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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.

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Dr. Nemechek
Dr. Nemechek

ATTENTION ALL READERS, PLEASE READ THIS MESSAGE: Unfortunately, due to the overwhelming time demands of my medical practice and time required to answer the questions on this blog (almost 5,000 questions answered to date), I am unable to continue answering questions while I focus my time on getting the 2nd Edition of The Nemechek Protocol Autism and the first edition of The Nemechek Protocol for Adults completed. You can still use the search feature on this blog to find answers to many of your questions. Many of the questions that are being asked have been answered repeated by me (Dr.… Read more »

Bee
Bee

Hello Doctor!
My 2 year old autistic kid has been diagnosed with metabolic acidosis since birth. May I go ahead with this protocol or her M A worsens?
Many thanks!

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

With a problem as serious as metabolic acidosis, I don’t think you should ever go ahead with any new protocol without first discussing it with your child’s physicians.

Inulin fiber and fish oil is safe for most children but in this circumstance please run it by your local physician.

Chris Mak
Chris Mak

My son is taking 500mg Azithromycin for Lyme disease. Can this antibiotics replace Rifaximin? Do you recommend to start inulin now or wait till after the antibiotics is finished? Is Krill oil ok?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Azithromycin and Rifaximin are completely different in scope, targeting and tissue penetration. They are not interchangeable. And please do not mix Rifaximin with another antibiotics unless specifically told to do so by your physician.

The real question is does your son have Lyme Disease or Autism? If he truly has Lyme’s then you shouldn’t need Rifaximin. If he has bacterial overgrowth there’s a good chance he doesn’t have Lyme Disease. If someone is claiming he has both, I think the odds are greatly against that happening. Although I’ve never seen the 2 together, it’s not impossible.

Kala
Kala

Thanks for your reply Dr. Before going ahead with the antibiotic, have a question.
Elsewhere in this blog you mentioned that sibo can return too. So once a ten day rifaximin is done, how to protect the gut?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Relapse is most likely a function of low biodiversity, acidification of the small intestine, intestinal dysmotility from autonomic dysfunction, exposure to antibiotics as well as other unknown factors.

ALthough probiotics, anti-SIBO diets, etc may have some appeal they seem to be ineffective, and unproven to “prevent” SIBO.

Anonymous
Anonymous

I read your blog post about vaccines indicating your belief that with a healthy gut vaccines should be low risk. My son has thus far been fully vaccinated and is due for his 5 year (MMR, DTP, Varicella, and polio boosters) in 3 months. Do you typically have a general recommendation/rule of thumb for a certain amount of time on your protocol before having vaccines? In my son’s particular case he never seemed to have any bad reaction to vaccines in the past.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

For a heathly child I think it would be a few months but no one knows for certain

Anna C.
Anna C.

We started this protocol 3 weeks ago, are on full recommended dose now for 1 week (of inulin and fish oil, still working on the olive oil since we have very limited diet). We have not yet seen any changes in behavior, but I am amazed that he now tolerates 3 tsp of fish oil without difficulty when previously even 1 tsp would cause diarrhea! I guess that is gut healing at work!!! and now daily, soft but formed stools. I am eagerly awaiting the behavioral benefits!

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The gut functions much better once bacterial overgrowth is reduced.

Kala
Kala

Rifaximin blows out sibo only right? But how does stomach lining, inflamed colon get treated? Do we have to add anything more?
Please advise.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The lining of the intestinal tract quickly repairs itself (10-14 days) after the offending agent (medicine, bacterial overgrowth) are removed.

Anonymous
Anonymous

Can your protocol help with speech apraxia?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Yes, I’ve seen it help a lot in patients under my care.

jamee
jamee

I would love to hear more about this as my daughter was just diagnosed with apraxia.

Anonymous
Anonymous

Do you have any examples/case studies of younger children gaining autism reversal? Thanks Dr Nemechek!

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

There is an example in the article of recovery of a 23 year old non-verbal autism young woman.

There are also several testimonials through this thread about how the commentors children have recently improved.

Humaira Noo
Humaira Noo

hello, thank u for sharing ur protocol. my non verbal 3 yo is taking cod liver oil and other supplinents like iron, folic acid, pyridixine, Zn, Ca, vit E,C and n acetyl cystine. also he takes biokult probiotic. we recently started giving him inulin powder. my question is should we stop probiotic? should we give him something else for omega 3? at the moment we use sunflower oil in cooking, hoping to change it to EVOO. would u please tell me if we should change the suppliments also? none of these are much available in our country Bangladesh, but we… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

As I state in my article, I generally recommend stopping all probiotics, digestive enzymes and supplements as these can be a source of side effects after stabilizing the intestinal tract with inulin.

Aussie Mum
Aussie Mum

He is 19 years old!! Happy birthday! We have been on the treatment road for 15 years on and off with successes here and there and yes he has made gains over the years, but nothing has ever been as simple as your protocol with such significant gains so quickly . Imagine the gains he will make once the fish oil is added? Exciting! I will update again in coming weeks//months. Thank you

Aussie Mum
Aussie Mum

My 19 year old Severe Autism, non verbal, PANDAS, OCD, ODD, Agoraphobia,severe anxiety etc etc etc is on week 3 almost 4 of inulin alone. Most days he has a table spoon and has handled it well. We have had success with high dose fish oil over the years to control the OCD and Tics but in recent months have had trouble getting it into him as he cannot swallow pills and will not take the omega fishies either! However on inulin alone he is settled, calm, loads of babbling, huge amounts of interaction, concentration and interest, he is happy!!!… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Oh my gosh. Reading this brings tears to my eyes.I

I’m going to consider your son’s improvement my birthday gift!

How old is your son?

Anonymous
Anonymous

Is rifaximin available as oral medicine too? Please advise.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Yes, it is used all over the world, and is relatively inexpensive.

Kala
Kala

My kid has IBS and symptoms are worsening with inulin. Gas retention, mucous in stool etc is what we are observing. Do you have any alternative to this, Dr N?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Make sure your child is not still getting probiotics or digestive enzymes. If not, you might need to stop the inulin and start at a lower dose or consider discussing with your physician about using Rifaximin.

Jaffa
Jaffa

Is elevated levels of serotonin addressed in this protocol?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

No but I don’t worry about such test results. Alteration in serotonin levels is a reflection of cellular dysfunction which resolves after using the Nemechek Protocol. The resiliency of a child’s brain is proving to be much great that anyone could of every imagined. I have several patients who is spite of their severe neurological dysfunction seem to be on the potential path for a complete recovery. Patience is key. As I’ve said on this thread several times, the brain recovers about as fast as hair grows. Day by day it doesn’t seem as if much is happening but then… Read more »

Citadines
Citadines

Trying the protocol for two weeks for an 8 year old partially verbal (1 teaspoon inulin, 1000mg Nordic Naturals Omega 3, both in mornings), main changes thus far are a reduction in separation anxiety (actually preferring own space) and an increase in visual stimming. The visual stimming is quite stressful as its done with saliva, is this a pass through phase or is there any other way to counteract?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I’m sorry I can’t provide a specific recommendation but generally there are pass through phases and as long as it doesn’t seem to be harmful to the child I stay on the treatment course.

