Stuart H. Freedenfeld, MD

Any mother who has had an ASD child should reasonably want to know how to prepare her body to become a healthy garden ready to receive the seed of her next child.

We are coming to understand that autism is a neurological expression of the impact of environmental toxins on a genetically susceptible individual. It manifests when a child, who is genetically more susceptible to certain toxins, is exposed to those toxic substances at a vulnerable period in his or her life. If this concept is true, then we can prevent this disorder by identifying and avoiding such exposure. Moreover, it is important to recognize that these children are genetically susceptible because they have inherited genes from each of their parents that are less protective with regard to toxic exposure. It is therefore reasonable that both parents, to a greater or lesser extent, are also genetically susceptible to diseases related to toxic burden.

We live in a very toxic world. As a result of the industrialization of manufacturing and the chemical-ization of agriculture and the pharmaceutical-ization of healthcare we have exposed our bodies and our children to a greater burden of toxic substances than any generation before. We have yet to see the overall long-term results of this drama but we are already in the midst of one of its early tragedies. We have seen such an explosion in the numbers of children developing autism spectrum disorders that it can be considered nothing less than a travesty.

In this paper we will explore the toxins of our world and discuss approaches to avoiding and eliminating these substances for the health of our next child and for the short term and long term health of ourselves, the parents.

Never before in the history of evolution have the developing fetuses of any species been exposed to so many chemicals and toxins. The US EP A estimates there are over 87,000 chemicals currently in widespread use. Of these, 62,000 are molecules small enough to cross cell membranes. Fifteen thousand are produced in annual quantities of over 10,000 pounds (that's five tons per year), and some are produced in tens of millions of pounds per year.

There are over 600 actively used pesticides, none of which have been adequately tested. Even after they are found to be unsafe they are not necessarily excluded from use. An example is DDT, which, while banned in this country, is still exported by the American manufacturers for use in other countries where the spraying precautions are often ignored. In addition to causing unconscionable harm to the world's poorest people, the produce may then be exported to the US for routine consumption without any warning labels required.

Our drinking water is "purified" by chlorination to kill the bacteria and then aluminum is added to precipitate out aluminum chloride sludge. In most communities there is no monitoring of aluminum levels in drinking water. As a result a 20-minute bath may allow more aluminum absorption through the skin than would be absorbed by drinking the water all day long. Showering exposes to less aluminum, but more organochlorines may be absorbed by inhalation than from a typical day of pesticide spraying. Some communities allow more chlorine in their drinking water than in their pools.

We are bombarded by chemicals in our cosmetics and cleaning fluids. We spray our homes with insecticides and use fungicides on our household plants. We have veritable toxic bombs under our kitchen sinks. Use of these chemicals in our homes creates toxic exposures that are often worse than a typical workplace.

We spray our lawns with toxic chemicals and then send our children out to play. We cook our food in plastic, releasing carcinogenic, xenobiotic estrogens and store leftovers in aluminum foil.

We smoke. (This is arguably the single most important individually modifiable health risk.) We don't exercise. For many Americans looking for the remote control is their major daily exercise. We don't even talk. Current statistics show that a typical American spends 3-4 hours a day watching TV and only 3-4 minutes per day talking to family members.

Our diets are deficient in minerals and important nutrients. The FDA sets guidelines for the "recommended daily allowance" for most nutrients. Most nutritionists would argue that these guidelines are terribly low for many, if not all, of the nutrients listed since they were set to prevent advanced expressions of illness in average healthy people. They were not set to prevent mild expressions of deficiency in healthy people and were certainly not set to prevent mild expressions of deficiency in unhealthy people, nor to maximize health benefits of these various nutrients in healthy or unhealthy people. But even give these very low numbers for the RDA, according to our own FDA, 70% of Americans don't even eat the RDA for the basic nutrients.

Americans consume an average of 140 pounds of sugar per person every year. That is nearly 0.5 pound per person per day! Compare this to an average of 12 pounds per person per year in the 1800's and it is easy to see how things have changed in recent years. We consume 23 gallons of ice cream per person per year or 1/2 gallon per person each week and 15 billion gallons of soda annually which comes to I gallon per person per week. The food we purchase may be full of undeclared chemicals. There are over 3,000 chemicals in our food supply. Over 10,000 chemicals are used as food additives. Only a few of these have been adequately tested for toxic effects and essentially none of them have been tested in combinations. It is important to understand that any substance that is tolerated by itself may not be tolerated in the presence of other substances. Furthermore, any substance that is tolerated by one individual ( or fetus) would not necessarily be tolerated by another.

We have been concerned with the effect that mercury and, in particular thimerosal, plays in the onset of Autistic Spectrum Disorders (ASD). We know that not everyone is equally susceptible. We also need to know that the potential effects of mercury are not just ASD and, in particular, are not just neurological. Mercury is considered the most toxic, non-radioactive element on the planet. Once it gains access to the body it remains detectable in the blood stream for 3-6 weeks. As it leaves the blood it enters every organ and every cell and every subcellular organelle in the body.

This country alone releases 200 metric tons of mercury into the environment each year. This includes 40 tons from coal burning, 17 tons from fluorescent bulbs, along with 40-50 tons from medical and dental waste. Two hundred tons of mercury at 454 gm/lb comes to 181,600,000,000 mcg. If we divide this amongst 300 million Americans it would come to 605,332 mcg per person per year. This is not what each person is actually exposed to since the pollutant spreads throughout the environment. On the other hand we must recognize that higher living organisms bioaccumulate mercury, concentrating it 200,000 to I from the environment. This means that Ippb mercury (I mcg/kg) in the environment accumulates to 200,000 ppb (200,000 mcg/kg) in higher living organisms such as humans.

