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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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Verna
Verna

Hello.  I’m the mom of twin 8 y.o. twin asd boys.  Recently, my younger 8 y.o twin son has started to hit his head.  Not too hard and sometimes.  This has been happening for a month.  We increased his now inulin dosage to 1/2+1/8 tsp now inulin on Jan 25, 2019 from 1/2 tsp.  He had the flu first week of January.  Should we reduce his dose? 

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

I’m sorry but its too hard to say. Maybe stop it altogether to see if it stops and then just start all over since the flu has passed (I’m assuming).

Parent
Parent

Hi Doctor,

My Son,7 year ASD non verbal,following GFCF,no sugar,no rice diet, has been on the NP for about 4 month.His eye contact,behaviour and understanding has improved.However no speech yet.He has 1 tbsp Inulin,5 ml NN Ultimate Omega and 30 ml EVOO. He also keeps complaining of feet pain,any reason why?

Thanks In advance.

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

I have no idea what might be causing the foot pain.

Ujunwa Egbu
Ujunwa Egbu

Hi Dr N ,I have a 4yrs old asd non verbal and I want to start Np .what will be the recommended dosage for inulin, EVOO and FO to start off with.

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

Please read the protocol

Nadyia
Nadyia

Hello! I understand sunflower oil should be avoided, but what about high oleic sunflower oil. It is in almost every non-dairy milk which is my sons only source of calcium. High oleic sunflower oil has small amounts of omega 6.

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

High oleic had a broad range of meaning. They should be fine if they continue to get their olive oil.

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Hi Dr Nemechek, My 3.5year old son has been on protocol 3.5 months. I have been on 1/2tsp inulin for 2 weeks now (after decreasing from 1tsp). His sleep is better, also more hyper/playful, speech is more. However, his tantrums are still there. He gets very angry if he doesn’t get what he wants, and has tantrums for very small reasons. He throws stuff away. Is this behaviour normal or should I decrease the dosage more? (I did decrease before to 1/4tsp for 3 days, however he was less energetic, less hyper/playful, less speech, still had tantrums). Will this behaviour… Read more »

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

It’s hard to say. Sometimes sitting tight and waiting for things to develop is the best strategy considering the improvement you’ve had with the change.

Kasia
Kasia

Dear Dr Nemechek, I’m sure this question has been asked before but it’s difficult to search in the blog. What is your view on using the protocol with Lyme diagnosis? My child suffers from SIBO but has other diagnosed issues such as lyme, viruses, mold, etc. Thank you for your help

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

The other infectious diagnoses you mention don’t need to be addressed with my protocol.

The patients seem to recover in spite of these diagnoses. Maybe the immune system improves enough to clear them on its own.

MLL
MLL

Hi Dr. Nemechek,

Just wondering if you approve of this petition to research your protocol? Someone from the Nemechek facebook group put together the petition.

https://www.thepetitionsite.com/en-ca/359/784/276/autism-recovery-demand-research-studies-on-the-nemechek-protocol/?fbclid=IwAR1giRZxcXmM7PCqnIv-2M4CN0Vgwjtlf0OWYM37dXS1_uTMLngcDb1gX5I

I will only sign it if you think this is okay. My daughter is doing so well on your protocol.

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

I understand this is a simple but complex issue from some parents out there. As a general principle, I believe everyone has a right to their opinions and I for one, would never stand in the way of that freedom even if it runs counter to my beliefs. I am flattered by the petition but have no idea if it will help provide more scientific attention towards the unique power our protocol is having with children. But I certainly do not believe it would cause any negative consequences for myself or Jean, for the protocol or the the power of… Read more »

Relita
Relita

My son, who just turned 5, had chronic hives when he was 18 months old which lasted for about a year. Could this be linked to his language delay and autistic like behavior? About a month into the protocol his hives came back and lasted for approx 2 weeks. He always had language, can talk in 4 word sentence, but refuses to use it, it’s his last resort. He also seems very distracted all the time unless he is doing his most preferred activity. He still seems the same after we have started the protocol. I have seen gains in… Read more »

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

Please read the protocol. The awakening relates to an increase in awareness not gains in neurological function.

Relita
Relita

Thanks for the reply Dr. That does makes sense. I was just wondering because sometimes he appears super engaged and some times he looks at different direction from me. I guess i’ll increase his does and check if things improve. Also, is it possible that chronic hives that he had could be related to his behaviors?

