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Since 1938: Autism, The Microbiome and Donald Triplett, CASE 1

MicrobiomeBy Teresa Conrick

In their groundbreaking book and articles, Mark Blaxill and Dan Olmsted described the very first case of autism:

Case 1 in the landmark 1943 paper that first described autism is Donald Triplett, who we located in 2005; he is now 80 years old and living in Forest, Mississippi. "Donald T.," as he was identified then, came down with a life-threatening case of juvenile rheumatoid arthritis as a young teenager. As we recount in our book, his treatment with gold salts cleared up the JRA and made a vast improvement in his autism symptoms, particularly the characteristic anxiety and lack of sociability….

….In 1930, Donald Triplett's parents built the house he was born in three years later. The comfortable, unpretentious residence set in a large, leafy yard is not far from the lumber mills where the first tests of the ethylmercury wood preservative Lignasan were done at the same time. We suspect off-gassing of ethylmercury from the wood -- a known risk that eventually led to Lignasan's decline -- affected the mother and her infant.

….Problems related to the immune system, then, look like a clue from early days to the nature of autism.

More and more research is connecting those dots, especially the research on the microbiome.  Consider Donald  T, Diagnosed with AUTISM and then RHEUMATOID ARTHRITIS:

Tags: Arthritis | arthritis | gut | bacteria | rheumatoid

Arthritis Tied to Gut Bacteria Monday, 12 Jan 2015 05:04 PM

A growing body of research is focusing on a surprising culprit in the cause of rheumatoid arthritis: the bacteria that live in our guts.

The truth is that doctors aren’t entirely sure what triggers the disease, in which the body turns on itself to attack the joints. But several recent studies have found intriguing links between gut microbes, rheumatoid arthritis, and other immune system disorders, The Atlantic reports. 

In new research published in 2013 New York University rheumatologist by Jose Scher found that rheumatoid arthritis sufferers were much more likely to have a bug called Prevotella copri in their intestines than non-sufferers and patients with psoriatic arthritis had significantly lower levels of other types of gut bacteria.

“It’s become more and more clear that these microbes can affect the immune system, even in diseases that are not in the gut,” says Veena Taneja, an immunologist at the Mayo Clinic in Minnesota, whose own research has also linked gut bacteria to rheumatoid arthritis.

….Scientists are increasingly focusing on how gut bacteria influence the immune system. Studies show the rate of autoimmune diseases is rising, and some scientists believe that may be due, in part, to changes in gut bacteria tied to unhealthy diets, the explosion of antibiotic use, and even anti-bacteria products.

Sound familiar?  I’ve been reporting here almost nonstop on the MICROBIOME and AUTISM.  CASE 1, Donald T could be considered GROUND ZERO on the issue of the microbiome being pivotal in autism.

BUT in doing so, consider those three listed reasons above as influencing bacteria in the gut -- “unhealthy diets, the explosion of antibiotic use, and even anti-bacteria products.”  In the 1930’s, these three factors did not yet exist.  What was new at that time were three, newly commercialized, ethyl mercury compounds: a seed disinfectant, a lumber treatment, and the vaccine preservative thimerosal. It is beyond coincidence that eight of the original Kanner Eleven have ties by location or occupation, to one or more of these compounds. (see the book,” THE AGE OF AUTISM, MERCURY, MEDICINE AND A MAN-MADE EPIDEMIC   “ and “Her Name Was Vivian: Clues From the Age of Autism’s First-Born Child "

Research indicates that mercury can change the microbiome:

“Is exposure to mercury a driving force for the carriage of antibiotic resistance genes?”

….Exposure to mercury might be a specific driving force for the acquisition and maintenance of mobile antibiotic resistance gene carriage in the absence of antibiotic selective pressure….This confirmed the well established link between mercury and antibiotic resistance (Edlund et al., 1996; Liebert et al., 1997; Pike et al., 2002, 2003; Ready et al., 2003, 2007; Summers et al., 1993; Wireman et al., 1997).

Could it be with those first eleven children that exposure to mercury shifted the bacteria in the microbiome?  Research shows there is an ominous consequence:

….early-life toxicant exposure could shift the microbial balance, potentially affecting both immune and microbiome development…

And this current study reiterates that theme -- Gut microbes may trigger autoimmune disease later in life, Jan 19, 2015:

Researchers have revealed that the colonisation of the gut of young mice by certain types of bacteria can lead to immune responses later in life that are linked to disease.

Vaccines, made from both bacterial and viral components, seem to also change the microbiome.  Is it possible that on top of mercury exposure, vaccination is altering the microbiome and we are seeing increasing numbers of autism and autoimmune disease as the consequence?

