Mark and David Geier, holed up in Missouri?

5 Oct

There is really no fun in writing about people whose lack of ethical standards harm disabled children. Seriously, it is painful. I know at least one autism blogger who quit in no small part because it was just too hard to keep writing about these topics.

And here in one week, both Andrew Wakefield and the Geiers (Mark and David) come back up in the news. A recent story in the St. Louis Post Dispatch discusses the Geiers: Controversial autism doctor loses license elsewhere, but can still practice in Missouri, Illinois

Mark Geier is an M.D. and was licensed in multiple states (I’ve lost count of how many and which ones). His home base is Maryland. His license was suspended there and many other states have followed suit. David Geier holds no medical credentials and is charged with practicing medicine without a license in Maryland.

As noted above, most, but not all, states have followed suit with suspending Mark Geier’s license.

The St. Louis Post Dispatch writes (reminding me of which states Mr. Geier has been licensed):

Dr. Mark Geier has opened eight autism treatment clinics called ASD Centers across the country but is only allowed to practice at two of them — in St. Peters and Springfield, Ill.

Missouri and Illinois are among the last states to seek discipline against Geier, whose hormone therapy for children with autism has been called dangerous, abusive and exploitive by various medical boards.

In the last two years, his medical license has been revoked or suspended in California, Florida, Indiana, Kentucky, Maryland, New Jersey, Texas, Virginia and Washington.

Missouri, Illinois and Hawaii have filed complaints against Geier based on other states’ actions, but his license remains active in all three states. A disciplinary hearing in Geier’s case is set for Oct. 19 before the Missouri Board of Registration for the Healing Arts in Jefferson City

The Geier hypothesis is that mercury binds with testosterone in the brain, making it difficult to chelate. They prescribe Lupron to reduce testosterone. The idea would be laughable if it weren’t being used on humans (or any animal for that matter).

Briefly–the Geier’s cited a paper showing that in hot benzene,
(more details in Miscellaneous Mercury Nonsense), mercuric chloride and testosterone can be induced to form chemical complexes.

I had hopes that the Geiers had moved away from this idea, but they stand by it:

David Geier said Wednesday that “many peer-reviewed scientific studies” have been published that support the theory. All of the research articles cited on the ASD Centers’ website are co-authored by Mark or David Geier.

The fact that the Geiers were able to get papers published in third rate journals doesn’t make their ideas true. Or even feasible.

Mr. David Geier did not attend medical school. Neither did I but I will offer him this small bit of medical advice: Among other logical problems with your idea, the human brain is not the same thing as a beaker of hot benzene.

Point two: even if your idea held any merit, Lupron lowers the level of testosterone in the blood, it doesn’t break up these mythical mercury-testosterone complexes.

The Geiers are demonstrating a major problem with the medical license system in the U.S.. It took years to bring the Geiers to hearing. Now that Mark Geier has lost his license in his home state, he has moved to other “safe havens” to continue business? How is this right.

I recall a number of med students and premeds I knew while in college and grad school. The hoops they had to jump through to get their degrees and get licensed and start working seemed enormous. Now we see why: it’s so hard to stop someone from practicing.

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33 Responses to “Mark and David Geier, holed up in Missouri?”

  1. Lawrence October 5, 2012 at 10:09 #

    Unfortunately, there is always Tijiuana or some islands in the Caribbean that would be more than happy to host the Geiers…..

  2. Dave October 5, 2012 at 10:18 #

    I have often wondered how ideas like this get started and continue to spread. I suspect it is because of the confusion between cause and effect. It is so easy to research these things on the internet, that everyone who clicks on a few links develops their own theory of autism. (“Learn Chemistry on the Internet” is the name of my new band.)

    The statistical link between autism and testosterone is well known but poorly understood. Autistic kids have high (or sometimes low) testosterone, much more often than the general population. The same is true (sometimes in reverse) of the chemicals that react with testosterone. These include vitamin D, glutathione, and, of course, zinc.

    The link between testosterone and mercury seems to be imaginary, but you can’t really charge people huge amounts of cash for vitamin D and zinc. ($5.99 each at Wally-Mart)

    If someone simply had high testosterone, it could be treated easily (by an actual doctor!). I assume that a doctor would also know what to do if someone had mercury poisoning. Some people clearly have worse reactions to mercury than others, but I just don’t get the link between that and testosterone.

