Background - The Autism Epidemic
The most recent CDC data shows that autism now affects one in 110 children overall and one in 70 boys. Some continue to deny we are experiencing an epidemic, but it is becoming increasingly obvious that we are. Furthermore, scientific research indicates the increase in prevalence is not simply a matter of more children being diagnosed now than in the past, but due to a real increase in affected children.[2,3] The pressing question for us as a society is why is this happening to our children? Why are there more autistic children now than in the past? After extensive research, I have come to the conclusion that the autism epidemic is due to an environmentally triggered encephalopathy/neuropathy of the prenatal period, infancy, or early childhood. In plain language, I believe the autism epidemic is the result of an interactive effect of multiple neurotoxins; the specific neurotoxins suspected are: acetaminophen, free glutamate, and aspartame. The sections to follow will provide evidence for the role of acetaminophen, free glutamate and aspartame, in the autism epidemic. Following this discussion, a detailed autism recovery program will be presented that involves avoidance of dietary and pharmaceutical neurotoxins.
The first neurotoxin to be discussed is acetaminophen. Acetaminophen’s neurotoxicity is attributed to the fact that a fraction of acetaminophen is broken down into n-acetyl-p-benzoquinone imine (NAPQI). Recent research shows that NAPQI kills cortical neurons (cortical neurons are a type of brain cell).
Rates of autism began to rise in the 1980’s.[5,6] During the 1980’s, acetaminophen replaced aspirin as the recommended pain killer for use in the pediatric population, after the Centers for Disease Control issued a warning that aspirin may be associated with Reye’s Syndrome (an association which has never been conclusively demonstrated). This greatly increased the number of infants and toddlers exposed to acetaminophen's neurotoxic by-product NAPQI, and I suspect fueled the autism epidemic. Unfortunately, acetaminophen is currently routinely recommended for use by pregnant women as well.
The next toxin to be discussed is free glutamate. Free glutamate is promoted by the glutamate industry as safe; however, it is a neurotoxin, more specifically it is an excitotoxin.  Free glutamate is an additive present in multiple childhood vaccines. Although thimerosal has been widely implicated as a potential causative factor in the autism epidemic, I suspect the vaccine component which is relevant to the autism epidemic is actually free glutamate and not thimerosal. Animal research supports this assertion. In 1969, Dr. Olney showed that injecting baby mice with free glutamate caused neurological harm (brain lesions) in these animals.  Disturbingly, decades after this research, the current CDC vaccine schedule has us injecting our infants and toddlers with vaccines containing free glutamate multiple times over the course of their young lives, despite the demonstrated neurological harm of injecting laboratory animals with free glutamate. For many years now, countless parents have been reporting that their previously normally developing children regressed into autism following vaccinations, and sadly these parents have been mostly dismissed by the medical profession and by the media as hysterical.
What is Free Glutamate and Where Else is it Found?
Free glutamate is probably most widely known as the adverse reaction causing portion of the common food additive monosodium glutamate (MSG). However, strict avoidance of monosodium glutamate is no longer enough to avoid dietary exposure to neurotoxic processed free glutamate. It seems that in response to public concern regarding the danger of monosodium glutamate, food manufactures have found ways to hide processed free glutamate in food in ways which do not require them to list monosodium glutamate (MSG) among the ingredients on the label. Currently, neurotoxic free glutamate is hidden in our food under several harmless sounding names, such as: yeast extract, hydrolyzed vegetable protein, and soy protein to name only a few. It is abundant in our food supply and sadly this neurotoxin is routinely consumed with every meal. Please see the Truth in Labeling and the Hidden Names for MSG websites for lists of ingredients and food items which contain processed free glutamate (please note that free glutamate is sometimes also referred to as free glutamic acid). The reason food manufacturers add processed free glutamate to practically everything is because it tastes great and it is relatively cheap; it produces a rich savory flavor, which has actually been described as the 5th flavor of umami. Dr. Russell Blaylock, neurosurgeon and author, describes processed free glutamate as “the taste that kills”. This is because free glutamate is not merely a flavoring; it is a neurotoxin.
