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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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Amanda
Amanda

Hello Doctor,
My 4 year old son has been on your protocol for 2 months. We have seen some positive changes, virtually from the beginning, and believe they are from your protocol. Thank you. However, he is still not progressing at a rate that will help him catch up and my fear is that he continues to get further behind. You had mentioned in your book that a child can expect to jump ahead 2-3 months in development for every one month. When should we start seeing that level of progress? Thank you.

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

You need to focus on your anxiety and impatience f you are having these thoughts only 4 months in.

Anonymous
Anonymous

Hi Dr Nemechek,

I have recently finished a course of rifaximin and I was asked by my family members how will my gut get repopulated again after the rifaximin wiped it clean? I know not to use inulin again, does this mean there will never be “birds” again in the small intestine? They all believe that probiotics is good and say I need to add that in -I know better but I would like to set them straight.

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

Rifaximin does not lessen any particular species of bacteria nor “wipe it clean”.

It only removes colon bacteria from the small intestine without harming the normal bacteria within the small intestines aand leaves the population of normal bacteria within the colon intact.

Think of it as re-organizing the bacteria without causing the elimination of any particular species as compared to killing off bacteria.

Pete
Pete

Good Afternoon,
After reading your book and removing soybean oil from the diet, we have noticed soy lecithin is in numerous amounts of food. If a food does not contain Soybean Oil, but does have soy lecithin should that food be removed as well? Thank you in advance for taking the time to read this and respond.

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

Just try to limit the amount of soybean OIL in your food

Olivia
Olivia

I’m on the protocol for 13 months for my 5 year old daughter, I lowered and increased inulin following difficult behavior and pee in her panties. ….. she understands better the instructions, but always of the opposition, but does not find any interest to speak, she does not say words badly pronounce that if I insist several times if she makes herself understood in her way to shoot us the hand towards the thing, do you think that it needs a vagus nerve stimulator, or I still have to continue, I currently give 2 times 1 / 4plus 1/8 inulin… Read more »

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.

HELLEN
HELLEN

Hello Doctor Thanks for this protocol. My son is five. 2 month since we started protocol. All recommended brands. He is getting 3/4inulin, 2ml fish oil and EVOO in cooking. Since he is five I tried to give him 1/2 TABLE SPOON OF EVOO directly, every time I give him, it gives him running stool. Since I started giving inulin , fish oil and EVOO one by one, clearly identified that EVOO is the reason behind the running stool. I tried to stop and started with very small dose of EVOO but the same result. His running stool stopped when… Read more »

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

Just stick with cooking only for now.

Sue
Sue

Hey Doctor, I’m really curious about sense of smell on the protocol. My 4.5 year old seems to smell everything before he eats it now. He also can smell when I’m cooking something and runs straight into the kitchen looking for it. Today when I picked him up from daycare my sister had some hot chips in the front seat and he kept sniffing around and looking for them. Can the protocol help with smell and taste etc.

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

Yes it can.

Maybe his brain is understanding smell for the first time.

Danielle
Danielle

Can recovery still happen if you are unknowingly giving too much inulin? My 3 year old has been on the protocol for 4 months and has autism. He has always been quite aware so it’s been difficult to determine his “sweet spot.” We got to 1 teaspoon of inulin and noticed he started responding to his name every time someone called him and very aware of his surroundings. However, on the flip , he has been jumping , running in circles, touching our faces obnoxiously (not curiously), laying on the ground with his car rolling them back and forth, and… Read more »

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.

Colleen
Colleen

I started the full NP about a month ago with my 12-yr-old son for PANDAS. He’s done the oils for 2 months, then added the inulin after a month. Everything is approved: 1500 mg fish oil, 1 tbsp. EVOO, and 1/2 tsp. inulin (started at 1/8 and working up). I thought I saw subtle improvements at first but not sure. He even got the rash I’ve read about. In the past few days, his PANDAS symptoms have gotten worse. (OCD, brain fog). He’s also constipated, so I put some prune juice in his smoothies. I’m planning to increase his inulin… Read more »

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

The increase in inulin above the 1/4 or 1/2 a teaspoon I recommend may be worsening the symptoms

Mom I
Mom I

Hi! There has been a lot discussion on your comment about too much inulin causing raise of BP and causing anexiety, hyperacitivty, increased hunger… is this a general Rule? My son is 4 and have been on your protocol for almost 2 Years and although there Are gains he is still Non verbal and his receptive language is Poor. We Are coming overseas for the summer to get vns. But my question is, he has been on 2 tsp inulin for the last 7 mth and when I increased Everybody saw an increased awareness, he started Sleeping better as Well…… Read more »

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

There are my guidelines and then the rules everyone else seems to contrive for themselves.

