seratonin-insulin-seizures

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Registered: 03-28-2003
seratonin-insulin-seizures
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Thu, 05-19-2005 - 5:43pm

I know I have been bugging about sugar and insulin and diet whenever I do post, but you might find this interesting.
In regards to autism, children with ASD (from what I've been reading) have extra serotonin and lack a transporter to actually be able to use the serotonin. So, really they are deficient in serotonin? So truly, a person with an inborn seratonin (transport)error might try to compensate by using foods to increase seratonin which tend to be carbs and sweets, which then tend to make a person insulin resistant and then you have even less insulin for transporting seratonin, which becomes a vicious cycle? I guess I wonder now why do some people get seizures (if this is the case with the seratonin transporter) or then some people just get anxiety disorder instead? Or maybe the 30% of kids with epilepsy and autism have the usual insults of autism injury AND this blood brain sugar thing...leading to a starving brain, leading to seizures? I know someone posted awhile back I think about there being a history of depression on the mother's side of the family being a commonality for those with autism.
I have been pursuing the insulin link because of my daughter's seizures and because I have an obsessive desire to know how her seizure meds work. I can tell you a lot about her valproic acid, but the one that might be interesting is that it contains vanadium, which is an insulin mimic. Obviously, because she is insulin resistant, the vanadium must be helping in this capacity. It really seems to explain the crazy carb cravings she used to experience. She was trying to get herself some serotonin through the short bursts provided by the carbo loading. Okay, the following is what I dug up from other sites that interested me along these lines.
LR
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http://www.doctorezrin.com/pages/464980/
The chief clinically relevant symptoms of serotonin deficiency are: 1. Sleep disturbances, e.g. insomnia, middle-of-the-night awakening, snoring, sleep apnea, and daytime fatigue. 2. Carbohydrate cravings which temporarily provide a brief burst of serotonin via an insulin-mediated increased transfer of tryptophane (the precursor of serotonin) across the blood-brain barrier. Although the comfort produced by the surge of serotonin is short-lived, the calories consumed to produce it are more lasting.
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What really caught my eye was the carbohydrate vehicle of transporting serotonin.

from:
http://www.shtup.com/naar/naarative2/hunt.htm
The Serotonin Gene

The serotonin transporter gene has been a puzzler. Cook and his team looked at genes controlling serotonin in the first place because one of the most robust findings in the biochemistry of autism has been that approximately one quarter to one third of people with autism show abnormally high levels of serotonin in the blood. And sure enough, Cook and his team found, in three separate studies, a statistically significant association between autism and a shortened version of the promoter of the serotonin transporter gene, HTT.

However, while it was no surprise to find a serotonin gene involved in autism, it did surprise everyone involved that the short form of HTT turned up in all three studies. In simple terms, the "transporter" portion of the gene transports serotonin inside blood cells-and the long form is better at doing this than the short. Thus if people with autism have more serotonin inside their blood cells than average, which they do, you would expect that people with autism would also have higher levels of the long transporter than typical people. But this is not what Cook's three studies found.

The precise relationship between serotonin in the blood and serotonin in the brain is complicated, of course, but basically blood cells are analogous to brain cells-which means that the long form of the transporter would lead to more serotonin inside the brain cells, and less serotonin outside the brain cells. Generally speaking (and again this is a simplification) we want good levels of serotonin outside our brain cells where it is free to work its magic. All of the "SSRIs" (selective serotonin reuptake inhibitors), -Prozac, Paxil, Zoloft and Luvox-are thought to work by increasing the level of serotonin in the spaces, or synapses, between brain cells.
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from
http://www.hypoglycemia.asn.au/articles/serotonin_connection.html

