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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 focused application of The Nemechek Protocol™ medical consultation and treatment services on Autism, and 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.

5,035 Comments

  1. Anonymous 2 days ago

    Please could you kindly recommend olive oil brand which is authentic and easily available in UK?

    • Patrick Nemechek, D.O. 2 days ago

      I personally don’t know of one.

  2. Pamela 2 days ago

    Hello Dr. I have been doing protocol to my 10 year old and have seen a lot of gains even though we havent used rifaximin. My question is, He’s been getting red pimples on his belly and on his face, they come and go but i wonder if this might be some type of detoxication. Thanks in advance.

    • Patrick Nemechek, D.O. 2 days ago

      The human body does not detoxify through the skin. This is more than likely some shifting of skin bacteria.

      Eventually this kind of issues takes care of itself.

  3. Carina Castro 2 days ago

    Will this help my son with teeth grinding, anxiety, chronic constipation, and anxiety? About how long before I see changes? He has been on the protocol for about 2 months.

    • Patrick Nemechek, D.O. 2 days ago

      Yes it can help these things but you need to be more patient, you’ve only just started. Don’t over-focus on a few symptoms because you will miss the recovery in other areas.

  4. Rish 3 days ago

    Hi doctor,

    My sister has got rheumatoid arthritis. Do you think this protocol helps her??

    • Patrick Nemechek, D.O. 2 days ago

      Yes it can especially combined with vagus stimulation.

  5. Mrs Samina Noor 3 days ago

    Dear Dr. My 9 yrs old epileptic GDD girl is on Lamotrigin 20mg daily.2 months on protocol. Can i still carry on with protocol. She will be seen by you in March. Plz advice . Thanks

    • Patrick Nemechek, D.O. 2 days ago

      Yes, continue.

  6. Meryem 3 days ago

    My son 5, has been on the protocol since April 30, 2017. Since, he has excessive nighttime sweating. The sweat smells like vinegar and is very intense. I’ve read articles that the Glands release a bacteria called propionic acid. Is this what’s happening and is this the same propionic acid in the gut? Thank you

    • Patrick Nemechek, D.O. 2 days ago

      I have never heard the glands excrete propionic acid. The smell is most likely from your son’s skin bacteria.

      Some times bacterial overgrowth can cause night sweats. Maybe try increasing his dosage of inulin.

  7. Diana 3 days ago

    Dr Nemechek
    We are from Macedonia and it is very far from you. Thank you for your answer but I still want to start with the protocol but I don’t know if it will be safe for her because of the epilepsy
    Thanks again.

    • Patrick Nemechek, D.O. 2 days ago

      Yes my protocol is safe in children with epilepsy.

  8. MEgan 3 days ago

    Hello,
    Does the protocol help with suspected PANS/PANDAS? Or should we address the PANS/PANDAS first then start the protocol?

    • Patrick Nemechek, D.O. 2 days ago

      My protocol will take care of the issues associated with PANDAS.

  9. Anonymous 3 days ago

    Hi docor my son stool test have very high hphpa level does that mean he have propoinic acid can protocal help to reduce his hphpa level

    • Patrick Nemechek, D.O. 2 days ago

      The primary purpose of the inulin and rifaximin are to reduce propionic acid levels.

  10. Jeny 4 days ago

    Hello Dr,
    Why does the child gets facial rashes after starting the protocol?
    Some disappears days after , then new ones comes.
    Only in the face,
    The peaditrician said it is harmless.

    • Patrick Nemechek, D.O. 3 days ago

      I’m uncertain what this might be.

  11. Neha 4 days ago

    Hello Dr Nemechek. I am really grateful to you for sharing this protocol and helping so many kids with autism across the world. I started the protocol for my 3 year old son almost a month ago with below dosages:
    1/4 tsp inulin NOW
    600 mg Omega 3 NOW
    1tsp evoo
    He is still passing semi solid stools with undigested food in it atleast 4-5 times a day and his stomach looks quite bloated. Can you please help in this regard? Shall I change anything or continue with the same dosages?