I recommend following your child’s overall progress closely, and discussing any adverse changes with your physician.

Adebayo Oluwatoyin Rashidat
Adebayo Oluwatoyin Rashidat

Thanks so much dr for responding, I sure will get the inulin asap, but can other brands aside that of the NOW and Nordic Natural be used as it takes long before I get shipment from amazon, I live in Germany. If I can go ahead with other brands, then I can start right away by getting it over the counter here. Thanks in advance.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I generally think other brands are fine.

My article was originally written for a U.S. audience and I had no idea it would spread internationally.

Anonymous
Anonymous

Hey Dr N
Greetings. Don’t you have your patients undergo Organic acid s test before advising this protocol? It reveals many other biological imbalances based on which we may need to customize this protocol. Don’t you think so?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I don’t believe we are capable of correctly interpreting those tests.

Again, the children I’ve treated have done without worrying about such tests.

Violet
Violet

Hi Dr. Nemechek, love your blog! My daughter has Lennox Gastaut Syndrome. She has always had digestive problems and silent GERD. I started with 1/8 tsp inulin and 1/2 tsp fish oil since she is so sensitive. I am surprised that she is tolerating it better than I expected. I have noticed seizures are changing – a little more frequent, but shorter and less intense, in addition to some improvement in her chronic apnea. I wonder if you have any short-term recommendations for constipation, any brand of magnesium or vitamin C that has worked for your patients in the meantime… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

For the constipation, I generally recommend a non-fiber supplement such as magnesium (Milk of Mag) or MiraLax. The constipation will go away. Vitamin C only helps constipation when it causes a toxic reaction in the gut – doesn’t sound like a good option to me.

Don’t worry about the white tongue. Thrush does not grow on the tongue. It appears on the tonsillar pillars or posterior pharyngeal wall way in the back.

Anonymous
Anonymous

Hi Dr, my son is 6years, autistic with saliva drooling, I am eager to start the protocol. He has been on cod liver oil which has omega 3 fatty acids, vit b complex, b6, Gabapentin, risperidon, medikinet retard and melatonin. Can I start him on the protocol and still use all these? And for the drooling, what do you advise please.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Sounds like all you’re missing is the inulin.

The drooling usually recovers with the improvement in motor function that often accompanies the first month.

Anonymous
Anonymous

Day 11 of the protocol and my daughter keeps plugging her ears and becoming very anxious. She is often bought to tears. She is normally fairly easy going and placid. Is this to be expected?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Very usual. Maybe have someone check her ears just in case.

Alan
Alan

Dr. Nemechek, your protocol sounds too good to be true. I start my seven years old 85 pounds on 2000 mg Omega 3 and ordered inulin through Amazon. I will start my son on two spoons inulin once it comes. I will mix it with Prune juice and give it to him at nigtht before sleep. Please, know that if this works and my son got better, i promise to take a trip to your office, pay the consultation fee and give you a big hug. I promise you and i swear if he got better, i would work to… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Alan, Please stay in touch, I’m excited to hear about his progress. Generally on the dosing, I recommend starting at lower doses and working your way up over a week or 2. Within the first 2 weeks parents will see their child “wake up”. The child becomes more alert of people and their surrounding, often are less anxious. Loose or frequent stools are reduced and sometime replaced with constipation – this is not a bad sign, just normal progression of the recovery phase. Remember, recovery happens about as fast as hair grows. It may not seem like much is happening… Read more »

Sam
Sam

There are some algae Omega oils available now with the same DHA + EPA content. Do you recommend them ? Is there a minimum dosage of inulin to start with?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

There are some algae omega-3 oils but I have no experience with them.

Vas
Vas

Hi Dr N
Can we use lime juice while on this protocol? Do you think this will interfere with your protocol? Inulin creates an acidic environment whereas lime alkalizes the stomach. So Any food restrictions?
My kid is unable to combat the acidity generated by inulin.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I do not restrict any foods when I treat my patients other that severe allergies (peanuts, etc) and obvious intolerance (milk causing diarrhea, etc)

Samantha
Samantha

Hello, thank you for sharing your protocol with us. My daughter is diagnosed with dravet, a catastrophic Form of epilepsy. She does have some delays, with no sign of autism. The results of some testing, showed heavy metals, bad gut bacteria. Her propionic (longer word on test, I assume it’s the same?) was only slightly elevated. She shows many nutrient deficiencies. I assume it’s Bc of a bad gut balance. Anyway, I have some questions. I understand you don’t feel the need to address heavy metals? I am curious as to why, When we know that heavy metal load on… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I don’t worry about heavy metals because I don’t trust many of the labs performing the testing. Secondly, when I treat autism and other developmental issues I don’t need to address the heavy metal issues and they still recover. I have no idea how heavy metals may be affecting your child in particular.

I use inulin because it has consistently worked for me but that is not to say other forms or mixtures of fibers might not work as well.

Anonymous
Anonymous

In your article (which i have read many times!) you say a child could start speaking again. My child has never spoken and is minimally verbal at 4. Have you known children to gain age specific speech during your protocol treatment?
Have you ever had children that are non responders?
We are so very worried that the protocol may not work for her……

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Many children under my care have started to speak even after 10-20 years of being non-verbal.

There may be non-responders but usually it seems the parents are patient enough, quit my protocol and move on to other avenues of treatment despite obvious neurological improvement. Sometimes the recovery of speech may occur later than the recovery of other areas of funtioning.

Anonymous
Anonymous

I’m sorry, Dr. Nemechek. I need clarification. Are you saying to go ahead with the protocol, as is? Or should I have her treated separately for the impaction first, then go ahead with the protocol?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I can’t tell you exactly what to do without formally being your daughter’s physician.

I recommend discussing it with them.

Anonymous
Anonymous

Dear Dr. N,

My friends son is 2.5 years old and ASD. Can they take inulin and omega-3. Could you please suggest the dosage.

Thanks
Sudhakar

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The doses I use in children are discussed in the article.

