The Official Website for The Nemechek Protocol™ Medical Consultation and Treatment Services

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.

Buy Your Copy of The Nemechek Protocol for Autism and Developmental Disorders Today!

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.)

Buy Your Copy of The Nemechek Protocol for Autism and Developmental Disorders Today!

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.

Buy Your Copy of The Nemechek Protocol for Autism and Developmental Disorders Today!

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.

6599
Leave a Reply

avatar
  Subscribe  
Notify of
Missi
Missi

Would a fluoride treatment from the dentist interfere with the protocol?

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

Most likely not.

Parent
Parent

Hello Dr. Nemecheck Thank you for your book, I have purchased and read and reread it. Since February 2019 I’m cooking with Evoo, trying to eliminate bad oils from my autistic son diet who is 3½ years old. We also are booked to visit you on September and I’m planning to start the protocol during this month. However, my child has been taking 14 different supplements for about 1 year prescribed from a well-known doctor in New York, but he did not have any progression. Some of them were different vitamins and the others for healing the gut and the… Read more »

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

You need to simply follow the advice in the book without alteration.

Mitra kariyat
Mitra kariyat

Hi Dr N, My daughter is 9 years old (looks like 15-16 with a height of 5′ and weight of 125lbs). We started the protocol in June 2018 and slowly increased inulin from 1/4tsp to 1tsp. She was much aware and less hyperactive. But I have always noticed that she has good gains when I increase inulin but that will subside in 2-3 weeks. That is why I increased inluin from 1/4 tsp slowly to 1 tsp. But when I tried to increase above 1tsp she got very aggressive. started crying /screaming/hitting. So I reduced it slowly to 1/2tsp. She… Read more »

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

I wouldn’t try rifaximin just yet

I would wait longer.

Deb
Deb

My 4yr 10 months old daughter is in NP from last 10 months. We have seen gains with her sensory issues, eating habits, sleeping and constipation. All these are almost at par with NT kids of her age. Her stimmings has reduced to great extent. We are also observing some gains with socialisation in last 1 month. She is trying to reach out to other kids. Also she now acknowledges if any outsider comes to our home and greets them. She is following simple commands. One of the biggest gain is that she got potty trained two months back. Accidents… Read more »

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

The requirement to start VNS does not necessitate a change in any doses.

Mommy
Mommy

Hi Dr Nemecheck, thank you for the work that you are doing. I have just started my 7month old boy on your protocol 9days ago, using NOW and NN, but he has developed severe, audible, painful gas which is waking and keeping him up at night. He has also started flapping his arms. What do you recommend?
Thank you kindly in advance!

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

Read the protocol and double check the starting doses.

You’re giving too much of something.

Mommy
Mommy

Thank you Dr.

Is the gas produced by the ‘fish bacteria’ in the small intestine? Does the excess gas mean that the inulin is not working for him or feeding bad bacteria?

Or do I just try to reduce the inulin to a level where he is comfortable?

Thank you so much

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

The colonic bacteria can generate gases from inulin in either part of the intestinal track.

Excess flatulence is a sign you might be giving too much inulin.

Shem Mandela
Shem Mandela

Hello Dr Nemecheck.
My almost three year old autistic nephew has been on omega 3 supplements, cod liver oil and recently we added Dimethyglycine (DMG) to the regimen.
If i were to start the Nemecheck protocol, should i still continue with the above mentioned regimen?

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

No. You need to read the complete protocol and not guess at what to do.

Parent
Parent

Hi Dr Nemechek, I have been told by my doctor to give multivitamins to my 4 year old. The brand I have is Children’s Mindlinx® Multinutrient from Biocare UK. It has fructooligosaccharides (Chicorium intybus Root) in the ingredients.
Will this add to the 1/2 now inluin I already give…or will it not make a difference?

Please help.

Thanks.

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

No an approved brand and I don’t recommend vitamins unless there is specific B12, folate or iron deficiency

Ally
Ally

Dear Dr Nemecheck
Thank you for your book which I purchased and read. My 6 month old son has visibly regressed into autism after a CMV virus, antacids and PPI for reflux and numerous vaccines. We have just started your protocol. He has not been on antivirals for the CMV (the dr said he would recover without), Would you recommend that we commence antivirals to treat the CMV in addition to your protocol?
Thank you so much in advance.

