Yeast (Candida)

Yeast and bacteria make up the normal flora in the gastrointestinal tract.  Competition between the two species is what maintains the balance.   Antibiotics, poor diet, insufficient soluble fiber in the diet and poor gastric acid and digestive enzyme production can result in gastric dysbiosis in which yeast overgrowth occurs in the intestinal tract.  Probiotics and antifungal medications are commonly prescribed to fight dysbiosis but it can be a long and difficult battle. 

 Research has shown that prebiotics are more effective than probiotics in most cases to resolve dysbiosis.  Prebiotics are the optimal food for the bacterial flora in the intestines, whereas probiotics contain the favorable bacteria for the intestines.  The reason prebiotics have been more effective than probiotics at reversing dysbiosis is because it doesn’t do much good to just keep reintroducing the good bacteria into the intestinal tract if you don’t provide them with their optimal food source (soluble fiber).  Yeast is a very opportunistic organism, meaning they can thrive on a wide variety of food sources.  But the favorable bacterial flora in the intestines cannot.  The optimum food for the bacteria is soluble fiber,which our diets are becoming very deficient in.  Without this optimum food source of soluble fiber, the bacteria will not flourish, resulting in yeast overgrowth due to lack of competition from the bacteria.   Of course if the dysbiosis is due to the administration of antibiotics, then a probiotic would be indicated followed with prebiotics.

 A very good prebiotic is frucotooligosaccharides (FOS).  FOS is a soluble fiber consisting of sucrose and fructose but the way the two simple sugars are bound together, our body can’t digest them but the bacteria can flourish on them.  The exception to when FOS should not be supplemented is if a bad bacteria such as Klebsiella is present in the stool as this bad bacteria will flourish on FOS as well.  So the stools must be negative for the bad bacteria before supplementing FOS. 

 The key to supplementing FOS to get the most benefit is to take 2,000-3,000 mg of FOS all at one time each day.  The reason for this is as the bacteria utilize the FOS, they produce a protein the stimulates gene expression of two very important calcium binding proteins, Calbindin D9k and Calbindin D28k.  In order to stimulate gene expression, a particular protein must be present in a finite concentration, which is achieved if 2,000 –3,000 mg of FOS are taken all at once.  The Calbindin D9k is needed for calcium and other mineral absorption from the intestines.  The Calbindin D28k is needed to protect the cells from too much calcium influx that can result in cell damage and inflammation. 

 Many doctors and parents are reporting that the gastrointestinal problems including dysbiosis have resolved in their patients and children respectively after starting Respen-A with FOS.

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Constipation

Constipation is common in autism due to the lack of gastric motility.  H2 receptors stimulate the production of gastric acid and digestive enzymes, which in turn stimulate intestinal motility.  So if the MAO-A activity is deficient, the H2 receptors don’t get adequate stimulation.  Many children or adults with autism are taking magnesium supplements orally or in the form of Epsom Salts baths to counteract the constipation. 

 Many parents have reported that their child’s constipation is resolved within days of starting the Respen-A.  It is recommended to stop the increased magnesium supplements when starting Respen-A as these can result in loose stools or diarrhea.  Also the increased magnesium intake can interfere with the calcium absorption that is necessary when using Respen-A.

Digestive Enzymes

Gastric disturbances such as decreased production of gastric acid, decreased digestive enzymes, poor absorption of nutrients, and dysbiosis are common in autism.  These gastric problems can be the result of deficient MAO-A activity.  MAO-A metabolizes histamine into the active H2 agonist.  H2 receptor stimulation by the H2 agonist stimulates the parietal cells in the stomach to secrete hydrochloric acid.  The hydrochloric acid helps breakdown the food in the stomach.  The low pH in the stomach as a result of hydrochloric acid secretion closes the sphincter from the esophagus into the stomach and opens the sphincter from the stomach into the duodenum, which is the beginning of the intestinal tract.  The intestines are alkaline so the acidic chyme (food from the stomach) lowers the pH of the duodenum.  The low pH of the duodenum stimulates the sphincter between the pancreas and the duodenum to open.  The opening of the sphincter between the pancreas and the duodenum stimulates the pancreas to contract and secrete digestive enzymes and secretin into the duodenum.  Secretin is the bicarbonate molecule for the intestines raising the pH of the duodenum back up to an alkaline pH.  The higher pH in the duodenum activates the digestive enzymes in the duodenum so that the food can be further broken down releasing the nutrients for absorption across the intestinal membrane.  So if MAO-A activity is deficient, the histamine is not converted to the H2 receptor agonist and the whole digestive process is hindered. 

 The active ingredient in Respen-A stimulates MAO-A activity resulting in H2 production, which in turn stimulates gastric acid and digestive enzyme production.  Many parents have reported that their child no longer needs the digestive enzymes after starting Respen-A.  Digestive enzymes can be taken with Respen-A but they may not be necessary.