1) A extended period of physical or psychological stress, will produce stress hormones such as cortisol and adrenaline, that can interfere with the synthesis of the brain neurotransmitter, Serotonin.
2) A neurotransmitter is any one of numerous chemicals that occupy the gap (synapse) between two or more nerve cells (neurons) and thereby allows the triggering of a tiny electrical currents in adjacent cells. Each neurotransmitter fits into a unique receptor - like a key fitting into a lock - thus allowing messages to be carried along nerve pathways
3) Serotonin is a neurotransmitter that conveys the positive sensations of satiety, satisfaction and relaxation. It regulates appetite and when converted to melatonin helps us to sleep.
4) A deficiency of Serotonin in the brain can cause endogenous depression, upsets the appetite mechanism and may lead to obesity or other eating disorders such as anorexia and bulimia nervosa and may be responsible for insomnia. Doctors usually prescribe Selective Serotonin Reuptake Inhibitors (SSRIs) which have the effects of increasing the amount Serotonin and thereby medically treat the above conditions. Unfortunately, SSRIs may have side effects in some patients.
5) Serotonin is produced from an essential amino acid (protein unit), called tryptophan, obtained from food and then converted to Serotonin under the influence of vitamin B6 (Pyridoxine). “Essential” amino acids are sources of protein, that the body cannot produce and must obtain from food!
6) If here is a deficiency of vitamin B3 (niacin),the body will use dietary tryptophan to synthesize niacin. It takes 60 mg of tryptophan to produce 1 mg of niacin. Hence, niacin deficiency may also be responsible for depression.
7) The absorption of tryptophan competes with the absorption of other amino acids in the digestive process.
8) The absorption of tryptophan can be accelerated by consuming refined carbohydrates, such as sugar.
9) Sugar consumption stimulates the body to produce insulin, a hormone which transports glucose, fatty acids and amino acids (except tryptophan) into body cells. Thus insulin speeds up the absorption of amino acids other than tryptophan.
10) This leaves tryptophan available for absorption and conversion to Serotonin (via 5-hydroxytryptophan, 5-HTP) in the presence of vitamin B6, and presto we feel happy.
11) A person low in Serotonin will be inclined to consume greater amounts of sugar in an attempt to increase Serotonin production and this may lead to sugar addiction.
12) Sugar addiction can lead to insulin resistance. High levels of insulin cause receptors for insulin to shut down by means of ‘down-regulation’.
13) Insulin resistance starts first as mild insulin resistance leading to hypoglycemia (low blood sugar level also called ‘hyperinsulinism’), then reactive hypoglycemia, more severe insulin resistance which causes unstable concentrations of blood glucose, and finally more complete insulin resistance, causing diabetes over time. Thus there is a range of insulin resistance from low to severe which causes erratic and unpredictable sugar levels in the blood and to the brain. This explains some of the variable ‘psychological’ and physical symptoms of hypoglycemia.
14) High levels of insulin - hyperinsulinism - blocks the utilization of fat cells (adipocytes) as a source of energy, thus causing obesity. It also causes to dump magnesium into the urine, upsetting the delicate balance of intracellular magnesium and calcium ions that regulate blood pressure, thereby contributing to hypertension.
15) In hypoglycemia wild fluctuations in blood sugar levels causes the body to produce excess adrenaline, which functions to convert glycogen (stored sugar) into glucose in an attempt to stabilize the supply of glucose to the brain. The brain normally has no other source of energy than glucose and needs a stable supply.
16) Treatment of hypoglycemia is achieved by adopting a hypoglycemic diet accompanied with vitamin and mineral supplements (Vitamin C, Zinc, Chromium picolinate, Thiamine (B1) and other B-complex vitamins, see The Hypoglycemic Diet ). This helps to stabilize the blood sugar levels, even out mood swings, rebalance the appetite mechanism, equalize energy intake and expenditure; and halt if not reverse obesity.
17) The overproduction of adrenaline, known as the fight/flight hormone, can cause nervousness, panic attacks, anxiety, phobias, extreme mood swings and bouts of aggression and many other symptoms of hypoglycemia, described in the article “What is Hypoglycemia?”
18) Depressant drugs, such as alcohol, tranquilizers, benzodiazepines, sleeping pills may temporarily counteract the effects of adrenaline, these are however very addictive and this helps to explain how hypoglycemia may lead to alcohol or drug addiction. Most drug addicts have been found to be hypoglycemic!
19) It is suggested that insulin resistance may also interfere with the absorption of other essential amino acids such as phenylalanine and tyrosine, which are forerunners of important brain neurotransmitters, such as dopamine and norepinephrine.
20) Norepinephrine (closely associated with dopamine) is believed to be a neurotransmitter that blocks out any irrelevant information from the brain and helps a person (usually young children) to concentrate on the task at hand. An error in norepinephrine synthesis has been associated with Attention Deficit and Hyperactivity Disorder (ADHD), because the person is bombarded with irrelevant information and cannot concentrate. Thus ADHD is considered another consequence of insulin resistance and hypoglycemia.
21) Hypoglycemia and/or insulin resistance is believed to result in a dysfunction of dopamine metabolism. Dopamine conveys the sensation of pleasure and many addictive drugs such as heroin and cocaine increase the amount of dopamine, by blocking (inhibiting) the reabsorption (reuptake) of dopamine by brain cells. This causes increased levels of dopamine which is felt by the addict as a high and as a feeling of great pleasure.
22) The presence of excess dopamine in the brain causes the down-regulation of dopamine receptors as a defence against superfluous dopamine. Receptors for dopamine are reduced and the person becomes dependent on the heroin, cocaine or any other addictive drug to artificially obtain ‘normal’ levels of dopamine. Treatment aims at rebuilding natural dopamine receptors through abstinence from drugs and with nutritional aids, such as omega-3 essential fatty acids (fish oil) which is thought to help restore brain cell membranes.
23) Treatment aims at reversing the Serotonin Connection by correcting the chemical imbalance of the various neurotransmitters. It is essential that the patient adopt the hypoglycemic diet together with nutrient supplements, vitamins and minerals, omega-3 fatty acids, neurotransmitter precursors, exercises and so on as explained in the article

