A 7-year-old white male with a 3-year history of anxiety and obsessive-compulsive behavior presented to a multi-physician suburban integrative medicine practice. The patient's mother reported that when the boy was 2 years old, she started receiving daily incident reports from his daycare of his pushing other children and violent outbursts. A child psychologist evaluated his behavior as normal. At age 3.5 years, the child began to be fearful and dependent. He started expressing severe separation anxiety, refusing to enter any room alone, including the bathroom. He was increasingly irritable and had trouble interacting with other children. When the patient was 5 years of age, his teacher noted that he had obsessive thoughts about "germs" and developed compulsive hand-washing. He avoided going near trash cans because he was afraid of "germs." He expressed fear of his feces and would only go to the bathroom if he were completely undressed. He expressed irrational fears of getting "lead poisoning" and developed a related phobia toward pencils, to the extent that he was unable to sit at a table where a pencil was present. He did not want to play with other children because he was scared that he would hurt them. Whenever he coughed from a mild upper respiratory infection, he feared that he was going to stop breathing and became preoccupied with death. The patient was taken to a child psychologist and diagnosed with OCD and anxiety disorder. He was started on cognitive behavioral therapy, which included play therapy, exposure therapy, and other goal-directed therapy that resulted in mild improvement of his condition.
Positive for nervousness, sadness, depression, irritability, anxiety, and difficulty concentrating. The patient had also been diagnosed with spatial apraxia, which resulted in the patient bumping into other children that precipitated conflicts. Finally, the patient had a pruritic rash which started at age 1 shortly after he started to eat solid foods. The rash was worse in the summer and located behind both elbows and both knees. It was persistent despite various lotions, topical steroid creams, and special baths.
Prolonged labor (>36 hours); chronic ear infections starting at age 3 months; Clostridium difficile colitis related to amoxicillin treatment; serum sickness after a course of antibiotics.
None. Patient's mother did not wish to do a trial of medication in light of the patient's episodes of rash, Clostridium difficile colitis, and serum sickness.
Patient was receiving occupational therapy for his spatial apraxia.
Multivitamin, docosahexanoic acid, fish oil supplements
Penicillin (rash), cephalosporin (rash).
Melanoma (mother), anxiety disorder (paternal aunt).
Anxious-appearing boy who appeared his stated age sitting next to his mother. Patient had a restricted affect and displayed little eye contact with the examiner. He displayed no psychotic symptoms. There were no unusual thought processes observed. There was an erythematous rash on the popliteal fossa, elbows, and chest.
Autonomic response testing (ART) was performed to determine the targets of therapy and guide which areas of the body and ear acupuncture points should be treated with low-level laser therapy (LLLT). ART was positive for wheat, barley, and rye (gluten sensitivity), lead, mercury, and Entamoeba.
Table 1 provides an overview and time-line of the patient's treatment course. Over the course of 5 visits in a 5-month period, the patient was treated with the following: (1) a gluten-free diet and avoidance of gluten-containing personal care products such as soaps, shampoos, toothpaste, and hair products; (2) low-level laser ear acupuncture using a 904 nm laser RJ Olympic Physiolaser (RJ Laser, New Brunswick, Canada) set at 150mW for 15-second pulses using various Nogier frequencies; (3) LLLT using a 532 nm 5 milliwatt green pen laser pointer to reduce sensitivity to or amount of heavy metals:per ART indication, treatment was applied to hairy portions of the head for 3 minutes with either EDTA, dimercaptopropanesulfonic acid (DMPS), or wheat adjacent to the laser beam; (4) ionic foot baths during the office visit to reduce the total body burden of heavy metals; (5) low-dose chelation therapy using DMPS 100 mg twice per week; and (6) microcurrent therapy to address a subclinical Entamoeba infection.
The patient's mother reported that the patient's OCD symptoms and anxiety improved 40% since the previous visit. She noticed that her child was less anxious and more at ease in social situations and did not bring up his fear of his stool. She also reported that his eczema improved 90%, which was a greater improvement than with any other treatment previously tried. She admitted that while the majority of her son's diet was gluten free, there were a few occasions where her son had gluten intake. She also reported that the patient had not started to use gluten-free personal care products. The mother was unable to determine any differences in OCD and anxiety symptoms the day of or after gluten intake.
The patient's mother reported that her son's OCD symptoms had improved 80% and his anxiety had improved 90% since the last visit. She stated that he generally had more energy during the day. His eczema was 100% improved. The patient ate only gluten-free food and used gluten-free personal care products.
The patient's mother reported that her son's OCD improved 75% and his anxiety had improved 85% overall. He had more energy. However, he still had trouble reading and focusing on words.
The patient's mother reported that her son's OCD and anxiety symptoms were 99% better. He no longer had trouble staying in a room by himself. Repetitive behavior, such as hand washing and hand sanitation, had resolved. He no longer showed any fear of his feces, and was able to go to the bathroom without taking off all his clothes. The patient was 100% free of eczema.
The patient's mother reported her son was doing significantly better since the start of the integrative medicine therapies. She reported 1 instance of a relapse in symptoms of irritation and anxiety the day after the child had eaten food that had been cross-contaminated with food containing gluten from another family member. In general, she reported that he was less anxious, did not worry about his health or dwell on death, did not express concern about the trash can or germs, could go to the bathroom without completely undressing, had friends, and was less socially fearful. However, she did report that in the past month, he had begun to echo his words by mouthing them to himself and continually inquires about the time and the exact length of activities. While the patient had drastic improvements with the treatments, the patient still needed ongoing treatment.
Patient's mother was very satisfied with patient's improvement symptom-wise, socially, and academically. The palilalia resolved. Whereas the patient had failed his kindergarten entrance test, now in second grade he scored higher than his grade level on standardized testing. The patient continued to follow a strict gluten-free diet and to avoid gluten-containing personal care products.
Patient's mother reported that her son had not had any recurrent or new symptoms. She reported compliance with the gluten-free regime. When inadvertent gluten exposure from family members occurred, the patient did demonstrate some symptomatology, which rapidly resolved. The mother reported that she occasionally used the laser pointer pen for home LLLT. She did this at times of inadvertent gluten exposure. Her son was no longer in individual or group therapy and was on no medications. His psychologist confirmed his improvement. Mother reported also that the patient's spatial apraxia resolved and he no longer needed occupational therapy. She stated the apraxia markedly improved concurrently with the OCD improvement.
The patient's mother paid for all treatment costs as none of the treatments was covered under her insurance. Total treatment costs were less than $1000 (Table 2).