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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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Sskl
Sskl

Hi Dr..
Pls correct me if im wrong, high inulin causing reduce brain BP, hyperactivity and increase stimming is actually showing the underlying ANS damage right.. after the sedative effect of propionic acid is lifted . By decreasing inulin we just want to sedate the ANS till it heals.. or does the inulin has direct effect on reducing the brain BP and causing hyperactivity and stimming.

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

The precise mechanism is unknown.

Melissa Achimon
Melissa Achimon

Hello Dr N, I need your help please. I have a 16 year old daughter diagnosed at age 3 with moderate to severe mental tetardation and severe ASD. She had always been non-verbal, and very sensory seeking. That’s almost all she does is seek sensory input. After meeting Jean, my brother suggested I reach out to your office for an appointment, which I have. In the meantime I have also joined a blog and support group where I have gotten great info and help. I started her with 1/8 of inulin, omega3(Nordic naturals), and evoo certified. After eight days I… Read more »

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

We have witnessed steady improvements in some children with severe retardation.

You need to read the protocol fully before starting it. There are a lot of things you need to understand, and it outlines all the doses and brands I use with my patients.

You can get an inexpensive copy at https://autonomicrecovery.shop

Durgalakshmi
Durgalakshmi

Hello Dr Nemechek.

My son 6 yrs was undergoing quantum biofeedback for his ASD and adhd condition and since 10 days we are into the protocol. Is it Okay if we continue the quantum biofeedback sessions ( twice a month) or will it interfere with the protocol. However it doesn’t involve any internal medicines.

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

Generally, biofeedback programs are allowed.

I am not familiar with quantum biofeedback.

Rani
Rani

Hi Dr . N, First of all thanks so much for this amazing protocol and for being such a great human being I admire you and I always watch your videos . God bless you ! Secondly , my son is 4.7 ASD along with language impairment nonverbal . He has been on your protocol for 6 months plus we had gains in areas of receptive language , easy hair cut , waiting for his turn to other patience , identifying his ABC numbers and shapes and all colors eye contact and awareness . I switched his FO from NN… Read more »

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

Traditional chiro should not interfere with the protocol.

I personally believe the tongue-tied diagnosis is way, way over used.

With all these great gains, he just needs more time and the speech will come.

Nazmun Nahar
Nazmun Nahar

Hello, Seven months on this protocol. Small gain. I saw the awakening when his inulin dose was half teaspoon. At that time I did not read your book, so I gradually increase his all doses. Now 2 teaspoon now inulin, 5 ml
Nordic natural fo, 1 tb evoo. My question is do I need to go back previous inulin doses? Also is this correct dose of fo and evoo? Thanks
Nazmun

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

Try cutting the inulin all the way back to 1/2 a tsp and see if things improve. Too much inulin causes a drop of brain BP and leads to increased anxiety, hyperactivity and increased hunger.

Lara
Lara

A number of us from the Nemechek FB group have seen similar issues when increasing inulin over 1/2 tsp. (My daughter dealt with months of aggression and SPD when we raised slowly to 2tsp, which have disappeared now we’re back down at 1/2 tsp.) Can you tell me whether the inulin dose being too high can prevent neuroplasticity so hampers recovery? Or could gains have been happening under the surface regardless?

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

We are finding that while the inulin suppresses the propionic acid and results in increased awareness, too much may cause increased anxiety in some kids (I think a small proportion of kids treated).

I do not think the inulin is hampering recovery, the kids seem to have difficulty accessing their gains when feeling too fidgety or anxious.

Try reducing the inulin back into the range I recommend in the book. I have never recommended doses higher than 1 tsp in any child and only rarely recommended 1 tsp in a few rare cases I personally manage.

“Better is the enemy of good enough.”

KLindor
KLindor

Hello Dr, is rapeseed oil an acceptable oil to occasionally consume in the ingredients of a product? I don’t mean cooking in it, it just seems to be in a lot of food’s ingredients. We avoid everything else and consume 2tsp EVOO a day – thank you

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

Yes, its fine as long as you get the olive in the diet. The EVOO will protect you from any excessive omega-6’s.

