Improving Detoxification Pathways

Kelly Dorfman, M.S.,Co-Founder of Developmental Delay Registry, (DDR), New Developments Newsletter. 
Preliminary research on autistic children in England and hyperactive youngsters in the United States has uncovered a possible common enzyme deficiency. The enzyme in questions, phenol sulfo transferase-P (PST-P) is an important component of liver detoxification pathways. When PST-P is inefficient, the body cannot property break down hormones, certain food components, and toxic chemicals. The reason many hyperactive children become agitated after eating foods with artificial colors is because PST-P is needed to render the mildly toxic dyes harmless.

As the environment becomes more polluted, those with the strongest capacity to break down poisons will survive the best. From a natural selection perspective, hyperactivity and autism may be nature’s way of sorting out those with the least ability, genetically speaking, to handle internally/externally produced toxins or “overload.” This hypothesis is supported by research showing that environmentally damaged areas often have a high density of developmentally delayed children.

There are several tests now being studied to identify individuals with weak detoxification pathways. Unfortunately, normal values for those under 12 years of age have not been fully established. Only Rosemary Waring from Birmingham University in England has a working test for children; however, many doctors in this country are using adult-oriented tests to “guestimate” a child’s detox capacity. Dr. Robert Sinaiko, a San Francisco based physician, is also in the process of developing an easier and more accurate way to screen children.

What is a parent to do while waiting for conclusive research? If sending 24-hours ‘ worth of urine to England is not possible, a parent can look at symptoms which may suggest possible low PST-P enzyme activity.

These symptoms include the following:

  • Known food/chemical intolerance
  • Agitated sleep
  • Regressive behavior after eating food/juice containing artificial colors
  • Self-injurious actions
  • High consumption of apple (or other salicylate-containing) juice
  • Large variation in functioning ability
  • High exposure (pre- or post-natally) to environmental toxins
  • High sensitivity to medications
  • Volatile/violent conduct

The most conclusive evidence is a visible reaction to apple juice or artificial food color. To test this possibility, all artificial dyes and juice should be removed from the diet fro several days. Then, on a day when the child will not be in school and there are no pressing obligation, give the child a few Fruit Roll-Ups or a glass of red Kool-Aid and observe. If weak PST-P enzymes are a problem, behavior generally deteriorates rapidly.

There are two ways to deal with poor detoxification: either lessen the toxic burden and/or increase the efficiency of the pathway. You can lessen the toxic burden, both internally and externally. Some parents have used dieters that remove all known phenol compounds to take pressure off the PST-P enzyme system. While sometimes helpful, these diets are extraordinarily difficult to implement long-term as naturally occurring phenols are in every food with color. Except in extreme cases, a diet reducing toxic load from the most concentrated sources (such as the Feingold Diet) appears to be the best. That is, reduce juices (or limit to pear juice) and eliminate all artificial colors and flavors. Try to eliminate or minimize preservatives. Also, examine external pollutants around your home and yard. Avoid pesticides, scrutinize cleaning solutions. Debra Dadd’s new book, The Non-Toxic Home and Office (available through the DDR) offers many safe alternatives.

Unfortunately, no amount of intervention on an individuals’ part can totally unburden PST-P enzymes. That is why it is critically important to improve the efficiency of the faulty enzyme system while attempting to lessen the load. Several nutrients may help. They include Vitamin-C, Vitamin-E, reduced L-glutathione and N-acetylcysteine. All of the antioxidants (including selenium and bioflavanoids) are valuable for detoxification in general.

The most common anti-oxidants (Vitamin-C and E) are readily available and easy to use. Vitamin-C can be purchased as a chewable vitamin. Long term or aggressive use of chewables is not recommended as the acid is hard on teeth enamel. For those who cannot swallow pills, soluble crystals can be purchased from most health food stores. For children age one to three years,, 500 mg. is safe. Larger amounts can be used in older youngsters or when the child is fighting an illness. Too much Vitamin-C will cause loose stools but it is otherwise non-toxic. Vitamin-E is soy or wheat-based in a majority of commercial preparations. Be sure to use a natural E listed on the bottle as d-alpha tocopherol or mixed tocopherols. Avoid synthetic Vitamin-E (dl-alpha tocopherol.) Liquid E as micellized Vitamin-E is available for those needing a liquid version.

Two lesser-known antioxidants that appear to be specific in helping PST-P enzyme, N-acetylcysteine and reduced L-glutathione, can be tried in cases of extreme sensitivity. The PST-P requires these sulfur-containing amino acids; however, these necessary antioxidants can sometimes backfire and agitate the child. Be sure to try only one or the other, by itself, and discontinue immediately if the child seems more irritable. The beginning dose (in children over three) for reduced L-glutathione is 50 mg and for N-acetylcysteine 250-300 mg. Start with 1/2 dose and work up to the full dose.

The above information is general. For specific questions or problems, contact a nutritionally trained medical professional. ###

published quarterly by DDR, Winter 96-97.

Published in the Orange County Learning Disabilities Association Newsletter, Vol.35, No.2, March/April, 1997 with permission.

Kelly Dorfman, M.S.
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