​by Janna Champagne, RN, BSN
Cannabidiol (CBD) is a non-psychoactive cannabinoid found in the cannabis plant, and it boasts the broadest therapeutic potential of any other component (1).  CBD is widely known for its vast array of medicinal uses, including relief of anxiety, nausea/vomiting, mental health disorders, inflammation, cancer, AND...(drumroll please)...CBD kills infectious organisms (2).  These facts, combined with CBD being readily available to purchase anywhere in the US (and many other countries), makes supplementation an excellent treatment option for many conditions.
But there's a catch!   Caution is warranted when administering CBD for Autism or related immune or infectious diseases, and considerations are necessary or CBD may actually result in the opposite of the desired effect.  Imagine taking CBD and expecting symptom relief, and instead having it worsen illness symptoms!  Being a professional cannabis dosing nurse with Autism as one area of specialty, I have witnessed this very reaction on many occasions.  Curiosity prompted me to further research this phenomenon, and now I'm sharing my theory and solutions below.
Fact #1: A major underlying factor for MOST kids with Autism and related immune disorders is chronic infections (3).   Chronic infections result from a combination of factors commonly underlying in Autism, including endocannabinoid deficiency (4), which can contribute to the immune dysfunction that facilitates the presence of chronic infections.
Fact #2: CBD is the most powerful anti-microbial component in cannabis, making it a very therapeutic intervention for killing infections (5).  CBD is especially helpful for remedying immune and infection-related disorders, because killing infections lowers the overall infectious load.   This is a critically important step to recover a struggling immune system from it's chronic state of overwhelm, as seen in Autism and related immune disorders.
 
 
 
 
 
 Fact #3: Another phenomenon supporting the potential for therapeutic benefit of CBD is research exemplifying an increase in production of CB2 (Cannabis-specific) receptors in the bodies of those with Autism.  So the Endocannabinoid Systems of those with Autism are literally begging for cannabis supplementation (6).  Pretty exciting stuff to this cannabis nerd!
 
 
 
 
So what's the problem with giving CBD to someone with Autism or chronic infections?   It's not so much a problem per se.  It's the conditions that exist, which if not taken into consideration, may result in worsening of symptoms.  Basically, giving CBD as a first-step intervention without taking any of the appropriate precautions is the equivalent of feeding a starving person Thanksgiving for their very first meal.   It's going to overwhelm their system and make them feel worse!
 
 
 
 
 
One possible issue that arises from giving CBD to a patient with Autism or chronic infections is the die-off effect, also known as a Herxheimer reaction.  Die-off occurs when harmful infections are killed, upon which their cell wall ruptures and they release an influx of toxins into the body.   Of course, the actual killing of harmful infections is a positive therapeutic action.
 
 
 
 
 
BUT with Autism and related immune disorders, die-off may increase illness symptoms when:
1. CBD is dosed too aggressively (detox can't keep up with die-off)
2: CBD is given without prior optimization of the detoxification pathways.
 
 
 
 
 
Without effective detoxification, die-off toxins add significantly to the already high levels of toxins found in those with ASD (7).  A Herxheimer reaction is known to increase symptom severity, which in Autism often presents as a spike in behaviors (especially in those with impaired communication abilities).
 
 
 
 
 
Those who do not understand Herxheimer reactions may incorrectly blame CBD or cannabis for the symptom exacerbation, when the issue is actually caused by inefficient detoxification.   The good news is that detox efficacy can be supported through a variety of interventions, including epson salt baths and activated charcoal administration (8) along with nutrigenomic interventions to optimize the body's own detoxification pathways. That brings me to another contributing aspect.
 
 
 
 
 
Fact #4: Most children with Autism (70-80%) have mthfr genetic mutations, which impair glutathione production, so they lack what is arguably the most important antioxidant in the human body (9).   Glutathione deficiency alters many areas of health, with one major impact being decreased ability to detoxify and clear toxins effectively.   So if nutrigenomic detox pathway optimization isn't completed, combined with a CBD-triggered increase in toxic load from die-off, then boom: Herxheimer misery.  This is best described as feeling like a severe flu, and in some cases the severity may require seeking medical attention...no wonder we see a spike in Autism behaviors!
 
 
 
 
 
In summary, CBD has considerable therapeutic potential as an intervention for Autism and related immune disorders, but I recommend taking special consideration of the patient's detoxification status before starting CBD supplementation.   This helps prevent a severe die-off reaction, and decreases the risk of an adverse event that may discourage use of cbd, however beneficial.
 
 
 
 
Of course, there are additional considerations, such as a CBD-rich strain's tendency to be more sativa dominant in terpene profile, which may also be problematic for some with Autism or anxiety.  This exemplifies the need to work with a practitioner who views clients from a holistic perspective, and can individualize recommendations based on a broader view of the mechanisms involved.   That's what holistic nurses do!
 
 
 
 
 
At Integrated Holistic Care, we offer help for those seeking support in managing therapeutic cannabis to treat Autism and related immune disorders and beyond.   If you would like more information, or to schedule a consultation, please visit our website at:  www.integratedholisticcare.com
 
 
 
 
 
Blessings,
Nurse Janna
 
 
 
 
 
 
Citations:
1. J Nat Prod. 2008 Aug;71(8):1427-30. doi: 10.1021/np8002673. Epub 2008 Aug 6.
2.  Zhornitsky S, Potvin S. Cannabidiol in Humans—The Quest for Therapeutic Targets. Pharmaceuticals. 2012;5(5):529-552. doi:10.3390/ph5050529.
3. Jepson, Bryan, and Jane Johnson. Changing the course of autism: A scientific approach for parents and physicians. Sentient Publications, 2007.
 