Valina
Valina

Hi Dr , Does higher doses of inulin gives bad effects ( such as decrease in cognitive skills or increase stimming ) compared to lower doses of inulin ? Or in what way higher doses of inulin is bad other than bloatedness/ cramping ? As you mentioned in books and videos the stimming is the underlying ANS damage, Does increasing the inulin escalates the recovery ? because at certain lower doses , sometimes the awareness seemed to be slipping away. and then plus with the daily fluctuation of child’s behavious – some days are excellent , some days are bad… Read more »

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

Yes, excessively high doses of inulin can cause hyperactivity and anxiety.

Frosina
Frosina

Hi Dr Nemechek, my son is 6y old, and we have eeg with some chenges, it is idiopatic epilepsy, but hi never had seizures so what doses of olive oil do you recomed for him, now we are giving 30ml. Is it to much?!And shell we give him depakine solucio 300ml/mg, our doctors are not for sure, about the terapy, becouse he dasnt have seizures, but hi has changes in the development, autistic spectrum, 3 monts on the protocol and there are some gaints…
Thank you

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

Yes the dose of EVOO is higher than what I recommend. Please read the protocol.

We sell copies in multiple languages at https://autonomicrecovery.shop

Marzenka
Marzenka

Hi Dr. Nemechek 🙂 My son ( autism, 4,5 yo ) is on the Protocol for 5 months. We are obviously having good gains (from non-verbal ->he started talking 2-letter words and reading very well) and steady on the recommended doses. From 3 days I observed him after dinner and he had reflux-like symptoms, stomach growling and stomach acid smell from the mouth. Just after main meals. It is very interesting, because all his life he had low stomach acid symptoms. When he was 3, he vomited every night and the content of the vomits wouldn’t smell like stomach acid… Read more »

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

Absolutely. Inadequate emptying of the stomach is an autonomic issue.

It will recover but it can take a while.

Sskl
Sskl

Hi Dr..
My 6 y.o daughter is 9 months in your protocol.
Small small gains are there but her stimming has increased, Speech is a major struggle. Why other children improving a lot but mine is static with minimal gain?
1.5 tsp inulin, 2 cap NN Pro Omega. 15 ml EVOO.
I am very depressed Dr.

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

Try backing your inulin down to the starting doses (1/4-1/2 tsp per day)

Alia
Alia

Hi Dr..
Do i have to test for Cerebral Folate Dificiency Test. FRAT test.. before embarking fully into this protocol? Do you think CFD can be a reason if a child doesnt improve on this protocol?

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

No

Lindor
Lindor

Hi Dr, my son 3.5 who is following your protocol for 6-7 weeks now, is passing wind a lot and having a mix between constipation and looser stools (increased frequency also) but not in pain by it at all or bothered… would you say this is tolerating the inulin? He’s on just under 1/2 tsp inulin daily
Thanks

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

The excess gas suggests the=is dose of inulin might be too much.

Margarita
Margarita

Hello, dear Dr Nemechek,
Both me and my friends are very grateful for your protokol, which makes miracles with our child. We would like to ask, if we can use Method of Tomatis alongside with your protokol (our child listens to music on headphones),. Won’t we harm him? Sinserely yours

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

It should not interfere with my protocol.

Anonymous
Anonymous

Hi Dr Nemechek I hope u are keeping well. I previously asked you about my son loosing awareness when I started fish oil with him, after him being on 1/2 teaspoon of inulin for 4 months. You responded by saying to keeping increasing the inulin. I have increased his inulin gradually to 1 & 1/2 teaspoons. He seems to be tolerating the fish oil better as he does not lose the awareness now, but he starts to grind his teeth and push his head into things (like sensory/pressure seeking) about 15 minutes after taking the fish oil. This lasts about… Read more »

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

This should resolve with a little time.