Oluchi
Oluchi

I began wrongly with Nemechek protocol. i started my son on fish oil for a day and added inulin on the second day. His stool became soft. Today is the third day and i gave him only 1/4 teaspoon of inulin but his stool has gone berserk. They have mucus like substances. Was it the fish oil? or the Inulin powder? Should i stop entirely or redose? TIA

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

If there are ever any problems I start with low doses of inulin and after a week or then slowly add in the fish oil.

Anonymous
Anonymous

I am wondering what your suggestion is in how to proceed if the child has an impacted colon. Would the protocol be the exact same or would the impaction have to be dealt with first? Thank you.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I have used inulin to successfully treat several children with severe constipation.

Anonymous
Anonymous

Hi doctor…Any side effects with rifaximin? What dosage for 4.5 year old? My child is not so strong to even face oral antibiotics. Do you think he can tolerate the side effects of this injection?
And If this does the required job, why do you insist inulin first…Any special reason?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I start with inulin first because it is very gentle, reversible, inexpensive and its very effective in reversing the effects of autism in young children when combined with fish oil.

Anonymous
Anonymous

Will your protocol eventually make my child neurotypical and reverse asd traits? We have a non verbal 4 year old….. what is the typical time scale in young children? Many thanks.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I’ve covered these topics in my article.

Please re-read.

Megan
Megan

Just in case there’s some other Australians reading, I contacted Cobram and they said their extra virgin olive oil averages 73% Oleic Acid. Any other suggested foods with oleic acid?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Thanks for the info.

Olive oil is one of the highest containing oleic acid foods in the world

A little of the olive oil every day is all that’s needed.

Anonymous
Anonymous

Thankyou doctor.
Do you discourage probiotics even for short term usage.. I mean as short as a couple of months? And do you discourage natural probiotics too such as fermented foods? My child could not even tolerate quarter tsp inulin last month. Can we start as low as few pinches or is there a minimum amount?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Yes I do. If I can’t control overgrowth with even small amounts of inulin, then I consider using Rifaximin.

You might discuss this option with your physician.

Anonymous
Anonymous

Dear doc,
Is the intestinal inflammation only because of sibo or can it be due to other reasons such as excessive dehydration etc? If this is possible, I shall only give omegas. My child almost always have stomach issues and has excess acids too. He doesn’t like to drink water at all. So little worried to give two supplements that too both that tend to be acidic.
Is it okay to give him these supplements since his digestive system is already acidic as per what the tests revealed? Is there a test to check for inflammation?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The inflammation is mainly from th e bacterial overgrowth. The upper small intestine is a naturally acidic environment. Some worry they have too much acid because of issues like heartburn of acid reflux. These are really problems with not being able to empty the stomach and not from excessive acid production per say. Fixing intestinal bacterial balance in kids often resolves most of their “acidic” symptoms.

Angela C
Angela C

I’ve seen some slight improvement in OCD but it got to a point where it stopped changing. I’m concerned that this might not be “enough” to treat PANDAS/PANS as I keep finding out just how complicated it can be… We’ll see, but I’m afraid to delay much longer. A few more weeks of inulin and omega -3 and we will have to make a judgement call – autoimmune diseases really spook me. I’m trying to also be patient and note the slow and steady perspective. Tourette’s like movements are still present. I’m optimistic that they might be easing up. Fingers… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Patience and persistence are essential for autism recovery.

If there are any new changes that concern you, always discuss them with your physician.

Anonymous
Anonymous

Dear Dr. N,

Thanks a lot for sharing your knowledge, God bless you. We are on second week of inulin but dosing very less as he gets stomach cramps not sure is it acidity or bloating, but managing with essential oils. Certainly we are seeing overall gains. I have a question, once we platue on this do you think anyone would require chelation or hbot or GAPS diet etc.

Thanks
Prashanthi

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Prashanthi, I’m glad to hear things are progressing. If you read in the post, if there is a plateau I increase the omega-3 fatty acids from fish oil and then if necessary, add vagus nerve stimulation. I would absolutely avoid chelation, and GAPS simply address bacterial overgrowth the inulin takes care of, and the anti-inflammatory effects from HBOT should not be necessary if omega-3 dosing is high enough. Remember progress is slow. The brain recovers as fast as your hair grows. You don’t notice much day-by-day but suddenly you realize it’s grown so much you need a haircut! Please keep… Read more »

Angela
Angela

Dear Doctor, I was wondering if a different type of fiber might be used in our case. My daughter’s stool test came back positive for candida tropicalis, a strain of candida that assimilates inulin. Please see Table 5 in this study: http://www.biotech-asia.org/vol13no2/prevelance-of-bacteria-and-candida-oral-colonization-infections-among-dialyzed-patients/ All of the other types of candida tested do not assimilate inulin, but candida tropicalis does. Would the candida compete with the good bacteria for the inulin? Should we use a different fiber? Thank you very much – I just want to make sure it’s okay before starting.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The candida you are reporting is typically that found in a stool specimen – in other words a sample from the distal colon.

Modern studies of the microbes within the small intestine show that children with autism have very little yeast (candida is a type of yeast), and no more than children without autism.

The positive effect from inulin is how it rebalances intestinal bacteria within the small intestine and not the colon.

anonymous
anonymous

We are following your protocol. Our child is 4.5 and around 20kg. We are using half a teaspoon of inulin and 600mg omega 3 (nn). We are cooking with extra virgin olive oil and drizzling it on her food.
Is this enough? Can we be doing any other dietary changes to help her? Many thanks Dr N ! X

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

No, just observe and be patient.

The brain recovers about as fast as hair grows. Everyday your hair looks the same length until in 4 weeks or so, you suddenly notice the change and realize you need a hair cut.

The same pace of change will occur in your child.

Lindsay
Lindsay

Is there a multivitamin that you would recommend to compliment this protocol? My son is 7, been on the protocol for a week and we’ve exchanged our large daily dose of supplements/probiotics for just the omega 3 and fiber well gummies. Eating very clean as well. Adding olive oil in this week.
Thank you so very much for sharing this with us, I can tell you have a genuine heart for healing our kiddos. I’ll continue to post progress as it comes.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I’ve had many cases where the supplements were complicating the picture by causing their own problems. Vitamins minerals, digestive enzymes, probiotics can all easily have a negative effect. Some are just a bit more subtle and difficult to detect. As a rule, I don’t recommend them to my patients, young or old unless they have a traditional deficiency (B12, iron, etc) whose tests are measured in a recognized, CLIA-registered laboratory. Many patients show me reports claiming a wide-array of nutritional, enzymatic problems. These are often produced by labs that run tests in an unorthodox manner, and produce results with interpretive… Read more »

Anonymous
Anonymous

My son started pooping on the potty on day 1. And has been doing it almost every day since. With only 2 or 3 accidents. We are on day 11.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Nice. Good news for both him and you!

Thanks for the update, please keep us informed of his progress.