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

It is very rare that anyone needs antivirals to recover from CMV.

Ally
Ally

Thank you Dr N.
I just saw that his infant formula contains GOS. Will it interfere – should I change brands?
(I have already taken him off a formula that contained probiotics. ) Thank you so much.

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

The formula issues should be discussed with your pediatrician

Dusan
Dusan

Hello Dr. Nemecheck! First of all I’d like to thank you for your work! Protocol is amazing for many many people.. My son will be 9 this year, he is on protocol for nearly 2 years. He started talking, not very clearly but we can understand him and he isn’t so much frustrated now.. He is getting 1 TBSP EEVO, 2x 500-DHA, and we reduced inulin to 1/4tsp. And probably we will need to reduce it to 1/8 or less.. He is hitting his head sometimes when he sees a baby crying on youtube, or when our dog takes some… Read more »

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

If the head banging, etc is relatively new, it might be from an emotional, inflammatory or physical trauma.

If not recovery with time or lower inulin, at this age you can sometimes have inulin failure and then need to bump up to rifaximin.

Anika
Anika

Hi Dr. Nemechek, I’m grateful for the amazing protocol , my daughter has come a long way on it in a year. We’re 13 months on NP. She has shown wide gains in eating variety , gross motor skills, understanding, fine motor skills, core strength and repeating words ( no functional speech yet). Her current dose Inulin – 1/2 tsp , reduced 6 weeks ago from 1 tsp Omega3 – 3.75 ml NN ultimate omega 3, upped 4 days ago she was at 2.5 ml Evoo – 7.5 ml No bad oils Our major concern is her anxiety, getting fussy… Read more »

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

She sounds like she is recovering nicely. It just may take longer than you are hoping for.

Aswini
Aswini

Hello Dr. Nemechek, I started my 2.5 yr old son on the protocol.. I started with 1/8th of inulin and found that he is very anxious that he doesn’t even want to enter into any closed space even our house. So I waited for a few days without inulin and started 12 days ago with 1/64th of inulin. Now he is not anxious but all the old behaviours started, like hyperactivity, uncontrollably excited if someone comes home, screaming loud, etc. Can this be considered as awakening?If this is awakening, do I need to stick with 1/64th inulin itself? If we… Read more »

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

Make sure you are using only recommended brands and discontinue any other supplements, probiotics or vitamins that might also be contributing to this. I can’t believe that small of an inulin dose is causing this.

Aswini
Aswini

Thank you Dr.Nemechek for your reply. We are giving him all approved brands.1/64th Now Inulin, 1 capsule Now DHA500 and 5ml Arbasona COOC olive oil. Apart from this he drinks raw milk so that he doesnt get constipated. Is raw milk considered as probiotics? Should I stop giving him raw milk?

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

Raw milk is not a probiotic (unless it’s spoiled).

Trupti
Trupti

Hello Doctor!
My Son is 16 years old and pre-verbal. we have been on this protocol since october 2018. I was giving him i tablespoon olive oil , 6 capsules fish oil, twice a day for 10 days rifaximin. i gave him . i need your suggestion for further treatment. I noticed he is getting angry and hitting me when he gets mad.

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

The protocol shouldn’t cause him to become angry unless this is part of his awakening and it started within the first week or 2 after Xifaxan.

Otherwise, sometimes medications for anxiety such as guanfacine can end up increasing anxiety and anger as they recover. Guanfacine is a blood pressure lowering medication.

Sharon Jenkins
Sharon Jenkins

Dr Nemechek, the above situation applies to my 23 yr old also. Do your comments regarding guanfacine also apply to Propranolol please?

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

Yes it does.

Nadyia
Nadyia

I came across this and guanfacine has been on my mind. I’m wondering you have any patient cases that have specifically discontinued guanfacine and seen positive results after starting the protocol. Trying to determine if the protocol or guanfacine is causing newfound agitation.

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

Usually with the protocol, the kids will have recovery of their autonomic nervous system, improvement of brain blood pressure levels and then are able to taper off the guanfacine.