I don’t really know if more or less inulin would make this better.

Margarita
Margarita

Dear Dr. Patric Nemechek. My son is on the protocol for 3 months and has been taking omega 3 Nordic without a break. Should he make a pause or take it constantly ?

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

Take it constantly

Shilpa
Shilpa

Hello Dr N My daughter 5yr 10 mo is on protocol for last 6 months , she is diagnosed with ASD and severe global developmental delay . She is very behind in her gross motor and fine motor skills and she is non verbal . She is not on any other supplements or medicines. She is on following dose which I have increased slowly 3/4 tsp 2 ml NN ultimate FO 10 ml evoo So far I have seen lot of awareness , when I am going out she comes and hold my hands to go out. Walks with me… Read more »

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

As long as she is continuing to improve (even if its slowly) in all major aspects, stay with present doses and be patient.

Trish Nelson
Trish Nelson

Many thanks for such a wonderful healing protocol for us all. My 7 year old who has Down Syndrome has made wonderful progress using your protocol. My question is relating to increasing urine output and frequency. We keep our eye on blood sugar levels and they are always perfect when these episodes occur. I’ve read this is a common issue, but wondering if it settles down and is it because of the fiber absorbing water etc? He has never had accidents like this since he was 3!!! Thanks for your insight

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

Yes it will calm down. It’s a common issue as the autonomics recover.

KLindor
KLindor

Hi we have a 3.5 year old (undiagnosed suspected ASD) that’s been on the protocol for 5-6 weeks and we are seeing mindblowing results. My question is about preschool booster vaccines which he is due. He has had all his vaccines to date so far. I’m so nervous about him getting his boosters and having a set back of some sort and us losing him again. Obviously I would prefer he has them but shall I expect a regression or should it be ok if I keep up the protocol? It’s the MMR booster (along with others) Thanks

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

If possible, I generally recommend trying to get 6-12 months of positive gains with the protocol before continuing the vaccination process.

Svetlana
Svetlana

Dear Dr Nemecek,
My daughter, almost five years old, have no developmental delay but have clostridia in her gut. She got it after strong antibiotic therapy. She have symptoms like, often stools with mucus and sometimes blood in it. She have been three times on antibiotics and during that time the symptoms disappears. But after a while, they show up again. Is it OK to give my daughter inulin and how? She drinks omega, and uses olive and coconut oil in the diet.
Respectfully,
Svetlana

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

If your daughter is having relapses of Clostridium difficle, I would give any inulin unless you receive approval from the managing gastroenterologist.

Vladimir, Moscow
Vladimir, Moscow

Hello, Doctor. You are our savior! We read your book. We noted the awakening of 1/4 teaspoon of inulin, the child became better engaged, eye contact appeared, and our joy knew no bounds. We continued to increase the dose, by 1/2 received a pronounced hyperactivity and decrease in cognitive skills. Restarting the protocol did not give more improvements. Now we are again at 1/2, but there is no improvement. What should we do next? We are in a panic.

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

Try going down a little on the inulin. Maybe a 1/4 is all you need.

Anonymous
Anonymous

Hello Dr N, my 6 year old son is on protocol from last 9 months he is doing great , his speech , handwriting, behaviour, Social development everything improved, I increased inulin on 1st of Jan due to eye stimming and after that eye stimming reduced alot sentence formation is also improved alot, now his learning capabilities is equivalent in language is equivalent to neuro typical kids, but from last few days some pee accident happened in his pants in school and speech class when things not going according to him. He is not constipated when constipated I used to… Read more »

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

At this point, it’s probably related to stress/mild injury (physical, emotional or inflammatory) and usually recovers without adjusting the dosage.

Harshika
Harshika

I increase his inulin dose in last july due to vit. D deficiency now, his vit.d levels has improved. Is it possible that these behavior arise due to high dose of inulin ? But he did great till mid January.

