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  <p><span style='color:red'>Down Syndrome &amp; Vitamins</span> <br>
  <a href="index.html">Home</a></p>
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  <td width="2%" style='width:2.62%;padding:.75pt .75pt .75pt .75pt'>
  <p>&nbsp;</p>
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  <p style='margin:0in;margin-bottom:.0001pt'><b><span style='font-family:Arial'>The
  Pioneering Work of Ruth <span class=SpellE>Flinn</span> Harrell: Champion of
  Children<o:p></o:p></span></b></p>
  <p style='margin:0in;margin-bottom:.0001pt'><b><span style='font-size:11.0pt;
  font-family:Arial'>by Andrew W. Saul<o:p></o:p></span></b></p>
  <p style='margin:0in;margin-bottom:.0001pt'><b><span style='font-family:Arial'><o:p>&nbsp;</o:p></span></b></p>
  <p style='margin:0in;margin-bottom:.0001pt'><span style='font-size:10.0pt;
  font-family:Arial;mso-bidi-font-weight:bold'>(Reprinted with permission from
  the <i>Journal of Orthomolecular Medicine</i>, 2004. <span class=SpellE>Vol</span>
  19, No 1, p. 21-26.)<o:p></o:p></span></p>
  <p><i><span style='font-size:11.0pt;font-family:Arial'>The person who says it
  cannot be done should not interrupt the person doing it. (Chinese proverb.)<o:p></o:p></span></i></p>
  <p><span style='font-size:14.0pt;font-family:Arial'>Early in 1981, the
  medical and educational establishments were shaken to their socks.</span><span
  style='font-size:11.0pt;font-family:Arial'> Ruth F. Harrell and colleagues,
  in Proceedings of the National Academy of Sciences (1), showed that high
  doses of vitamins improved intelligence and educational performance in
  learning disabled children, including those with Down syndrome. Though to
  many observers this seemingly came straight out of left field, Dr. Harrell,
  who had been investigating vitamin effects on learning for forty years, was
  not inventing the idea of megavitamin therapy in one paper. But she had at
  last succeeded in focusing much-needed public attention on the role of
  nutrition in learning disabilities, a problem that ink-well-era US RDA's and
  pharmaceuticals by the lunchbox-full have failed to solve.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>The start of the second
  World War was breaking news when Ruth <span class=SpellE>Flinn</span> Harrell
  conducted her first investigations into what she called &quot;<span
  class=SpellE>superfeeding</span>.&quot; Her 1942 Columbia University PhD
  thesis, &quot;Effect of Added Thiamine on Learning&quot; (2), was published
  by the university in 1943 and would be followed by &quot;Further Effects of
  Added Thiamine on Learning and Other Processes&quot; in 1947 (3). Her
  research was not about enriched or fortified foods; &quot;added&quot; meant
  &quot;provided by supplement tablets.&quot; World War II had just ended when
  Dr. Harrell stated in a 1946 Journal of Nutrition article (4) that &quot;a
  liberal thiamine intake improved a number of mental and physical skills of
  orphanage children.&quot; By 1956, Dr. Harrell had investigated &quot;The
  Effect of Mothers' Diets on the Intelligence of Offspring&quot; (5), finding
  that &quot;supplementation of the pregnant and lactating mothers' diet by
  vitamins increased the intelligence quotients of their offspring at three and
  four years of age.&quot;<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>THIAMINE (Vitamin B-1)<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>Most everyone has heard
  of <span class=SpellE>beri-beri</span>, and few are all that passionate about
  it anymore. But <span class=SpellE>beri-beri</span>, which literally means
  &quot;I can't, I can't,&quot; may all too well describe the learning disabled
  child. Such children, recognized as truly disabled by the Americans with
  Disabilities Act, are not unwilling but rather unable to perform well in
  school. To see the physical incapacitation thiamine deficiency causes in impoverished
  countries is all too easy. To see the mental incapacitation in American
  classrooms is not difficult, either. Yet both may be caused by thiamine
  deficiency, and both helped by thiamine supplementation. Harrell zeroed in on
  this topic sixty years ago, demonstrating that supplemental thiamine improves
  learning. One reporter wrote, &quot;An experiment was conducted by Dr. Ruth <span
  class=SpellE>Flinn</span> Harrell which involved 104 children from nine to
  nineteen years of age. Half of the children were given a vitamin B1 (thiamine)
  pill each day, and the other half received a placebo. The test lasted 6
  weeks. It was found by a series of tests that the group that was given the
  vitamin gained one-fourth more in learning ability than did the other
  group.&quot; (6)<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>Carbohydrates, including
  sugar, increase the body's need for thiamine. Children eat a lot of sugar. An
  unmet increase is effectively the same as a deficiency. This may be part of
  the mechanism of ADHD and other children's learning and behavior disorders,
  as many so-called &quot;food faddists&quot; or &quot;health nuts&quot; have
  proclaimed for decades. Vitamin deficiency can become vitamin dependency.