Let’s add more clues:

Autistic populations have a unique microbiome  consisting of more  clostridial species.[44] Half of all autistic children with gastrointestinal dysfunction were found to have the bacteria Sutterella which was completely absent in non-autistic children with gastrointestinal dysfunction.[45] There is evidence that for some children with late-onset autism antibiotics can alleviate symptoms temporarily.[46]

In 2005, Anne McCartney, a microbiologist and senior research fellow at the University of Reading in the U.K., found that children with autism have higher-than-normal concentrations of Clostridium bacteria, a microbial group that can produce neurotoxins. Other researchers have reported similar findings.

"There does seem to be a case to suggest that both the numbers and types of certain bacteria in the gut are different in autistic and non-autistic children," McCartney says.

Armed with these findings, researchers began to explore whether changes in gut bacteria, rather than being mere symptoms of autism, contribute to the disorder. Anecdotal evidence suggested that might be the case — parents often reported that their children's behavior seemed to get worse when their gut symptoms were exacerbated.

......MacFabe is investigating whether gut microbes can influence the brain in ways that explain the symptoms of autism spectrum disorders. He is using rats to study fatty acids produced by the microbes that live in the gut, focusing particularly on propionic acid, which is produced by Clostridia, the bacteria that seem to be present at higher levels in children with autism.

When MacFabe and his colleagues injected propionic acid directly into the brains of rats, they became hyperactive, began engaging in repetitive behaviors and lost interest in social interactions4.

Interestingly, Rheumatoid Arthritis seems to also have that Clostridium connection:

……differences in the bacterial populations of mice bred to be genetically prone to rheumatoid arthritis. In those more susceptible to the disease, a species of bacteria from the Clostridium family dominates. In mice without arthritis, other strains flourish, and the Clostridium strains are scarce.

So back to Donald and this clue:  “As we recount in our book, his treatment with gold salts cleared up the JRA [Juvenile Rheumatoid Arthritis] and made a vast improvement in his autism symptoms, particularly the characteristic anxiety and lack of sociability.”

An investigation into GOLD SALTS led to this trail of research:

Newly Discovered Reactions From An Old Drug May Lead To New Antibiotics 

…. The key discovery occurred when the team found that the gold drug Auranofin, used to treat arthritis, impacted selenium's metabolism process. The chemical reaction changes the selenium, which prevents bacteria from using it to grow. Auranofin is an FDA-approved gold salt compound that is used to control inflammation and is already known to inhibit the activity of certain selenoproteins. Since certain bacteria, such as C. difficile, require selenoproteins for energy metabolism, the drug acts as a potent antimicrobial halting the growth of the bacteria.

…. "No one has tried to block the metabolism of selenium before as a therapeutic approach," Self said. "That's what's new and exciting and could lead to a whole host of other possibilities, including a better understanding of how the gold salt works for arthritis."

Very interesting and possibly a huge clue into both AUTISM and AUTOIMMUNITY, both of which my daughter has been diagnosed. Megan regressed in skills and language after being given the MMR vaccine and a Hib vaccine at 18 months.  That Hib vaccine contained 25 mcg of Thimerosal, the mercury preservative. As the years have passed, she has been ill with one infection after the other, Clostridia and Strep, being high on that list.  The autoimmune diagnosis, like Donald T, came years after the diagnosis of autism. These are important clues into autism.  Kanner missed these clues but we do see in his descriptions, glimpses of children who had chronic infections.  Little did he know these were the biggest clues to this new disorder he would call AUTISM. I will repeat that the microbiome seems to be a big piece into autism and thus may be a big piece in healing.  Donald T’s treatment with gold salts may be showing us that exact mechanism.

To summarize:

•  Donald Triplett, CASE 1 from Dr. Leo Kanner’s  historic paper  developed Juvenile Rheumatoid Arthritis as a young teenager.

•  Both Autism and  Rheumatoid Arthritis have much evidence of pathogenic bacteria and a dysfunctional microbiome, including Clostridium.

•  Clostridium bacteria can produce neurotoxins that research is showing, can cause the behaviors of autism, including social impairment, repetitive behavior and obsessive-compulsive behavior.

•  Donald was treated with gold salts which halted his Rheumatoid Arthritis and his symptoms of Autism.

•  Gold salts are now being shown to stop the growth of Clostridium (and possibly other pathogens) by disrupting selenium metabolism. (NOTE: I am not endorsing use of gold salts. This is research and not prescribing information)

•  There is much finger pointing to ANTIBIOTICS as the culprit in microbiome dysfunction, yet they were not in use in the 1930’s when these eleven children were diagnosed.  Antibiotics may both help or hurt depending on the unique microbiome of each individual. 

•  Plasmid sharing is one way bacteria develop resistance to antibiotics but to any agent that threatens their survival, which would include mercury. 

•  Vaccines also have shown to change the microbiome.  Niches created by vaccine elimination of organisms seem to alter the structure of the microbiome.  The unintended consequences of this alteration remain to be seen.

