A Pilot Study with Homoeopathic Secretin

Homoeopathy and autism

Homoeopathic remedies have been prescribed widely in autism with variable success. Remedies which may have been well considered, sometimes appear to yield less favourable responses than anticipated and the issue behind the ever present leaky gut seems to have some connection to the problem. Essentially the whole intestinal tract is technically outside the body and problems affecting digestion and in particular what is allowed to travel through the gut wall, have a huge impact on our person. The ‘Opioid effect’, caused by inappropriate absorption of large chain polypeptides, is well documented as being a problematic symptom of autism and ASD. Clearly if a gut dysfunction exists some resolution of its cause must occur to enable a change in the symptom picture.

Homoeopathic Secretin

Secretin, in the context of this article, is described in its homoeopathic form and is not viewed as a cure but rather as an aid to facilitate other individual homoeopathic remedies and other approaches to succeed. However there does appear to be a strong relationship between secretin and leaky gut, and administering homoeopathic secretin has some surprisingly beneficial effects on the attentiveness of autistic and ASD children. It is important to stress there is no magic bullet here, rather one of many steps one can take to build upon a child’s capacity to improve. In this context homoeopathic secretin would certainly appear to be worthy of consideration.

 

What is Secretin?

Secretin is a gastrointestinal peptide hormone, present within the so called S cells of the mucosa of the upper small intestine (duodenum and jejunum) in an inactive form, prosecretin. First extracted by Jorpes & Mutt (1961) and sequenced by Mutt, Bodansky (Karolinska Institute), Secretin was found to be a polypeptide containing 27 amino acids. Secretin is produced commercially in the form of an injection for the purpose of pancreatic function tests; the Ferring brand is the purest form of porcine secretin with 3000 clinical units/mg peptide.

 

Action of Secretin

During digestion a bolus of food (chyme) is emptied from the stomach into the small intestine where it is broken down into suitable components by enzymes before absorption across the gut lumen. The stomach and its contents are extremely acidic (pH1), equivalent to battery acid and the acidity of this bolus must be neutralized by alkaline bicarbonate secretion from the pancreas before digestion can proceed and also to protect the lining of the small intestine. Secretin is released and activated, in response to the hydrochloric acid component of chyme with a pH value of 4.5 to 5.0 entering the duodenum from the stomach, and increases the volume and bicarbonate content of secreted pancreatic juices. However it is also important to note that blood serotonin levels change after administration of secretin, indicating that it has a more profound effect than the local action described above. Serotonin is the ‘awakening’ neurotransmitter which could account for some actions described below.

 

How did Secretin become associated with ASD?

In April 1996 Gary and Victoria Beck, having exhausted every other approach, took their autistic son Parker for an endoscopy and a pancreatic function test in which he was administered a secretin challenge test. The results of the endoscopy and biopsies were rather unremarkable, however, within days of the procedure Parker’s bowel movements became very normal, not merely formed but dark brown and not pungent. In addition his eye contact improved dramatically and he was calmer. He began to sleep at night without a problem and his facial tics disappeared. Two and a half weeks later he began to speak for the first time in over two years. By the third week he was saying short three word phrases. He began dancing and singing to his favourite videos and was potty trained within weeks, his bowel movements having remained normal despite no change in diet throughout. A summary of his changes over a three week period appear in Table 1

 

Parker BeckBefore Secretin	Parker Beck3wks After Secretin
2 words	100’s of words
no sentences	short sentences
no flash cards	40-50 flash cards
no focus on tasks	concentrates
diapers only	completely potty trained
sleep disturbance	sleeps well
spinning episodes	no spinning
abnormal bowel movements	normal bowel movements
No apparent connection made betweenlanguage and objects	Many connections made between new language learned and objects
No response to requests for gestures	Responds spontaneously to gestures
No interest in drawing	Desires to draw constantly
No imitation	Imitates any mutli-step command
Minimal eye contact	Eye contact 75% of time

 

The origin of homoeopathic secretin

In 1999 I was contacted by a charity for Autism who were concerned about the safety and cost of secretin being administered to children in the UK following the interest raised by the serendipitous discovery of Victoria Beck. The tidal wave of interest had opened a market for an extraordinarily expensive six weekly routine of intravenous injections of a product designed for one-off pancreatic function tests. Consequently there were reported incidents of side effects mixed in with remarkable responses. The question posed was whether a homoeopathic version of secretin could achieve the same goal more safely and economically? In answer to this Ainsworths homoeopathic pharmacy produced a homoeopathic remedy from porcine secretin and made it available to a number of parents referred by the charity. The results were quite remarkable and initiated the need for further investigation.