Trupti
Trupti

Hi Dr Nemechek. After Rifaximin, is there a ‘maintenance’ strategy that you recommend to prevent SIBO from returning? I know to avoid Inulin but is there anything else to be done?

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

I have not found any way to avoid relapses after rifaximin other than to limit the use of antibiotics.

Glenn
Glenn

Dr. Nemechek, First of all, I would like to thank you for taking the time to answer questions. My son has been on your protocol for the past 10 months. Good gains in the beginning, but I believe he is going through major relapse right now. We haven’t seen any gains in the past 3 months. I’m not sure if it’s a propionic or inflammatory relapse (He had a cold/asthma and flu in February and March). He used to have constipation issues, but that has been resolved. However, we’ve been noticing hyperactivity, emotional outbursts, defiance, and visual stimming since February.… Read more »

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

You might try shifting to low dose NOW Foods inulin and see if that helps. If not the he may have inulin failure and will need rifaximin.

Iva
Iva

Hi Dr Nemechek. My 9 year old (ASD, ADHD) started taking Rifaximin 3 days ago. We have a 10 day course. His behaviour is completely different to when he was on Inulin. Then it was lots of angry aggressive behaviour even on 1/16 tsp, which is why we took him off it. Now he is doing strange things like standing on his toes and swaying or standing and hopping around on one leg for very long periods of time. Maybe you’ve seen this before. What do you think is happening – is this another type of awakening and why is… Read more »

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

The bacteria are causing this as they rebalance. Remember, rifaximin does no appreciably get into the blood stream.

As long as you do not see any symptoms suggestive of a severe allergic reaction, finish out the rifaximin dose.

Mushabir Zaki
Mushabir Zaki

Hello Doctor! My daughter 6 yo, diagnosed with ADHD and IDD, was seizure free for 2 years. I started protocols after reading the book in Dec 2018. 3 days back she had sudden repetitive seizures after every 2 – 3 hours. Took her to hospital emergency and the doctor after administering diazpam had to put her on daily epival (sodium valporate ‘ 4ml 2 times daily). My question is now can I continue with the protocols plz? I know that it would interfere but I’m at a lost please advice!

PS: I was really starting to see gains.

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

Look for some other eason for the seizure. Fish oil, olive oil and inulin do not precipitate seizures.

Parent
Parent

Hi Dr nemechek, my nearly 2 year old has been on 1/2tsp inulin for 6weeks, (after decreasing from 1tsp as he was very hyper and falling over easily, then increasing from 1/8, then 1/4 with no improvement), he is still spinning sometimes, opening closing doors, spinning toys. However he is pulling my hand when he wants something. Trys to copy action songs rarely. Still doesn’t respond to name when someone calls him. Still no babbling talk.
What do you suggest?

Thanks.

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

Give him more time. Keep the doses as they are.

Remember, he may not want to respond to you yet.

If he gazes into your eyes and responds if you ask him if wants a cookie (or some other sweet treat), then he is awake.

Keisha Williams
Keisha Williams

Hello Dr,I started my son who is 3 years old on the protocol. 1/2 of inulin 3.5ml of fish oil. An olive oil on foods. All reccomeneed brands you suggested. He has had some gains which I am grateful for. However hes stimming a bit like constantly stamping his feet and being quite hyperactive. Would this be the awakening ? or should I reduce inulin to 1/4 . Many thanks for any advice

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

Either a little less inulin or a little more time (or both) will help you get past this.

Nathan
Nathan

Hi Dr Nemechek. After Rifaximin, is there a ‘maintenance’ strategy that you recommend to prevent SIBO from returning? I know to avoid Inulin but is there anything else to be done?

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

The only thing I can sense that limits relapses after treatment with Rifaximin is to limit the use of antibiotics, probiotics, antacids as much as possible.

Avoiding sugar or other foods does not seem to prevent (or trigger is eaten in excess) SIBOP relapse.

Once the autonomics fully recover (this often takes up to a year in adults), relapses tend to become very infrequent.

