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Reversing Autism with The Nemechek Protocol – Update 2017

Reversing Autism with The Nemechek Protocol – Update 2017
March 20, 2017 Dr. Patrick Nemechek and Jean Nemechek

Nemechek Autonomic Medicine Autism 2017There is growing scientific evidence that an imbalance of intestinal bacteria called SIBO (Small Intestinal Bacterial Overgrowth) along with excessive inflammation within the brain are responsible for the features associated with Autism as well as ADD/ADHD, mood disorders, and developmental delay in children.

Bacterial overgrowth occurs when large numbers of bacterial that predominantly live in the colon migrate upwards, and increase the number of bacteria within the small intestine by 10,000 to 100,000-fold. This added bacterial load in the small intestine has two consequences that contribute to Autism.

First, the bacteria often tend to be of a clostridium species which can produce propionic acid in massive amounts. Propionic acid is a short chain fatty acid that is normally produced in small amounts within the intestine but the higher concentrations are being linked to some of the behavioral aspects of autism.

In animal studies, high propionic acid leads to the development of antisocial behaviors, increased sensitivity to sound, light, and touch, as well as gait abnormalities. In human studies, children with autism have very high concentrations of propionic acid within their tissues.

Secondly, the increased concentration of bacteria within the small intestine causes leakage of pieces of bacteria into the large concentration of immune cells that surround the small intestine and triggers the inflammatory reaction referred to as leaky gut.

A TESTIMONIAL

Hello! Just wanted to share that I started my Autistic/Apraxic 3 year old son on your protocol almost a month ago. He had about 10 words before this, averaging 1 new word a month prior. He has since, in that short time had an explosion of speech. He has been saying now about 1 new word a day, said 3 new words just yesterday, and has even spoken a few 3 word sentences. I felt hopeless before trying your protocol and cannot believe the large gains we are seeing so quickly! Thank you thank you thank you!!!!!!!   –   A Mom on Facebook

Leaky gut causes an increase in peripheral pro-inflammatory cytokine levels and allows for the inflammatory priming of a specialized form of white blood cell known as microglia within the central nervous system.

The combined production of inflammatory cytokines and activated microglia are primarily responsible for the developmental issues, seizures, sensory issues, mood and attention disorders commonly associated with autism.

A child is born with approximately 100 billion neurons and over the ensuing 18 years, needs to prune these neurons down to 50 billion in a process referred to a synaptic pruning. Excess inflammation from leaky gut, microglia priming and omega 3:6 imbalances prevents otherwise healthy microglia from pruning fast enough, and results in developmental delay.

The priming effect from the bacterial overgrowth causes many microglia to shift into the M1-phenotype, and results in the brain being less able to fully repair itself from commonplace physical (falls and bumps to the head), emotional (fear, abuse, neglect) and inflammatory (surgery, infections, vaccines) brain injuries.

A small residual amount of damage will remain after each injury, and each new injury leaves residual damage upon the prior injury in a process referred to as cumulative brain injury. The abnormal neurological functioning from cumulative brain injury can occur slowly over time and or rapidly depending on the intensity of the brain injury. Damage to different portions of the brain will result in different outward symptoms such as ADHD, chronic anxiety or gait abnormalities.

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The elevated inflammatory cytokines are also able to turn on certain genes that are linked with autism and may be responsible for certain features or more severe forms of Autism.

And finally, the excessive inflammatory environment in the brain reduces the seizure threshold and make seizures more likely to occur. The drop in the seizure threshold from inflammation is seen when young children without Autism develop febrile seizures with the fever and inflammatory reaction that occurs with simple upper respiratory viral infections or middle ear infections.

My understanding of the bacterial and inflammatory features in Autism have opened the door for me to provide groundbreaking treatment. The bacterial overgrowth increases propionic acid levels that cause kid’s brains to function differently, almost like a chemical impairment or slight intoxication, and at the same time the inflammation prevents normal neuron pruning and development as well as inhibits normal brain injury repair.

My approach to reverse the key components in Autism is straightforward. To provide the brain with a healthy, non-inflammatory environment to function more normally and to allow microglia to correctly prune and repair the brain, we need to reverse bacterial overgrowth and suppress the production of inflammation cytokines that are produced from a variety of sources.

By applying a logical understanding of science, I have focused application of The Nemechek Protocol™ medical consultation and treatment services on Autism, and have reversed the key features of Autism in many children.

The Nemechek Protocol for Autism uses a prebiotic fiber called inulin to reverse and control bacterial overgrowth, and high doses of omega-3 fatty acids to normalize microglial function and normalize the inflammatory state within the brain.

Cooking with domestic extra virgin olive oil also helps reduce brain inflammation resulting from linoleic acid, an omega-6 fatty acid found in in high concentration in cooking oils and processed foods.  Inulin is a natural fiber found in onions, garlic, artichokes, agave, chicory root and many other plants.

When buying powdered inulin, I avoid ones that also contain probiotics or digestive enzymes as these ingredients can makes some aspects of Autism worse.  (See my post on probiotics for more info on this topic.)

I find that 2-4 inulin gummies or 1/2 to 1 teaspoon of powdered inulin daily can reverse bacterial overgrowth enough to allow an autistic child (2-8 years of age) to become much more aware and interactive with their environment within a few weeks. And depending on the amount of underlying developmental delay, children will often start speaking within a few weeks to a few months.

