Upcoming Events

Inside Edition TV

Ask The Doctors

CHERAB Home

Join Our Group

Index

Apraxia what's that?

Success Stories

At our January 2001 meeting, Dr. Kane talked about the dangers of buying supplements that did not come from areas where fish are not contaminated due to mercury poisoning. She also warned against having your child eat to much tuna fish for the same reason. Problem is, we do need the healthy fish oils, and most of our waters are polluted with mercury, which increases with the larger predatory fish, since they eat the smaller fish, who eat the smaller fish, etc.

Below is information from 20/20  TV, where they talked about mercury poisoning with medical and other authorities who spoke about a link between mercury poisoning and neurological conditions, including...language!

I've always said how powerful the media is, well 20/20 kept trying to contact the FDA, who declined comment, but yesterday, coincidently, they published the information found below.

I would really like to thank Dr. Kane for raising awareness about this at our meeting to our group, but we also need to really thank 20/20 for raising awareness to the world, and possibly making it a safer place for the babies of the future.  Lisa Geng President CHERAB Foundation

Mothers-to-Be, Children Should Avoid Fish High in Mercury. Women who are or may become pregnant shouldn't eat shark, swordfish, king mackerel or tilefish because these fish may contain high levels of mercury that could harm unborn babies. FDA's advice extends to nursing mothers and young children, too...

FDA ANNOUNCES ADVISORY ON METHYL MERCURY IN FISH
The Food and Drug Administration (FDA) is announcing its advice to pregnant women and women of childbearing age who may become pregnant on the hazard of consuming certain kinds of fish that may contain high levels of methyl mercury. The FDA is advising these women not to eat shark, swordfish, king mackerel, and tilefish. As a matter of prudent public health advice, the FDA is also recommending that nursing mothers and young children not eat these fish as well. 

Fish such as shark, swordfish, king mackerel, and tilefish contain high levels of a form of mercury called methyl mercury that may harm an unborn baby's developing nervous system. These long-lived, larger fish that feed on smaller fish accumulate the highest levels of methyl mercury and therefore pose the greatest risk to the unborn child. Mercury can occur naturally in the environment and it can be released into the air through industrial pollution and can get into both fresh and salt water.

The FDA advisory acknowledges that seafood can be an important part of a balanced diet for pregnant women and those of childbearing age who may become pregnant. FDA advises these women to select a variety of other kinds of fish -- including shellfish, canned fish, smaller ocean fish or farm-raised fish -- and that these women can safely eat 12 ounces per week of cooked fish. A typical serving size of fish is from 3 to 6 ounces. 

The FDA's Center for Food Safety and Applied Nutrition will launch a comprehensive education program to reach pregnant women and women of childbearing age who may become pregnant and their health care providers concerning the hazard posed by methyl mercury to the unborn child. As one of its priorities for fiscal year 2001, the Center will also develop our overall public health strategy for future regulation of methyl mercury in commercial seafood. 

Today, EPA is also issuing advice on possible mercury contamination to women and children eating fish caught by family and friends (non-commercial fish). EPA particularly recommends that consumers check with their state or local health department for any additional advice on the safety of fish from nearby waters. Additional information is available on EPA's Web site 

20/20 went shopping for fresh fish in three major cities, not to eat, but to test for mercury. (ABCNEWS.com) 
Mercury in Fish 
Threatens Unborn
A 20/20 Investigation

Jan. 12  Pregnant women and women who may become pregnant should not eat shark, swordfish, king mackerel and tile fish because they could contain levels of mercury that could lead to brain damage in a developing fetus. The Food and Drug Administration said on Friday. 


The advisory comes on the heels of an extensive report issued by the National Academy of Sciences which estimates that each year 60,000 children may be born in the United States with neurological problems as a result of exposure to methylmercury in the womb.   According to the NAS report, humans are exposed to methylmercury primarily through the consumption of contaminated fish, particularly large predatory fish species such as tuna, swordfish, shark and whale. 