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. The progress you saw might we from the fish oil, EVOO or just waiting for more time to pass.

Dawn
Dawn

Hi Doc, I’ll make this concise. What doses should I change.? My 5 yr old on 1200 mg recommended fo, 1.5 tsp inulin , 2 tsp recommended olive oil. She started in Oct 2018 at 1/8 inulin and by 3/8 she made gains with awareness , focus and speech . Increased to 5/8, 3/4 then 1tsp by dec still with gains. She had a low grade fever for 1 day in Dec . No further gains since that day dec 22 then so I ve worked up to 1.5 tsp inulin, 1500 mg fo (switched from NOW TO NN end… Read more »

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.

KH
KH

Since the issues with the Certified EVOO occurred, I have been cooking with canola oil and giving EVOO in a syringe to my ASD almost 4 year old child. What would be a good amount to give him in the syringe since in your book you recommend to only cook with it? He sill has some snacks and bread that has OMEGA 6 in it. Is that ok?

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

no more than a teaspoon

Amanda
Amanda

My 4 year son is getting his FO, Inulin, and EVOO all together in the morning at his first meal. Is this OK or should these be spread out throughout the day and/or separated? Thank you.

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

Together is fine

Elaine
Elaine

Hello Doctor Nemechek, my four-year-old daughter has been on the protocol for two months, and especially in the beginning she has had amazing verbal gains. We are now at 5/8 tsp inulin (just increased from 1/2 tsp last week) and the recommended amounts of fo and evoo. She flaps her hands a lot, there is a lot of toe-walking and she sometimes tries to stand on her head. She gets upset easily at different things. Those symptoms have been happening more often than normal for a few weeks. She has also been having a cold for a couple of weeks… Read more »

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.

Elaine
Elaine

All right, thank you for the advice, Doctor. I will get back to the book. 🙂

As for the Rifaximin, I will approach my family doctor about it, unless you tell me otherwise.

Anamika
Anamika

Hi Dr Nemechek, It’s been 11 months on NP, not a smooth journey, but seen small gains, my daughter is 6 yo, has autism , limited verbal and SPD. In this 11 months she fall sick 4-5 times with flu so definitely had relapse but reached to the same point where she slipped into relapse. Good news are/ she is no more picky eater, walks flat sometimes on reminding her( earlier was on toes all day) , imitates tons of words , but little functional speech , eating herself, receptive is improving but still long way to go, Now the… Read more »

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.

Joan Boyle
Joan Boyle

Hi Dr. N, Is it ok to give Calm magnesium with this protocol? Does the combination with the fish oil and olive oil cause diarrhea? My son is 21 and a little constipated , doing better with oils in that regard but he has meltdowns almost daily, hitting himself in the face ,that last about 20 min. I would like to try to add the Calm magnesium to see if this issue can resolve. Thank you!!!!

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

Magnesium seems not to interfere with the protocol

Joanna Marais
Joanna Marais

Dr Nemechek,

I want to purchase Omega 3 for my 2 year old and 5 year old. Could you please let me know which omega 3 will be the best for my kids and the strength.
Many thanks

Regards

Joanna

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

Please read the protocol before starting. The answers to your questions are all spelled out in the book.

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

M Kelly
M Kelly

What does awakening look like in a child that is not autistic? Will they have an awakening? My child is 3 with speech delay how do I know when inulin is enough?

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

There is no awakening if the child is not autistic

M Kelly
M Kelly

Thank you but how do I know when inulin is high enough if there is no awakening

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).

There is what I call the cookie test. Many child will not respond to commands because the commands are of no interest to them. But if you were to ask the child if they wanted a cookie (or candy or or the iPad or ice cream), many will quickly respond. If they do this, they have had aenough inulin and are aware.

Ashu Mahajan
Ashu Mahajan

Hi Dr. My son is 5 years and 8 months old. We read your book and got great hope for our son who had infantile spasms at the age of 7 months and later struggled with development and is now mild autistic as per Psychologists. We started protocol 1 month and 4 days back. At present we are giving him 1.5ml FO, 7.5ml EVOO and 0.5 tsp inulin. Today we had a rough day with strange behaviour from him. He cried a lot during lunch for no reason. We took him for a haircut. He cried there also whereas he… Read more »

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

Try cutting back on the inulin, maybe an 1/8 or 1/4 tsp per day.

