Is Tylenol Causing Autism? and other Autism Questions
Why is autism rising? Is it genetic, environmental, or just overdiagnosed? And what's the deal with Tylenol? Phoenix children's doctor Richard Frye joins the program to answer the questions millions of American couples find themselves asking as they become parents. Watch every episode ad-free on members.charliekirk.com! Get new merch at charliekirkstore.com!Support the show: http://www.charliekirk.com/supportSee omnystudio.com/listener for privacy information.
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All right, welcome to the Charlie Kirk Show.
I'm Andrew Colvett, executive producer of this show.
We have a special episode for you guys, and it's all about autism.
This is a conversation that has become very much front and center in the national dialogue, of course, with the Maha movement, RFK studies, and this discussion about Tylenol and potential treatments for it.
And so we wanted to make sure that we address this issue head-on so that you guys have all the information that you need in order to make wise decisions for yourself, for your family, for your kids.
And to help me make sense of this is going to be a very special guest, Dr. Richard Fry.
You are a medical doctor, you're a PhD.
You're a pediatric neurologist studying treatments for kids with autism.
You're also the director of research at the Rosignol Medical Center, and you were the president of the Autism Discovery and Treatment Foundation.
It's very, very amazing resume that you got there.
And we also have Riley Marty, who's actually on our team as well.
And Riley is a passionate, passionate advocate for, I think, it'd be safe to say, for doing this the right way, the right studies.
You and your husband Ryan both have some sort of medical background and studies and school and that sort of thing.
And so you're kind of our resident expert.
So I wanted Riley to be here with me as we go through this very important topic.
But Dr. Richard Fry, welcome to the Charlie Kirk Show.
Well, thank you so much, really.
Thanks for having me.
Yeah, absolutely.
And so as I understand it, you have been way out front on this issue in a way that it was, you know, you almost have to use that expression, you know, they're not crazy.
They're just early.
That was kind of you, right?
You were studying autism and ways to treat autism before it became part of our zeitgeist, part of our national dialogue.
Tell me, what made you start in this way?
When did you start noticing that autism rates were increasing and why did you decide to get so involved in this area of study?
Yeah, no, I appreciate the question.
And I'd like to say autism found me, you know.
So I was, you know, very interested in neuroscience.
I was talking to Riley before and, you know, very interested in how the brain works and the wiring of the brain.
But being a doctor, you know, you think of things beyond just kind of academics of, you know, the interesting science of it of how to make kiddos better.
So I was actually very interested in learning disabilities when I was in residency and I did a fellowship in learning disabilities and behavioral neurology.
But what was happening is, you know, I was interested in dyslexia, but, you know, I was also a doctor.
And as a doctor, you know, when I'd see patients, there was a lot of kids with dyslexia and learning disabilities that would come to me.
What was happening, this was the early 2000s, and I was a fellow, you know, and all these autism was being recognized more and more.
So parents were bringing their children to the neurologist to say, my child has autism.
You know, what can I do about it?
And of course, nobody really knew all that much about it, how to treat it or anything.
And when they come to the department, what do you do if nobody really knows?
You give the patient to the fellow, right?
See what they can figure out.
And so parents would come to me and they would say, well, my child just got diagnosed with autism.
They say they don't know what causes it and they don't really know what to do about it, but probably has something to do with the brain, so maybe you can figure it out.
And I kind of took it as a challenge because, you know, I wanted to make these kiddos better.
And I was doing my residency, you know, in neurology.
So we knew how to do EEGs to look at seizure activity.
And we know that some kiddos with autism have strange type of seizure type of phenomenon.
So I knew I could do an EEG.
And then a friend of mine had a child with autism who had a mitochondrial disorder.
And I had been very actually interested in mitochondrial disorders when I was in pediatrics.
So I said, well, I know how to test for that.
Well, I can do that.
So I can do an EEG.
I could do, you know, I could look for mitochondrial disorder.
And then I went on to get a job.
And so in academia, I was in academia for about 20 years.
And I'd go to the department, of course, and my colleagues would say, you know something about autism?
Because I have a whole clinic full of them and I have no idea what to do with these kiddos.
So they gave me all their kids with autism.
And finally, I had to make my own clinic where I was seeing pretty much only kids with autism.
And as I saw more and more kids, I started to figure out other things to do.
And as, you know, as neurologists, one of the things we do when we can't figure things out is we do what we call lumbar puncture to look at the chemistry in the brain to see if there's something wrong with the chemistry.
And I was at a very big center.
And so we were very good at doing these things.
So I'd send kids for these lumbar punctures.
And I noticed that the biochemical findings were abnormal.
And I found a couple of kids that had low folate in their nervous system.
And I looked at it about the same time, really, cerebral folate deficiency was really described in about 2005.
So this is just a little bit about the same time.
I said this brand new research.
I said, oh, maybe I can treat it with this drug leukovorin.
And I did.
And the kiddos had some amazing results.
Well, and I want to pause right there because I actually have a personal experience with this.
Not me, not my family, but it was, you know, Riley's been helping get this interview set up and kind of telling me some of the backstory.
And it finally was like, I'm literally texting with a dear friend whose son is nonverbal, four or five years old, and all of a sudden is taking this drug and is adding words, additional words to his vocabulary.
He literally didn't talk.
And now all of a sudden he's using multiple, multiple new words every week.
And the parents are ecstatic, as you might imagine.
But let's, before we get to the Lucovorin conversation, I want to kind of take a step back because Charlie had somebody on this show named Craymu.
He's got a Twitter account, X account.
And he's kind of like a statistician almost.
He looks at big, broad things.
And they discussed, this wasn't that long ago, they discussed whether or not what we're calling this rise in autism is, is it more statistically?
Is it more because we broaden the definition of what autism is?
Or is it really, really truly, you know, what are they saying?
What are the rates in California?
One in 22 kids or something like that in California.
It's one in 30 across the nation, something approximately like that.
Do you, I mean, is it maybe a bit of both that we've opened the aperture and now we're considering more kids with learning disabilities or what have you autistic?
And we just simply didn't classify them that way.
So, it's misrepresenting the numbers, or is it also that there just simply are more kids that are autistic?
I think it's a little bit of both.
Yeah.
I know when we went from the different definitions, so we used something called the Diagnostic Statistical Manual of Mental Disorders to diagnose the DSM.
We went from the DSM four to five, we actually thought it was going to be more strict and that we'd lose.
