmental delays in the closing of the heart muscle wall between the right and left sides of the heart. This results in the mixing of blood from the right side of the heart (which pumps oxygen-depleted blood to the lungs) with blood on the left (which pumps oxygenated blood to the rest of the body). This effectively diminishes oxygen delivery capacity and exposes affected individuals to some degree of chronic hypoxia.

Hypoxia has an adverse effect on cognitive functioning, which piracetam effectively prevents [see SDN v1n10].
Hypoxia is also associated with increased lipid peroxidation, which is inhibited by piracetam and antioxidants [Nagornev et al., 1996]. This effectively increases human resistance to high altitude. In aged patients with ischemic heart disease, the combination of piracetam and tocopherol acetate (vitamin E) provides better control of angina pain, increases exercise tolerance, and positively influences hemodynamic measurements [Pimenov et al., 1997]. These observations confirmed earlier work [Pimenov et al., 1992].

Hypobaric hypoxia of pregnant rats causes memory impairment and learning delays (in both passive and active tasks) in newborn pups. Postnatal piracetam (200mg/kg/day) in the second and third weeks of life partially corrected behavioral disturbances and physical development, but not adaptive behavior, caused by this prenatal hypoxia [Trufimov et al., 1993].

The adverse role that oxidative stress can play in cognitive functioning can also be blocked by piracetam. Craniocerebral trauma in rabbits causes 1) increased free radical activity, 2) decreased antioxidant function, and 3) increased lipid peroxidation throughout the brain. These effects are prevented by piracetam or amphetamine (which are stimulants), but not by phenobarbitol (a CNS depressant) [Promyslov and Demchuk, 1995]. The lack of any direct antioxidant effect of piracetam or amphetamine in an in vitro model suggests that the antioxidant effect is entirely mediated by secondary metabolic effects of these compounds.

Helpful Website

If your child has anemia this is a great web page: https://sites.google.com/site/superdownsyndrome/sleep/iron


Sources

http://www.livestrong.com/article/195055-does-vitamin-c-increase-iron-absorption/#ixzz29ff0A5NK

http://www.livestrong.com/article/207206-normal-ferritin-levels-for-children/#ixzz1JWkDsED8

Down Syndrome: What You CAN Do edited by Kim & Qadoshyah Fish

The Guide to Good Health for Teens and Adults with Down Syndrome by Brian Chicoine M.D. & Dennis McGuire Ph.D 

HealthCastle.com 

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