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Reversing Autism with The Nemechek Protocol – Update 2017

Reversing Autism with The Nemechek Protocol – Update 2017
March 20, 2017 Dr. Patrick Nemechek and Jean Nemechek

Nemechek Autonomic Medicine Autism 2017There is growing scientific evidence that an imbalance of intestinal bacteria called SIBO (Small Intestinal Bacterial Overgrowth) along with excessive inflammation within the brain are responsible for the features associated with Autism as well as ADD/ADHD, mood disorders, and developmental delay in children.

Bacterial overgrowth occurs when large numbers of bacterial that predominantly live in the colon migrate upwards, and increase the number of bacteria within the small intestine by 10,000 to 100,000-fold. This added bacterial load in the small intestine has two consequences that contribute to Autism.

First, the bacteria often tend to be of a clostridium species which can produce propionic acid in massive amounts. Propionic acid is a short chain fatty acid that is normally produced in small amounts within the intestine but the higher concentrations are being linked to some of the behavioral aspects of autism.

In animal studies, high propionic acid leads to the development of antisocial behaviors, increased sensitivity to sound, light, and touch, as well as gait abnormalities. In human studies, children with autism have very high concentrations of propionic acid within their tissues.

Secondly, the increased concentration of bacteria within the small intestine causes leakage of pieces of bacteria into the large concentration of immune cells that surround the small intestine and triggers the inflammatory reaction referred to as leaky gut.

A TESTIMONIAL

Hello! Just wanted to share that I started my Autistic/Apraxic 3 year old son on your protocol almost a month ago. He had about 10 words before this, averaging 1 new word a month prior. He has since, in that short time had an explosion of speech. He has been saying now about 1 new word a day, said 3 new words just yesterday, and has even spoken a few 3 word sentences. I felt hopeless before trying your protocol and cannot believe the large gains we are seeing so quickly! Thank you thank you thank you!!!!!!!   –   A Mom on Facebook

Leaky gut causes an increase in peripheral pro-inflammatory cytokine levels and allows for the inflammatory priming of a specialized form of white blood cell known as microglia within the central nervous system.

The combined production of inflammatory cytokines and activated microglia are primarily responsible for the developmental issues, seizures, sensory issues, mood and attention disorders commonly associated with autism.

A child is born with approximately 100 billion neurons and over the ensuing 18 years, needs to prune these neurons down to 50 billion in a process referred to a synaptic pruning. Excess inflammation from leaky gut, microglia priming and omega 3:6 imbalances prevents otherwise healthy microglia from pruning fast enough, and results in developmental delay.

The priming effect from the bacterial overgrowth causes many microglia to shift into the M1-phenotype, and results in the brain being less able to fully repair itself from commonplace physical (falls and bumps to the head), emotional (fear, abuse, neglect) and inflammatory (surgery, infections, vaccines) brain injuries.

A small residual amount of damage will remain after each injury, and each new injury leaves residual damage upon the prior injury in a process referred to as cumulative brain injury. The abnormal neurological functioning from cumulative brain injury can occur slowly over time and or rapidly depending on the intensity of the brain injury. Damage to different portions of the brain will result in different outward symptoms such as ADHD, chronic anxiety or gait abnormalities.

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The elevated inflammatory cytokines are also able to turn on certain genes that are linked with autism and may be responsible for certain features or more severe forms of Autism.

And finally, the excessive inflammatory environment in the brain reduces the seizure threshold and make seizures more likely to occur. The drop in the seizure threshold from inflammation is seen when young children without Autism develop febrile seizures with the fever and inflammatory reaction that occurs with simple upper respiratory viral infections or middle ear infections.

My understanding of the bacterial and inflammatory features in Autism have opened the door for me to provide groundbreaking treatment. The bacterial overgrowth increases propionic acid levels that cause kid’s brains to function differently, almost like a chemical impairment or slight intoxication, and at the same time the inflammation prevents normal neuron pruning and development as well as inhibits normal brain injury repair.

My approach to reverse the key components in Autism is straightforward. To provide the brain with a healthy, non-inflammatory environment to function more normally and to allow microglia to correctly prune and repair the brain, we need to reverse bacterial overgrowth and suppress the production of inflammation cytokines that are produced from a variety of sources.

By applying a logical understanding of science, I have developed a simple approach referred to as the Nemechek Protocol for Autism, and I have reversed the key features of Autism in many children.