Homoeopathic Secretin pilot study

The reason for conducting this study was to establish answers to questions such as;

Does it have an action and if so to what extent? Does it have the same action in homoeopathic form as material dose? Can any light be thrown on why homoeopathy has been less successful than anticipated? Only limited inaccurate information about secretin in autism appeared to be available, with rare exceptions and published studies that had been conducted were so small in scale that they yielded deceptive results. For example it is obvious that only ASD cases with a known leaky gut could benefit from secretin and yet this was not a necessary criteria for entry into the published trials. With a sample size of only six patients the chance of demonstrating any benefit seemed impossible under the circumstances. It was hoped that, if successful the pilot study would garner evidence for prospective trials and perhaps extend to an exploration of the concurrent use of secretin alongside individual homoeopathic treatment.

 

Secretin Pilot study

Secretin porcine, prepared in combination of homoeopathic potencies 3,6,9,12cH was supplied on request to parents of autistic spectrum, Aspergers, ADD, hyperactive children and adults, with a free choice of pills or liquid potency and an advised initial dose of 2-3 drops or two pills twice daily for a minimum of six weeks. A questionnaire and Rating scale similar to the Secretin Outcomes Study used by Dr Bernard Rimland of the Autism Research Institute was used to assess changes (Table 2)

 

Behaviour evaluated
Eye contactSocial skills play, greeting, imitation Attention (easier to teach) Mood (less crying, tantrums) Hyperactivity Anxiety,compulsions Self-stimulating Comprehension Verbal communication Non-verbal communication Sound sensitivity Digestion (diarrhoea or constipation)
Rating scale0 – no change 1 – possible change 2 – moderate change 3 – significant change 4 – great change -1 – worse than before

 

Results

Over 3000 children received homoeopathic secretin sufficient for the period of the pilot study and each parent received a questionnaire to complete and return. Oral reports were received from 6 weeks to 18 months during which homoeopathic secretin was in continual use. Written reports were received from a number of patients and 159 completed questionnaires were returned, forming the basis of the graph below. This number was less than expected but nonetheless representative of the responses obtained by continued contact with the patient group.

The results demonstrate an incremental benefit from possible to moderate change observed in 12 key symptoms of ASD over the seven weeks of recording. There is a clear variation in benefit over the symptom range and direct communication faculties improve more significantly than behavior patterns. Eye contact and vocalization being the most profound and immediate changes observed. Continued use beyond the study period maintained the upward trend demonstrated in the first seven weeks. The individual variation in response between patients was also quite large with some children fairing well above average and others below average, hence the results understate the actual picture that can occur, whilst it must be appreciated that secretin will not help all cases. The negative value for a worsening of symptoms was unwise in retrospect as this is generally indicative of a positive outcome with homoeopathic treatment and in experience undervalued the outcome of the symptom when further examined.

 

Conclusion

The modest aim of this pilot study was met insofar that a large sample size, far greater than in any trial to date, reported incremental beneficial improvement to their ASD symptoms over a seven week period with many concurrent reports of a profound change in the child as a whole person. Many children were able to reduce stringent diets or stop taking Ritalin and Risperidone as a consequence of taking secretin. At least one report has been received of a child taking homoeopathic secretin for over seven years

As to why homoeopathy has been less successful than anticipated, the results indicate a clear reason. Each meal that a child consumes acts as a maintaining cause for their symptoms and as such a block to individually chosen treatment. By taking a regular dose of homoeopathic secretin the maintaining cause is offset enabling other remedies to act more significantly. In addition it became apparent that increasing size of dose increases effect (2-6 drops) and this was necessary over longer term use of the remedy. Homoeopathic secretin was also found to potentiate the action of the injected secretin, in particular increasing its longevity from six to nine weeks.

