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David kirby plays the segregation game

3 Jan

A truly fascinating start to 2007. David Kirby writes a blog entry entitled ‘There is no autism epidemic’. Why is it fascinating? Two reasons. Firstly, it reveals the lengths David Kirby is willing to go to shift goalposts even further. The entire entry is replete with strawmen arguments. An example – in his opening paragraph, Kirby talks about being vilified by people who who believe that autism is a stable genetic condition and then names the neurodiversity community as amongst his most spirited detractors.

Nobody I know who shares the opinion of neurodiversity believes autism is *only* a stable genetic condition. However, unless we want to throw out what we know about Rett Syndrome then we do have to accept that some of the spectrum of autism is indeed a genetically based condition.

He further describes neurodiversity as a ‘group of adults with autism’. Again, nowhere near accurate. As I wrote about only yesterday, neurodiversity is not specifically associated with autism, neither is it anything other than a fairly nebulous opinion shared by people who think respect and equality matters. Neither is it an opinion not shared by people who are parents of autistic children.

Here’s how Kirby sums up ‘the neurodiverse’:

Most of them, I believe, have what science calls “Asperger’s Syndrome,” or very high functioning autism. From their eloquent and well reasoned point of view, autism has no “cause,” and it certainly requires no “cure.” To suggest otherwise is to brand these adults with the stigma of disease and disability, which is patently absurd given their educational and intellectual achievements.

No.

Time and time again, the people I speak to who are autistic and who are sharers of the opinion neurodiversity expounds tell me that as children they either were not diagnosed at all and left to rot or diagnosed with low functioning autism. How do I know this? I asked, Mr Kirby, and then I listened to the answer. I didn’t make up any old opinion that suits my argument better. Some, like Amanda Baggs, still _are_ considered low functioning. My Great Uncle was ‘low functioning’ and my Great Aunt was ‘high functioning’ – both were born way before thiomersal was ever around by the way. My Grandma said that her brother-in-law was ‘much worse’ as a child than as an adult. As adults they were able to converse.

The first part of Kirby’s post sets up the second. He is attempting to dismantle the idea of the autistic spectrum and at the same time, corral all ‘the neurodiverse’ into a place where they cannot speak about autism. Here’s the filibuster part of his post in full:

But if that’s autism, then the kids that I have met suffer from some other condition entirely. When I talk about “curing” autism, I am not talking about curing the “neurodiverse.”

I am talking about kids who begin talking and then, suddenly, never say another word.

I’m talking about kids who may never learn to read, write, tie their shoes or fall in love.

I’m talking about kids who sometimes wail in torture at three in the morning because something inside them hurts like a burning coal, but they can’t say what or where it is.

I’m talking about kids who can barely keep food in their inflamed, distressed guts, and when they do, it winds up in rivers of diarrhea or swirls of feces spread on a favorite carpet or pet (no one said this kind of “autism” was pretty).

I’m talking about kids who escape from their home in a blaze of alarms, only to be found hours later, freezing, alone and wandering the Interstate.

I’m talking about kids who have bitten their mother so hard and so often, they are on a first name basis at the emergency room.

I’m talking about kids who spin like fireworks until they fall and crack their heads, kids who will play with a pencil but not with their sister, kids who stare at nothing and scream at everything and don’t even realize it when their dad comes home from work.

These are the kids I want to see cured. And I don’t believe they have “autism.”

Woah! My daughter very rarely speaks, she’s just on the cusp of learning to write, she can’t tie her shoes, she wakes up regularly in the night (on New Years Eve she got up at half past midnight – not 3am) but she is distinctly burning coal free, she tolerates certain foods very well and refuses to touch other foods, she used to smear faeces regularly on both the carpet, the walls, her bed, us, the cat and she’s had the odd bout of diarrhoea (no one said autism was pretty, right?) – she’s pulled out of my hand on occasion and ran and I’ve followed, heart in mouth, she sometimes has the odd pinch or smack at me if I’ve told her she can’t have something, or I’m not getting what it is she wants, she loves to spin – and bounce (have you see my video Mr Kirby?) and she used to be non-social completely.

So yeah, I know what you’re talking about. Guess what? Its still autism. I still love her just the way she is. I still don’t want to change anything about who she is. I’m happy for her to be autistic.

Here’s what *I* think.

I think you’re goalpost shifting again Mr Kirby. You don’t believe they have autism? So what was the last two years about? Why the constant harping on about the CDDS until it stopped showing you what you wanted it to? Why the sudden panicky need to dismantle the idea of a spectrum of autism? Why redefine? Is redefining easier than explaining why your hypothesis isn’t panning out?

And what’s this about?

Asthma, diabetes, allergies and arthritis are ravaging their bodies in growing numbers

Sounds suitably scary but a) has nothing to do with autism and b) would appear to be partly wrong. And what about this:

There is something, or more likely some things in our modern air, water, food and drugs that are making genetically susceptible children sick, and we need to find out what they are.

Wow, is this an admission of error? From stating a belief that thiomersal caused autism you are now suggesting that ‘some things’ are making ‘children sick’ – that’s quite a change of heart. Why? Is it so hard for you to say – ‘guys, I was wrong. Back to the drawing board and I’m sorry you wasted your hard earned dosh on my book’.

Here’s something for you to read on the subject of neurodiversity Mr Kirby, I hope the point doesn’t escape you.

On May 19, a small group of people with Down Syndrome and their supporters disrupted the International Down Syndrome Screening Conference at Regents College in London. This is the first time that people with disabilities have spoken out publicly about prenatal screening. Their protest opens up the debate about genetics, eugenics, and the rights of disabled people.

As a result of the protest, the conference organizers allowed Anya Souza to speak from the podium, a platform her group had previously been denied. Ms. Souza, a trustee of the Down Syndrome Association who is labeled as “suffering” from the condition herself, told the doctors why she opposes the screenings.

The protesters found it unacceptable that doctors would discuss better ways of preventing the birth of people with Down Syndrome while excluding the voices of people with that label from the debate. That runs, they said, directly counter to one of the main demands of the disability rights movement: Nothing about us without us.

“We are what we are,” Gilbert [another protester] concluded. “Ask our opinion.”

Do you get the point(s) Mr Kirby? What you are doing by pretending that AS and autism are two different things is taking away the opinion of autistic people. You are doing it without evidence that you are right, without anything other than a ‘hunch’. An MO that is becoming more than a little familiar. You are following the proud tradition of Lenny Schafer and Rick Rollens, who also want to stop autistic adults talking about autistic children being OK just as they are.