Remember this is a simple plant fiber found in foods we eat every day, and is safe in children. If children get a little gassy or bloated, I recommend cutting back on the dose. Inulin is heat-tolerant and can be mixed or sprinkled over any form of liquid or food.

To help reduce the inflammation within the brain and normalize the behavior of microglia, my autistic patients are placed on omega-3 fatty acids (EPA and DHA) from fish. A recommended starting dose for small childrens is about 600 mg of omega-3 (the total of EPA plus DHA) per day.  DHA is particularly important as it is the main omega-3 in the brain.  (Read this post for more information on DHA as brain food.) Omega-3 fatty acids may be given in the forms of simple fish oil mixed in their food or drinks.

I don’t recommend fermented fish oil.  And when dosing I tend to increase the dose of omega-3 is the children are older (specific dose for varying ages of children can be found in The Nemechek Protocol for Autism and Developmental Disorders)  When in doubt, I favor a high dose.

If children have difficulty with diarrhea or prior problems with fish oil causing diarrhea, I have the kids start inulin fiber alone for 2-3 weeks in order to let the gut bacteria balance out, and then slowly increase the dose of fish oil and usually the tolerance is much better.

Whether the parents use Nordic Fishies or or another brand of liquid fish oil, I recommend they buy a high-quality brand as there is a very high level of fraud in the supplement industry.

All families are asked to cook their foods in domestic extra virgin olive oil (EVOO).  EVOO contains 70% oleic acid, and oleic acid reverses the underlying inflammation coming from excessive linoleic acid toxicity.  (Watch my screencast for more information on the benefit of olive oil.)

Linoleic acid is most commonly found in the unnatural vegetable oils added to the foods we purchased.  (See my other post about omega-3/omega-6 rebalancing for more information on this topic.)

The bigger, older children with autism require more effort and higher doses of inulin.  To gain better control of SIBO in older children I often treat with a 10-day course of Rifaximin (Xifaxan in U.S.).  Rifaximin is a non-absorbable antibiotic that is only used for other bacterial overgrowth conditions (hepatic encephalopathy and IBS with diarrhea).

Follow-up use of inulin after Rifaximin is sometimes used if intestinal symptoms are still present.  If inulin does not make any significant difference as a follow-up therapy, I stop it.  I never add probiotics after resetting with Rifaximin because probiotics can easily make things worse even if they helped prior to the use of Rifaximin.

The reversal of bacterial overgrowth with inulin results in a drop of propionic acid and can result in a sudden improvement in function within a few weeks.  But many children do not fully return to normal because they still have underlying developmental delay (some quite severe) as well as ADD, ADHD, sensory issues, seizures, as well as chronic depression, anxiety or aggressive behaviors. ( Watch my screencast about how leakage of LPS from bacterial overgrowth prevents the brain from fully recovering from injuries.)

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These remaining conditions take longer but week by week things can slowly improve.  If there is no significant improvement within 2 months, I generally increase the dosage of omega-3 fatty acids. If things still do not improve or seem to plateau after a couple months, I now add bioelectric Vagus Nerve stimulation to the Nemechek Protocol with good results.  (See my screencast about vagus nerve stimulation.)

The brains of older kids that have experienced prolonged bacterial overgrowth and inflammation as well as more brain injuries that occur over time, generally take longer to show improvement but I have seen significant progress in older kids as well.

I care for 2 teenage non-verbal autistic boys (14 and 16 years of age), and although they showed signs of continual improvement, they took about 4-5 months to begin speaking.

More recent is a remarkable case of a 23-year-old non-verbal autistic girl with frequent seizures. Within 8 months her seizures had reduced from 5-7 per day to 2-3 per week, and she can now write her name and converse in both Spanish and English (she lives in a dual language family).

For autistic children, the Nemechek Protocol will need to be daily and possibly forever but the benefits are life changing. Inulin fiber, omega-3 fatty acids and olive oil are from natural sources, are commonly consumed by most of us every day, and are available without prescription.

I am a classically trained internal medicine physician (D.O.) from UCLA and my Internal Medicine and Autonomic practice is in the Phoenix area. My research background has been focused on the Autonomic Nervous System, brain metabolism, and metabolic inflammation.

I use all available scientific and medical tools to induce the nervous system and organs to repair themselves by normalizing inflammation control mechanisms, inducing natural stem cell production, and re-activating innate restorative mechanisms.

March 23, 2017 –  An Addendum on Recovery

My Experience with Autism Recovery:

Uniformly all the kids under my care (50-60 to date) seem to be improving in significant ways.

In terms of speech, some younger kids start speaking within a few weeks while kids in the teens might take 4-6 months.  Our 23-year-old patient didn’t start speaking until after 8-9 months of treatment.

Importantly, even the most severe cases have a noticeable improvement in their awareness of their surroundings within a week or 2.  I interpret this as a decline in the toxic effect of the propionic acids on their brains.  Parents report more eye contact, awareness or acknowledgement others have entered the room.  They also seem more tolerant of being touched or held, or are more willing to approach someone and be physically close to them.

After the first few weeks, recovery rates are highly variable, and I believe this is due to the degree of developmental delay underlying the toxic state.  If the inflammatory cytokine process has been going on since birth, there can be so much developmental delay as to be labeled mentally retarded.  But if the developmental delay is simply mild, kids may seem very functional quickly.

The important point to remember is that your child’s brain and an enormous capacity to continue the path of development once the inflammation is controlled.  Neuronal/synaptic pruning will re-initiate, and according to the developmental delay literature, they can catch-up about 2-3 months of development for every 1 calendar month.  In my estimation, it seems to advance this fast if not faster.