Nathan
Nathan

Thanks

Krys h
Krys h

When we first started the protocol we were using NN Cod Liver Oil. We saw gains and awakening but decided to switch the fish oil to your recommended NN Ultimate Omega. Looking back, I am realizing that a lot of the bad behaviours came after this switch like Major AGGRESSION, head banging, hitting etc. Recently, after he became aggressive again, I took him off of the fish oil completely and his mood has greatly improved. Do you think that the Ultimate Omega was not a good fit for him and if so, would you recommend that I go back to… Read more »

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

The type of fish has nothing to do with the issues you are discussing.

Kelly M Langan
Kelly M Langan

Hi Dr. Nemechek! My son is 5.8 years old with ASD. We’ve been on the protocol for 18 months now! We’ve never missed a day! We’ve seen great gains in overall engagement, clarity, decreased stimming, participation, and receptive language. But we still do not have expressive speech! He can say very simple words, mom, dad, baby, blue, boo, toe, two, etc. When asked and these are words we’ve worked on repetitively! When I ask him to say other words, he attempts the words, however mostly unrecognizable. My main question, do you think speech will come? True, real, conversational speech! I’m… Read more »

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

True, real, conversational speech will come.

It just always takes longer than our patience can accept.

Missi
Missi

Me and my two kids have started the protocol. My 10 year recently got diagnosed with autism. My 12 year is diagnosed with ADD.
With the protocol do I do inulin everyday for all of us or only the one diagnosed with autism?
Also, is the attention piece generally that last to recover?

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

Please read the book

Missi
Missi

I have read and re read the book. I also carry it with me wherever I go. I believe inulin will be part of the daily routine to maintain healthy intetestial balance for all of us. Just wanted to make sure I was totally understanding.
Just a scared parent making sure I am following the protocol to a T.
Thank you and most appreciated of your posts and reaching out to helping to follow your wonderful protocol.

Monica
Monica

Hi Doctor, We started your profile with my 18 month old on April 9. She has no diagnosis but we suspect ASD, ADHD, possible CP, possible dystonia and possible verbal apraxia. She has shown great gains over the last month. More sounds, better gross motor control, a few word approximations. We had issues with the agave inulin and switched to chicory root inulin. She lost her words immediately but the gross motor skills improved. Last night I increased her inulin very marginally. She was on 1/16 and I added 1/32nd. She soon after developed a nosebleed. She has never had… Read more »

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

Stick with you originally dosing and quit overthinking everything.

Naushad
Naushad

Hello Dr Nemechek: I purchased your book yesterday and while reading the section on Fish Oil and recommended dosages, you mention that your protocol focuses on DHA portion of Omega 3 and EPA percentage is not very relevant. Based on this information in your book, would you recommend using Nordic Naturals DHA XTRA supplement versus their Ultimate Omega supplement? NN DHA XTRA contains 960mg of DHA and 410mg of EPA as compared to Ultimate Omega which contains 450mg of DHA and 650mg of EPA. Even NN Ultimate Omega XTRA has only 425mg of DHA and 850mg of EPA. So for… Read more »

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

The DHA content is only particularly important in adults

Caroline
Caroline

My son has been on your protocol for 10 months and was doing really well. I believe his issues were primarily caused by multiple rounds of antibiotics for ear issues starting around 4 months and continuing until he was 4.5. He will be 8 later this month. 12 days ago he had his first positive strep test. The doctor prescribed 10 days of amoxicillin. The only strep symptom he exhibited was out of control OCD. OCD/rigidity is his worst issue and the one we’ve yet to see improve on your protocol. We continued your protocol while he did his full… Read more »

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

In spite of what other doctors are saying, strept does not cause OCD.

The source for the OCD is either an injury that he should recover from within a few weeks and if not then I would consider inulin failure and treat with rifaximin

Shireen
Shireen

I started my son only oils for first 2 months and he was on NOW fo capsule, and did it for 1 month. But changed to nnuo capsule as i was not seeing gains with NOW and he became hyperactive on NOW and his poop always smelled like FO. He started showing gains on nnuo capsules. Then i added inulin. On oils 2 months Full protocol 2 months Age 2.5 years Doses- Inulin 1/8 Nnuo 1 cap lemon flavour(550mg) Evoo on food 5ml Cooking in mustard oil and coconut oil My concern – He is always sick on and off… Read more »

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

Oil in the stool is either from too much oil at one dose or poor absorption because of bacterial overgrowth (SIBO).