The FDA rejected calls to put tuna on the do-not-eat list, stressing that swordfish and shark have far higher mercury levels than tuna. Vermont Sen. Patrick Leahy, who helped commission the NAS study, calls the FDA's announcement, "a step in the right direction," but the FDA's warning comes amid criticism that the agency has not been aggressive in informing the public about the risks of high-mercury fish. 

In 1998 the FDA stopped testing fish for mercury and has relied on the fish industry to police itself. National Fisheries Institute president Dick Gutting says that, overall, the industrys tests show that mercury is not a problem. 

Last summer, 20/20 conducted its own tests. 20/20 bought 40 samples of fresh tuna, swordfish and shark in three major U.S. cities and sent the fish to Battelle Marine Science Labs, a facility that performs food tests for the FDA and the EPA. 

20/20 discovered that while the tuna samples averaged well below the FDA limit of 1 part per million (ppm), the shark and swordfish did not fare as well. Two out of four shark samples and 14 out of 18 swordfish samples had mercury levels greater than 1 part per million. Two of the swordfish samples tested had mercury levels triple the FDAs limit. 

When 20/20 presented its findings to Dick Gutting, he could not explain the results but said that the fact that one particular meal is over one part per million is not significant. Gutting stressed that the average level of mercury in commercially sold fish is well below the FDA limit. Both the fish industry and the FDA say that there is a ten-fold safety factor built in to the 1ppm limit. 

But Dr. Jill Stein, of the Boston Physicians for Greater Responsibility, disagrees. She says that even one meal of swordfish with levels between 2 ppm and 3 ppm could potentially harm the fetus at a critical point of brain development.

Both the fish industry and the FDA say that there is no evidence that people are eating enough of this high-mercury fish for it to be a problem. However, Dr. Jane Hightower of San Francisco, Calif., has several patients who eat large amounts of high-mercury fish in question and have blood-mercury levels as high as 15 times the normal level. Hightower says when her patients cut down on such fish, their blood-mercury level drops to normal level. 

The Environmental Protection Agency added to the FDA's advisory on Friday saying that pregnant women who eat fish their family and friends catch should follow state warnings about fishing from waters with high mercury levels. 

While Sen. Leahy has proposed legislation to further tighten restrictions on mercury emissions, the fishing industry worries that the public may overreact to new warnings. 

Additional Resources

Toxicological Effects of Methylmercury 
The report from the National Academies of Science estimates that each year 60,000 children may be born in the United States with neurological problems as a result of exposure to methylmercury in the womb.
The National Fisheries Institute
The NFI represents the interests of the fishing industry before Congress and other regulatory agencies. 
Americas Seafood: Fair or Foul?
Consumer Reports investigates fish in 6 U.S. cities for freshness, presence of mercury and bacteria.
Food and Drug Administration
FDAs consumer advisory on explains the risks of eating shark and swordfish for pregnant women and women of childbearing age. 
In Harms Way
Dr. Jill Epstein of the Greater Boston Physicians for Social Responsibility co-authored the report which provides guidelines on how much fish to consume to stay within EPA and National Academy of Sciences safety limits. 
The Mercury Policy Project
This Vermont-based non-profit organization promotes policies that reduce mercury emissions and peoples exposure to mercury. Their report, The One That Got Away, criticizes FDAs seafood monitoring program. 


Even though many apraxic children do not have autism, I have to still do research at the autism sites for apraxia since there are very few (no) sites pertaining to medical research and apraxia, other than the information we have with CHERAB Foundation, which is just forming. Here is some information I found at the autism research sites you may find of interest. Please notice the mercury vs. neurologically based language disorder part:

Autism: A Unique Type of Mercury Poisoning

Even though autism is not apraxia, there are some characteristics of Mercury Poisoning which also mirror apraxia.  These will be our speakers for our April 2001 meeting.