But instead, we went the opposite way.
And so, they have studies that you know.
So, who determines the definitions?
So, that's a group, a group of experts that look at these different symptoms and they decide how you can best define these.
And that's one thing that we have to understand.
Yeah, and it's a limitation of our diagnostic methods.
So, the DSM looks at behavior.
So, all we look at is behavior.
And when these behaviors come together, we say it's a certain disorder.
And we don't always look at the underlying biology.
And that's something that's really lagged behind, right?
And it's many times thought, you know, for a long time, thought maybe there wasn't any biology to it, but we learn more and more that there is biology.
And the more we look into it, we find out that there's actually medical causes that are causing the brain and these behaviors to actually occur.
So, right now, we're still left at that point where we're using this behavioral definition without having any blood tests or scans or anything.
So, it's the American Psychiatric Association, which determines the DSM guidelines.
Exactly.
Right.
So, you're saying that they are looking at behavioral outcomes and not looking at the underlying biology, or in this case, blood work or hormones, whatever that you're noticing that is deficient.
So, there's underlying.
But in an even deeper sense, is there something that's causing the underlying abnormal situation?
Whether it's you were talking about folates, is it our diet?
Is it the toxins in the environment?
Is it plastics?
I mean, do we know more about what these underlying causes are?
I think what we know is that it's complex, you know.
But definitely, there are predispositions, sometimes genetic predispositions, and there's a lot of-button between 1950 and well, this is the very interesting thing.
Yeah, so this is the interesting thing.
And what I've started to talk about a lot is this fact that a lot of people for a long time, for the last 20 years, we've assumed that autism is genetic because it's very heritable.
Okay, and we think that most of what's heritable is genetic, and that's not completely true, and that things that are genetic are untreatable.
Both of those things are not true.
So, first of all, what we're learning is those genetic mutations are what we call de novo.
So, they're non-inherited, they're new mutations.
So, it's a kind of interesting way to try to think about it because, yes, autism is genetic, but it's also environmental because you have to get those mutations somewhere.
Okay, so and that's an interesting question.
When you're talking about mutations, is that something that will happen in the parents' life?
So, they're having kids, let's say, at 30, but something happened between 20 and 25, and a genetic mutation happened, and then they pass that on, or is it happening in conception?
So, all of the above, and it's different for men and women.
Okay, because for females, their eggs are actually made when they're developing in their mother's room.
So, you can go back to their mother, the grandmother.
And men, we're making sperm all the time.
So, actually, we can have mutations throughout our life.
Do we know what causes mutations?
Well, there's all types of environmental toxins.
So I think we can look at one, you know, there's certain types of toxins in the environment that we're exposed to that cause problems, but there's also the other aspect of the nutritional aspect of it.
So, and that's kind of where the folate comes into it too, is because we know that folate abnormalities will cause problems with replicating DNA.
Interesting.
So we know that there's two sides of it.
One, not having enough of good stuff and having too much of bad stuff.
So these are very complex.
So that's why you can't really say it's this or it's that.
It's really this complex soup of things that have changed in our society, both probably poor nutrition and also maybe more toxins too.
So could you give me a couple of examples of real lived experiences that would actually change somebody's genetics?
Because you're right.
We sort of think of genetics as being the set formula.
This is your sequence of DNA.
It's set for life.
You're saying those genetic mutations can happen in a human during lived experience.
Would it be the cleaners that you use inside your home?
Is it smoking?
Is it drinking too much?
Is it a traumatic experience?
Is it stress?
Like what can make somebody's.
Yeah.
All of the above.
Right.
I mean, you know, that's where we think of it, and not only autism, but cancer, right?
Many times we have cancer because something has happened to the genetics of some of the cells.
And it's more of the cells that are replicating.
So some of our cells don't replicate.
You've made them, they're there.
But there's also cells that renew themselves.
And many of those are the ones that are more likely to have those changes because they're making new DNA all the time.
And what are those for men that's making the reproductive cells, the sperm, we're making them all the time.
So those are going to be more susceptible to having those mutations along the way.
Understood.
Now, that's super helpful to know.
So it's basically like a very complex situation just got way more complicated.
Right.
Exactly.
It's now more difficult because of our evolving understanding of the way the human genome works and the way cell replication works and DNA replication works, that you could identify multiple nodes along the life cycle of reproduction and development where you could isolate a potential mutation, which could then lead to autism or other abnormalities.
Right.
And then we find that's just one piece of it.
It's the genics.
Sometimes there's pure genetic syndromes, you know, where it can be the genes that are very, but then more likely it's a genetic predisposition.
And then there's some type of environmental agent that interacts with that to predispose to change the way our bodies work.
And we know that one of those major, you know, the most, probably the most influential environment you have is those nine months in your mother's belly.
You know, so we know that that influences the way that the baby develops.
And, you know, there's been many links to certain types of both, of course, low folate, but also certain types of environmental agents that can change the way that those cells develop, that can change the physiology.
And so that's one of the mysteries we think of, you know, how do we have this heritability, right, without having necessarily those genetic mutations, you know, is because much of what we think is happening is that the environment in the mother is changing the way the baby develops.
So you're actually inheriting changes that are due to the environment you had in your mother's womb.
And so let's say if the mother has a problem with having processing folates, let's say, that's going to be transmitted to the baby.
So the baby is going to develop that way with abnormal folate metabolism, and that baby is going to change its development.
Same thing with other types of metabolic disorders, which we find that run in families.
That environment in the mother's womb is going to be different.
The fuels that the baby gets, the different types of metabolites that may be off because the mother isn't metabolizing things as well.
That changes the way the baby develops.
For example, one of the studies that we did, and this is associated with another study.
It was a really good study by the Mount Sinai School of Medicine.
Some of my colleagues there, they did some really amazing research where they actually can take baby teeth, and baby teeth start to develop at the end of the first trimester.
So what you can do is you can go back and look at what's deposited in that teeth and tell what toxins, but also what nutrients the baby was exposed to.
Interesting.
And so one of the things.
It's almost like rings on a tree.
Exactly, exactly, exactly.
And so one of the first studies, they did a very, very nice study that was published in Nature, one of the best journals, where they showed out of twins that the twin that developed autism, that they were deficient in zinc and manganese in, I think, about the second or third trimester.
So for some reason, that nutrient wasn't getting to that baby, and there was changes in the physiology of that baby.
We actually showed when we, you know, were very interested in mitochondrial function.