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

We are finding that while the inulin suppresses the propionic acid and results in increased awareness, too much may cause increased anxiety in some kids (I think a small proportion).

Try reducing the inulin back into the range I recommend in the book.

Sejal Shah
Sejal Shah

I had to give antibiotics for pneumonia for my 6 year old, overall healthy girl, hiw else can i protect the good bacteria?

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

If your child is prescribed antibiotics for pneumonia, by all mens follow your physician’s instructions.

Laura W
Laura W

Hi Dr N, My 7 year old ASD son has been on the Protocol for almost 2 years (thank you!). He started at age 5, and quickly ramped up to the max dose of Inulin (4 gummies) without any adverse effects. Week 1 I gave him 1 gummy and by week 4 we were up to 4. At that point we so a noticeable positive awakening which included expanded language, more eye contact, and more overall awareness and better cognition. He also wakes every night in the middle of the night and the first day that I gave him the… Read more »

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

As the children grow older, the fish oil dosage will gradually need to be increased and at some point the inulin fails.

In inulin failure tends to be an obvious event as their behaviors change is a strange, unaccountable way. They often act a little spacey or slightly drugged. When this happens in unpredictable – might be at 12 or at 18 years of age.

If all things are improving, there is no advantage to treat early with rifaximin just because someone else did. The kids are all very different.

Shirley
Shirley

Does this protocol addresses halitosis? Thank you

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

Sometimes halitosis is from bacterial overgrowth

Rob
Rob

Dr Nemechek ,

Our son who is 21 months old is showing signs of Autism, so we read the book and started him on the protocol a couple of days back , we are giving him dosage as mentioned in the book, however since these last few days he seems to be very lethargic with no energy at all, just wants to be carried and would not run around or play by himself as he used to do. Could you please advise.
Regards
Rob

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

Very unusual for the protocol to do this. Maybe he has a coincidental viral infection.

Stop the protocol, give him a ew days to recover and start again.

Anonymous
Anonymous

Thanks for your reply! Yes he does have a common cold at the moment . The lethargy is totally out of proportion to the cold as he would be very energetic even with a cold.. we will stop the protocol and see how he gets on.
Many thanks

Gaurav
Gaurav

Hello Dr.,

In addition to following your protocol, I have been giving my child one tea spoon of Virgin Coconut Oil empty stomach in the morning. I know it is not necessary for protocol, but do you see any issue with it?

Thanks

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

No I don’t see any problem with it.

Anamika
Anamika

Hi Dr.Nemechek, my kid is on protocol since October and I could see the hair growing. Thanks for your wonderful work!
I wanted to know if energy drinks like boost or Bournvita which we add to milk is allowed or not. I have stopped it for now but my son is missing it a lot

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

I would prefer the children are fed actual food prepared at home and not convenient food-in-a can replacements.

Dikins
Dikins

Hi Dr.,
Is there any thought if we need to increase our intake on butyric acid / butyrate rich foods to further help healing the gut?

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

No, it is not necessary.

Balaji G
Balaji G

Hi Dr.
My son is 4.5 years old, started with Inulin(1/4 tsp) more than a week and just started with fish oil(500 mg) .After 3 days he has got mouth ulcers and they went off in 3 days .Now, he has heat boil under his chin ,it’s been 3 days it’s spreading with little puss . Can we give him anti-biotics for the heat boil as the Pediatrician suggested anti-biotics.
Please suggest.
Thanks,
BG.

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

Sounds like his immune system is turning on more and he is cleaning up some latent infections.

Without seeing your child in my office, I recommend following the advice of your pediatrician.

Jennifer Y.
Jennifer Y.

Hello Doctor, Im hoping I could ask you a quick question for myself, I’m 37 yo. I’ve tried asking 2 of my doctors for a rifaxamin prescription and they would not. Have you ever heard of Candibactin ar/br? I was reading a few articles online comparing them to rifaxamin. I just thought it was worth a shot to ask your opinion. Until then I will continue to save for an appointment with you. Thank you for your time.