Be brighter than them Mr Kirby. Try and understand that no one advocates letting kids suffer painful medical issues but that these things do not, and never did, equate to autism. What you’ve taken away over the last two years from both these adults and the kids of those you call friends and those you don’t is dignity. Nothing about us without us.

Update: Kristina weighs in too and Joel writes a first class piece on proving one is broken. Diva gives us good instructions and spotting autistic people and Do’C and Jospeh ferries across a river of shit.

Autism extremists

28 Dec

There is a lot wrong with the UK in terms of provision for autistic people and education about what autism is to the mainstream. One of the things that isn’t quite right is the National Autistic Society. It’s numerous flaws include a lack of autistic people at policy making level.

But you know what? It knows this about itself and is trying to change. It is also a deeply responsible society. It carries a link to this PDF on its data pages. This article is a short ‘what is…’ guide that explains clearly what people should look for in a decent science paper and why these things are important. Peer review is discussed, as is the importance of publication in a respected journal. I strongly urge people to download this and pass it on to any parent or interested researcher. Its a great, non-technical, helpful and clear article.

By contrast, the US Autism Society of America (which is obviously in a battle with Autism Speaks as its strapline is ‘the voice of autism’) seems to have taken a step further down the road to quackery. In the latest issue of its ‘Advocate’ magazine, it included a number of interviews with such mercury militia stalwarts as Mady Hornig, JB Handley, Dan Olmsted and Martha Herbert. It also included a ‘how-to recover autistic children’ guide from ARI (home of the DAN! docs). Of note was the trumpeting of a new treatment option I hadn’t seen before:

Medical Marijuana to control aggression…

So if your autistic child is acting up, give ’em an illegal Class C narcotic….is this really the periodical of the most mainstream autism organisation in the USA? Giving space to people who want to push illegal drugs to kids?

I’m not going to pretend I’ve made it through 37 years of life without imbibing the odd narcotic but I was an adult, making my own informed choices. These people are trying to suggest that its OK to give these things to kids. Incredible.

I’ve discovered some of the most informed, considerate and knowledgeable people in the US. I’ve also discovered some of the most frightening, genuinely ignorant (and desirous of that state) people in the US.

Every now and then I can’t hold back from posting to web forums that discuss autism. I did that just before Christmas at a web forum that I’ve now stopped posting at again – it reaches such a fever pitch of idiocy that you think ‘what’s the point?’ And of course, people mail me every so often to point out something dumber than usual that that poster boy for assholery John Best has posted. I stopped reading John’s blog awhile ago for the same reason – the people who post there aren’t interested in debate or enlightenment. They desire their state of ignorance. Well, a quick toke on what DAN! promote those days should help with that!

But anyway, a quick example of one of the more extreme people who post at both these places (I didn’t know until today that this person posts at John’s blog but it wasn’t a surprise) is a poster called ‘dgdavies’ – real name Diane. I find her utterly fascinating and repulsive at the same time.

I found out via her that there is a conspiracy to somehow tie in the vaccine/autism hypothesis to the 11/9 WTC terrorism (which, by the way, was orchestrated by an internal agency according to her). She was, understandably, not clear on the details but she was adamant.

I found out via her that the vaccine/autism hypothesis could well be an Illuminati plot as suggested by FAIR Autism Media wacko David Ayoub.

Her latest fascinating conspiracy theory is that (and this truly is an awe inspiring piece of self delusion) is that the diagnostic criteria for autism was widened at the last DSM revision _in order to ‘hide’ the mercury poisoned hordes_ .

I hear tell, that like John Best himself, Diane doesn’t believe in evolution.

Is this the legacy of Bernie Rimland? A bunch of whacked out stoners swapping addled stories? Pass the hash pipe dude.

There’s also the small matter of at least one ARI DAN doctor being a paedophile, another being very closely associated with a convicted paedophile, DAN doctors belonging to cults like Scientology and, of course, the DAN! hierarchy happy to accept killers. These aren’t conspiracy theories. These are established facts. Why have these people been given any time at all in a supposed mainstream autism publication?

David Kirby – what have you done?

20 Dec

I want to follow up somewhat on Joseph’s techncial takedown of David Kirby’s recent act of intellectual suicide. On the Huffington Post he wrote a bewildering post called ‘Bad News for Mercury Defenders‘ which discussed how Dan Olmsted’s recent sleuth-like skills led him to talking about a report that undermined studies conducted using VSD data.

Let us begin:

Next June, when the Vaccine Trial of the Century gets underway in Federal Claims Court, government lawyers will defend the direct injection of toxic mercury into infant children by repeating the well-worn mantra that “five large population studies” in Europe and the US have completely exonerated the vaccine preservative thimerosal as a possible cause of autism.

My, my – vaccine trial of the century eh? I’ll have to remember that one when the verdict comes back. This is crap. No lawyer will have to defend the direct injection of mercury into infant children. What they will have to do is counter the accusation that thiomersal in vaccines caused autism. Kirby (as usual) presents a highly distorted view to his adoring fans. The truth is that as in all legal cases, the burden of proof lies on those making the accusation. The accusation is not that mercury is dangerous. the accusation is that it caused autism.

Again:

The VSD study is constantly held up by public health officials as EXHIBIT A in the defense of injecting mercury into little kids.

No, its not. If its held up as anything, its held up as a study that refutes the link between thiomersal in vaccines and autism. Seriously – isn’t this man a journalist? What’s difficult to grasp about this concept?

Kirby goes on to diss the remaining studies and surmises this section of his blog thusly:

With so many holes shot through their “five large studies” defense, the government lawyers will be left to argue that autism is purely genetic, that there is no environmental component, and that the rates of illness have not “really” gone up. We are simply better at recognizing and diagnosing the disorder, that’s all.

Well, if that is the case, the mercury-defense lawyers should have no problem proving it. All they need do is produce irrefutable evidence that 1-in-166 American adults of ALL ages (and 1-in-104 men) fall somewhere within the autism spectrum disorder, at the same rate as kids. But they can’t, and they won’t.

I can only surmise that Kirby is a big fan of the Wizard of Oz and had strawmen on his mind whilst writing this. Yet _again_ he fails to grasp the fact that what this trial is about is simply if thiomersal caused autism. All the vaccine makers have to do is refute the ‘science’ from the other side. And lets be honest, after the RhoGAM smackdown that’s going to be about as difficult as falling off a log. It’ll be surprising if any of the ‘scientific’ evidence ever gets past a Daubert hearing as it failed to do in the RhoGAM case.

