Introduction to TNI in Down Syndrome

TNI stands for Targeted Nutritional Intervention. It is a mixture of vitamins, minerals, amino acids, fatty acids and digestive enzymes targeted to reduce the biological impacts of that extra 21st chromosome.

That extra chromosome isn’t just sitting there in your kid’s body. The DNA on the chromosome is active all the time, and when it isn’t replicating itself it is busy making proteins. The upshot is that your kid has too many of certain chemicals in his body, and this excess causes the physical problems we recognize as Down Syndrome. The mix of stuff in TNI is designed to either rebalance cycles that are out of whack due to too much of these proteins to prevent damage from occurring, or to repair the damage done by cycles out of whack.

Ginger Houston-Ludlam writes:

Here’s the reader’s digest version of what Down Syndrome is. The primary function of the DNA on chromosomes in the body is to make proteins. Therefore, since our kids have an extra copy of chromosome 21, in general it makes half-again as much of the proteins “coded for” on chromosome 21. In some cases, there are alternative mechanisms to tone those genes down, so not every gene is out of control. But some gene products have been measured, and we know that there is too much of them in a person with Down Syndrome. The term for that is “overexpressed.”Much of the biochemistry chatter on the [Einstein-syndrome email] list has to do with specific genes on chromosome 21, whether or not that gene is overexpressed, what that particular protein does (and how it affects other chemicals) and the effects of having too much of that protein in the body. Some of this chatter is speculation, and needs to be viewed as such. Two of the gene products that are known to be high, and are known to have bad effects are SOD1 and CBS. (The yard-long names are Superoxide-Dismutase and Cystathione Beta Synthase.) SOD causes there to be too much hydrogen peroxide (H₂O₂) in the body, which in turn damages the cells (just like it damages bacteria cells when you pour some on a cut). The most susceptible to H₂O₂ damage seem to be brain cells.

The best thing to do to help ameliorate this problem is to take extra antioxidants; hence the heavy dose of antioxidants in the NuTriVene.

CBS causes there to be an imbalance in folic acid metabolism. There are two impacts of that. First, folic acid is “trapped” and not available to help make DNA for new cells, so the body has a tough time growing. The second impact is that the body can’t produce a chemical called SAM. SAM is responsible, amongst many other important things in the body, for turning certain genes on and off. The precursor to SAM is an amino acid called methionine, which is required by the body to make proteins. If there isn’t enough methionine, the body can’t make proteins and this also affects growth. The excess CBS in Down Syndrome reduces the amount of methionine available to make SAM.

The vitamins you will hear batted around on the list regarding [triplicated CBS] are B12, B6, folic acid, Trimethyl Glycine (TMG, also called Betaine) choline and …folinic acid, which is a specific form of folic acid that seems to have a particularly helpful effect in Down Syndrome.

Where is the Research?

The Riverbend site has done a great job of compiling relevant research on nutrition in Down syndrome. Riverbend is fairly overwhelming… most of what is worth knowing about Trisomy 21 is available there. Here are a few links from the Riverbend site to get you started.

Targeted Nutrition Intervention Introduction
This page gives you the current protocol recommended by the Trisomy 21 Research Foundation. On this page you will also find a history of the changes in the protocol.

Nutrivene Daily Supplement Formula.
This page is very helpful. You put in your child’s age and weight at the top, and click “Calculate” and you get a readout of the dosages of the various nutrients that your child would receive in the daily recommended dose of Nutrivene-D. The added bonus of this page is the little pop-ups. Click on the little question marks and you will get a brief explanation of each ingredient and why it is included in the formula.

Links to Supplement Articles
Twenty semi-technical articles are linked from this page. Each of these articles is written by a credible researcher or medical professional. Together, these articles will give you an overview of the current understanding of nutritional supplementation in Down Syndrome, plus some historical background to this question.

Abstracts of research related to nutritional supplementation in Down Syndrome
Here you will find abstracts of research. While the entire TNI protocol has not been subjected to double-blinded, placebo-controlled, peer reviewed study, the individual parts of the protocol are based on established, unquestioned research results. This listing of abstracts is a beginning for your study.

Dr. Leichtman’s letter
This letter is written to your pediatrician and will be helpful in explaining to him what TNI is. Print this letter/article, including all 17 pages of bibliography, and take it to your child’s pediatrician.