  Chronic subclinical <span class=SpellE>beri-beri</span> may result in
  thiamine dependency in the same way that chronic subclinical <span
  class=SpellE>pellegra</span> results in niacin dependency.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>B-COMPLEX<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>The B-vitamins as a group
  are absolutely vital to nerve function, and it would be difficult to imagine
  the juvenile owner of malnourished nerves performing well in school.
  Specifically, it is well established that thiamine deficiency causes not only
  loss of nerve function and ultimately paralysis, but also according to The
  Nutrition Desk Reference (7), &quot;memory loss, reduced attention span,
  irritability, confusion and depression.&quot; (p 43) Riboflavin (B-2)
  deficiency causes &quot;nerve tissue damage that may manifest itself as
  depression and hysteria.&quot; (p 45) Niacin (B-3) deficiency causes
  &quot;loss of memory and emotional instability.&quot; (p 46) Pyridoxine (B-6)
  deficiency results in &quot;impaired production of neurotransmitters (and)
  mental confusion.&quot; (p 48) Folic acid deficiency causes irritability,
  apathy, forgetfulness and hostility. (p 49). <span class=SpellE>Cobalamin</span>
  (B-12) deficiency causes &quot;degeneration of the spinal cord, fatigue,
  disorientation, ataxia, moodiness, and confusion.&quot; (p 51)<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>Though these symptoms
  generally appear after prolonged deficiency, they are very serious and, if
  untreated, the ultimate result in each case would be death. Practically
  speaking, a shortage of any one of the B-vitamins can be seen to lead to
  neurological damage sufficient to contribute to learning and behavioral
  troubles.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>Harrell recognized that
  thiamine and the rest of the vitamins work better as a team. She used two
  clinically effective but oft-criticized therapeutic nutrition techniques:
  simultaneous supplementation with many nutrients (the &quot;shotgun&quot;
  approach), and megadoses. Working on the reasonable assumption that learning
  disabled children, because of functional deficiencies, might need higher than
  normal levels of nutrients, she progressed from her initial emphasis on
  thiamine to later providing a wide variety of supplemental nutrients.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>DEFICIENCY DEBATE<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>The only escape from the
  inevitability of concluding that vitamin deficiency is a serious factor in
  learning is the political one: declare a victory. Dodging the issue is as
  easy as proclaiming that, thanks to food fortification (coupled with a
  generous portion of wishful thinking), no child has such deficiencies. Though
  the processed food industry and its apologists continue to assert exactly
  this, statistics fail to bear this out.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>An analysis of National
  Health and Nutrition Examination Survey (NHANES III) data from 1988 to 1994
  by Gladys Block, PhD, indicates that over 85 percent of American elementary
  school-age children fail to eat the recommended five or more daily servings
  of fruits and vegetables. &quot;NHANES III, a federally sponsored survey
  shows that on any given day, 45 percent of children eat no fruit, and 20
  percent eat less than one serving of vegetables. The average 6 to 11 year-old
  eats only 3.5 servings of fruits and vegetables each day, achieving only half
  the recommended 7 servings per day for this age group.&quot; (8)
  Additionally, Dr. Block reports, 20% of children's caloric intake comes from
  junk snacks, such as soda pop, cookies, and candy.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>Though it is a stretch to
  say that all learning and behavioral disabilities are due to inadequate
  vitamin intake, it is certain that some are. Behavioral deficiency tends to
  show up before nutritional deficiency is recognized. Arthur Winter, MD,
  writes that &quot;In thiamine (vitamin B1) deficiency, symptoms such as lack
  of well being, anxiety, hysteria, depression, and loss of appetite preceded
  any clinical evidence of beriberi. Other studies using the Minnesota