And whilst we’re at it, no one has said anything about arguing autism is purely genetic. Why in Gods name would _that_ be required? Autism may well have an environmental component – I know I think it does – but unless Kirby is trying to say that the word ‘environment’ is interchangable with the word ‘vaccine’ then this is also just…meaningless.

And lets get back to the clinical science for a moment:

Instead, one must also consider biological studies (animal, clinical, test tube) when assessing causation. And that’s where the plaintiffs will come to court armed with reams of published evidence – produced at Harvard, Columbia, Davis, etc., and printed in prestigious journals – to suggest a highly plausible biological mechanism that would link a known neurotoxin with a neuro-developmental disorder

Has no one broken the news of the thiomersal/RHOGam/autism case to Kirby? _All_ the ‘science’ that Kirby is talking about here was brought to that trial (follow the link and you can download the entire Daubert findings and read the studies presented for yourself) and was cumulatively dismissed. Here’s what the presiding Judge stated:

However, upon being subjected to extensive cross examination, much of Dr. Geier’s analysis, based upon his collective review of a motley assortment of diverse literature, proved, in the Court’s view, to be overstated……[Dr. Geier] could not point to a single study that conclusively determined that any amount of mercury could cause the specific neurological disorder of autism.

So, that’s exactly what effect eliminating VSD based studies will have on the respondents case. None whatsoever.

But what about the plaintiffs? They have to prove beyond reasonable doubt that thiomersal in vaccines caused autism. And as Kirby helpfully points out:

….They wanted to know if the US database, the Vaccine Safety Datalink (VSD), could be used to compare autism rates in kids before, during, and after the gradual removal of thimerosal, which began in roughly 2000.

Unfortunately, the answer was a resounding “not really.” A laundry list of “weaknesses” and “limitations” associated with the database would render such a comparative analysis “uninformative and potentially misleading,” the panel said, (though it did suggest some excellent ways to re-approach the data going into the future).

Some weaknesses had to do with changes in medical practices over time. But many of the limitations sprang directly from the poorly designed VSD study itself….

So what studies could be killed off by this examination. Well, there are two actually. The first one is Verstraeten et al (2000) which is the one we’ve been discussing so far and Kirby’s been bashing. The other one is Geier and Geier (2005) which they plagiarised from Verstraeten et al (2000). Oops.

Why does the nuking of Geier matter whilst the nuking of Verstraeten does not? Burden of proof, which lies with the prosecution. The Geier paper will be used to help _establish_ causation which is vital, not prove it didn’t happen, which is not called for. The Geier paper (which was crap anyway, lets face it) has now been neatly and effectively taken out by Olmsted and Kirby. Don’t Americans refer to that as friendly fire? By removing Geier 2005 from the playing field, the prosecution are now left with clinical science which has already failed one Daubert hearing (I believe the legal term is ‘setting a precedent’) and any epidemiological data they can scrape together from VAERS and CDDS.

As far as VAERS go, I’d like to remind people of my own experimentation with VAERS. And as far as CDDS data goes, lets remind ourselves one more time what Kirby has said about CDDS data:

“if the total number of 3-5 year olds in the California DDS system has not declined by 2007, that would deal a severe blow to the autism-thimerosal hypothesis.”….total cases among 3-5 year olds, not changes in the rate of increase is the right measure.

And here, helpfully provided by Dad of Cameron are the ever-growing numbers in that cohort.

There’s also the small matter of The Simpsonwood Conspiracy. To quote Joseph:

….it completely undermines the foundations of the Simpsonwood conspiracy theory. You see, Verstraeten et al. were supposed to have found significant associations between thimerosal and neurodevelopmental outcomes beyond those that were reported in 2003. But now Kirby is endorsing a NIH report which says that ecological studies on the VSD database, specifically those done by Verstraeten et al., are likely flawed.

In other words, without the VSD data being good, the Simpsonwood Conspiracy is a non-starter.

Amazing.

Just Sayin’ Part VI

19 Dec

Just Sayin’ Part V

7 Dec

Porphyrins, autism and enviromental militia

4 Dec

You know those nature programs where they film sharks in a feeding frenzy? That’s what I’m reminded of when a new test or treatment appears on the radar of the mercury militia. First there’s one lone parent taking a chomp but after a few minutes there’s a whole school of them twisting, turning, biting indiscriminatingly.

Porphyrins are the New Big Thing amongst the mercury militia. Never mind that the sole paper that exists on the subject (pertaining to autism) contradicts the Holy Edicts of DAN! and also fails to note that some forms of chelation affect how Porphyrin’s are measured and further, that the lead author of the study acknowledges the substantial grey areas and unaddressed discrepancies in the paper. Full steam ahead Jeeves and don’t spare the horses.

In a nutshell, these people believe that Porphyrins can be used to give a very accurate measure of how much mercury (or other metals) are in someone’s system. They send their kids wee off to a lab in France to be analysed at €80 a pop. The French test is considered the best as they test for Precoproporphyrin which is supposed to be a specific marker of mercury. Never mind the fact that only one scientist has ever found this association.

So how’s it panning out for the mercury boys and girls? Here’s a series of quotes from the Yahoo ChelatingKids2 Email Group:

A fellow listmate had her son tested twice– once over the summer which showed he had no elevated metals, and one this fall that showed he did indeed have elevated metal levels. She has sent an email to the lab asking about the differing results and has not received a response. I believe she is still trying to contact them.

FWIW, my neighbor’s dad happens to be a porphyrin specialist here in Boston (believe it or not– how many of those are there??). He reviewed lots of info for me– Nataf’s paper, my son’s results that showed very elevated metals across the board– and said he would have rejected the paper for publication had he been asked to review it. He said that fecal, not urine, should be used to measure the porphyrin levels. I sent an email to the lab inquiring about this and also received no response.

It concerns me that if someone does one test and goes on those results, do we know that those are accurate. I hate the idea of implementing treatment on a child based on less than accurate info. It is hard to GET good info I realize on the toxicity issue but just wondering if this is reliable enough to trigger chelating a child etc.

The answer is ‘no’. Here’s another one:

I just received the results of the French porphyrin test for myself and my 7 year old NT daughter, and the results also show severe lead and mercury toxicity. My daughters numbers are worse than my ASD son!

Sadly, this parent was considering chelating her NT daughter anyway even though….

My daughter is terrified of oral capsules and blood draws after seeing what her brother goes through

I’ll bet.

