A Pilot Study with Homoeopathic Secretin

Dr. Tony Pinkus, Joint Managing Director of Ainsworths Homeopathic Pharmacy discusses research he conducted on the use of homeopathic Secretin for children afflicted with autism and ASD.

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.

 

secretin-hormone-moleculeWhat 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 words100’s of words
no sentencesshort sentences
no flash cards40-50 flash cards
no focus on tasksconcentrates
diapers onlycompletely potty trained
sleep disturbancesleeps well
spinning episodesno spinning
abnormal bowel movementsnormal bowel movements
No apparent connection made betweenlanguage and objectsMany connections made between new language learned and objects
No response to requests for gesturesResponds spontaneously to gestures
No interest in drawingDesires to draw constantly
No imitationImitates any mutli-step command
Minimal eye contactEye 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.

secretin-study

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!

About the author

Tony Pinkus

Tony Pinkus

Tony Pinkus qualified as a pharmacist in 1980 and accepted the offer to take over Ainsworths Homeopathic Pharmacy when John Ainsworth retired in 1989. Having learnt from John Ainsworth, Tony went on to teach homoeopathic practitioners including doctors, vets, and dentists at both the Faculty of Homoeopathy and The College of Homoeopathic Education amongst others both in the UK and overseas. Tony has co-written five books on the homoeopathic treatment of animals with homoeopathic vet Mark Elliott and herdsman Philip Handsford. He also wrote self-help books for the kits and a self-help, interactive computer program for the OTC range. Tony is the grantee of two Royal Warrants of Appointment to HM The Queen and HRH The Prince of Wales and previously HM The Queen Mother. In this position he is consulted on matters concerning homoeopathic remedies by The Royal Family. Tony also developed a new potentizer to making ultra-high potencies in a standardized and practical way. The Pinkus Potentizer utilizes a combination of Korsakovian and Fluxion methods and makes up to CM potencies.

5 Comments

    • Thank you Martin. I acknowledge the use of Secretin in AS is not a standard homoeopathic approach, which to all intents and purposes has failed because, paradoxically, each meal ingested provides the source of the maintaining cause. Also that Secretin effect has been overlooked since, unfortunately, most trials using material doses of Secretin for Autism have failed because they used such small sample sizes of patients (ie 6) that the chance of enlisting kids with gut-related issues that were amenable to treatment with Secretin were ignored.

      The most significant thing for me is that parents of AS kids are looking for a magic bullet that doesn’t exist and they move like a tidal wave in response, alighting on the latest discovery that offers a glimmer of hope. The real answer is more like a flight of stairs to climb slowly. Secretin offers the first step and unlocks the door of the maintaining cause issue thereby enabling a classical homoeopathic approach to follow through afterward.

  • Thank you so much for this fascinating study, and with such large numbers. Have you tried to publish it anywhere so it can counteract the other (published) secretin study by Robinson?
    And can you expand on how ‘increasing the size of the dose’ was managed over the longer term please. We are about to start a trial of individualised homeopathy for ADHD and I would like to be able to discuss using secretin with my trial homeopaths.

    • Sadly I neglected to publish it elsewhere, other than a report in Autism File, which is a monthly journal directed to parents of AS children. The study was conducted back in 1998 and I have appraised many homeopaths of its conclusions over the years, including many CEASE practitioners who I trust use it wisely.

      As regards the numbers, I was fortunate to be in a situation where the fact that we made it up as a remedy and the AS movement heard about it, created a tidal wave of interest and we received over 3000 requests for supply. Although we sent out VAS forms to all only a small percentage actually returned them, but many others provided astonishing anecdotal and verbal reports off form. Some of these were quite heart-rending, such as the almost mute kid who went up to hug his parents and told them he loved them for the first time. Another was a dyspractic child with an IQ of 135 who had previously required a scribe to write for him. After one dose of secretin he sat down and wrote two A4 pages on the history of the Romans! And many more.

      One mistake I made with the trial was to include a negative number for an aggravation. This hampered the recording of what were positive outcomes and invariably the gut centred reactions following administration of the remedy.

      Tim Robinson is a great friend of mine and was motivated to conduct his trial after the reading the results of my pilot study. Unfortunately he was constrained with his age and sample size and ended up with a small group of older children who were less likely to respond. He recognized this and with great humility made this known when he presented his paper to the community at the British Homoeopathic Conference.

      The crucial thing is to ensure that the children enlisted in the trial have a gut problem; either perpetual loose stools or constipation, otherwise you create a glass ceiling and invalidate your own efforts. Rather like how Ernst and his team excluded kids who had a previous asthmatic attack withing twelve months of enlisting on his asthma trial!

      As regards increasing the dose size this came as a result of consistent feedback from patients. They reported a consistent improvement up until a variable period of 2 to 6 weeks after administration of the secretin, whereup it appeared to wane or plateau out. I suggested they increase the physical dose size from 2 to 6 pills and this appeared to kick start the response.

      I cannot stress the point I made previously sufficiently:
      Secretin is not a cure for AS, it should be considered the first step on the rung of many steps to treat the patient, but in resolving gut-centred AS it is perhaps a critical and fundamental step. Parents of AS kids wonder around like a guilty cloud, alighting on any ray of hope that might cure their child. Unfortunately, in so doing they fall prey to every new cranky idea that hits the news before they move as a sea towards the next, its painful to watch. They need to understand and have patience with this approach and realize it leads on to a greater improvement with conventional homoeopathic treatment. Many of the cases raised by others in this journal would follow on extremely well and perhaps be facilitated by concomitant secretin therapy. Because of the neglected gut excoriation, from continual acid boluses not being neutralized, the gut lumen has suffered greatly in these patients and their repsonse to the outside world has been to hide in their own inner world. The metaphor for the lumen being a replication of ones repsonse to the outside and inside world should not be lost here. Transport accross the lumen is facilitated and the world view changes as a result. The consequence is that higher than regular dosage regimens of subsequent remedies that fir the patient’s case need to be given in order to achieve a successful outcome.

  • hi Dr. Pinkus
    I want to know how can i buy secretin, we are seeing a USA Dr., but the secretin she carry has corn, and my son is sensitive to corn and alcohol, but we use alcohol products and gas them off, the problem is corn, she prescribe an homeopathic secretin and i looking up for one my son can use.
    Can you be so kind in helping me in this issue

    thanks !!
    warm regards

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