FO is not trigger the illnesses

Sujatha
Sujatha

Hi Dr NemeCheck We started protocol 1month back on my 2yrs (yesterday he turned 2)old boy … diagnosed with asd (no constipation ,no diarrhea but little eczema )……..when he was 17 months ….i saw him how he lost all senses(hearing,watching,name responding)…all gone one after other…finally he regressed for 3-4 when he was 23 months….. after that with therapy & GFCFSF diet from us …. His daily diet is green homemade juice (organic),eggs ,chicken rice ,fruits ,Indian curry ,…70./. Organic food …. he slowly started responding to name …then pointing & eye contacting for requesting things(toys&food) ……. then I came to… Read more »

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

I do not respond to questions asking about specific doses for a specific individual

IRENA
IRENA

Hello, Doctor! Thank you for your work. I have a question. We live far from America. How do you feel about laser stimulation of the cerebral cortex!

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

Potentially helpful with comes with a lot of risks.

Martha
Martha

Dr. Nemechek, my son Philip (almost 9 years old) has been in the protocol for 14 months now. We started seeing some overall improvement during the past 5 months after we stopped inulin and gave him Rifaxamin. ( we are seeing improved behavior, less stimming, overall progress at school). There is however no speech.. He tries sooooo hard, but he has serious difficulties. I read somewhere that kids with MTFHR mutation should take leucovorin, which is supposed to help them with speech and social skills. What do you think?

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

No, just hang in there. If he is trying, he is pruning his brain. It will come soon.

Martha
Martha

Thank you

Missi
Missi

My 10 year old son got a Late diagnosis of ASD in August. He is verbal, but socially withdraws and has limited joint attention with no behavior problems. One of his main issues is insomnia. His doctor has prescribed a scheduled 5ml of melatonin nightly. I started the protocol 8 days ago and eliminated the melatonin. His insomnia has returned. My husband, an MD, believes we should stick to the melatonin because he believes it resolved his sleep issue as he has sleep through the night since we started the melatonin 7 months ago. Does melatonin interfere with the protocol?… Read more »

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

OK to continue the melatonin for a little while.

Soon his sleep will improve on its own and then you can stop it.

Missi
Missi

Thank you.

Pragyan
Pragyan

Hi Dr.Nemecheck, we live in India the temperature here is 106f, I have stocked up some olive oil, is it safe to leave it at this temperature or can I store them in the fridge(not freezer). I have kept 2 bottles in the fridge, the oil has turned semi solid, is it safe to use on the protocol?

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

It is OK to store EVOO in the fridge. This is better than getting too hot.

Noelle
Noelle

I usually mixed EVOO with milk powder dissolved in just boiled water. Is that okay?

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

Yes

Christy
Christy

According to the protocol, how much daily COOC should I give my 2 year old daughter via gtube? Thank you!

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

Please read the book

Christy Naughton
Christy Naughton

I have but I just wondered if it was ok to give the oil alone directly in her gtube?

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

Yes it is.

Christy Naughton
Christy Naughton

Thank you!

Chandra
Chandra

Hello Dr. Nemechek, I am following your protocol for 2.5 yr old son who has Autism. After starting the protocol, we saw gains in terms eye contact and name call response. However his hyperactivity didn’t reduce even after 9 weeks on protocol. Some people on FB wrote that it’s because of Now DHA-500. I am giving 1 capsule per day. Should I switch to NN ultimate omega or wait and see with Now DHA-500?

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

The type of fish oil is not responsible for this.

Maybe too much inulin?

IRENA
IRENA

Hi Doctor! Thanks for your work. I have a question. How do you feel about the point laser stimulation of the cerebral cortex!

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

Too risky

Ekaterina
Ekaterina

Hello Doctor Nemechek
I’ve read in one parent group about use of “Speak” (which is Omega 3, D, E, and K vitamins), have you heard of this product. Would you say it is possible to incorporate this into the Protocol as the “FO” component? Thank you very much!