The underlying wild card is what gene has been activated by the inflammation and what might it do to the neurological impairment of your child’s brain.  The inflammatory environment that prevents normal synaptic pruning and recovery from brain injury also triggers the litany of genes being found in autism.

Inflammatory cytokines abnormally produced by the mother are affecting the child’s nervous system within the womb, and then the imbalance of intestinal bacteria of the child as well as high omega-6 food sources continue to fuel the inflammatory process within the child after birth.

These inflammatory cytokines are the primary process through which the genes within the DNA that had been dormant for 1,000’s of years in the child’s ancestors are finally activated, begin altering how cells function, and contribute to the overall variety of neurological, behavioral characteristics that manifest in autism.

Here’s the potential for recovery in the autistic brain. A 23-year old non-verbal autistic female (Lennox-Gastaut Syndrome), was having 6-8 seizures per day and had never held her parents gaze for her entire life.  She did not like to be held, could not color or write, and sat curled up in a chair most of the day rocking.

Within 2 months’ of starting our protocol (rifaximin, high dose omega-3 fatty acids, and mother cooking with California olive oil), her seizures had dropped to 1-2 a day, she would sit upright in a chair and she slept through the night.

At month 4 she started looking her parents in the eyes and holding their gaze, and was more able to be touched and hugged.

At her month 6 office visit, she started smile at me, her seizures had reduced to 1-2 per week, she could now write her name (although she had never been shown previously) and could draw objects that were recognizable.

At 8 months, she began speaking rudimentary Spanish and English (dual language household) but emotionally is behaving as if she is 3 years old.

At 18 months, she speaks very clearly in full sentences, her seizures have declined to 1-2 per month (despite discontinuation of 2 seizure medications), and her emotional maturity has risen to about that of a 4-5-year-old.

But don’t despair. No matter how badly the developmental delay has slowed brain maturation, the potential for an unbelievable recovery is present.  We are beginning to understand that once human genes are turned on by inflammation, they can ultimately be shut back off again once the inflammatory environment within the body is significantly reduced.

Do your best to be patient and give this approach a chance.  Because the path to recovery over all things medical is 3 steps forward, and 1-2 back, compare today’s behavior to last month’s, not yesterday’s. The neurons within the human brain, like your hair, can only grow and change only so fast.

Every month, your child’s brain has the ability to “catch-up” 2-3 months in development.  That means every calendar year, they may catch-up 2-3 years.  I believe once the inflammation is suppressed, all that is required for recovery is a good solid inflammation suppressing regimen and patience.

May 26, 2017 – Addendum on The Misconception of Feeding Bad Bacteria and Yeast

The conclusion that increased stemming, less sleeping or increased anxiety is from inulin feeding “bad” bacteria such as Klebsiella has been a concern of several commenters.

I’m not saying this is impossible but I do not believe that to be the case, and have never seen such a reaction in the many children I’ve worked with. There are several reasons for this.

First, inulin’s main effect is within the lumen of the small intestine where bacteria digest inulin through a process referred to as fermentation. The primary effect is the production of the healthy short chain fatty acid known as butyric acid. Only small amounts pass through to the colon.

Secondly, a significant increase in pathogenic bacteria, or overgrowth bacteria would almost certainly cause an increase in diarrhea, stool frequency, abdominal cramping, reflux and eczema. We do not see this, and in fact there in general a reversal of these symptoms with the use of symptoms with the use of inulin.  If the intestinal ( not neurological or behavioral) symptoms were to worsen on inulin, I would suggest the inulin be discontinued and would suggest using Rifaximin.

The development of constipation with the use of inulin is a sign of underlying autonomic dysfunction from developmental and cumulative injury that eventually reverse after a few months of fish oil.

Thirdly, propionic acid has a sedating effect on children, almost as if the children had been taking Valium or Xanax. Therefore, once inulin reverses the bacterial overgrowth and the propionic acid levels decline, the children will come out of their stupor. There behavior at this point is predicated but their pre-existing developmental abnormalities and cumulative brain injuries and not some toxic effect of inulin.

A fourth point is that the detection of pathogenic bacteria such as Klebsiella in the stool by no means suggests these bacteria are present within the small intestine where inulin has it’s main effect. Detection of pathogenic bacteria such as <em>Klebsiella pneuomiae</em> or <em>Clostridium difficle</em> are commonly in asymptomatic patients and are essentially harmless. Their growth is kept in check by a healthy balance of other bacteria which is further bolstered with inulin.

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And finally, some parents are worried about overgrowth of candida. I agree that candida and other yeasts/fungi inhabit the intestinal tract but more detailed studies demonstrate yeast/fungal overgrowth does not occur in autism. And while the observations of clinical improvement about reduction of sugars and etc. are correct (think GF/CF, FODMAPS, GAPS), they were misattributed to yeast instead of the bacterial overgrowth for which we have mounting evidence.

Because of this, I believe the use of potent anti-fungal drugs is unwarranted in the specific treatment of autism.

Hope this helps.

© 2017. Dr. Patrick M. Nemechek and Jean R. Nemechek. All Rights Reserved. Patent Pending.

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Dr. Nemechek
Dr. Nemechek

Please use the search feature on this blog to find answers to your questions. Many of the questions that are being asked have been answered repeated by me (Dr. N) in the past.

Thank you.