In Mark and Dan’s AGE OF AUTISM  book, they describe when Donald became ill:

When Donald was nearly fourteen, he became quite ill....he had a high fever, his joints were severely swollen, and he'd stopped eating….the Triplett’s looked far and wide, even taking him to the famed Mayo Clinic in Minnesota. But no one could figure out the problem…….. 

They did find help finally at the Campbell Clinic in Memphis which specialized in arthritis.  Ironically, the Mayo Clinic is now investigating the role of Clostridium difficile infection .  Autism’s “abdominal symptoms” is on that list for fecal microbiota transplantation.  Stay tuned as my next installment will focus on that very topic.


Jeannette Bishop

Maybe adding to the discussion (maybe just convoluted threads and thoughts), regarding this sentence:

"In addition to humans, several pathogens, including, but not limited to, Clostridium difficile, Treponema denticola and Plasmodium falciparum also produce selenoproteins [17-19]."

Plasmodium falciparum -> malaria

There is some evidence that mercury exposure increases susceptibility to malaria infection:

Treponema denticola -> peridontal disease spirochete (mercury contributes to gum disease risk, I believe, but I'm having trouble looking up info on whether Hg is associated with T. denticola levels) also linked to AD, ALS, heart disease...

Then there is


Selenoenzymes are required to prevent and reverse oxidative damage in the brain and neuroendocrine system, but these enzymes are vulnerable to irreversible inhibition by methylmercury (MeHg). Selenoenzyme inhibition appears likely to cause most if not all of the pathological effects of mercury toxicity. This biochemically based understanding seems to explain why certain tissues are affected by mercury, why the latency effect is unique to mercury poisoning, why selenium status is inversely related to mercury toxicity, why fetal exposures are so much more harmful than adult exposures, and why prenatal inhibition of selenoenzymes by high MeHg results in sustained loss of their activities.

I can't access the above research fully (and I probably wouldn't be very good at judging or interpreting results anyway), but if the above is correct (that mercury inhibits our selenium synthesis) then it doesn't seem to inhibit the type of synthesis these microbes perform (unless they don't rely upon the process to survive)?

Maybe Hg in the gut, mouth, etc. supplies higher levels of unused selenium for these pathogens and that's why they get root, causing whatever problems, possibly including further reduction of selenium to our cells (or maybe a bypassing of some helpful steps--like a mercury binding/inhibiting stage?--in the synthesis process if our cells happen to use the selenoproteins these microbes produce?)?

Teresa Conrick

Hi Jeanette.

Thanks for your comment. I find this all very fascinating and important.

The full study is listed and here it is again.

There are some unknown factors which is why looking at in in both autism and autoimmunity is important for researchers....

"Recently we found that auranofin blocks the incorporation of selenium into selenoproteins in mammalian cells in culture [7], however the mechanism of this inhibition has not yet been determined. Selenoprotein synthesis is well defined in both prokaryotic and eukaryotic systems. It should be noted, however, that transport and metabolism of selenium upstream of the specific selenoprotein synthesis machinery is not well understood. In the first step of selenoprotein synthesis, the highly reactive, reduced form of selenium, hydrogen selenide (HSe−), serves as the substrate for selenophosphate synthetase (SPS) [8-12]. SPS produces selenophosphate in an ATP dependent manner. Selenocysteine synthase subsequently catalyzes the reaction of selenophosphate with a serine charged tRNA to form selenocysteine [13, 14]. Specialized translation factors and a stem-loop structure within the mRNA (selenocysteine insertion sequence or SECIS) then direct the insertion of selenocysteine into the polypeptide chain [15]. Given its reactivity with active site selenols, the possibility exists that auranofin could interact with reactive selenium metabolites upstream of SPS, such as HSe−, thus blocking selenoprotein synthesis entirely.

The role of selenium and selenoproteins in human health has been studied extensively. At least 25 human selenoproteins, have been identified [16]. In recent years studies have focused on the role of human selenoproteins as catalytic antioxidants and the impact of selenium supplementation on cancer incidence. In addition to humans, several pathogens, including, but not limited to, Clostridium difficile, Treponema denticola and Plasmodium falciparum also produce selenoproteins [17-19]. The importance of these selenoproteins and how they impact pathogenesis has yet to be fully elucidated. These unique enzymes and their specialized assembly machinery present an intriguing target for antimicrobial development."

Jeannette Bishop

Thank you. Interesting that selenium supplementation has been found to help with arthritis/autoimmune conditions. Would the disruption of the microbiome's (or some component's) selenium metabolism by gold salts make less or more selenium available for the body? Or perhaps to more beneficial microbes?


great stuff Theresa. The article about gold salts, in particular, was especially topical.

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