Pages

1/22/2008

Your Diet and Tourette Syndrome

Many of us have been wondering what could possibly be the correct diet regimen for people who have Tourette Syndrome. For people who are very meticulous with what they eat, they also sometimes wonder whether certain ingredients affect the production of tics in individuals with Tourette Syndrome. Unfortunately, this is where all the complications come in.

It is universally accepted that if we eat healthy then good health will follow.
Same concept lies in consuming foods containing too much fat which can lead to high levels of cholesterol in the body which can eventually lead to heart disease. But then again the question still remains whether there are some foods that lead to the symptoms present in an individual with Tourette Syndrome.

One needs to understand that the symptoms of Tourette Syndrome wax and wane during the course of the illness. This means that there are times when the symptoms are less and there are also times when the symptoms are at their peak. In connecting these to the diet of the person, you will really come to terms when you might be questioning your own nutrition that may lead to the changes in symptoms. Another thing is whether there are certain cyclical events that can also lead to having the symptoms of the disorder. One example is a woman’s menstrual cycle. According to Dr. Gerald Erenberg, the medical advisory board of the Tourette Syndrome Clinic at Cleveland, there are actually two theories that explains the relation of nutrition with the symptoms of Tourette syndrome.


“…that certain components in food lead to the symptoms, acting in that individual like a toxin or poison, and two, that the symp­toms are due to food allergies.”

There were a variety of foods that have been regarded as possible crooks in leading to tics or that of ADHD. The first report on this was documented by Dr. Feingold. He said that SUGAR and ARTIFICIAL INGREDIENTS cause the problems. Because of this discovery, Dr. Feingold came up with a diet called the FEINGOLD DIET. Many people found this to be true and felt that this is the nutritional answer to what causes Tourette Syndrome and ADHD. Eventually, other food groups have also been suggested that may cause these disorders. These foods are GLUTEN and DAIRY PRODUCTS.

Considering those food groups, it is an important note that the effect of these foods may not be the same for each individual. Others may find these effective, and others may not. Consequently, foods containing these ingredients may cause problems with an individual, but not with the other. The diet will now be a combination diet restricting all of the suspected ingredients. But still, this is an impossible diet to follow since most of us especially children consume some of these ingredients almost everyday. Taking for example, a 7 year old child diagnosed with Tourette syndrome who, in most cases, would take his daily dose of milk.

The second theory entails that any person can be allergic to any foods. Dr. Erenderg said that the allergic reaction shows up as tics and behavioral problems rather than the usual allergic reactions such as itching, bloating, hot flushes, rashes, etc. When we think that the person is allergic to certain kinds of foods, we subject the person to tests and put on an elimination diet to see what foods cause the increase in tics. For most people, this is a very challenging undertaking especially if the foods that were supposed to be eliminated are our favorite foods. And also because of the fact that the reliability of the tests used to diagnose food allergies are being questioned by the doctors themselves.

The facts mentioned above plus the oscillating symptoms of the disorder makes it even more complicated, complicating the question whether the increase in tics is due to cause and effect or just because of the standard course of the illness. This concept also applies in pharmacotherapy or the use of medications to manage symptoms of Tourette Symptom. The question also lies whether the tics are managed because of the effects of medication or just because of the waxing and waning of the symptoms of the disorder.

So what should you do then? Well, there is no definite answer as to what foods to avoid. It’s just keeping track on what you eat and finding out if these foods actually lessen your tics. It is often advised to keep a food diary. In this way, you will be monitoring the effects of the foods you consume on your tics so that the actual effects of these foods will be more concrete rather than just assuming that certain foods actually cause the tics. It is better if you do this yourself rather than just relying on hearsays.