    I don’t always trust everyone who made it through medical school, nor automatically distrust anyone who did not. But if someone tells me that my son’s testosterone levels are elevated, that is the kind of diagnosis where I would go see a doctor or two.

    I suspect that there are a few symptoms of autism that can be treated more effectively than they are currently being treated. It would not surprise me to find out that high (or low) testosterone is one such issue.

    But if it were as easy as mixing some timed-release DMSA with some timed-release Lupron, some big drug company would have done it already. Those guys love money.

  3. Fielding J. Hurst October 5, 2012 at 14:51 #

    I don’t really see lupron as much of a therapy for autism, but I do know a family who’s 13 year old son with severe autism is able to co-exist in the family and attend school when on lupron. I grasp the negative issues related to the drug, but when off it, he is uncontrollable and has fits of major rage. They have reduced and removed lupron on a few different occasions in last year and when stopped he has resorted to violent behaviors which had been gone in previous years and is out of control at school and home. Biting, hitting teachers and parents. Self injurious behaviors returned. I know lupron has no value as it relates to “curing” autism, but am sure that it provided relief to this particular family. This child is a totally different person when on or off lupron.

    • Sullivan (Matt Carey) October 5, 2012 at 15:20 #

      So Lupron is being used as a chemical restraint.

      The adolescent is 13, clearly not in “precocious puberty”.

      All this begs the question of whether the doctor involved is an endocrinologist. Are the real downsides of this drug being considered? At this point it isn’t a question of risk.

      The Geiers are clearly out of their expertise here. The fact is that David Geier is not a medical professional and Mark Geier’s specialty is not pediatrics or endocrinology (or many other areas he acts in). Beyond that, people who make up and apparently believe nonsense like their mercury/testosterone hypothesis have demonstrated a lack of the skills needed to treat humans.

      Will shutting down sex hormone production in an adolescent going through puberty change behavior? No surprises there. What is the long term plan for this young man? Never to complete puberty? At what concequence?

      • futuredave5 October 6, 2012 at 01:28 #

        I don’t think we should assume that anyone getting lupron is being mistreated. As far as I know, there are many cases of autistic children with too much testosterone.

        High testosterone has a variety of sympoms from cysts to depression to sudden uncontrolled rage. A child (or even adult) autistic with excessive testosterone is a danger to himself and others.

        There are medical circumstances where lupron would be a safe and appropriate treatment. Assuming that your doctor is an actual doctor.

      • Sullivan (Matt Carey) October 6, 2012 at 01:39 #

        If and when I hear this from someone qualified–say a pediatric endocrinologist–I’ll buy it.

        Perhaps you could read the complaints. And the patent applications. They were giving lupron to children and adolescents who were clearly not high in testosterone.

        What is the exit strategy, I will ask? Consider the adolescent you referred to above. 13. No pre-pubescent, but in puberty. How long will that child be on Lupron? What will be the consequences?

        There is a strong parallel here with chelation. There are times when chelation is the appropriate treatment. In which case, find a specialist in medical toxicology and take his/her advice. Don’t settle for anything less. With lupron, find a pediatric (or reguluar) endocrinologist.

      • futuredave5 October 6, 2012 at 08:50 #

        I am agreeing with you in this case. Mark Geier deserved to lose his license, according to the rules of medical licensing. He was diagnosing precocious puberty in cases where it did not exist. This would be similar to diagnosing prostate cancer: you can’t just make up a diagnosis to fit the treatment.

        Lupron is approved as a treatment for precocious puberty and certain types of cancer. Anything else is experimentation. There are rules that govern medical experimentation on humans, and rule number one is: “you can’t just start injecting dangerous drugs into patients to see what happens.”

        I always thought that was the odd irony of the anti-vax community in general, and the Geiers in particular. They believe that the danger of vaccines lies in injecting minuscule quantities of harmful ingredients. Their solution frequently involves injecting larger quantities of more harmful ingredients.

        I don’t know the 13-year old mentioned by the other writer, so maybe I spoke too soon. Maybe you are correct, and we actually can assume any autistic receiving lupron at 13 is being mistreated.