Ayesha
Ayesha

Is this possible that yeast over growth gives the symptoms of autism?If yes then your protocol will help to cure yest over growth or along side we have to treat yeast separately?

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

In spite of everybody repeatedly taking about this for years, I can find no scientific evidence that yeast overgrowth exists.

The tests often run that purportedly “proving yeast overgrowth” are misleading and inaccurate in their claims.

Ibrahim
Ibrahim

Hi Dr
First I would like to say thank you very much for help you r giving us and our children. My 4 years old son who is in ASD is in NP for 4 months. He is in 2ml Inulin, 1tsp NN fish oil and 1tbsp olive oil. But I can’t see improvement in his speech , still non verbal. Is this normal in 4 months no single word, and Inulin we have reached almost 5ml and we redused it when we saw anxiety and not normal movements. Any advice here will be very grateful
Ibra
From Norway

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

Not unusual. Be patient and give your child time to recover.

Sandip
Sandip

Hello Dr.,

Thanks for your good work.
I have one question for increased hyperactivity
I got best result , when I have divided fish oil dosage for my son he is 2.5 y old
Nordiac natural 0.5 ml morning and 0.5 ml evening
When i have converted it to single dose morning 1ml.i am seeing he is more hyper and eye contact also reduced . inulin dosage was same in both.

Thanks in advance

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

Taking fish oil in a single or split dose doesn’t matter.

If twice a day seems better for you, use it twice daily.

carolyn matos
carolyn matos

Hello, would greatly appreciate some advice both of my kids 4 and 6, have anxiety, and some stuttering, I had last spoke to you 2018. You had advised that I give them 5ml of inulin. and thy are also on 5 ml of omega nordic and cook with california oil no other supplements,. Wondering if the dosage needs adjusting due to anxiety, they are both very anxious and also some stuttering.

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

Unusual that this didn’t improve things.

I would recommend an appointment for further in-depth discussion.

Swethapriya
Swethapriya

Hi Dr, We are on protocol since a year, my son is 4.1 yr old ,i started slowly with 1/8 till last October ,then after Skype session we did increase to 1 tsp slowly ,now in Feb he was hyperactive ,sleepiness and sensory issues so as per your advise we decreased inulin to 1/2 tsp.My main concern is after ayear of protocol also iam not seeing much gains. Gains : speech he was non verbal prior but now he is in repeating phase this also I saw intially after starting of the protocol ,still he is in same phase Mild… Read more »

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

He may need VNS.

Gaurav
Gaurav

Hi Dr.
Been on your protocol for my 4 year old daughter since 8 months. I have seen minor improvements in terms of speech and she has started repeating the words. Do you have any idea how long does it take to develop functional conversational speech? Other thing that worries me is her verbal stemming. She does make a lot of noises throughout the day. Is it the hardest part to get rid of?
My doses :-
Inulin – 1/4 tsp
Fish oil – 1000 mg of DHA + EPA
EVOO – 10 ml

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

Speech is the most complex thing any animal does and not surprisingly seems to take the longest to recover.

Hang in there and do your best to be patient.

Ayesha
Ayesha

Hi Dr. N,
My son of 4.4 yrs old is on your protocol since 11 months ans indeed have improved lots but his teeth grinding is not ended.What can i do for this?MAy i use b12 for this?

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

B12 won’t help with teeth grinding. I think waiting longer and allowing more recovery will.

You might drop the dosage on inulin a little to see if this helps.

Diandra Simmons
Diandra Simmons

Hi Dr. Nemechek, A few questions. My son is 4.5 years old and has been on the protocol for a year this month. Lowered inulin from 1 tsp to 1/2 a tsp (due to a recent post about lowering for hyperactivity/anxiety), 1 tsp Nordic Naturals Fish Oil, 2 tsp approved olive oil. He has gone from pre-verbal to being able to say around 5 – 10 independently words in a year (but not sentences). It’s not clicking to become conversational yet and he can say over 100 words, but doesn’t put words with items/people/places. Is this normal for being on… Read more »

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

Sounds like he was doing a little better on the prior dosage of inulin.

It sounds like there is a lot of improvement but I understand the concern.

His speech is coming along, its just that some kids without speech may be starting with more profound developmental issues than other kids without speech.