Now, I think most of the people diagnosed have been taking supplements to aid them in controlling the symptoms of Tourette syndrome. Here’s the deal about supplements available today. While there have been many anectodal reports saying the efficiency of these supplements in the treatment and/ or management of Tourette Syndrome, the predicament of these supplements lies on which one to take because makers of these products claim that their products are more effective than others. Some of these supplements are the vitamins, minerals, enzymes, products from organic sources (grape seed extract, blue green algae, omega-3 oil) and other herbal products. Oftentimes we are more enthusiastic if these supplements are based on some proven scientific studies. But unfortunately, there are not enough studies to lead us to these supplements reliability. One thing you need to look for if it is approved by BFAD (Bureau of Food and Drugs in the Philippines) in the Philippines or FDA (Food and Drug Administration) in the US or its counterpart in your country for the products’ effectiveness and safety. Because some of these supplements especially herbal products contains potentially dangerous contaminants. And oftentimes, the efficiency of these products vary from supplier to supplier or varies within different batches of the same supplier.

All of these information should lead us to be very smart consumers. And we should also keep in mind that TOURETTE SYNDROME HAS NO CURE. All the products available to treat or manage the disorder provide the purpose of controlling the tics just so the individual will not have a hard time. It is also an important note to keep in mind that the tics wax and wane during the course of the illness. The thing is, take in what works best for you. I would also like you to remember that the PROGNOSIS IS GENERALLY GOOD...BUT THE NEUROBEHAVIORAL PROBLEMS MAY PERSIST AND CAN DEBILITATE THE PERSON MORE THAN THE TICS THEMSELVES. We may be more focused on the tics of the person that we forget the person behind the disorder who is first and foremost an individual before becoming an individual with Tourette Syndrome.

See the convential treatment for Tourette Syndrome
------------------------------------------
This article was written from a reference article by Dr. Gerald Erenberg entitled "Is There a Connection Between Nutrition and an Increase in TS Symptoms?"

1/18/2008

Having Tics? Here's What You Need To Do

Having Tics? Here’s What You Need To Do


If you are experiencing tics (sudden, repetitive movements or sounds) most of your life or if you have observed that your child has been experiencing some form of uncontrollable movements which you cannot explain, DO NOT DISREGARD. At first we may think that the movements may just be mannerisms that they will overcome in the long run--think twice and address. It is always a better way not to disregard especially if the movements bother you or the person who has it.

Though, we may not conclude that you or somebody close to you is having Tourette Syndrome, here is the basis for it. Doctors actually use The Diagnostic and Statistical Manual of Mental Disorders for making the diagnosis. If you happen to fall on this criteria then you may have Tourette Syndrome.

DSM-IV Criteria for Tourette Syndrome:

• both multiple motor tics and one or more vocal tics must be present at
the same time, although not necessarily concurrently;
• the tics must occur many times a day (usually in bouts) nearly every
day or intermittently over more than 1 year, during which time there
must not have been a tic-free period of more than 3 consecutive months;
• the age at onset must be less than 18 years;
• the disturbance must not be due to the direct physiological effects of
a substance (e.g. stimulants) or a general medical condition (e.g.
Huntington's disease or postviral encephalitis).

Having said that, the DSM-IV is not the only tool for diagnosing the disorder, doctors may also ask for the history--- how you come to notice the tics especially the frequency and types of tics. Just to refresh your memory on what Tourette Syndrome is all about, please read “What You Need To Know About Tourette Syndrome”.

Now, you may be wondering what you will undergo having those kinds of repetitive movements. It is very important to visit the doctor as soon as you notice the tics. It is better to address everything as soon as possible rather than later. Be prepared for tons of questions. The doctor will definitely look at the family’s medical history, the person’s symptoms and other clues to make a diagnosis. However, there are no standard tests for TS. Oftentimes, the doctors may use imaging tests like computerized tomography scan (CT Scan), electroencephalograms (EEG’s), magnetic resonance imaging tests (MRIs) and blood tests to rule out other conditions that might have symptoms similar to Tourette Syndrome.

TOURETTE SYNDROME IS NOT A PSYCHIATRIC ILLNESS, for people who want to be finally diagnosed, please go directly to a NEUROLOGIST or a MOVEMENT DISORDER SPECIALIST. But do not be surprised if you will be referred to a psychiatrist or a psychologist, they will also help in addressing certain issues involved with TS. Oftentimes, these people work together to finally come up with a correct diagnosis and eventually help the person seek treatment.

