The tool of “Metabolomics” looks to revolutionize how we view children’s chronic diseases. The basic lab markers of yesterday revealed shadows of underlying dysfunction. Metabolomics works to shine clearer light deeper into the actual mechanisms of our next generation’s growing chronic illness epidemic. Today’s article of interest shares insights into how this developing tool has begun to change the care of pediatric heart diseases, kidney disease, cancers, newborn conditions, and neuropsychiatric disorders like autism spectrum disorder and PANS/PANDAS. The final field of neuropsychiatric disorders will serve as primary discussion field.
Metabolomics may be a new term in your medical vocabulary which combines “metabol” which you suspect is connected to metabolism and “omics” which you may have heard connected with other beginning like “Gen-omics” or “transcript-omics”. You are on the right track, but let’s take it a step further. True, “metabol” comes from the same root that gives us metabolism. When combined with “omics”, we are looking at the “wholeness” of metabolism, all the interconnected operating reactions of our cells and systems. In terms of childhood neuropsychiatric disorders, this means we look at all the metabolic markers of a child’s cellular and organ systems to determine what contributors or factors are influencing the symptoms and conditions we witness on the surface.
One may ask why this is a new concept. Should not we have been doing this all along? In a sense yes, but in another sense it would be like asking an 1870s New Englander to fly to California instead of taking the transcontinental railroad. Neither planes nor metabolomics has been possible forever. Now that we have more tools of measurement to assess cellular metabolism of our own cells and also those of our microbiome, we can take into consideration a far greater number of connected metabolic markers. Seeing metabolomics more as a collection of tools which allow us to examine all the steps in dozens of directions simultaneously may helps us see the newness and the potential benefits in conditions like autism and PANS/PANDAS.
Turning our attention to these debilitating disorders, how can metabolomics impact their treatment? First, both Autism and PANS/PANDAS present as a complex array of both symptoms and recognized causes. Each child with either condition enter our clinic exam rooms as unique cases to whom we must apply certain time-tested principles in order to help them recover. Metabolomics greatly assists us in the principles of personalization and root cause discovery. By looking across the interconnected contributors- genetics, environment, infections, nutrients, immune system, and mitochondrial functions-, we can personalize our therapeutic response to the specific root causes in that single patient rather than solely the shotgun approach of one size fits all medicine.
The article emphasizes the discovery of particular metabolites (single chemicals which serve as a step in the metabolic pathway) associated with autism development which include: “amino acid metabolism, cholesterol metabolism, folate abnormalities, antioxidant status, nicotinic acid metabolism, and mitochondrial metabolism.” It also mentions the potential role of metabolites derived from our gut microbiome which further impact on “behavior, metabolic patterns and immune response, tryptophan, vitamin B6, purine metabolic pathways, phenylalanine and tyrosine biosynthesis, intermediary compounds of the TCA cycle (1-4)”
The primary article summarizes various research findings concerning metabolomic studies. The bacteria Clostridia appears to play a role in autism behavior (109-110) and potentially several other bacteria (108). A few differences in the prevalence of autism in boys versus girls was linked to some metabolomic markers (112). Further research into the effects of various medications like Tylenol on autism development was urged (108).
For Pediatric Acute-onset Neuropsychiatric Disorder (PANS), two brief lines of metataboloimc evidence was summarized. First, a case study of a 10 year old with PANS was discussed in terms of the effects of an antibiotic on gut microbiome and metabolomic markers of “protein biosynthesis, energy metabolisms, aminoacids involved in brain functions and microbial products also related gut colonization” (114)
Contrary to the proclamations of the contemporary voices to the contrary, science is never truly and ultimately settled. Yes, there exists a final truth in science, but we have not reached it in any area, especially pediatric neuropsychiatric disorders like autism or PANS and PANDAS. Science is grasping at the frontiers, working to shine light upon more treasures of knowledge and understanding, yet in many areas only peering at the simplicities. Functional medicine strives to operate at these edges of exploration while holding to those truths previously discovered in past explorations. Metabolomics stands before us as one of those recently discovered deeper complexity tools offering more hopes of caring for the broken lives of children and their parents knocking at our doors.
At Sanctuary we already use metabolomics in our organic acids testing (from several different companies tailored for the patient’s needs). These tests often help us discovered vitamin deficiencies, nutrient imbalances, toxicities, energy cycle dysfunctions, yeast overgrowth, and more which lead to effect targeted therapies and healthier more abundant lives for our patients.
Primary Aritlce:
Bardanzellu, Flaminia, and Vassilios Fanos. “How could metabolomics change pediatric health?.” Italian journal of pediatrics vol. 46,1 37. 27 Mar. 2020, doi:10.1186/s13052-020-0807-7
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See also: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7099833/
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.