To understand how free glutamate harms the nervous system, it first needs to be understood that free glutamate (glutamic acid) actually functions as a neurotransmitter and is essential for proper neurological function, in small quantities. However, in large quantities, it acts as an excitotoxin causing the neurons to fire rapidly and repeatedly which can literally excite them to death. As the manufacturers of processed foods like to point out, glutamate is also present in healthy, unprocessed foods. However, in these natural, unprocessed foods, glutamate is not typically harmful, because most of the glutamate in such foods is in its bound form which is freed slowly and in appropriate amounts. In contrast, in its unnatural, processed form, such as from MSG, yeast extract, or hydrolyzed vegetable protein the glutamate is already free and the neurons are exposed to excessive amounts very quickly. When this occurs, the free glutamate acts as an excitotoxin, causing neurons to fire rapidly and repeatedly which can excite the neurons to death.
As previously mentioned, rates of autism began to increase in the 1980’s.[5,6] I suspect that changes in eating habits since the 1980’s, notably the reduction in home cooked meals with the corresponding increase in the consumption of prepackaged, microwaveable convenience foods; restaurant food; and delivery or take-out food have all increased the amount of neurotoxic processed free glutamate consumed in the typical diet on a daily basis.
The final neurotoxin to be discussed is aspartame. Aspartame breaks down into aspartic acid which is an excitotoxin with neurotoxic effects very similar to those of free glutamate and like free glutamate it can similarly excite neurons to death. Initially, aspartame was found mainly in diet soft drinks marketed toward adults (particularly women, which includes pregnant women). Aspartame’s use has since spread to products marketed directly toward very young children such as pudding cups, flavored yogurt and various deserts and candies. Furthermore, it is also added as a sweetener to many pediatric pharmaceutical products, such as children’s vitamins, the liquid suspension form of the antibiotic Augmentin, and children’s Tylenol. For a more complete list of children’s pharmaceutical products which contain aspartame please refer to this website.
Rates of autism began rising in the 1980’s. [5,6] Aspartame was approved for use in the United States in 1983.
Neurotoxin Interactive Effects
With respect to the development of autism spectrum disorders, I suspect there is an interactive effect between NAPQI (the toxic by-product of acetaminophen) and free glutamate and/or aspartic acid. Typically, NAPQI is quickly detoxified in the body by glutathione; however, this process leads to depletion of glutathione. This is significant because glutathione is the major free radical scavenger in the brain.[10,11] A detailed explanation of “free radical scavenger” is beyond the scope of this article, but in plain language, when neurotoxins such as free glutamate or aspartic acid (aspartame) wreak havoc on your child’s nervous system, these toxins cause a cascade of destructive events, and it is glutathione’s role to attempt to keep the resulting damage in check. This potential interactive effect between acetaminophen and free glutamate is supported by research. Recently, researchers from the University of California, San Diego, found that among children who experienced an adverse reaction to the MMR vaccine (a vaccine which contains neurotoxic free glutamate), the children whose adverse vaccine reactions were treated with acetaminophen (Tylenol) were eight times more likely to develop an autism spectrum disorder than the children who were treated with ibuprofen (Advil). 
For detailed information regarding MMR and other vaccine ingredients, please refer to the official Centers for Disease Control website. Pay particular attention to the following vaccine ingredients: monosodium glutamate and yeast extract. These are known sources of neurotoxic processed free glutamate. Additional ingredients listed as vaccine components which may also be sources of neurotoxic processed free glutamate include: amino acids, egg protein, mouse serum protein, yeast protein, gelatin, bovine protein, and Medium 199. Please note that the MMR vaccine, a vaccine routinely implicated in the autism epidemic, and the varicella vaccine (which is often administered along with the MMR) both contain neurotoxic processed free glutamate in the form of monosodium glutamate.
This recovery program attempts to interrupt the causal mechanisms of autism, preventing further neurological assault, and thus allowing your child’s nervous system to recover to the greatest extent possible. Because the dietary portion of this recovery program involves the avoidance of multiple food items and food additives, and will likely require a drastic change in your child’s diet, I suspect it will be easiest to proceed with the elimination process in steps. To reduce the neurological assault on your child’s already damaged nervous system, I believe it is essential to strictly follow step one. However, to achieve maximum benefit, I recommend steps two and three as well.
