Tag: pediatrics

Expanding Orthomolecular Medicine Through an Integrative Systems Approach

Reflections on a Case Report of Treatment-Refractory Pediatric OCD

By Richard Z. Cheng, MD, PhD
Editor-in-Chief, Orthomolecular Medicine News Service (OMNS)

Highlights of the Accompanying Case Report

This editorial accompanies the thoughtful case report by Drs. Aarti Midha and Naresh Midha, who describe the successful long-term management of treatment-refractory pediatric obsessive-compulsive disorder (OCD) using a comprehensive . Their careful clinical investigation and nine-year follow-up provide an important opportunity to reflect on the evolving role of orthomolecular medicine in understanding complex chronic disease.

Key observations include:

  • A 5-year-old child developed sudden-onset OCD, anxiety, anger outbursts, and ADHD-like behaviors that responded poorly to conventional psychiatric treatment.
  • An unexpected improvement following antibiotic therapy prompted clinicians to investigate potential infectious, metabolic, and physiological contributors.
  • Comprehensive evaluation identified multiple potentially modifiable abnormalities, including gut dysbiosis, gluten and dairy intolerance, sleep apnea, elevated aluminum levels, genetic polymorphisms affecting methylation and detoxification (MTHFR, GSTM1, and SOD2), and possible chronic dental focal infection.
  • An individualized, multimodal protocol-including dietary modification, gut restoration, targeted nutritional support, methylation support, mitochondrial support, management of sleep apnea, and dental intervention-was implemented.
  • Complete clinical remission of OCD, anxiety, and anger occurred within six months, with ADHD symptoms resolving over the following two years.
  • Nine years later, the patient remains symptom-free, with excellent academic performance and normal extracurricular participation.

Read the Full Article

This editorial accompanies an OMNS case report on treatment-refractory pediatric OCD.

Download the complete PDF below.

⬇️ Download the complete editorial (PDF)

What is driving the disease?

Rather than accepting symptoms as isolated disorders requiring lifelong suppression, orthomolecular medicine seeks to identify and correct the underlying biochemical and physiological disturbances that permit disease to develop.

As with all case reports, this publication should not be interpreted as proof that any single intervention-or even the entire treatment protocol-will produce similar outcomes in other patients. Multiple therapies were introduced over time, and their individual contributions cannot be determined. Yet that is not the principal lesson of this report.

The importance of this case lies in its way of thinking.

For decades, medicine has largely approached complex disorders by assigning a diagnosis and selecting a corresponding therapy. This strategy has been remarkably successful for many acute illnesses. Chronic diseases, however, rarely arise from a single cause. Instead, they often emerge from interactions among nutrition, metabolism, barrier integrity-particularly the gut and blood-brain barriers-immunity, environmental exposures, endocrine regulation, the microbiome, mitochondrial function, sleep, genetics, and lifestyle.

Pediatric OCD may be one example.

Rather than asking only which medication best suppresses obsessive thoughts, we may also ask:

Why did normal brain function become disturbed in the first place? Why are physiological systems no longer functioning optimally? Which of those abnormalities may be reversible?

The strength of this report lies not only in its favorable outcome, but also in the authors’ willingness to investigate beyond conventional diagnostic boundaries and to consider multiple interacting physiological contributors.

These questions also form the foundation of Integrative Orthomolecular Systems Medicine (I-OM Systems Medicine).

Built on the foundations of Orthomolecular Medicine, I-OM Systems Medicine expands this tradition by focusing on identifying the interconnected root drivers of disease, restoring physiological function, and supporting long-term health.

The accompanying case exemplifies this philosophy. Rather than focusing solely on symptom control, the treating physicians systematically investigated multiple physiological contributors-including the gut microbiome, nutrition, metabolism, toxic burden, sleep, and dental health-and addressed them through a comprehensive, individualized treatment strategy.

From this perspective, the accompanying case is not simply a report about OCD. It is a clinical example of an integrative systems approach applied at the bedside.

The child described in this report was treated not only according to diagnosis, but also according to underlying physiology. Multiple potentially reversible contributors were identified and addressed through an integrated treatment strategy.

Whether every intervention was necessary remains unknown. Whether some interventions contributed more than others will require future investigation. Nevertheless, the sustained clinical remission suggests that comprehensive physiological investigation deserves further scientific study.

Medicine advances through observation as well as experimentation. Many transformative ideas begin with careful attention to individual patients whose clinical course challenges prevailing assumptions. Case reports cannot establish causation, but they often generate the hypotheses that later reshape medical practice.

For readers of OMNS, this report also serves as a reminder that orthomolecular medicine has always been more than a collection of nutritional therapies.

At its core, it is a way of thinking-a commitment to understanding the biological foundations of health and disease, correcting physiological dysfunction whenever possible, and supporting the body’s remarkable capacity for recovery.

As biomedical science increasingly embraces systems biology, network medicine, metabolomics, microbiome research, and precision nutrition, the principles that have guided orthomolecular medicine for decades are finding broader scientific expression.

Rather than viewing these developments as separate disciplines, we should recognize them as complementary parts of an evolving framework for understanding human health.

The thoughtful work of Drs. Midha and Midha reminds us that careful clinical observation, combined with a willingness to investigate the biological foundations of disease, can generate important insights that extend well beyond a single patient.