Although a safe level of mercury has never been identified, the US EP A recognizes that there is no option for total mercury avoidance. As a caution it recommends ingestion of no more than O.lmcg of mercury per Kg body weight per day. Most fish have 0.2-0.3 mcg of mercury per gm of fish. Sharks, swordfish and tilefish have 1.0 mcg/gm. Atypical 6 oz (170 gm) fish would therefore yield 42.5 mcg of mercury. In atypical 150-pound (70kg) person this would come to 0.46 mcg/kg of body weight. So this would be 4.6 days worth of mercury toxin. However if you ate the same amount of swordfish you would be getting 2.43 mcg/kg or 24.3 days worth of mercury .

That sounds pretty ominous but we still need to realize that fish is not even the major source of environmental mercury exposure. According to the World Health Organization "silver" amalgams may account for over 85%. The average "silver" filling weighs I gram and is 50-55% mercury by weight. It is 30% silver but not many of us would have bought into the offer if we were offered "mercury" amalgams so the dental industry uses a euphemism. The amount of mercury in one average sized "silver" filling would cause a 10-acre lake to be closed to all swimming and fishing for at least a year. The American dental industry places over 100 million new amalgam fillings each year. One hundred million amalgams containing 50 million grams ( or about 27.5 tons) of mercury are being placed into the mouths of patients every year. Atypical amalgam with a O.4cm surface releases about 17mcg mercury per day mostly as a result of chewing. If an average person has 8 amalgams, that would result in about 136 mcg of mercury being released as elemental mercury vapor. Of this 10-15% or about 17mcg would get absorbed every day on average for the next 70 years.

And a pregnant mother would also absorb 17mcg/day every day during a 270-day pregnancy. Should we not give serious concern to the 4590 mcg given to the mother-fetus unit over the more vulnerable 9-month gestation? Any dental work done during pregnancy, including dental cleanings, when amalgams are in the mouth, will dramatically increase mercury absorption by the mother. Mercury is bioconcentrated by the placenta during gestation and has been found to concentrate 8 fold in the fetus primarily in the liver and kidneys of fetuses and in the kidney and brains of infants, at levels that correlate with the number of dental amalgams in the mother.

A new amalgam will typically release mercury at an increased rate for the first several months. Studies demonstrate that more than 25% of the original mercury is gone from dental amalgams after the first five years. The rate of release increases after dental brushing, cleanings and during chewing. The level of mercury in the mouth after chewing is 15 fold greater in people with amalgams than in those without amalgams. Increased mouth mercury levels gradually fall back to baseline about 90 minutes after chewing stops. Many biologic dentists will measure mercury levels in the mouth before and after chewing gum for I minute. Normal chewing may cause mouth levels of mercury to rise above the levels considered safe by EP A for an industrial work place. People with amalgams may have 20-150 mc~ per cubic meter (mcg/m3) of mercury vapor in their mouth after chewing. A level of 100 mcg/m in the mouth while chewing is 500 times the level considered safe by the EPA for workplace exposure. To put this in perspective we can note that before 1990, mercury was added to latex paint as a fungicide. It was removed from latex paint because it released 2-3 mcg/m3 into the room air. This is 1/50th the amount inside a mouth with amalgams after chewing gum for one minute.

The half-life of mercury in the brain is 30 years. Mercury is transported in breast milk and breast milk may actually promote better absorption of mercury by the nursing infant. According to the EPA, 60,000 babies per year in the US are born with neurodevelopmental disorders due to neonatal exposure to mercury. The EPA estimated that 630,000 babies per year (I baby in 6) are born to a mother with a blood mercury level that exceeds the Agency's safety threshold.

I will sidestep the mercury in vaccines issue because it would be beyond the scope of this essay. I believe that vaccine safety remains a very important issue that needs to be addressed. The fact that thimerosal and other potentially toxic chemicals are still added to vaccines intended to be injected into our body is tragic and my focus on other sources of mercury and other toxins is by no means intended to construe otherwise.

We can prevent one important source of mercury exposure to the children by eliminating or improving vaccines. But there will still remain the other major sources of this toxic metal. The best prevention for our children would be to never again place a mercury containing substance anywhere in a child's or a woman's body. And let's not poison the men either. The next best action would be to SAFELY y remove existing amalgams. We must also act to vigorously change

environmental laws to prevent continued mercury , as well as thousands of other toxins, from being released into the environment.

It is vital to understand a basic concept. We must recognize that Autism Spectrum Disorders are neurological expressions of the impact of environmental toxins on genetically susceptible individuals. These children have been damaged simply because they are less able to handle the toxins in our environment (and the toxins injected into their bodies ). This is a simple statement of genetic variability. Our genetic thumbprint determines our susceptibility to environmental changes. This, after all, is what determines successful evolution. Any species that does not have a genetic opportunity to propel forth in time of change would become extinct. Sometimes susceptibility in individuals is nature's evidence of environmental changes. We see this in the frogs and other reptiles that are showing signs of genetic disorders due to environmental toxins. Our ASD children are also showing signs of environmental toxins at a very young age. Many others show environmental effects at a later age and then we call it Alzheimer's disease or Parkinson's disease or cancer to name just a few.

So much for the bad news. Let's consider what we might do to keep our body healthy and make it a nutritious garden within which a new life can develop. The following is a list of recommendations that should be read carefully and contemplated deeply. This kind of list often is scanned and ignored, but I am going to ask you to read each bullet then stop and think how you might incorporate the idea into your daily life. Even while struggling to care for an autistic child, earn money and run a house we MUST create time for our own health and fulfillment. So: .Sleep well and sleep adequately. Rest is vital to your body's ability to repair itself.