We showed that the function of the mitochondria as a child was actually correlated with those levels of manganese and zinc that they had prenatally.
So this is a change that happened prenatally that then probably programmed the physiology, how the body works long term.
So what was the difference?
Could they tell between the two twins?
So yeah, so that was divided.
Mitochondria.
So we found that, well, they found that there was the zinc and manganese, and we found that those nutrients correlated with mitochondrial function later on in life.
And was that a genetic, I guess, predisposition of the autistic right.
So that's still an open question.
Why did that twin, you know, get more of those nutrients or less?
All we know is that they tended to get more or less of those nutrients for some reason.
And so then you have to go back and ask why.
Why was one delivered to one child and not the other?
Yeah.
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So in regards to mitochondrial diseases, If a mom is predisposed to a mitochondrial X-linked disease, what would you suggest or is there anything that that mom can do if she's planning on having a baby, if she's currently pregnant, to help minimize those risks of the baby inheriting that disease?
Yeah, well, first of all, if it's a genetic disease, so we divide these into what we call mitochondrial disease and mitochondrial dysfunction.
So what we find is that some type of mitochondrial disease is due to actually problems with the genes, you know, and the genes that run the mitochondria.
What we're finding is that there's many other diseases, including autism, where the mitochondria isn't working well because other parts of the body aren't working well.
So it's trying to compensate for other factors that are not working correctly in the cell.
So it might be working harder.
So we actually find that some kids with autism, their mitochondria actually works twice as hard as it should be.
And it puts it in actually in a more vulnerable state, is that what we found.
Some have this more mitochondria that work not very well, and that's more of the mitochondrial disease standpoint.
So there's two aspects of it.
If a mother has mitochondrial disease, if the child has that gene, then they're going to be more predisposed for the child's body not to work well.
But if they don't have that gene, we have to make sure that the abnormalities and metabolism in the mother is not interfering with the baby the way the baby grows.
So is this like the new front line, the forefront of the research that's going on with autism is how to identify these abnormalities prenatally and treat them in the womb.
Right, exactly.
Right.
Even preconception.
So if we can figure out, you know.
So even further back.
Right.
So we're finding is that many of these metabolic disorders and inflammatory disorders run in families, you know, and they may be influencing the baby and when the baby is growing, you know, prenatally.
But if you can go back and identify those things before time, you know, and control them, then you have a much better chance of the child.
Could it be supplements?
It could be supplements, yeah.
So there's really.
Yeah, what are the treatments?
Yeah.
So I would say for really very simple things, okay, and this, and you know, and we've written some blogs on this, that it's not even that difficult because we know things that predispose to autism and intellectual disability.
You know, folate, you know, iron, iron deficiency, you know, thyroid abnormalities, you know, and carnitine.
Carnitine's really important.
That's a really important vitamin that helps with what we call fatty acid metabolism.
But it's also important for clearing a lot of toxic molecules from your body.
So it's really important.
Yeah, so I have like a thousand questions.
I'm sorry.
I was just like my brain is spinning.
So say you're a 28-year-old couple and you're thinking, we're about ready to start a family.
Maybe you're 25.
Could they go to a doctor like you and be like, hey, run some tests, see what I'm predisposed to.
And you would do some blood work and you would test their levels and you'd be like, okay, you're good, good, good.
There's a little bit of lightness here.
You're not in a folate or there may be some indications there's a mitochondrial situation or this vitamin.
I can't even remember the carnitine.
So here's some supplements.
Try and switch your diet like this.
I mean, is that essentially, you know, you've got a thyroid situation, so we want to deal with it.
Right.
And you would do this pretty trying to conceive a child.
And yeah, so that's the idea is that pre-conception, you actually look at how the body is working to optimize the way the body works.
And then you do things that are smart.
There's another foundation I work with called the Neurologic Health Foundation.
We have something called the Healthy Child Guide.
And so, what we did is really review the literature to see what evidence there is, you know, even vitamin D.
So, there's really simple things.
Charlie talked about vitamin D all the time.
Yeah, it was mostly about COVID, but yeah, he was a big believer in it.
So, yeah.
But these are simple things, you know, that you don't have to do any fancy tests or anything.
They're very simple things that if you watch, you know, and you make sure you get ahead of the game, you know, that you can increase the chances of your child being healthy without chronic disease.
We find a lot of these things not only related to autism, but other types of chronic disease, especially inflammatory disease like asthma and eczema and all these other so-so, are there genetic markers that you could also screen for it?
Like when me and my wife, we you know had our first child, our daughter, we, you know, our OBGYN did a genetic screen to see if we had any inheritable diseases.
We didn't, thank God.
But could you do a test like that that is a new iteration of it that would test for, you know, does that test exist when it comes to autism to see how likely you might be in certain risk factors or whatever?
Well, so there's a so there's a difference between two things.
There's mutations.
So when they do those genetic tests, they look for things called mutations.
And those are changes in the genome that will absolutely cause some type of disease.
Sure.
If both parents usually share the same marker.
Exactly.
But there's now we're looking at things called polymorphisms.
So polymorphisms are small changes in the gene that are very common and make your body work better or worse.
Okay.
And you can, what we try and do is look at these changes to see how maybe some of, you know, if you have a pathway that has a number of weak spots, weak links, maybe you need to be supplemented in one way or the other.
You know, and this is, and it's very complex.
So we combine this with not only looking at the genetic changes, because one of the problems with looking at combinations of genetic changes, right, is you have 23,000 genes in your body.
So, you know, it's hard enough to look at all those 23,000 genes.
Think if you're going to start to look at all those combinations.
You know, so this is what's really kind of limited us in a lot of ways.
So you have to be smart in how you look at those things.
And then you really have to look at the biochemistry.
That is, what do those changes do to the function of the cell?
So it takes a lot of science to come up with really very definite recommendations.
So now we know some of these polymorphisms, how things work a little bit worse or better.
But still, the science of what that solution is is still developing.
But that's what you are doing.
That is the purpose almost of your professional career, right?
Right.
Like looking how to take the science and then apply useful treatments.
Exactly.
And then if we can do things, yeah, and that's the thing is that these things may be preventable.
And that's the only way we're going to reverse the trends right now.
Well, just one other question on the trends.
Do you notice a difference in boys versus girls as far as autism rates?
It seems to be my impression at least is that more boys are getting information.
Well, definitely more boys have autism or diagnosed with autism in girls.
And there's different theories of why that may be.
