Antibiotic-induced D-lactic Aciduria

Summary

Supplementation with L. acidophillus in a child with carbohydrate absorption difficulties can produce an encephalopathic syndrome associated with D-lactic acidemia. Testing shown in this case spans over the interval of time where urinary D-lactate was added to the Organix report.

This content was created by the Metametrix Institute

History

This patient presented with autistic signs at a clinic that has a strong reputation for restoring normal development through metabolic corrections. They know that the best results are obtained when the interventions are done early in the progression of autism. This infant presented a typical set of abnormalities including the appearance of elevated levels of bacterial and yeast products in urine.

Age

2

Gender

Male

Description of Results

The initial dysbiosis portion of the ION report is shown below. There were strong elevations of products of multiple bacteria, including clostridia, and of yeast, especially the marker of invasive stages, D-arabinitol. Antibiotic therapy was implemented with courses of flagyl and diflucan.

Several other areas of nutrient insufficiency were detected and a custom supplementation program was started. Corrective doses of vitamins, minerals, and fatty acids were also started.

When the follow-up Organix profile was performed 3 months later, urinary D-lactate had risen from 1.1 to 7.4 ug/mg creatinine. This change was accompanied by signs of ataxia that are known to be effects of D-lactic acidemia. GI symptoms had worsened. Otherwise, the parents reported several improvements in areas of autistic syndrome such as eye contact.

Recommendations

This case illustrates the need to use ways to restore orthobiosis other than aggressive killing of intestinal organisms. If there is a tendency for carbohydrate maldigestion/malabsorption, then a course of broad spectrum antibiotics can be the trigger that sets off L. acidophillus overgrowth.

Other ways of managing general bacterial overgrowth are the use of specific prebiotics like ground flax seed and the careful introduction of non-D-lactate producing probiotic organisms like S. boulardii, L. rhamnosus, and B. bifidum. Simultaneous control of dietary carbohydrate should be implemented until GI normalization is demonstrated. This may include restriction of complex carbohydrates as well as avoidance of simple sugars.

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