  Multiphasic Personal Index (MMPI) have also demonstrated that adverse
  behavioral changes precede physical findings in thiamine deficiency.&quot;
  (9)<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>DOSAGE DEBATE<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>Dr. Harrell anticipated
  that her use of megadoses would result in &quot;controversy and
  brickbats.&quot; (10) She was right. A number of well-publicized studies
  (11-15) conducted to &quot;replicate&quot; Dr. Harrell's work seemingly could
  not do so. Would-be &quot;replications&quot; fail the moment they start when
  they refuse to use adequate dosages. Surely it is the most basic condition
  for any replication that one must exactly copy the original experiment, or it
  is not a replication at all. When DNA replicates, it forms an exact and
  indistinguishable copy of the original. Even the smallest of changes can
  result in dysfunction, mutation, and death. Yet Harrell's &quot;<span
  class=SpellE>replicators</span>&quot; failed to adhere to her protocol, and
  consequently but not surprisingly, failed to get her results. (16)<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>Probably one of the
  closer replications was done by Smith et al (17) and even that study totally
  omitted <span class=SpellE>dessicated</span> thyroid, a component of the
  Harrell protocol that her coauthor Donald R. Davis, PhD, says was
  &quot;emphasized to Smith (as) Harrell's subjects received thyroid
  continuously.&quot; (18)<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>F. <st1:place w:st="on"><st1:City
   w:st="on">Jack Warner</st1:City>, <st1:State w:st="on">MD</st1:State></st1:place>,
  a supporter the Harrell approach (19) writes: &quot;Even today many medical
  professionals scoff at the validity of Dr. Ruth Harrell's study with
  nutritional supplements and the important addition of thyroid medication. Dr.
  Harrell pleaded with her <span class=SpellE>replicators</span> to use exactly
  the same chemical values of supplements and medications. To date, this still
  has not been accomplished.&quot; (20) In spite of obvious bias, negative
  &quot;replication&quot; studies using incomplete or low doses are the ones
  that have been accepted, and Harrell's work shelved. This is saying that the
  results of inaccurate replication are more valuable than the original
  successful research. Imagine cloning a sheep, getting a hedgehog, and then
  claiming that it was the sheep's fault. Incredible. But that is what
  politicized medical apologetics are capable of.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>The Harrell study was
  successful because her team gave learning-disabled kids much larger doses of
  vitamins than other researchers are inclined to use: over 100 times the adult
  (not child's) RDA for riboflavin; 37 times the RDA for niacin (given as
  niacinamide); 40 times the RDA for vitamin E; and 150 times the RDA for
  thiamine. Supplemental minerals were also given, as was natural <span
  class=SpellE>dessicated</span> thyroid. Harrell's team achieved results that
  were statistically significant, some with confidence levels so high that
  there was less than on chance in a thousand that the results were due to
  chance (P &lt; 0.001) Simply stated, Ruth Harrell found IQ to be proportional
  to nutrient dosage. This may simultaneously be the most elementary and also
  the most controversial mathematical equation in medicine.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>There is a tone to the
  controversy that does more than merely suggest that Harrell's research was
  careless or incompetent. This is unlikely in the extreme; Dr. Harrell,
  formerly the chairman of the psychology department at <st1:place w:st="on"><st1:PlaceName
   w:st="on">Old</st1:PlaceName> <st1:PlaceName w:st="on">Dominion</st1:PlaceName>
   <st1:PlaceType w:st="on">University</st1:PlaceType></st1:place>, had been
  studying children before many of her critics were even born. What is more
  likely is that Harrell's critics embrace the assumption that medicine must
  ultimately prove to be the better approach, and if there are any megadoses to
  be given, they shall be megadoses of pharmaceutical products. Vitamin therapy
  is unattractive to pharmaceutical companies. There is no money in products