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Hi Dr Nemechek, after 2 weeks of 1/2tsp inulin (decreasing from 1tsp), my nearly 4 year old is trying to talk more, sings songs all day and does actions to songs. His eye contact has improved, he asks for things now. His big tantrums have GONE and he is sleeping peacefully all night. Big improvement. THANK YOU very much. I can’t wait for more gains and for him to be conversational. I have a question for my 22 months old son. He is not talking yet. He was on 1/4 tsp inulin for a few weeks, however not much gain.… Read more »

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

Inulin does not raise blood pressure. We are concerned that too much might lower brain BP (cerebral hypoperfusion) in SOME children.

Many children seem to be do well on the higher doses of inulin.

Eduardo
Eduardo

Hello Dr. N,

We have a 2 year old with typical development but erratic bowel movements (loose, hard, constipated, etc) and feeding has worsen (picky eater). We believe this happened after we started giving him probiotics (due to what we believed was gut bacteria imbalance). Is there any harm in trying your protocol on him? Like I said, he is a “typical development” child. Her older sister was diagnosed with ASD though.

We have your book, love your ideas.

Eduardo

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

No harm and it will most likely help him a great deal.

Eduardo
Eduardo

Much appreciated

Megan
Megan

Hello, just wondering how you label Autism? Is it an autoimmune issue? An immune issue? A gut issue? An inflammation issue? The Medical Board of Australia defines it as a psychological issue so that’s what most GPs here think it is.

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

I think it is a metabolic encephalopathic (propionic acid) inflammatory (excessive pro-inflammatory cytokines from primed microglia) state.

Paul
Paul

Hi Dr Nemechek. VNS is pretty hard to get hold of for most people especially those living outside of the US. What are your thoughts on external Trigeminal Nerve Stimulation?

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

I understand the difficulty in getting VNS but Trigeminal nerve stimulation is completely different, and does not lower inflammation nor shift microglial phenotypes.

Paul
Paul

Thanks for your reply. What do you suggest for people who are unable to travel to the US to see you? There is another VNS available in Europe that goes on the tragus of the ear – is this worth trying in your opinion?

Bonnie Roberts
Bonnie Roberts

My 10 yo son is on erythromycin for gastroparesis. Is this a contraindication to utilizing the Nemecheck Protocol since it can be viewed as a long term antibiotic? Should it be stopped to see success with the NP? Thank you!

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

Yes it is contraindicated with my protocol but I do not recommend stopping it without first consulting the physician who prescribed the erythromycin.

Alberta
Alberta

My 4 year old son has been on your protocol since August 2018. Gains Sensory issues have decreased Constant singing gone Following commands Sits and writes in class whilst previously he did not have the pincers grasp to hold a pencil Functional speech (still awaiting conversations) Plays with toys appropriately… The list can go on and on. I just want to say thank you I put my newborn girl on the protocol as well. Started with the fish oil. Constipation is gone. Eczema has disappeared. She is 11 months old and can point, wave and clap. She has ten words… Read more »

Barnali
Barnali

Hi Dr nemechek..I am in this protocol since January 19,my boy is 3.3yrs now.i gave him 1/4 tsp inulin,2. 5 ml of Nordic naturals omega 3 lemon,EVOO, 5ml.He is stimming more,some old behaviour back..is his dosages are correct according to his age?

Thanks in advance

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

Look for a cause of relapse that I discuss in the book.

Juliana
Juliana

doctor, my daughter has mild difficile clostridium, is inulin indicated? we used it for a week, and she often vaccinated several times a day, a dense stool. thank you

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

If your daughter is ill from Clostridium difficle then she needs to be managed by a gastroenterologist.

Rob
Rob

Hi Dr, my partner and I started the protocol a couple of weeks ago and have gone gluten free. We’re finding that most gluten free foods contain an oil names Rapeseed which I have read many mixed reviews about. Just wondering what your opinion is on the oil and its impact on his new diet?

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

EVOO has a great potential to block the linoleic acid toxicity relating to grain-based oils.

Cristy
Cristy

Dear Dr Nemechek! We are so thankful for you and this protocol! It’s done wonders for our family. God bless you! I have a question for my 22 year old who is just starting the protocol (rest of us started 7 months ago!) She has mild type 1 VonWillibrands and a mild factor 11 deficiency. I’ve watched your video about fish oil, but I am not quite clear on how this ties in w/someone who has a known clotting issue such as hers. So far she’s started w/just two of the DHA 500’s. I wasn’t sure if she could tolerate… Read more »

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

I would recommend discussing this with her hematologist.

Nancy Poit
Nancy Poit

My son has been on the protocol one year! He had his annual EEG and it was perfect for the first time ever. No more spikes. No more abnormal EEG! The neurologist was amazed and I told him all about this protocol!

I’m still figuring out my son and his dosing. I raised his inulin and it was too much for him to handle with school. He was with the dean 5 times in two weeks and received his first suspension. He’s 7! So we are waiting until summer to make any adjustments.

Liza
Liza

Hi Dr.N, We are 9 months into NP with my daughter 6 yrs. we are visiting you in July 2019. I just wanted to ask that we have seen some great gains in cognitive skills and potty trained. But not much with proper eye contact or even in social skills (now that it’s 9 months into NP. So I was expecting her to initiate in social skills but we are seeing no improvements in these areas). Even limited gains in communication. I have tried to lower inulin like you suggested in my last message. But no luck. Do you think… Read more »

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

This is a case that I would consider VNS.