    • Patrick Nemechek, D.O. 11 hours ago

      This generally improves over time but maybe try splitting up the oils so he gets it in smaller doses throughout the day.

  12. Shan 4 days ago

    Dear Dr Nemecheck

    We had started on protocol for my 9 year old autistic son this January. We gave him Riflaximin in March and saw good progress. He is now on 5ml EVOO and Nordic Natural DHA Extra containing 960mg DHA daily. The growth had plateaued since last 3 months or so. We have doubled DHA as per your advise – it did help (thank you) but still not at same level earlier.

    Wondering if we need to restart inulin or Riflaximin. Or do something else.

    Many thanks.

    • Patrick Nemechek, D.O. 11 hours ago

      You might need another round of rifaximin or VNS.

  13. Diana Jonovska 4 days ago

    Hi
    My daughter is not autistic but she had stroke when she was 7.Now she is 14 and still having problem with seizures .Can we start the protocol?Do we have to start with oils only do we have to wait seizures to calm down.She is having seizures almost every day.
    Thank you.

    • Patrick Nemechek, D.O. 3 days ago

      Yes you can but she will probably do better with vagus nerve stimulation. This would require a visit to our office in order to get one.

  14. Ann Fil 4 days ago

    Dear Dr N!
    I live in Ukraine very far from the USA. So it’s difficult to get to your office. Anyway I hope we won’t need it, just in time a Skype session to say thank you for everything you do and to tell you how I appreciate your work and hope you gave us.
    We don’t have a VNS stimulation here in Ukraine.
    But we have official Tomatis listening program and bio acoustic correction.

    I wanted to ask your opinion on bio acoustic correction. It’s listening to EEG so brain corrects itself. Founders of bio acoustic correction promise it will calm down brain and help it work more properly.

    Is it ok to use Tomaris and bio acoustic correction along with the protocol to stimulate neuroplasticity?

    • Patrick Nemechek, D.O. 11 hours ago

      I’m sorry but I don’t have any experience with the bio acoustic correction method.

  15. Diana 4 days ago

    Hello
    14 year old girl with seizures.Already taking cbd oil and antiseizure drug Keprra.Any advice please how to start the protocol.She has the seizures since she was 7 when she had a stroke

    • Patrick Nemechek, D.O. 3 days ago

      Don’t change her seizure med nor the CBD if you think it has been effective in lowering the seizures.

  16. Diana 4 days ago

    Hello
    14 year old girl with seizures.Already taking cbd oil and antiseizure drug Keprra.Any advice please how to start the protocol.She has the seizures since she was 7 when she had a stroke

    • Patrick Nemechek, D.O. 11 hours ago

      Please read the book. Copies can be purchased at https://autonomicrecovery.shop.

      The protocol should not interfere with her seizure treatment.

  17. Natalia 4 days ago

    Hi Dr..
    My daughter 5 months in protocol.
    Having bad fruity breathe for past 2 months.
    3/4 tsp inulin, 2 NOW DHA, 15 ml EVOO
    she doesnt have this before.. is it protocol related?

    • Patrick Nemechek, D.O. 3 days ago

      uncertain.

  18. Tessa 4 days ago

    Just starting my 9yr son on the protocol… he is on prescription medications. Should these be stopped?

    • Patrick Nemechek, D.O. 3 days ago

      Not without your physicians consent.

  19. Anonymous 4 days ago

    Hello,
    My boy is 3.11 and on protocol from 5 months .having gains and my son again coming on speech which he lost at 2 yrs .my son sometimes start laughing without reason please tell me what is the reason behind this behavior?what should i do?

    • Patrick Nemechek, D.O. 3 days ago

      We don’t understand but this is common and some parents refer to it as “the drunken sailor”.

      It will resolve.

  20. Anonymous 4 days ago

    May i use moringa along protocol?

    • Patrick Nemechek, D.O. 3 days ago

      I don’t recommend it.