  that cannot be patented. Children learn at an early age that mud pies don't
  sell. No investment is <span class=GramE>made,</span> no research is done
  where no money is to be recovered. Drug companies do not expect to find, nor
  do they want to find, a cure that does not involve a drug. A tragic example
  is modern medicine's approach to Down syndrome.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>DOWN SYNDROME<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>If there is orthodox
  resistance to using vitamins to enhance student learning, there is positively
  a fortified roadblock to the suggestion that vitamins can help children with
  Down syndrome. Nutrition, critics say, can not undo <span class=SpellE>trisomy</span>
  21. But nutritional therapy is not a science-fiction attempt to rearrange
  chromosomes. Nutritional intervention may help the body to biochemically
  compensate for a genetic handicap. Roger Williams, discoverer of the vitamin
  pantothenic acid, termed this the &quot;genetotrophic concept.&quot;
  Genetotrophic diseases are &quot;diseases in which the genetic pattern of the
  afflicted individual requires an augmented supply of one or more nutrients
  such that when these nutrients are adequately supplied the disease is
  ameliorated.&quot; (1) Ruth Harrell's decades of research showed that it is
  plausible. Conventional Down syndrome educational material holds that it is
  hogwash.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>As of August 2003, the
  National Down Syndrome Society's &quot;Position Statement on Vitamin Related
  Therapies&quot; states that &quot;Despite the large sums of money which
  concerned parents have spent for such treatments in the hope that the
  conditions of their child with Down syndrome would be bettered, there is no
  evidence that any such benefit has been produced.&quot; (21)<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>At the heart of the issue
  are the usual, and largely philosophical, front-line disagreements of
  definition and interpretation. First, what precisely constitutes a
  &quot;deficiency&quot; in a society that, as nutritional legend would have <span
  class=GramE>it,</span> has eliminated vitamin deficiency? Adherents of
  conventional dietetics presuppose that anyone who claims that there are
  widespread vitamin deficiencies among children must proceed from a false
  assumption. Those who advocate vitamin therapy would answer that Down's
  creates a &quot;functional deficiency&quot; which must be met with
  appropriate supplementation. The very idea that doses sufficiently high to
  effectively do so should be 100 times the RDA is positively repellent to most
  investigators. When asked about whether she had received National Institutes
  of Health funding for her study, Dr. Harrell replied, &quot;Heavens, no!
  Nobody knows anything about the area of dietary supplementation, but the
  National Institutes of Health knows for sure it's impossible.&quot; (10)<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>Some reviews of Down
  nutrition studies actually state that doses as low as 500 mg of vitamin C are
  unsafe, and <span class=GramE>that other Harrell-sized dosages</span> are
  harmful as well. In one such article posted at the Down Syndrome Information
  Network, the authors conclude that &quot;If it is necessary for additional
  vitamins to be given to someone with Down syndrome, all that is usually
  needed is a multivitamin tablet, not more than once a day, at a cost of about
  one penny per tablet. Meanwhile, the best nutritional advice anyone can
  honestly offer is to consume a varied and balanced diet - whether you have
  Down syndrome or not.&quot; (22)<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>Another popular argument
  is that, even allowing that children eat poorly, there is insufficient
  evidence that <st1:place w:st="on">Downs</st1:place> is aggravated by poor
  nutrition, or helped by good nutrition. After all, <st1:place w:st="on">Downs</st1:place>
  is a genetically-determined disease. But surely the genes do not operate in a
  nutrient vacuum. For example, vitamin E has recently been demonstrated to
  preferentially protect genetic material in Down patients' cells.