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Registered: 03-26-2003
Thu, 05-19-2005 - 6:32pm

wow, little roses, i followed it about half way.

but it made me think. what does that mean for women who have gestational diabetes or need insulin during their pregnancy? so, yet again if your child is predisposed to autism, and the mom is gest. diabetic, then that seems to seal their fate?

v

~Valerie
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Registered: 03-26-2003
Thu, 05-19-2005 - 7:15pm

LR

Thanks for posting that. More info to digest and read. OY!!! Though my brain is hurting now so I only made it through a skimming of the articles. Darn ADHD brain!!!

I am very interested because we want to take Cait off her seizure meds but the teacher thought she saw some seizure like symptoms today. Cait didn't feel anything though. I hope it was just tics. Her whole side of her face was twitching and Cait couldn't stop it. Cait said her shoulderblade was twitching too. Sounds like tics but since it was rapid fire over the course of a period of time (15 or so seconds) rather than isolated tics, it is something I have to keep in mind since Cait's seizures are mostly sensory or movement related.

Hmmm, this also makes me wonder about those with BP usually craving carbs to the denial of all else. My friends son does that. I have read lots about it and I know there is a connection somewhere between BP and AS and lots of other similar syndromes. Plus Dave is my possible BPer and is also a sweet craver though he will crave sweet fruits too.

Very interesting! Now to get all that metabolic testing done.

Renee

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Thu, 05-19-2005 - 7:48pm

Gestational diabetes probably has a lot to do with iron overload. (prenatal vitamins loaded with iron!) And too much iron increases insulin resistance, which we don't want. Also iron cannot be excreted easily and will store preferentially in the fetus. This would be a good thing since an infant is born with 6 months of iron supply (because drinking all that milk will make them anemic) but too much iron is also bad.

As for BP, I was just learning some interesting things about that today. I was reading that vanadium levels in those with BP tend to be very high when in the manic phase. Suggesting that blood brain sugar hugely has a part in it.