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

Rifaximin and Candibactin are not the same in any respect.

Amanda
Amanda

Hello, Two questions. Our 4.5 year old son has been on your protocol for 5 weeks. He has little speech (very difficult to understand and does a lot of repeating) and has some difficulty understanding basic language. He has no interest in peers and no pretend-play skills, but is generally happy. We have been taking the recommended amounts and brands of EVOO and Fish Oil and he’s been on 1/2 tsp Inulin for about 3 weeks. He had normal bowel movements (once/day and soft consistency) before the protocol and now his poop is significantly harder and he’s going about every… Read more »

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

I can only recommend reading the protocol and following the methods I use for my own patients.

Anonymous
Anonymous

Thank you. The protocol states that 1/8-1/2 tsp once or twice a day is generally adequate for children. This tells me that my son may need up to 1/2 tsp twice a day. Page 44 talks about the 2 goals, but it doesn’t state how much time is enough time (when there’s no progress) before increasing the inulin. Any clarity would be appreciated. I do have an appointment booked with you for August.
Also, would CBI show up on an MRI or not necessarily?
Thanks again.

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

A few weeks between changes in dosing of inulin is generally all that is required before changing doses.

No, most cumulative brain injuries do not show up in typical MRI scans.

Saritha
Saritha

Hello dr,
My son 11 nonverbal asd, is getting crazy mostly on nights and shows his leg paining under the leg. What can be the reason how can k help him he gets too upset and want to bite someone but he knows its wrong and just act like bitting .

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

Read out protocol and watch the Youtube video on Aggression and Anxiety

Scott
Scott

My doctor would not prescribe me (48yrs) Rifaximin. Would higher amounts of inulin eventually do the same thing for SIBO and/or will the NP still work but just take more time, or do I absolutely need the Rifaximin? I’ve been taking inulin for a few weeks and am able to tolerate 6 teaspoons a day without much discomfort. No idea if more is better in this case, but I thought I’d try it out. I’m about to start the DHA and EVOO this week.

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

In order to get substantial recovery of autonomic function in adults, I require rifaximin. Inulin just does not seem to do the trick.

Anonymous
Anonymous

Hello Doctor – Our son is 3.11 year old and we started him on protocol 2 months ago – 1/2 tablespoon Inulin, 450 mg fish oil (EPA+ DHA) and 1 table spoon EVOO. We have not seen any noticeable changes. What should we do next – shall we increase the doses of both Inulin and Fish Oil or should we wait? He is a happy kid with average eye contact, understand most of the commands, good vocabulary and memory, can speak a lot of words and can build 2 word sentences but speech is not clear. It is the same… Read more »

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

I think you need to re-read the protocol to understand the dosage requirements.

A copy can be downloaded at https://autonomicrecovery.shop

Anjali
Anjali

Hi Dr. Nemechek We are following the protocol for our son who is almost 11yrs old. We completed the Rifaximin course end October 18. Now our dose is EVOO 2tsp and 1 Now fish capsule (750mg). He is slightly verbal. After starting the protocol his awareness has increased, eye contact with known people is better, started learning cycling and makes more verbal sounds. However, we see increased hyperactivity and multifold increase in stimming (fidgeting with bead and string). And not much improvement in speech. Also he has been having linguistic memory recall issues which seems to be impeding speech. Should… Read more »

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

I think you need to re-read the protocol to understand the dosage requirements.

A copy can be downloaded at https://autonomicrecovery.shop

Puja
Puja

Hello Sir,
I want to ask 2 questions:
1. Do kids with regressive autism recover faster than kids with autism since birth?
2. My 3 yo son exhibits severe anxiety which often ends up with terrible, sometimes self harming meltdowns. Is this a sign of ANS dysfunction?
Thank you very much.

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

1. Kids born with autism seem to have a greater degree of developmental delay and cumulative brain injury than those with a regressive pattern. So I would guess it might take longer but I have no clear data to support that.

