I spent a couple of days last month looking at every single bit of research I could find on Sleep Apnea and came up with a great list which I’ll post very soon.
What I didn’t expect was to discover something much bigger and more significant for many children with T21 than Sleep Apnea. How can anything be more important? I can hear all the sleep deprived parents out there muttering.
What I discovered has completely changed my approach to treating people with T21, virtually turned it 180 degrees.
Imbalanced Neurotransmitters
After collecting four pages of research on Sleep Apnea I discovered that one of the drivers of Sleep Apnea is elevated Glutamate and low GABA 1. Why is this significant? Because from what I’ve studied, regression, autism spectrum disorder (ASD) and seizures are also associated with elevated Glutamate and low GABA 2, 3, 4. Obviously there are more things involved in these pathologies, in many cases there are also gut issues, mineral deficiencies and mitochondrial dysfunction. But what you’re about to learn is that they’re all related.
Glutamate is a neurotransmitter which works in tandem with GABA in the brain. They function like a see saw, when one is high, the other is low. Glutamate is stimulating, it stimulates neurons (brain cells) for intelligent thinking, but we also need good amounts of GABA to keep us calm at other times.
In the past, clinical trials have always pointed to elevated GABA and low Glutamate in T21, which explains why some people with T21 are calm and take time to learn things learn compared to children with ASD who are more likely to be highly intelligent but socially withdrawn 5. I believe some children with T21 do have this scenario playing out – elevated GABA low glutamate, some children have balanced levels of neurotransmitters, while others have elevated glutamate, poor methylation, dysbiosis, poor mitochondria and mineral levels. Signs of elevated glutamate include allergies, poor sleep, increased strabismus and stimming 6.
What is causing elevated glutamate in our children?
One cause is poor methylation. If methylfolate is available but Vitamin B12 isn’t, it can’t enter the methylation cycle and in its unbound form it becomes glutamate (folate is also known as polyglutamate) 6. Unbound folate is beneficial as it increases glutamate receptors in the brain for increased intelligence, but chronically elevated glutamate leads to cell death. If Vitamin B6 levels are low, GAD enzyme can’t convert glutamate to GABA 5. This enzyme which converts glutamate to GABA can also be compromised due to rubella vaccination and also type 1 diabetes, which exists in T21 6.
Why is it important to prioritise glutamate treatment?
Chronically elevated glutamate causes inflammation and increased TNFalpha 6. Chronic inflammation leads to low Glutathione levels and eventually to leaky gut, allergies and autoimmunity 7. Autoimmunity is associated with T21; Hashimoto’s, Alopecia, Addison’s Disease, Grave’s Disease, Rheumatoid Arthritis, Dermatitis, Diabetes Mellitis, Lupus 8.
It makes sense to prioritise treatment for neuroinflammation. If inflammation is occurring in the body we can’t maintain glutathione levels necessary to heal leaky gut.
How are we going to reduce elevated Glutamate?
First step is to do some testing. Urine Amino Acid (UAA) testing is one of the best ways to gauge if your child is methylating efficiently or not. Using UAA tests we can measure Glutamate, GABA and other amino acids related to methylation such as Taurine, Cysteine, Homocysteine, Cystathionine and Methionine. A few of these amino acids will also indicate how the CBS enzyme is functioning in T21, in its overexpressed state.
Treatment
Firstly we want to address Glutamate if it is elevated. Many supplements in a Nutrigenomic protocol can be utilised to lower Glutamate such as Valerian, Huperzine A, Trehalose (adults), Resveratrol, Curcumin, EGCg and Lithium Orotate 9. We can retest using the UAA to make sure glutamate levels have come down into range.
Another important test we can do is Hair Mineral Analysis (HMA). In the presence of elevated Glutamate, Mercury becomes more volatile and causes damage to neurons 10. Glutamate is also known to transport Calcium into the brain efficiently to cause chronic stimulation, which is why we avoid supplements containing Calcium. We can work with a HMA to determine whether you have Mercury toxicity or low calcium.
Vitamin B12
Some people with T21 aren’t absorbing Vitamin B12 due to Candida, Strep, Lead and Mercury toxicity. Being vegetarian, nitrous oxide, proton pump inhibitors, low stomach acid, SIBO and low lithium can also reduce B12 levels.
When Vitamin B12 isn’t available, methylfolate can’t be transported from the folate cycle into the methylation cycle. This is known as folate trapping. Without going into detail, basically you aren’t methylating and you’re not making SAMe. SAMe makes methyl donors, the job of which is to repair tissue in our body, like repair our gut lining, heal a cut finger or make an immune cell. All this repair work is essential to keep our body in top condition, strong and healthy and functioning efficiently 6.
SAMe is responsible for converting serotonin to melatonin to put us off to sleep, for making glutathione – our body’s strongest antioxidant which protects us from ear, nose and throat infections, it creates myelin which covers and protects our nerve cells, and it helps make CoQ10, creatine and carnitine for healthy mitochondria. It also converts norepinephrine to epinephrine to regulate dopamine which is critical for our children to be able to focus 6.
Methylation is also crucial for us to be able to detox heavy metals from our system, and most of the methyl groups used for metal detoxification are donated by SAMe. Having good methylation also helps reduce the viral and bacterial load 6.
Vitamin B6
Due to various reasons, people with T21 can be low in Vitamin B6 and this may be another factor driving elevated glutamate. We have to be careful supplementing Vitamin B6 as it can increase CBS enzyme activity drawing methylation nutrients down into the trans-sulfuration pathway 6.
In conclusion, elevated glutamate needs to be recognised as a potential driver of several pathologies associated with Trisomy 21. Testing and treatment are in the early stages but may prove to be beneficial for reducing neuroinflammation, supporting methylation and restoring health for people with T21.