        I was just trying to ask what I see as the next logical questions. Are there common hormone imbalances associated with autism, or is that just a myth? Can the hormone imbalances be treated in any safe and effective manner, or is that a myth as well? I wasn’t raising the questions to try to muddy the water, these just seem like interesting questions to me.

  4. Molly October 5, 2012 at 19:29 #

    Has any patient of the Geiers, other than that plant, ever filed a complaint against them ?No! I didn’t think so. Has any of the more than 250 pateints seen by Wakefield ever filed a complaint against him? No! I didn’t think so. The people going after these folks are the very same people who have caused the pain and suffering of millions of children. They need to destroy the Geiers and Wakefield to hide their crimes.

    • Sullivan (Matt Carey) October 5, 2012 at 19:45 #

      Andrew Wakefield saw 250 patients? Can you post the information on that here?

      I ask because Mr. Wakefield has not had responsibility for patient care. He is not licensed in the U.S. and his position at the Royal Free specifically excluded him from direct patient care. If there are records of him treating 250 patients, that would be a very serious breach of ethics.

      How do you conclude the people complaining about the Geiers were “plants”? It’s a convenient way to dismiss their views. Listen to the parents…except when they say what you don’t want to hear?

    • Chris October 5, 2012 at 20:26 #

      Has any patient of the Geiers, other than that plant, ever filed a complaint against them ?No! I didn’t think so.

      The action to revoke Mark Geier’s license by the Maryland State Board of Physicians was due to more than one parent complaint. You can read the final decision here. One paragraph says:

      For example, Dr. Geier treated Patient I for nine months without any physical examination and in fact without seeing him and without even documenting this patient’s height and weight. He treated Patient B for almost three years without a physical examination and before ever seeing him, and he also treated Patient G without first physically examining him or even seeing him in person.

      That looks like more than one parent complained.

    • mikemawords October 5, 2012 at 21:47 #

      Molly
      Your drooling dotage to frauds and criminals does not put you in a very good light.

    • Julian Frost October 5, 2012 at 21:55 #

      pwned.

    • novalox October 5, 2012 at 23:09 #

      @molly

      [citation needed] for your scurrilous claim.

    • Science Mom October 6, 2012 at 01:06 #

      I don’t know Molly, it looks as though there were at least nine complaintants against the Geiers: http://www.casewatch.org/board/med/geier/order.shtml

      I too would be interested in the patients Wakefield treated. Would you like to share with us where and when?

  5. David N. Brown October 8, 2012 at 10:04 #

    ” Autistic kids have high (or sometimes low) testosterone, much more often than the general population. ”

    Rather an equivocal claim, isn’t it? I’ve never heard of anyone going to the trouble of testing testosterone levels in spectrum children. But, given the volume of reports of such children having low muscle tone and small stature, one would reasonably EXPECT to find a high rate of LOW hormone levels. As I have pointed out a number of times, high testosterone in an autistic child would be about on par with elevated insulin in a diabetic: conceivable, but counterintuitive, and certainly requiring far more prove than the Geiers ever pretended to possess.

    David N. Brown
    Mesa, Arizona

    • Teresa Badillo October 8, 2012 at 19:26 #

      “You’ve never heard of anyone going to the trouble of testing testosterone levels” And WHO ARE YOU? A parent? Or an observer from the side lines? Obviously you have never heard of DAN physicians testing hormones for children with autism. Do you know anything about Hyperandrogenemia, CPP – Children with Precocious Puberty,….given the fact that autism is an autoimmune disorder AND recognized by US Supreme Court in 1991 as no longer a Mental Health Disorder but a biological one; then we can assume that hormones may or may not play an integral part with the immune system for some children on the autism spectrum. Since you don’t mention that you have a child with autism, then the assumption is you are not dealing with the issues at hand. And if you do have a child on the autism spectrum and they are still young and not yet in puberty, then you are yet to arrive and deal with the issues. Oh, and by the way, the low muscle tone you are talking about is called hypotonia which has to do with the mitochondria and the kreb cycle. The all have low muscle tone but are also sympathetic overdrive which is fight or flight. This is no way an indicator that hormones would undoubedly be low. And just for the record, measuring hormones accurately is always a challenge because they have high and low levels throughout the day. However, if you are dealing with a child with autism by shear observation of what goes on in the home and the school front, the aggressive behaviors, the precocious puberty signs, the inappropriate sexual activity, the development of seizure activity at the onset of puberty, the increase in fear and anxiety especially in the late evening, the notable excessive OCD(obsessive compulsive disorder) behaviors are all strong indicators of high androgens…. Ask a parent who lives with this if they think this is like elevated insulin in a diabetic!!!