The Nemechek Protocol for Autism uses a prebiotic fiber called inulin to reverse and control bacterial overgrowth, and high doses of omega-3 fatty acids to normalize microglial function and normalize the inflammatory state within the brain.

Cooking with domestic extra virgin olive oil also helps reduce brain inflammation resulting from linoleic acid, an omega-6 fatty acid found in in high concentration in cooking oils and processed foods.  Inulin is a natural fiber found in onions, garlic, artichokes, agave, chicory root and many other plants.

When buying powdered inulin, I avoid ones that also contain probiotics or digestive enzymes as these ingredients can makes some aspects of Autism worse.  (See my post on probiotics for more info on this topic.)

I find that 2-4 inulin gummies or 1/2 to 1 teaspoon of powdered inulin daily can reverse bacterial overgrowth enough to allow an autistic child (2-8 years of age) to become much more aware and interactive with their environment within a few weeks. And depending on the amount of underlying developmental delay, children will often start speaking within a few weeks to a few months.

Remember this is a simple plant fiber found in foods we eat every day, and is safe in children. If children get a little gassy or bloated, I recommend cutting back on the dose. Inulin is heat-tolerant and can be mixed or sprinkled over any form of liquid or food.

To help reduce the inflammation within the brain and normalize the behavior of microglia, my autistic patients are placed on omega-3 fatty acids (EPA and DHA) from fish. A recommended starting dose for small childrens is about 600 mg of omega-3 (the total of EPA plus DHA) per day.  DHA is particularly important as it is the main omega-3 in the brain.  (Read this post for more information on DHA as brain food.) Omega-3 fatty acids may be given in the forms of simple fish oil mixed in their food or drinks.

I don’t recommend fermented fish oil.  And when dosing I tend to increase the dose of omega-3 is the children are older (specific dose for varying ages of children can be found in The Nemechek Protocol for Autism and Developmental Disorders)  When in doubt, I favor a high dose.

If children have difficulty with diarrhea or prior problems with fish oil causing diarrhea, I have the kids start inulin fiber alone for 2-3 weeks in order to let the gut bacteria balance out, and then slowly increase the dose of fish oil and usually the tolerance is much better.

Whether the parents use Nordic Fishies or or another brand of liquid fish oil, I recommend they buy a high-quality brand as there is a very high level of fraud in the supplement industry.

All families are asked to cook their foods in domestic extra virgin olive oil (EVOO).  EVOO contains 70% oleic acid, and oleic acid reverses the underlying inflammation coming from excessive linoleic acid toxicity.  (Watch my screencast for more information on the benefit of olive oil.)

Linoleic acid is most commonly found in the unnatural vegetable oils added to the foods we purchased.  (See my other post about omega-3/omega-6 rebalancing for more information on this topic.)

The bigger, older children with autism require more effort and higher doses of inulin.  To gain better control of SIBO in older children I often treat with a 10-day course of Rifaximin (Xifaxan in U.S.).  Rifaximin is a non-absorbable antibiotic that is only used for other bacterial overgrowth conditions (hepatic encephalopathy and IBS with diarrhea).

Follow-up use of inulin after Rifaximin is sometimes used if intestinal symptoms are still present.  If inulin does not make any significant difference as a follow-up therapy, I stop it.  I never add probiotics after resetting with Rifaximin because probiotics can easily make things worse even if they helped prior to the use of Rifaximin.

The reversal of bacterial overgrowth with inulin results in a drop of propionic acid and can result in a sudden improvement in function within a few weeks.  But many children do not fully return to normal because they still have underlying developmental delay (some quite severe) as well as ADD, ADHD, sensory issues, seizures, as well as chronic depression, anxiety or aggressive behaviors. ( Watch my screencast about how leakage of LPS from bacterial overgrowth prevents the brain from fully recovering from injuries.)

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These remaining conditions take longer but week by week things can slowly improve.  If there is no significant improvement within 2 months, I generally increase the dosage of omega-3 fatty acids. If things still do not improve or seem to plateau after a couple months, I now add bioelectric Vagus Nerve stimulation to the Nemechek Protocol with good results.  (See my screencast about vagus nerve stimulation.)

The brains of older kids that have experienced prolonged bacterial overgrowth and inflammation as well as more brain injuries that occur over time, generally take longer to show improvement but I have seen significant progress in older kids as well.

I care for 2 teenage non-verbal autistic boys (14 and 16 years of age), and although they showed signs of continual improvement, they took about 4-5 months to begin speaking.

