Thimerosal and autism: two questions
The last few days have been hectic ones. Circumstances conspired again to turn me, almost against my will, into a vaccine blogger, leading me to step with both feet into the mercury-autism controversy with this post and this followup, the combination of which have brought more attention to this blog than anything I've ever written before. I honestly didn't expect to make my first big splash in the blogosphere on this topic, but c'est la vie. Fortunately, most of the responses were, surprisingly, less hostile and more supportive than I had feared they would be. However, the sheer hostility of a small minority of responses was amazing. For example, someone calling him or herself "cellis" said something that very much reminds me of the sorts of abuse anyone who points out how weak the evidence for a link between mercury and autism can expect, similar to what Kathleen Seidel wrote about in her open letter to David Kirby. Cellis said:
There's more where that came from, some even just overnight. I tell you, it's almost enough to make me go back to blogging about less controversial topics, like, say, creationism (or maybe Terri Schiavo). At least creationists usually offer to pray for me, rather than angrily and gleefully wishing autism on my or other people's children just to "teach us a lesson." It half makes me hope that my joke about wanting an Instalanche doesn't come true. But, before I attempt to move on to other topics, I can't resist one last post. (Whether I succeed in moving on is another issue entirely, but I'm going to try; as I pointed out less than three weeks ago, vaccine hysteria was never intended to be a primary focus of this blog. I'm sure I'll end up coming back to the issue sooner or later, but I need a break. Also, this has delayed the writing of a series of posts I've wanted to do for almost two weeks now.)
I've been trying to think of a way to boil the whole issue down to its utter essence, as one commenter suggested. However, I'm going to do it a little differently than what the commenter had in mind. I think two questions serve that purpose quite nicely:
For my part, I can answer my question fairly easily. There is indeed something short of having an autistic child that could make me "eat my very ignorant and uneducated words," as cellis put it. Thimerosal has been removed from vaccines in the U.S., and the last lot of thimerosal-containing vaccines expired in January 2003. If indeed mercury in vaccines causes autism, then five years from now and ten years from now the rates of new cases of autism should plummet dramatically and unambiguously. That they have not done so in Canada or Denmark, both of which removed thimerosal from their vaccines in the 1990's, suggests that it's highly unlikely that the U. S. will see a major decrease in new autism cases over the next decade. However, I'm willing to start fresh and, for the sake of argument, for the moment take on the attitude that seems to be implied by the willingness of activists to dismiss teh Danish and Canadian data so blithely: namely, that it doesn't matter unless it happens in the U.S. But how much is enough? I propose as quite a reasonable measure that, if autism rates fall by 50% or more in 2010 or even 2015, I will happily admit that I was incorrect in my assessment and rejoice that such a blow has been struck against this condition. If rates fall by less than 50% but still inarguably statistically significant, I will concede that this would be pretty good epidemiological evidence that there might be a connection, although in that case the connecton would clearly not be nearly as strong as the link claimed by some activists, like J.B. Handley, founder of Generation Rescue, whose website states quite bluntly that "childhood neurological disorders such as autism, Asperger’s, ADHD/ADD, speech delay, sensory integration disorder, and many other developmental delays are all misdiagnoses for mercury poisoning."
Given such rigidly dogmatic statements, question #2 takes on more importance. What evidence would convince someone like J. B. Handley to change his mind? I can't imagine what evidence would convince him, or Boyd Haley, or the Geiers. It also leaves the a followup question for those of you out there who are so sure that mercury in vaccines causes autism or is a major contributor to autism: Will you concede that you were incorrect if, in 2010 and 2015, autism rates in the U.S. remain unchanged or have increased? I don't have a lot of hope that you will, given the Canadian and Danish experience, where no decrease in autism rates have been observed several years after removal of thimerosal, but I hope I am wrong.
Simplistic?
Well, yes and no. For obvious reasons, it's impossible ever to do the gold standard study about this issue: a double-blinded randomized control trial comparing vaccination of babies with vaccines containing thimerosal and vaccines not containing it and follow the children prospectively to see if the babies receiving vaccines with thimerosal have a higher rate of autism than those receiving thimerosal-free vaccines. So what's the next best thing? Good epidemiological evidence has a way of trumping all the theoretical concerns, cell culture experiments, and even animal data, and the removal of thimerosal from vaccines two years ago provides an epidemiological experiment that is seldom possible to do with other diseases. It's a golden opportunity to test once and for all the hypothesis that autism is caused primarily by mercury in thimerosal in vaccines. If, after a decade of no thimerosal in vaccines, austism rates do not decline, that would be very strong evidence that mercury in vaccines is not and was not the cause of autism. In such as case, it would be very difficult indeed to say that there is a link between the two.
I'll even go out on a limb a bit here (well, probably not really). My prediction is that, in 2010 and 2015, autism rates will remain roughly the same as they are now or maybe somewhat increased, thanks to the continuing improvements in recognition and diagnosis. My further prediction is that, in 2010 and 2015, in light of the unchanging incidence of autism, the mercury-autism activists will either (1) still be claiming that mercury causes autism, (epidemiological evidence be damned) or (2) have changed their claim to say that it is something else in vaccines that is causing autism.
Anybody want to bet against those predictions? Think I'm being disingenuous? Tell me why.
ADDENDUM: OK, I changed my mind and posted on this issue one more time.
As for the original creator of this absurd post (and all you other ignorant morons), I just hope you have a child or grandchild with autism in the very near future so that your small minds will be blown away when you finally wake up and realize how they got that way...which, since the rate has now "miraculously" risen to 1 in 150 children, I'm sure someone you care for will be affected very soon...Karma's a bitch. Can't wait to see you eat your very ignorant and uneducated words.