Hang in there and more recovery will come. Avoid the temptation to speed things up by adding other treatments. This often just causing more problems.

smita
smita

hello sir, My son would be 5 years old in June 2019 who was diagnosed ADHD.Its been 15 days now I have started giving him Inulin less than half a tablespoon full. Since 1 week I am seeing he completely stopped eating food, his aggression increases a lot and he used to be more stubborn and his bowel movement is also changed. He is skipping a day completely. I read your complete book and understood that as his gut system is getting settled ,that’s why these changes came ,correct me if I am wrong and let me know the cause… Read more »

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

He is probably getting too much inulin.

Smita Dalbehera
Smita Dalbehera

Sir,would you be able confirm about the vaccination query which I raised .
When my son will be turning 5 ,do I need to give him vaccination or should I need to avoid as he is on the protocol rite now .

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

It is inappropriate for me to answer such specific questions on the blog.

Melissa
Melissa

Dr Nemechek is it ok if I give my child vitamin d drops while on protocol? Her vit d level was 35.

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

Doesn’t sound like he needs it.

Karen
Karen

Hi Dr. Nemechek, My 5 year old son has been on the protocol for almost a year, and is seeing great improvements in speech and social functioning. He still need to be in an autistic support classroom, but is so far from where he was a year ago it is amazing. I’ve read your book and all your blog posts, so I know what you say about vaccines; it is the SIBO, and not directly the vaccinations themselves that escalate regression into Autism. My son is fully vaccinated except for a final dose of 4 needed for school. His last… Read more »

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

If you’ve had a positive response from inulin, treating with rifaximin will not increase the child’s ability to tolerate the vaccines further.

The fish oil, olive oil and inulin over the last year will greatly improve an individual’s ability to recover from injury whether it be from a physical injury, emotional trauma or an inflammatory insult such as a vaccine.

Priya
Priya

Hello Dr Nemechek, we are almost 2.5 months in your protocol. My son is really doing well but still there is no gain in speech. Hoping to see some gain In Speech too. My son is also taking leucovorin 10 mg in a day as we got FRAT blood positive. what’s the best time to drop leucovorin while doing NP or I should retest FRAT again before dropping. Curious to know what you suggest to your patient who are FRAT positive. My son is 4.5 year old. He takes 1/8+1/16 Now Inulin, EVOO-7.5 ml + in food and Nordic’s ultimate… Read more »

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

I’ve never needed to test for the FRAT gene in the treatment of my patients.

Ask you ever ran the test what their opinion is about stopping leucovorin.

Be patient, you’ve only just begun the recovery process.

Nasir hussain
Nasir hussain

HI I am going to start your protocol my son is 8years old. He has autism adhd Lyme and co infection.My question is does your protocol treat the Lyme and co infections aswell.

Plz reply my answer.

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

There is a great deal of controversy as to whether the Lyme and other coinfections actually exist or are simply a result of misinterpreting labs results.

The bottom line is that the kids I care for who have previously been diagnosed with these infections recover without me needing to address the infections per sey.

Maybe they didn’t have them or maybe the child’s natural immunity cleared the infections without any additional help.

Sandip
Sandip

Hello doctor, First of all tons of thanks to your good work. My son is 2.5 year old ASD. We have started your protocol 2 months back. With inulin 1/8 tsp and food on evoo as suggested in protocol.we we’re not having fish oil at that time Instead used DHA syrup 200mg daily. We have seen impoovement in awareness, sensory problems got improved, More eye contact. Last week we have got fish oil and inulin dosage has increased to 1/4. Hyperactive has got increased,teeth grinding ,we are seeing some his old behaviors with sensory, now he don’t want to be… Read more »

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

I would stay at the dosage that first showed awakening. IN your case it sounds like 1/8 a tsp.

Bruktawit Ayelew
Bruktawit Ayelew

Hello Doctor, can inulin also be taken with milk? I also wanted to know why inulin not be given in the evening? Thanks from Germany

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

Yes, inulin can be mixed with almost anything

Rebecca
Rebecca

Hello,
Will drinking bovine colostrum affect the protocol? Thank you.

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

It could alter the gut bacteria is a negative way.

If it is being used to heal leaky gut, this heals on its own within a couple of weeks after starting inulin or taking rifaximin.

Jyobis
Jyobis

Hello Doctor ,
Can Camel raw milk interfere with the protocol ?
I have started my almost 3 yr old with NP about 3 months back with starting dose 1/8 and way up to 1/2 , 2 ml NN fish oil , Evoo on cooking . Thinking to start camel milk for faster gut healing along with GFCF diet . What’s your recommendation for camel milk with NP ?