Nadia
Nadia

Hello Dr Nemechek

My 20 month asd son was have iron deficiency with iron level just 31 while iron range in his age should be 65-175. His pedicitrian prescribe him with high dose of iron polymaltose complex until. should I continue the supplementation while doing Nemechek protocol?

Thanks

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

The protocol often improves absorption of nutrients including iron.

Nadia
Nadia

So should I continue with iron supplementation with your protocol? My physician suggested to supplementation until 2 years old and see how it affect his iron level. No other supplementation given to him other than iron though

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

Follow your physician’s recommendations

Noelle Scalzo
Noelle Scalzo

Do you think your Protocol could be helpful for a person with Prader-Willi Syndrome and if so how ?

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

Yes. The protocol reduces overall inflammatory stress in the brain and the body and allows the tissues to repair if injured. Certain genes may even be able to toggle off if the inflammation is lowered enough.

Julie Danielson
Julie Danielson

Hi sorry to intrude ! My daughter is 9 and has Mosaic Angelmans Syndrome, a mix of Prada Willi and Angelmans ! Because of the complexities of this no doctors are able to control her anxiety, behaviour and her rapidly increasing weight ! Ava is also non verbal ! I have just started this on Monday as a final push that she may get some value of life ! Every doctor agrees Ava has an issue with her hypothalamus and that it’s possibly inflammation to that area ! Courses of anti inflammatories haven’t helped do u think your protocol could… Read more »

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

The protocol reduces inflammatory stress within the brain.

The ingredients are so safe its well worth a try just be sure to use the recommended brands.

Julie Danielson
Julie Danielson

Great thank you ! 4 days in keeping everything crossed

Srujana
Srujana

Hi Nemechek,
My daughter 15 years old is on the protocol for stomach pain and bloating issues from last 3 months. I started her on inulin evoo and 5 Now Dha pills . Few days back I gave her 10 day Rifaximin course. She was fine on Rifaximin ,but after I finished the course her original stomach issues with pain and bloating came back . Does she need 1 more dose of Rifaximin or can I give her inulin for stomach pain. Thank you for your help

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

Pain from cramping and bloating are not directly from bacterial overgrowth (SIBO), these are autonomic problems.

More rifaximin will not help. She needs appropriate fish oil and EVOO for her nervous system to recover and these symptoms will go away.

Aruna singisetty
Aruna singisetty

Hello doctor,
My son is 5 yo We have started full protocol since 19 March 2019 with doses 1/16 tsp inulin,3 ml fo(1560 mg Omega 3) and 7.5 ml evoo and didn’t observe much changes . after 2 weeks I have increased the inulin to 1/8 tsp now constipation has started. So which level should I continue?

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

The onset of constipation (an autonomic problem) is a sign that bacterial overgrowth has successfully been reversed.

Christine Caibiran
Christine Caibiran

Hi doctor. Is ok to replace NN omega to NN algae omega? I have seen increased aggression and insomnia with my 11 year old with the NN omega 3. I switched to NOW DHA but still there is heightened aggression. By the way I did the modified protocol by just EVOO and FO for the first 2 months. I have not given Inulin for fear of increased aggression. We have stopped the protocol for now but I am willing to give it another shot.

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

The fish oil is not the source of your aggression. Stay with what I recommend.

Bimpe
Bimpe

Hi Dr Nemecheck, I ordered your book (on its way) but I’m just curious if your protocol is good for overall health and well being? My 15 month old son only eats oats (baby cereal stage 1) and yogurt. He won’t eat anything else and I’ve tried for several months. We’re seeing an OT once a month. Would starting him on inulin, the fish oils and olive oil be beneficial/recommended, and can I expect to see improvements in this feeding delay? I’m concerned he’s nutritionally deficient which could potentially lead to a lot of other issues in the future, but… Read more »

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

Yes, the protocol goes a long way to maintain health.

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Sujatha
Sujatha

Hi Dr NemeCheck

Can please suggest which one should I use for 23months (showing autism symptoms)boy ….Nordic Naturals – Children’s DHA, Healthy Cognitive Development and Immune Function(175 EPA. & 245 DHA mg per half tsp (2.5ml)). OR Nordic Naturals ProOmega Lemon Liquid(EPA 1460 & DHA 1010 mg per 1tsp (5ml))…….in book suggested dose is 450-600 mg(EPA+DHA).,,..but iam bit confused in choosing kids one or proOmega one (through your(full script) site iam seeing only proOmega ….not kids type)

Thank you

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

Use the ProOmega or the Ultimate Omega versions.

Priya
Priya

Hi Doctor , My son 5 years old asd son has been in protocol since November 2018 and his current dosages are 1/4+1/8 tsp inulin . 1.2 ml ultimate omega and 7ml evoo on food .. his sensory seeking issue raised to peak .. wherever he sees hard surfaces he is trying to touch and lick .. he has pica as well mouthing everything .. he is laughing continuously for hours ..my son was a normal child until 2.10 yrs with good social skills and imitation and later he got regressed .. bggest gain is he become verbal but still… Read more »

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

Time will help you overcome these issues. You have to give the nervous system enough time to recover.

Dts
Dts

Hi Dr. Nemechek. With the measles outbreak I’m concerned about my son’s health. How do I know if his body can tolerate a second MMR vaccine? He has autism and eczema. Also, can I give him vitamin A to help against the outbreak or no supplements at all on the protocol?

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

I discuss my approach to vaccination in the book.