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

If you are using other supplements you are not on my protocol and run the risk of poor progress

Ekaterina MATAMOROS
Ekaterina MATAMOROS

Thank you. We re NOT using anything other than in the Protocol. We will read it as Fish Oil is not substitutable by anything other then the indicated supplements. Thank you!

Leigh
Leigh

Hi Dr Nemechek. My 8 year old son with ASD and ADHD had a hydrogen breath test 2 years ago which showed SIBO. He was given Metronidazole and another antibiotic to take concurrently which seemed to help gastro issues. He hasn’t had any antibiotics since then. We’ve been on the protocol for 6 months with some gains but have had to come off inulin as lowest dose was still causing some behavioural problems. My question is whether, given his background, we should now take Rifaximin since we are no longer on inulin and gains seems to have plateaued. Would you… Read more »

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

Yes, a significant drop in the rate of previous gains might be a sign that another round of rifaximin is needed.

Anonymous
Anonymous

My son is a 33 weeker 17 weeks (4months) old 10 weeks adjusted. He Never do eye contact in upright position but do while laying in crib, diaper changing table etc. I think he does not have eye sight problem as he tracks me while I am moving around. I have searched a lot on this topic and the results shows Autism everywhere. My Dr. said you cannot diagnose autism before 1 year you have to wait till then, babies develop differently especially preemies. I am really worried as anyone in the family hold him he doesn’t see in the… Read more »

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

Interesting. People with ADD are more able to focus when laying flat that when upright. Sounds a little similar to your child. This condition is called orthostatic intolerance.

I only recommend starting the complete protocol if trying anything.

Magda
Magda

Hello, is it possible to take blockers h1 and h2 after rifaximin while the histamine reactions do not calm down? Will it not cause a relapse?

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

H1 and H2 blockers are not known to trigger relapses of SIBO

Honey Bon
Honey Bon

Hi Doctor,
Thanks for your protocol which we were following for our kid.
I am suffering from migraine from past 8 years. I wanted to try your protocol for relief of migraine. In your protocol it is specified that Rifaximin 550 mg should be taken twice for 10 days and stop after that. If I get migraine again and if it’s a little headache,then do I need to take Rifaximin again for 10 days?? How long do I need to take this medicine?
Please reply Doctor. Thanks in advance

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

Just follow the protocol and over a few months most of your headaches will resolve.

Kashif
Kashif

Hi dr
We have been using Nemechek protocol for our 4 year old son for last two years as describe in your book . He has shown no improvement . He has scripted speech only three word he speak. He is also diagnosed for celiac decease after that we have put him on total gluten free diet. He has cramping or constipation most of the time .he has so much anxiety’ .i believe his anxiety (he does lot of stimming because of anxiety) is not letting him speak .is there anything we should do to control his anxiety .

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

If there is no improvement of any sort after several months on the protocol, I believe the inulin has not reversed any of the overgrowth and would recommend rifaximin.

Discuss this option with your managing physician.

kashif
kashif

Thanks for your Reply Dr nemechech
what mg rifaximin we should do and for how long?

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

Please read the book.

Brigitta
Brigitta

Good morning, I have been told many times that EVOO is not suitable for cooking as it burns at higher temperature and it is not safe …I have just started to read your book and would like to ask this from you.many thanks Brigitta

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

EVOO is not harmed or turned into an unhealthy substance by cooking.

It may burn at a higher temperature that coconut oil but this is simply a reflection of its chemical properties and not evidence it is unhealthy.