Anonymous
Anonymous

We are day 10 into the protocol. We are getting better sleep and more awareness. We are hearing lots of Babbling but no clear words. Our daughter is 4.5. Do these signs sound promising?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Yes it is. Day 10 is only the beginning.

Radhika
Radhika

Hello Dr. N
We have started on the protocol but our son has heavy metals issue. If there are heavy metals in the brain, will this protocol help.?
Thanking you in advance.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Please ask who ever suggested your child may have heavy metal problems.

Raghu
Raghu

Is bloating and intestinal gas issue forever? My kid has been waking up in the night frequently due to above said issues. Will they get resolved on their own?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Bloating, cramping and gas are often a result of an imbalance of the autonomic nervous system, and yes will over time resolve themselves. Autonomic imbalance and dysfunction is a common occurrence in children and adults after their brains have been injured. Autonomic damage is very repairable and the Nemechek Protocol.

Holly
Holly

Is taking the Omega’s 6&9 via fish oils an issue if you’re child eats ZERO processed foods? We make everything from whole/raw foods. Also, we only cook in duck fat, beef tarrow, extra virgin olive and coconut oils. Would giving the Omega 6 and 9 be beneficial then or still shouldn’t give?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I can’t make any judgement about the particulars of your diet.

With the high degree of fraud in the labeling of meats and fish, oils and supplements,

I still hold to my recommendation of restricting all omega-6 fatty acids from the diet

Jay
Jay

Hello Doctor
My kid was born normal but regressed in between due to malnutrition. He lost social connections and cognition during that phase.
With this protocol is it possible to re-make the lost connections and continue pruning process?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I would think so yes depending on the cause of the malnutrition.

Noel
Noel

Hi Dr..Have an interesting observation. My kid has dev. delay with no ye contact, speech etc. So far we have been told it’s autism disorder. I just happened to start him on Omega 3s alone seeing this blog, since inulin was not readily available. Within days I could see he is paying more attention and eye contact to me with reduced hyper activity. Could it be possible that he was not giving eye contact all these days purely due to inflammation in the brain? Does it mean that children who don’t give eye contact may not be in ASD ???Of… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The vast majority of children with autism have developmental delay, the developmental delay in large part is due to inflammation (elevated pro-inflammatory cytokines) within the brain.

Fish oil lowers brain inflammation and inulin lowers brain inflammation as well as reduces the production of propionic acid.

Good luck and let us know how your son does.

Anonymous
Anonymous

My kid is having ulcerative colitis and with developmental delay. Can I still go-ahead with inulin or does it worsen the colon ulcer?
Can omegas reduce only brain inflammation or does it help reduce anywhere else?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

In adults, bacterial overgrowth is more of an issue in Crohn’s and less so with Ulcerative Colitis. Less in known about the role of bacterial overgrowth in these 2 cases in children.

Any source of inflammation can impair neuronal pruning and normal development. I believe omega-3 fatty acids are universally beneficial to kids especially thise with any developmental issue.

Supplementing with omega-3 fatty acids from fish oil and nuts or flax will help to normalize inflammation control mechanisms, and can result in a decrease of inflammation in any part of the body.

Anonymous
Anonymous

I am giving
NN Pro EFA 369
1270mg Omega 3
500 mg Omega 6
500mf Omega 9

Is this okay?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Please read my other comments concerning Omega 369

Beth
Beth

We do have to continue to give him Allegra due to the hives and today had to give Zantac for the H2 blocker. Does giving the Allegra (and Zantac when needed) effect the clearing out of the bacteria overgrowth? Could the probiotic have been stopping the inulin from clearing out the bacteria overgrowth? Is the histamine release part of the process of getting the bacteria overgrowth under control?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Children with autism and most developmental disorders would be expected to have some underlying autonomic dysfunction. The autonomic nervous system normally controls the inflammatory response in the tissue surrounding the small intestine., and if the ANS is damaged, excessive inflammation including histamine release can result. With time, the autonomics will recover and the inflammation and histamine release should stop.

Until then, dual histamine blockage is a standard approach to controlling the symptoms.

Beth
Beth

My on has been on both fish oil and inulin for awhile but we recently stopped all other supplements including probiotics. He has battled hives for 4 plus years and the last few days he has been itchy (no actual break out of the hives). This morning his skin on his legs was burning. He does seem to have a very faint raised bumpy rash on his torso and thighs. But his skin is so fair and sensitive it isn’t uncommon for him to have bumps (which never both him). Wondering if his body is detoxing. Would activated charcoal help?… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Most of the itching and hives I see in patients, the source if the intestinal tract. The itching and hives are often a manifestation of histamine release from mast cells, a specialized form of white blood cell. Mast cells are predominantly found in the GI tract, brain and respiratory tract. So as long as a patient doesn’t have significant respiratory issues, the histamine induced itching is coming from gut inflammation. Bacterial overgrowth is a major source of histamine release, and it is not a detox phenomena. If one has an allergic reaction to inulin or fish oil, it would most… Read more »

Ian
Ian

Hello, my 5 year old child not only has autism, he is also has severe food allergies leading to anaphylaxis. He already had two documented anaphylactic reactions when he was about 1 year old. First is was with casein. Second was with nuts. The doctor did IgE testing and we found out he is also allergic to fish and shellfish, among other things. My question is, what is an alternative source of omega 3? We are currently using Flora 7 Sources 100% Plant Origin Omega 3-6-9 with EPA & DHA. It has the ff nutrients: Omega-3 ALA 5,500mg (DHA 123mg,… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

A few points about omega fatty acids. Most people are getting too many omega-6 fatty acids in their foods so therefore I recommend eliminating all omega-6 fatty acids. The minimum starting dose is for reversal of underlying developmental delay is around 600 mg of EPA+DHA, and I prefer starting at a higher dose if possible. The oleic acid is important but that is why I have people cook their child’s food in California olive oil.

Megan
Megan

Hello, my 3 year old son seems to be FODMAP sensitive (so no onion, garlic etc). Can he still take Inulin?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

FODMAP sensitivity is evidence of bacterial overgrowth, and inulin helps reverse bacterial overgrowth.

Kim
Kim

Hi Dr. N,
I know you like to see less swimming with the protocol, in one of our groups several mothers are experiencing higher stimming in their children with the regimen. What do you think is causing this? How far into protocol would you be concerned if there was still an increase in excitatory behavior like stemming with the protocol?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

It hard to answer because I’ve found that most of what was called “stemming” was actually just a more awake, energetic child that with a little more time continued to improve.

Remember, all autistic children have underlying developmental delay, and when the toxic effects of propionic acid lift, this will become more apparent. Given more time, the developmental delay will also begin to recover. Please re-read my article about the phases of recovery.

