#67 Emily Gutierrez, DNP, CPNP, PMHS: Neuroinflammation in Kids including Autism, OCD, ADHD, PANDAS/PANS

Autism, ADHD, OCD, and PANDAS/PANS are some of the challenging neuroinflammatory conditions in growing numbers of children these days. While the conventional treatment has typically been pharmaceuticals and behavioral therapies, we are truly in the midst of a paradigm shift aiming at root causes and asking 'why' and 'how' for both cause and treatment. Innovations in medicine are bringing us new evaluation tools, nuanced diagnosis capabilities, and treatment options. 

Dr Emily Gutierrez, a seasoned pediatric psychiatric doctorally-prepared nurse practitioner in Austin, Texas, prioritizes these kids who need new approaches. We begin the show by walking through the names, diagnostic criteria, and developmental progressions of some of these disorders like PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections),  PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome), and autism spectrum disorder, including their associated symptoms of anxiety, depression, and OCD (obsessive compulsive disorder). She delineates autism as kids with global delay who have never met milestones (consider genetic testing with chromosomal microarray and Fragile X testing) versus those with regression or later development of symptoms (consider environmental triggers). 

We review Dr Richard Frye's formula for regressive autism or PANS/PANDAS etiologies being 20% genetics + 80% environmental triggers, including oxidative stress (aka total toxic burden of metals, infections, mycotoxins, poor elimination), methylation deficiencies, and mitochondrial dysfunction. She notes, "Psychiatric symptoms can have an immunological basis that needs to be ruled out before sticking a kid on a medication. Maybe the med is amoxicillin instead of prozac." We get far into the details with these physiological processes. 

This is an exciting conversation about understanding root causes, choosing treatment approaches and celebrating the inherent resilience of children. The earlier the intervention, the better the outcome. She emphasizes that these conditions are not the fault of the child or the parents and that it is somewhat a war of attrition, meaning, staying with it is the best way to support kids long term to become their best selves. For the benefit of our kids and society as a whole, we all need to heed the call to approach children with neuroinflammatory conditions with fresh, science-based, evidence-backed eyes- listen in to learn what this means and how it can be done. 

Resources: 

• Dr Emily Gutierrez's clinic: https://www.neuronutritionassociates.com/
• Dr Emily Gutierrez's nutritional supplement line: NeuroNutrients (coming July 2022!)
• Dr Emily Gutierrez's book link: The Parent's Roadmap to Autism (2018)
• MAPS: Medical Academy of Pediatric Special Needs for clinicians
• TACA for parent support: The Autism Community in Action