This
is not the kind of post that I expected to be writing. How can the effect of something so simple as
a mineral, not have been noticed by others and researched in depth?
Potassium
(K+), is one of several electrolytes
that occur in humans, the others being sodium(Na+), calcium (Ca2+),
magnesium (Mg2+), chloride (Cl−), hydrogen phosphate (HPO42−),
and hydrogen carbonate (HCO3)
Electrolyte balance or homeostasis is
regulated by specific hormones. These
electrolytes are used to control many aspects of your body. The concentration of each electrolyte varies
across the boundary of each cell.
Electrolytes pass through the cell wall/membrane through so called ion
channels. These are like special valves
that open and close based on particular pre-programmed circumstances. When these ion channels malfunction, often
due to a genetic fault, disease occurs.
Ion channel diseases have a special name - channelopathies. This is still an emerging area of science.
In autism the brain has developed in an unusual way and
although it is thankfully not a degenerative disease, the biological equilibrium
it has evolved to is not the one originally intended. There are both channelopathies and hormonal
irregularities; indeed the two are interrelated.
Many hormones are interrelated and have multiple
functions and therefore a change in one may have a cascading effect on others. The same applies to the electrolytes, for
example a deficiency in magnesium will trigger a deficiency in potassium.
Choride (Cl-)
I started my blog when I read about a successful clinical
trial that set out to prove whether an imbalance in chloride between the
extra/intra cellular fluid could cause one of the brain’s main neurotransmitters
(GABA) to malfunction. A clever
Frenchman called Ben-Ari, had been researching neonatal seizures and proposed to
trial the drug Bumetanide. Bumetanide
is known to block the NKCC1
cation-chloride co-transporter, and thus decreases internal chloride
concentration in neurons. In
turn, this concentration change makes the action of GABA more
hyperpolarizing. Do not be put off if
this does not make sense to you.
The trial showed the positive effect on autistic
behaviours of this long established and inexpensive drug.
A randomised controlled trial of bumetanide in the treatment of autism inchildren
Potassium (K+)
Not long after making a trial of bumetanide on Monty,
then aged 9 years, I started this blog and my own research. I soon came across a condition called
Hypokalemic Sensory Overstimulation. In
this condition, the subject becomes overwhelmed by his senses of sound, light,
smell etc. After taking oral potassium,
the symptoms disappear within 20 minutes. It is claimed that this is also a
characteristic of ADHD (attention deficit hyperactivity disorder). Well sensory overload is pretty common in
autism, and, as I have learnt, ADHD is really just a light case of autism.
There is almost no research into this condition, which is
odd since it is linked to the very common ADHD condition. The paper below was only ever cited 3 times in other research,
and only once in English.
I then did my own experiment using a small dose of
K+ supplement (equivalent to one banana)
to see if by any chance I could see a reduction in sensory overload. I tested both my sons, and only in the ASD
son did the potassium have any impact; and it was a marked impact. I wrote this up in a blog post.
I kept potassium and channelopathy on my list of things
to research and left it at that.
Ion Channels
& Ion Channel Diseases (Channelopathies)
Ion channels are an emerging area of science all about
how signals are sent throughout your body to control it. It gets very complicated and is still far
from fully understood. So you may want
to skip this part.
So far 300 types of ion channel have been
identified. The main types are:-
·
Chloride (Cl-) channels
·
Potassium channels
·
Sodium channels
·
Calcium channels
·
Proton channels
·
Non-selective cation channels
Then there are differing ways in which the channels open
and close such as:-
·
Voltage gated
·
Ligand gated
And odd ones like
·
Light gated
·
Temperature gated
·
Calcium activated potassium channels
When the ion channel and/or its gating does not work
properly then a disease called a channelopathy may result. Examples of well know disease are cystic
fibrosis, various types of epilepsy and ataxia.