That being said, anytime any patient experiences an adverse, unexpected side effect from any treatment (natural or pharmaceutical), they should stop it.

Tiffani Lam
Tiffani Lam

My daughter has a shellfish and seafood allergy. She was taking the Inulin and Omega gummies for 2 weeks without any reaction. Then, she got a concussion and picked up a virus, had a high temperature for 5 days and developed a rash around her mouth, back and stomach. I gave Benadryl and stopped the Nordic Omega gummies and the rash went away. I really want to get her back on your protocol after she recovers from this virus. Should I do it even if I have to use Benadryl too?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

It doen’t sound like she has an allergy to fish oil from what you describe in the first 2 weeks but if you have any questions I would ask your local physician

Sameer
Sameer

Hi Doc, you say that it takes a few weeks till the gut is stabilized. So Can we use an alkali till then?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

In regards to autism, I cannot see where an alkylating agent would be useful. One of the main purposes of inulin is to help acidify the upper small intestine.

Maria Sakellid
Maria Sakellid

Could you recommend dosing for a 9 year old, 50lbs? Our son also has a confirmed Lyme diagnosis in addition to ASD. would this necessitate starting right off with the antibiotic? He has been treated for the Lyme for over s year using the Weigman Protocol. Our physician has received your article and is very interested. Are you willing to do a telephone consult with her, as we are located in Canada.
Any insight would be helpful.
Thanks so much.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The general guidelines required for your doctor to start the Nemechek Protocol in your child are present in the Update already and consultation is not required.

Adnan
Adnan

Thank ypu for your quick response Dr,
But I would like to ask you about the dosage of Omega- 3, 690 mg .

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Please re-read the article

Navi
Navi

This protocol is working in my kid for sure. I can see the changes that you anticipated above in him. But the concern is about bloating and pain. Do you have natural remedies ? I tried splitting fish oil dosage of 600 mg into 3/4 parts and gave him olive oil too, but the troubles remain. Sometimes we end up giving an allopathic medicine but due to its potential side effects we are little reluctant to go with it always. Should he put up with the pain and bloating till it gets resolved by itself or can we help ease… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Children having pain should always be evaluated by a doctor.

Vas
Vas

Can inflammation be present only in abdominal region or at stomach region too. If yes does inulin repair stomach lining too? Thank you!

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Inflammation can occur anywhere along the intestinal tract but the inflammatory response associated with bacterial overgrowth is due to the leakage of bacterial cell membrane components into the immune tissue that surrounds the small intestine, not swelling and redness of the lining of the small intestine itself.

Dolby
Dolby

Hello Dr for this information. My 3 year old kid has been diagnosed with moderate autism, and with digestive issues, so would like to put him on this protocol . Right from birth his rib cage seems little longer than other kids and that makes his stomach and tummy region look very small. In the first 10 days to couple of weeks after birth he was not feeding well for some unknown reason. So do you think his structural defect(small stomach), lack of proper feeding initial days can contribute to his digestive issues. Could the intestines have contracted due to… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

If there is no identifiable congenital disorder in regards to the rib cage anomaly, I can’t image any bone structure (long rib cage, scoliosis, etc) negatively affecting any organ development including the intestinal track.

Diana Sarkisian
Diana Sarkisian

My son has speech, but it’s echolalic scripting. Our major issue is his comprehension of speech and multi step directions. He’s 6 years old. Will this protocol help with receptive speech? Also, should inulin be taken on empty stomach in the mornings or no matter? TIA, Diana

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

My protocol helps a wide range of developmental issues.

Inulin can be taken with or without food and can be mixed with hot or cold solids or liquids.

Alan
Alan

Hello Doc! Started two boys on NOW Inulin yesterday morning 9am. One 5 years diagnosed ASD at 2. Younger one 2 years old, no diagnosis, but no language as of yet. Older son started burping a little early morning and spit up a bit and then lost his blueberries at around the 24 hour mark, but happy beyond that and eating away still. 2 year old totally normal. My question: You think the Inulin is taking around 20hrs to ferment and could that activity be causing slight nausea or enough gas to cause a little throw up? In situations where… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The gut goes through some adjustments for a week or 2 when starting the inulin fiber, and most of the little issues straighten themselves out.

Adnan
Adnan

Greetings Dear Dr. I am a concerned parent from Kosovo, I have read all of your replies and others comments as well as your protocol, I would like to start with your protocol after i Have received Omega 3, 690 mg and a substitution for Inulin called Miricale fiber this is the link that you may check for it https://www.amazon.com/Vitamin-Shoppe-Miracle-Fiber-Powder/dp/B000OQ4BNC . This is my son’s condition 2 years ago some Psychologist diagnosed him with a light Autism, bu he can read and write also he accepts different commands and asks for his needs but does not communicate with us. He… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The Vitamin Shoppe fiber looks like it is pure inulin.

anonymous
anonymous

Hello Dr Nemechek. We have been giving our 4 year old half a teaspoon of inuin and 5ml og nordic naturals 369 daily. We have stopped her probiotics. We are currently on day six. What should I be expecting to see over the next few weeks? Could there be any negative reactions? Are we giving adequate amounts? Or daughter weighs 20kg. Mamy thanks

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Please see my prior comments about recovery times.

And do not use any 3-6-9 omega combinations. The excessive amount of dietary omega-6 fatty acids are a part of the problem with inflammation.

Sri
Sri

She has actually recovered p hysically with therapies and weighs at par to her age Except that the abdominal muscles are slightly weak that doesn’t allow her to climb up independently. Cognition has improved but minimal. No eye contact N speech at current age of 6. In a way tough to conclude if it is autism or development delay or cognition loss during the tough episode that she had.
Do you think that the damage done during infant stage is permanent? But her MRI N other reports are normal.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

If MRI is normal and no serious genetic defects such as Down’s Syndrome, I believe the brain still has the capacity to recover.

Sri
Sri

Sounds promising doctor.
Just another concern – my kid had metabolic acidosis and severe dehydration as a baby. That’s when she had fluid loss and development hampered. Till then she was all fine socially, emotionally, developmentally.
Till date the effect of that episode has not subsided…Even now abdominal muscles seem weaker apart from digestive and nervous weakness. Will this protocol suffice to reinitialize her development or more needs to be done.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

It’s uncertain but I would be hopeful.