I've been trying to think of a way to boil the whole issue down to its utter essence, as one commenter suggested. However, I'm going to do it a little differently than what the commenter had in mind. I think two questions serve that purpose quite nicely:
- What evidence would convince me that the Geiers and Boyd Haley and all the others who are so convinced that mercury in thimerosal used as a preservative in vaccines is a major cause of or contributor to autism are correct and that my skepticism is ill-founded?
- What evidence would convince those of you out there who are utterly certain that thimerosal in vaccines either causes or is a major contributor to autism that there is no link between mercury in vaccines and autism?
For my part, I can answer my question fairly easily. There is indeed something short of having an autistic child that could make me "eat my very ignorant and uneducated words," as cellis put it. Thimerosal has been removed from vaccines in the U.S., and the last lot of thimerosal-containing vaccines expired in January 2003. If indeed mercury in vaccines causes autism, then five years from now and ten years from now the rates of new cases of autism should plummet dramatically and unambiguously. That they have not done so in Canada or Denmark, both of which removed thimerosal from their vaccines in the 1990's, suggests that it's highly unlikely that the U. S. will see a major decrease in new autism cases over the next decade. However, I'm willing to start fresh and, for the sake of argument, for the moment take on the attitude that seems to be implied by the willingness of activists to dismiss teh Danish and Canadian data so blithely: namely, that it doesn't matter unless it happens in the U.S. But how much is enough? I propose as quite a reasonable measure that, if autism rates fall by 50% or more in 2010 or even 2015, I will happily admit that I was incorrect in my assessment and rejoice that such a blow has been struck against this condition. If rates fall by less than 50% but still inarguably statistically significant, I will concede that this would be pretty good epidemiological evidence that there might be a connection, although in that case the connecton would clearly not be nearly as strong as the link claimed by some activists, like J.B. Handley, founder of Generation Rescue, whose website states quite bluntly that "childhood neurological disorders such as autism, Asperger’s, ADHD/ADD, speech delay, sensory integration disorder, and many other developmental delays are all misdiagnoses for mercury poisoning."
Given such rigidly dogmatic statements, question #2 takes on more importance. What evidence would convince someone like J. B. Handley to change his mind? I can't imagine what evidence would convince him, or Boyd Haley, or the Geiers. It also leaves the a followup question for those of you out there who are so sure that mercury in vaccines causes autism or is a major contributor to autism: Will you concede that you were incorrect if, in 2010 and 2015, autism rates in the U.S. remain unchanged or have increased? I don't have a lot of hope that you will, given the Canadian and Danish experience, where no decrease in autism rates have been observed several years after removal of thimerosal, but I hope I am wrong.
Simplistic?
Well, yes and no. For obvious reasons, it's impossible ever to do the gold standard study about this issue: a double-blinded randomized control trial comparing vaccination of babies with vaccines containing thimerosal and vaccines not containing it and follow the children prospectively to see if the babies receiving vaccines with thimerosal have a higher rate of autism than those receiving thimerosal-free vaccines. So what's the next best thing? Good epidemiological evidence has a way of trumping all the theoretical concerns, cell culture experiments, and even animal data, and the removal of thimerosal from vaccines two years ago provides an epidemiological experiment that is seldom possible to do with other diseases. It's a golden opportunity to test once and for all the hypothesis that autism is caused primarily by mercury in thimerosal in vaccines. If, after a decade of no thimerosal in vaccines, austism rates do not decline, that would be very strong evidence that mercury in vaccines is not and was not the cause of autism. In such as case, it would be very difficult indeed to say that there is a link between the two.
I'll even go out on a limb a bit here (well, probably not really). My prediction is that, in 2010 and 2015, autism rates will remain roughly the same as they are now or maybe somewhat increased, thanks to the continuing improvements in recognition and diagnosis. My further prediction is that, in 2010 and 2015, in light of the unchanging incidence of autism, the mercury-autism activists will either (1) still be claiming that mercury causes autism, (epidemiological evidence be damned) or (2) have changed their claim to say that it is something else in vaccines that is causing autism.
Anybody want to bet against those predictions? Think I'm being disingenuous? Tell me why.
ADDENDUM: OK, I changed my mind and posted on this issue one more time.
posted by Orac @ 7:55 AM
120 example(s) of insolence returned:
At 6/20/2005 9:47 AM,
I wouldn't bet 'gainst that proposition regardless of the Vegas odds!
Thanks for the good work. I get disgusted by otherwise rational people spouting the anti-vax line as if god-itself told 'em it was a fact! You supply Reason I can pass along. Thanks again.
At 6/20/2005 9:52 AM,
There are places in the world where there has been or still is, chronic mercury poisoning, bordering on the acute, what is the autism etc. level in those communities?
At 6/20/2005 10:53 AM,
Good question, Anonymous... Why don't you find out and tell us?
Here is one way to go about it:
Go to the PubMed website at www.pubmed.gov -- type in the search criteria of "mercury poisoning" or "autism mercury" or whatever you think will work. Then you will notice a bunch of journal articles (plus editorials, tutorials, etc). Most will link to the abstract and some will actually let you read the full article. To get the full articles you will need to wander down to your local university library and see if they have a subscription to the journal it is in (some municipal libraries also subscribe). When you find out, please tell us -- and make sure you are clear if it is elemental mercury, methylmercury or ethylmercury.
At 6/20/2005 11:05 AM,
wow orac:
I disappear for wo weeks and suddenly you've got this vaccine issue going? Well, I'll be damned, it seems to be working out ok.
I'll bet it goes your way. If I'm wrong, so what, I'm a resident, I'm allowed to be wrong!
At 6/20/2005 12:48 PM,
I'd take a bet on the side that autism rates will decrease, and I would give the other side 4 to 1 odds - on one condition.
That the states bans on thimerosal are not overturned by federal legislation, such as the proposed senate bill 3.