More recent is a remarkable case of a 23-year-old non-verbal autistic girl with frequent seizures. Within 8 months her seizures had reduced from 5-7 per day to 2-3 per week, and she can now write her name and converse in both Spanish and English (she lives in a dual language family).

For autistic children, the Nemechek Protocol will need to be daily and possibly forever but the benefits are life changing. Inulin fiber, omega-3 fatty acids and olive oil are from natural sources, are commonly consumed by most of us every day, and are available without prescription.

I am a classically trained internal medicine physician (D.O.) from UCLA and my Internal Medicine and Autonomic practice is in the Phoenix area. My research background has been focused on the Autonomic Nervous System, brain metabolism, and metabolic inflammation.

I use all available scientific and medical tools to induce the nervous system and organs to repair themselves by normalizing inflammation control mechanisms, inducing natural stem cell production, and re-activating innate restorative mechanisms.

March 23, 2017 –  An Addendum on Recovery

My Experience with Autism Recovery:

Uniformly all the kids under my care (50-60 to date) seem to be improving in significant ways.

In terms of speech, some younger kids start speaking within a few weeks while kids in the teens might take 4-6 months.  Our 23-year-old patient didn’t start speaking until after 8-9 months of treatment.

Importantly, even the most severe cases have a noticeable improvement in their awareness of their surroundings within a week or 2.  I interpret this as a decline in the toxic effect of the propionic acids on their brains.  Parents report more eye contact, awareness or acknowledgement others have entered the room.  They also seem more tolerant of being touched or held, or are more willing to approach someone and be physically close to them.

After the first few weeks, recovery rates are highly variable, and I believe this is due to the degree of developmental delay underlying the toxic state.  If the inflammatory cytokine process has been going on since birth, there can be so much developmental delay as to be labeled mentally retarded.  But if the developmental delay is simply mild, kids may seem very functional quickly.

The important point to remember is that your child’s brain and an enormous capacity to continue the path of development once the inflammation is controlled.  Neuronal/synaptic pruning will re-initiate, and according to the developmental delay literature, they can catch-up about 2-3 months of development for every 1 calendar month.  In my estimation, it seems to advance this fast if not faster.

The underlying wild card is what gene has been activated by the inflammation and what might it do to the neurological impairment of your child’s brain.  The inflammatory environment that prevents normal synaptic pruning and recovery from brain injury also triggers the litany of genes being found in autism.

Inflammatory cytokines abnormally produced by the mother are affecting the child’s nervous system within the womb, and then the imbalance of intestinal bacteria of the child as well as high omega-6 food sources continue to fuel the inflammatory process within the child after birth.

These inflammatory cytokines are the primary process through which the genes within the DNA that had been dormant for 1,000’s of years in the child’s ancestors are finally activated, begin altering how cells function, and contribute to the overall variety of neurological, behavioral characteristics that manifest in autism.

Here’s the potential for recovery in the autistic brain. A 23-year old non-verbal autistic female (Lennox-Gastaut Syndrome), was having 6-8 seizures per day and had never held her parents gaze for her entire life.  She did not like to be held, could not color or write, and sat curled up in a chair most of the day rocking.

Within 2 months’ of starting our protocol (rifaximin, high dose omega-3 fatty acids, and mother cooking with California olive oil), her seizures had dropped to 1-2 a day, she would sit upright in a chair and she slept through the night.

At month 4 she started looking her parents in the eyes and holding their gaze, and was more able to be touched and hugged.

At her month 6 office visit, she started smile at me, her seizures had reduced to 1-2 per week, she could now write her name (although she had never been shown previously) and could draw objects that were recognizable.

At 8 months, she began speaking rudimentary Spanish and English (dual language household) but emotionally is behaving as if she is 3 years old.

At 18 months, she speaks very clearly in full sentences, her seizures have declined to 1-2 per month (despite discontinuation of 2 seizure medications), and her emotional maturity has risen to about that of a 4-5-year-old.

But don’t despair. No matter how badly the developmental delay has slowed brain maturation, the potential for an unbelievable recovery is present.  We are beginning to understand that once human genes are turned on by inflammation, they can ultimately be shut back off again once the inflammatory environment within the body is significantly reduced.

Do your best to be patient and give this approach a chance.  Because the path to recovery over all things medical is 3 steps forward, and 1-2 back, compare today’s behavior to last month’s, not yesterday’s. The neurons within the human brain, like your hair, can only grow and change only so fast.