Which theory do you prescribe to most?
Or are you open-minded?
I'm open-minded.
Yeah.
What are some of the theories?
Well, I mean, some people think that it has to do with changes in the endocrine system.
So certain types of toxins can be endocrine modulators that change things.
It may be that girls are more resilient, you know, because Right.
They have 2X chromosomes, so they're more resilient.
They're going to double up the redundancy.
They have more redundancy baked in.
They think that.
And some people just think that women are more, their brains are more socially wired, so it's harder for their brains to change.
So they have less social abilities.
They kind of are compensated already.
Interesting.
So, and this is, why don't you come in here, Riley, and explain for our audience, because I know it enough to be, I would say, 50% right here.
But essentially, there was a big press conference that came out earlier in the year.
RFK, it must have been a cabinet meeting, basically said, we're doing a moonshot.
We're going to find out what the cause of autism is.
And this is going to take our conversation into this folate, Tylenol, this drug that we talked about.
I always forget the name, Lucovorin.
Lucovorin, which is apparently amazing for a subset of autistic conditions.
So give us the update of the FDA, Dr. Marty McCary, came out and gave some presentation recently.
And I think it sparked as much confusion as it did hope and clarification.
So walk us through what he announced.
Towards the end of September, RFK, as well as FDA Commissioner Dr. McCary, had announced this approval, FDA approval for Lukavorin to treat kids with autism.
I think a lot of people thought at the time it wasn't very clarified as to if this is for all autism cases or if this is just for a subset.
If you could go into detail on how this isn't necessarily a cure-all for autism, but it is a step in the right direction for where we are right now.
Sure.
So yeah, to clarify the announcement, the FDA is not approving it for autism.
So they're approving it for genetically confirmed cerebral folate deficiency.
And so that's kind of the model is we think many kids with autism have cerebral folate deficiency, or we call insufficiency, not enough folate.
So it's very different.
The genetically confirmed cerebral folate deficiency, there's about 47 cases actually described.
So 47 kids are now approved to take leukavorin.
Right.
And so, yeah, and I from the FDA, at least from the FDA.
And you can understand, I mean, if they were to say, oh, I'm just going to suddenly approve this drug, you know, I mean, that would just open up a, you know, a Pandora's box of, you know.
So what they did is they looked at these 47 cases, you know, that were, and when you have that, you know, those few cases, they're what we call case studies.
So we have very dense clinical data that shows, okay, you give this medication, this is exactly what it does to the body, you know, so we can definitely say, you know, why this happened and this actually was a therapeutic agent.
So when you look at large numbers, like kids with autism, you don't have that very granular data where you can see that.
So the idea of leukavorin, so leukavorin is a type of folate, vitamin B9, and it's really important for everybody to understand that leukavorin and what we call reduced folates are very different than folic acid.
So we think of folic acid, that's the folate that we take.
Folic acid is the synthetic form of the drug.
And there's certain caveats because of that.
Because of that, our body has to actually activate it for folic acid to be useful in the body.
And we have an upper limit to how much we can activate.
And certain Estimates have put that at about 400 micrograms, which is what's in kind of a high-dose multivitamin.
So, if you need extra folate in your body, if you have some type of folate deficiency or your body systems need extra folate, you can't do that with folic acid.
Because you can only process so much.
Exactly, exactly.
So, you have to use special types of folate like leukovorin.
Some people use 5-methotetrahydrofolate.
We know leukavorin is something that's been around for 80 years almost.
So, it's been used to treat to rescue the body from the side effects of chemotherapy.
Okay.
So, we've used it for 80 years in oncology.
If we've injected it, given an IFC, was that because that treatment created a folate?
Yes, exactly.
Yeah, so we know that cancer cells, one of the ways that they grow quickly is that they need a lot of folate.
So, one of the treatments is to block folate.
But then you don't want the body to get sick, so you have to supplement folate.
Interesting.
So, leukovorin has been around a long time.
So, that's one of the reasons that it was started to be used because it's really a known quantity.
So, that's great.
You know, we're starting out with something that we know.
So, what was found is that some kiddos with autism had what we call cerebral folate deficiency.
And this was going back to about 2005 or so.
These are the 47 cases.
So, yeah, it's a small cell.
Well, no, it's actually not the 47 cases because it's very interesting.
When this was first discovered, that there was low folate, as I had mentioned, you know, we do lumbar punctures, we find there's low folate.
And so, a doctor by the name of Dr. Rainmakers in Europe discovered this.
And he noticed that these kids that either weren't developing or actually had regressed, had lost skills very early on.
He did a lumbar puncture and he found there was low folate.
And we know that the major way that folate gets into the brain, because everything that goes to the brain has to be carried there.
There's a big barrier, is this thing called the folate receptor alpha?
And so, he said, okay, that was his first idea: there must be a genetic problem with it.
And so, he sequenced a gene in these cases.
He didn't find any genetic mutations.
So, that's when he collaborated with Dr. Edward Quatros, who's at SUNY Downstate in Brooklyn, who actually had been working on that same folate transport mechanism, but for women's health, and had discovered that there's this antibody that the body makes.
So, you know, antibodies usually, you know, attack viruses and bacteria and such.
But sometimes your body makes antibodies against yourself.
So, he found that some people had this antibody that attached to this mechanism, this pump that brings folate into the brain.
And so, they tested those kids for that antibody, and they found out that, yes, indeed, most of those kids had this antibody, and that's the reason why folate wasn't getting into the brain.
Interesting.
So, how do you treat it then?
So, leukovorin.
So, so what's interesting is so the levels of folate in the brain are two to three times higher than they are on the blood.
So, what's important about the folate receptor alpha is that it actually pulls folate into the brain.
So, it has to pull it uphill, right, because of the higher concentration.
So, if that's not working, how do you get folate into the brain?
Well, there's something called a reduced folate carrier, which is a backup system.
But it doesn't like folate as much, and it doesn't pump folate into the brain.
It's kind of like a tube.
So, I say, like, the folate receptor alpha is kind of like a fire hose that puts folate into the brain, and the reduced folate carrier is like a straw.
So, now what we have to do is we have to push folate through that straw and a special type of folate.
It only transports reduced folate.
So what we have to do is increase in the blood levels of reduced folate and essentially now push it into the brain to restore those levels in the folk.
Well, how do you do that?
And so that's where leukovoran comes in.
So is leucovorin just a special type?
What was the second type of reduced folate?