What’s the cut off point when an honest desire to help someone based on love for them and sound science to underpin your decision becomes a dangerous chasing after any sort of unproven treatment no matter what the consequences might be?

The scientist and author Michael Crichton once gave a speech about environmental issues that may as well have applied to the autism/vaccine issue:

We are basing our decisions on speculation, not evidence. Proponents are pressing their views with more PR than scientific data. Indeed, we have allowed the whole issue to be politicized—red vs blue, Republican vs Democrat. This is in my view absurd. Data aren’t political. Data are data. Politics leads you in the direction of a belief. Data, if you follow them, lead you to truth.

Increasingly it seems facts aren’t necessary, because the tenets….are all about belief. It’s about whether you are going to be a sinner, or saved. Whether you are going to be one of the people on the side of salvation, or on the side of doom. Whether you are going to be one of us, or one of them.

That’s sad, worrying, dangerous. And true. When did we start to let PR driven media become more important and carry more weight than scientific fact? When papers scream headlines about the evils of mercury causing autism what is it about the apocalyptic way the story is written that catches attention? We live in a world where we think we see threats at every turn. This is a world where I cannot videotape my kids school plays any more as its considered ‘a security risk’. This is a world that now exists in biblical terms like ‘terror alerts’ and ‘axis of evil’. No one conditioned to this hysteria is going to listen to the scientists simply repeating the fact that no science supports such an assertion. That won’t give us a fix of melodrama – maybe if we portray these scientists as part of a global conspiracy that might quicken our terror-conditioned pulses a bit.

There are people who get their ‘facts’ not from scientists but from people like this man – an American DJ names Don Imus. He is, apparently, an autism advocate. He also seems to be something of a racist bigot.

If I have wishes for Christmas its that we stop listening to hyped-up media merchants like the odious Mr Imus and start listening to actual scientists regarding autism and its causes.

Jock Doubleday’s $75,000 vaccine offer

27 Nov

Jock Doubleday, author of such excellent works as ‘The Burning Time (Stories of the Modern-day Persecution of Midwives)’ and ‘Lolita Shrugged (THE MYTH OF AGE-SPECIFIC MATURITY )’ (Jock is a middle aged man by the way) is most famous in the autism community as the creator of the $75,000 vaccine offer in which he;

…offers $75,000.00 to the first medical doctor or pharmaceutical company CEO who publicly drinks a mixture of standard vaccine additives ingredients in the same amount as a six-year-old child is recommended to receive under the year-2005 guidelines of the U.S. Centers for Disease Control and Prevention. (In the event that thimerosal has recently been removed from a particular vaccine, the thimerosal-containing version of that vaccine will be used.)

The mixture will be body weight calibrated.

Doubleday claims;

14 doctors, or persons claiming to be doctors, have contacted me about publicly drinking the vaccine additives mixture. None have followed through.

Nobody seems sure why participants have to be doctors or big pharma CEO’s and not ordinary folks like you and me. I’m also not sure why Doubleday insists on such a bizarre contract that any participant must adhere to, including psychiatric evaluation, a history of any mental health based counselling (these are probably to add to the air of drama), an email exam of 10 questions regarding vaccine theory and history, the compulsory purchase and reading of at last five altie books on anti-vaccine woo, a 20 question written exam, a certificate of good health…oh, I give up read the rest here.

To be honest, I got bored just reading that contract. And that’s only Part A. If I was a more cynical man I’d say that’s not so much of a contract as an endurance test designed to make everyone with an actual life of their own say ‘Sod this, I could be having a curry or watching Father Ted‘, both of which are activities much more interesting and enjoyable than satisfying the terms of that contract. But then the same could be said of watching paint dry.

Of course, the point of all this is that it shows how few people are willing to ‘take the challenge’. Luckily for Doubleday, someone already ‘took the challenge’ in 1996.

Clinical course of severe poisoning with thiomersal, published by the then Journal of Toxicology – Clinical Toxicology (now just called Clinical Toxicology) was the case study of a German 44 year old man who ingested 5g Thiomersal.

Lets compare that to the maximum load that US kids got before 2001.

The average US child got 187µg of Hg from all thiomersal containing shots. If we bend the rules in favour of the thiomersal (and Doubleday) theory and say that a 1 stone (14 pound) child had had that total of 187µg of Hg we can compare that to our 44 year old man who weighed 60kg (9.4 stone or 132 pounds).

Child Adult Male
187µg of Hg 2,480,000µg of Hg1
13.36µg per pound2 18,787.87µg per pound3

15g Thiomersal = 5,000,000µg of Thiomersal. 5,000,000/49.6% (Mercury in Thiomersal) = 2,480,000µg of Hg
21 stone (14 pound) child 187/14pounds = 13.36µg per pound
3 9.4 stone (132 pounds) 2,480,000/132 pounds = 18,787.87µg per pound

I think we can easily state that this man got vastly more thiomersal per pound then any child would. Even if we inflate the weight of our adult subject to 25 stone (350 pounds) he still gets 7,085.71µg per pound – over 530 times the amount. As it is, using the real figures, he’s getting over 1,400 times more thiomersal than the infant.

So what happened to our German friend? Surely he must’ve had one of the most ‘severe’ cases of autism ever seen right?

He developed gastritis, renal tubular failure, dermatitis, gingivitis, delirium, coma, polyneuropathy and respiratory failure.

Hmm. Sure doesn’t look, act, sound or quack like a duck….I’m going to go right ahead and surmise that in this man’s case, after ingesting over 1,400 times more mercury from thiomersal than an infant that he developed no signs of autism whatsoever and in fact somehow managed to avoid becoming autistic.

And the eventual outcome?

The patient recovered completely…..The decline of mercury concentration in blood, urinary mercury excretion, and renal mercury clearance were not substantially influenced by chelation therapy

It also looks like his total course of recovery took about 5 months. All neurological symptoms were resolved in 46 days. Not several (and ever increasing amounts of) years.

Put your money away Mr Doubleday – its not needed.

Just Sayin’ Part IV

18 Nov

David Kirby: Whats with the scaremongering?

17 Nov

Letter from DOJ (980kb)

Ploughing through my email which had accumulated whilst I was ill, I found that David Kirby had published a piece on the upcoming Autism Omnibus hearings in the US. Go have a read.

NB: For the uninitiated, the Autism Omnibus court hearings are going ahead in June next year. They are a joint action brought against the vaccine claims court. These are important because it will be these hearings that determine whether there is any official recognition that thiomersal/MMR causes autism. This is almost certainly not going to happen. Mainly because vaccines don’t cause autism and there is no science to suggest they do, but also because the thiomersal/autism expert witnesses would be better termed expert witlesses. Geier, Haley, Hornig, blah blah blah – the same science and the same people that recently resulted in the thiomersal/RhoGAM/Autism court case being thrown out.