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

Camel milk is not required to heal the gut. Both inulin and rifaximin result in reversal of leaky gut within just a few weeks without any additional supplementation.

Haneesh
Haneesh

Hi Doctor, Thanks for your protocol which we are following it for our kid. I read your book. From past 2 years i am suffering from VITILIGO, white spots on my lips and few on my body . I have used allopathy and homeopathy medicines with which i didn’t find any result. Now my question is:
Does Nemechek protocol works for Vitiligo? If yes, then what would be the dosage and can i continue during pregnancy as i am planning for my second kid.
Please reply doctor.. Thanks in advance

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

The protocol seems to be inconsistent in its benefits for vitiligo.

Anonymous
Anonymous

Thanks for your reply doctor. Does the protocol works for Thyroid and migraine problems? If yes please suggest the dosage. Thanks in advance

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

It certain helps migraine headaches go away.

The book contains the dosages I use in my practice. As a reminder, the dosing for adults with autism was developed over 10 years in adults without dosing prior to the publication of the book.

Kelz
Kelz

My husband also has those little white bumps inside his lower lip for years. He just recently starting rubbing apple cider vinegar over them daily. After approx. 2 weeks they just dried off and he was able to aggressively rub them off, they are very close to all gone.

.
.

Hi Dr Nemechek, I started protocol 3.5 months ago for my 3.5 year old. He has severe speech delay. I worked up to 2 tsp, however this increased anxiety and hyperactivity. He lost his self feeding skills and now will not touch food, I have to feed him. He has also lost his appetite. I reduced to 1tsp for 3 weeks, which improved his speech alot, however he was still waking at night with tantrums. It has been 4 days of reduced dosage to a 1/2 tsp, however it is not helping. He still has big tantrums. Do you think… Read more »

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

Stay at the lower dose and wait. The sleep issue is from underlying developmental issues or injury and just needs to recover.

Anonymous
Anonymous

Hi Dr. Nemecheck, I just started my 4.5 y.o. son on inulin ONLY. I haven’t introduced the oils yet. The day after his 1st 1/8 tsp inulin dose he started he had VERY loose stools, & the loose stools have continued everyday since then. Today will be the 5th day. I kept everything the same to see what happens. However, these very loose stools is preventing him from going to school because it over flows his pull ups, running down his legs and messing up his clothes everytime. I dont want him to miss school, but not sure if i… Read more »

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

Stop the inulin, wait a week or so and restart to make certain it doesn’t happen to be something else causing the diarrhea (virus?)

Ayesha
Ayesha

Hi. After starting your protocol, my son became hyper still after 6 months on np ,he regress or go back when get flu or sore throat medication and head banging increases . My question is as VNS helps in decrease inflammation so kids become more restless in start or in whole process stage wise like during nemechek protocol,we saw changes in behaviour good bad moods regression etc all again and again since 6 months.still now,

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

Infections are a common source of relapse. But over all they do not seem to prevent overall improvement.

Olivia
Olivia

Hello doctor
I am on the protocol for 13 months for my 5 year old daughter, she goes a surgery for her teeth, we must do general anesthesia, to remove teeth t put some fillings for others, I worry a lot, es ce that I continue the protocol of the same doses, I currently give 1/4 inulin 2 times a day, 1ml omega 3, twice a day, and I cook with the olive oil, is what I have to change something. Thank you

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

Continue at the same doses.

Zuzana
Zuzana

Dear Dr. Nemechek. My autistic son 3,5 yo started with inulin last November (no fish oil, EVVO only for cooking). Dose of inulin is 1/2 teaspoon 2 times a day. He has e-coli and still diarrhea. He has never had normal stool. What to do? Thank you for your reply.
Zuzana from Slovakia

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

His diarrhea could also be from inflammation within the colon.

The fish oil and olive oil might also help reduce the inflammation.

Sara
Sara

My 7 year old has mild Asperger’s symptoms and also is intellectually gifted including an amazing memory. Do you typically see the giftedness that comes with Asperger’s disappear along with the other symptoms as they heal? Thank you.

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

I’ve never seen the gifted skills autistic children have disappear when recovering on the protocol.