Dts
Dts

What about the vitamin a? How do you feel about this to boost immune system

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

I don’t think Vitamin A substantially boost the immune system unless there might be a severe deficiency of Vitamin A.

Ayesha
Ayesha

Hi,
My 4 yrs boy has prominent blue vein on nose bridge also one vein coming from eye to ear.I have read on net it is called sugar bug/Kanmushi and sensitive with sugar. Should i avoid sugar?Would this problem resolved with your protocol?Would this be fade out?

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

I’m sorry but I have no idea what that would be from.

Lynne Susanne
Lynne Susanne

Hello Dr. Nemechek,
How do you feel about the use of medical marijuana in conjunction with your protocol? I’m thinking about the most severe cases of autism where self injurious behaviors and aggression is dangerous. Would it be beneficial or detrimental? Thank you for your expertise.

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

Because I of unreliable quality and content issues, I don’t recommend using it.

The same concerns as I have with supplements and EVOO.

Simmons
Simmons

Hi Dr. Nemechek. My son has been on the protocol for a year. He’s 4.5 with autism. Not much change in speech. Do you recommend foods or herbs that can help reduce mucus in the brain (Dr. Sebi approach)? Wondering if that could be a factor. Also with children who haven’t had tremendous gain in speech or had huge gains in the beginning and have lost some of those gains do you recommend increasing F.O. or Inulin? My son is 1 tsp fo, 2 tsp evoo and 1/2 tsp inulin. thanks.

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

I no of no evidence support a concept of too much mucous in the brain.

Mushabir Zaki
Mushabir Zaki

Hi Dr.! My 6 yr old daughter (IDD) is following protocol since Dec 2018 (1/2 tspn inulin, 2.5 ml FO and 10 ml EVOO). Due to nausea and vomiting doctor occasionally prescribes her omeprazole + sodium bicarbonate (RISEK or LOSEC sold locally) usually for 2 – 3 days. In your good opinion do you think this would affect or interfere with the protocol, please?

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

No it should not

Swethapriya
Swethapriya

Hi Dr,
As my son 4 yr old ,not seeing much gains even after a year of protocol, u advised for vns but it is very tough to travel and visit to you in person we can only go for Skype which I think VNS is not prescribed.Can we try rifaximin for 4 yr old .
What would dose ? Is it same ?
If it ok to try rifaximin we want to try first.
Thank you .
Please guide us

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

I have occasionally used rifaximin for 4 years who have absolutely nor improvement with the protocol including inulin.

You prescribing physician will need to decide on dosing.

Noelle
Noelle

Can we continue your basic protocol (fish oil, inulin &evoo) after completion of the course of Rifaximin?thanks

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

I generally don’t use inulin after the use of rifaximin because I only use the rifaximin when the inulin fails to work.

Always continue the fish oil and olive oil.

Imraan Fredericks
Imraan Fredericks

Hi Dr N

My daughter is 4years old and has been diagnosed with autism from 20months,I just need to know how I can give this to her as she does not eat anything at all and only drinks pediasure(meal replacement) is there certain ingredients that we should stay away from as the ingredients listed in this powder are as follows:
Nutritional info

Inositol
Taurine
Carnitine

Vitamins
Biotin
Choline
Folic acid
Niacin
Pantothenic acid
Vitamin a
Vitamin b1
Vitamin b2
Vitamin b6
Vitamin b12
Vitamin C
Vitamin d3
Vitamin e
Vitamin k

Minerals

Calcium
Chloride
Chromium
Copper
Iodine
Iron
Magnesium
Manganese
Molybdenum
Phosphorus
Potassium
Selenium
Zinc
Osmolarity

If this powder is permissible can we mix in the inulin,omega3,olive oil for her to consume ?

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

If Pediasure is necessary because it was prescribed by a physician, then continue it. If not, then just feed your child regular food in order to get nutrition.

Fil Anna
Fil Anna

Dear Dr. N!
Could you please kindly tell your opinion on grounding blankets. Recent studies tell it has anti-inflammatory effect.
Could it possibly have a similar effect to your VNS in any way? I know it’s not the same though.
We live far from the USA. So it’s hard to us to get to your office. So I was wondering if this blanket could help with recovery.
Thank you very much for your precious time.

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

Grounding blankets offer some interesting autonomic benefits but will not provide the similar benefit of vagus nerve stimulators.

Ayesha
Ayesha

Sir ,can we use vns with psychotropic medicine plus all your protocol for kids age 5 or more .e.g medicine like Ritalin ,risp etc

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

You need to ask that question to whoever is supplying you with the VNS.

Noel
Noel

Hi Dr. Nemechek, can we give antibiotics for h pylori treatment at the same time while on your basic protocol?thanks

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

I would recommend it unless there are biopsy proven changes and then I would not recommend mixing rifaximin with the H. pylori cocktail.

90% of blood test + H. pylori testing does not require treatment – treatment should be reserved for biopsy + cases only.

Many things can mimic the gastritis symptoms of H. pylori and I have seen many resolve with the use of our protocol alone.

olivia
olivia

What the protocol can help an autistic child with intellectual disability

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

My protocol can. Read the book to find out more.

Martin L
Martin L

Hi Dr N,.
My friend highly recommends your protocol, I’m considering all options for my 5.5 year old daughter who has general developmental delay, hyper mobility/low tone and is coeliac. She struggles with concentration and controlling her emotions.

1 year after her birth a full genetic screening identified a number of gene deletions but none that pointed to anything other than this general developmental delay.