      • Sullivan (Matt Carey) October 8, 2012 at 19:32 #

        Teresa Badillo,

        let’s go through your comment.

        1) Mr. Brown is an autistic. My guess is he has some idea of what tests he has been through.
        2) If testosterone levels were high in all autistics, why are so many of the Geier’s patients in the normal range?
        3) Autism is not an autoimmune disorder. Even if it were, that is not the same thing as a hormone imbalance.
        4) Many (most, all?) of the patients seen by the Geiers did not have precocious puberty. The Geiers didn’t even perform all the necessary tests to make the diagnoses.
        5) What Supreme Court decision are you referring to?

        Mr. Brown (a) has read much of what parents have to say and (b) has something to say as an autistic. Do you listen to autistics? Or do you get all your information from parents? Whatever the source, you are either misrepresenting what you are reading or you are getting very bad information…or both. Sorry to be so blunt, but your comment is filled with mistakes, as I’ve just pointed out.

      • Lara Lohne October 8, 2012 at 20:36 #

        Not all autistics have hypotonia. Many have delayed gross motor and fine motor skills, but that has more to do with brain communication networks then physical malformations. I have an autistic child and he is very well coordinated and has very good muscle tone and is extremely strong for his age, so your statement that all autistic have hypotonia is nulled by my son alone, and I’m sure my son is not an anomaly.

        As for precocious puberty, from what I have read, that is due to feeding children soy based products, such as soy formula, soy based bread, milk, cheese, etc. Which can elevate levels of estrogen, not testosterone.

        It appears you are basing your own personal experience with your own child and applying it to everyone who has autism. Autism isn’t a cookie cutter disorder and not one person presents with the same symptoms each and every time. Just as the saying goes, “If you’ve seen one person with autism, then you’ve seen one person with autism.”

        There are many people with autism who have co-morbid conditions which are responsible for all of the other things you are linking to autism, but they are not specific to autism and are not required for an autism diagnosis to be reached. My son is very healthy, strong, active and bright. He does not have any co-morbid disorders, he simply has autism. And those aggressive behaviors typically have an external trigger (E.g. loud noise, odd smell, too many people, unpleasant lighting, etc.) which causes physical discomfort. It is the physical discomfort that causes the classic autism meltdown and acting out, but an autistic individual can be taught how to self regulate and calm themselves when their environment may tax their systems. If an autistic person is given the tools they need to calm themselves, they become more functional and better able to interact positively with others and are able to progress. In time, the environmental factors that can overwhelm a person with autism become less severe and bothersome for them and they can learn to filter them out so they are just back ground noise for them, just as they are for an NT individual.

        One thing I have learned, if an autistic feels the need to stim, let them, because that is self regulating behavior which allows them to deal with the external bombarding of their senses. When they are not allowed to self sooth, that is when anxiety will set in. You try living with constant over stimulation and see how high your stress and anxiety levels become. I admire people with autism for their ability to deal with the world and the rest of us. It takes some kind of strength and guts to go out into a world every day that is too loud, too smelly and too bright. Not to mention the communication confusion that can be a constant companion. It’s time that the world embraced people with autism for the unique and amazing people that they really are. I believe I have learned more from my son then he has ever learned from me.

    • futuredave5 October 9, 2012 at 04:15 #

      I don’t know much about the subsequent comments, but it was my understanding that low muscle tone can be unrelated to low testosterone. My son, for example, has low muscle tone, and it seems to be related to the way his nerves work, (or to the number of neural connections).

      The way the doctor describes it, his muscles are built normally, but the nerves that control them are inadequate. The doctor described this as roughly the exact same condition that caused him to be under-sensitive to touch (also sound).

