This is a Case Study of a 13 y/o boy who was raised on a wheat free diet (WFD) since age 4. As an infant, he experienced monthly ear infections and was placed on prophylactic antibiotic therapy. His pre-school years were mired with monthly strep throat infections. Occasionally, he had concurrent small red blotches, indicative of rheumatic fever, on his torso. A tonsillectomy was recommended by his pediatrician.
He began a WFD at age 4, the strep throat infections ceased …. unless he ingested wheat without antihistamine prophylaxis. Occasionally, he ate a piece of wheat pizza at school without a immediate anti-histamine. Subsequent strep throat infections would ensue resulting in swollen cervical lymph nodes, a flushed face, swollen, red and pussy tonsils, but no fever. All infections presented similarly, however not all tested positive for strep. This condition was treated with antibiotics and resolved in a few days. (Please see the www.wheatfreediseasefree.com post on “Keep the Tonsils, Pull the Strep Throat”).
As a pre-schooler, the boy had wound healing difficulties. During his middle school years, he experienced anxiety, fatigue, a lack of physical maturation, restless legs, painful joints, middle belly weight, athlete’s foot, and a slightly curved back.
At age 13, he ate two pieces of wheat pizza without antihistamine prophylaxis. In the days following, his face flushed intensely, cervical lymph nodes swelled, but no fever was present. His back was painful at the level of his adrenals. He experienced extreme fatigue, his eyes were sensitive to light, and he had a tremor. The tremor traveled down his spine and caused his fingers to vibrate. He was started on his standard Azithromycin antibiotic therapy. However, the condition did not resolve.
Within a couple days he “crashed“. He had sufficient energy to be active for a couple of hours in the morning and then he lived on the couch for the remainder of the day. He headed for bed shortly after dinner. Any form of stress intensified the tremor including homework or attending school. He was started on a second antibiotic.
Differentials considered included infection, PANDAS, serotonin syndrome, and depression. Medical personnel questioned whether he was avoiding school. Blood panels were negative. EEG was negative. He was prescribed Zoloft to control the tremor. This drug made him sick and was discontinued.
One month later, a naturopathic physician identified the boy’s flushed face as being caused by adrenal problems. Through intracellular saliva testing, he was found to be adrenal insufficient. The flashlight adrenal insufficiency test was positive. To support his adrenals he began began a supplemental therapy of vitamin C (1000mg/day), B complex (200mg/day), adrenal cortical extract, minerals, vitamin A, CoQ10, vitamin E, spirulina, quercetin, a probiotic, 1g/day of omega-3 fish oil (DHA+EPA) and 1000mg/day of calcium citrate. His energy levels gradually improved but the tremor continued.
Sugar, high fructose corn syrup, caffeinated drinks, and deep fried, greasy foods harmful to his adrenals were removed from his diet. The high levels of fruit juice previously consumed were replaced with low, no sugar, or sugar substitute juices.
It was determined that wheat contains methionine, lysine and threonine. Methionine controls the hypophyseal-pituitary-adrenal (HPA) axis and is involved with cardiac rhythm. Lysine is found in collagen thus supports wound heading and dental pulp formation. Threonine supports tooth enamel formation. Hypothesizing that the patient was deficient in these amino acids due to his WFD, he was started on 1500mg/day of methionine and 1000mg/day of lysine. The boy craved red meat and eggs. His diet was modified to include methionine containing foods such as brown rice, oranges, additional red meat, eggs, nuts, spinach, onions, peas, yogurt, and popcorn. Within a week, the boy had regained sufficient energy to work on small hobbies.
Within a month, he began to experience some quick, sharp chest pain. Methionine is stored in the heart. The methionine dosage was reduced to 1,000mg/day. Although he had more energy and felt better, the facial flushing, swollen lymph glands, fatigue, back adrenal pain, and tremor continued.
A urine amino acid profile showed the boy’s methionine level (with supplementation) in low normal range. Also in low normal range were phosphoserine, taurine, phosphoethanolamine, aspartic acid, hydroxyproline, serine, asparagine, alanine, tryptophan, carnosine, and anserine. Some success has been found with taurine in relieving tremor. He was given a trial of 1000mg/day of taurine. His energy levels increased, however evening doses made it difficult to sleep and there was no improvement in the tremor.
Repeat urine and blood amino acid profiles showed phosphoserine as the only amino acid below normal range. The patient was supplemented with 1,000mg/day of serine. One week post therapy, he developed a skin rash on his arms and legs. Serine therapy was discontinued then reduced to 500mg/twice each week. The tremor persisted.
Next, the physiological function of each of these amino acids was addressed in relation to the patient’s signs/symptoms. Proline was found to be a critical component of cartilage and important to joint structure. Proline works with vitamin C in this capacity and can be synthesized by glutamic acid. Arginine was important in wound healing, the production and release of growth hormone, insulin, and glucagon release, collagen synthesis, and GABA production. Arginine can be produced from glutamic acid or proline. Glycine was critical to GABA neurotransmitter and energy production. GABA was important to inhibitory nerve function. Tyrosine was important to the production of neurotransmitters dopamine, norepinephrine, epinephrine, and melanin. This patient’s grandfather had Parkinson’s Disease which involves low neurotransmitter levels in the Tyrosine – Dopamine Pathway.
Hypothesizing that the boy’s current amino acid levels may not be sufficient for the age dependent physical growth, adrenal stress due to methionine deficiency, and adrenal stress due to the wheat hypersensitivity reaction, this patient was additionally supplemented with 1500mg/day glutamine, 1500mg/day glycine, and 1000 mg/day tyrosine. After one week of therapy, the tremor was alleviated and would resume only under stressful conditions.
After several months, the individual dosages of amino acids were replaced with a 750mg amino acid complex capsule, three times each day. The patient continued to improve. This complex differed from ingesting protein rich foods in that all 20 amino acids were given concurrently through the complex. All 20 amino acids must be present concurrently for protein synthesis to occur. Supplementation of the 20 amino acid complex relieved the tremor whereas his protein rich diet did not.
The patient returned to school six months post amino acid therapy initiation with improved physical activity levels, reduced anxiety, and alleviation of restless legs. The daily tremor was absent except under stressful conditions. His night time activities were kept to a minimum to ensure sufficient rest.
In subsequent years, he remained on 1500 mg/day amino acid complex, 1 gram of DHA+EPA omega-3 fish oil, B complex 100mg/day, vitamin C 1000mg/day, bovine adrenal cortex 340 mg/day, calcium 1000mg/day, lysine 500mg/day, choline 500mg/day, 5-HTP 100mg/day, probiotic, and minerals. It appeared that minimal amounts of these supplements are required to maintain good health.
Six years post presentation, this patient continues with occasional stress and fatigue. This is typically visible as facial flushing on the outer periphery of his cheeks. The tremor has been alleviated under normal and stress conditions. This patient continues on a WFD and ingests no wheat. He ingests minimal sugar and deep fried foods, and no caffeine. Accidental wheat ingestion receives immediate antihistamine and aspirin prophylaxis. The patient is careful to obtain sufficient rest, take supplements, and eat healthy food. His back continues to be hunched causing him back, neck, and knee pain, but is otherwise most healthy.
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Photograph: 8 week old dobie pup
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