Would going on your protocol be beneficial to her?

Many thanks

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

Yes, absolutely.

Sujatha
Sujatha

Dr NemeCheck My 23 moths boy recently diagnosed with autism…showing symptoms ..not responding to name ….playing with pebbles in Park ,no eye contact,running in airports …but he used to chew every toy …now he is not doing …..doing one on one playing stacking ,beading with me.(learned in 3weeks)he wait s patiently …until he gets what he wants(trained point & eye contact for what he wants….he is doing with strangers as well)….planning start your protocol …just received the book …..can you suggest the dosages of insulin & olive oil,fish oil ….iam also using supplements calcimax,cognicare,acetylcysteine effervescent tablets, bevon .can please suggest… Read more »

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

The dosages are all spelled out in the book.

Kristina
Kristina

Dr. Nemechek,
We saw the “awakening” at 1 teaspoon inulin. I took it up to 1.5 teaspoons because I got impatient (before I knew better) and now I’m wondering if I should take it back down, given your new recommendation. We are 6 months in and still getting reports from school that he still is having trouble sitting. He is 4.8 years. His stims are back, it has been about a month, and he stopped trying new foods at feeding therapy. He was doing really well.

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

If anxiety, hyperactive, hinger or stimming increase as you increase the inulin, you may want to trim it back.

If the higher dose resulted in generally positive improvement, stay at the higher dose.

Kristina
Kristina

The behaviors did not happen as I increased the inulin. I increased it back in December. This must just be our longest relapse. THANK YOU!!!

Danwine
Danwine

Hi Dr N

I only recently had a look at my sons breakfast box, which is Futurelife.
It claims to have 21 vitamins and minerals, 1 Amino acid, Omega-3, inulin, Selenium and Moducare.
I see it also has Palm mesocarp (unsure if its hydrogenated or not). Considering he eats this every single day,
is this something that we should rather be removing from his diet and replace?

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

Yes I would think so.

Sounds like it should be replaced with something that sounds more like food.

Tracy Waxman
Tracy Waxman

Hi Dr Nemechek. For a 7 year old with ASD and ADHD and significant lack of emotional regulation, having suffered at least two major bumps to his head at age 2 and 4, how long would you wait after a period with no further recovery/plateau until recommending VNS?

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

Several months depending on other circumstances

Atharv
Atharv

Hi Sir, I recently started with Nemechek Protocol & started reading the book. My son is 3 years old & he has very low muscle tone. He can’t walk straight, always on toes & walks, runs inwards, falls a lot while walking, running. He is very wobbly, not stable at all. Always on toes, running & jumping (as you said may be trying to balance oxygen in the brain), hyperactive(always on the go). We are trying inserts at home & outside but not helping with his walk, running & jumping. He still does it. Diagnosed with ASD, behaviors include not… Read more »

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

Yes, the protocol commonly helps with all of these issues especially in such a young child.

Atharv
Atharv

Hi Sir, Thanks a lot for your response. Just wanted to check our Developmental Pediatrician has prescribed L-Carnitine (250 mg) as my son has low Carnitine level – 24 uM/L (Low) Reference Range:35 uM/L – 84 uM/L. He is mostly drained out of energy & clumsy throughout the day when he is not running & jumping. And also Magnesium Powder (1/4 TSP) in the night for help in sleeping as my son doesn’t sleep well in the night, wakes up multiple times in night with crying. Sometimes takes very-very long to sleep & sometimes won’t sleep for 3-4 hours. My… Read more »

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

No they should not interfere.

Follow your developmental pediatrician’s advice.

Danwine Liebenberg
Danwine Liebenberg

Hi Dr
Is Nordic Natural Ultimate Omega better than NOW DHA500 or perhaps the other way around, specifically in kids? Or do you feel that it shouldn’t really matter? We use the NOW DHA as it’s more cost effective and easily available, but we would definitely try harder getting the NN, if it’s more advisable.

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

Either brand is fine. I have never seen a meaningful difference between the 2

Charlotte bidmead
Charlotte bidmead

Hello doctor I have had my 2.5 yo son on protocol for 4 months first 2 months he had high fevers and runny nose every 10 days until mid jan he then had a fever seizure believed by the hospital, to be viral after that he had a new fever and runny nose every 3 weeks until now, it seems very frquent could this be protocol related or just a bad winter no rash or hives and very little gains due to illness 1/4tsp inulin 1ml nn fo and evoo in cooking inulin kept low due to aggression, could this… Read more »

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

The protocol tends to lessen the intensity of common colds. This is probably just a bad winter

Francesca
Francesca

Hi. I’m an italian mum of an autistic 4 years old. I started 7 days ago wjth protocol in the right doses but i was wondering if he has a major need of omega 3 since he went through surgery at the age of twelve months for a fall that caused head trauma with peridural hemorrahge. Thanks.

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

If he doesn’t fully recover with the basic protocol, he’ll need daily vagus nerve stimulation to help further his recovery.

High doses of FO, EVOO or inulin will not help

Johanna
Johanna

Hi Dr N, We have been in protocol for 9 weeks, my 5.5yr son had very loose stools with portions of foods on it before starting on protocol. He was having 2-3 BM a day. Now, stools look more dried, still soft but I will call it “getting better stools”. I am not seeing a lot of food on it, so it means he is actually getting nutrients. Right? Is this an indicator of gut healing? Recently, (as last week) we lower inulin because of hyper activity (hitting, screaming behaviors). I know you recommend a low pace. He is now… Read more »

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

Yes, what you are describing is a sign the gut bacteria are rebalancing and his ability to absorb nutrients has improved.