At 6/20/2005 12:50 PM,
You missed one option - if rates haven't gone down it will be due to the high levels of mercury in amalgam fillings. Or, if they are being partially phased out as I suspect, then it will be due to mercury in fish. Or if we manage somehow to clear the fish up, it will be due to, erm, the remnants of Mercury space capsules raining down on Earth?
At 6/20/2005 1:03 PM,
Your strategy is sound, although I just had a new parent in my practice tell me her ex-pediatrician actually believes the reason autism rates haven't gone down since the removal of thimerosal is that the government is still putting the preservitive into vaccine and just not telling anyone. There are some people you just can't convince!
At 6/20/2005 1:44 PM,
Orca:
Why 50%? That seems rather arbitrary. You seem to be proceeding from the idea that mercury exposure has to be causing a very large percentage of autism or that it causes none at all. Why does that have to be the case?
If the incidence of autism falls 49% after the appropriate lag time, you would conclude that mercury had no role in causes autism but if it fall 51%, you will conclude that it is the culprit?
How about instead you institute a test by which you will conclude that mercury exposure caused autism in some people if but only if the incidence of autism falls by a statistically significant percentage?
Even better, how about a test that by first identifies the subgroup of kids suspectable to becoming autistic from mercury exposure.
Then, if, after an appropriate lag time, the incidence of autism of that group falls by a statistically significant percentage, then you could conclude that mercury was the culprit.
BTW, did you get a chance to read Dr, Deth's research? You may alos wish to read the NIH funded research on the differences between ethyl and methyl mercury in infant, non human primates (monkeys). That study is here (pdf).
It is fairly compelling research.
Thanks.
Dwight Meredith
At 6/20/2005 2:10 PM,
Oh I can practically guarantee that the anti-vaccination types will continue to argue that one wy or another early childhood vaccination is the "cause" of autism. After all there are still anti-fluoridation activists and communities where they have managed to keep fluorine out the water, with the expected effects on teeth.
I do suspect that there is an environmental cause for autism, but the evidence you have in support of vaccination seems sound. Of course when you Google "Autism Rates Worldwide" you get a lot of anti-vaccination claims so finding the truth may not be as easy as one might wish.
At 6/20/2005 2:30 PM,
Sonja:
It really doesn't matter what Congress or any state legislature does. The medical community has already acted to remove mercury from childhood vaccines. As a Pediatrician, I am surprised that the anti-vaccine fanatics have not picked up something new to demonize by now. Obviously now it is all about the potential money from future settlements.
At 6/20/2005 3:15 PM,
Well, Orac, I'll have a piece of that wager, but I want to bet that no matter what happens - autism rate stays steady, goes up, goes west, God comes down and says "It wasn't the thimerosal", that Boyd Haley, Greier & Greier and the rest will go to their graves saying that thimerosal is THE cause of autism. Picture "Citizen Kane" but instead of Orson Welles whispering "Rosebud", it's Boyd Haley whispering "Mercury".
At this point, most of the thimerosal-autism proponents are way, way past scientific arguments. Those who have some scientific background have by now invested so much of their diminishing reputation into making thimerosal the cause of autism that they can't see a way out. Of course, the grand majority of the people nattering on about thimerosal and autism never had any science education past high school Health and seem to see scientific inquiry as a sort of "American Idol" competition or popularity contest. Regretably, in science, the most popular hypotheses aren't always the one's that win - only those that survive testing.
The scary thought is that by getting equally uninformed legislators involved, the autism-mercury crowd will accomplish the biological equivalent of passing a law making Pi = 3.0.
Here, in a nutshell are the basic problems with the autism-mercury argument:
[1] Although correlation is not causation, the autism-mercury connection is rapidly losing any correlation between thimerosal exposure and autism rates. They have tried valiently to trash-talk the Danish studies, but they have no explanation for why the autism numbers in Denmark (and Canada) keep going up year after year.
[2] The myriad studies the autism-mercury supporters point to are all very interesting, but what they show - even the study by the aptly-named Dr. Deth - is that thimerosal has effects on a variety of organ systems, enzymes and structural proteins. None (NONE) of these studies shows that thimerosal causes anything that can be identified as autism. They need to explain how thimerosal can cause such a selective neurological impairment as autism when its major toxic component - mercury - is nowhere near that selective.
[3] Resorting to conspiracy theories (hypotheses, actually, since they have not withstood even minimal testing) is a sure sign that the rational part of the argument is over and that the side with the conspiracy hypothesis has lost. For all those out there who cling to the hope that a conspiracy is "suppressing the truth", I have two words: Deep Throat.
In any large corporation or government agency, there is always SOMEONE who has a chip on their shoulder and would "blow the whistle" if they had the chance. In the case of "Deep Throat", the number-two man in the FBI "blew the whistle" in Nixon because - at least in part - he had been passed over for the number-one spot. The half-life of "juicy" secrets in government is measured in nanoseconds. All it takes is for one disgruntled employee or one person who would like to trade a humdrum GS-6 job for some time in the spotlight to pick up a phone and talk to a reporter and it's "slip the hounds, the game's afoot!"
Besides, if the government WAS able to maintain such a tight conspiracy, do you think they'd hesitate to arrange for a convenient accident (or major IRS audit) for those people who are trying to expose them? The fact that the conspiracy-mongers are still consuming oxygen is the biggest indictment againt their claims.
Prometheus
At 6/20/2005 3:21 PM,
You don’t have to wait until 2010 or 2015. And incidentally, here is the evidence that would convince me I am wrong about there being a casual link between thimerosal and autistic symptoms.