      In any case, the low muscle tone appears to be a neurological condition, and (more or less) unrelated to testosterone.

      This is not said to defend the Geiers. In fact, the opposite. As I understand it, testosterone levels can’t be determined by behavior, muscle tone, or anything else except lab tests. Even with the appropriate tests, autistic behavior can’t be attributed to any one cause.

      So it is not as counterintuitive as it seems. Even if it were, counterintuitive is not the same thing as wrong.

      • Lawrence October 9, 2012 at 10:41 #

        The Geiers latched on to a “pet theory” and proceeded to treat children with a drug which is traditionally used for “chemical castration” with no evidence or proof that it would do anything other than what the drug was designed for – how exactly can anyone defend this practice or these people?

      • futuredave5 October 9, 2012 at 13:41 #

        Hmm. I think that is what I said. Maybe I should go back and re-read my own comments to see if I am not being clear.

        So let me restate the sentences, with the appropriate disclaimer: “I am not saying this to defend the Geiers, or any of their practices, nor any of their silly theories.” Although Lupron can be used for chemical castration, that is not the only approved use.

        Although autistics can have very low muscle tone, that does not always indicate low testosterone.

      • Lawrence October 9, 2012 at 14:03 #

        @futuredave5 – no saying you were, that was my own statement.

  6. Science Mom October 8, 2012 at 20:44 #

    Teresa, It appears as though you have a vested interest in testing of special needs children but considerably short on any supporting evidence while trying to knock down another commentor here. If you want a conversation then try starting with literature that supports your dubious tests.

  7. lilady October 10, 2012 at 05:30 #

    Theresa is spamming for her own business which is a bio-chemical laboratory that DAN! doctors use to determine “toxicities” and the *treatments* they prescribe for autistic kids, whose credulous parents ascribe to those bogus *bio-medical interventions*.

    Lupron is used for treatment of certain breast cancers and for palliative treatment of advanced prostate cancer…not autism.

    http://en.wikipedia.org/wiki/Leuprorelin

    My son who was born with a rare genetic disorder actually had “precocious puberty” at age eight. His neurologist and I made the instant decision to not send him for an endocrine consultation and additional medication….at long last, we had achieved a measure of control of his intractable-to-treatment seizure disorder, with four potent anti-convulsant drugs.

    I actually welcomed his early precocious puberty, because he was totally dependent and wheelchair-bound. An early end to his growth spurt, made it easier…and safer…to transfer him from his wheelchair to his play mat and to his bed.

  8. David N. Brown October 10, 2012 at 06:32 #

    @Lora Lohne,
    Just to be clear, I don’t have any children, but I am “on the spectrum”, and I probably fit the general description for “low muscle tone”. As far as whether this is in any sense “typical” for people on the spectrum, it’s my strong impression that there probably isn’t enough out there even to address the question. What we seem to have at this point is a large volume of basically “annecdotal” evidence. What seems to be necessary is for the professional researchers to start sorting through it.

    One other thing that I want to be sure is understood: I am well aware that there are forms of diabetes in which natural insulin levels are elevated. Evidently, it’s a matter of the body producing the insulin, but not utilizing it properly. Just by analogy, I can accept it as at least conceivable that someone could have elevated testosterone yet appear “underdeveloped” physically. At this point, that’s the only reason I can see to take any form of the “excess testosterone” idea seriously. (Ms. Badillo’s comments on what that would entail would seem only to make what the Geiers offered as “evidence” more absurd.)

    Something else I will add is that I emphatically agree with you on stims. I have gone so far as to propose that any recognized “stim” behavior can and should be used as a “gauge” of the individual’s comfort level. (I have also suggested that, in those terms, trying to suppress the stim behavior is fully equivalent to a Simpsons gag in which Homer “fixes” his car by putting tape over the “check engine” light!) I think this really gets to a fundamental problem with “researchers” like the Geiers: They keep people chasing biomedical causes and “cures” to “behavioral problems” instead of looking at the immediate issue of how a person responds to a given environment.