  &quot;Vitamin E treatment decreased the basal and G2 chromosomal aberrations
  both in control and Down Syndrome (DS) lymphocytes. In DS cells, this protective
  effect, expressed as a decrease in the chromosomal damage, was greater (50%)
  than in controls (30%). These results suggest that the increment in basal and
  G2 aberrations yield in DS lymphocytes may be related to the increase in
  oxidative damage reported in these patients.&quot; The results would also
  suggest that antioxidant vitamin supplements would be an especially good idea
  for Down's individuals. (23)<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>Although the greater
  question may be, can optimum nutrition help compensate for a genetic defect,
  the essential question must be this: can nutrition help a given <st1:place
  w:st="on">Downs</st1:place> child? Dianne Craft, a special education teacher,
  comments on Harrell's 1981 research:<o:p></o:p></span></p>
  <p><i style='mso-bidi-font-style:normal'><span style='font-size:11.0pt;
  font-family:Arial'>&quot;Dr. Harrell noted that one of the observations that
  they made during this study was that when there was a ten point rise in IQ,
  the family noticed it. When there was a fifteen point rise in IQ, the
  teachers noticed it. When there was a twenty point rise in IQ, the
  neighborhood noticed it.<o:p></o:p></span></i></p>
  <p><i style='mso-bidi-font-style:normal'><span style='font-size:11.0pt;
  font-family:Arial'>&quot;The story of one child is particularly poignant.
  This seven year old child was still wearing diapers, didn't recognize his
  parents, and had no speech. His motor skills were relatively unimpaired and
  he could walk and run fairly well. In forty days, after some of the
  supplements were increased, his mother <span class=GramE>telephoned.</span> .
  . saying, &quot;He's turned on, just like an electric light. He's asking the
  name of everything. He points and says, 'What <span class=SpellE>zis</span>?'
  Finally he pointed to his father and said, '<span class=SpellE>zis</span>?' I
  said, 'That's your father and you call him daddy, and he looked at him and
  said 'daddy.' I'm your mother; can you call me mommy?&quot; She went on to
  say, &quot;I think he saw us for the first time.&quot; This little boy went
  on to do very well in his learning, and eventually tested with an IQ of
  ninety, which an average IQ.&quot;</span></i><span style='font-size:11.0pt;
  font-family:Arial'> (24) I have seen a beautiful photo in Medical Tribune (9)
  of Dr. Harrell being hugged by one of the study group children. The kids
  noticed their own improvement.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>Perhaps Harrell's
  dramatic IQ gains were merely due to the placebo effect. If so, I want every
  school district on earth to lay in a stock of sugar pills, for gains like
  this, in only eight months, are astounding. Perhaps success was due to Dr.