Reduced folate?
Is that what it is?
Yes, it's a special type.
So you're just flooding the system with...
Essentially, yeah.
Which is making it easier for this backup system to have enough to sort of push through the tube into the brain to balance out the chemistry in the brain.
Exactly.
And the great thing about B vitamins is they're what we call water-soluble.
So at the end of the day, you pee them out.
Sure.
So your body has a safety mechanism where they can't build up in your body.
So that makes them very safe.
Okay.
And we say like the worst you can do is make expensive pee.
Right.
Right, right, exactly.
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So this is kind of full circle to this.
My friend's son, who was nonverbal to four or five years old.
And it obviously was terribly stressful for the parents.
And, you know, they were asking a question, was it because we got this vaccine?
Did we over, you know, those were where their heads went.
Did we overdo the vaccines?
And so Lukavoran comes in within the last, I guess, month, and all of a sudden verbal skills are developing with their son, and they are over the moon ecstatic.
I mean, it's every day a new word or a couple new words.
And I've seen some of these videos of the mom just so excited, you know, because she loves her little boy so much, of course.
And all of a sudden, watching it, and it's because of this drug.
So you're saying that probably it's, or at least it's possible that this kid, and I have not asked follow-up questions of the diagnosis, but what you're seeing a lot is that there's actually an antibody that is working against the body's ability to get folate through mechanism one, the normal mechanism into the brain, which will help with verbal processing and social skills.
Yes, yeah.
Okay, so that's probably the diagnosis.
You would probably guess.
Right.
So what we find now, there's other reasons too.
So that's kind of the most prevalent and straightforward reason.
Now, also, as I said, that this folate receptor, alpha, actually pulls folate into the brain, so that takes energy.
So it ends up that if the mitochondria isn't working, that also that's another reason.
And so, and we found that in individuals with mitochondrial disorders that have cognitive issues, actually that that is the mechanism sometimes that they have some cognitive issues.
And there's another mechanism that we can help those individuals.
Describe what mitochondria is, just for people who don't know.
I mean, mitochondria is like a weird thing to me because it doesn't have its own DNA and it's like the power center of the cell.
And I mean, there's like crazy theories about where mitochondria came from, and we don't need to go into that.
But like, just explain what mitochondria is.
Yeah, so mitochondria, we think of it as the powerhouse of the cell.
It makes the energy currency of the cell called ATP.
ATP.
So it takes, it can usually take carbohydrates, but it takes fats.
Also, it can take amino acids and take all these things, and it can make energy.
But, and your cell has anywhere from hundreds to tens of thousands of mitochondria, depending on each cell, each cell.
So you have many of them.
And it's different genetically from it has its own genome, too.
Right, which makes a complex situation incredibly much more complex because you not only have your DNA, then you have mitochondrial DNA.
Yeah, the mitochondria, which you inherit from your mother.
And then it ends up that not all the mitochondria that you have, if you have a hundred mitochondria, not all of them may have the same DNA.
Some may have mutations on it.
And we call that heteroplasmy.
So that makes it even more complex to understand how mitochondrial DNA and mitochondrial inheritance goes on top of what we call Mendelian inheritance.
And the mitochondrial DNA also is very sensitive.
It's more sensitive to environmental stressors.
Right, okay.
And so is the mitochondria.
It sounds like maybe that because the environmental stressors, we talk about all these toxins and plastics and cleaning material.
I mean, it's like there's a thousand theories on what's causing environmental toxins to build up in our society and just our lived experience.
And so you're saying that mitochondria is more susceptible to that, which makes me think that that's probably, I mean, maybe you could correct me.
Are you seeing more autism being linked to mitochondrial dysfunction or to or to just miss?
So yeah, definitely we think that mitochondrial dysfunction is one of the major parts of autism that's driving autism.
So when we look at the biochemistry and how the cells aren't working, we find that there's kind of three pillars.
We find that there's mitochondrial dysfunction.
There tends to be there's high levels of what we call oxidative stress.
The body can't handle certain types of stresses that can come from toxins or not having enough nutrients.
And then we see the inflammation too.
So all of these three things kind of can reinforce each other in a bad way and cause a vicious spiral, which we think cause chronic disease.
Could you also explain how severe mitochondrial diseases truly are and how catastrophic they can be in more detail?
Yeah, yeah, yeah.
So definitely, you know, kind of your traditional mitochondrial disease many times, you know, starts very early on in life, especially, you know, at birth.
And the mitochondria is so important for energy and for many things, actually, for actually brain development.
We know that the mitochondria is important for actually putting the neurons in the brain in the right place, you know, helping them get there.
So if the mitochondria isn't working prenatally, you know, actually the brain doesn't develop correctly.
So and so if we don't have those, that energy, then our bodies can't grow, especially very early on, right?
Because one of them you need the most energy is when you're little and your body is going from very small to very big.
It has to build up.
If you don't, one of the things that happens is the body, if the mitochondria energy, it can use different things for energy, including, as I said, carbohydrates, fats, but also amino acids.
And amino acids are important for building your body and your proteins to make your body bigger.
So if your mitochondria is under stress, it'll actually use that protein in your body as energy instead of building up your body.
Go ahead.
So if you have mitochondrial disease, it'll actually break down your proteins.
Is that what you're saying?
Yeah, yeah.
Yeah.
So one of the treatments that sometimes for mitochondrial disease is just to pour in proteins so that the body, so the mitochondria can use those proteins and the body can actually also build itself.
And how does the ketogenic diet play into that?
I know that with mitochondria, it comes to energy and you need to boost up your protein, but you also, with keto, it is low carb, but it's the high fat.
So is the body utilizing that fat as the energy source to kind of compensate?
It is.
No, it does seem that it's utilizing that as an energy source.
It's a very dense energy source, so it can get more energy out of it.
But there seems to be other properties of the ketogenic diet that make it anti-inflammatory too, and an antioxidant diet too.
So it has many different types of properties that will actually help protect the body than using carbohydrates.
It changes the program of how the cells work and changes the way that the mitochondria works to make it more efficient.
And, you know, one of the things is that it may actually help repair the mitochondria too.
And so, you know, that's one of the things that we're trying to do.
At some point, we think of mitochondrial disease.
We're trying to stop the body from not falling apart, but we know we're trying to go to that next level of now how do we repair the mitochondria, you know.
And there's a lot of people working on that of how do you take that next step and have the mitochondria repair because the mitochondria can repair themselves, you know, and you can make more good mitochondria.