Anyway, back to David Kirby. He was blogging about a recent turn of events wherein the Special Master (the person who will be overseeing the whole trial) had asked for opinions from both claimants and the DOJ on granting public access to the trial. Both duly obliged. Of course, the response the DOJ gave was immediately leapt on by David Kirby. I’ll be doing something Kirby didn’t do in his blog entry and actually looking at the letter. I’ll also be quoting from both that letter and Kirby’s post. If you want the whole letter for yourself, you can download it from the link at the top of this page.

Kirby starts off by setting the mood:

Next year, a “Special Master” in an obscure Federal court known only to a few Americans will preside over a highly sensitive judicial matter of urgent national importance. The Bush Administration wants to hold the hearings in a sealed courtroom, off limits to the press and public, with stiff “sanctions” for any outsider who attempts to gain unauthorized access to the secretive proceedings within.

Terror trials in faraway Gitmo? Good guess. But these are vaccine trials on New York Avenue, in downtown Washington, at the U.S. Court of Federal Claims.

You may not know it, but there is an official federal “vaccine court,” where some 4,750 autism-related cases have been pending for years. Claimants believe the mercury-based vaccine preservative, thimerosal, and/or the MMR vaccine, contributed to their children’s autism, and they are seeking compensation from a special vaccine injury fund administered by the federal government.

So, apparently, the DOJ wants to hold the hearings in a sealed court, off limits to press and public with stiff sanctions for any outsider who attempts to gain unauthorized access to the secretive proceedings. I have to be honest, when I read that I was on Kirby’s side. It sounds terrible. Then I remembered that David Kirby has been known to tell the odd porky on occasion. and decided to reserve judgement until I’d read the letter. Now I have.

Firstly, what is particularly odd about denying public access to these proceedings? The DOJ state quite plainly that:

…public broadcast of federal trial court proceedings appears to be without precedent. Broadcast of criminal proceedings is banned by federal rule.

It would in fact be odd if they did agree to this. If the Omnibus memebrs believe they are special cases then they need to explain why.

And a sealed court Mr Kirby? Hardly. From the letter:

…respondent agrees that some arrangements, unique in Vaccine Act proceedings should be taken to permit Omnibus claimants and their counsel to observe the trial…..[a]udio webcast of the hearing to those claimants who do not attend in person appears to be the best available method to permit them to follow the trial.

I wouldn’t call that a sealed courtroom. All the people who need to hear what’s being said, can hear what’s being said. From a technical standpoint managing audio instead of both audio and video is both easier, cheaper and more reliable.

So what about these ‘stiff sanctions for any outsider who attempts to gain unauthorized access to the secretive proceedings’…? Well, first, I wouldn’t describe a hearing that is being broadcast to every claimant and their legal team to be secretive. That’s just silly hyperbole. Secondly, I’m not sure after reading the letter exactly what stiff sanctions would be directed against people attempting to get unauthorized access. The word ‘sanctions’ is mentioned once when laying out the conditions for being amenable to an audio stream.

The order authorizing access as specified would contain provisions for sanctions, including termination of the webcast, and the closing of the courtroom in the event of disruptive behaviour, witness intimidation, unauthorized access or other inappropriate conduct.

So sanctions would come into play if the rules were being broken. Said rules include unauthorized access to the feed. In other words, anyone trying to hack the media server. An audio feed goes one way only. If David Kirby wants to cosy up in a room with John Best whilst John’s accessing his protected feed then know one is ever going to know. As far as I know PsychicWare v 1.0 never made it out the concept room. Whether or not the parents feel like talking to press during the trial is, I would think, a matter for their ethical beliefs.

Kirby continues:

The plaintiffs and their attorneys have asked for complete transparency in every aspect of the tribunal, including public disclosure of all evidence and unhindered media access to the hearings. The few autism families whose medical records will be scrutinized as legal examples are waiving their right to privacy and confidentiality, so that their stories may finally be told in an open court of law.

Well, of course they have! It’s in their best interests to turn the whole thing into an OJ Simpson style media circus as quickly as possible. I’d ask anyone who witnessed the trials of Simpson or Michael Jackson – do you think justice was served by turning these trials into a media driven frenzy? Sorry America, but from over here they both looked like a pair of debacles.

There will be public disclosure of all accepted evidence. The DOJ letter makes it clear that they also desire that the official record of the hearing exists. What the Omnibus people want is a discussion on the quackery and pseudo-science that was recently thrown out in the RhoGAM case. And they want this discussed by the media. They know that journalists aren’t as exacting as a Daubert hearing and they know that the best way to win a case in US culture these days is trial-by-media. This is exactly why the DOJ wants to place the emphasis back on actual legal and scientific proceedings. As they state in their letter:

The general rationale behind the ban is preventing witness harassment or intimidation, minimizing disruption, preserving the dignity of judicial proceedings and maintaining a trial free of extraneous influence.

Now, if anyone thinks that the wory regarding witness harassment is far fetched they should consider the absolute vilification that Mercury Militia mainstays, the NAA rained down on scientist Paul Shattuck when he stated there was no good evidence for an epidemic one way or the other. They lied about his funding sources, blew up the fact that he knew someone who’d been disciplined once to insinuate he was involved and generally made the poor man’s life hell. Members of the Yahoo group that carries the name of Kirby’s book have posted the addresses and telephone numbers of scientists who publish science that doesn’t validate their beliefs and encouraged members to harass them with email campaigns and phone calls.

I can only imagine might happen to the poor people called to witness for the DOJ if their faces were made known. If the Mercury Militia want to get up in arms about this then they need to grow up and realise that their own childish irresponsibility led them to this exact outcome.

Likewise, I’d again ask readers to think about the influence the media exerted during the Simpson and Jackson cases. Wouldn’t it be nice to have a trial that’s not run by the paparazzi? Or to put it another way – maintain a trial free of extraneous influence.

Kirby continues with the amusing sleight of hand of stating:

The government may call this privacy, but I call it secrecy. In fact, there has been a long and unseemly history of secrecy when it comes to federal data on thimerosal and autism.

This ‘long and unseemly history’ as recounted by David Kirby relates to precisely one incident where the Geier’s tried to get access to VSD data and when they couldn’t, turned to plagiarism.