  Harrell's group's expectations or to her bedside manner. But, as Abram Hoffer
  has said, &quot;I am nice to all my patients. Only the ones on vitamins
  improve.&quot; Harrell colleague Donald Davis writes, &quot;No amount of
  matching or variable control with Harrell's subjects could change their large
  IQ gains which are the crucial and so far unexplained difference between the
  Harrell group and others.&quot; (25)<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>When Dr. Harrell died in
  1991, she was far from being alone in reporting success with high-dose
  nutrition therapy. Dianne Craft writes, &quot;For over forty years, Dr. Henry
  Turkel (26, 27) treated Down's children successfully using orthomolecular
  methods. He used a combination of vitamins, minerals, and thyroid hormone
  replacement. His patients improved mentally and they lost the typical Down's
  syndrome facial appearance. With over 600 children treated, he found an
  eighty to ninety percent improvement rate.&quot; (24)<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>To date, the orthodox
  Down authorities' position may be summed up as, there is no evidence that it
  helps, so do not try it. Dr. Harrell's view would be<span class=GramE>,</span>
  there is reason to believe that nutrition might help, so let's see if it
  does. The first view prevents physician reports. The second generates them.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>Theorization can only go
  so far. The proof is in the pudding, and Ruth <span class=SpellE>Flinn</span>
  Harrell's approach yielded smarter, happier children. Her results are
  sufficiently compelling justification for a therapeutic trial of
  orthomolecular supplementation for every learning-impaired child.<o:p></o:p></span></p>
  <p><b><span style='font-size:11.0pt;font-family:Arial'>References:<o:p></o:p></span></b></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>1. Harrell RF, <span
  class=SpellE>Capp</span> RH, <st1:Street w:st="on"><st1:address w:st="on">Davis
    DR</st1:address></st1:Street>, Peerless J, and <span class=SpellE>Ravitz</span>
  LR. Can nutritional supplements help mentally retarded children? An
  exploratory study. Proc <span class=SpellE>Natl</span> <span class=SpellE>Acad</span>
  <span class=SpellE>Sci</span> <st1:place w:st="on"><st1:country-region w:st="on">USA</st1:country-region></st1:place>,
  1981. 78: 574–8.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>2. Harrell RF. Effect of
  added thiamine on learning. NY: Bureau of Publications, Teachers College, <st1:place
  w:st="on"><st1:PlaceName w:st="on">Columbia</st1:PlaceName> <st1:PlaceType
   w:st="on">University</st1:PlaceType></st1:place>, 1943. Issued in the
  series: Contributions to education, no. 877. Reprinted: <st1:place w:st="on"><st1:State
   w:st="on">New York</st1:State></st1:place>, AMS Press, 1972. ISBN:
  0404558771.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>3. Harrell RF. Further
  effects of added thiamine on learning and other processes. NY: Bureau of
  Publications, Teachers College, <st1:place w:st="on"><st1:PlaceName w:st="on">Columbia</st1:PlaceName>
   <st1:PlaceType w:st="on">University</st1:PlaceType></st1:place>, 1947.
  Issued in the series: Contributions to education, no. 928. Reprinted: <st1:place
  w:st="on"><st1:State w:st="on">New York</st1:State></st1:place>, AMS Press,
  1972. ISBN: 040455928X.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>4. Harrell RF. Mental
  response to added thiamine. J Nutrition, 1946. 31:283.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>5. Harrell RF, <span
  class=SpellE>Woodyard</span> E and Gates AI. The effect of mothers' diets on
  the intelligence of offspring. Also known as: Relation of maternal prenatal
  diet to intelligence of the offspring. NY: Bureau of Publications, Teachers
  College, <st1:place w:st="on"><st1:PlaceName w:st="on">Columbia</st1:PlaceName>
   <st1:PlaceType w:st="on">University</st1:PlaceType></st1:place>, 1956.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>6. Dr. Ruth <span
  class=SpellE>Flinn</span> Harrell: Effect of added thiamine on
  learning.&quot; The Health Seeker, p 18-19. </span><span style='font-size:
  11.0pt'><a href="http://www.geocities.com/HotSprings/2194/vitamin.html"><span