Every month, your child’s brain has the ability to “catch-up” 2-3 months in development.  That means every calendar year, they may catch-up 2-3 years.  I believe once the inflammation is suppressed, all that is required for recovery is a good solid inflammation suppressing regimen and patience.

May 26, 2017 – Addendum on The Misconception of Feeding Bad Bacteria and Yeast

The conclusion that increased stemming, less sleeping or increased anxiety is from inulin feeding “bad” bacteria such as Klebsiella has been a concern of several commenters.

I’m not saying this is impossible but I do not believe that to be the case, and have never seen such a reaction in the many children I’ve worked with. There are several reasons for this.

First, inulin’s main effect is within the lumen of the small intestine where bacteria digest inulin through a process referred to as fermentation. The primary effect is the production of the healthy short chain fatty acid known as butyric acid. Only small amounts pass through to the colon.

Secondly, a significant increase in pathogenic bacteria, or overgrowth bacteria would almost certainly cause an increase in diarrhea, stool frequency, abdominal cramping, reflux and eczema. We do not see this, and in fact there in general a reversal of these symptoms with the use of symptoms with the use of inulin.  If the intestinal ( not neurological or behavioral) symptoms were to worsen on inulin, I would suggest the inulin be discontinued and would suggest using Rifaximin.

The development of constipation with the use of inulin is a sign of underlying autonomic dysfunction from developmental and cumulative injury that eventually reverse after a few months of fish oil.

Thirdly, propionic acid has a sedating effect on children, almost as if the children had been taking Valium or Xanax. Therefore, once inulin reverses the bacterial overgrowth and the propionic acid levels decline, the children will come out of their stupor. There behavior at this point is predicated but their pre-existing developmental abnormalities and cumulative brain injuries and not some toxic effect of inulin.

A fourth point is that the detection of pathogenic bacteria such as Klebsiella in the stool by no means suggests these bacteria are present within the small intestine where inulin has it’s main effect. Detection of pathogenic bacteria such as <em>Klebsiella pneuomiae</em> or <em>Clostridium difficle</em> are commonly in asymptomatic patients and are essentially harmless. Their growth is kept in check by a healthy balance of other bacteria which is further bolstered with inulin.

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And finally, some parents are worried about overgrowth of candida. I agree that candida and other yeasts/fungi inhabit the intestinal tract but more detailed studies demonstrate yeast/fungal overgrowth does not occur in autism. And while the observations of clinical improvement about reduction of sugars and etc. are correct (think GF/CF, FODMAPS, GAPS), they were misattributed to yeast instead of the bacterial overgrowth for which we have mounting evidence.

Because of this, I believe the use of potent anti-fungal drugs is unwarranted in the specific treatment of autism.

Hope this helps.

© 2017. Dr. Patrick M. Nemechek and Jean R. Nemechek. All Rights Reserved. Patent Pending.

2,081 Comments

  1. Kate Montesano 2 days ago

    Hello Dr. Nemecheck,
    My son is 7 years old, ASD, ADHD, apraxia, hyperlexia, and SPD. We’ve been on the protocol for nearly 3 months. He currently takes 1 1/4 tsp of NOW inulin, 3 gel caps NOW DHA 500, and 10mls of fish oil. We have seen what appears to be awakening pretty early on. We had a very aggressive period of about two weeks. His super hyperactive and has been aggressively hitting his ipad screen, banging it on his head, hitting walls and, slapping the glass in our windows (has broken 3 panes to date). I should state that he is typically happy when he’s doing these things. We’ve been seeing this since the start of the protocol and it’s getting worse. His hands and forearms are swollen and bruised. It has caused a tremendous amount of stressed in our home. Looking for thoughts. Thank you in advance for your time. – Kate

  2. Billie 2 days ago

    Do you believe that a diet high in dense acellular carbohydrates beside other factors also contributes to altered microbiota as Dr. Ian Spreadbury says?
    When our children who are on the protocol grow up, will they be able to control SIBO with inulin or at some point they will need Rifaximin? I also read in some of your articles that you recommend keeping carbs around 100 g for adults. That would be like Atkins diet. Would avoiding acellular carbs along with including more of prebiotic foods help control SIBO?
    Those are my last questions. Thanks for answering. I learned a lot from your website,and screen casts.
    p.s.Do you allow translating your articles and publishing them with the link included to your website?
    Greetings from my family.