Kirby again:

But some documents have already been leaked, including one published in the Los Angeles Times showing that Merck officials knew of the cumulative and alarmingly high levels of mercury in vaccines way back in 1991, but said nothing about it to anyone.

Are there other incriminating memos from Merck (or Lilly or Glaxo, etc.)? My sources indicate that there are, but we may never get to see them. And now, by barring public access to the trial, we may never get to hear them, either.

So, the first paragraph as far as I can tell has absolutely no bearing on the science needed to establish thiomersal causes autism. Neither does it have any bearing on the issue of access to a trial. The second paragraph is, I’m sorry, a joke. Your sources Mr Kirby? I’d say anyone unable to remember the difference between 2005 and 2007 is in no position to pretend sources. And your invocation of a conspiracy theory is both specious and tiresome. Is this really a journalist or just someone who enjoys a good anti-science rant?

Sorry, more Kirby:

Whether he (the Special Master) decides for the parents, or for the DOJ, his ruling will forever be considered within a vacuum, subject to intense criticism from either side, unless he agrees that all thimerosal evidence should at long last be made public.

What unmitigated twaddle Mr Kirby. His ruling will be made in full view of all the claimants who wish to be there either in person or via the audio stream. This isn’t a case of evidence being made public or not, its an attempt to legitimise ‘science’ which is poor beyond belief.

If this UK resident can pass on any advice to the US it would be – ditch media trials. Ditch scaremongering. Ditch bad science. Ditch innuendo.

Autism, A Killer App., And A Drug Of Choice

11 Nov

Below is the content from the post of a guest blogger Do’C invited onto Autism Street recently. It concerns the death of Tariq from chelation and the spurious claim that his death was simply down to a bad choice of drugs. I have shut comments off on this post. Please go to Autism Street to comment.

Part One: A Drug Of Choice

Reading here and there on web, one may notice people still scratching their heads about why Dr. Kerry used the drug he did to treat Tariq Nadama. Science blogger, Orac (Respectful Insolence), did an excellent job explaining why there is no right or wrong drug in this case, but there is another bit – Dr. Kerry quite likely used the drug he did, because this is the drug specified in the EDTA chelation “protocol” published by the American College for Advancement in Medicine, a chelation proponent organization.

When CDC scientist Mary Jean Brown recently said “No medical professional would ever have intended to give the child Disodium EDTA”, she was likely unaware of what’s often referred to as the ACAM protocol.

Roy Kerry is a member of ACAM.

The American College for Advancement in Medicine (aka ACAM) is the chelation proponent organization related to the protocol described below.

Protocol citation:
Rozema TC.The Protocol for the Safe and Effective Administration of EDTA and Other Chelating Agents for Vascular Disease, Degenerative Disease, and Metal Toxicity.
The Journal of Advancement in Medicine. 1997;10(1):5-100.

Note: ACAM’s journal is apparently no longer known as The Journal of Advancement in Medicine, and is now known as Clinical Practice of Alternative Medicine.

The protocol is republished in: E Cranton Ed. A Textbook of EDTA Chelation Therapy. 2nd Edition Hampton Roads (2001).

The ACAM protocol for so-called “EDTA” chelation therapy specifically prescribes the use of Endrateâ„¢, the disodium salt of EDTA. Endrateâ„¢ lowers blood calcium. More information about Endrateâ„¢ Edetate Disodium Injection USP safety and professional prescribing is available at this link. Examples of specification of the use of Endrateâ„¢ (DISODIUM EDTA) for so-called “EDTA” chelation therapy within the ACAM protocol include:

P. 9 I. OVERVIEW OF EDTA CHELATION THERAPY

[…EDTA is an abbreviation for the compound Ethylene Diamine Tetraacetic Acid. The form approved by the FDA for the treatment of lead poisoning is calcium EDTA. (1,2,3,4,5) The form of EDTA used to treat atherosclerotic conditions, on the other hand, is disodium EDTA, for reasons that will become apparent later. (6,7,8,9) EDTA chelation therapy is part of a comprehensive therapeutic program for the treatment of atherosclerosis. Other components include nutritional and dietary recommendations, oral nutritional supplements, an exercise program, a stress management program, if necessary, and medication, if necessary. On rare occasions, surgical intervention may be beneficial, but the vast majority of patients can be effectively managed without surgical intervention.

P. 10 II. PROTOCOL OBJECTIVES
[…The purpose of this treatment protocol is to assure maximum clinical efficacy and patient safety in the use of Ethylene Diamine Tetraacetic Acid, (otherwise known as EDTA or disodium Edetate or the disodium salt of Ethylene Diamine Tetraacetic Acid), and other chelating agents in a comprehensive therapeutic approach to the treatment of arteriosclerosis, atherosclerosis, and other disorders in which chelating agents have been shown to be beneficial. A knowledge of biochemistry, pharmacology and the basic clinical sciences is assumed. This protocol is also intended to establish international standards for the safest and most effective use of chelation therapy in a comprehensive multi-modality treatment program. In this protocol the use of the term EDTA will refer to the disodium form of the molecule as distinguished from the calcium disodium or magnesium disodium forms. Where appropriate, these other forms of EDTA will be identified as such. Written and oral examinations are offered periodically by the American and International Boards of Chelation Therapy (ABCT-IBCT), to assure that sufficient comprehension of this discipline has been attained.

P. 11 III. CHEMISTRY AND PHARMACOLOGICAL ACTIONS OF EDTA

A. Chemical Structure
The EDTA discussed in this protocol is the disodium salt of EDTA. It occurs as a white crystalline powder, soluble in water, slightly soluble in alcohol and mildly acidic. (10)

pp. 43-45 3. Supplies and Equipment

e. Disodium EDTA (Ethylene Diamine Tetraacetic Acid), NOT the calcium-disodium salt), is readily available in the United States in 20 ml (3 gram) vials, and is best tolerated without a chemical preservative.

Part Two: Confusion

The protocol clearly indicates Endrateâ„¢ is the drug to be used. Elsewhere, and especially in information readily available to the public, this is unclear and often confusing. ACAM, for all its reassurance about the safety of so-called “EDTA” chelation therapy, rarely identifies Endrateâ„¢ by its proprietary or generic name as the drug prescribed by their members according to the protocol – rather ACAM apparently refers to the drug as “EDTA.” For example, a recent ACAM press release announced a new program to credential chelationists:

The next twelve months will be a most important time for the staff and membership of the American College for Advancement in Medicine (ACAM). With the help of Applied Measurement Professionals, Inc. of Lenexa, Kansas, ACAM will be undertaking the development, validation, and administration of a national program for use in credentialing individuals as Certified Chelation Therapy Practitioner (CCTP). Chelation therapy is currently used as a treatment for blocked blood flow in arteries (atherosclerosis) by administering ethylenediamine tetraacetic acid (EDTA), a man-made amino acid, into the veins. While EDTA has been used in the past to treat lead toxicity, EDTA also “chelates” calcium, a component of atherosclerotic plaque. This therapy has been employed to improve blood flow through previously narrowed blood vessels, help restore lost bodily function and reduce pain.