So how do you promote the cells to make more good mitochondria so that the body actually repairs itself?
So is your message to maybe parents or people that want to become parents that if you know that you have a mitochondrial disorder, you're scared about that maybe impacting your son or daughter that you're hoping to have, that there is hope.
There is potential solutions, treatments.
Yeah, no, I think that's, you know, the, and I say one of the most important parts with that announcement of leukovorin, you know, as a treatment for autism is the fact that somebody's actually said there's a treatment for autism.
You know, so as I said, the mantra has been it's genetic and you can't treat genetic disorder.
So it's, it's, you know, genetics is just one little part of it.
And actually we find out that leucovorin actually treats a lot of genetic disorders also, because many genetic disorders have these same physiological abnormalities that we see in autism.
So if you say you're living in Cincinnati, Ohio, or wherever, and you're worried about these things that we're talking about right now, what do they do?
What does a would-be or current parent, who do they look for?
Are they looking for what, like, is it a neurologist?
Is it a psychiatrist?
Is it a, I mean, who do they go to for help?
Yeah, I mean, unfortunately, as you say, that's it, you know, science really hasn't gotten there yet, you know?
And still, it's very surprising to me that there's been a lot of resistance to, you know, this revelation about leukovorin.
It's not really a revelation to me, right?
I've been doing it for 20 years.
But now we have, you know, five blinded controlled studies that show that leukovorin helps with kids with autism.
You know, and they're all positive.
Yeah.
So we should.
Yeah.
Yeah.
I mean, so two questions.
And so please wrap up, but I, but we got to get to Tylenol.
And leucovorin sounds super promising for a specific type of autism, right?
This folate lack of folate.
And it's important, yeah, to say that, you know, leukavorin or anything, autism is very complex.
So there's no autism pill.
You know, leukavorin sometimes works great.
As you said, your friend's son started talking.
And we have patients on the news, you know, that we interviewed with, but that doesn't always happen.
Sure.
And it actually, it helps many, many, many children, but you don't have that dramatic effect.
And that's because, you know, autism is very complex.
There's many other problems that are associated with autism for kids.
And you have to take a look at the whole body and the whole child.
So I want to talk about Tylenol.
I want to talk about vaccines.
But you have a yes, before you go into that, we were talking earlier.
I think with the research that you've done on this medication and the different formulations that you have found and what you have found that works best and go into detail on that because that was very interesting.
Yeah, yeah, yeah.
Yeah.
So this is something that is very important, yeah, is that, you know, we thought at some point that, you know, that some kids with autism just didn't, you know, react very well to the commercial forms of leukavorin because one of the problems is that commercial formulations have additives in them, you know, and there's actually a study that estimates that 50% of what we think are allergic reactions to drugs that we take are really to the additives,
not to the drunks, you know, and so we, what are those additives?
What is this?
There's all types of dyes, lactose, other types of.
So what we finally figured out last year, actually, that they were good brands and bad brands.
So brands that kids seem to tolerate really well and brands that they didn't tolerate really well.
Are you comfortable sharing some of the good ones versus the bad ones?
Well, I'll tell you the story because that's kind of academic because what I started doing at the beginning of this year was only prescribing the good brands.
And in March of this year, that manufacturer ran out of their year supply.
Seriously.
Just seriously.
And you're prescribing it.
Just me and maybe I tell my colleagues, but yeah.
How long is it going to take them to get the good one again?
Well, they only make so much a year.
So all these guys, the drug companies, it's a generic drug.
So they produce X amount for the year, right?
And when they run out of that, they're producing all these other drugs.
They're not going to go and just produce more just because they ran out.
They sold out.
So next year, maybe they'll produce more.
So it shows you the fragileness of the supply and the fact that these and the fact that leukavorin isn't made for this population.
So right now, I will only prescribe leukavorin from a compounding pharmacy that I know well that's going to make a very high quality leukavorin.
So you can still get it from this group, this so you can get it from a compounding pharmacy.
Yeah, okay, fine.
And so, yeah.
So right now, that's what we're trying to do is actually making a special formulation of leukavorin just for kids with autism so that they will have something that they can tolerate and that will be useful for them.
But we see all also all these over-the-counter formulations now of folinic acid, high-dose folinic acid, where you can get doses that are medicinal up where leukavorin should be.
And so, and these are completely uncontrolled.
So, you know, it's very important for parents, I think, to know that not all the formulations are the same.
Okay, well, that's really good to know.
Is there a resource where they can go maybe that are on one of your websites that you would point them in the right direction?
Sure, sure, sure.
So they can go to our foundation website, the autismdiscoverypeer.org.
Yeah, we've got it up there on the banner right now.
And you have an easy-to-find tab where you recommend certain formulations.
Yeah, I mean, we definitely can direct them to the things that the formulations we think that are best.
Okay, great.
And that's on your website right now.
We'll put it on our website.
We'll put it on.
I wanted to give you an ad.
I'm kind of putting you on the spot here.
I totally get it.
But it's something we should have.
No, you're right.
Yeah, because there's going to be parents all over the country that are going to be watching this interview, and they're going to be like, well, I don't live in Arizona.
I don't know how to find a guy like him in my backyard.
So where do I go for this, you know, and we're struggling with autism.
So I want to make sure there's like things that they know to do.
We will put something.
We have lots of information about folate and all that stuff, but we'll put in suggestions so that people will know where to go.
Wonderful.
Also, before you do your title thing, what are some questions that parents should ask their pediatricians if they're interested in this Lukavorin to help treat their child?
What are amazing questions that if their pediatrician isn't as adverse in Lukavorin as you might be, what's something that could kind of get them to where they need to be?
Yeah, I mean, definitely the parents should, they can do a number of things.
You know, there's varying amounts of comfort, you know, and I can understand that if a pediatrician doesn't know anything about it, you know, they want to prescribe something they're not comfortable with, you know.
So they should, you know, ask their pediatrician about it.
We have all of our, one of the things we've done for every article that we've written, we have both parent articles and we have science articles.
We have a lot of parent articles.
We have a lot of videos and such.
So the parents can actually print it out and bring it to their pediatrician, ask their pediatrician to look into it.
You know, if their pediatrician doesn't want to take that step, ask if they can be referred to somebody that will, you know, actually prescribe the Luke Vorin.
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So, Tylenol.
It's a big thing I made about Tylenol.