  3. Patrick Nemechek, D.O. 2 days ago

    Hyperactivity combines with anxiousness or aggressive is often a sign of low cerebral blood pressure from cumulative brain injury.

    The short term use of stimulants can boost blood pressure to the brain and calm these behaviors. After a few months the stimulants can be weaned as the brain blood pressure begins to normalize though recovery of autonomic function.

  4. Kate 2 days ago

    Thank you for the response. We have tried nearly every single stimulant medication with severe adverse reactions, tremendous aggression as a result>He’s broken 3 noses, knocked out others teeth with his head, fat limps and bite marks on himself and others. He’s currently taking .25mg Risperdone in the morning as well as .5mg Klonipin and Clonide/Melatonin at night for sleep. He has a negative response to nearly all medications, SSRIs, ADHD, anti-psychotics alike. Aggression is always the reaction. He’s far less aggressive since the protocol but the aggressive nature of his sensory seeking behavior is troublesome.

  5. Kristina 2 days ago

    Good Morning,

    Thank you so much for sharing your protocol with us. My 9 year old son has ADHD, SPD and high anxiety, we have had great success following the Feingold diet. After reading your book I decide to give it a try. We started the inulin and EVOO on Sept 10, and the Omega 3 a couple days later. Currently he is taking 1/2 tsp of NOW inulin, 2 DHA 500, and getting at least a 1 TBSP of California Olive Oil. Physical he has tolerated the protocol well. We saw awakening on 1/4 tsp of inulin. We increased the inulin dosage as we were still seeing reactions to high salicylic foods, especially corn, and that was the recommendations of the Facebook group. While food reactions are much less, he is still having them. I hesitate to increase the inulin again, as we have seen the awakening. Is the food intolerance due to SIBO or ANS dysfunction? Should I increase the inulin, or give it more time at the current levels. We have no intention of stoping the protocol even if we continue to have food intolerance, as we have seen such improvement in our son.

  6. Dana C 2 days ago

    Hello! We have been doing your protocol since the summer! I have a two part questions. First of all Wow this has made a tremendous difference in my son who was seeing a DANS doctor.

    My son is on all recommended supplements. He does 1/8 inulin NOW, two fish gummies Nordic tutti fruitti, and the California EVO. We were told he needed the methylation B-12 with folinic acid shots, i have now stopped the shots and i am doing the nasal spray. I was told this is a something the body cant do- absorb the B-12 and too continue the nasal spray. What are you thoughts on this?

    2nd my son had low iron, we are giving him a whole
    Food iron supplement. It seems to help him, is this ok? He is still an extremely picky eater so getting the iron in with food is not happening.

    Thank you for your time!

  7. Aida 2 days ago

    Hi dr.Nemechek! I am from Azerbaijan. My son,he is 15 year, on inulin 1/4 tsp. He is 5 days on inulin. When he can start to take the fish oil omega3 Dha Epa and olive oil? Thank you

  8. Patrick Nemechek, D.O. 2 days ago

    I think carbohydrate intake can certainly worsen the degree of bacterial overgrowth but I do not think it will trigger it.

    I have had a few kids that were controlled on inulin for 1 year + but then relapsed spontaneously and needed Rifaximin.

  9. Patrick Nemechek, D.O. 2 days ago

    Once you reach the awakening stage with inulin, I do not recommend my patients increasing the inulin further as it just seems to increase gas, bloating and occasionally diarrhea.

    I believe the majority of food intolerance is related to SIBO with the exception of inflammatory responses from gluten which seem to improve further after parasympathetic recovery. Other times I’ve seen the food intolerances actually be from issues with digestive enzymes, acidifiers, etc.

  10. Patrick Nemechek, D.O. 2 days ago

    The cause of both the B12 and iron deficiency might be from malabsorption caused by bacterial overgrowth which resolves shortly after treating with inulin or rifaximin.

  11. Patrick Nemechek, D.O. 2 days ago

    Many of my patients start the inulin, fish oil and olive oil at the same time.