This is unusual because there is no drug named “EDTA”. In fact, it ‘s not necessarily clear that the compound exists except as a disodium or calcium disodium salt. This brings up an important point: Endrateâ„¢ is trade name for the disodium salt of EDTA, and Versenate is the trade name for the calcium disodium salt of EDTA. Versenate is labeled for treatment of lead poisoning; because it contains calcium (unlike Endrateâ„¢), Versenate binds with lead preferentially, and leaves calcium alone. More information about Calcium Disodium Versenate (Edetate Calcium Disodium Injection USP) safety and professional prescribing is available at this link.

It’s also unusual that physicians would use the generic term “EDTA” when there is a possibility that doing so might increase the likelihood of confusing Endrateâ„¢ with Versenate. Sound-alike drug names are widely known to be a serious threat to patient safety. Several organizations work to prevent situations in which drugs have similar sounding names, as does the Food and Drug Administration. The sentence “While EDTA has been used in the past to treat lead toxicity, EDTA also “chelates” calcium, a component of atherosclerotic plaque” conflates Endrateâ„¢ and Versenate into a single product – “EDTA.”

This is precisely what not to do. In fact the CDC recently reported a two year-old child died after the unintentional administration of Endrateâ„¢ instead of Versenate. Source: Deaths Associated with Hypocalcemia from Chelation Therapy – Texas, Pennsylvania, and Oregon, 2003–2005. MMWR Weekly. March 3, 2006 /
55(08);204-207.

The “Position Paper on EDTA Chelation Therapy” published by the American College for Advancement in Medicine is sort of baffling. “Disodium magnesium EDTA” is used once, while “EDTA” is used 25 times. The following passage exemplifies the confusion because it seems to suggest Endrateâ„¢ and Versenate are one and the same thing, called “EDTA”.

Ethylenediaminetetraacetic acid (“EDTA”) is a synthetic amino acid first used in the 1940’s for treatment of heavy metal poisoning. It is widely recognized as effective for that use as well as certain others, including emergency treatment of hypercalcemia and the control of ventricular arrhythmias associated with digitalis toxicity.

In point of fact, Versenate was “first used in the 1940’s for treatment of heavy metal poisoning” and is currently labeled for use in treatment of lead poisoning. On the other hand, Endrateâ„¢, the drug specified in the protocol, is indicated for use in “emergency treatment of hypercalcemia and the control of ventricular arrhythmias associated with digitalis toxicity.”

The assertion below is misleading because it refers to the use of Versenate to treat lead poisoning in children, yet the ACAM protocol appears to direct physicians to use Endrateâ„¢ while apparently emphatically directing them not to use Versenate.

Whenever chelation is used in its widely-accepted role to combat lead poisoning, the dosages given even to children are administered much more rapidly than those administered to adults under this protocol.

How peculiar is it that that ACAM’s telephone number is 800-532-3688 or 800-LEAD-OUT? What’s the point of this?

Part Three: Safety In Death

Broad claims of safety are made for so-called “EDTA” chelation therapy in the ACAM position paper. For example:

The Food and Drug Administration determined that EDTA chelation therapy was safe prior to approving the Investigational New Drug protocol for the ongoing double-blind placebo-controlled studies.

It may (or may not) be true that FDA determined “EDTA chelation therapy
was safe” preparatory to beginning research subject to an Investigational New Drug application, but it’s undoubtedly true that a “safe” drug doesn’t carry a “black box warning” on its label. Endrateâ„¢, however, does:

WARNING The use of this drug in any particular patient is recommended only when the severity of the clinical condition justifies the aggressive measures associated with this type of therapy.

The position paper emphatically argues that “restriction to FDA package insert guidelines is inappropriate” with the obvious implication that the use of Endrateâ„¢ for so-called “EDTA” chelation therapy is simply an off-label use of the FDA-approved drug Endrateâ„¢, and as such ought not be restricted. While it’s generally true that FDA doesn’t regulate the off-label use of marketed drugs by physicians, it’s not clear that the use of Endrate in so-called “EDTA” chelation therapy is an “off-label” use. The drug label includes a contraindication warning physicians that Endrateâ„¢ “is not indicated for the treatment of generalized arteriosclerosis associated with advancing age.” Under what circumstances is a contraindicated use an off-label use?

The ACAM position paper incorporates a long quote by JAMA editor John Archer supporting the right of physicians to use approved drugs for off-label or unlabeled indications, ostensibly to hammer the argument home. Ironically, FDA assistant commissioner Stuart Nightingale wrote a response to Dr. Archer in a subsequent issue of the journal and used the example of Endrateâ„¢’s contraindication for use in arteriosclerosis to make the point that physician freedom was not absolute. Archer agreed with Dr. Nightingale in his reply. Source: Nightingale SL. The FDA and drug uses: Reprise. JAMA.1985;253:632.

The claim that there have been no fatalities is difficult to accept in the face of evidence to the contrary:

The safety of this therapy, when properly administered, is not an issue. It is estimated that over 500,000 patients nationally have been safely treated with this therapy by physicians utilizing the protocol developed by the American College for Advancement in Medicine. No reported fatalities have occurred in the United States when the ACAM protocol has been followed.

Following the deaths of fourteen people treated with Endrateâ„¢ in so-called “EDTA” chelation therapy the federal government sued to enjoin a notorious chelationist from all use of the drug – Source: United States v. An Article of Drug*** Diso-tate, et al. It might be objected that this physician used a higher dose than that specified by the ACAM protocol, but the report of expert medical reviewer J. David Spence, M.D. identified the dose used as 3 g. (p. 3), the same dose indicated in the protocol, and in the FDA-approved label for Endrateâ„¢ – Source.

There are other deaths associated with the use Endrateâ„¢ in so-called “EDTA” chelation therapy in addition to these fourteen patients. For example, in March of 1995 Jerry Osuch died the day after receiving his tenth session of so-called “EDTA” chelation therapy as the patient of Dr. Neil Ahner, a physician with “board certification” in chelation therapy, and a member of the ACAM board of directors.