  21. Mrs Samina Noor 4 days ago

    Dear Dr. Thanx for every reply.my 9yrs old epileptic girl with GDD and non verbal , booked skype appointment in March with you.shall i carry on with her dosages untill then.? 2 months on protocol but no gains at all.
    inulin 2tsp
    Evoo 10ml +on foods
    FO 4ml
    Since 7 months she has no seizures, on 20mg Lemotrigine daily. Plz advise shall i carry on with protocol and medicine both untill you see her? Thanx

    • Patrick Nemechek, D.O. 11 hours ago

      Yes, continue with both.

  22. Harshika Singh 5 days ago

    Hello, dr
    my 6 year old son is on protocol from last 5.5 months and had huge gain in social area, completely independent in school complete all his class work as well as home work independently, also got exilent grade in all subjects, now he follow all instructions of his teacher and even reply back to his teacher, in between he had speech regress due to vit.D supplement which I stopped just after 2 weeks, and he came back on track after 3 weeks with increase dose ,now problem is that his eye stimming is still very much there and he crazy about fan and any rotating things and sometimes looks from corner from his eyes
    Last week I increase his inulin he continuos starts laughing and his eye stimming little bit reduce after one week again his eye stimming came back more strongly and his laughing reduced now but again sometimea he can able to speaks complecated sentences and sometimes he face difficult to froming simple sentences.. sometimes looks his sentence froming going to next level but again in next moment looks like he regress…
    But his eye stimming is constant .what should I do continue current dose or reduce ?
    Dose are
    1 + 1/8 tps inulin
    2 capsule now DHA 500
    1.5 tbpn evoo
    All recommend brand

    • Patrick Nemechek, D.O. 11 hours ago

      Continue if its tolerable.

      He will continue to recover.

  23. Mercedes Grandberry 5 days ago

    Hello dr. My question to you is. Is the protocol still affective if I’m not able to give it at the same TIME everyday?

    • Patrick Nemechek, D.O. 4 days ago

      Yes it is. Dosing every day, regardless of time is all that matters.

  24. Ibrahim 5 days ago

    Hi dear doctor Patrick Nemechek ,the best doctor ….
    my son 6.7 year old showing less crying ,less anxiety, little understanding improve but sometimes not understand simple sentence .(developmental delayed and cognition of age 2 )
    My question is as I am seeing some gains in the mid of 3 rd month on protocol .
    Can my non verbal (say mama ,baba )kid start talking also because age is 6.7 soi am very very much worried.
    I want to know if kids show awakening and gains both then be recover fully only on your amazing protocol without vagus nerve stimulator or has a chance of it also (speech and cognition)
    See in awakening before 2 months near more sleep ,more head banging,pee accident,more aware etc

    • Patrick Nemechek, D.O. 11 hours ago

      Yes, most children recover without the VNS.

  25. Alexa Jose 5 days ago

    Hello Dr Nemecheck,
    I have read your book and my son(6 years age, mild ASD) has been on the protocol for one year now. Current dosage as follows:
    Inulin – 2 Tsp
    DHA – 1 capsule now dha 500
    1 tablespoon of Evoo plus cooking in it.
    Everything of the recommended brands. Gains so far have been better receptive language, better eye contact, trying to from sentences and more observant of the peer group. My question is that every time I try to increase the dose of omega 3 , I start getting complains from school about throwing things, not behaving appropriately, lack of concentration and defiance to general rules that he usually follows. So do you think there is a chance of recovery from the current dose of 1 caps of Now dha 500. I AM ALSO A MEMBER OF THE FACEBOOK PAGE SINCE LAST YEAR AND EVERYONE RECOMMENDS HIGHER DHA DOSES. please suggest weather I need to make any changes or weather his dosage seems enough. Please note that he does not take any other supplement. Is there a chance he will become fully conversational and social? Thank you so much for the protocol. I read great stories every day and keeps my hopes up.

    • Patrick Nemechek, D.O. 11 hours ago

      I don’t recommend higher doses of DHA in children for 2 reasons; it’s not necessary for their recovery and sometimes it can be overstimulating.

