Dramatic improvements in children with autism when they have a fever suggest that the disorder may be reversible if one can replicate the phenomenon in other ways.
Autism currently affects about 1 in 68 kids in the United States, yet we don’t even have drugs to treat the core symptoms, never mind the underlying disorder itself. We can treat some symptoms, just not the “core symptoms” of the disorder. If you’re aggressive, we can give you antipsychotic drugs, and you can get stimulants like Ritalin for attention-deficit/hyperactivity disorder, or we can knock you out to help you sleep. But, although “social and communication impairments are the main signs and symptoms of ASD,” autism, we have little to offer, and the disorder appears to be on the rise. What can we do about it?
Decades ago, a clue was published that offered a ray of hope: When children with autism get a fever, “they invariably display dramatically more normal behavioural patterns, including a greater desire or ability to communicate.” They can become less withdrawn, more alert, more talkative, and more communicative. All hospital staff members working with children with autism “during an epidemic of viral upper respiratory infection” noted the marked behavioral improvements, but as soon as the fever stopped, the children went back to their baseline. If we could figure out what’s going on, could we develop some sort of treatment? First, though, let’s take a step back and realize what this could mean.
What makes this idea so groundbreaking—so earth-shattering—is that it challenges the whole presumption that autism is some kind of static, irreversible brain disorder, where the brain is inexorably damaged in some way with no hope of recovery. But the fever glimpses suggest it may be more of a dynamic brain disorder, where the normal healthy circuits are in there somewhere but are actively being suppressed, and the fever somehow lifts that suppression and relieves the active disorder process. In this way, it suggests that if we could figure out what’s going on, we could theoretically relieve it for not just days, but for forever.
This must be what’s on every autism researcher’s mind, right? Unbelievably, “there is practically no mention of the high fever/improved behavior phenomenon in the entire autism literature,” even though nearly everyone who is knowledgeable about the disorder—parents and professionals alike who deal with autism day to day—evidently knows about it. In fact, the first (and only) Nobel Prize for Medicine ever given to a psychiatrist for brain ailments went to the “father of fever therapy,” Julius Wagner-Jauregg, who injected malaria into people. Some got better—if they didn’t die first from the malaria, that is. What is it about fever that can improve brain function? And, can we figure that out without killing people?
First, let’s confirm the phenomenon is real. “The rapid behavioral changes reported during fever” in autism suggest that those neural networks in autism may still be intact, just dysfunctional, “and understanding the reasons for improvement during fever might provide insight” into what’s going on. The “fever effect” in autism had been based on case reports and anecdotes until researchers “undertook a formal study” of the reported phenomenon, “given the…potential implications for treatment opportunities.” And, indeed: children with autism got better when they got a fever, officially documenting the phenomenon as real.
Now that we have confirmation, let’s figure it out. Full steam ahead! But, who cares how it works? Well, you can’t give people malaria like Dr. Wagner-Jauregg did, but why not just take them to a sauna or hot tub? Because it doesn’t actually increase your body temp. When you sit in a sauna or hot tub, your skin gets hotter, but your brain pretty much stays the same temperature. Why? The brain has special cooling mechanisms so it stays about the same temperature inside no matter what temperature it is outside, which is a good thing. This is the reason we can bite into a snow cone without literally getting brain freeze. When you get a fever, though, your internal thermostat gets turned up to fight infection, and there is actually an increase in brain tissue temperature.
Your brain has to be careful not to cook itself to death, so it releases “heat shock proteins.” As your brain turns up the heat to give you a fever, it releases heat shock proteins “in the prevention and repair of protein damage.” At higher temperatures, proteins can start unraveling, which is known as protein denaturing. That’s what happens when you cook egg whites—the proteins denature—but that’s not what you want happening in your head. What does this have to do with autism?
One of the causes of autism may be the dysregulation of synaptic function, meaning a dysregulation of the nerve-to-nerve signaling pathways in the brain may play “a key role” in the cause of autism spectrum disorders. Well, guess what those heat shock proteins do: They protect and sustain synaptic function. Given that, the next question is whether there is any way to activate the heat shock response without having to get a high fever infection. As you can imagine, there “is now strong interest in discovering and developing pharmacological agents capable of inducing the heat shock response” among drug companies—but broccoli beat them to it.
As I discuss in my video Fever Benefits for Autism in a Food, sulforaphane, the active ingredient in cruciferous vegetables such as broccoli, kale, and collard greens, activates the heat shock response. (No malaria necessary!) So, in theory, giving sulforaphane in the form of broccoli or broccoli sprouts to those with autism might reap the same kind of fever-related benefits in function.
At this point, you might be expecting me to make a crack about Big Broccoli and how such a study would never get funded, and I wouldn’t blame you…but now there are family and nonprofit foundations that just want to see people with autism get better, whether or not corporate stock prices get better too. We find out what happened in my video, Fighting Autism Brain Inflammation with Food when broccoli is actually put to the test.
I also discuss autism in:
Michael Greger, M.D.
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