On February 25, 1992 Louis Labbe died following so-called “EDTA” chelation therapy administered by Dr. Daniel Roehm. According to the Sun-Sentinel:

Labbe’s case outraged Dr. Stephen Nelson, then a Broward associate medical examiner. Nelson complained to the state’s medical licensing board that, given the gravity of Labbe’s illness, Roehm should have hospitalized him on his first visit. The Florida Board of Medicine agreed. In June 1992, a three-member panel found probable cause to believe Roehm’s care of Labbe fell below accepted standards. Roehm’s medical records “failed to demonstrate that the doctor even understood how serious and how sick this patient was and how important it was to get some intensive care and some aggressive therapy,” argued Larry McPherson, a state health care agency attorney. The state went on to accuse Roehm of gross malpractice in treating Labbe. Roehm relinquished his medical license in July 1993 to avoid further board action against him. He died in 1996.

Source (for both Osuch and Labbe): They wanted to look better, feel better. Fred Schulte and Jenni Bergal. The Sun-Sentinel. 1999-12-11.

The survivors of Susan Alexander, a 56-year-old woman who died in 2002, filed suit against Progressive Medical Group (PMG), several of its staff members, and Metametrix (a laboratory that offers nonstandard tests). The suit accused the defendants of negligence, fraud, racketeering, and wrongful death. According to the complaint, Ms. Alexander’s heart stopped beating during chelation therapy for alleged lead poisoning that had been diagnosed with a fraudulent test – Source.

On October 31, 1993, the man identified as “W.L.H” died during a course of treatment with Endrateâ„¢ for so-called “EDTA” chelation therapy prescribed by Dr. Eleazar Kadile – Source.

Part Four: What About Autism?

How is it possible for former president and long-time ACAM member Ralph Miranda, M.D. to make like a statement like the following after the death of Tariq Nadama?

“If the child’s death is tied to chelation therapy, it would be the first associated with the procedure since the 1950s”, said Dr. Ralph Miranda of Greensburg. Miranda is the former president of the American College for Advancement in Medicine, a group that sets clinical practice and education standards for chelation and other, similar therapies.

Source: Boy dies during autism treatment. Karen Kane and Virginia Linn. Pittsburgh Post-Gazette. 2005-08-25.

Inconsistent statements about the safety of Endrateâ„¢ and confusion over the identity of the drug used in so-called “EDTA” chelation therapy tends to cast doubt on the integrity of ACAM and its members and their commitment to provide accurate, factual information to the public. Patients considering so-called “EDTA” chelation therapy would do well to remember the case brought by the Federal Trade Commission charging ACAM with “false advertising over promotion of chelation therapy.” This brief synopsis is taken from the FTC press release announcing the consent agreement on December 8, 1998:

ACAM, based in Laguna Hills, California, is an association comprised principally of physicians who administer traditional and complementary/alternative medical therapies including chelation therapy. ACAM promotes chelation therapy in brochures and promotional materials and by maintaining a Web page on the Internet. Chelation therapy involves the intravenous injection of a prescription drug, ethylene diamine tetra acetic acid (EDTA), which is approved by the Food and Drug Administration for the limited use of ridding the human body of excess heavy metals.

According to the FTC’s complaint detailing the charges, ACAM’s advertisements and promotional materials for chelation therapy contained such statements as:

Chelation therapy is a safe, effective, and relatively inexpensive treatment to restore blood flow in victims of atherosclerosis without surgery;

Every single study of the use of chelation therapy for atherosclerosis which has ever been published, without exception, has described an improvement in blood flow and symptoms; and

Chelation therapy promotes health by correcting the major underlying cause of arterial blockage. Damaging oxygen free radicals are increased by the presence of metallic elements and act as a chronic irritant to blood vessel walls and cell membranes. EDTA removes those metallic irritants, allowing leaky and damaged cell walls to heal. Plaques smooth over and shrink, allowing more blood to pass. Arterial walls become softer and more pliable, allowing easier expansion. Scientific studies have proven that blood flow increases after chelation therapy.

Through the use of such statements, the FTC alleged, ACAM has represented that EDTA chelation therapy is an effective treatment for atherosclerosis, and that ACAM possessed and relied upon a reasonable basis when making the representations.

The FTC charged that the representations are false and misleading because ACAM did not possess and rely upon a reasonable basis to substantiate the claims – Source.

Six years later in response to the death of Tariq Nadama, ACAM issued a press release in which they invite the public to believe so-called “EDTA” chelation therapy is safe on the basis of the safety and efficacy of “EDTA” for treatment of lead poisoning. ACAM apparently forgot to mention they’re referring to Versenate – the drug their protocol apparently directs physicians NOT to use for so-called “EDTA” chelation therapy. ACAM asserts, “millions of infusions have been administered … without any deaths being noted.” Nevertheless deaths have occurred.

However, it is important to note that IV EDTA is an FDA approved treatment for lead toxicity in children and adults, with an excellent track record for safety. Millions of infusions have been administered over the last 30 + years, without any deaths being noted, when used in accordance with established guidelines. These guidelines were developed by experts in the field and include the intravenous administration of Magnesium Disodium EDTA.

ACAM asserts that, “Chelation Therapy has been clinically helpful for many autistic children who have evidence of heavy metal burdens, and have an impaired ability for detoxification.”

Shouldn’t ACAM explain to the scientific community and to the public why we should believe that lowering blood calcium would lead to clinical improvement in autistic children?

Shouldn’t ACAM explain to the scientific community and to the public why we should believe Endrateâ„¢ would be safe and effective in removing “heavy metals” – like the implied mercury – when the pharmacology of Endrateâ„¢ is sufficiently well known to permit experts to conclude Endrateâ„¢ doesn’t bind effectively bind and remove mercury. In simple terms, if Endrateâ„¢ doesn’t get to the places where mercury accumulates in the body, how would it bind and remove it?

Shouldn’t ACAM provide evidence to the scientific community and to the public proving that “many autistic children … have evidence of heavy metal burdens” (bona fide experts using valid laboratory tests have been unable to do so)?

Shouldn’t ACAM provide evidence to qualified specialists in pediatrics and toxicology that autistic children can be diagnosed with an “impaired ability for detoxification” and explain how correcting this impairment would lead to clinical improvement?

Is it possible that the parents of Tariq Nadama had no idea what they might really be getting into when their son was brought to the U.S. for chelation therapy that turned out to be a fatal attempt to treat him?

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