We are finding in a small proportion of kids, too much inulin can result in higher levels of anxiety

Ambika Pant
Ambika Pant

Dear Dr Nemechek, we have almost completed 10 months on the protocol with my 17 year old non verbal autistic son. As far as I can see, he is slightly more responsive to me, and is sleeping a lot (which seems to be a little unnatural for his age). His tummy which was mostly upset (5-6 times a day) has now gone down to 2-3 times a day. He is on 5 Now DHA, 1tbs EVOO and has completed two rounds of rifaximin (last one on 7th Dec). There is no other significant change. His bouts of head hitting, scratching… Read more »

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

I’m sorry but the blog is for more generally topics. It is improper for me to comment on particular dosing for an individual

Swetha
Swetha

Hi my son is 4 yr old, he is having a lots of sensory seeking like tight hugs especially in middle of the night around 3 am he will get up and lots of jumping ,pressure seeking, pressing his private parts.Gravitational insecurity he is fear of swings,but he climbs ,uses slides and all
What are things need to do with issues
He is already taking OT, he is on NP since a year
Inulin 1 tsp, cooking EVOO and fish oil 600 mg

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

Maybe try a little less inulin.

Everyone seems to think I want everyone up to 1 tsp per day of inulin at a minimum. This is not true and it is not in the book.

After experiencing a little awakening at 1/4 or a 1/2 tsp of inulin, higher doses can make some kids more anxious, or hyperactive.

Swethapriya
Swethapriya

H I Dr,
We had Skype appointment in September ,you said us to increase inulin to 1 tsp after that we saw little gains but since 2 months we are not seeing any gains , plateau phase so we doubled fish oil ,we thought hyperactive is because of fish oil so we reduced it but still it is same
Now IAM in dilemma to decrease inulin or continue same dose

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.

John
John

I asked this on the support group and wasn’t able to find an answer. I’d really appreciate you’re help. If started on the protocol young enough (age 2) will everyone eventually need Rifaximin or can you continue to manage sibo with inulin as they grow?

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

Inulin quits becoming effective for neurological recovery in the teens and then rifaximin is needed.

You have at least a decade before you need to worry about this.

Manos
Manos

Dr. Nemechek,
we live in Greece. We’ve found some excellent early harvest organic extra virgin oil, but it is early harvest.
Does it matter that it’s early harvest?

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

No it shouldn’t.

Martha
Martha

Dr. Nemechek, is olive pomace oil acceptable ?
It is contained in Neuroprotek (Quercetin, Luteolin, Rutin) which treats mast cell activation and we are considering trying it along with NP protocol. We are one year in the protocol, my son (8) continues to have hives, despite antihistamine therapy (XOZAL fpr 7 months). Because hives persisted we stopped inulin and took Rifaximin (recommended doses). We also decreased FO to 1 capsule a day. Hives persist, and we are worried that the antihistamine therapy has lasted too long… Please advise

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

I have no idea what olive pomace oil is.

Just stick with simple COOC-certified EVOO

Martha
Martha

Thanks Dr. Nemechek. What about the rash (hives) though? Why does it persist despite the 7 month antihistamine therapy plus a 10 day course of rifaxamin? The moment we try to stop XYZAL, it comes back. Shouldn’t that have been resolved after a year in the protocol? Why would he still have a histamine reaction to Fish Oil despite the above?

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

Uncertain as to why but not overly concerned about the hives. Continue the anti-histamines for now

Amanda
Amanda

My 4 year old son has been on the NN Fish Oil Lemon (derived from sardines and anchovies) and has been tolerating it well. I have seen a few studies recently saying that Vitamin A from Cod Liver Oil has been useful in ASD recovery. Would you see any problem in switching to NN Cod Liver Oil (looks like they have an orange flavor)?
Thank you.

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

Just stay with what works. Remember, “Better is the enemy of good enough.”