...b. Language and Hearing
The third diagnostic criterion for autism is a qualitative impairment in communication (APA, 1994), and such impairment is a primary feature of mercury poisoning.  Delayed language onset is often among the first overt signs of ASD (Eisenmajer et al, 1998). Historically, half of those with classic autism failed to develop meaningful speech (Gillberg & Coleman, 1992; Prizant, 1996); and oral-motor deficits (e.g. chewing, swallowing) are often present (Filipek et al, 1999).  When speech develops, there may be "specific neuromotor speech disorders," including verbal dyspraxia, a dysfunction in the ability to plan the coordinated movements to produce intelligible sequences of speech sounds, or dysarthria, a weakness or lack of control of the oral musculature" leading to articulation problems (Filipek et al, 1999). Echolalic speech and pronoun reversals are typically found in younger children. Many ASD subjects show poorer performance on tests of verbal IQ relative to performance IQ (Dawson, 1996; Filipek at al, 1999). Higher functioning individuals, such as those with Asperger's Syndrome, may have language fluency but still exhibit semantic (word meaning) and pragmatic (use of language to communicate) errors (Filipek et al, 1999)...

In regard to language and auditory phenomena, autism's parallels to mercurialism are striking. Emerging signs of mercury poisoning are dysarthria (defective articulation in speech due to CNS dysfunction) and then auditory disturbance, leading to deafness in very high doses (Clarkson, 1992). In some cases, hearing impairment manifests as an inability to comprehend speech rather than an inability to hear sound (Dales, 1972). Hg poisoning can also result in aphasia, the inability to understand and/or physically express words (Kark et al, 1971). Speech difficulties may arise from "intention tremor, which can be noticeable about the mouth, tongue, face, and head, as well as in the extremities" (Adams et al, 1983). 

Mercury-exposed children especially show a marked difficulty with speech (Pierce et al, 1972; Snyder, 1972; Kark et al, 1971). Even children exposed prenatally to "safe" levels of methylmercury performed less well on standardized language tests than did unexposed controls (Grandjean et al, 1998). Iraqi babies exposed prenatally either failed to develop language or presented with severe language deficits in childhood. They exhibited "exaggerated reaction" to sudden noise and some had reduced hearing (Amin-Zaki, 1974 and 1979). Iraqi children who were postnatally poisoned from bread containing either methyl or ethylmercury developed articulation problems, from slow, slurred word production to the inability to generate meaningful speech. Most had impaired hearing and a few became deaf (Amin-Zaki, 1978). In acrodynia, symptoms of sufferers (vs. controls) include noise sensitivity and hearing problems (Farnesworth, 1997). ..

Many apraxic children, even those without autism, also have sensory intergration issues.

*Contact: sbernard@nac.net
**Contact: (201) 444-7306
njcan@aol.com

Copyright (c) 2000 by ARC Research
14 Commerce Drive
Cranford, NJ 07016

April 3, 2000
Revision of April 21, 2000

------------------------------------------------------------------------------




ABSTRACT
Autism is a syndrome characterized by impairments in social relatedness, language and communication, a need for routine and sameness, abnormal movements, and sensory dysfunction. Mercury (Hg) is a toxic metal that can exist as a pure element or in a variety of inorganic and organic forms and can cause immune, sensory, neurological, motor, and behavioral dysfunctions similar to traits defining or associated with autism. Thimerosal, a preservative frequently added to childhood vaccines, has become a major source of Hg in human infants and toddlers. According to the FDA and the American Academy of Pediatricians, fully vaccinated children now receive, within their first two years, Hg levels that exceed safety limits established by the FDA and other supervisory agencies. A thorough review of medical literature and U.S. government data indicates (i) that many and perhaps most cases of idiopathic autism, in which an extended period of developmental normalcy is followed by an emergence of symptoms, are induced by early exposure to Hg; (ii) that this type of autism represents a unique form of Hg poisoning (HgP); (iii) that excessive Hg exposure from thimerosal in vaccine injections is an etiological mechanism for causing the traits of autism; (iv) that certain genetic and non-genetic factors establish a predisposition whereby thimerosal's adverse effects occur only in some children; and (v) that vaccinal Hg in thimerosal is causing a heretofore unrecognized mercurial syndrome. 


