As the symptoms get stronger, so does the therapy,
going up in steps from May to July/August and then down to October
Today’s post is a practical one. There is an interesting scientific one in preparation all about applying the emerging science of gene silencers and enhancers.
I discovered in previous years that the summertime raging exhibited by Monty, now aged 12 with ASD, could be prevented using a small dose of the L-type calcium channel blocker, Verapamil. Verapamil is also a mast cell stabilizer and blocks potassium channels linked to some inflammatory response.
This summer the story has repeated itself. As the amount of airborne allergens increases from spring to summer the same seemingly mild allergy symptoms return. So in late spring there was some sneezing and by mid-summer some eczema (atopic dermatitis) behind the knees and finally a very mild amount of asthma (slight wheezing); all of which were easily treated.
This apparently mild allergy triggers a flare-up in autism that is anything but mild. To treat that the “silver bullet”, so to speak, is Verapamil. It has a short half-life and so after 3-4 hours, depending on the initial dose, the effect is lost. So in the peak of the allergy season, 20 mg every 4 hours provides near guaranteed protection. Skipping a dose, like first one in the morning, will almost guarantee a mood change to agitation and then extreme anger. That mood reverses within a few minutes of treatment again with Verapamil.
In late spring and early summer the use of allergy treatments (Azelastine, plus quercetin) and verapamil twice a day keeps things all under control. But once the first faint signs of asthma reappear, due to the growing allergy effect, the only way to maintain normalcy is to make more frequent use of small doses of verapamil. Using more antioxidants (NAC) does not have any effect; the verapamil addresses a summertime need.
In a previous post I did mention that I tried verapamil on a winter-time flare-up, just to see. It had no effect whatsoever. That problem was traced back to losing milk teeth and was solved with some ibuprofen, which was later replaced with Sytrinol/Tangeretin, the PPAR gamma agonist.
Some children with autism are treated long term with Ibuprofen, or other NSAIDs, on a daily basis. I have no doubt that it can be effective in specific cases, but the known side effects made me look for a safe alternative, which turned out to be Sytrinol. Sytrinol has exactly the same effect as Ibuprofen, for this kind of flare-up, with no apparent side effect. Sytrinol is not a painkiller.
Since the roots of the final four milk teeth take several months to melt away and all the time levels of the inflammatory cytokine IL-6 are raised, there will be recurring behavioral flare-ups in those with the kind of over-activated immune system common in autism. It seems plausible that the PPAR gamma agonist is down regulating the activated microglia and thus blunting the immune over-reaction. Anyway it works, for whatever reason.
The mast cells, degranulating due to allergens, release histamine and IL-6, the histamine causes further subsequent release of IL-6. Verapamil blocks this process. The IL-6 released by the body to signal teeth to dissolve clearly is not reduced by Verapamil.
The amount of inflammatory cytokines (IL-6 etc) produced by allergy is logically over a different order of magnitude to that used to signal milk teeth to dissolve. The effect of Sytrinol is perhaps too mild to sufficiently dampen the response to the IL-6. Maybe it helps somewhat, but I really cannot say one way or the other.
There seems to be a good case for Sytrinol year round and then Verapamil as required. When I next update my Polypill formulation, Sytrinol will be included.
I think Verapamil likely has beneficial pleiotropic effects and so, in those who well tolerate it, it might be useful year round. A small number of people do experience side effects.