2. Most of the anxiety meltdowns (as well as hyperactivity, increased hunger/thirst, toe-walking) I see in children with autism is from autonomic dysfunction that results in low brain blood pressure and suboptimal oxygen delivery. The low pressure leads to a rise in noradrenaline (fight or flight hormone) levels.

suruchi.awasthi@gmail.com

Hello Dr Nemechek, I’m writing with a lot of hope. I know someone who’s daughter ( now 22 months ) was born with tiny patent ductus arteriosus. Due to some further complications her brain got damaged and now she has some major developmental delays. She remains in lying down position, is tube fed (can’t swallow) and her legs remain in crossed position. Will Nemechek protocol be helpful for her? She lives in a remote village of Sri Lanka and doesn’t have access to quality health services but is willing to travel to Arizona if it can help her. I can… Read more »

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

The phrase “brain damage” has a wide range of meaning in regards to severity.

The protocol is certainly safe and might provide some benefits without having to travel to the U.S.

Anonymous
Anonymous

Dr Nemechek,

Firstly, thank you for the time and effort you have put into the protocol and helping so many children and adults recover. My mother is doing really well on the modified protocol (she has severe anxiety) but now my sister says that too much omega is not healthy with severe side affects, is there any truth to it. Im afraid she might frighten our mother who cant afford to not be on the protocol. Thank you Dr Nemechek.

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

Modern inuit eskimos get far, far larger amounts of omega-3 fatty acids in their daily diets as do not suffer any negative consequences from it.

Chinnu
Chinnu

Hello Doctor, First of all I would like to thank you for giving us hope in reversing Autism. I have baby girl who is diagnosed as Autistic at 2.5 years of age, now she is 4.5 years we were giving here ABA therapy from 1 year on wards and we do not see much improvement and I got to know about nemecheck protocol from my friends ,I started using the protocol since 2 weeks on wards, first we started with 1/8 of inulin powder and Fish Oil and Extra vigin olive oil which is manufactured in Germany, do u think… Read more »

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

The concern with supplements in the U.S. is that there is almost no regulatory oversight and the vast majority are fraudulent. Different countries have different regulations – I am uncertain about Germany.

The book gives you guidance on how to manage the dosing of the individual components used in the protocol.

Evelyn
Evelyn

Hi. You mentioned the possibility of cerebral hypoperfusion with CBI. What is this? And how can I help her?

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

It’s the cause of low brain blood pressure from autonomic damage.

My protocol helps reverse this type of problem.

Evelyn
Evelyn

We have been on your protocol for 2 years. My daughter is 6. Her school have commented that some days she is really switched on and learns fast and on others she’s ‘zoned out’, quiet and doesn’t pick things up as quickly. Is this typical behaviour for a child on your protocol? She doesn’t have any diagnosis or medical conditions. Some asd traits.

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

Really hard to say without a detailed evaluation but my first bet would be a little cerebral hypoperfusion from CBI.

Charvi
Charvi

Hello Doctor,

Curious to know how many have lost asd diagnosis and functional at a neuro typical level and how long did it take to reach that stage???

I am aware that the protocol is lifelong and gave no issue with it

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

The vast majority of those trying the protocol are seeing very significant gains. The time required to reach the neurotypical stage varies greatly depending on time of regression, time of development of SIBO and the frequency of brain injuries.

In general, younger kids recover faster and older kids take longer.

Anonymous
Anonymous

Is there a way of testing how high or low the inflammation going on in the body? Thank you Doctor!

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

Surprisingly, as important of an issue as inflammation is, there is not readily available and accurate test.

Susan Johnson
Susan Johnson

We started my 7 yo autistic son on high doses of omega 3 summer of last year — had not heard about your protocol at that time but had received that recommendation. He became much more “aware” but also much more hyper, stimming, and began vocal outbursts (inappropriate and near constant laughing during therapy and other times). His aba therapists requested I stop the omega in Sepetember, which I did. But the new behaviors continued and are making aba and classroom very difficult. In Nov after addressing the issues with a physician, he was prescribed Intuniv. Initially it seemed to… Read more »

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

Yes, you are in a quandary.