4.  Siniscalco, D., Sapone, A., Giordano, C. et al. J Autism Dev Disord (2013) 43: 2686. doi:10.1007/s10803-013-1824-9
 
5. Lone, Tariq Ahmad, and Reyaz Ahmad Lone. "Extraction of cannabinoids from Cannabis sativa L. plant and its potential antimicrobial activity." Universal Journal of Medicine  1.4 (2012): 51-55.
 
6.  Siniscalco, D., Sapone, A., Giordano, C. et al. J Autism Dev Disord (2013) 43: 2686. doi:10.1007/s10803-013-1824-9
7.  Grandjean, Philippe et al.  Neurobehavioural effects of developmental toxicity
The Lancet Neurology.  2014; 13(3): 330 - 338
 
8.  Woeller, Curt MD.  Autism Treatment: Herxheimer reactions and Autism.  Website: http://autismrecoverytreatment.com/autism-treatment-%E2%80%93-herxheimer-reactions-and-autism/
 
9.  Boris, Marvin, et al. "Association of MTHFR gene variants with autism." J Am Phys Surg 9.4 (2004): 106-8

By Janna Champagne, RN, BSN + ASD parent
I talk with clients about the importance of epigenetics and nutrigenomics every day and often get the "wha???" response.  With a little explaining, the light bulb brightens until the realization hits.   Yes it's true, epigenetics are a major cause of many chronic illnesses, including Autism Spectrum Disorders (plus many other conditions) .
I consider nutrigenomics so important for recovering kids with ASD, that it's often the first tool I grab from my bag of tricks.  The following is my rationale for prioritizing nutrigenomics plus some bonus info on the subject.   Because I'm sweet like that😊
First, a couple of helpful definitions:
1. Epigenetics- environmental impact on gene expression (switches genes on and off)
While our genes are inherited and static (DNA doesn't change), every gene has an on and off switch that can be triggered by environmental factors.   This is a phenomenon known as epigenetics. University of Berkeley has been integral in researching and has published extensively on this subject.
2. Nutrigenomics is the term for genetically individualized supplementation used to offset the health-damaging results of epigenetic mutations.
Basically it's like the oil for your car.  Helps keep all the moving parts flowing as they should.   (It's really more of a chemical thing, but I'm a fan of car analogies)
3. Single Nucleotide Polymorphism (snp) is a fancy name for a gene.   Pronounced "snip" in conversation.
In referring to mutations:
Homozygous means inherited from both parents, (double=more severe impairment)
Heterozygous means inherited from only one parent (single=less severe impairment).
The most recognizable snp in regards to health impact is mthfr (methelenetetrahydrofolate reductase).   In this case mthfr isn't the abbreviation for a bad word, but if this mutation isn't offset, the "less PC" term is a fair description of the insult to ones health.   See, mnemonics work!
Mutation of mthfr is found in 70-80% of those with Autism. This mutation manifests as lack of an enzyme which impairs the body's ability to metabolize (break down and utilize) folic acid appropriately.  Ample folate is pretty important, so this is kind of a big deal.
Those with mthfr end up with folate deficiency, which results in lacking  critical components for several foundational chemical cycles.   Correct folate metabolism is required for production of neurotransmitters, detoxification (glutathione production), neuro development, immune balance, and the list goes on.  Bonus question: which epidemic childhood illness features these very deficiencies and imbalances?    You guessed it....Autism.
The severity of mthfr mutation impact varies.  Homozygous (double)  mutation causes an 80% impairment in folic acid metabolism, while heterozygous (single) is only 40% impairment (while less the impact is still significant). Offsetting mthfr mutation requires nutrigenomic supplementation, which entails matching individual gene mutations with the best nutrient formulations to fill the specific deficiency.  This ensures the body gets critical nutrients despite the missing chemical reaction links.
Mthfr is just one of several dozen Autism-applicable  snp's that are addressed through our nutrigenomics consulting process at Integrated Holistic Care.   The gene test kit costs $99 and uses saliva, which is collected at home and submitted by mail.   Easy peasy.
There's is a prioritization to therapeutic nutrigenomics, and mthfr is not the first snp on the list, so medical oversight by a knowledgeable practitioner is strongly advised. Our body is one system made of many moving parts, all of which work synergistically. The order snps are addressed is individual and based on which mutations are present, with consideration of all the moving parts and the body as a whole.
I chose to exemplify mthfr because it's the popular kid, the most readily recognized, and reputable information can be found here for those wishing to delve deeper: www.mthfrsupport.com  *Disclaimer: the information contained herein may cause overwhelm and anxiety.    No worries, a nurse specialized in nutrigenomics is standing by, and consult scheduling is just a click away!   www.integratedholisticcare.com/services
The take home message is that nutrigenomic interventions help slow or stop a major contributor of the imbalances and toxic build up causing symptoms of Autism. Once the foundational/causal issues are addressed, faster recovery from the collateral damage is facilitated.   Nutrigenomics helps halt the incoming toxins, and facilitates clearing  what's already built up.  For those with Autism, this is a necessary component to healing and the road to recovery.
Happy to answer questions😊.   Please share if you found this helpful.   Wishing you all a blessed New Year❤