The outcome of this study has been discussed with many homoeopathic practitioners who have as a consequence changed their management of ASD cases. It has also promoted a further clinical pilot study of the use of homoeopathic secretin in autistic adolescents.

 

References

Beck G, Beck V, Rimland B, Unlocking the Potential of Secretin, NAS Information Centre Sept 1998

Autism File Issue 2 Winter 2000 p26

Robinson T W, Homoeopathic Secretin in Autism – a clinical pilot study Brit. Hom Journal vol 90. No 2 April 2001

 

Some Further Comments On Secretin, The Bowel And Autism And Current Practices.

Tony Pinkus

 

I see the approach to AS, not as a single remedy or treatment but as a flight of steps to a cure of which secretin is perhaps the crucial first step. Why? because the thing that is most important is that in these kids, each meal becomes a maintaining cause and you cannot stop them eating to remove this as you would with any other maintaining cause. This being the case you have to find another way to neutralise its effect and remove the shadow of ‘false’ symptoms that arise from what appear to be dietary indiscretions or food intolerance. Many of these so called ‘leaky gut cases’ are due to eating foods which disagree and to which they are allergic or intolerant. The plight of parents bringing up such a child is to do their best to remove harmful foods and this invariably leads to draconian measures in which the AS child is placed on highly restrictive diets whilst craving those foods. The child may be controlled at home then uncontrolled at school. The problem is magnified if he has non AS siblings who are on normal diets.

In essence the isolation of the already isolated patient is magnified here. The child lives in a world of his own due to the opioid effect described in the article. He cannot be reached there, and what secretin appears to do is offer a hand out into normality. Other remedies then follow to further normalise him by pulling him from the abyss, step by step. Interestingly the nosodes are chief amongst these and we have to ask why? Jean Lacombe’s article also questions why apparently rare remedies like Carcinosin, Tuberculinum and Medorrhinum are chief amongst those that surface in repertorizing these cases.

The gut is now being recognised more for what it is:

1) a means of subtle communication between the microscosm and the macrocosm; our inside and outside worlds. This is part of the reason we manifest in physicality and a reason for being. Lessons clearly have to be learnt here and the AS kid certainly has some tough lessons to learn.

2) a means of gaining nutrition for the body

3) a means of creating and maintaining the immune system; 80% of immune function is centered around the gut, so it’s no surprise that we are now entering a period when the ignorant overuse of antibiotics, which destroy the essential bowel flora, is finally being considered. The subtle interaction of these colonies of billions of commensal organisms that inhabit our gut, with us, is a rare phenomenon only now being appreciated. In essence they control the potency of the lumen among other immune functions, and stabilise our state of health. The age old saying ‘you are what you eat’ is apt.

If you look at Wakefields work here it fits in nicely. The measles jab introduces aberrant colonies of the measles virus in the gut that disrupt normal function and it is this that causes the ensuing chaos. I used to work with many respected and highly esoteric practitioners who have long since died. Amongst the relevant ones here were the Psionic practitioners (who routinely gave Malandrinum as a remedy to correct this) and Bowel nosode practitioners who unraveled the chaos. These esoteric homeopathic arts are crucial to an understanding of the above but are themselves in danger of extinction.

We are living at a time where rigid mind forces determine that we should live inside a tight mental box, to control the status quo from changing and enforce evidence based medicine as a means to offsetting change. Change is inevitable and these attitudes can only delay it for a spell of time. From a cynical perspective (and I speak as a pharmacist now), curing people is bad for business and the adage ‘follow the money’ is useful when explaining why homoeopathy continues to be under such vitriolic attack. Offering to supply cheap and effective, side-effect free, non-patentable medicines that can cure in a few doses is not going to be popular in an environment of shareholders who depend on dividends from the very opposite!