  style='font-family:Arial'>http://www.geocities.com/HotSprings/2194/vitamin.html</span></a></span><span
  style='font-size:11.0pt;font-family:Arial'> <o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>7. Garrison RH and <span
  class=SpellE>Somer</span> E. The Nutrition Desk Reference. <st1:place w:st="on"><st1:City
   w:st="on">New Canaan</st1:City>, <st1:State w:st="on">CT</st1:State></st1:place>:
  Keats, 1990.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>8. </span><span
  style='font-size:11.0pt'><a
  href="http://www.eurekalert.org/pub_releases/2002-05/pn-akp051602.php"><span
  style='font-family:Arial'>http://www.eurekalert.org/pub_releases/2002-05/pn-akp051602.php</span></a></span><span
  style='font-size:11.0pt;font-family:Arial'> 16 May, 2002. Accessed August,
  2003.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>9. Winter A. Differential
  diagnosis of memory dysfunction: Finding the cause when your patient can't
  remember. </span><span style='font-size:11.0pt'><a
  href="http://www.afpafitness.com/articles/Memory.htm"><span style='font-family:
  Arial'>http://www.afpafitness.com/articles/Memory.htm</span></a></span><span
  style='font-size:11.0pt;font-family:Arial;color:yellow'> </span><span
  style='font-size:11.0pt;font-family:Arial'>Accessed August, 2003.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>10. <span class=SpellE>Horwitz</span>
  N. Vitamins, minerals boost IQ in retarded. Medical Tribune. <span
  class=SpellE>Vol</span> 22, No 3. Wednesday, 21 January, 1981. Pages 1 and
  19.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>11. Bennett FC,
  McClelland S, <span class=SpellE>Kriegsmann</span> EA, Andrus LB, Sells CJ. Vitamin
  and mineral supplementation in Down's syndrome. Pediatrics. 1983 Nov;
  72(5):707-13.)<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>12. Bidder RT, Gray P, <span
  class=SpellE>Newcombe</span> RG, Evans BK, Hughes M. The effects of
  multivitamins and minerals on children with Down syndrome. Dev Med Child <span
  class=SpellE>Neurol</span>. 1989 Aug<span class=GramE>;31</span>(4):532-7.)<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>13. <span class=SpellE>Menolascino</span>
  FJ, Donaldson JY, Gallagher TF, Golden CJ, Wilson JE, <span class=SpellE>Huth</span>
  JA, <span class=SpellE>Ludvigsen</span> CW, Gillette DW.) Vitamin supplements
  and purported learning enhancement in mentally retarded children. J <span
  class=SpellE>Nutr</span> <span class=SpellE>Sci</span> <span class=SpellE>Vitaminol</span>
  (<st1:place w:st="on"><st1:City w:st="on">Tokyo</st1:City></st1:place>). 1989
  Jun<span class=GramE>;35</span>(3):181-92.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>14. Smith GF, <span
  class=SpellE>Spiker</span> D, Peterson CP, <span class=SpellE>Cicchetti</span>
  D, Justine P. Failure of vitamin/mineral supplementation in Down syndrome.
  Lancet, 1983. 2:41.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>15. Weathers C. Effects
  of nutritional supplementation on IQ and certain other variables associated
  with Down syndrome. Am J <span class=SpellE>Ment</span> <span class=SpellE>Defic</span>.
  1983 Sep<span class=GramE>;88</span>(2):214-7.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>16. <span class=SpellE>Pruess</span>
  JB, <span class=SpellE>Fewell</span> RR, Bennett FC. Vitamin therapy and
  children with Down syndrome: a review of research. Except Child. 1989 Jan<span
  class=GramE>;55</span>(4):336-41.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>17. Smith GF, <span
  class=SpellE>Spiker</span> D, Peterson CP, <span class=SpellE>Cicchetti</span>
  D, Justine P. Use of megadoses of vitamins with minerals in Down syndrome. J <span
  class=SpellE>Pediatr</span>. 1984 Aug<span class=GramE>;105</span>(2):228-34.<o:p></o:p></span></p>
  <p><st1:Street w:st="on"><st1:address w:st="on"><span style='font-size:11.0pt;
    font-family:Arial'>18. Davis DR</span></st1:address></st1:Street><span
  style='font-size:11.0pt;font-family:Arial'> and <span class=SpellE>Capp</span>
  RH. Vitamins and minerals in Down Syndrome. J <span class=SpellE>Pediatr</span>.
  1985 March<span class=GramE>;106</span>(3):531.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>19. <span class=SpellE>Thiel</span>
  R.J. Facial effects of the Warner protocol for children with Down syndrome.