All the liberals, this is for me that you don't have to weigh in.
All the liberals are like drinking Tylenol on TikTok and all this stuff.
What's the truth?
So as I said before, autism is complex.
There's lots of things in our environment that are toxins, you know, that if we're vulnerable, we may be vulnerable to.
You know, Tylenol is, if you take too much Tylenol, you can overdose, right?
People, as we've seen, you can kill yourself with Tylenol actually causes liver failure.
So The fact that we have it in every single different cold medicine, every single different pain medicine has Tylenol in there.
And a lot of times we're not aware of how much Tylenol we may take.
And when you're pregnant, there's very few things that you can take.
And so many women, they're told to use Tylenol.
And so we know that one thing that Tylenol does is the way that it becomes toxic is it decreases something called glutathione.
And we know that kids with autism and possibly the mothers have low levels of glutathione.
So there may be a vulnerable population you can think of where maybe somebody that's vulnerable takes too much.
You know, it could be a factor.
Is it causing autism?
But that's only during gestation, right?
That's only during when a mother's pregnant.
We're not talking about when the kid is born or anything later, or what is that window of time?
You know, I mean, it's definitely possible.
There's a story.
So I've written a book also on NSylcysteine, which is the antidote to Tylenol.
And so one of the developers of that compound wrote the first chapter.
She's at Stanford, and she talks about a little girl, seven years old, that was brought into the ER by her grandparents in liver failure.
And the child was taking, the grandparents were taking care of the child over the weekend, and the child had a cold.
And so they just kept giving the kid cold medicine, cold medicine, cold medicine, not realizing that Tylenol is in all of those.
And it was enough to put this little girl into liver failure.
Thankfully, she did well when she came to the ER.
So is it something that's isolated just to gestation?
Who knows?
Tylenol is at high doses.
We know that it's toxic.
And it's something that I think anything we put in our body, we have to kind of question about how much.
So anything, I think, at too much can be toxic, right?
So, you know, is there a case where you're using too much of something and you also have this vulnerability that you don't know about?
You know, possibly.
So, you know, I think that we have to, you know, look at these things carefully and kind of reevaluate.
I think in every drug you put into your body, you really have to question.
Do you think there are other pain medications for kids that you would recommend more than Tylenol?
Yeah, I'm usually I suggest avoiding Tylenol when not necessary.
And I don't think it's Tylenol itself.
Most parents will use Tylenol for fevers.
Or they'll use Motrin or Advil or Motrin, Advil.
You recommend that more?
Well, yeah, and sometimes you have to use both.
You can alternate between the two if the fevers are really high.
But yeah, I would more use the non-Tylenol medications.
For children, because with women who are pregnant.
So that's a whole nother problem.
So the problem with women that are pregnant is they can't take those, what we call the NSAIDs, because the chemistry of what regulates labor is influenced by those.
So they can put themselves into labor.
So they're told only to take Tylenol.
So are there other things they can do?
I mean, I think, you know, the other thing is to kind of, you know, and I'm not saying just don't take any pain medication.
It's probably my wife didn't.
My wife just completely abstained from pain medications during pregnancy.
Yeah, so she just ducks it out.
That's amazing.
Yeah.
Not during birth.
No, no, during the breadth of process, she took all the pain medications proudly, actually.
And there's some women that are, you know, they believe that that's not the right thing.
But anyways, the point is, so if you are a woman that's pregnant and you've got a migraine, you've got some sort of ache pain, like it becomes debilitating.
Yeah.
So the thing is, ask your doctor.
Of course.
Ask your doctor.
But it's a safe way to get on, doctor.
This is non-binary.
Where do we have to get you to sign here that lets you off the hook?
But the general advice is to take Tylenol.
It is.
It is.
But that is now changing, I think.
Or there's confusion about it.
I think that there's confusion.
That's why I'm producing it better.
I mean, I just think it's the idea that too much of anything is real good.
So that, you know, if you, so think twice, you know, and, you know, there's other, you know, I'm not saying that, you know, women should just, you know, tough it out.
Or, you know, there's other things.
There's meditation, there's relaxation, you know, possibly that could be helpful too.
So it may just think of those other things, you know, and use them in conjunction.
First and see if they work before you end up putting a chemical in your body.
Exactly.
And being more mindful during your first trimester and how important development is to the baby at that point.
Right.
So it's important.
Your nutrition, everything you put in, your water, your food, everything you do, you really have to think about during gestation.
So we can't talk about autism without talking about vaccines because it's just been, it's just too there.
Even if I don't bring it up, like all the comments are going to be like vaccines.
So what is your opinion on the level of vaccines that we, you know, I mean, there's far more vaccinations now than there were in the 1980s.
Could this, you just got done saying with Tylenol, the level at which it becomes toxic, you know, maybe there's a vulnerability.
Couldn't you then extrapolate that same logic and say, well, if we're doing more, at some level, does it become toxic?
Do you not ascribe to that?
Do you not ascribe to that general theory of things?
No, I mean, I think it's, you know, it's true we're doing more.
First of all, you know, we don't know what causes autism.
So I think everything's open, right?
We've got to look at everything, everything that's changed.
You know, did we give more vaccines?
Yeah.
You know, is that having a role in our immune system?
We know that, you know, autism does seem to have this immune component.
You know, could early exposure to some of these vaccines that many, you know, reprogram the body?
Maybe.
We really don't know.
Well, why is there such a reticence from the establishment medical community to even address it?
It's like, you take your darn vaccines or you're an anti-vaxxer.
Well, you know, maybe we want to take the vaccine.
We just want to space them out a little further for our kids or maybe not have to take this particular one for school because there's quite a bit of, for our kids to attend like a public school or whatever.
Sure.
I mean, why is there such a reticence and such a resistance within the medical establishment?
Well, I mean, I think the thought of giving vaccines early is that you have the kids there, right?
You tend to lose the kids as they get older.
That doesn't feel like a very good because they're there.
Well, yeah, you know, and now you've pumped them full of drugs and they can't talk.
I don't know.
I'm just saying, like, I'm not, listen, I am not anti-vax.
We have vaccinated our children, but we spaced it out.
And we had a bunch of doctors, and we're still spacing it out, actually.
We had a bunch of doctors totally refuse to continue being our pediatricians.
Yeah, I don't understand that.
I mean, I think, you know, I've made my career at listening to parents and listening to their concerns.