Their report provides an encouraging example of how expanding orthomolecular medicine through an integrative systems approach may open new possibilities for patients with complex chronic disorders.

The future of medicine will likely depend less on finding a single “magic bullet” than on understanding and restoring the interconnected physiological systems that sustain health.

This case invites clinicians to look beyond symptom management, explore the root drivers of disease, and continue advancing orthomolecular medicine through an integrative systems approach.

Reader Discussion and Questions

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Orthomolecular Medicine

Orthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org

Children’s Eczema

Children’s Eczema

Eczema, also known as atopic dermatitis, is an inflammation of the skin and occurs in up to 25% of children and some adults. The term eczema is used as a blanket term for numerous skin conditions, but is primarily used to describe dry, itchy, red, flaky skin. The acute form of eczema includes fluid filled blisters that may become scaly, form a crust or can result in thickening of the skin. The chronic form also includes redness, crusting, scaling and a thickening of the skin. The skin can become so dry that it often cracks and bleeds. This is known as the weeping stage of eczema. Individuals affected by eczema will notice that it occurs predominantly in parts of the body where flexing occurs, but it is not limited to these areas and can occur all over the body.

There is no single known cause of eczema and its origin is multifactorial; however, allergens are believed to play a huge role. Individuals who are hypersensitive to allergens and develop other diseases such as asthma, hay fever and pinkeye are more susceptible to developing eczema. There is a genetic component to eczema. Children whose mothers had asthma or eczema during pregnancy are twice as likely to develop eczema in their life. Some other factors that are known to trigger eczema include; stress, pollution, certain foods and chemical sensitivities. Liver toxicity also plays a role in eczema. The liver is the main organ of detoxification, if it is not working well, then the detoxification process is taken over by the skin and lungs. Both of which are not particularly good at detoxing and patients will then present with allergies, asthma and eczema.

The conventional approach to eczema is cortisone cream. It is an extremely potent steroid cream that is applied directly to areas affected by eczema. However, anything applied to the skin eventually finds its way into the bloodstream. The most common side effect is thinning of the skin. Overuse of steroid creams can damage your liver and kidneys. Additionally, cortisone can be damaging to your adrenal glands resulting in hormonal imbalances. The downfall of steroid creams is that it reduces inflammation by masking the symptoms of eczema and does not get to the root of the problem. So as soon as you stop using the cream your eczema will re-appear.

Naturopathic Doctors understand that inflamed skin is just a symptom of a deeper problem; therefore, treatment involves treating the root cause of your problem. To understand this, we must understand that eczema is caused by a hypersensitive immune system. A part of the immune system contains two types of T helper cells (TH); TH1 and TH2. TH1 cells actively kill viruses, bacteria, fungi, tumours and other invasive in organisms in your body. TH2 cells protect the body from allergens, chemicals and other things such as parasites. Those with a dominant TH2 immune response are more likely to develop asthma, hay fever, eczema. All infants are TH2 dominant while in the womb so that the mothers TH1 cells cannot reach the developing fetus. This carries into adolescence, but by adulthood TH1 cells should become dominant. However, this is not always the case and there are many hypotheses why this occurs.

There are many reasons for a hypersensitive TH2 response such as:

  • Food intolerances
  • Liver toxicity
  • Gut dysbiosis
  • Antibiotic use
  • Environmental toxins
  • Stress
  • Vaccinations (stimulate the TH2 response and inhibit TH1)

A child with a hypersensitive TH2 immune system has predictable symptoms that generally develop over time (1).

  • In infants, atopic eczema and food allergies are seen
  • In childhood asthma and hay fever commonly occur
  • During the teenage years, development of seasonal rhinitis and conjunctivitis can occur

The first step to treating eczema is determining what factors are causing the hypersensitivity reaction. Dr. Mason-Wood, ND may perform various lab exams to find what these are. Tests can include blood, urine, hair, stool and saliva testing, hormone and adrenal testing or various other tests. The most common test that Dr. Mason-Wood, ND recommends for patients with eczema is a Food Intolerance testing. This test checks to see if an individual is intolerant to certain foods. This intolerance is not life threatening, but does cause an immune response which may be a factor in eczema. Once the intolerant foods are discovered, removal from a patient’s diet helps reduce the symptoms of eczema. Further steps include addressing Leaky Gut Syndrome, treating gut dybiosis and then healing the gut with botanicals and supplements. Additionally, removing irritants such as soaps, detergents, scents and creams may be needed, as well as detoxifying toxins in the body. Finally, balancing the body’s TH2 dominance is important and ensures that eczema will not re-occur.

Since the development of eczema is multifactorial removing foods you are intolerant to may not be enough. Other factors may be involved and so other treatments may be necessary. Other common treatments for eczema include botanical medicine, environmental medicine, injection therapies, supplementation, lifestyle counselling, Traditional Chinese Medicine and homeopathy. Once Dr. Mason-Wood, ND has assessed the root cause of your eczema he will work with you to choose the correct treatment plan for you. To address your eczema, book an appointment with Dr. Mason-Wood, ND today by calling 587-521-3595.

1. Douglas JA, O’Hehir RE. Diagnosis, treatment and prevention of allergic disease: the basics
MJA 2006; 185:228-233
2. Adapted from http://www.ccnm.edu/health_concerns_rsnc/eczema