I think you're right, I think it's almost ALL related, just different pathways really. Migraines are really just seizures. I never had them, but my mom did. Sensitive to light, smells, etc. Sounds a lot like a seizure, right? People drink coffee to make their migraine better. They say it opens up the blood vessels or whatever. Well, another thing about coffee is that it also has an effect on insulin which is probably more than likely why it helps, though temporarily. You hear people say to give their ADHD kids coffee to calm them down. I really think it has to do with the insulin factor more than the caffeine. I was watching Dr. Phil the other day and there was a girl on who had acute OCD. I was thinking about that and realized that almost is epileptic-like as well. It's not a seizure, it's just very similiar when I was thinking about it. She is stuck in a "loop" and cannot break out of it. Happens to my daughter who can be mildy OCD at times. I try to help her by "breaking" the loop when I see she is stuck. I don't feed into the loop and try to distract her from her thoughts. She seems relieved when I do it even though it would appear she WANTS to be focused on it, I can see when she is stuck. It's a weird thing, but it works for her. Her teachers have caught onto that as well. The more they try to comfort her or address the topic, the worse she descends into the cycle. The more they ignore it and readdress her, the quicker she recovers. It's nothing like the girl on Dr. Phil though! Anyway...I was also reading that back in the 1930s they used to treat schizophrenia with insulin. Don't know why they stopped, maybe it was because it was only temporary or something. So, I think these are all very related and boil down to the "energy" and the different glitches and pathways the energy is being utilized. Which is why one person may have seizures and another migraines.

LR

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Registered: 12-24-2004
Thu, 05-19-2005 - 8:35pm

O.K. Let's take a deep breath and talk about how this research generalizes to all kids with ASD's because it most certainly DOES NOT. Most autism research uses kids with an Autism label, especially High Functioning Autism (even though this is not a formal diagnostic label). HFA's are especially sought for neuropsych research because they have language and can follow directions, but they also have pretty similar brains. For examlpe, if you have read the studies of immune system dysfunction that causes excessive white matter to form, these were entirely based on people with Autism or HFA diagnoses (no PDD-NOS and no Aspies among them).

There are really very few studies on autism that include people with Aspergers or PDD-NOS diagnostic labels. If kids with Aspergers are studied, the study usually says Aspergers, not Autism. PDD-NOS is a very heterogenous group, so researchers avoid kids with this label when studying brain anatomy, genes, and other biological bases. Researchers get rewarded for publishing meaningful results, and if the group you study is too heterogenous, you will not get significant statistical results. Without significant stats, you get no publications and no funding, hence the paucity of research on PDD-NOS brains.

The truth is that kids with Autistic Spectrum Disorders are a heterogenous group, with those in the PDD-NOS class being particularly diverse. I believe, most of the studies that you quoted are applicable to kids with an Autism diagnosis or those who have co-morbid seizure disorders. There are many kids with Aspergers and PDD-NOS, who are successfully taking SSRI's and getting good results from these drugs. They are typically recommended for children with ASD's who also have obsessive tendencies and anxiety. Many of these kids actually have a co-morbid condition, such as a mood disorder or obsessive compulsive disorder, and the SSRI is designed to treat this, not the autism per say. To the degree that social and cognitive functioning is being impaired by this co-morbid condition, the SSRI treatment may prove helpful.

In our case, our DP was well aware that Cassian had no history of seizures before he put him on Lexapro. He also had no difficulty sleeping. He likes carbs about as much as any other kid, I would say. He is less interested in sugar than most kids. There is a history of depression on both sides of his family. The dosage he is on is very small even for his weight, but we have noticed some positive effects of the drug so far. It seems to increase his social interaction, cause him to be less obsessive, and improve his thought processes (he seems to have more plans and problem solves better). The only downside has been that with more plans at his disposal, he is upset more frequently because I have to tell him "no."

Did you know that Temple Grandin has been taking Prozac for years and says it is a "Godsend" for her? Apparently, it really helps her function. Many kids and adults with Asperger's, whom I know are also on SSRI's.