Noel
Noel

Hi Dr nemecheck, in your book, stated”My patients take 1/8 to1/2 teaspoon of inulin powder, one to two times a day.The maximum inulin dose I use in older, larger children is 2teaspoons per day” Can I interprete that the inulin dose for smaller children , 1/2tsp*two times=1 tsp per day is fine?
can I double confirm that my child is 3yrs11months, having been on your protocol for more than 4months, current dose is 3/4teaspoon inulin per day,is it fine?
Thanks

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

I start low with the dose and only increase if there is no initial response.

Noel
Noel

My child still has no awakening at 3/4tsp inulin, still no eye contact, same hyperactive as before protocol, same sleeping disorder issue/ as bad temper as before protocol, do I need to increase inulin dosage?thanks

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

With no increase in eye contact and presuming you are using NOW brand, my reason leads me to believe they’ve failed inulin and may need rifaximin.

noel
noel

Can I just confirm that no eye contact means no awakening ? thanks

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

Generally yes.

Noel
Noel

Also a new concern here, we just observed over past two week, she is on n off dropping few hairs , can this due to the effect of the protocol? Is it normal? Thanks

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

I think that is from something else.

Noelle
Noelle

Hi Dr nemecheck, Are the following ingredients in aloe Vera gel which is applying externally, is fine for your protocol ?
Organic aloe barbadensis (aloe vera) gel*, deionized water, cucumis sativus (cucumber) fruit extract, organic symphytum officinale (comfrey) extract, carbomer, potassium sorbate, sodium benzoate.

Thanks

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

External aloe is fine.

PC
PC

After a round on Rifaximin, my son has bad flatulence. It’s socially affecting him. It’s been over a week since his Rifaximin finished but his flatulence is not ebbing, it too much. Does this mean he needs more Rifaximin? Or inulin? How can we help him? Thanks?

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

Should improve with a little more time.

Also make sure he is not on inulin or any probiotic.

Precious Prieto
Precious Prieto

Hello, Dr. Nemechek.

We have been told at the FB support group to stay at the inulin dosage where we encountered awakening. I also read you mentioned 1/2 to 1 tsp powdered inulin can reverse bacterial overgrowth for kids 2-8 years old. I find these two information confusing. If my 4-year-old son encountered awakening at 1/8 tsp inulin, should we stay there? Or if we could increase, when is the proper time for us to increase his inulin dosage?

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

In my book, I recommend 1/4 – 1/2 of inulin for kids.

Ayesha
Ayesha

Dear Doctor Nemechek! Can childeren taking Ritalin and nemechek protocol both can also use your VNS for full brain recovery . Ritalin with VNS is fine plus protocol?VNS I heard helping a lot specially severe in autism or fits etc . Thanks a lot for replying .

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

I don’t believe ritalin interferes with recovery

Ayesha
Ayesha

This means we can buy VNS from you coming Arizona and continue Ritalin with it . Am I right ? I also read that VNS helps in adhd so may be slowly remove Ritalin if VNS stop anxiety, restlessness of 7 year old .Am I right Sir ?

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

Children with ADHD are often able to come off their medications after being on my protocol.

I recommend only tapering medications with the advise of the prescribing physician.

Sarah
Sarah

Hi,
I have two children, one child with development delays including moderate speech delay and sensory processing difficulties who is currently doing well and catching up, however I wonder If I have any further pregnancies, how can I prevent them having the same delays? Thanks

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

I have a chapter in my book where I discuss my thoughts on this. I suggest you get a copy of the book and read it.

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

Sarah
Sarah

Thank you. I have ordered a copy from Amazon UK.

Aruna singisetty
Aruna singisetty

Hello doctor N,my son is 5 yo having ASD we are using homeopathy medicine since 3 months we are seeing little improvement with that .his hyperactivity got reduced ,speech there is no improvement,his awareness is improved and following our commands we are following gfcf diet, Sugar free diet since 3 months.we heard about the NP and we want to start it so can we continue homeopathy or We should stop it

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

Read the protocol before starting the protocol.

Alina
Alina

Hello Dr,
Thanks for your amazing protocol. Just checking to see if potato starch as effective as inulin.

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

No it is not.

Shalee
Shalee

Good day Dr. N! My son is 11 yrs old, ASD and had a history of aggression and being violent (he hits everyone when he is upset). He is taking abilify and devalproex NA. His dosage is 1tsp inulin, 2tablespoon EVOO, 3 Now DHA, 6 months on NP. We have great gains from speech and social skills. My concern is his aggression and tendency to hit others. Like suddenly he had outburst and hit me but he would apologize. Its like he cant control it. Last week, his inulin was 1 1/2 tsps but after reading the blog i lowered… Read more »

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

Maybe the inulin isn’t working.