First, some facts. In 1999 the government recommended that thimerosal be removed from childhood vaccines. That order did not require immediate removal nor did it require a recall of vaccines already in the distribution cycle. Had all thimerosal use stopped in 1999, there would still be significant quantities in the distribution system in use through 2003. Given that use diminished, not stopped all at once, there are vaccines expiring this year that still contain significant amounts of thimerosal.
Second, autism is not a disease that has a specific onset at which it is diagnosed. Most cases are picked up between 18 months and 3 to 4 years of age, some as late as 5 or 6.
Third, the best source of U.S. data on autism is that collected by the state of California. They record only full-blown cases of classic autism. This is the data that when adjusted for birth year of autism diagnosis showed a steady increase in cases through out the 1990s with two steep spikes occurring approximately two yeas following additions to the vaccination schedule.
If there is an epidemiological connection between thimerosal and autism, one would expect the California cases (aggregated by birth year of diagnosis) to begin a gradual decline this year with a steeper decline in 2007 or 2008. It is too early to draw conclusions, but thus far in end 2004 and the first part of 2005, the trend is establishing.
I read your posts, and on this issue, you need to step back from the trees of individuals with axes to grind, and look at the forest of cummulative evidence. Most of the studies -- pro and con -- on this issue can be nitpicked methodologically. However, if one looks at the body of evidence -- epidemiological, theoretical science and practical science -- it continues to grow for the side supporting a link while the opponents of a link keep coming back to the same epidemiological studies, which are apples to oranges with conditions in the United States.
By the way, epidemiological studies -- both pro and con -- have lost some significance in light of research identifying a genetic predisposition for the inability to excrete mercury. An epidemiological study by definition assumes a genetically consistent sample. That is not the case.
I have responded to the Captain’s Quarters post here and have other posts from the perspective a converted skeptic.
http://craigwestover.blogspot.com/2005/06/mercury-autism-and-childhood-vaccine.html
At 6/20/2005 4:12 PM,
Prometheus:
You write:
"They need to explain how thimerosal can cause such a selective neurological impairment as autism when its major toxic component - mercury - is nowhere near that selective."
Yes, it would be very helpful to know the exact biological mechanism by which mercury could cause autism. It is not clear that there are any definitive answers to that question but this study is a pretty interesting start on such an explanation.
Dwight Meredith
At 6/20/2005 4:25 PM,
References to scientific articles (abstracts at least) presenting the data from Canada, Denmark and California would help the discussion. In a problem like this the devil is in the scientific details which have not been presented here or at Salon.com. What does not help the discussion is emotionalism and appeals to or against authority. The scientific issues need to addressed separately from the Conflict of Interest and political issues to achieve clarity of thought.
At this point the anti-vaccine crowd has not proven that vaccines cause autism, IMO. Likewise, the vaccine makers never did a controlled double blind study showing safety within specified statistical limits. Aren't there some solid references, using data from Canada, Denmark of California, that establish statistical limits on the number of cases of autism that might be realted to vaccines?
Can anyone post some scientific info/links?
The vaccine makers are in this mess because proper science was not done in the first place. Now the lawyers and scared moms are making a mess of the situation.
_g
At 6/20/2005 4:55 PM,
I was amused to see my introduction of the Rodier research on autistic spectrum conditions dismissed by Anonymous as 'riddled with bad assumptions'. Dr Rodier wouldn't be keeping her job at the University of Rochester if her work was bad science: furthermore, her work has been extensively peer reviewed. According to the university's own short biography of her:
"In 2003, she won the Warkany Award for research in birth defects from the Teratology Society, and in 2004, she won the Bock Prize in Developmental Biology and Genetics from The DuPont Childrens’ Hospital."
Hardly the achievements of someone engaged in 'bad science' and promulgating work 'riddled with bad assumptions'.
I'm sorry, Anonymous, but this is FACT. Variant HOX genes and transcription errors arising from those genes are now implicated in autistic spectrum conditions. And once again, I ask you, given the structural details discovered by Rodier, I'd like you to explain how Thimerosal could replicate those structural changes in a post-natal brain stem without additionally affecting other regions of the brain.
Oh, and as for Rodier beiong a 'bad scientist', well this little list of publications of hers is readily available to be checked:
Current research and publications:
* Rodier, P.M. (2004) Environmental causes of CNS maldevelopment. Pediatrics.,113:1076-1083.
* Conciatori M, Stodgell CJ, Hyman SL, O’Bara M, Militerni R, Bravaccio C, Trillo S et al. (2004) Association between the HOXA1 A218G polymorphism and increased head circumference in patients with autism. J Biol Psychiat. 55:413-419.
* Rodier, P.M. (2004) The 2003 Warkany Lecture: Autism as a birth defect. Birth Defects Research A, 70:1-6.
* Rodier, P.M. (2002) Converging evidence for brain stem injury in autism. Devel. Psychopathol.14: 537-557.
* Hyman, S.L., Rodier, P.M., Davidson, P. (2001) Pervasive developmental disorders in young children. JAMA, 285:3141-3142.
* Ingram, J.L., Stodgell, C.J., Hyman, S.L., Figlewicz, D.A., Weitkamp, L.R., Rodier, P.M. (2000) Discovery of allelic variants of HOXA1 and HOXB1: Genetic susceptibility to autism spectrum disorders. Teratology,62, 393-405.
* Ingram, J.L., Peckham, S.M., Tisdale, B., and Rodier, P.M. (2000) Prenatal exposure of rats to valproic acid reproduces the cerebellar anomalies associated with autism. Neurotoxicol. Teratol. 22:319-324.
* Rodier, P.M. (2000) The early origins of autism. Scientific American, 282, 56-63.
* Rodier, P.M., and Hyman, S.L. (1998) Early environmental factors in autism. MRDD Res Revs, 4, 121-128.
* Rodier, P.M., Bryson, S.E., and Welch, J.P. (1997) Minor malformations and physical measures in autism: Data from Nova Scotia. Teratology, 55:319-325.
