The following information is prepared for doctors and for parents who are working with their doctor. It is not medical advice and is only the latest information available on these issues.  We do not sell TNI or Euro-TNS and we always ask that parents work with their doctor.

TNI is not "Megavitamins" it is a new program of intervention to improve the health and growth of children and adults with Down’s syndrome. Having an extra set of genes at Chromosome 21 results in a 50% over production of several very specific proteins which are responsible for progressive cell damage. This damage can now be identified with urine analysis for oximarkers which are the DNA fragments and the product of cell death through-out the body. Intervention can now be seen to be effective in reducing that damage. There is a wide variation in oximarker readings of cell damage, but people with DS appear to have (on average) about 1.5 to 2X the rate of cell damage than is normal and a wider range of variation. This additional damage is believed to be due to oxidative stress caused by the extra genes in T21. Oxidative stress is seen to be 3X normal. Damage at a cellular level is believed to result in many of the health and growth problems that are part of the syndrome. It is possible to reduce oxidative stress by increasing the intake of foods which are high in naturally occurring antioxidants. But in DS the extra production of SOD and the problems with malabsorbance makes it difficult to get the correct intake from food so that dietary supplements are being advocated.  

Antioxidants are the most important and the least expensive and they are readily available but they need to be in high dose levels. Essential fatty acids are also advocated and these are also inexpensive.  An amino acid supplement is also advocated but individual refined amino acids are expensive and while they are part of the TNI program this is still in a developmental phase and subject to a great deal of debate.  But there is good evidence that every person with Down’s syndrome can benefit from some level of intervention with antioxidants and TNI has a great many supporters in the USA. TNI is not a cure for Down’s syndrome but it is a specific program designed to reduce the impact of the extra genes in the 21^st Chromosome. Anything that reduces that impact will allow these children and adults to live a more normal and a healthier life.

However these same benefits are often seen in children who have a very healthy diet, plus a supportive and stimulation environment. Giving every child these advantages must be regarded as a top priority for all parents before resorting to dietary supplements. Dietary supplements are not a "fix" for unhealthy, and even harmful eating, but many parents make this assumption. 

Scientific evidence of usefulness: None of these products have been tested in a "Placebo controlled randomised double blind clinical trial". Without this evidence any use of these interventions is speculative and largely based on observational evidence and parental opinion. In 2001 we have initiated the first high quality RDB clinical trial of a new and very safe antioxidant and folinic acid therapy. Babies under age 6 months took part in this study.   Click here for information  Parents who want to wait for  proof from this study need to understand that brain damage is irreversible and a few extra antioxidants such as ACE makes good sense and is a very inexpensive strategy.

Results from our study will be available in 2006.

Disclaimer:
This information is provided by The Down’s Syndrome Research Foundation as a service to parents and medical professionals. The DSRF has no financial interest in the sale or marketing of these products. Parents should advise their doctor if they plan to use any nutritional suppliments and they must carefully monitor the health of their child.

Targeted Nutritional Intervention (TNI) and Targeted Nutritional Support (Euro-TNS) for Down’s syndrome can be purchased from the following companies:

Euro-TNS: Is Targeted Nutritional Support for people with Down syndrome. It is made in the UK and is very similar to TNI formulations from the USA and Canada.  Enzymes are not included as these are often not required and they are not suitable for young babies, they can easily be purchased from health food stores. Adjustments have been made to incorporate the latest information on the importance of zinc and the need for increased levels of folic acid and selenium. The product is not advertised for sale on a commercial basis but it can be bought from the following organization.  The product is sold on a cost basis with the expectation that parents will provide financial support for medical research initiated by the DSRF.  This product is VAT free in the EC when purchased from the following organization.  Please consult your doctor when buying this product.

Compare costs from these manufacturers on a per day basis as packaging quantities may be very different.

To import TNI into the UK & the EC from the USA or Canada without Customs and Excise duty
You need an exemption certificate from the Dept. of Trade & Industry.
Phone 0171 215 4508 - ask for Form DFA (BH) 89

• Application for relief from Common Customs Tariff Duty
• Articles for the use of the Blind and the Handicapped.

The Integrated Tariff Heading to put on the form is:  21 06 90 98 96
Complete this form and return it to the DTI. They will issue a certificate to Customs that is good for 6 months. They will tell you the certificate number.
The Shipper must put the Certificate number on the Customs Declaration form when they ship the order of TNI. Customs will look up the certificate and the TNI will be allowed into the UK duty free. You can reclaim duty that you have paid in the past by using the same certificate number. The DTI will assist with other queries on this issue.

Parents should always inform their doctor and get their support with TNI or Euro TNS
Monitor health and growth rates from the beginning and every 6 months.