Thanks for sharing the info you posted. The only change I would recommend is that you try in the future to use conditional terms, like "some people with ASD's," "many kids with Autism," etc. A few of the articles did use this terminology, but your initial introduction made it sound like you were warning everyone to avoid using these drugs with their ASD kids, and I don't think that is what the literature is saying.

Thanks for posting.

Suzi

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Thu, 05-19-2005 - 10:05pm

I don't read anywhere at all in that paragraph where it warns anyone to stop taking SSRI's or even hints at it. (Which sentence was that?)I was pointing out the relationship between insulin and seratonin. Your smacked my hand for something I didn't do. I have nothing against SSRI's. I have nothing against prescription drugs since that was the hit nerve. My husband also takes SSRI's and he is not ASD, HFA nor PDD, but our daughter is and I wanted to know more. So, I don't have an anti-drug agenda here. Someone else here might be curious and want to know about this too. It is not a warning to avoid SSRI's, it's a look reaffirmation how seratonin use is a problem for *some* ASD persons and how those who were interested in knowing what role insulin may have in that process.

Also, I will try in the future to make sure that everyone understands how diverse ASD people are in the event they didn't already know that.

LR

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Registered: 03-26-2003
Fri, 05-20-2005 - 5:52am

LR,

thank you for posting your article. i found it very interesting. i also know that you are not a doctor trying to give medical advice. i think we are all intelligent enough to know that this is another piece of the puzzle, and i for one find it helpful, especially considering my pregnancies and my 2 children on the spectrum.

also, as most know i have one son with pdd and the other with more typical autism. and i know this is the pdd/asperger's board. but it seems to me that sometimes we get too tied up in making sure everyone knows when we have a high functioning autistic or a pdd child. when i talk about my sons in person, i say they both have autism. if we truly feel that each child is different (with autism or not) then there shouldn't be the need to classify their weaknesses and strengths, which only tends to alienate those have canaries instead of eagles.

valerie

~Valerie
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Registered: 12-24-2004
Fri, 05-20-2005 - 9:37am

O.K. LR. I reread, and maybe I was being overly sensitive about the drug issue. There's a lot of good info there. I have been getting some raised eyebrows lately from teachers and parents, who think 5.5 yrs is too young to medicate.

Also, to Valerie, I'm not trying to differentiate eagles from canaries when I emphasize differences in etiology and brain function. I just think it is important to understand each individual child's needs to diagnose at a more specific level. From what I have been hearing from my Psych friends who specialize in autism, the new view is that the "Spectrum" should not be viewed as running from Aspergers to PDD-NOS to Autism. In fact, there are new autism measures (e.g., the ADOS) that have found many Aspies to be lower functioning in social realms than their HFA or PDD-NOS peers.

In RDI, many parents of Aspies are upset after their initial evaluation because their child scores at the level of a 1 or 2 yr old on many indices. Parents of Autistic kids, on the other hand, are often surprised when their child scores at a 3 or 4 yr old level. Specifically, Aspies, because they have verbal strengths, often fool the casual observer into thinking they have social skills, but when evaluated, their social interaction turns out to be more of a monologue and is therefore given a low score. Less verbal Autistic kids can also turn out to have much better nonverbal interaction skills than Aspies. Another thing that is very interesting about kids along the spectrum is that it is often easier to teach a child in his/her deficit areas when this child has universally low functions, whereas children who have a few very high functioning areas and a few low ones, are harder because they keep trying to rely on their strengths and don't want to work on their weeknesses. Cassian has actually made slower progress in RDI than some lower functioning kids because of this.

So, I guess, I don't really regard the "Spectrum" as a ranking system on all fronts, like many people do. I prefer the view that these kids have different brains, which cause some similar deficits to occur. I don't look upon the Autistic child as lower functioning than the Aspie. I see them as different.