SYNOPSIS
A review of medical literature indicates that the characteristics of autism and of mercury poisoning (HgP) are strikingly similar. Traits defining or associated with both disorders are summarized in Table A immediately following the Table of Contents and are discussed and cited in the body of this document. The parallels between the two diseases are so thorough as to suggest, based on total Hg injected into U.S. children, that many cases of autism are a form of mercury poisoning. 

For these children, the exposure route is childhood vaccines, most of which contain thimerosal, a preservative which is 49.6% ethylmercury by weight. The amount of mercury a typical child under two years receives from vaccinations equates to 237.5 micrograms, or 3.53 x 1017 molecules (353,000,000,000,000,000 molecules). Most such vaccinal Hg may not be excreted and instead migrates to the brain. 

The total amount injected into infants and toddlers (i) is known to exceed Federal safety standards, (ii) is officially considered to be a low level; whereby (iii) only a small percentage of exposed individuals exhibit symptoms of toxicity. In fact, children who develop Hg-related autism are likely to have had a predisposition derived from genetic and non-genetic factors. 

Importantly, the timings of vaccinal Hg-exposure and its latency period coincide with the emergence of autistic-symptoms in specific children. Moreover, excessive mercury has been detected in urine, hair, and blood samples from autistic children; and parental reports, though limited at this date, indicate significant improvement in symptoms subsequent to heavy-metal chelation therapy. 

The HgP phenotype is diverse and depends upon a number of factors - including type of Hg, route of entry into the body, rate and level of dose, individual genotype, and the age and immune status of the patient. Historically, variation among these factors has caused slightly different manifestations of mercurialism; Mad Hatters disease, Minamata disease, acrodynia, and industrial exposures provide examples. 

The pathology arising from the mercury-related variables involved in autism - intermittent bolus doses of ethylmercury injected into susceptible infants and toddlers - is heretofore undescribed in medical literature. Therefore, in accord with existing HgP data and HgPs ability to induce virtually all the traits defining or associated with autism spectrum disorders, we hypothesize that many and perhaps most cases of autism represent a unique form of mercury poisoning. 

This conclusion and its supporting data have important implications for the affected population of autistic individuals and their families, for other unexplained disorders with symptoms similar to those of heavy metal intoxication, for vaccine content, and for childhood vaccination programs. Due to its high potential for neurotoxicity, thimerosal should be removed immediately from all vaccine products designated for infants and toddlers. 

Mercury Contamination: A Critical Issue

New evidence substantiating a variety of health benefits of LCP supplementation is being published month after month. Unfortunately, at the same time, concerns have been raised about the possible contamination of some fish that provide the critical fatty acids found in LCP supplements.

Last month the FDA advised pregnant women and women of childbearing age who may become pregnant (as well as nursing mothers and young children) not to eat shark, swordfish, king mackerel and tilefish. These fish, said the FDA, may contain high levels of a mercury called methyl mercury that may harm an unborn baby's developing nervous system. Some experts on the ABC television show 20/20 also advised against eating tuna, but the FDA rejected calls to put tuna on the do-not-eat list stressing that swordfish and shark have far higher levels of mercury.

As you're probably aware mackerel and tuna contain significant quantities of the fatty acids DHA and EPA and are often the source of these nutrients manufactured in fish oil capsules.

It is quite understandable that many parents giving such supplements to help their children with ADHD, dyslexia and dyspraxia (or taking omega-3 for personal health reasons) should be alarmed by the contamination reports. It is a serious issue and before making any recommendations it is worth reviewing the history of the problem.

The Mad Cats of Minamata

The danger of mercury contamination was discovered in 1953 when fish, contaminated with mercury, first drove cats mad and then killed and maimed people in a fishing village in Minamata Bay, Japan.