Recovery Program Step 1:This step attempts to eliminate most of the above discussed neurotoxins from your child’s diet starting with processed free glutamate. To accomplish this, refer to the Truth in Labeling website and do not feed your child anything that contains any of the ingredients listed in the first column of this website labeled “Names of ingredients that always contain processed free glutamic acid”. Check all labels carefully. Also, do not feed your child anything that contains “vital wheat gluten” (vital wheat gluten is a processed wheat protein used to manufacture monosodium glutamate.). In addition, avoid a commercial seasoning product called Bragg’s Liquid Aminos, which is frequently sold in health food stores.
Additionally, do not feed your child any ultra-pasturized dairy product. Ultra-pasteurization frees much of the naturally occurring bound glutamate in cow’s milk, converting it to free glutamate. Organic milk, which sounds like a healthy choice, unfortunately is often ultra-pasteurized to prolong its shelf life. Check the label carefully of any dairy product (organic or not), it should read “pasteurized” and not “ultra-pasteurized”. In addition, avoid reduced fat dairy products; opt instead for full fat versions. Full fat dairy products are favored over reduced fat versions because full fat dairy is a less processed product. Milk solids are often added to low fat dairy products which can contain processed free glutamate. Unfortunately, to ensure complete control over the ingredients in your child’s food, it will be necessary to avoid all restaurant and take-out food.
Also, eliminate cheese from your child’s diet, except for very mild cheeses such as mild cheddar, monterey jack, or mozzarella. This is recommended because cheese is one of the few natural foods high in free glutamate and sharp and/or aged cheeses tend to be highest in free glutamate and thus should be avoided.
Finally, as part of step one, do not feed your child anything that contains aspartame and avoid medications and children’s vitamins which are sweetened with aspartame. Also, do not give your child acetaminophen (Tylenol) or any medications containing acetaminophen. Check all labels carefully.
Recovery Program Step 2:You will hopefully notice improvement in your child within a few weeks of following step one, because step one eliminates acetaminophen, aspartame and the majority of the processed free glutamate from your child’s diet, freeing your child from continuous ongoing neurological assault, and thus allowing some natural recovery to take place. At this point, the goal is to further eliminate free glutamate from your child’s diet. To follow step two, go to the Truth in Labeling website and do not feed your child anything that contains any ingredient in the second column labeled ”Names of ingredients that often contain or produce processed free glutamic acid”. Also, at this point, it is probably best to eliminate all cheeses from your child’s diet as well, at least for a while because even mild cheeses are relatively high in free glutamate
Recovery Program Step 3:The final step involves eliminating all ingredients listed on either the Truth in Labeling or the Hidden Names for MSG website from your child’s diet. Fermented food was listed earlier under step two, so you hopefully have already eliminated obvious examples of fermented foods such as sour kraut. However, at this point less obvious foods, such as foods which contain vinegar (which is fermented) should also be avoided. Vinegar is found in many common food items such as ketchup, mustard, and mayonnaise. Fermentation is also employed in the leavening of bread so leavened bread should be avoided or limited at least for a while. This applies to any leavened bread product whether leavened rice or wheat bread.
Tomatoes and tomato products should also be consumed with caution and in moderation because over-ripe tomatoes are one of the few natural foods high in free glutamate. Walnuts are also naturally high in free glutamate and should be limited or avoided.
After all of this elimination, your child should now be consuming a diet of fresh natural whole foods including varied food items such as: fresh natural meats, low mercury seafoods, whole milk (which has not been ultra-pasteurized), eggs, rice, nuts, nut butters, and plenty of fruit and vegetables.
What about Wheat and Dairy?
