Wednesday, May 2, 2007

Can the low NO hypothesis of ASDs be proven false?

The answer is yes, it can. If nitric oxide is raised in an ASD individual and that individual does not experience an improvement in symptoms, then low NO is not the problem for that individual.

NO is involved in a lot of pathways, and the pathways that seem to be producing symptoms characteristic of ASDs seem to be affected in the direction that low basal NO would produce.
My perspective on ASDs is that they are a natural consequence of low NO in utero. They are a "feature", which programs the brain to produce the "tool-making and tool-using" phenotype, most precisely characterized by the person with Asperger's. But like all evolved features, if you push it too hard, it becomes dysfunctional. Just like anaphylaxis.

That is why I am extremely confident that there will never be a genetic test for ASDs. If your genotype is such that development in utero under conditions of low NO would not lead to an ASD phenotype, then you are not human. Tool making and tool using is such a fundamental part of being human, that you can't remove it and remain human.

NO will not be a "cure" along the lines of what the curebies want. It won't change the characteristic brain structures that lead to ASD behaviors and neurological characteristics. An ASD individual with high NO will still have an ASD. They won't melt down as much, or as badly, they won't be as anxious or as easy to bully. They will be better able to lead happier and more productive lives as they perceive them to be. A lot of things will get "better". It won't turn them into NTs.

If ASDs were actually a "disorder", then it would be too complicated to be treated. If it is a disorder, it is obviously a disorder that affects neural development on many levels, and has ongoing effects in physiology. A simple treatment will not be able to have complicated effects unless the "simple treatment" ties into the already existing control systems used in phsyiology. The physiological pathways that seem to be "dysfunctional" in ASDs are too coupled and to complex to regulate artifically, that is with anything other than the innate regulatory systems that the body and physiology already has.

If you look at what some of the DAN! practicioners are trying to do, they are trying to substitute external pharmacological interventions via supplements, drugs, vitamins, glutathione, ect, etc, etc, for things that physiology regulates on its own. That approach is not going to work. Physiology is too complicated.

So far, only one person with an ASD has tried my stuff, that would be me. It has not made me NT, but it has greatly improved my ability to be in social situations. I can now notice that there is a lot of body language and non-verbal communication that I am missing. I am getting a lot more than I did before. I can't "focus" like I used to be able to do, that is, I can't work while listening to NPR. My health is a lot better. A lot of things are better. Has my personality changed? I don't think so. Certainly I am different, but not in any ways that I find objectionable. I would not revert to the way I was before I raised my NO level.

Is my "treatment" permanant? I don't think so, not like a course of treatment that resolves a problem and makes it go away, like an antibiotic. It is more like a nutrient, one that you absorb through the skin.


bluedevilRA said...

Hi daed, sorry it's been awhile, but med school is keeping me busy. One of my major points of contention, as before, is that you make statements like "most us have deficient NO physiology" and that it can be the source of any number of diseases (ASD, alzheimers, morgellons, cancer, etc). So why aren't most of us symptomatic. You do provide lots of studies to support your theory but none of it is conclusive, hence why I take issue with you claiming your hypothesis as fact.

In the above post, you say that you feel your ASD symptoms have improved. This is meaningless as evidence. How do you know its not placebo? You can't know that.

daedalus2u said...

BluedevilRA, I think a placebo effect is unlikely because I didn't know I had Asperger's until well after it started getting better. It was only then that I read up on autism and Asperger's and the physiology behind them.

After my Asperger's got better, I started trying to find clinicians to work with. A year ago, one of them commented (while watching me present a poster on NO and autism when I said that I noticed my Asperger's got better before I knew I had Asperger's), that “since I have known you, I have noticed that your Asperger's has gotten better”. This is a senior clinician working with autistic patients, someone who is board certified in neurodevelopment. I met her after I had noticed my Asperger's getting better, so it was not as “severe” when she first met me as it was before I increased my NO level (severe is not a good term to use in relationship with ASDs).

In any case the placebo effect is mediated by a neurogenic increase in NO levels. I think this is the reason that there are so many quack treatments for autism; placebos work particularly well on conditions that are due to low NO.

My improvement has persisted over many years now, and is continuing to improve.

I appreciate that a single case study is not “gold standard proof.” But it is not “meaningless”. It is data of very low statistical power.

Most people with low NO do have symptoms. That is what causes things like hypertension, diabetes type 2, obesity, depression, allergies, insomnia. The normal regulation of those things is via NO, so low NO skews them in a characteristic direction. It is only after long time periods that the symptoms reach a level that is considered clinically pathological.

If you send me an email address I can send you the posters I have presented on autism. If you look at nitroceutic dot com, there is an email address for me.

bluedevilRA said...

I appreciate that you say unlikely rather than impossible.

I never really made this clear I guess. In the case of data, when I say meaningless, I mean "meaningless as proof." It certainly isn't meaningless to you as a data point or to other researchers that might find such a data point interesting, prospective, etc. However, it is useless as a proving point. In the clinical world, even well-documented case reports are interesting (I love to read them), but no (good) physician would ever point to one and say "case report A proves that medicine X works."

Hope that clarifies that. Send 1-2 posters. As I said before, I am curious but suspicious. How do you account for the recent rise in DM2, hypertension and obesity? Why would NO start dropping in people. I don't think we're cleaning ourselves anymore than we used to (30-50 years ago).

daedalus2u said...

Every piece of data is “meaningless” as proof. Positive “proof” is not a scientific possibility. All that data can do is prove a hypothesis is wrong. If you have looked pretty hard at a lot of data that is relevant to the issue being considered and can't find any that is inconsistent with it, then the Bayesian likelihood goes up.

There has been a gradual decline in NO/NOx levels since the germ theory and the advent of modern water systems, piped water with abundant soap. That started in the 1850's. Following WWII, there was a pretty big increase in indoor plumbing in the US, but it was the advent of synthetic anionic alkyl sulfate and sulfonate detergents in the 1960's that was the first major modern hit. Then there was the advent of conditioning shampoo in the 1970's and 1980's that allowed people to wash their hair every day without it turning to straw. The modern use of anti-bacterial everything is the final hit. Here is a link to a write-up on the history of bathing and how it relates to the hygiene hypothesis and NO/NOx bacteria on the skin.

I emailed you the posters, I will email you this write-up too.