* Rodier, P.M., J.L. Ingram, B. Tisdale, S. Nelson, and J. Romano (1996) Embryological origin for autism: Developmental anomalies of the cranial nerve motor nuclei . J. Comp. Neurol. 370:247-261.
Now, given the above, whom shall I put my trust in on this issue? Dr Rodier (and the hundreds of other scientists who peer reviewed her work and agreed that it was of merit), or someone posting on a blog who cannot even summon up sufficient courage of conviction to identify him/herself, let alone answer the questions I and others have posed repeatedly? I rest my case.
Oh, and Orac, keep up the good work.
At 6/20/2005 5:27 PM,
Dwight Meredith posts a study that is supposed to show how thimerosal/mercury can cause the very specific and discrete problems that result in autism.
The study, "Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism", by S Jill James, et al, is a perfect example of exactly what I referred to.
How does one go from "increased oxidative stress" and "impaired methylation capacity" to autism? Ah, that is the part of the story that is left untold.
Unfortunately, it is the MAJORITY of the story and leaves untold the part that explains why this sort of problem - interesting though it may be - can explain autism.
I must point out that both "increased oxidative stress" and "impaired methylation capacity" affect a wide range of cells and cellular processes. That is a pretty blunt instrument to cause so specific an injury as autism. Of course, the autism-mercury proponents expect us to take it on faith that it DOES cause autism, without so much as a hint about how it might do so.
Sorry, nice try - thank you for playing! BTW - if you want to find some good science on autism, stay clear of Jeff Bradstreet - he is more interested in the politics of autism than the science.
Prometheus
At 6/20/2005 5:36 PM,
Craig Westover says:
"Third, the best source of U.S. data on autism is that collected by the state of California"
California DDS says:
"Although the source of information for many reports on autism for California is the Department of Developmental Services (DDS)' "Quarterly Client Characteristics Report", the numbers reported by DDS are often misunderstood and misrepresented by others. Except for Table 2 of the Report, only persons with a Client Development Evaluation Report (CDER) on file who have "active" status in the DDS system are counted in the report tables. So, numbers reported do not represent all persons with developmental disabilities in the State of California. The numbers can not be used to report the incidence of autism, for example. Also, the quarterly report represents the number of persons with various characteristics in the DDS system as of a point in time."
Source
Now, I'm not American so I could well have misinterpretted the data here not being familiar with what Craig Westover refers to as 'California' and what 'DDS' means. Maybe someone could confirm or deny that I'm drawing an unwarranted conclusion by reading the rest of the source.
At 6/20/2005 6:09 PM,
If autism can be cured and reversed by removing heavy metals, heavy metals MUST be the cause.
Read my post about Dr. Rashid Buttar and TD-DMPS.
At 6/20/2005 6:17 PM,
Thanks for the links, Dave Edwards, they were informative. I agree with your assertion that Rodier has done good work but you should read her conclusions again, IMO.
You try to shift the burden of proof and make a straw man when you write " I'm sorry, Anonymous, but this is FACT. Variant HOX genes and transcription errors arising from those genes are now implicated in autistic spectrum conditions."
All of them? And genetic disease doesn't rule out a major role for environmental effects.
"And once again, I ask you, given the structural details discovered by Rodier, I'd like you to explain how Thimerosal could replicate those structural changes in a post-natal brain stem without additionally affecting other regions of the brain."
Are other regions of the brain unaffected in autism? There is a broad spectrum of autistic disorders so I don't think that just one part of the brain is affected. And since when did individuals have to prove that drugs or vaccines are unsafe and demonstrate the mechanism by which those substances do damage?
Why don't you read the review article she wrote on environmental effects again? She concludes in http://pediatrics.aappublications.org/cgi/content/full/113/4/S1/1076
"Most reviews end with a call for more research, and no one can doubt that there are enormous gaps in our knowledge of the causes of CNS maldevelopment. However, what is most discouraging in this field is not the limitations of the information available but the limited use that we have made of that information in protecting children from environmental factors that cause CNS injury. If a pediatrician were to read only 1 article from this reference list, then it should be the article by Kimmel and Makris.3 It reviews the present status of regulations and guidelines. Using the screening methods now in place, virtually none of the human teratogens mentioned in this review would be detected as hazardous to the developing brain of test animals at doses already known to cause lasting impairments of the human CNS. "
_george
At 6/20/2005 6:33 PM,
"And since when did individuals have to prove that drugs or vaccines are unsafe and demonstrate the mechanism by which those substances do damage?"
This is a remarkable statement by itself and really I don't think it needs any further comment. Why do you THINK this needs to be done? You definitely do need to prove that the mechanism of damage from X exposure is consistent with Y pathogenesis. If something causes completely different forms of damage every time than the disorder in question (which displays different pathology), then that is very strong evidence that the two things are not linked.
Again, how does the mercury used in these vaccines specifically cause the types of brain damage seen in autism? If you (or anyone else) cannot establish why the mercury used in this case can cause the *same* pathology seen in autism, I highly recommend asking yourself "why not".
At 6/20/2005 7:30 PM,
Pat Sullivan:
Where is the research showing the effectiveness of transdermal DMPS, the Buttar Cream? I looked in www.pubmed.gov for the research, and there was nothing by Rashid Buttar.
For the search terms "DMPS transdermal" I found:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12100989&query_hl=14
and http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12324424&query_hl=14
Can you point to where his research has been checked, validated and repeated, please?
At 6/20/2005 8:45 PM,
Transdermal DMPS is even more bogus as a "treatment" for autism than intravenous chelation therapy. Advocates can't even show that it is absorbed through the skin in concentrations adequate to chelate anything. At least intravenous chelation therapy can remove heavy metals; the problem with it as a treatment is that heavy metal poisoning does not appear to be the cause of autism.