Puberty and
Epilepsy
As a result of the changes in hormones triggered by
puberty it is therefore not surprising that around this time other changes
occur in the body. In some children with
asthma, their symptoms become more mild or even appear to disappear. In autism the hormonal changes often trigger
an improvement, but may be the trigger of the onset of epilepsy. When you consider the importance of all these
electrolyte levels, and the variation of each across one each cell boundary in
the body and how this is intertwined with how the neurotransmitters function,
it is not surprising that a shift in Homeostatis occurs.
That shift in Homeostatis could be reflected in a
mellowing of autistic characteristics.
But if you can now make some small adjustments in these levels via diet
and mild drugs, why not investigate it?
You will not be able to achieve perfection, but you might be able to
shift from one stable equilibrium to another one, with milder autism and no
troubling side effects.
This would also imply that those children developing
epilepsy during puberty might be able to treat it using the diuretic
bumetanide. By blocking the NKCC1
transporter, the level of Cl- is blocked and GABA becomes more inhibitory and
thus the risk of an epileptic attack might be reduced, or perhaps eliminated. This is surely worth some research?
K+ ion channel
disease – Epilepsy & Autism
There is existing research linking potassium ion channels
to both epilepsy and autism
ADHD &
Ritalin
I read some research about a stimulant drug used to calm
children with ADHD. It seemed odd to use
a stimulant to produce calm. Here again
potassium (K+) and sodium (Na+) levels are at the centre of argument.
In the world of alternative medicine there is talk of
Ritalin helping in ADHD due to it altering the level of potassium:-
This
inverted ratio of Na/K may be helpful in explaining why a stimulant drug like
Ritalin would have a calming effect on hyperactive children and adolescents.
Ritalin does, indeed, have a stimulating effect on these children, but its
stimulating mechanism is neuroendocrine and biochemical, not behavioural. More
specifically, its stimulating effect is on the adrenal glands and the retention
of sodium in the tissues relative to potassium. It is critical for normal
cellular functioning that sodium and potassium (Na and K) be in balance for the
optimal operation of the Na/K pump at the cellular level. It is also critical
for efficient neurotransmissions that there be a proper balance between sodium
and potassium (Na and K) for neuronal conductance.
Measuring electrolyte
(Ka, Na, Mg, Cl etc.) levels
I would have expected that it was easy to check the level
of electrolytes and indeed to check the levels in blood is very easy. I have done this and all was normal. When you read further in the literature, you
will realize that the level of electrolytes at the extra/intra cellular level
is not so easy to measure. A whole
business has been created by people analyzing hair samples for clues as to the
balance or imbalance of various minerals in the body.
Hair analysis is used in forensic toxicology and drug testing
to detect the presence of various chemicals in the body. The method has been adopted by the complementary
and alternative medicine (CAM) community to try to predict food intolerance and
dietary deficiency. It is viewed by the
scientific community that much of the CAM use of the technology is not valid
and potentially fraudulent,
So there is no certain way of checking the cellular
level of electrolytes. You can only measure
what you eat and you can measure what is in your blood.
Other suspected
electrolyte imbalances in Autism
There have been several studies regarding Magnesium and
autism, but the peer reviews of these studies are highly critical of the
methodologies used and conclude that nothing has been proven.
Vitamin B6-magnesium treatment for autism: the current status of the research
Calcium has also been put forward as an intervention. One mother spent a great deal of time
collecting supporting information in her paper below.
DAN doctors and
Spironolactone
Having come across a “bible” of therapies proposed by DAN
(Defeat Autism Now) doctors I noted the use of a potassium-sparing diuretic
called Spironolactone. For a change,
there is actually a published paper setting out their case for this drug. The case made has nothing to do with
potassium, even though the intended purpose of the drug is to raise potassium
levels.
Bradstreet et al wrote a
paper on this in 2006. It has been cited
only 7 times up until 2013 and two of these times by the authors
themselves. This tells you that other
researchers were either skeptical or just disinterested.
