HYPOGLYCEMIA IN CHILDREN’S BEHAVIOR PROBLEMS
by Paul J. Dunn, MD, member of NOHA’s Professional Advisory Board
Behavior problems in children range all the way from the colicky baby, to the so-called terrible twos, to the investigative threes, to the school age child who can’t sit still and disturbs the whole class, to the emotionally labile adolescent who is a trial to his parents and who in the extreme may be a school dropout on drugs and in trouble with the police. He may have mild or wild aberrations in his mode of conducting himself at home, in school, or in his neighborhood. A child’s behavior in school may be either an irritation to all around him or possibly an irritation primarily to himself in the form of continual frustration and failure in being able to learn adequately and efficiently. Hyperactivity is extremely common, however, in children with learning difficulties and having even one child like this at home or in the classroom can activate latent behavior problems in the parents and teachers. In a way, inability to learn is a behavior problem in itself.
Currently, my work is primarily with adults having chronic symptoms not responding to the usual treatment but I also see a significant number of children with reading, learning, and behavior problems. Here we will discuss this group of children and the relationship of their aberrant behavior to carbohydrate metabolism.
Many terms and definitions have been used in regard to this widespread pediatric problem. For our purposes let us say that learning disability refers to a retardation, disorder, or delayed development in one or more of the processes of speech, language, reading, writing, or arithmetic (or any school subject) caused by other than primary mental retardation or poor instruction.
The most frequently cited characteristics of this disorder in order of decreasing frequency are:
These are symptoms of a disorder that probably affects more children than anything save the common cold.
Learning disability, then, like hyperkinesis and its related behavior problems, is one of a constellation of manifestations of a basic organic problem of cerebral dysfunction, which has been caused by a variety of factors. These are central nervous system injury, sensory deprivation, cultural deprivation, hereditary factors, food sensitivity, emotional factors, chemical factors, malnutrition, noxious chemical environment, allergy, and stress. The net results of this disorder, if untreated, are not only the ten most frequently cited characteristics mentioned above, but also possibly superimposed psychological problems and school dropout, with the resultant possibility of unemployment, delinquency, narcotics problem, a generally miserable life for the child and his family and a great loss to society.
In our work with children with learning disability, we consider carbohydrate metabolism and trace mineral imbalance as very important parts of an overall evaluation and treatment program.
In addition to the five-hour glucose-tolerance test and hair and blood analysis for trace mineral ratios, the following evaluations are implemented:
1. Detailed medical, family, and social history
2. General physical examination, neurological exam, and osteopathic exam (most of these children have osteopathic, i.e., musculo-skeletal problems), including cranial osteopathy
3. Functional neurological evaluation
4. Audiology, if indicated
5. Developmental visual analysis
6. Complete blood count and urinalysis
7. Comprehensive blood profile
8. Tests for food sensitivity and chemical and inhalant sensitivity, if indicated
9. Comprehensive stool exam
10. Test for Candida (yeast)
Glucose Tolerance Test Procedure
The patient fasts after the evening meal the day before the test is given. The next morning fasting blood and urine specimens are obtained and the patient is given a glucose-containing drink, the number of grams depending on the child’s weight. Additional blood specimens are then taken at one-half hour, one, two, three, four, and five hours. The specimen is a drop of blood from a finger.
Responses to Five-Hour Glucose Tolerance Tests
Analysis of the five-hour glucose tolerance test in 144 children with known cerebral dysfunction and learning disabilities revealed that 77.09% had hypoglycemia or some other disorder in carbohydrate metabolism. Most also had a trace-mineral imbalance determined by analyses of whole blood and hair. These results probably stem from a combination of many factors, often including a poor diet high in refined carbohydrates.
In the group whose glucose tolerance curve fell into the normal range, 16 of 33 had elevated lead levels. The same number had a low potassium-to-zinc ratio, and 19 had symptoms of underlying allergy. Do these children, with normal glucose tolerance curves, react to learning disability with an allergic response instead of with a hypoglycemic response? Unless treated, do they eventually develop both? Yes, we see this happen.
As I have talked to parents about their child’s glucose problem and about the symptoms that can result, the mother and/or father at times has said to me, "You are talking about me. I have been going to doctors for 20 years now because I am tired all of the time, even after a good night’s sleep. They put me on tranquilizers or pep pills or they advise me to take up a hobby or take a trip. And I am still exhausted." A glucose tolerance test was arranged for one parent who said that and it was worse than the child’s. She came back to see me after going on a diet and said, "I haven’t felt so good in years!"
Typical Case Studies
A 21/2-year-old girl was brought to the office with no learning problem but manifesting wild, crazy behavior. The child cried all day long. She could not be picked up. At night she cried and screamed until 1:00 AM and then fell asleep fitfully and got up at 6:00 AM with severe tantrums. This went on day after day. Their pediatrician started some Ritalin® to no avail. We got a five-hour, glucose-tolerance test and a trace-mineral analysis, both of which were abnormal. We started an appropriate diet and some chelated mineral-vitamin supplements. When the mother came back after a few weeks, she related, "She is like a different child, she is lovable, she comes to be picked up, she sleeps all night long." The Ritalin® had been stopped. She continues normal.
This was a 4-year-old boy in a Montessori class, who would do beautifully until 11:00 or 11:15 AM, at which time he would go stark, raving mad. He would run around the room and throw materials. A glucose-tolerance curve showed that at the fourth hour his blood-glucose dropped precipitously. We started him on the appropriate diet and supplements, had him stay away from all of the various chemical additives, colorings, flavorings, etc., and in approximately four to five weeks, this was another very different child. He worked beautifully all day. His mother recently said, "Behaviorwise, he is still doing great." However, if he gets one cookie, or one piece of candy, she knows it. There is no question in her mind because of the change in his behavior.
The treatment of the basic cerebral dysfunction should consist primarily of:
Most important in treatment is prevention. Parents on their own can greatly help prevent sugar problems by severely restricting refined carbohydrates—candy, cookies, sweet rolls, donuts, cake, pie, ice cream, jelly, jam, soda, etc. Physicians, going right back down to the newborn period, have an excellent opportunity to prevent learning disabilities and to prevent the associated chemical problems by what they advise parents to do. Give the baby every opportunity to move. Get a really good diet into the mother during pregnancy and also into the baby from the very first day. Breast milk is the ideal start. Subsequently, physicians should at least recommend limiting refined sugar products, which can have such a devastating effect. If physicians would be conscious of their role in preventing learning disability, it would be very helpful in solving the problems of thousands and thousands of children across the country who are plagued with cerebral dysfunction and its aftermath..
Article from NOHA NEWS, Vol. XXIII, No. 3, Summer 1998, pages 1-2.