Sri
Sri

Ok thanks for that detailed response. So doctor, do you also suggest high water intake since inulin seems to be high fiber food? I see many comments on cramping , so just warning myself. We live in a tropical country where the temperatures are quite high which demands more water intake.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I would think in your situation the extra attention to water is warranted just as it can be here in arid southwest U.S. But in general, I do not think water beyond normal amounts to stay healthy really have much effect on constipation. The constipation is mainly a result of neurological dysfunction either as a direct effect of the bacterial overgrowth communicating with the nervous system or chronic damage to the autonomic nervous system from past unresolved inflammatory or physical brain injuries. The first improves with inulin or rifaximin, the second improves with suppression of systemic and brain pro-inflammatory cytokine… Read more »

anonymous
anonymous

Day six of the protocol for my minimally verbal child. We are giving half a teaspoon of inulin and 5ml of Nordic Naturals Omega 369 daily. She weighs 20kg is this the correct dosage? What should I be seeing in the coming weeks?, we have night waking presently! Any side effects? Many thanks

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Over the 2-4 few weeks parents will notice their child acting less anxious and more connected with their word. I believe this is due to suppression of the propionic acid-producing bacteria and the level of propionic acid within the child’s nervous system. Again, this drop is the result of using inulin, the prebiotic fiber or Rifaximin, the non-absorbable antibiotic. Lower propionic acid levels result in the initial improvements seen by parents. The children often start making more eye contact, will seek out their parents for comfort or when they need something, more purposeful gesturing, less stemming (hand flapping, head-banging) or… Read more »

Anonymous
Anonymous

We live in another state and would have to fly to Arizona. Do you ever see patients solely by Skype? My son is 91/2 and Autistic.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

No, initial Skype visits are educational but I am prevented by state licensing and insurance regulations from offering specific diagnostic or treatment recommendations.

The best thing to do it fly to AZ for your initial appointment, and then after the first face-to-face we can perform follow-ups via Skype.

Sri
Sri

My kid is on ASD, has too weak digestive issues. For example, I soak Chia seeds and give her. She has stomach bloating and cramps. I tried giving her biscuits, cookies etc. She gets cramps easily while all her peers eat and digest almost everything easily. Does this weak digestive system come under autonomic dysfunction? Do you think this will get resolved with inulin?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

There is a wide variety of complexity to bacterial overgrowth of the small intestine. Which bacterial species are predominantly over grown, how large is the bacterial burden, and how do the bacteria interact with the individual can be a little or greatly different between 2 individuals. Autonomic dysfunction can contribute to intestinal bloating, and when symptoms are caused by a wide variety of foods or from just water I suspect autonomic dysfunction is part of the problem. When bloating is from a specific food, tomatoes of fruit for instance, I then suspect bacterial overgrowth. An thirdly, gluten reactivity is a… Read more »

Anonymous
Anonymous

We’ve started a few days ago and it seems my son is sleeping better, but also more tired than usual. Is that a common side effect? Does it go away? Thanks!

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The intestinal bacteria can communicate to the brain through 5 or 6 different pathways.

In kids with autism, I like seeing signs that they are calming down more (better sleep, less anxiety, less stemming) and more in touch with their surrounds (improved eye-to-eye contact, recognizing the arrival of a familiar person). These are signs to me that the propionic acid levels are dropping.

Patients can feel a variety of minor effects and bacterial balance is restored with either inulin or Rifaximin. Their symptoms and developmental issues seems to slowly improve over the ensuing weeks and months.

fenella marchant-James
fenella marchant-James

My daughter is four. She had infantile spasms as a baby but has since become seizure and drug free. She is developing well accept for her expressive speech. She is minally verbal. We have had organic acids tests in the past and they have revealed alot of bacteria and yeast. We have tried many biomedical treatments and her speech hasnt improved. Could your protocol with inulin and fish oil help her? She weighs just over 20lbs. Thankyou

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The Nemechek Protocol will help many childhood issues because they all have similar origins, an overgrowth of intestinal bacteria and multiple mechanisms that fuel inflammation. Autism itself has 2 basic components: Brain inflammation + excess propionic acid from gut bacteria Some kids with ADD or developmental delay but no autism diagnosis have brain inflammation alone because their particular gut overgrowth doesn’t produce propionic acid. Gut bacterial overgrowth causes: increased inflammation with or without propionic acid production, priming of microglia within the brain, direct stimulation of brain (anxiety, stuttering, dyslexia, fidgety, food cravings) Other causes of inflammation: primed microglia within the… Read more »

Beth Ratliff
Beth Ratliff

Thanks for posting info regarding the diet. We have tried a couple of the restrictive diets but didn’t have much luck. I was wondering if it would help to pair diet change with the protocol. Although not on a specific diet we do try to limit processed food and eat organic when possible. Right now my focus has been on expending the variety of foods my son eats vs a specific diet. We had been using both the fish oil and inulin fiber for a while before I read about this protocol. But giving them along with a few other… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Wow fantastic. Yes I strongly discourage probiotics. They may dampen some intestinal symptoms but do not resolve the bacterial overgrowth enough to make a difference. More importantly, they have the potential to worsen neurological functioning.

I understand kids might seem a little better on probiotics is some respects but its very limited in most cases I’ve seen.

Keep up the good work and remember recovery from developmental delay is slow like hair growth, you can’t speed it up but before you know it you need a haircut!

Monik
Monik

My son is 11 years old and weighs only 60 pounds, he is not verbal, does’nt control sphincters and he has problems with aggression and self-cracked, eczema and constant diarrhea, we have done several protocols with poor results, because of his weight we thought it would be better to try to start with Inulin before using the antibiotic (rifaximin) we started with half a teaspoon and 1000 mg of Omega 3. I just want to know if you think we are doing well or would it be better to start with the antibiotic? My sister is a doctor and she… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

If inulin is all that is readily available, I’d start with that.

As a rule, the older the kids get, the better they do with rifaximin rather than inulin but I’ve seen do wonders for teenagers.

Jim Coffey
Jim Coffey

Hi Doc,

I recently read about your protocol and am considering it for my son (6 yrs old Non verbal ASD with very few other noticeable issues). I have read some people mentioning about constipation, bloating etc from the Inulin and Omega 3. at the moment my son has no apparent diet or bowel issues. He urinates and defecates regularly with no issue. I am worried that in trying to help him with his speech that i may create a different problem.

Thoughts?

Jim

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

From the child’s perspective, I think he would rather be able to talk and have constipation than the opposite.

Kim
Kim

Dr N, thank you for giving us the information on diet restriction. Do you gave any kids under your care that initially had SIBO/overgrowth of yeast? Many parents are concerned with the inulin feeding yeast, is it possible it might exasperate yeast at first before the good bacteria get stronger? Would it be beneficial to take Nystain as a combo? Does Inulin feed small bowel bacteria, or just colon bacteria? What keeps yeast and bad bacteria from becoming stronger with inulin? Is it the SCFAs? If we have access to Rifax, would it be a faster outcome if used? And… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Ignore they hype about yeast, I personally think it is great overblown.

