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A charcoal flush soaks up excess ammonia in the body. You may want to do a
“trial run” with magnesium citrate the day before to determine how much you
need to use to produce a bowel movement within 8–12 hours. You can do the
flush on a weekend, as that may be more convenient. Use charcoal flushes if ammonia
is high or needs to be kept under control, as indicated on the MPA and/
or biochemical testing.
As you will see on your MPA, there are two different CBS enzymes and therefore
different permutations of the basic protocols. Look at your results to see which
combination you have and follow the corresponding supplement recommendations
below. I recommend that people fine-tune the individual dosage based on
test results (from a UAA) that track ammonia and taurine levels, also taking into
consideration the number of CBS mutations.
For example, for those who have both copies of CBS C699T, the most severe
CBS variation, it’s likely that you need to use the Ammonia Support RNA closer
to three times per day. On the other hand, if you had a single CBS A360A, the
least severe variation, you may require less of the RNA used only once a day.
Biochemical testing done through my office will allow me to determine your
optimal dose, but the bottom line is that Ammonia Support RNA should be on
board daily with any CBS+, with the amounts adjusted based on ammonia and
taurine levels. Do not stop giving it, even once these levels come down. At that
point you can determine a maintenance dose that will keep taurine and ammonia
in the normal healthy range. Periodic testing will help you make the necessary
adjustments.
Limiting Sulfur
Since the CBS mutation can lead to elevated levels of taurine and excess sulfur
groups, it’s important for those with CBS upregulations to limit their intake of
sulfur-containing foods. The intolerance to sulfur may be enhanced or lessened
by the specific CBS SNP affected, and will also depend on whether the mutation
is homozygous or heterozygous. Excess sulfur, resulting from CBS activity may
also trigger chronic stress (the cortisol response), which regulates the pathway
mediated by the BHMT enzyme. Normally, sulfur is bound to amino acids (such
as homocysteine, methionine, SAMe, SAH, or cysteine), and can’t create systemic
havoc. However, with the increased CBS activity produced by this SNP,
those sulfur groups are instead released into the system as sulfites.
To avoid that problem, I recommend that if you or your child have CBS upregulations,
consult the list of sulfur donors below—and avoid foods and nutrients
with high sulfur content. Garlic, an antimicrobial; DMPS, a widely used chelation
agent (which helps to remove metals from the body); broccoli; and other
common foods and supplemental compounds, like glucosamine sulfate (note the
sulfate!) are all sulfur donors. Since those without CBS sometimes need more
132 Autism: Pathways to Recovery