Intuniv can lower brain BP levels but also can block some of the anxiety often stimulated by low brain BP.

I generally tell my patients to slowly back off the Intuniv as their child improves. I suggest discussing this with your prescribing physician.

Keerthi
Keerthi

Hi Doctor, is there any 2nd awakening?? It’s been 16 months on the protocol with huge gains but we are facing sleeping issues past couple of weeks. He was on 1tsp inulin for more than a year, past a month I added 1/2tsp at night too (slowly worked up to 1/2).He is 6yrs old. FIsh oil 1500mg and lots of EVOO. No other supplements and all recommended brands. Though we are facing sleep issues, we are also seeing huge improvement in speech. Im happy that he is calling me mommy Everytime. Earlier it was like robotic kind. You are our… Read more »

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

Many of these “second awakenings” are actually relapses to a new injury (emotional, physical or inflammatory)

Angela Biv
Angela Biv

Hi Dr Nemechek! I have set my alarm to call it office in the mor because we feel we desperately need a Skype call! My now 4yr old has been on ur protocol for almost a year and while we have had slight improvements I am still struggling to get his loose/frequent stools formed! And he is still nonverbal and delayed.. stool tests have confirmed both clostridium and klebsiella overgrowth, this test was done a few months before starting it protocol. Doses are as follows, inulin – 2tsp, fish oil- 1ml (ultimate omega), EVOO – 5ml plus all foods cooked… Read more »

Cathy
Cathy

Hi Dr. N, My 8.5 year old girl has been on your protocol since Oct 2018 for constipation, anxiety, irritable/ poor behaviors, and poor sleep. We started slow on the inulin but by mid-November, she hit 1/8 tsp of inulin powder. (I haven’t been able to increase due to constipation.) The rest of the protocol has been on the correct dosages. My question to you is that when we started the protocol, she slept pretty well. Not sure if from protocol/ olive oil or bc I rubbed magnesium lotion on her tummy to help with bowel movements. But by late… Read more »

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

I’m uncertain why the peanut powder has made things worse but I’d probably stop that and take my protocol slow and let her recover a bit before tackling another problem,

Charvi
Charvi

Hello Doctor,
FMA test (bioscreen) reaveals overgrouth of streptococcus , eubacteria and Bifidobacteria species. Also undergrowth of bacteriods and Lactobacillus species. Does the protocol help to normalise this dysbiosis?

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

Inulin helps rebalance gut bacteria and increases bifidobacterial species.

I would be careful believing the FMA test as it is often very inaccurate.

Charvi
Charvi

Is there any reliable test that shows the correct gut health?

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

There are no accurate tests generally available at this time.

Noelle
Noelle

Hi Dr nemechek, my girl (3yr8mths)is on your protocol more than three months, she has been suffering from sleeping disorder issue more than two years .she has been having difficulty in falling asleep. She usually takes more than an hour to get into bed,usually cries badly before nap/night sleep and she wakes up crying hysterically for two hours in mid night.Can this protocol help all her sleeping issues/lessen her crying before bed time? The whole family has been affected by her sleeping disorder.thanks

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

Yes it can but be aware, sometimes some issues such as sleep might get a little worse for a few weeks during the awakening.

Jan
Jan

My 20 yr old daughter has PANS, brain inflammation, neurological problems, Lyme, Bartonella Sibo. The only thing that keeps her brain inflammation down so she can function is doxycycline (she becomes very lethargic and can barely talk or leave bed without it). She had to stop the doxy due to side effects (Papilledema/intracranial hypertension). Can this protocol work quickly ? Do you know of any fast acting anti inflammatories that can give her temporary relief while we try this? Would it be worthwhile to book a phone appointment with you? Thanks

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

This protocol works but very little can work quickly because the brain cannot recover quickly.

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