Mercury is one of a group of substances called heavy metals. Other members of the group include selenium, chromium, cadmium, manganese and lead. Some of these heavy metals are essential in the diet (selenium, chromium and manganese), but all of them are toxic when taken in excessive amounts.

There are three forms of mercury that are used by industry––metallic mercury, organic mercury compounds and inorganic compounds. All forms of mercury are poisons but some are less dangerous than others are. The inorganic forms are the least dangerous and the organic forms (for example, methyl mercury) the most dangerous. Unfortunately, when industrial waste including inorganic mercury is discharged into rivers, lakes and the sea, the sediments including microorganisms and animal life convert it to the more toxic organic methyl mercury. This is what happened in Minamata Bay and is happening in contaminated lakes, estuaries and rivers worldwide today. And this is what concerns the FDA and the Environmental Protection Agency (EPA). The greatest risk is from the fish mentioned by the FDA because they are long-lived, larger fish that feed on smaller fish and therefore accumulate the highest levels of methyl mercury. These fish would be perfectly safe to eat if they lived in uncontaminated waters. Much of the tuna that's caught lives in clean South Pacific waters.

So, What Should You Do?

Unfortunately, the very groups of people advised not to eat king mackerel and tuna are those with a great need for the fatty acids that these fish contain––anyone likely to get pregnant, moms-to-be, nursing mothers and young children. It is a great pity that the safety of these fish is in question, but the advice must be heeded and only uncontaminated fish consumed. The EPA has information on which places are contaminated and where fish is safe to eat.
Most people, of course, now choose to obtain the vital fatty acids by consuming fish oil supplements such as those mentioned in my book, "The LCP Solution: The Remarkable Nutritional Treatment for ADHD, Dyslexia and Dyspraxia." Reputable manufacturers of fish oil supplements regularly monitor their products for heavy metal contamination, so one way to get around the problem is to take a fish oil supplement that is free from such contaminants.

How can you be sure? A large, reputable manufacturer is going to do everything in its power to ensure that its products are not contaminated. It is not worth its while running the commercial risk of putting such products into the marketplace. But be an aggressive consumer! Contact the manufacturer of your preferred fish oil supplement. Ask them directly if their product contains mercury and if they screen every batch of fish oil they use. If you obtain a quick response and an explanation of how they monitor their product you can be reassured of its safety.



A Mother's Story

My thanks to Mary F. for sharing this story:
"Our son was born with a very rare type of brain tumor, a hypothalamic hamartoma, that causes intractable seizures, is not responsive to anti-convulsants, and can have profound effects on speech and speech development. He was showing developmental delays from three weeks after birth. The brain tumor was found when our son was eighteen months old and began to have grand mal seizures. The few sounds that he had gained by eighteen months were quickly lost as the seizures increased in size and frequency. The brain tumor was removed when he was twenty-nine months old. The seizure activity decreased and finally stopped eighteen months after surgery.

"In September 1999, his speech therapist diagnosed him as having developmental verbal apraxia. She tried in vain, using touch cues, to get some of the basic consonant and vowel sounds from him. This proved frustrating for all parties involved and would usually produce tantrums and head banging episodes from him.

"In September 2000 our son got a new speech therapist. She started using a program called "Apraxia for Preschool." For the first two weeks he showed little progress. The third week of September, after reading "The LCP Solution," we started giving him a DHA/EPA supplement. Within one week we saw a huge improvement. Our son was more focused and less irritable. He started to make new sounds and he started to play with toys functionally-not just lining them up or sorting them endlessly. Before our son started the supplement he only had about five consonant sounds and three word approximations. After three months of being on the DHA/EPA supplement, he can make all the long vowel sounds, sixteen consonant sounds and is saying one, two and three word combinations as clear words or word approximations. He still has a long way to go, but this DHA/EPA supplement is nothing short of a miracle.

