Why would treatment with gold help someone with autism?
That is the question raised by The Age of Autism's report last week that the first child ever diagnosed with the disorder appeared to improve significantly after treatment with gold salts.
We've heard from a number of readers -- some with autistic children they're trying to help -- asking the same question.
So far, we've found a couple of possible explanations, both courtesy of those who believe autism is triggered by some sort of toxic exposure in susceptible children. The idea -- dismissed by federal health authorities -- is that the culprit in autism is the mercury preservative that was used in vaccines or, in some cases, the actual vaccines themselves.
That first autism patient, known as "Donald T.," is now 71 and lives in the small Mississippi town he grew up in. Diagnosed with autism at age 5, he had a life-threatening attack of juvenile arthritis at age 12, according to his brother; his temperature spiked uncontrollably, his joints stiffened and were extremely painful. He stopped eating.
"It looks like Don's getting ready to die," his father told a small-town physician after specialists failed to diagnose the ailment or find an effective treatment. That doctor suggested it might be juvenile arthritis, and after treatment with gold salts at a Memphis clinic, Donald's autism as well as his arthritis improved.
Injectable gold salts -- sodium aurothiomalate -- were used to treat arthritis because they have anti-inflammatory properties.
"He had a miraculous response to the medicine," his brother told us at his Mississippi law office. "The pain in his joints went away. When he was finally released, the nervous condition he was formerly afflicted with was gone. The proclivity to excitability and extreme nervousness had all but cleared up." Donald also became "more sociable," he said.
We couldn't find any record of that in subsequent writings about the first patients with autism. Instead, the child psychiatrist who diagnosed those cases attributed Donald's remarkable success in life -- he belonged to a college fraternity, was a bank teller and now, in retirement, travels the world -- to four years he lived with a "wise, intuitive" farm couple.
An alternative explanation -- biomedical rather than behavioral -- involves the body's immune system as a triggering agent of autism:
-- Start with the idea that gold salts reduce the autoimmune response that causes juvenile arthritis. Although the mechanism is unclear, they appear to do so by suppressing a type of immune-signaling cell called cytokines.
-- Brain cells called microglia produce a specific type of cytokine, which can be activated in the presence of mercury or neurotoxic viruses including measles. That type of cytokine has been found on autopsy in the brains of people with autism.
-- The cytokines that are produced chronically in an autoimmune condition may contribute to neurological problems, including oxidative stress, overstimulation of brain cells and abnormal growth signals during development.
So the state of immune activation that is present in juvenile arthritis may contribute in parallel to autistic symptoms. Suppressing the immune activation, as gold salts do with arthritis, may have additional benefits on the autism-symptom side.
We found a version of this idea in a 2002 report by the Meridian Institute, titled "Gold and Its Relationship to Neurological/Glandular Conditions."
The four authors suggest that a useful experiment would be "attending to the side effects of gold medications in cases where there is co-morbidity of rheumatoid arthritis and a neurological, psychiatric, or glandular disorder. For example, one could ask, do patients with epilepsy, depression, or adrenal insufficiency who may be receiving gold for arthritis show any improvement in neurological/glandular symptoms?"
One could just as well ask: How about patients with autism? That experiment may inadvertently have taken place in Mississippi in 1947. Subject: Donald T.
Gold and other elements have been used since antiquity as "nervines" to treat mental conditions. The authors note that lithium is an element that has proven highly effective against bipolar disorder.
"It is clear there is a long tradition of gold as a nervine," they write. "But there were no multi-center clinical trials; that is a modern phenomenon. There were only observations and reports of individual cases."
They quote a 1983 study on animals that showed gold "localizes in nervous system tissue." And they cite a small, preliminary 1996 study that showed after four weeks of colloidal gold treatment, IQ scores increased dramatically in test subjects.
"While a study of this small size is very preliminary, it is encouraging evidence of the potential of gold as a nervine, and as a demonstration of a non-toxic preparation," they wrote.
In the next column, we'll look at how the controversial treatment called chelation might fit with all this.