Sarah Bowden
Sarah Bowden

I have purchased and read most your book and it’s very interesting. My second child had moderate development delays and I am keen to avoid this in a possible future child so will be taking your advice from chapter 10 for pregnancy to hopefully avoid the same happening again. (Interestingly, in my second pregnancy I did have a sinus infection and was prescribed antibiotics and I have often worried if these things contributed as well as other things.) Here in England we are advised to get the flu vaccination and whooping cough vaccination during pregnancy. Would you recommend avoiding these?… Read more »

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

Vaccinations can cause enough inflammatory stress to alter brain function and potentially can harm a child. Why not get those vaccines prior to conception?

Sarah Bowden
Sarah Bowden

Thank you. What are are your views on taking folic acid throughout all of pregnancy rather than just the first three months? I read a study that linked high folic acid levels at the time of birth to autism so once again I don’t know what to do for the best.

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

Difficult and complicated issue that I think is better left to the neonatologist.

Anita
Anita

Hi Dr. Nemechek, My son is 6/5 yrs old we have been on your protocol over 2 Months, with 1/4 tspn inulin. Last few weeks his stomach issues worsen at a point the pain attacks and spasms has been going on all day with anything he eats! As well as constipation comes and goes, Reflux, gass and acid pain! Started to having nightmares his sleep has been disturmb I thought maybe inulin was too much! We took him to his gastrologist he recommended giving him Nexium 20mg 2X a day. So I stopped the protocol and started Nexium which seemed… Read more »

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

With the pain, I would have to defer to the gastroenterologist.

Inulin, fish oil and olive oil would not trigger this. There is another factor responsible for his pain.

Thomas Chong
Thomas Chong

My son is already 1-2 months with inulin. His stool frequency increased from normally 2 times a day to now 2-4 times a day. Its not diarrhea but solid and sometimes loose stool and sometimes, minor balls of stool. What is the theory behind this?

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

That is an unusual response.

Check you doses and stay within the recommendations in the protocol.

Leigh
Leigh

Hi Dr Nemechek. Prior to starting your protocol, my son was on 750mg of EPA on the advice of our paediatrician, to help with ADHD. We saw some initial ‘calming effects from the EPA but switched to higher levels of DHA (Nordic Naturals) as per the protocol and stopped the oil he was taking immediately because it had a small % of Omega 6. Is it always best to have a higher ratio of DHA to EPA or will some children respond better to EPA? What is the benefit of EPA at all if it doesn’t penetrate the blood/brain barrier?

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

EPA certain helps lower inflammation outside the body and may have indirect benefits within the brain.

Leigh
Leigh

Thanks. I’ve now also seen the issues with the strawberry flavoured Nordic naturals product and am having to switch to lemon flavouring which doesn’t come in the high DHA version in the UK. The Ultimate Omega 2x lemon capsules have 1125mg EPA and 875 DHA in its daily dose. Is this ratio ok? It’s the best I can find in lemon. Many thanks!

Tracy
Tracy

Hi. Thank you so much for opening my eyes to your ground-breaking approach. I wish that I had known about your protocol 3 or 4 years ago! It’s a massive regret of mine! My 7 year old son is a text book case that you describe in your book (gut issues, anti-biotics, bad bumps to his head as a toddler…the list goes on). He was always hyper due to ASD and ADHD and always struggled with self regulation and anxiety, but we have definitely seen a worsening in the severity of these responses during his awakening period – lots more… Read more »

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

If there is a negative response during the awakening and you are not overdosing with inulin, the symptoms are from underlying developmental and CBI issues that will recover with time.

Tracy
Tracy

Thank you so much for your reply. I started on 1tsp of inulin but that was in the first week or two and quickly reduced to 1/4 when behaviours started. We’re going into week 8 and he’s been on a low dose of inulin for most of that time. It’s taking extreme patience and hope but I have to believe that things will improve.

Ramina
Ramina

Good evening! Doctor, does the protocol struggle against gelminth infestation? Or is it necessary to use other methods?

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

If you mean helminth infection, no my protocol will not help that.

Priya
Priya

Hello Dr, I want to know if giving ozone water is ok with your protocol.

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

I’ve never used ozone water so I can’t give the OK for this.

Gideon
Gideon

Hello

My 4 year old son is very verbal /social and diagnosed with asd.but I still doubt he may have only adhd. How to conclude if it is adhd or asd for 4 year old. For adhd is inulin is still needed?

Gideon

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

Inulin is needed for any form of developmental disorder including ADHD.

John
John

Dr. Nemechek, I just brought my new born 2wks old home from the hospital. He is showing signs of colic, restlessness, grunts and cries all night, constipation. His brother 3yo ASD is on the protocol and I am 100% sure has SIBO. We have started giving our newborn Nordic naturals dha and he is formula fed. Should we start inulin? What would the dose be like for a newborn? Our pediatrician recommend a probiotic, but I’m not sure this is right. What are your thought? Please help

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

There are many studies supporting the use of inulin in newborns. I wholly disagree with giving probiotics.

Anita
Anita

Hi Dr. Nemechek,

When other health issues are factor is ok to stop the protocol and go back to it in few weeks? Would being on and off the protocol would worsen the stemming, and other issues?

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

Of course that is OK, and yes being off would worsen how well they do.

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