Potassium
Supplements
There are many hundreds of types of mineral and vitamin
supplements; these days many contain far more than recommended daily amount
(RDA). This is not the case with
potassium. Even though the RDA for
adults is 3,500 – 4,700 mg, in the US supplements by law may not contain more
than 100 mg of potassium. In Europe
potassium supplements with 500mg are common.
In the US it seems that there is a perceived fear of
potassium poisoning. It is indeed the
home of the lethal injection. Potassium
chloride in a very high dose will stop your heart.
You will even find people debating whether you can poison yourself with bananas . It would seem that while you can reduce your high blood pressure
with bananas, it does not kill you. One
person was even eating 30 bananas a day!!
The fear of potassium though remains and it is all over
the American internet.
But, in the UK, the National Health Service advises:-
You should be able to get all the
potassium you need by eating a varied and balanced diet. If you take potassium
supplements, do not take too much because this could be harmful.
Taking 3,700mg or less of
potassium supplements a day is unlikely to cause any harm.
That amount of potassium would require 37 American
supplement tablets each and every day!
In reality, a concentrated dose of potassium may indeed
upset your stomach and this is why it is better to get it from a healthy mix of
fruit and vegetables. The average
American apparently consumes about 1,000mg of potassium per day.
Internet
Chatter
If, like me, you use Google to see what other people are
up to, you will come across talk of potassium and autism. The discussions in forums never get far,
because someone starts talking about lethal injections, and then fear prevails.
Sodium Potassium Pump (Na+/K+-ATPase)
The sodium-potassium pump was discovered in the 1957 by a
Danish Scientist, who later went on to win a Nobel prize for his discovery in
1997. Its main application has been in
the understanding and treatment of heart disease, but it is now thought to be
directly involved in a critical part of the brain already known to be damaged
in autism.
As I have already mentioned in my blog, the comorbidities
of autism (asthma, high cholesterol etc.) mean that much of the work has already
been done by others.
Those many people with hypertension (high blood pressure)
are suffering due the way the sodium potassium pump works. They eat too much sodium and far too little
potassium and the end result is high blood pressure.
An author and researcher, Dr Richard Moore, has a simple explanation on his website and a link to his book showing how diet can indeed
control your blood pressure. If you
check the book on Amazon you will see many very favourable comments from people
who have indeed lowered their blood pressure with bananas.
His book is called: The High Blood
Pressure Solution: A Scientifically Proven Program for Preventing Strokes and
Heart Disease.
Sodium
Potassium Pump and Autism
I was looking for evidence (other than my own) that
potassium levels affect the autistic brain.
Potassium plays a key role in how most ion channels function, but I was looking
for something really tangible. I think I
have found it.
In my earlier posts I introduced readers to a part of the
cerebellum called the Purkinje Cell Layer (PCL). This is a critical part of the brain and
unfortunately in autism, half of the cells are dead and this then manifests
itself in altered brain functioning and hence behaviour.
As recently as 2012, scientists in England showed that
the neurons in the PCL are controlled by the Sodium Potassium Pump.
The paper’s summary concludes “We propose that Na+/K+
pump activity controls the intrinsic firing mode of cerebellar Purkinje cells”
Our new friend Dr Richard Moore puts it very simply:-
For the Na-K-pump to operate normally, the diet must
have a ratio of potassium to sodium ratio (the K/Na ratio, or "K
Factor") that is above a threshold that is somewhere between 2 and 4. Our
ancestors ate a diet with a K/Na ratio ranging between 12 and 16. However, the
average American white eats a diet with a K/Na ratio of less than 1 - about 0.6
- and the average American black eats a diet with an average K/Na ratio of
about only 0.38! Obviously, the American diet generally has a very deficient
K/Na ratio.
A low dietary K/Na ratio causes a low K/Na ratio in each and every cell in
your body. This has been known since the end of World War II when whole body
radio-active counters were used to determine the amount of potassium (a small
part of which is naturally radioactive) in the human body. Almost universally,
to their surprise, it was found that people with hypertension have a deficient
amount of potassium in their body.