  Journal of Orthomolecular Medicine, 2002;17(2):111-116<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>20. Warner FJ. Metabolic
  supplement for correction of raging free radicals in <span class=SpellE>Trisomy</span>
  21: A <span class=SpellE>noncomparative</span> open case study. </span><span
  style='font-size:11.0pt'><a href="http://www.warnerhouse.com/radicals.htm"><span
  style='font-family:Arial'>http://www.warnerhouse.com/radicals.htm</span></a></span><span
  style='font-size:11.0pt;font-family:Arial'> . Accessed August, 2003.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>21. </span><span
  style='font-size:9.0pt'><a
  href="http://www.ndss.org/content.cfm?fuseaction=SearchLink&amp;article=45"><span
  style='font-family:Arial'>http://www.ndss.org/content.cfm?fuseaction=SearchLink&amp;article=45</span></a></span><span
  style='font-size:9.0pt;font-family:Arial'> .</span><span style='font-size:
  11.0pt;font-family:Arial'> Accessed August, 2003.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>22. Sacks B and Buckley
  F. Multi-nutrient formulas and other substances as therapies for Down
  syndrome: An overview. Down Syndrome News and Update, 1998. 1(2), 70-83. </span><span
  style='font-size:9.0pt'><a
  href="http://www.down-syndrome.info/library/periodicals/dsnu/01/2/070/DSNU-01-2-070-EN-GB.htm"><span
  style='font-family:Arial'>http://www.down-syndrome.info/library/periodicals/dsnu/01/2/070/DSNU-01-2-070-EN-GB.htm</span></a></span><span
  style='font-size:9.0pt;font-family:Arial'> <o:p></o:p></span></p>
  <p style='margin:0in;margin-bottom:.0001pt'><span style='font-size:11.0pt;
  font-family:Arial'>23. <span class=SpellE>Pincheira</span> J, <span
  class=SpellE>Navarrete</span> MH, de la <span class=SpellE>Torre</span> C,
  Tapia G, Santos MJ. Effect of vitamin E on chromosomal aberrations in
  lymphocytes from patients with Down syndrome. <span class=SpellE>Clin</span>
  Genet. 1999 Mar<span class=GramE>;55</span>(3):192-7.<o:p></o:p></span></p>
  <p style='margin:0in;margin-bottom:.0001pt'><span style='font-size:11.0pt;
  font-family:Arial'><o:p>&nbsp;</o:p></span></p>
  <p class=MsoNormal><span style='font-size:11.0pt;font-family:Arial'>24. Craft
  D. Can nutritional supplements help mentally retarded children? 1998.<o:p></o:p></span></p>
  <p style='margin:0in;margin-bottom:.0001pt'><span style='font-size:10.0pt'><a
  href="http://www.diannecraft.com/nut-sup1.html"><span style='font-family:
  Arial'>http://www.diannecraft.com/nut-sup1.html</span></a></span><span
  style='font-size:11.0pt;font-family:Arial;color:blue'> </span><span
  style='font-size:11.0pt;font-family:Arial'>Accessed August, 2003.<o:p></o:p></span></p>
  <p><st1:Street w:st="on"><st1:address w:st="on"><span style='font-size:11.0pt;
    font-family:Arial'>25. Davis DR</span></st1:address></st1:Street><span
  style='font-size:11.0pt;font-family:Arial'>. The Harrell study and seven
  follow-up studies: A brief review. J Orthomolecular Medicine, 1987. 2:2,
  111-115.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>26. Turkel H. Medical
  amelioration of Down's syndrome incorporating the orthomolecular approach.
  Journal of Orthomolecular Psychiatry, 1975. 4:102-115.<o:p></o:p></span></p>
  <p><span style='font-size:11.0pt;font-family:Arial'>27. Turkel H. The medical
  treatment for Down's syndrome. <st1:place w:st="on"><st1:City w:st="on">Southfield</st1:City>,
   <st1:State w:st="on">MI</st1:State></st1:place>: <span class=SpellE>Ubiotica</span>.
  1985.<o:p></o:p></span></p>
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