Anonymous
Anonymous

Hello doctor Nemecheck,
My son is 3 yr 1 month old and on full protocol since 2.5 months.
We have gains in appetite, much better response to name,Answering some basic questions , yes or no reply on preferences. Thank you so much
He is at 3/8inulin
2ml NN omega3 and EVOO in cooking and foods.
But his core autism symptoms are still there.
I have been seeing all your videos and also reading blog replies.
But im still not sure if i must increase dosages or stay there.

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

I have no idea what you mean by core autism symptoms since he is more aware and now even answering questions.

You are very early into this. Be patient and give the brain more time to heal itself.

Priya
Priya

We saw that he was getting more irritable at 3/8 inulin and we saw your responses for others and reduced inulin to 1/8 tsp.
We are 4 months down the line now.
We lost some improvements in viral episode
We have no improvement in spontaneous speech yet so we doubled his fish oil to 4 ml NN omega 3 (1560).
He gets plenty of olive oil in cooking and over foods.
We booked an appointment for November this year. But if you can help us check if we r on right track it will be great

Michaela O’hare
Michaela O’hare

Hi dr!! My son is on protocol six months. He has no diagnosis but speech delay and food intolerances. Just 4 weeks into protocol words started coming fast he now has 100’s of words but everything is scripted. He is able to follow direction but If I ask questions he’ll answer random things like fire engines for what is your name, this has been going on for months, is this normal? He is 3 years old I stopped inulin at 1/2 teaspoon I felt he was a little bit more aware. I have followed parents who has visited you with… Read more »

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

I don’t generally recommend inulin that high. I recommend 1/4 to 1/2 a tsp per day.

I generally start 3 year olds at 1/4 tsp

Steven
Steven

Hello Dr. N. Our 1 year, 10 month old daughter (asd) has been on the protocol for 6 months. After many gains and what seemed to be a two month slow period, we increased inulin from 3/8 tsp to 1/2 tsp (1/8 tsp fish oil and 1tbsp EVOO). Three weeks ago she recovered from RSV. Three days ago we believe she hit her head very hard on her crib. Since the inulin increase, she’s been more hyperactive, has been throwing temper tantrums and significantly reduced her eye contact. She has also been stimming a lot (identical to her stimming behavior… Read more »

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

Stick to the plan and she’ll recover out of this relapse

Adam
Adam

do you think the protocol will help my son with his verbal dyspraxia, it’s not easy for him to understand everything at school despite his will, I only give the omega 3, thank you

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

Yes the protocol is very effective against dyspraxia and apraxia

Michaela O’hare
Michaela O’hare

Hi dr nemechek,
My son has been on protocol for six months no diagnosis but I feel maybe is at risk of autism. He has food intolerances. He is 3 years old and I’m confused at what inulin dose should be. At 1/2 teaspoon I felt he was a little more aware so kept him there but I have read from many parents with children the same age that have seen you in person that you have advised to up inulin to 1 teaspoon for food intolerances. Is that right?

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

Just follow what I outline in the book

Leyla
Leyla

Hi Dr nemecheck. I took 2 rounds of rifixamin and oils and now am 4 weeks pregnant i have the most severe acid reflux ive ever experienced it had gotten alot better with protocol. I am cough all day and night…would you recommend taking inulin during pregnancy for this? I have no idea if this means my SIBO is back ? Thank u!

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

The inulin might help. Ask you OB/Gyn before starting

Dana
Dana

Where would I be able to find a list of references for the medical studies you cited above? I have a brother on the autism spectrum and I try my best to stay current with the latest treatments/therapies/research. Thanks!

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

References are listed in the back of the book.

But your copy at https://autonomicrecovery.shop

Anita
Anita

Hi Dr, Nemechek,

My son is 6 1/2 yrs old. He has been on your protocol about 2 months. We have seen awekining but stemming has been increased comes like in waves high and down! We are up to 1tsp inulin then he started to have constipation, crumbs and stomach pain and his sleep has been disturbed. I also noticed his urine has been dark and smelly. Do you think this all related inulin doses is too much?

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

Try dropping inulin back to 1/2 tsp

Smita
Smita

Hello Sir, I heard about this protocol from one of my friend who herself is a doctor. My son is 4 and half years old with very little verbal. He is not potty trained yet and has some issue with communication. However is very good in imitating. He always looks side and he has stemming/self talk/hand flapping issue. One of my therapist recommend us to use Nordic natural 525mg omega 3 Strawberry flavored medicine. I am giving him 2.5 ml daily as per the dosage mentioned. I red in one of the testimonials where you mentioned about the lemon flavored… Read more »

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

We have had several reports of fish oil with strawberry flavoring causing relapses.