Since Tourette Syndrome is a SPECTRUM DISORDER ( a combination of tics, attention deficit hyperactivity disorder, obsessive compulsive disorder and other neurobehavioral disorders) other symptoms that may last for a longer period of time needs to be taken into consideration especially if they interfere with the normal function of the individual. Upon diagnosis, it is also suggested that you come to a neuropsychologist or clinical psychologist who are experts in handling special population such as TS for a deeper evaluation. Why do you need to do this? This will help you understand more of the issues or problems associated with TS in the behavioral, psychological, and social aspect which according to some parents, are more debilitating than the tics themselves. Counseling or psychotherapy is also a big help since it is proven to be effective treatment modality in medical clientele such as TS individuals.

In order to help you or your loved one cope with TS, it is very important for you to;

· EDUCATE YOURSELF ABOUT TS. Read on articles, journals, books, newspapers, and other resources about Tourette Syndrome. In this way, you can also educate others as well especially those people who will be dealing with TS in the long run.
· KEEP A JOURNAL OF THE HISTORY OF YOUR DISORDER. Jotting down important situations in your life that may be relevant in identifying specific factors associated with your disorder may help you a lot.
· OBSERVE, MONITOR AND DOCUMENT YOUR TICS. Keeping track of your symptoms will help you see the progress of your disorder and find out specific treatments that may be effective during the course of your illness.
· GET INVOLVED. Since TS is just new in the Philippines, we will all find great comfort if we get to learn from each others experiences with TS and offer a helping hand.
· FIND EXTERNAL SUPPORT. Join organizations or support groups offering services for the people involved with TS. In the Philippines, you can join the Philippine Tourette Syndrome Association to know other Filipinos involved.
· STRENGTHEN FAMILY SUPPORT. If the family is intact in providing support for the individual with TS, the person can go a long way in coping with the disorder better.
----------------------------------------------------------------
Reference: Kids Health Website, 2007
Tourette Syndrome Diagnostic Criteria, 2004

1/11/2008

Very Thankful

As expected there were some major challenges in pursuing my research about Tourette Syndrome. The one that had a major impact on me was the process of validating the original scale that I did for Tourette Syndrome (Tourette Syndrome Symptom Assessment Scale). I had a few contacts for that in Manila which provided negative results. I was kind of pessimistic at first to reach out to those people who were really appropriate for this type of validation. The reason was that, there seems to be a little bit of that Pinoy mentality where people will make it harder for you in times when you needed them the most. Well, bitter sweet realities but all true. I even made all the necessary letters and attachments for the validation but these professionals really just put it to trash. But that did not stop me from pursuing these passion of continuing the research. I emailed a couple of other people I knew not only in the medical world but also in Psychology. In fact, I also considered foreign professionals for the validation. I even considered my father's dissertation adviser way back in the 80's in Cincinnatti. Well all in all, I got 50 emails sent to foreigners, and 4 others who were Filipinos. Unfortunately, most of the emails I sent were sent back to me...server problem, I guess. But some of them were kind enough to write back and tell me that they were not qualified for this specific task. After the holidays, though, I got two letters in my inbox from foreign neuropsychologists and psychiatrists who happened to be also professors in universities in the US. Luckily, they reviewed the scale and validated it together with the suggestions for the final copy of the assessment scale. I was really very thankful. More thankful, indeed, when another Filipino neurologist validated it and gave out a certification. So..well, I guess I just took this opportunity to thank my reviewers namely:


Maria Cristina Macrohon, MD,MPH
Neurologist
International Institute for Neurosciences
Adult Neurology



Ronald Ruff, PhD.
Neurologist and Rehabilitation Psychologist
Faculty at University of California (Department of Psychiatry)
and Stanford University (Division of Physical Medicine and
Rehabilitation)
[visit Dr. Ruff's website]




William Drew Gouvier, PhD
Professor
Department of Psychology
Louisian State University
[access Dr. Gouvier's vita]
[LSU page]





PHILIPPINE TOURETTE SYNDROME ASSOCIATION's Fan Box

WHAT PEOPLE ARE SAYING