Because I think that, you know, the thing is, even if vaccines have nothing to do with it, a parent, if their child, you know, develops autism And they were coerced into having five vaccines, you know, they're going to question: did I make that wrong decision?
And did I cause my kid to have autism?
So that's why I think it's important for parents to make their decisions and support it.
Vaccines are important in some states because, you know, the schools won't let your child go to school.
So in those instances, you're left with: do we pod school?
Do we homeschool?
You can't even send them to Christian schools, for example, in California, because they won't give you a religious exemption.
The Christian schools, in order to keep their charter, have to keep doing what the state tells them to.
So it's completely, you know, there's no options.
I mean, I've talked to the HHS and tried to say, hey, you need to do this, but it's such a local issue that federally they don't have much control.
So a lot of parents in states like California or Massachusetts or New York, they're up a creek, and there's not a whole lot that they can do other than homeschool their children.
So, and we've run into this.
It's like you've either find a doctor that's willing to shoot the thing over your shoulder and give you the slip, or which nobody wants to have to lie.
Nobody wants to have to misrepresent the truth at all.
But it's either that, homeschool, or you just say, you know, yes, sir, may I have another?
And you just send your kids off to school fully vaccinated, and you hope for the best.
Yeah, I like to be a problem solver, and I don't see that the current way that things are doing is solving any problems.
It's just causing more fracturing of things and kids maybe not getting their vaccines that they should.
Because, as you say, a lot of parents want to give the vaccines.
They just want to give it on their own schedule.
Yeah.
And then what's the deal with this MMR vaccine where they put it used to be given in separate doses?
And it feels like the only rationale I've heard for combining them into a single shot as opposed to three separate shots is that we have the kids there and we want to make sure we get them when we have them.
And that seems to be one of the vaccination that's on the schedule that is most controversial.
Yeah, no, it is.
I mean, there's been definitely controversy over the MMR, but I don't know that it's, you know, that the controversy has any more validity than anything else.
Yeah, but again, to your point, it's like if you're going to coerce a parent into having to do it, and then something, God forbid, does happen in the development of that child, then they're going to probably look to you as opposed to just spacing it out like they used to do.
I don't know.
Stuff like that does bother me simply because it does feel coercive.
It does feel like just trust your betters and shut up, plebe.
And I don't think anybody wants that experience with the health system.
Well, that's not what doctors should do, and that's not how the medical system should really work.
Really, it should be something that's a collaboration, right, between the parent and the doctor.
Well, I want to show your book here, Doctor, The Folate Fix.
And I mean, this is really exciting because I think I have just this week, that's what's so wild about having you on the show.
Just this week, I have a friend that is having this breakthrough with this drug that you've been using and experimenting with, using, treating patients with now for, did you say, 20 years?
Yeah, almost 20 years now, yeah.
And you've seen, maybe that's where we land this plane is just explain, you know, one more time so it's really clear.
If you're a parent, you have a child that you're worried about their development, you're wondering, because there is that point where you're like, they're one, two, three years old, and you're like, is everything okay?
And I think I have three kids and I've thought about it with all three of them because parents worry, right?
And thank God I think, you know, they are and they're developing on their route and the pace that they should.
But if you're a parent and you're worried about this, you know, explain, just land the plane there with this folate fix.
Tell them about your book and resources they can get from you and why they should consider maybe looking into this.
Yeah, no, I think definitely, you know, if a parent is concerned, they should bring it up with their doctor and talk to them.
You know, yeah, some kids, you know, some kids are late talkers and such.
That's true, but some of them do have signs for autism.
So you definitely want to ask your pediatrician, make sure that they do a screening for autism.
The universal screening is something called the MCHAT, which is a questionnaire that the parent fills out.
And if they screen positive for that, they should definitely take that seriously.
It's important to find pediatricians that embrace autism.
I think that some are more comfortable with it than others.
What does embrace it mean, though?
So I think that some pediatricians just don't see that many kids with autism.
So they don't know as much and they may not be that comfortable.
And then you find those other pediatricians that kind of embrace it.
They see almost all the kids with autism, you know, and they take it on as their and they're more solution-oriented, probably.
Exactly.
Because you don't have to, I think that's probably the main thing here that I'm taking away: is that if you find yourself in a situation where your kid does have autism, it could be light, it could be severe.
There are people like you out there working on solutions, working on ways to help.
And this, you know, the Lukavorin is a new breakthrough for a lot of parents.
It won't be the silver bullet for everybody, but these things are being worked on as we speak.
Yeah, and what's great also in the book is that we have 12 stories from parents about what they went through to get to get their children diagnosed.
And you can see that one of the things I always say is that really it's really important for the parent to advocate for their child.
Yeah.
And so if you think there's something wrong, you know, don't stop.
And if your doctor doesn't seem concerned, then find another doctor that may be concerned.
You know, you don't have to.
That's good advice.
For all medical situations, by the way, not just for your kid, but if it's you in the hospital, you've got to be your own advocate.
I've learned that much in life.
And there's nothing wrong.
Sometimes you just don't merge with a good doctor a certain way, but find somebody that you're comfortable with.
Don't get discouraged.
I have family members with severe autism.
And I know 20 years ago how hard it was to watch my parents go through doctor after doctor after doctor.
They just weren't, they weren't there.
They didn't get it.
And they were very standoffish to my parents saying, you know, like, is it worth it?
This, she's not worth it.
We don't want to treat her.
This isn't going to work.
And just what, and what would you say to encourage parents to don't give up?
Keep fighting for your kids.
Keep going.
And you can see some of the stories in the book of the parents and what they went through to actually find.
And what, you know, some doctors told them that they were shocking, shocked them.
They were very upset.
You know, but they actually found the solution to their child.
And that's what we used to say.
A lot of patients come to us and they say, you know, you're Dr. 51.
But what's really good is we've been finding that we're no longer Dr. 51.
More and more people are learning about it.
And so now we're Doctor one or two for a lot of patients.
So we can really treat the kids earlier and get them at start at the start so they can do better.
Yeah, and there is hope.
Even if your kid is at a younger age showing these signs and you intervene in whether it's supplements or Lukavorin or whatever the treatment that are out there, and a lot of love and a lot of attention, a lot of sociability, like a lot of prayer for friends that I know that have gone through this, They watch these young kids grow up and have full lives and breakthroughs, and whether it's speech or social ability,
those kinds of things.
So, keep the faith and keep pressing in and just love your kids, I think, is another big, big thing here.
