Functional Medicine and Asperger’s/autism: A rant and a possible solution

I am a Functional Medicine doctor.

I’m also an Aspie.

In Functional Medicine circles, the name Dr Mark Hyman is very familiar and respected.  He has also been one of my own role models.  Indeed, he’s quite knowledgeable, and most of what he says is spot-on.

Recently, I wanted to see what he had to say about autism.  Naturally, I googled “mark hyman autism” and I came upon one of his articles on autism.  His article claims that the medical community has it wrong, that genetics are not involved.  He goes on to say that some of his pediatric patients have recovered/overcome their autism, by healing their gut, balancing their immune system, eliminating problem foods, and removing heavy metals, etc.

I say: Bullshit.

The ASD/ASC spectrum issues are indeed genetic and epigenetic.  They’re a family of neurological variants, combined with–and activated by–epigenetic stimuli, whether positive or negative. (A little background: Epigenetics is the concept of the interface between our genes and our environment.  Environmental stimuli have the ability to turn certain genes on or off.  Examples of positive epigenetic stimuli include good nutrition, sunlight, and an enriched, supportive environment.  Examples of negative epigenetic stimuli include toxins, infections, poor diet/malnutrition, and stress.  For more information on the subject of epigenetics, Bruce Lipton is an excellent resource!)

As with most variants, there are positive and negative aspects.  We feel the negative more acutely and obviously: no one understands us, social awkwardness, clumsiness, forgetfulness, and anxiety or depression.

But there are positive aspects, too.  Abilities to hyper-focus on special interests, saying what we mean without playing mind-games, higher than average IQs, deep complex emotions, and a different way of looking at the world are just a few examples.

Autistic people will always be autistic.  People who are of the Asperger’s type will always be Aspies.  It’s a falsehood and a scam for anyone to claim otherwise, and worse yet, it’s a slap in a person-on-the-spectrum’s face to attempt to pathologize our neuro-type and make us “more normal”, which is perceived as an “improvement”.

I’ve seen “normal” and attempted to live/be normal.  It sucks.  It’s not all it’s cracked up to be.  It’s boring.  It’s petty.  It’s noisy.  It’s too simplistic, yet too needlessly complicated at the same time.  There’s too much drama, and too little common sense.

People on the spectrum have a shit-ton to offer the world.  As an Aspie Functional Medicine doctor, my Aspie-ness makes me a better doctor!  Why?

  • Because I spot the details every other doctor misses.
  • Because when I spot those details, I don’t just write them off or ignore them.
  • Because when those details confuse me, I don’t just let it slide; since Functional Medicine is one of my special interests, I get curious and I have to know; I have to solve the puzzle, I can and will hyper-focus until I do, and I don’t stop or rest until I’ve done so.
  • Because I explain everything thoroughly to my patients.
  • Because I understand their desperation when they say they have problems and no one else believes them. I do believe them, since I’ve been there and know what it’s like
  • Because I respect their privacy immensely. Since I’m not an extrovert, I don’t need to gossip and thus, I’m not likely to accidentally blab about a patient or their issues.
  • Because I’m straight up. What you see is what you get, and I’m not going to play head-games, manipulating patients into something they don’t need. And I’m also not going to hold back; if they need something, I’ll tell them.

But on some days, my Neuro-variant gets in the way.  I might be tired, toxic, nutrient deficient, overstimulated, or otherwise stressed out.

Someone observing me might have seen the outward effects of my spectrum-ness as “something wrong” and I might have been treated as disabled, the “treatment” for which might have left me even worse off.

What would have happened if I had turned to and listened to Dr Hyman for “help” with my Asperger’s?  I see two possibilities:

1) I might have been convinced that Functional Medicine could “cure” or “resolve” my autism, and when it turns out that it’s a permanent status for which there is no “cure”, I would have been disillusioned, seeing Functional Medicine as non-infallible.  I might have even lost my faith in this 21st-century medical paradigm that has given so many people their lives back.

Or,

2) By some “miracle”, let’s say Functional Medicine could have made me “normal”.  I would cease to be the doctor I am.  I would have lost all the gifts that make me so well-suited for my line of work.  I might even be OK with being a mediocre doctor.

Uh, no.  Neither one of those scenarios is good, for my patients or myself.  In fact, that would suck.

The Functional Medicine doctors writing their ASD/ASC-curing drivel have good intentions.  What they have to say is indeed misinformed drivel, but it’s well-intentioned just the same.

The purity of their intentions, however, does not make their philosophy or their assertions right, realistic, or acceptable.

I’m advocating that Functional Medicine doctors (and indeed, all doctors) see Asperger’s/ASD/ASC for what the research is saying it really is: a neurological variant, with positive or negative epigenetic stimuli.  And then begin to support the unique epigenetics with positive stimuli so that we Aspies/autistics can function better, with less disability.  The negative traits could subside and pose less of a burden, allowing the positive traits and gifts to come to the forefront and flourish.