Smita
Smita

hello Sir,

Do I need to stop giving him other vitamin supplements .I am giving him daily zincovit which is a zinc multivitamin tonic.
As he is 4 and 8 years old what would be the Inulin dosage for him ?
Thanks.

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

Please read the protocol before starting. It will answer all these questions

K Lindor
K Lindor

Hello Dr, we have been on protocol 2 months and seeing good gains in communication and language. Slow but definite progress. I have read your book also. I just wanted to ask about ‘scripting’ and if it ever stops? He’s 3.5 and scripts most of the time stuff like songs and alphabet etc…. he does speak relevant stuff too. It does seem to be more since the protocol and also in night if he wakes. Will this improve with age?
Thanks

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

Yes scripting resolves as well.

Tamila
Tamila

dear doctor in a child; strong gas formation cries at night from bloating in the stomach (almost 2 months on the protocol); 1.4 inulin can this be from him (ultrasound examination did everything in order)

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

Maybe too much inulin?

Mary
Mary

Hello Dr. Nemecheck

My 8 year old son has been on your protocol for a month now. I believe he might be in awakening stage now. He has laughing spells, is extra silly & very emotional/angry. I have bought your book and read your blog. Maybe I missed it somewhere but can you tell me based on your experience how long is awakening stage? Just want to know what should I expect time wise.
Thank you!

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

The awakening is just the initial recognition of increased awareness of the child. It persists as long as the gut bacteria are adequately controlled.

Mary
Mary

So should I expect that awakening symptoms such as laughing/increased stimming will dissapear once brain recovers?

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

Yes

Mushabir
Mushabir

Dear Doctor
Few questions please, would appreciate if you could clarify:
1) Do you think if the protocol can help reducing mild hydrocephalus condition and repairing the brain?
2) Is bed-wetting and insomnia considered normal during the protocol and will gradually fade away? (if they weren’t there before the protocol).
Thanks!

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

1. Very difficult to tell. The protocol certainly seems to help normalize a significant amount of autonomic function and CSF production and fluid balance seems to be under autonomic control. So the potential for benefit exists and the protocol is pretty harmless.

2. Some insomnia and bedwetting can occur from too much inulin. Try cutting back the dose a bit.

Lior a.
Lior a.

Hi
My son is 3 month after his own cord blood infusion performed in duke university as part of expand access protocol. He is showing similar symptoms to your description. Initial boost of good behaviour and awareness followed by ups and downs. His therapists clearly sees he is awakening but stimming has increased lots of shouting due to enthusiasm. Should we benefit from the nemecheck protocol? Should we start with the omega3 only? Combine inulin? The mechanism of stem cells from cord blood might be interrupted?
Regards
Lior.

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

I wouldn’t start the protocol if you are in the middle of such a complicated study.

Run it by your study coordinator or physician before starting NP.

Tamila
Tamila

Hello dear doctor, my son is 3.4 years old on a protocol of 1.5 months and we have a problem with worms (parasites). Please tell me whether to take the medicine or inulin will affect them yourself?

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

Inulin will not clear parasites

Helena
Helena

Dear Dr. Nemechek, I feel your portocol could help my 6 y.o. son to develop his speech. He is quite hyperactive, verbal but with low socials skills and speeks only when motivated .. He has hard time to concentrate on one this. I am member of one support group in my conuntry and I read many good examples on how the protocol made miracles with the kids with similar issues. We plan to start with the portocol , with all recomended brands, but we are a little bit confused on how to start. Dosage is quite clear but I see… Read more »

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

It is fine to start everything at once or one at a time.

Agnes
Agnes

Dear Dr. Nemecheck, after emotional trauma i got als disease. Is there any chance to have improvement with your protocol?

Thank you in advance for your reply
All the best
A.

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

Yes, I think it can help

Maria
Maria

Dear Doctor.
When the Polish language version of your book will be available. In Poland, more and more children are suffering from Autism, and doctors seem to be without strength due to the enormity of the problem.

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

We understand that children all over the world are suffering.

My staff includes just my wife Jean, our assistant Kim and myself. We do not have the money to pay for so many different translations.

If organizations would like to fund raise and contribute to the translation costs (they can run up to $5000 per book), we would gladly coordinate and organize the translations.