  26. Anonymous 5 days ago

    Hi Dr Nemechek
    What is your opinion on other supplements when they show they help the child to talk more or stim less? Do you think they should not be given? Could they be interfering or since showing they help, are they okay? It’s a cream w mb12, 5-mthfr, vit d and b6. Also she takes zinc.
    What are your thoughts on lithium deficiency? Our daughters bloodwork showed no detection of any lithium so dr advised lithium orotate.

    • Patrick Nemechek, D.O. 11 hours ago

      Anything with a stimulant capacity can make a child less hyperactive or stim less but might interfere with the repair process.

  27. Azra 6 days ago

    Dear Dr Nemecheck,
    We are starting with the protocol for my 10 year old daughter who has ASD, food allergies and asthma(she’s been on many therapies including various diets and supplements with very little difference or none at all)I know you don’t recommend any additional therapies as I read that in the book but NAET therapy was suggested to me recently and since it’s drug free and does not involve any supplements I would like your opinion would it be compatible with the Protocol? We are only considering it as her asthma symptoms have never been worse.

    Best wishes,

    • Patrick Nemechek, D.O. 11 hours ago

      NAET therapy is not required once the intestinal bacteria are balanced. Watch my latest YouTube about inflammatory foods.

  28. asuman 6 days ago

    Hi dr.,
    my son,22,diagnosed as asperger+OCD is on protocol for 1 year now ..Using NN fish oil ..After 1-1.5 hours taking his fish oil dosage,he feels sleepy,tired .This is always the case..(i tried different hours of day,still the same)then sleepiness fades after 2 hours..
    why does it happen?Any suggestions?
    thanks

    • Patrick Nemechek, D.O. 11 hours ago

      No certain exactly but sleepiness after eating is a sign of autonomic dysfunction.

      Maybe try splitting the dosage.

  29. Sandhya 6 days ago

    Hi Dr Nemechek.
    My almost 9 year old son has been on the protocol for 10 months. I’m so grateful to have found this protocol. We’ve seen a lot of improvements in terms of understanding, sitting tolerance, eye contact and speech. He surprises me with something new every day. My one concern is that he has darkening on the inside of his joints especially armpits, back of his knees and inguinal area. The darkening has decreased since we started the protocol. My question is whether this is an autoimmune disorder ? Do I need to get him tested ?

    • Patrick Nemechek, D.O. 11 hours ago

      The darken of the skin might be acanthosis nigracans which is a sign of insulin resistance. Having the darkening go away is a clear sign of his body recovering.

  30. Ann’s mom 6 days ago

    Hi Dr. N,

    I need your advice on dosages.
    I started my now 8 yo Autistic daughter on Nemechek Protocol in dec 2016 when she was 6 yo. I started with 1/4 tsp on now inulin and 1/2 tsp of fish oil.
    Later, when the book was released, started her on olive oil too.
    Right now we are at:
    3/4 tsp of now inulin
    1 tbsp of ultimate omega
    1 tbsp of olive oil

    I have been increasing 1/4 tsp inulin in every 6 months( on an avg because of complaints from school) and every time I increased, we saw some hyperactivity, giggling and frequent peeing behaviors for 2 weeks and then it settles down. We have seen some great gains too in this process. She was at 2-3 word sentences, now has a 5-7 word sentences( with incorrect sentence formation). Her understanding is greatly improved, no tantrums, no meltdowns at all.
    However, language seems to be a problem even now, she is able to put the right words into her sentences but will not form a grammatical correct sentence, no articles and incorrect prepositions.
    She is very good in math but she struggles with reading and does not prefer to work on it.

    Please advice.
    Thanks

    • Patrick Nemechek, D.O. 11 hours ago

      There is nothing to add other than be patient.

