Letters to the Editor

Townsend Letter for Doctors and Patients, April, 2001

Anti-Fungal Drugs More Helpful than Ritalin in Autistic Children

Editor:

I really enjoy the many articles, comments, letters, advertisements and other information I read each month in TLfDP. Congratulations on the job you have been doing and are doing now. In every issue I learn things I do not know, that I need to know.

I'm writing to comment on Dr. Reiner Rittinghausen's article, "Natural Treatment for Otitis Media" (TLfDP, Nov. 2000). In discussing conventional treatments for otitis media, "Treatment regimens usually include antibiotics, decongestant nasal drops, anti-inflammatories and secretolytics as necessary. This regimen is rarely questioned, despite the fact that antibiotics can produce a large number of adverse effects, particularly allergies, weakness of the immune system and intestinal colonization by pathogenic and/or mycotic organisms."

I agree and I'm writing to expand on Rittinghausen's comments. Researchers in the Department of Pediatrics, University of Colorado, and the Department of Psychology, Yeshiva University, found an association between recurrent otitis media in infancy and later hyperactivity. (Hagerman, R. and Falkenstein, A., "An Association Between Recurrent Otitis Media in Infants and Later Hyperactivity," Clinical Pediatrics, 28:253-257, 1987.)

"Sixty-nine percent of children being evaluated for school failure who were receiving medication for hyperactivity gave a history of greater than ten ear infections.... By comparison, only 20% of the nonhyperactive children had more than ten ear infections." (Emphasis added)

Based on my own observations in practice, and those of other physicians and parents, here's a probable explanation for this relationship. When a child with pain or fluid in the ear is treated repeatedly with broad spectrum antibiotic drugs, the microflora in the intestinal tract is altered. As a result, there's an overgrowth of Candida albicans and other unfriendly organisms, including Clostridium difficile.

Based on the research studies carried out in Japan in the early 1970s, Candida produces high and low molecular weight toxins which weaken the immune system. So a vicious cycle develops and the child may experience repeated ear infections. (Iwata, K. and Yamamoto, Y., "Glycoprotein Toxins Produced by Candida albicans," Proceedings of the Fourth International Conference on the Mycoses, June, 1977, PAHO Scientific Publication, No. 356.)

Disturbances in the gut flora also weaken the protective membranes lining the intestinal tract, creating what has been termed the "leaky gut." Food allergens and/or toxins may then pass through the membrane and go to other parts of the body including the nervous system, playing a part in causing the current epidemic of ADHD and other behavior and learning problems.

I'm also concerned about the tremendous increase in the number of children with autism, pervasive developmental disorder (PDD) and other neurological symptoms. At autism conferences in Indianapolis, St. Louis, Stamford, Connecticut and San Diego in the 1990s, in presentations to parents of autistic children I asked for a show of hands among the parents when I asked these questions:

* How many of you are parents of a child with autism or PDD who showed normal development during the first year of life? (Approximately half of the parents held up their hands.)

* How many of you are parents of a child with autism who received repeated or prolonged courses of antibiotic drugs for ear or other respiratory infections during the first year of life? (Approximately 2/3 to 3/4 of the parents held up their hands.) Although these were anecdotal, unscientific observations, I would also like to mention an anecdotal study carried out by Bernard Riniland, PhD, head of the Autism Research Institute. Here are excerpts from his report published several years ago. (Rimland, B., "Parents' Ratings of the Effectiveness of Drugs and Nutrients," Autism Research Review International, October 1994)

"The parents of autistic children represent a vast important reservoir of information on the benefits and adverse effects of the large variety of drugs and other interventions that have been tried with their children. The data presented in this paper have been collected from the more than 8,700 parents who have filled out questionnaires designed to collect such information.

"The thirty-one drugs listed first were prescribed by the child's physician in each case. Note that Ritalin, the drug most often prescribed, is near the bottom of the list. Only twenty-six percent of the parents reported an improvement while forty-six percent said the child got worse on Ritalin." I studied the graphic charts in Rimland's report and I noted that nystatin or Nizoral ranked higher than any other prescription drug. Of the 208 children who were given one of these medications, forty-nine percent found that the child was "better on the medication" and only four percent said the child was worse. The better/worse ratio was more than 12:1.

By contrast, none of the other drugs showed a better/worse ratio of more than 2.7:1 and many prescription medications, including Ritalin, which was given to 1,661 children showed a better/worse ratio of 0.5:1.