Most of issues they attribute to yeast are actually from bacterial overgrowth.

If you would like to search for the science yourself, at “pubmed” to search terms and this will primarily restrict you to peer-reviewed research articles.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Comment about Restrictive Diets: I believe the benefits that occur in autistic patients after starting any diet that restricts carbohydrates (GAPS, FODMAPS, gluten, casein, etc) is from a relative, non-specific decrease in the overall bacterial load within the gut. The bulk of gut bacteria thrive on carbohydrates, and a decrease in bacterial counts occurs with a decrease in dietary carbohydrates. As I see it, lower bacterial growth leads to a decrease in the production of propionic acid with a resulting improvement of symptoms. Inulin fiber has the particular effect of increasing the acidity within the small intestine lumen leading to… Read more »

Angela
Angela

Thank you so much for more info and answers Dr. Nemechek. I believe as you do. While we aren’t 100% sure we’re dealing with PANDAS/PANS over here or not, it appears to be, but it’s not as severe as some others report. We’ve known about the ADHD for 5+ years, but now there’s some OCD, and Tourette’s like movements, lots of anger, cognitive delays, etc. (Maybe several things I’ve done helped her somewhat, including addressing the herpes virus, which is pretty darn inflammatory to the brain/brain stem). She’s 10, so hormones could be a factor too. I’m starting her at… Read more »

Zhana Zlatanova
Zhana Zlatanova

Hi Dr. Nemechek, My boy age 6y, 9mths has MAO A R297R ++ mutation which slows MAO-A enzyme . It means he breaks down serotonin much more slowly than most people. But that also means that levels can sometimes get too high temporarily and then too low in compensation. ;MAO-A enzyme may also be depleted by stress, lipid peroxidation from breakdown of polyunsaturated fats, and high levels of aluminum mercury, copper and cadmium. Polyunsaturated fats create lipid peroxides when they are broken (metabolized) in the body. Lipid peroxides are neurotoxic and they inhibit monoamine oxidase-A (MAO-A), which is the enzyme… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I suggest you ask your genetics consultant.

ella
ella

Hi doc..from all autism mums…we grateful….w really hope we can apply protocol and get progress

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The Nemechek Protocol is inexpensive, readily available for most and has the potential to help a lot of children.

Good luck.

Ram
Ram

Quite interesting My nephew had reflux as a months baby and his growth is worse affected. He does walk but has a poor body control. His MRI report says mild damage but the child looks alarming as though severely damaged. None of the doctors that we met could trace out his actual problem but now that I got to read your explanation on autism and heartburn, autonomic dysfunction etc, i am able to relate it to his problem. Will pass on this article to them. Is this protocol only for improving behavioral aspects or does it address his poor body… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The Nemechek Protocol was specifically designed to reduce levels of pro-inflammatory cytokines within the brain as well as throughout the body.

If lowered enough, inflammatory disorders greatly improve and repair mechanisms are activated leading to improvement in neurological functioning of not only the autonomic nervous system but all other aspects of the brain as well.

Because of the broad neurological benefit, improvement can be seen in a variety of ways.

Good luck.

Dr. N

Raghu
Raghu

He has cramps with both I guess. Will try stopping like you advised and see if that helps. Many thanks for your time to reply and that too so quickly. But I still have a question- with inulin the bad bacteria is eliminated and with omegas his ANS is normalized; which means that his system is brought under better control than before. why then he is experiencing such severe pain only now? Is it because he is unable to digest fish oil since we otherwise gave him only vegan diet? One more question- how are the vegetarians able to make… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

How are vegans able to get enough DHA (since most DHA comes from animal meats) for proper neurological function is an unsolved question yet.

It’s looking like the high ALA (an omega-3 in nuts and flax for instance) diets boost the small amounts of DHA into the brain. This issue is still being worked out.

Angela
Angela

“The increase in acidity of the small intestine suppresses the overgrowth of propionic-producing bacteria and results in the resolution of the toxic encephalopathy”.

Dr. Nemecheck, I have thoroughly enjoyed reading how you explain things in a way that’s fairly easy to understand. Thank you so much for your research and work! Given the statement above, I’d love to know what you think about alkaline diets and alkaline water and the studies saying acidity sets the stage for disease. What affect would alkaline foods and water have on propionic-producing bacteria? Thanks for all you’re doing 🙂

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

For starters, changing acidity of the foods eaten will not change the pH of the blood stream. The body is designed to strictly keep the pH at 7.4 and variations of this come at great peril physiologically. An the rather massive amount of acid normally produced by the stomach probably make the differences of pH in foods insignificant. That being said, it does not mean changes in the acidity or alkalinity of the diet might not have some other benefit unrelated to pH. So I tend to believe the experiences people feel when changing the pH in their food, I’m… Read more »

Anonymous
Anonymous

Hi Dr. Nemechek, our son is six years old and has Chiari malformation, severe apraxia of speech, developmental delays and attention issues. He has not been diagnosed with autism and none of his specialists suspect autism. Is your protocol something that could possibly help with the apraxia? Thank you for your time. Lav

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The Nemechek Protocol was specifically designed to reduce levels of pro-inflammatory cytokines within the brain as well as throughout the body.

If lowered enough, inflammatory disorders greatly improve and repair mechanisms are activated leading to improvement in neurological functioning of not only the autonomic nervous system but all other aspects of the brain as well.

Because of the broad neurological benefit, developmental delay and the attention issues from cumulative brain injury both are things that a commonly see improve.

gina
gina

Thank you for sharing this information. Do you think this protocol would help with other autoimmune conditions?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

In it’s full force, the Nemechek Protocol for autonomic Recovery can greatly help adults with autoimmune disorders. I have patients with rheumatoid arthritis, ankylosing spondylitis, Hashimoto’s, Crohn’s, psoriasis, and multiple sclerosis whose symptoms have greatly improved. I have not treated any children as of yet with autoimmune disorders but I don’t see why it wouldn’t help them as well.

We are beginning to understand that the autonomic nervous system must be damaged in order for most autoimmune disorders to be activated. The damage is to the vagus inflammatory reflex. Read my recent post on autoimmune disorders.

Angela
Angela

We might have a case of pandas/pans…. Hard to say. OCD and some evolving Tourette’s like movements are happening over the past 9 months, might be “comorbid” with her ADHD/aspergers, or coincidence that these things kind of started happening following strep. She’s age 10, petite, and we’ve been trying to help her naturally with ADHD for 6 years (not very successfully). Tried a million things but never medicated. Since she’s at the age of 10… And 60 pounds… I’m confused about how we might approach using your protocol for ages under 8. Is she “an older kid” or not? Should… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Bacterial overgrowth and intestinal dysbiosis alter the blend of bacterial within the mouth and throat as well.