    David N. Brown
    http://www.evilpossum.weebly.com
    http://www.autismandreligion.weebly.com
    http://www.exotroopers.wordpress.com

    • Lara Lohne October 10, 2012 at 06:49 #

      Mr. Brown,

      Thank you for your comments, and I was aware you are on the spectrum, it’s one of the main reasons I subscribed to your blog. I still feel like an infant when it comes to autism, I didn’t know much about it until it was part of my life. I feel I can learn a great deal by learning from adults on the spectrum, because they’ve already been through what my son is now going through and I can hopefully learn how to help him achieve his full potential better by listening to what you and your peers (not the neurotypical ones) have to say on the subject.

      There is actually a disease that affects females called Poly-cystic Ovarian Syndrome (PCOS), which the root cause in insulin resistance or hyperinsulinimia, but it causes a significant number of different endocrine problems, one of which is elevated testosterone. But they don’t treat the testosterone because that is just a symptom of the core issue, which is elevated insulin levels. Once the insulin is under control, be it from diet or with medication (Glucophage or Metformin traditionally) the other symptoms lessen significantly or disappear entirely.

      I know there are many people with autism that do have hypotonia, but Ms. Badillo’s claim that all autistics have it is incorrect, simply because my son doesn’t. He was diagnosed with global developmental delay a year and a half ago when he got his official medical diagnosis of autistic disorder, but his muscle tone is actually very good. He has slightly delayed gross motor skills and significantly delayed fine motor skills. We are working on that though with OT. Lupron may alleviate the more bothersome autistic behaviors, but that doesn’t alleviate the core cause of the behavior. It amounts to nothing more then chemical restraint.

      • David N. Brown October 10, 2012 at 09:11 #

        On the hypotonia question, I’m really not at all familiar with the terminology, but I would take it as a matter of “common sense” that “low” muscle tone would potentially include a range of things, from simply the lower end of the range for the general population to conditions serious enough to limit mobility. My guess is that, given the resources and proper criteria (those for hypotonia don’t seem to be too precise at the moment!), we would probably turn up more autistic individuals who are “low normal” than clinically abnormal for muscle tone. But, the former could be more valuable as evidence of a real pattern.

        Something else I was thinking about is the problem of biomedical testing. One consideration Ms. Badillo has inadvertently raised is that, if testosterone levels are as variable and sensitive to specific circumstances as she indicates, then elevated testosterone could occur as a symptom rather than a cause of autism. It occurs to me that, for a sufficiently sensitive individual, even the testing environment and procedures could be their own confounding factor. It’s a kind of problem I’ve personally suspected in some of my own experiences: My doctors carefully monitor my heart rate (I believe to check whether my psychiatric meds are likely to kill me), and frequently have expressed concerns. But, I have to take their tests after I get across town on public transportation, often with a last leg on foot, which seems like a pretty good way to get one’s heart rate up!

        Incidentally, I don’t really think of myself as an autism blogger. I prefer to describe my two sites as “resource sites”. I would consider my exotroopers site to be my first real blog, and that’s intentionally all over the place. Hey, it’s fun….

        David N. Brown
        http://www.evilpossum.weebly.com
        http://www.autismandreligion.weebly.com

    • lilady November 3, 2012 at 20:01 #

      I just “stole” your link Michelle…and posted it on the Respectful Insolence blog. Hope you don’t mind…but the news is *too good* to not share it. 🙂

      Mark Geier’s medical license in Hawaii expires on January 31, 2014…

      http://pvl.ehawaii.gov/pvlsearch/app?_a=d&_f=n&lictp=MD&licno=14996&off=&nm=MARK%20R%20GEIER

      • Michelle November 3, 2012 at 20:49 #

        @lilady…First thing this morning I emailed Orac, Todd W. and Kathleeen. I’ve been working with this St. Louis reporter on the story and I’m so glad to finally see some results. Bad press really helped.

  9. Lawrence November 3, 2012 at 16:35 #

    @Michelle – FINALLY!!!!

    Hawaii, I believe.

  10. lilady November 3, 2012 at 22:01 #

    @ Michelle…Good for you. You’ve done the world, and autistic kids whose parents even *contemplate* these *biomedical* interventions, a great service. I’m in awe and Brava!

  11. MikeMa November 4, 2012 at 11:16 #

    Nice to see the end in sight for another ‘profit from pain’ sleazebag doctor.

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