At 6/20/2005 8:59 PM,
I think I was pretty clear when I wrote: "And since when did individuals have to prove that drugs or vaccines are unsafe and demonstrate the mechanism by which those substances do damage?"
But JM O'Donnell replied:
"This is a remarkable statement by itself and really I don't think it needs any further comment. Why do you THINK this needs to be done?"
The basic problem here is that the applicant to the regulatory agency has the burden of proof to show that the product is safe. It's not my job as a usenet poster or blogger to prove that a product is unsafe. The drug companies never did standard double blind studies to prove safety, within bounds, of vaccine preservatives. It's not my job as a geochemist to figure out biochemical mechanisms when biochemists are still doing basic research on the problem.
I support "Orac" in his position that medicine be evidence-based. When a very well respected researcher concludes: "Using the screening methods now in place, virtually none of the human teratogens mentioned in this review would be detected as hazardous to the developing brain of test animals at doses already known to cause lasting impairments of the human CNS.", it causes me great concern. I cannot conclude that vaccines cause autism from this but I can conclude that the regulatory process is failing to protect health and safety. Got it?
Yes, the Salon article failed to prove its assertions. But the bigger issue of the safety of products that were not adequately tested remains. Safety is what we should all be concerned about.
_george
At 6/20/2005 10:07 PM,
HCN, if Dr. Buttar does not have anything on PubMED, I don't have an explanation for that. I don't know what is required to have something posted there.
What I do have is his testimony, given to US Congress on May 6, 2004 that clearly discusses his findings. Click here to read it.
I also have my own personal findings w/ TD-DMPS which I'll get to in a minute.
Orac, where is your research to prove your statements? Where is the study that proves conclusively that heavy metal toxicity does not appear to be the cause of autism? You say these things as if they were complete fact, but they appear to me to be just your opinions. Or do you personally have more experience than Dr. Buttar treating and curing 23 plus autistic kids?
It is well known that whatever is placed on your skin is absorbed. If you swim in a chlorinated pool, the skin will absorb a certain amount chlorine, right? You are concerned that there is no measure for how much DMPS is entering the skin. I say who cares if they have not yet done randomized, double-blind, placebo studies to determine how much DMPS is entering into the bloodstream through the skin? That costs money and why do a big expensive study on a substance that is already approved by the FDA? What they do know is that heavy metals are being removed without any other explanation as to why, other than TD-DMPS.
I personally have been using TD-DMPS -- "Buttars magic cream" directly from AMT Pharmacy -- for the last 6 months. I have done DMPS provocation testing twice during this time period and can confirm that there are elevated levels of heavy metals being removed. What is also significant is that like many autistics, I have confirmed through expensive genetic testing that I have the gene mix APO-E3,4 which is the second to least worst gene mix you can have for determining your ability to chelate heavy metals.
I'm not a scientist, nor am I a doctor. I'm a man who's been trying to get well for 18 years. Along the way, I've learned quite a few things. One of those being that peer-review generally just means status-quo. It is the "quacks" and "charlatans" working in a garage somewhere that make an observation, form a hypothesis, and follow the truth/science wherever it leads them.
I'm glad that at least my comments are cutting through the clutter on what is obviously a highly controversial subject. I am sure that as someone who claims to be intellectually honest, you are continuing to keep an open mind on your position as new data is presented.
- Pat Sullivan
At 6/20/2005 10:09 PM,
HOX/autism link - interesting.
Does the data imply autistic drosophila? And for that matter, can an animal model developed? Would it be possible test this in some sort of mouse model?
At 6/20/2005 10:30 PM,
"It's not my job as a usenet poster or blogger to prove that a product is unsafe. "
But if you're going to argue that it is, then find someone elses work and present it. That is what I was asking, not that you should go and do the research yourself :D
Again, you come out with:
"I cannot conclude that vaccines cause autism from this but I can conclude that the regulatory process is failing to protect health and safety. Got it?"
But not in regards to this case and autism, which is what matters when we are discussing this. Again, prove that mercury based preservatives cause autism by presenting research that the damage caused is exactly the same for mercury poisoning, as in the neurological damage in autistic children.
At 6/20/2005 10:42 PM,
Do not try to equate congressional testimony with real research (especially to some very gullible politicians). Nor should you try to claim Buttar Cream works because "it worked for ME"... and then demand that Orac provide evidence that you would accept.
It is quite an incredible claim that Buttar Cream can cure autism. To quote Carl Sagan "extraordinary claims require extraordinary evidence"... so it will require more proof than testimonies from Buttar or parents (I saw one claim that it worked for a four year child after starting the cream application when the child was 15 months old! It is almost as credible as believing the child was diagnosed at 15 months old... most kids are at least two years old). So until Buttar puts his "magic" cream under closer scrutiny... it will remain an unsubstrantiated cure that is preying on the wishes of desparate parents.
My guess is the reason Rashid Buttar has not submitted any of his research, case studies and methods to be checked to see if it really works may be to not cut into any sales.
At 6/20/2005 11:05 PM,
Pat:
It's very easy. To be listed in PubMed, you have to have published scientific articles in the peer-reviewed scientific literature. It's just that simple. Apparently Dr. Buttar couldn't be bothered to submit his work to real scientific journals. It's hard to be taken seriously as a researcher or scientist if you aren't published in peer-reviewed scientific journals. Certainly, I don't take him seriously.
And testifying in front of Congress means little, as Congress is notorious for its inability to properly evaluate scientific issues.
At 6/21/2005 12:24 AM,
To JM O'Donnell, "Orac" and others: I think the science/analysis on both sides of the Thimerosal and autism controversy is lacking. I think that the regulatory process has failed. I don't have access to a med library but it's becoming clear to me that we don't know how safe or unsafe the thimerosal is because proper research was never done.