I routinely use inulin fiber in children to halt the pattern of recurrent oropharyngeal strept infections.

I personally think that what is being called PANDAS might just be a different manifestation of dysbiosis or overgrowth.

Rachel
Rachel

What are your thoughts on getting the insulin through the foods you mentioned? Onion, garlic, etc? My son is on Gaps diet and eats these things already, perhaps concentration is not high enough? Thank you

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Yes, I don’t think those foods offer enough fiber to get the proper fermentation.

Raghu
Raghu

Hi Dr, a couple of weeks that I started on this journey and find it quite helpful. My kid is not as restless as before and sustaining eye contact little better. But what bothers me is his tummy aches. With inulin he is unable to urinate freely and with omegas constipated and is miserable just before emptying bowels. Is this expected behavior and how long will it take for his issues to settle down. Many thanks!

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Excellent. The improved eye contact and calming effect is most likely due to a drop in propionic acid levels.

Try stopping one or the other to see which is causing the problem with cramping.

If inulin, add a little olive oil as a laxative or something else mild. If fish oil, split the dose or take with food.

Kim
Kim

Dr. N, First please allow me to extend my highest gratitude and appreciation to you. I admire your accomplishments and servitude to all the families affected. Our 2 year old son was recently diagnosed ASD- preverbal–I felt in my gut it was coming from his gut. We had a stool test come back showing dsybiosis, acidic stool and low SCFAs, high lactoferrin (inflammation). After looking at many options we decided your science fit our case well. We started the protocol 3 days ago and he has already said 4 words ( only said each word once, but it’s a improvement)… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Kim, Thanks for the kind words. Jean and I feel blessed to be able to help so many families struggling with autism, and other developmental disorders. I never do stool testing because we don’t know how to interpret it, and the mix of bacteria in the lower colon that produces feces (and the specimen tested) is very different and no way representative of the mix of bacteria in the small intestine. The small intestine is actually where the overgrowth of bacteria is occurring. This is the environment we need to improve. Adding bacteria as found in common probiotics in an… Read more »

Alex
Alex

My kid is on the autism spectrum with intellectual disability too. Does this help bring up his cognition? We are going for genetic examination shortly and worried if that’s going to show up positive. Just want to try this as a last attempt. Plus he has had some neuero degenerative disease at a young age when he was an infant.
Thanks!

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Don’t let the genetics scare you. It doesn’t mean things are permanent, it just means this gene is present more often in autism.

I have a variety of kids with this and that gene that are recovery.

I just posted an addendum to the updated autism 2017 post that talks about recovery and genetics in a broader scope.

Dr. N

Chrystal
Chrystal

I think my son should go on the antibiotic but I’m trying to figure out how to get him on one. His pediatrician is far from open minded. I read in your previous comment to someone else that you wouldn’t be able to prescribe anything over Skype. Do you have any suggestions or know any doctors that follow your protocol in the New Jersey area? Thank you!

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

No, I’m sorry I don’t.

As cumbersome as it may seem, I’ve had several families fly in to Phoenix for a consult and get the Rx.

We then do follow-up visits by Skype.

Dr. N

Sandy
Sandy

Thank you doc. Finally, is there a recommend time for taking inulin supplement for best results?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I’m sure there might be some differences for individuals, but I haven’t noticed any.

Katie
Katie

hi. Would larch arabinogalactan work as well? Is Rosita cod liver oil ok for the omega and finally how do people who previously have done badly on FOs and inulin in probiotics fare? Thanks

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I’m sorry, I’m not familiar with those products.

Sandy
Sandy

So one should not use give probiotics to child when on this protocol? We currently give our child bcomplex, zinc, buffered c, fish oil, vitamin d and probiotics. Please help me understand. My son is 4.5, high fuctioning autism and non verbal..

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Read my recent post on Probiotics and you’ll better understand my concerns.

From a practical standpoint, most of the kids who come to me are on probiotics and still are having a great deal of trouble with autism. The probiotics may of helped some indigestion issues but not so much the autism.

When I stop the probiotics and add, inulin and omega-3 fatty acids, they start improving at a much faster trajectory.

Dr. N

Maggie Karuga
Maggie Karuga

Could you use this protocol and use ACC (Andrew Cutler Chelation). Also does it mean stopping taking probiotics?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Doing my protocol alone seems to help.

Please see my previous comments on probiotics as well as my recent post on the topic.

Vas
Vas

Hi Dr, my kid brain MRI says Focal cortical dysplasia. He has epilepsy too. Does this protocol help him come out of FCDs? I donot really know how serious is FCD but still want to give this a try.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Difficult to say. This will for certain give his brain a fighting chance to repair itself.

Navi
Navi

Oh, I will then surely give this protocol a try. Could you also blog about your kids case and their current health status. That will be a positive inspiration for many, am sure.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

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… Read more »

Navi
Navi

Hi does this help rett syndrome of autism? My daughters are 8 and 4 resp and they don’t like to use hands. They are also severely developmentally delayed and no hand function and lack of eye contact is affecting their cognition. Please help!

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

It may. I’ve had 2 kids with another severe version of autism, Lennox-Gausaut and it helped both of them tremendously.

Beth
Beth

My son is 11 and just diagnosed with high functioning autism in Jan (it was no surprise). He has sensory and anxiety. We are doing the fish oil and fiber gummies and cutting out all other supplements starting today. I realize it will probably take longer and maybe higher doses due to his age. Is there a chance SIBO could be the cause of his hives (had for 4 years and on daily Allegra)? We have been told that the hives could be connected to PANDAS (but hasn’t had strep in a long time). Do you do Skye appointments for… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Yes, we should Skype first. I can fill you in on the medical issues surrounding his health. Only limitations are I cannot by law provide a diagnosis, nor order prescriptions or testing.

With that being said, I can give you a lot of insight into what is going on.

More info about consultations is available under the About tab.

Dr. N

Alan
Alan

The brilliance of your protocol is the simplicity by which you relay the science supporting it. After applying several approaches over the years, it’s refreshing to see a approach that can actually be applied fairly easily and inexpensively. My son got a rash/hives two weeks in, but now I suspect (based of your previous response to me) either a fish oil allergy or a gelatin allergy from a gelatin-based gummy with additional vitamins and low dose omega 3 (SmartyPants). Will let the rash clear and start with just powdered Inulin in applesauce. I have a younger son using Nordic Naturals… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Thanks for the kind words. My wife Jean is the wordsmith. She helps refine my scientific explanation into a more fluid, digestible prose.

Eliminating unnecessary supplements often helps a lot of little problems go away.

Dr. N

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