If you hear of any cases of children in the United States with a diagnosis of hypothalamic hamartoma I would be happy to talk to their parents. I know how deadly this type of tumor can be and how its removal in the U.S. is not an option. We ended up at the Montreal Children's Hospital, which has conducted six of these tumor removals-more than any other major center in the world.
Sincerely,
Mary F.

Your Questions Answered

Here is a selection of questions that I have received since the last newsletter along with my answers.

Q My 12-year-old son who has dyslexia has been on Efalex for two weeks. He takes two capsules in the morning and three in the evening. He says that it is "helping him do his work." However, he has become quite hyper. Is there an adaptation period and, if so, how long is it? Or should he be switched to another formulation?
A. Please don't worry about your son becoming hyper on Efalex. It is very unlikely that it will last for long. It is probably because he is now finding certain tasks so much easier that he is able to do things at full speed and is enjoying that. Give him lots of challenges and fun activities and you will be happy at his new achievements.
••••••••••••••••••••••••••••••••••••
Q. Thank you for your research and for helping a lot of people to a better life. I'd like to know for how long it would be sensible to nurse your child when your family has no previous history of ADHD, dyslexia or dyspraxia. My sister has adopted three children from South Korea. The oldest has pronunciation difficulties and voice problems. He is twenty years old, clumsy and has problems with sentence syntax. He also has milk-intolerance. Is Efalex worth a try?
A. For many reasons I would recommend nursing a child for at least six months. It is fine to go on nursing even longer if that is what suits mother and infant but obviously, other foods should also be introduced. It is certainly worth trying Efalex in the young man with the problems you describe. Please let me know how he gets on.
••••••••••••••••••••••••••••••••••••
Q. What do you do if a child is severely allergic to fish? Does that affect his ability to take fish oils? What replacements can be used?
A. I would not recommend fish oils for anyone with a fish allergy. You could try supplementing with a vegetarian, micro algae product such as Neuromins.
••••••••••••••••••••••••••••••••••••
Q. I love the web site! Thanks for taking the time to develop and maintain it. My problem is that I can't get any of this stuff into my 5.6 -year-old son. He can't swallow whole capsules or pills yet. What do you suggest?
A. It is really difficult to suggest new ways to deal with the problem you face as the fish oil does confer its flavor to anything it is mixed with. Some children will take it mixed with jelly or orange juice-but others just won't. One mother told me that she mixed the capsules with stiffish, pureed foods such as breakfast cereal or mashed potato. She found the capsules were disguised and swallowed whole. It's worth a try! Try one capsule surrounded by potato on a spoon. The other great motivators are 'bribery' or setting a challenge. Try a competition, for example: "I bet you can't swallow this before me."
••••••••••••••••••••••••••••••••••••
Q. Is LCP supplementation helpful for children with Down syndrome?
A. There have been anecdotal reports that omega-3 LCP supplements can help people with Down syndrome, but no detailed studies have yet been conducted. Dr. Tuomas Westermark in Finland has shown that taking plenty of antioxidants can help Down syndrome. It is possible that a combination of antioxidants and LCPs would be even better-but the research has just not been done.
••••••••••••••••••••••••••••••••••••
Q. We have seen dramatic improvements in our daughter since we began supplementation eight weeks ago. However, I've heard that EPA can stunt growth in children. Is there any truth to this?
A. There is little evidence that EPA stunts growth in children. It was noted in studies of infants (fed on milk) who were not supplemented with omega-6 LCPs, as well as omega-3 LCPs, that grow was slower. As we explain in our book, "The LCP Solution," the modern diet contains relatively much more omega-6 than is desirable, so it is very unlikely that growth would be stunted by anyone taking a fish oil supplement.

••••••••••••••••••••••••••••••••••••
Q. I am very thankful to you for writing your awesome book. Does the LCP diet help autistic children?
A. We do not yet know whether LCP supplementation helps autistic children. There is a little evidence that it might, particularly those with Asperger's syndrome.

Best wishes,
Dr. Jackie Stordy and Malcolm Nicholl

Late Talker vs. Apraxia? 

Click to subscribe to childrensapraxianet