By 1983, several scientists including myself had worked out the vital role of
the Na-K-pump in cell function to the point where our understanding predicted
that other dysfunctions, or disease states, of the body's cells would occur.
Not until the mid 1990's did anyone bother to look for these other conditions.
Since then, it has become well established that in the U.S., our typical diet
with its low K/Na ratio is the cause of:
About 95% of the cases of high blood pressure.
At least 90% of strokes whether or not high blood pressure is involved.
Much of the osteoporosis and kidney stones.
An increased likelihood of h-pylori infection with resulting stomach ulcer and
stomach cancer.
An increase in the severity of asthma.
An increased likelihood of mental decline with aging.
In addition, there is some evidence that this low K/Na ratio in the American
diet contributes to insulin resistance, to obesity, and to adult diabetes
So since in autism a critical part of the brain is
already damaged and has been shown to be subject to oxidative attack and
neuroinflammation, it is not surprising that it is particularly susceptible to
further interference. As a result
whereas, in a typical childlike Ted, aged 13 with an aversion to fruit and
vegetables, can function perfectly well and additional potassium made no
measurable difference to his sensory behaviour, the same was not true of Monty,
aged 10 with ASD, and with a diet full of fruits and vegetables. The additional potassium actually changed his
sensory behavoiur. Now I have a
plausible explanation
Electrolytes etc.
If you really want to go into the biology and understand
intercellular/extra cellular fluid, role of hormones vasopressin and aldosterone
and all about sodium and potassium balance, then take 10 minutes to carefully
read the following link:-
Autism and
Heart Disease, Diabetes and Cancer
On this blog I have already shown that several strategies
for cardiac health also help autism.
Since in autism there is proven high cholesterol and high
neuroinflammation and most likely also hypertension, it would make great sense
reduce these risks regardless of the fact that those steps may likely also
reduce autistic behaviours and improve functioning.
I made a study into omega 3 and conclude “eat fish”, it
is cheaper than omega 3 oil, and it definitely will help cardiac health, but
probably will do little to nothing for the autism.
A high potassium diet, particularly if it is based on
food rather than supplements, will protect your child from heart disease later
in life. He/she is already in an at risk
group.
So there are two very good reasons increase potassium and
reduce sodium in his/her diet. If you are
not aware of the health issues surrounding autism, take a look at this:-
Without
intervention, adults with autism spectrum disorder appear to be at significant
risk for developing diabetes, coronary heart disease, and cancer by midlife.
For
a general discussion on these and other health issues, there is a well-researched
paper called:
Conclusion
In the case of Monty, aged 10 with ASD, incremental potassium in diet and
via an over the counter potassium supplement (that also contains magnesium and
B vitamins) has a positive effect on autistic behaviours. The total daily potassium ingested (1g as
supplement, plus banana, orange juice, potato etc.) is still probably below
the adult RDA of 3.5g, but much higher than most 10 year olds with ASD.
There is a scientific logic to show why potassium might produce beneficial
effects due to better functioning of the sodium-potassium pump, particularly in
the Purkinje cell layer of the brain, which is a known to be damaged in ASD.
It may also be that the magnesium, that is also present in the potassium
supplement, is having a beneficial effect.
This could easily be investigated by some further research, should
anyone be so inclined.
In any case, a relatively high potassium diet is well established to be very healthy and, along with strategies to lower cholesterol, will promote a healthy heart. The literature shows that autistic people have elevated cardiac risk and so already have a good reason to be following this kind of diet; I have just added another good reason.
Early on in
this blog I wrote about a supposedly rare condition, where somebody suffers
from sensory overload, usually from sound, but it could be light or even
smell. That condition has fancy sounding
name, Hypokalemic Sensory Overload. The
cure is very simple, just to give oral potassium and within 20 minutes there is
a full recovery. Here is one research study.