Siva
Siva

Dear Dr. Nemeckek ,
I just came to know about your protocol through a friend . My son is 9 y/o Non verbal and hyper active with no other medical issues. My question is can we get a appointment to see you please and what is the best way to get an parvite pay appointment with you .i order you book and very exited to read it to help my child. Hope to hear back from you !
Siva

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

Call 01-623-208-4226 to inquire about appointments.

Shilpa Singh
Shilpa Singh

My son is been on the protocol since November 2018 and doing all well on it. That being said I was able to wean him off totally from homeopathy since November which he was since 3.5 years of age. He’s 4.10 now. 2.5 ml inulin, 10ml evoo, 1.25 ml NN ultimate Omega FO. Not on therapies since Jan this year. His hyperactivity gone down totally,stays around us in a mall, feels winter feels chill,wears warm clothes, the baths use to be fussy now little hesitant only if I put too much water on him, but not to extreme extent as… Read more »

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

OT is compatible with the protocol.

Zameera
Zameera

Greetings dr! Many told there is a latest version of Nemechek protocol is that where can I buy the latest version of protocol book..

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

Not available yet.

Pallavii Chauhan
Pallavii Chauhan

My son started experiencing headaches midway through his course of Rifaximin. It’s been 5 days since his course finished but he is getting bad headaches everyday. I give him Motrin. Is this expected? How can I help him?

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

Not expected. Maybe he has something different like a sinus headache or a middle ear infection

Margarita
Margarita

Dear Dr. Nemechek! Tell me, please, how to deal with a child on a protocol that has a low level of vitamins D and B12. Does the child need to be given these vitamins, or are they normalized on the protocol? We just started the protocol.

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

Medical supplementation of low vitamin levels is allowed with my protocol

ANIMESH KULSHRESTHA
ANIMESH KULSHRESTHA

Dear Dr, After 7 months on protocol, my 6 year mild ASD non-verbal son behaviour is fluctuating- i have tweaked doses from 1/4tsp to 2 tsp NOW inulin. He seems to be sometimes hyperactive- sometimes ok. We initially saw gains in tracing letters, verbal repetition of letters, potty training etc, but speech related gains seem to have regressed. Awareness of surroundings and social interaction interest is minimal. We are planning to commence Rifaximin during school breaks in April. We are totally confused due to the fluctuative behaviours-if the protocol was working for him, then should’nt he have shown better awareness… 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.

Lisa Mark
Lisa Mark

Dear Doctor, My 6 years daughter is now 7.5 months on NP. Before Np my daughter was doing mostly echolalia, more jumping , giggling & stimming. First few months we saw lots of awakening with little gains. But from last 3 months she was doing great. Her echolalia was changing into long sentences. Jumping, giggling & stimming were all reduced by 70%. As we are in Australia she had2 months summer holidays December & January. Then in February her school started and from day 1 of her school she has regressed. Her long sentences have gotten back to limited but… 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.

Tamila
Tamila

dear doctor, two months on the protocol, a 3.5-year-old boy completely lost his toilet skill (he has been going to the pot for a year) 1/2 inulin, if I reduce my stomach and bloating to 1/4 and less, but the behavior seems better ..how can we be

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).

He might just need less inulin than most. It’s not a bad thing, just a difference.

Ann Van Peteghem
Ann Van Peteghem

Hello Dr Nemechek,
I am Ann, a Belgian mother with a son (22), has speech, normal education, regressive autism, slow reflexes, deeper receptive and expressive language issues, shyness, difficulties with making friends.
Been on the protocol for 5,5 months now, worked quickly our way up to recommended doses, first inulin than rifaximin, no TVNS.
In the beginning some more awareness (needlestitches) and less shyness but now somewhat plateauing more or less, since 1,5 months.
When can I expect more progress in the language area and reflexes ?
Warm regards and thank you for the reply 🙂
Ann

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

Kids this old often need VNS to continue their recovery

Masa
Masa

Dear dr N, my son 6 yo is on the np for a year an a half. Asd. We didnt see awakening so I was upping the inulin. Now on 2 tsp. Anxiety and agression kicked in. Wanting to eat often and mostly sweets. His stool is hard but going regularly. But more requests language and ideas as well. Sleeping a bit less. Im confused is it awakening or too much inulin causing low blood preasure?

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.

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