You have likely heard that many parents of autistic children follow a strict wheat free and dairy free diet. Personally, I suspect this helps to a limited degree because it eliminates a portion of the processed free glutamate from the diet, but unfortunately does not eliminate enough of it for maximum benefit. Remember that ultra-pasteurized and reduced fat milk are sources of processed free glutamate and that cheeses are naturally high in free glutamate. Wheat bread often contains vital wheat gluten, so it is likely worse than rice bread which does not; however, all leavened bread is to be avoided under step three of the autism recovery program, at least for a while. Whole milk which has not been ultra-pasteurized is allowed on the autism recovery program, as are non-bread wheat products such as pasta. However, if your child seems sensitive to wheat, eliminating all wheat products is easily accomplished because rice, rice cakes, and rice pasta are good substitutes for wheat. If your child seems sensitive to whole milk which has not been ultra-pasteurized, this is more complicated. Your child’s need for dairy varies by age. Please consult with your child’s health care provider, if you plan on eliminating dairy entirely from your child’s diet.
Avoid Unneeded Pharmaceuticals
Use your best judgment here, but when it seems reasonable to do so, discuss with your child’s health care provider regarding the possibility of delaying or avoiding pharmaceuticals for your child. If your child suffers from frequent ear infections and is repeatedly prescribed antibiotics, please be aware that recent research suggests that repeated use of antibiotics appears to be of little benefit to children with recurrent ear infections.(13,14) The overuse of antibiotics is particularly concerning because antibiotics are to varying degrees neurotoxic (15,16) and while antibiotics are certainly lifesaving and essential at times, I believe they should be used with caution on recovering autistic children.
- MMWR Surveillance Summary "Prevalence of Autism Spectrum Disorders---Autism and Developmental Disabilities Monitoring Network, United States, 2006."
- Newschaffer CJ, Falb MD, Gurney JG. National autism prevalence trends from United States special education data. Pediatrics. 2005 Mar;115(3):e277-82.
- Yeargin-Allsopp M, Rice C, Karapurkar T, Doernberg N, Boyle C, Murphy C. Prevalence of autism in a US metropolitan area. JAMA. 2003 Jan 1;289(1):49-55.
- Posadas I, Santos P, Blanco A, Munoz-Fernandez M, Cena V. Acetaminophen induces apoptosis in rat cortical neurons. PLoS ONE. 2010 5(12).
- Previc FH. Prenatal influences on brain dopamine and their relevance to the rising incidence of autism. Med Hypotheses. 2007:68(1):46-60.
- Good P. Did acetaminophen provoke the autism epidemic? Altern Med Rev. 2009 Dec;14(4):364-72.
- Orlowski JP, Hanhan UA, Fiallos MR. Is aspirin a cause of Reye’s syndrome? A case against. Drug Saf. 2002;25(4):225-31.
- Blaylock RL. Excitotoxins the taste that kills. Albuquerque,NM: Health Press; 1997.
- Olney JW. Brain lesions, obesity, and other disturbances in mice treated with monosodium glutamate. Science. 1969 May:164(880):719-21.
- Gawryluk JW, Wang JF, Andreazza AC, Shao L, Young LT. Decreased levels of glutathione, the major brain antioxidant, in post-mortem prefrontal cortex from patients with psychiatric disorders. Int J Neuropsychopharmacol. 2011 Feb;14(1):123-30. Epub 2010 Jul 16.
- Chiba M, Pang KS. Glutathione depletion kinetics with acetaminophen. A simulation study. Drug Metab Dispos. 1995 Jun;23(6):622-30.
- Schultz ST, Klonoff-Cohen HS, Wingard DL, Akshoomoff NA, Macera CA, Ji, M. Acetaminophen (paracetamol) use, measles-mumps-rubella vaccination, and autistic disorder: the results of a parent survey. Autism. 2008 May;12(3). 293-307
- Johnson NC, Holger JS. Pediatric acute otitis meida: the case for delayed antibiotic treatment. J Emerg Med. 2007 Apr;32(3):279-84. Epub 2007 Feb 23
- Damoiseaux RA. Antibiotic treatment for acute otitis meidia: time to think again. CMAJ. 2005 Mar 1;172(5):657-8
- Snavely SR, Hodges GR. The neurotoxicity of antibacterial agents. Ann Intern Med.1984 Jul; 101(1): 92-104.
- Grondahl TO, Langmoen IA. Epileptogenic effect of antibiotic drugs. J Neurosurg.1993 Jun;78(6):938-43.