      You are describing very impressive improvements so far

  31. Sidra Naveed 7 days ago

    Hello Dr Nemechek,

    My 7.10yr old ASD son is completely non verbal. He has severe SIB and has complex tics and possibly ADHD( diagnosed after we started the protocol).He takes medication for tics ,sleep and laxative for constipation even after the protocol.He’s on the protocol since May 15, 2018. Right now he’s on 1tsp inulin, 6.25ml of FO( not ultimate) and 15ml of EVOO all recommended brands.I try to cook his food in evoo if not we all use canola oil at home. If he eats something from somewhere else I give him a little extra EVOO.Everytime I increase his inulin his SIB increases, his tics increase, extremely gassy,sleep decreases and he becomes extremely hyper.Also his forehead is always warm.I have stopped increasing inulin since a couple of months now but still he is the same. The only improvement I see since May is his eye contact and a little bit awareness .Everything else is either the same or became worse. Please tell me what to do about speech and SIB.

    • Patrick Nemechek, D.O. 11 hours ago

      I’m sorry I do not know what you mean by SIB

  32. Lana 7 days ago

    Hello, Dr. Nemechek! My name is Lana. Very interested in your method. I have a question: if a child has a genetic disease, will your method be relevant?

    • Patrick Nemechek, D.O. 11 hours ago

      I’ve had several patients with genetic deletions and even more severe conditions such as lennox-gastaut and the protocol is still very effective.

  33. Prak Sac 1 week ago

    Thank you Dr Nemechek for all your help answering questions here! I very much appreciate them. I had a quick question regarding traditionally fermented food like yogurt and kefir

    Since my son is on a non dairy diet I make homemade kefir and yogurt using coconut milk. Somehow it seems to me he does not do well with these. How do I increase his natural probiotic intake? I know probiotics pills are not allowed on the protocol and I am struggling with ways to increase his probiotic intake from traditional food

    Thank you

    • Patrick Nemechek, D.O. 6 days ago

      There is no need to increase to increase the natural probiotic intake. The bacteria in food has nothing to do with the types of bacteria that normally inhabit a human and ingested fermented foods will not help rebuild the gut flora.

  34. Anonymous 1 week ago

    I have a product that says it contains HIGH OLEIC sunflower oil. I know your book mentions to avoid sunflower oil, but it also mentions that oleic acid blocks brain damage. Having said that, is this an acceptable ingredient?

    • Patrick Nemechek, D.O. 6 days ago

      High oleic can mean only 30% oleic acid.

      Until the time comes when there is regulation about what “high-oleic” actually means, avoid these oils when possible and get a good dose of genuine EVOO in to protect you from the rest.

  35. Sskl 1 week ago

    Good day Dr,
    Few weeks ago, my daughter 5..8 y.o nearing 5 months in protocol had teeth grinding reoccur back after an URTI episode. You mentioned it will go away , stay the course.
    Yes… it went away eventually!
    Thank you ..
    3/4 tsp inulin ( staying at this for past 2 months), 2 NOW DHA cap, 15ml EVOO
    good clarity , boost in receptive language, expressive still a struggle, but i believe it will come eventually. Mimicking ability a big boost.
    just 1 question , do i have the need to increase the inulin to 1tsp?
    i dont want to be greedy , definitely best is the enemy of the good.
    When should i increase the inulin ?

    • Patrick Nemechek, D.O. 6 days ago

      I would keep the dose where it is as long as things continue to improve.

  36. Vithal 1 week ago

    Hello Dr,

    My son is 3.7 yo.he didn’t start talking yet.he started hand flapping (less frequently) at about 1.5 years.he doesn’t respond to name call.but very good listener of cartoons and rhymes.je doesn’t eat everything we eat. Eats only 4 things. Doesn’t allow to brush his teeth. Very hesitation to touch his head while bathing and wearing shirt.he toewalks.humms all day.stares from corner of the eyes.sometimes self laughing is there.
    Likes wheels of the toys.but his motor skills are really good. He doesn’t follow any instructions. Till now he didn’t speak 1 word.

    Will your protocol help him?
    What dosage should I give to him?

    Please advice
    Thanks

    • Patrick Nemechek, D.O. 17 hours ago

      Yes my protocol can dramatically reverse all these symptoms over several months. You need to read the protocol – it is translated in 8 different languages. A copy can be purchased at https://autonomicrecovery.shop

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