  12. Pam 1 day ago

    Hi Dr,
    I am about to start your protocol.
    My son is deficient in iron, D3, B12 for which he takes supplements.
    He also takes biosuperfood, an algae product, that naturally contains antioxidants, probiotics and omega 3 6 9.
    Would these interfere? Whats your advice please?
    Regards
    Pam

  13. Hope 1 day ago

    Would S. Therm, L bulgaricus, L acidophilus, Bifidobacterium Lactis be permitted in a frozen yogurt or regarded as prohibited? I ask as yogurt is fermented with added cultures. Thanks

  14. Daniela Tamer 1 day ago

    Dear Doctor,

    Would you have time for some recommendations on the sides?
    9 yrs old receives
    1/8 inulin (after one week and absolutely NO CHANGE, i increasee to 1/4 statind Nov 20th; no immediate reaction. Just some agitation but that was there even from before)
    4 fishies (Will go with now capsules – they have 250 DHA and 500 epa)
    Half tablespoon EVOO – can it be increased?

    IS THAT ok? How many capsules of fish oils should he receive? Was thinking to go with 1 per day…
    Many thanks for your time
    Daniela

  15. Patrick Nemechek, D.O. 1 day ago

    I discuss my views on all of these issues in the book.

  16. Patrick Nemechek, D.O. 1 day ago

    Traditional fermented food is fine but the addition of bacterial strains can turn a simple food product into a probiotic and probiotics are strictly prohibited with my protocol.

  17. Patrick Nemechek, D.O. 1 day ago

    I’m sorry but I cannot specifically comment on dosages for individuals, it is inappropriate without a fuller understanding of your child’s case.

    My protocol book outlines how I decide which dosages are adequate, etc for a given age of a child. I recommend following what I write and not what others might say on other blogs or chat forums.

    You can get a copy at https://autonomicrecovery.shop

  18. Kiran 22 hours ago

    Hi doctor nemechek,
    My husband is suffering from IBS for the last 8 years. We have started your protocol 2weeks ago. He is taking 1/2 tsp insulin, 1fish oil cap and olive oil. Now he has started severe pain below his ribs, swelling and stabbing wounds like pain . His symptoms of IBS were suppressed due to some dietary changes but after starting your protocol all his symptoms are back . What should we do right now he has stopped the protocol.

  19. Patrick Nemechek, D.O. 19 hours ago

    Inulin is not effective for bacterial overgrowth in adults, especially those with IBS.

    IBS is an autonomic disorder with varying degrees of bacterial overgrowth, and often requires vagus nerve stimulation for successful treatment.

  20. Cindy 8 hours ago

    Will the protocol work for someone who is diagnosed as mentally retarded?

  21. Ugur Gezer 8 hours ago

    Hi. Dr. Nemachek,

    we started your protocol 3 weeks ago. Repetetive behavior and stimming has increased. Is that normal?

  22. Narayan 7 hours ago

    Dear Doctor
    I am writing in to you from India. Our son is 12 yrs old and diagnosed as moderate to high functioning autistic.He has made significant progress so far on a GFCF diet + home schooling. In the last 3-4 months we hit a plateau and more recently a bit of regression with elevated levels of stimming, clapping and head/chin banging. My son also complains of a gut issue but we are unable to figure out where it is coming from. Meantime, I read your book and have decided to start your protocol. The NOW Omega and Inulin are on the way while we source some good quality EVOO locally. The question I have is, reg the Inulin adminstration. Starting with 1/8 teaspoon, you have mentioned that the same can be increased upto 2 teaspoons till results are seen. At what pace should this increase be done ? For e.g increase in steps of 1/8 teaspoon every week or biweekly ? Although our son is 12 yrs , we thought of starting with Inulin before trying Rifaximin. Thanks in advance for your inputs

  23. 7nod 5 hours ago

    Hi my daughter has been on the protocol for more than six months and there has been no much improvement i am using all the brand that you said to use and I bought the book so I was wondering if I could give my daughter L-carnosine

  24. Patrick Nemechek, D.O. 2 hours ago

    Yes, of course. Individuals with severe intellectual impairment can still be affected by bacterial overgrowth, and autonomic dysfunction.

    The mental retardation may even to some degree be a process of severe developmental delay that could also improve to some degree with this protocol.

  25. Patrick Nemechek, D.O. 2 hours ago

    This is part of the awakening period. I discuss this at length in the protocol book.

    There is a 1/2 price sale on the book from this coming Friday through Monday.

  26. Patrick Nemechek, D.O. 2 hours ago

    I have no hard and fast rule for increasing the inulin. Maybe once weekly by an 1/8 of a teaspoon would be fine.

  27. Patrick Nemechek, D.O. 2 hours ago

    If there is no improvement at all I would start eliminating other non-prescription supplements and see if any of these are impairing recovery.

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