I live with ADHD and perhaps some autistic spectrum symptoms. My concern is not for pro or con in an argument between two sides. I have utterly no respect for snake oil salesmen or PI attorneys who manipulate fear. And I despise those who use the struggles and suffering of others for a political point. That is what I see happening here and it stinks.
The only solution to this kind of problem is sound science and objective government regulation based on it. Unfortunately, the objective regulator is a very endangered species and the objective independent scientist is not far behind on the list.
As for the poor fool who is using skin cream to try to cure autism: Try sunscreen. It won't cure your autism but it will help prevent skin cancer.
_george
At 6/21/2005 1:02 AM,
Of course, but there is still a range of literature available that describes the effects of mercury poisoning and an increasing amount that describes what effects have been observed on austic individuals brains.
The observations are utterly unalike, with mercury poisoning producing different kinds of pathology than that seen in austic individuals:
http://pediatrics.aappublications.org/cgi/content/full/111/3/674
For example details some of this.
Again, all I want to see is a single study demonstrating that mercury damage produces the same pathology as seen in autism. Until this evidence appears there can be no reasonable way to assert mercury based vaccines are the cause of autism.
At 6/21/2005 3:15 AM,
It is easy and usually wrong to imagine the motivations of others as you are doing here. You don't know why Buttar has not attempted to have his work peer reviewed.
I know from a doc whom I know personally, who HAS had peer reviewed articles published, it is not nearly as easy to do as you indicate. It was VERY hard for him, a practicing clinician to find time and to fund the effort. He only got it done because he got a ton of help from a researcher at the EPA.
It is well known that DMPS does indeed chelate heavy metals. It is well known that transdermal creams readily carry substances into the bloodstream. It is verifiable that pre and post TD DMPS tests show very elevated levels of metals being excreted both through urine and feces. These are not leaps of faith!
Parents have spent considerable sums of money to take out advertisements in USA Today to say that they have their children back because of TD DMPS. These people have nothing to gain financially! From the "anecdotal" data that they have from pure observation of their children they are willing to spend their money to publically say that there is a cure for autism and be called crazies by you! Their likely motivation? Could it be to help others?
To me there is more than enough data to support at least the suspicion that heavy metals from multiple sources, is at least a contributory factor in autism as well as other neurological diseases for which NO CAUSE has yet been found by medical science.
Should not suspicion alone be sufficient to stop using these known toxins in our bodies? Who does it benefit financially to continue to use these toxins?
Given the fact that normal toxic studies for Thimerersol or for Mercury Amalgams have NEVER been done by the vaccine makers or the ADA, how can one be so certain that the most non-radioactive metal known is somehow absolutely safe in our bodies at ANY LEVEL? Why are they so readily proclaimed to be safe? Why? Follow the money!
If they are ever shown to be as dangerous as many reputable scientists believe them to be, the lawsuits will make the tobacco lawsuits look like childs play.
How many decades did "the experts" assure us that smoking was safe?
At 6/21/2005 8:02 AM,
First of all, I am prepared to admit, hand on heart, that I skimped with respect to Rodier's caution over the possibility of environmental contributions to autistic spectrum conditions. However, her research concnetrates upon substances that are likely to trigger the HOX gene transcription errors cited in the paper I referred to. One of her research papers covers valproic acid, which is used as a treatment for epilepsy, and which is listed in the various phamacological lexicons as being a substance that should NOT be administered to women who are pregnant or considering conceiving, because it is a known teratogen in utero. Likewise, Thalidomide fell under her remit, not only because it led to her detective work in the first place, but because it was of compelling interest to her from the standpoint of developmental embryology.
However, the fact remains that the evidence increasingly points to HOX gene errors and HOX gene error transcriptions in the early days of foetal development after conception as being the underlying molecular biological basis of autistic spectrum conditions. And Rodier is not alone in pursuing this line of research. Indeed, she will be presenting lectures on the subject at a conference in Wales on austistic spectrum conditions later this year, along with other esteemed individuals such as Dr Simon Baron-Cohen and Professor Uta Frith. I say again, if her work was in some way 'wrong', she wouldn't be dwelling in such company.
Incidentally, those brain stem changes seen by Rodier (including the complete absence of a structure called the Superior Olive) explain why ABR (Auditory Brainstem Repsonse) testing is a useful diagnostic tool in the diagnosis of autistic spectrum conditions. The Superior Olive is a relay station for auditory signals, and ABR prolongation has been recognised as a feature of autistic spectrum conditions for a number of years prior to Rodier's paper. The simple fact, however, is that there is now a proven link between thosed brain stem structural changes and HOX gene errors (including transcription errors). Environmental factors may trigger transcription errors (and Rodier cites that valproic acid is capable of doing just that), but those environmental factors have to occur while those genes are active, i.e., in the early days after conception. The race is now on to find other potential teratogens capable of triggering said transcription errors. However, this does NOT alter the fact that HOX genes provide a repeatably demonstrable mechanism for the development of autistic spectrum conditions. If I had the money to set up the requisite labs, chances are I could repeatedly demonstrate this myself.
Once again, given the existence of a genetic basis that is subject to all manner of rigorous scientific tests to establish its validity (and if there was any reason to refute that validity, Rodier would have abandoned that line of research for something more fruitful), the burden of proof lies upon those who wish to claim that Thimerosal causes the very specific structural changes I have repeatedly cited without causing other brain trauma at the same time. I see nothing in the literature that points to Thimerosal possessing this remarkable neurotoxic specificity - only affecting specific cells in the brain stem and no others.