Seth's Mom
Seth's Mom

Hi Dr. Nemechek. Firstly, thank you for helping so many. I am planning on buying your book. My son just turned 6. He has been having a lot of behavioral issues at school resulting in referrals. We have tried everything we could minus medicines. The school wants him on medication for ADHD. Will this help him? I’m desperate and need help. Thank you!

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

If you and his physician think these medicines will help him, they will not interfere with the protocol

Melissa
Melissa

Dr. Nemecheck,
Is there any evidence that shows improvement in those suffering from autism and mental retardation? Both very severe. I have a 16 year old daughter that I started on your protocol and just wondering if I might get a desired outcome with this process. I am scheduled to see you in late year but in the meantime I have her at 1/4 dose of everything. Should I attempt to use the adult protocol instead and again, with both of these diagnosis together is there hope in recovery? Thank you for your time.

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

Yes, we have seen several children with ASD and mental retardation improve a great deal.

Melissa
Melissa

Hello, are the doses I provided you ok? 16years, 1/4 of all three? Should I obtain Rifaximin because of her age or stay on protocol dosages I am at?

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

I will not comment on particular doses without seeing an individual face-to-face as a patient

Ramon
Ramon

Hello. We’ve been on the protocol with our autistic son (6) for probably a year. He is up to 1 teaspoon of inulin, and on the maximum size recommended of fish oil. He always gets lots of olive oil and coconut oil and walnuts/almonds in his diet (and hardly any other oils). He is doing quite well, but lately we have noticed he is not coping as well as before (more screaming). Sometimes he shows some of his weird behaviours that he hasn’t shown since years ago. Should we increase the inulin? Would that help? Should we continue as is?… Read more »

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

Its either he suffered a new injury or he’s getting too much inulin.

J. G.
J. G.

Dear Dr. Nemechek, I have 12, 1/2 year old autistic son. I bought and red your book before we started protocol. He has been on your protocol since june 2017. In July of 2018 he had his first round of rifaximin, and another one in November 2018. We have been seeing slow results, and we’ were patient and hopeful. But at the end of October he started having his pee accidents. First I thought it was a “peetox” and that it will go away. But three and a half months later accidents are still here. We checked his urin, had… Read more »

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

Yes, there is a good chance VNS will help this issue.

Ella
Ella

Hi Doctor.
My son has been on protocol for a month. Unfortunately he is supposed to take antibiotics for 10 days because of nasal congestion starting today. Do I keep him on protocol while taking antibiotic?
Will he have a relapse because of antibiotics?

Thanks,

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

Do not stop the protocol while on antibiotics.

Diana
Diana

Hello Dr Nemechek
We started the protocol in october but still just on EVOO because of epilepsy.When do you recomend starting with fish oil and Rifaximine.It is about a girl 14 years old .Her epilepsy is simptomatic and started after ischemic stroke in the brain.She has seizures every day

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

I generally do not think one needs to avoid fish oil or inulin if they have epilepsy.

Since you are so worried, ask your neurologist.

Zorka
Zorka

Dear Dr. Nemechek, I have recently heard about your work and study and.. THANK YOU for everything you do! I read your book, many blog texts and youtube videos and I thought I should try your protocol because many of the issues you are addressing are my issues as well. I have been fighting Helicobacter for a year.. I was trying to remove it with antibiotics (twice within 6-7 mnths period) and it keeps coming back ☹ Long story short, my Q is, am I eligible to start using your protocol ? Is inulin influencing H. Pylori in a god… Read more »

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

H. pylori is generally harmless in 90% of persons and doesn’t always need to be eradicated except if it is associated with gastritis..

Work more on rebalancing your intestinal tract and your symptoms will most like resolve.

Sush
Sush

Dear Doctor,
My 3.3 yr toilet trained son is urinating frequently and small amounts. He’s wetting his pants too. He seems to be losing control. Is this related to the protocol? I’m super worried .
Thank you!

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

Try decreasing the dose of the inulin a bit.

Olga
Olga

Doctor hello! help please understand! Having read your book, I could not find an answer about the possible application of the protocol for my child. My daughter is 5.5 years old. CONCLUSION: – venous angioma of the left posterior temporal region – gliosis focus in the left posterior temporal region, in the projection of the proximal venous angioma segment – hypoplasia of the distal intracranial segment of the left vertebral artery. shorting by MRI results. Please tell me if I can use the protocol for it?

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

You best ask your neurologist.

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