Suzi

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Fri, 05-20-2005 - 1:05pm

Thanks Valerie and Suzi

I get very into what I learn and I don't realize how it may all sound unclear. Suzi, I know what it's like to be judged for having your child on meds. I would never judge anyone for that. My oldest daughter was on adderall for 2 years and boy, did my family make it clear how they thought I simply didn't want to parent. Lack of involvement, if anyone knew me at all (and you think my fam would) is not who I am so that just really annoyed me to no end. I do not regret she was on adderall. I found she no longer needs it, but don't regret having her on it. I also had a choice when my younger daughter was 2 to give her drugs that could potentially kill her liver and cause her mental deficits or to risk her having continued seizures. The painful part is that people judge and don't realize that the last thing a mother WANTS to do is take this route, but you don't want your child to suffer and you want what is best so you do take the very brave step of defying what people think of your parenting and proceed with what you are sure would help your child not suffer. That takes courage and I know that.

What I was so poorly getting across was actually a validation for SSRI's for some people. I think what I was trying to say that if a person has plenty of serotonin, but lacks the ability to utilize it in the cells, then they have a serotonin deficiency despite plenty of serotonin floating around in the system. All the materials, but none of the tools to build with. Insulin, from what I'm reading, helps transport serotonin into the cells, although not very longlasting. This may be why you consistently hear parents talk about how the kids go crazy over the french fries at McDonalds. Or in our case, my daughter would freak out for pancakes. They truly may have been trying to get relief by the temporary dose of serotonin brought by that insulin vehicle. However, at least in my daughter's case, she must have a genetic predisposition to have a weakness in the insulin/glucose response anyway. So all those pancakes and things she loved would have been a relief to her, but also at the same time, increase her insulin resistance. This may not happen in your average person so quickly or even at all, but this happened to her when she was an infant so there must have been an acceleration or susceptibility towards that. And the insulin resistance may mean excess insulin which leads to less glucose-less fuel for the brain. Then the brain is forced to find alternative forms of "fuel". It can convert cysteine into glucose, it can use adrenaline, and it can use glutamines. It may use other forms I am not aware of. However, to use those other fuels causes an imbalance of other systems. If you use up too much cysteine, then the body will use methionine to make cysteine. Methionine is important to breakdown proteins (which man ASD kids do seem to have a hard time with certain proteins). Also, cysteine is part of a tripeptide to make glutathione. Glutathione is an antioxidant made by the body to remove heavy metals and viruses, etc. Glutathione is made up of cysteine,glutamate and glycine. So, if her brains is using glutamines for fuel, these excitatory neurotransmitters flood the brain, but are still "on" and "excited" so now the body's defense is to shed the excess energy because these excited cells will basically be excited to death. How the body dramatically sheds this rush of excitatory energy quickly is to seize. (Not for everyone, perhaps).
So, truly a lack of serotonin may be the cause of all these other imbalances down the line. Not to say it's a cause or a cure of ASD, but an understanding of what might be happening to her. For whatever reason, serotonin is not getting to where it needs to go. This is maybe why Temple Grandin feels SSRI's are so wonderful. And, in fact, I might consider this path for my daughter someday in the future. First, I would like her off the seizure meds though...that is my first fire to put out. The only way I can do that is to figure out what is causing them. I have been looking very hard at what the ingredients are in her meds and it all seems to come back to insulin and the right fats. Her seizure medication is a short chained fatty acid with vanadium (which mimics insulin).

I also am not pushing SSRI's nor am I saying that diet will be the key to fixing her right up! It seems like controlling the blood sugar will help bandaid the seizure part for her somewhat, but will not likely fix the reason why serotonin is not getting into her cells. Which is also a problem for her dad. I am going to try and learn about that next, how that process works, if it's an enzyme that is responsible for this or is due to the permeability of cell walls or what, I don't know, but I'll share whatever I learn. I know it may not be true for everyone, but it could ring some similiarities for others which is why I like to share. My obsessive curiosity has driven me to this. I used to be a fun person. LOL

LR