I say again, HOX genes are now the focus of research in the field of autistic spectrum conditions, and are such because a link (indeed, a compelling one) has been established. And to dismiss the transgenic mouse studies in this area (in which the removal of HOXA1 produces exactly the same pattern of brain stem changes - note, EXACTLY the same pattern) is simply untenable.
Incidentally, I asked Scientific American some time ago if MRI scanners now possessed the level of resolution required to home in on these structural changes without invasive surgery. At the time, they told me that this was not the case, but the scanner manufacturers are increasing the resolution of their machines all the time. Once an MRI scanner with the requisite resolution is an engineering reality, I'm willing to bet that they'll show up the same brain stem structural anomalies in living autistic patients.
At 6/21/2005 8:51 AM,
Pat,
Alties frequently make the claim that it is "too difficult" or that they are "too busy" taking care of patients to submit their work to peer-reviewed biomedical scientific literature. Such an excuse is a cop-out. It won't wash. If you want your research to be taken seriously, you have to get it published in peer-reviewed scientific journals. Period.
As for the "follow the money" argument, please, give me a break. Vaccines are one of the lower profit items pharmaceutical companies make, and lawsuits make them even less profitable. I could make the same argument as a reason why mercury-autism advocates are so intent on "proving" a link; trial lawyers want "evidence" to use to sue pharmaceutical companies and the government. In any case, I've never said that thimerosal was good or completely; what I've said is that people like you have never made a convincing case that mercury, whether from thimerosal or other environmental sources, causes autism. And you haven't. The evidence that is out there now does not support such a link, and the new evidence that has been coming out does not change that.
At 6/21/2005 9:27 AM,
Rose in SC said...
"hmm...
My son had an HHE (hypotonic-hyporesponsive episode) returning home from 2 month shots. It was not a good day for a coincidental brain swelling. I'll be damned if it wasn't vaccine related...we're talking minutes later. It was a rare side effect, 1 in 100,000, and never reported."
Rare side effect, 1 in 100,000
I am guessing that is only counting the REPORTED side effects. How many more, like yours, go unreported? If all vaccine reactions were reported, it could change that "rare" status.
An FYI, you can report this reaction yourself. Request a copy of your child's medical records, by law, those records must include the vaccine given, date, lot #, exp dt. You will need this info to report your child's reaction to
http://www.vaers.org
[b]Vaccine reactions are not rare, just rarely reported.[/b]
At 6/21/2005 12:13 PM,
One way or another, you will be getting more data. From the RFK article, near the end:
"Another soon-to-be published study shows that autism rates are in decline following the recent elimination of thimerosal from most vaccines."
Either the study shows up and there can be more reasoned debate, or the study never appears and the RFK article gets that much closer to a complete dismissal.
At 6/21/2005 2:39 PM,
Orac,
I appreciate your comments.
Agreed that having peer reviewed scientific articles is very valuable. It is also my understanding that getting a peer reviewed article that goes against the mainstream belief is often VERY difficult to get placed even when that article is very well done and well supported.
I am personally aware of an editor who got fired for allowing an article in a journal that passed peer review because it challenged the mainstream of current thought/belief.
It is actually an old trick of scientists protecting the mainstream. They argue that the data cannot be any good because it has never been published in a peer reviewed article, all the while preventing anyone from actually getting their articles published in peer reviewed journals.
I am not saying that this has happened in this case but I am aware that this happens. The mainstream CONTROLS most of the good journals.
Look at the thought police at universities who preach tolerance but shout down any dissenting opinion on a wide range of topics that they don't like!
As to your argument that vaccines are low profit, it has nothing to do with their profits. It has everything to do with litigation! True, the legal vultures on the anti-thimerasol side are circling and waiting to pounce and WILL do so! But the reason is that there is a growing body of evidence building up JUST like it built up around the tobbaco controversy.
Vultures only circle where they sense something dying and the thimerasol/mercury mfg's have created what will be a feast for these vultures to feed upon for many decades to come. It is inevitable!
Vultures actually serve a useful purpose in the wild as well as in our society. I don't like them much either and support efforts to reign them in. But there are times where the damage is so egregious and the carcus so smelly that it is great that these vultures are there to punish the ones who simply ignored reason and used substances that in most cases they KNEW were highly suspect and dangerous!
So it is with the use of mercury in any form! Those organizations SHOULD be punished and will be eventually!
Finally, there are many brighter people than I who have made great cases against the use of mercury in any form. To those who don't want to believe it, no amount of evidence or data will convince them, ever! I know many who smoke and still deny that it is bad for them! NO amount of data or argument will get them to stop!
At 6/21/2005 3:00 PM,
As for the money trail... the folks who sold you the genetic testing as well as those who sold you Buttar Cream must not be in it for the money. They just want to make you "better".
PT Barnum was right.
At 6/21/2005 3:21 PM,
Pat Sullivan,
You said, "I am personally aware of an editor who got fired for allowing an article in a journal that passed peer review because it challenged the mainstream of current thought/belief."
Could you please let us know the name of the editor or the journal or possibly the article in question?
At 6/21/2005 3:37 PM,
Out there somewhere on the internet is a .pdf file of Buttar's vague references to his "research" written by him. It consists of, "I put this stuff on a bunch of kids and they got better."
There's a link to Buttar's little essay thing in a couple of places on the British medical Journal Rapid Response board, but I don't feel like chasing it down.
In Buttar's own words, he doesn't know how much of the stuff is going in to the kid or how long it stays there.
What he says he uses are possibly horrifically faulty urine test results, HE CLAIMS.
But when she showed up at the AUTISM ONE convention a month or so ago in Chicago he gave a long whiney presentation about how unappreciated he is. He used emotional threats to tell parents not to bring their kids to him when their other attempts at chelation failed...
He showed NO graphs or anything vaguely like data.
The man has "carnival snake oil seller" tatooed on his forhead... or everything but that.
You need to check his background an