I would also like to add that I enjoy cooking and have never had my olive oil burn or smoke. 🙂

trackback
When Your Child Is Diagnosed with Autism: Here's What You May Not Have Been Told * An Upstream Life

[…] treatment options include the Nemechek Protocol, hyperbaric oxygen chamber, chiropractic care, Neurolink, NeuroModulation Technique, CBD oil, […]

Angela
Angela

Hi Dr. Nemechek, I recently had a stool test done for my 6 year old son. He’s been on the protocol for 13 months and while his gut inflammation has GREATLY decreased (thank you!!), his zonulin levels have significantly increased. His strep levels and also candida are now within “high” ranges, though they were mostly normal when we did the same stool test about 16 months ago. We have been diligent with the protocol, he gets 2 fiber choice gummies, 2 tsp of approved EVOO, and 1/4 tsp NN fish oil daily. I would appreciate your thoughts on how to… Read more »

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

I suggest you focus more on your son’s health and less on lab tests. I have never needed zonulin, strept or candida tests to help my patients. Focus on administering the proper doses I recommend and be patient.

k h
k h

Over a year on this protocol for my now almost 4 year old ASD non verbal son. After intiially seeing gains we have been at a stand still for months. Absolutley no gains for months and some of the gains he had at the beginning have also disappeared. Annd worst of all, still zero words. Why is this not working for my son? What would you suggest?

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

I always suggest being sure to use approved brands, discontinuing other supplements as looking for other issues that limit recovery (recurrent infections, emotional trauma).

If there still isn’t any recovery, they a follow-up appt with me is probably necessary to sort out the issues and even consider starting a vagus nerve stimulator.

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

Inulin dosage might be too high or behaviors might be from other supplements or even another source of relapse. Please review the chapters on the book on this topic.

Lisa
Lisa

Hi Dr. Nemechek, First of all, thank you for all your help. I’m a big believer in your protocol and have been following your protocol for the past 9 months. My son (3.10 yr) initially made some gains in the first six months (awareness, constipation, reduced symptoms of sensory issues, cognition), but he is not making any progress in the past 3 months. I see a high level of visual stimming and other sensory issues. He was sick in early February (asthma and fever) and hasn’t been the same kid since then. Prior to this protocol, he was nonverbal, so… Read more »

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

I wouldn’t change anything in the protocol but look for other causes such as other supplements, other forms of stress (school or home emotional stress), etc.

Brigitta
Brigitta

Hello Dr Nemechek, Just ordered your book and would like to start your protocol.
My son is 2.5 years old who has autism signs however his diagnose is Global Developmental Delay. He has several allergy issues such as dairy, soya and gluten. He started to get Bioray detox drops, CBD oil , fish oil and probiotics for 6 months now and showed big improvement.
Could you tell me how I should continue as I want to try your protocol. Just drop all of the above and only start using inulin? Thank you

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

Read the book and you’ll have your answer.

Sarah M
Sarah M

Hi my son has Down syndrome, he doesn’t have any focus or attention issues so has no propionic acid production (I’m guessing) would you still recommend inulin in this instance?

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

Yes, it is still useful for helping with recovery from developmental issues and cumulative brain injuries.

Landon
Landon

Hi Dr. Nemechek, Thank you so much for the Protocol. It is working so well on my 9 year old asd son. We have seen huge gains over the past 8months with the exception of hyperactivity and sporadic anxiety issues. I know you have been recommending a decrease in inulin in certain circumstances and we tried this with no luck. Thank goodness for the Facebook group because one of the admins (J) suggested I try upping the EVOO a tad bit or giving it direct to try and lower the inflammation more. His diet isn’t that great at the moment.… Read more »

ibrahim Omer
ibrahim Omer

Hi Dr
Thank you for your help with the Protocol. My 4 years old son is in Autism disorder and he is following your protocol. But now my concern is before one month he started laughing a lot and in inappropriate situations and we can not stop him laughing. Is there any thing we can do to help him. He takes 2 ml Inulin, 5 ml NN fish oil and 10 ml EVOO all right products as mentioned in your book. thanks sir

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

These laughing episodes have been referred to as “the drunken sailor” by some parents. I’m uncertain what causes it but it will resolve on its own without any changes in protocol.

Natalya
Natalya

Hi, dr. Nemechek! My daughter is 11 years old. She started a rifaximin course. On the fifth day, she developed vomiting from rifaximin. What should we do? Stop rifaximin and try the next round after some time? How often can rifaximin be repeated?

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

How do you know it was the rifaximin that caused the vomiting?

Subscribe & Get Helpful Tips for The Nemechek Protocol® Delivered Weekly to your Inbox!

SUBSCRIBE NOW
close-link

Send this to a friend