Doctors, let’s treat people on the spectrum like we would treat anyone else: if they have anxiety, help them with that; if they have digestive problems, help them with those.  And so on.

How should doctors “treat” ASD/ASC?  Like we would treat anyone else.

  • Allow all patients to be themselves, without judgment…
  • Ask the same questions to determine the same symptoms…
  • Run the same functional testing…
  • Personalize a health recovery plan…
  • Treat the whole person…
  • Meet and love them where they are…
  • Give them the same thorough information and explanations…

…Like I/we (doctors) would (and should) for anyone-freaking-else.

Asperger’s/autism itself is not a pathology.  It is not wrong.  It is not a sickness.  It does not need “fixing”.  We (Aspies) simply require support.

Guess what?

So do allistics.  It doesn’t mean they’re wrong or broken.  It also doesn’t mean that one neuro-type has it harder or easier than the other.  Everybody, allistic and autistic alike, can use support for what ails them.

Asperger’s/autism is not an ailment in itself.  We do, however, tend to need specific types of support.  Many of us have anxiety.  Some of us even have PTSD, even if we’ve never been in combat.  Some of us appear to suffer from irritability, low frustration tolerance, or even anger issues; however, if one looks closer, it’s usually tied to an inner anxiety caused by a neurological stimulus overload.

What would one do for these issues?  Well, the answer is actually a second question: what would we do for anyone with these issues?  The correct answer: look for the root cause.

Functional Medicine would be correct in looking deeper in the body’s physiology (functions) to determine the root cause(s) of those issues.  Once the root cause of a symptom is determined and addressed, those symptoms will improve and so will that person’s quality of life.  Yes, regardless of whether they’re autistic or allistic.

Functional Medicine can’t change the genetic makeup or the prenatal development processes; those ships have sailed.  Thus, people currently on the spectrum will always be on the spectrum.

What Functional Medicine can do can work step-by-step to eliminate the irritants to the human organism and replenish that which is needed but missing (such as nutrients).  Functional Medicine truly shines in this area.  For example, got anxiety?  Functional Medicine can determine whether this is an overactive adrenal issue, excess thyroid function, neurotransmitter (brain chemical) imbalance, infection, food reactivity, nutrient imbalance…you get the idea.  The better Functional Medicine doctors can go so far as to determine whether or not there is a genetic tendency that predisposes us toward anxiety in a particular way, and even give support for that!  No, we can’t change our genes, per se, but we can often change how they express themselves.  Another example: got depression?  Functional Medicine can evaluate fundamental physiology to figure out whether it’s due to a slow thyroid gland, a nutrient deficiency, a cellular energy production problem, toxic exposure (such as a heavy metal or environmental chemical), or a(nother) neurotransmitter imbalance…you get the idea (again).  A good Functional Medicine doctor would do this for allistics and spectrum people alike.

Many people, both on and off the spectrum, have gluten reactivity/intolerance problems.  Many people have neurotransmitter imbalances.  Many people have issues with methylation.  Many people, even in developed nations, have extreme deficiencies of certain nutrients.  I’ve personally observed these problems in an alarming percentage of the population, whether or not they are part of the autism spectrum.  Indeed, eradicating these issues can 1) resolve a wide variety of symptoms, and 2) improve the quality of life for anyone with these issues (yes–including those of us on the spectrum!).

But when Functional Medicine says it can “cure” autism itself with gluten-free diets, infection resolution, removal of toxins in the body, etc, that’s ethically going too far, and it’s absolutely incorrect.

That’s not to say that people on the spectrum, like anyone else, can’t benefit from these measures; of course we could.

Yet, our spots on the spectrum would remain.  Is that a bad thing?  I argue that it isn’t.  Would it really be desirable to change our neuro-type, to wipe out autism?  I say Hell No.  People on the spectrum have many unique gifts that the world needs; you give the world these gifts simply by living on the planet, just by your existence.

A well-functioning human machine (and healthy mind and spirit to match) can attain an excellent quality of life, being happy and content, moving about as desired (with plenty of energy), thinking clearly and retaining information, remaining on an even mood-keel, accomplishing impressive achievements, making amazing contributions to the world, and participating in pleasant relationships (even if with just a few close people).  This is possible–and realistic!–whether you’re on the spectrum or not.

A good Functional Medicine doctor will see the potential in each unique patient.  A good Functional Medicine doctor will evaluate each person consistently across the board, identify any underlying issues, and create a personalized recovery plan.

The best Functional Medicine doctors (unfortunately an infinitesimal group) will look beyond the neuro-type, and see and value the whole person.  If our neuro-type doesn’t have to hold us back, then it shouldn’t hold them back, either. 🙂

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