On Things That Won't "Cure" Autism

One of the tendencies of the assorted parents' groups which I find most annoying is the tendency for many of them to promote an attitude of desperation towards autism -- and, with it, the idea that a parent should try anything and everything which could help their child "recover". In practicality, of course, this means anything or everything that someone somewhere claims will help.

The fact that people get swindled as a result is among the least appalling aspects of this.

The list of things which have been promoted as such -- and which parents have tried -- is absurdly long and often just plain absurd. Seriously, it almost mocks itself at times. If it wasn't for the fact that parents are actually doing these things to their kids (which I cannot emphasize enough) out of desperation to "cure" or "recover" their children, it would actually be comedic.

Among other things, the horrific list of things which parents have done includes (but is by no means limited to):

•  Feeding their kids massive overdoses of vitamins to the point that they suffer from or risk vitamin poisoning.
• Putting their kids into a potentially explosive tube full of compressed air for a prolonged period of time (usually around an hour per session).
• Getting their kids high on marijuana.
• Forgoing protection against potentially deadly diseases.
• Strapping their kids down for several hours while they pump an irritant into said child's veins.
• Deliberately infesting their children with intestinal parasites.
• Chemically castrating their children.
• Feeding their kids an industrial chemical which has never been subjected to proper safety testing.
• Making their children drink an industrial bleaching agent.
• Giving their children bleach enemas.

 
 This is a highly incomplete list.

When I say that the stigmatization and panic-mongering that organizations like Autism Speaks engage in has real consequences for autistic people... the above is just one of the things I'm talking about.

Take this as you will.

Edit: Was corrected on a relatively minor point.

On Yet Another Stupidly Harmful Therapy

"Helminthic therapy" is the treatment of autoimmune disorders via deliberate exposure to parasitic worms. I know this for two reasons: One, I live within easy driving distance of what is apparently the quack capitol of the United States. Two, the parents of the kids I work with often have no common sense whatsoever.


If you've reached the obvious conclusion, you are entirely correct. I now know more than I ever wanted to about this, including the name of a company that will ship whipworm eggs from Thailand.

Ugh.

There really isn't much on the 'net about helminthic therapy and autism as of yet, but what I have found is suitably disturbing. The rationale is discussed here and here. The first part of a three-part video lecture is available here (with parts two and three available here and here, respectively). A very disgusting blog post can be found here.

Any other sources would be greatly appreciated.

A Few Things You Probably Didn't Know About Hyperbaric Oxygen Therapy

As with megavitamin "therapy", hyperbaric oxygen as a "treatment" for autism can be accurately classed as too much of a good thing.

In medicine, too much of a good thing can be a very bad thing, and the research reflects this. Essential nutrients can easily become poisons if you consume too much of them, and many of today's common medical problems can be laid at the feet of too much consumption of essential macronutrients... and macronutrients are generally far better tolerated than the micronutrients which are used to excess in "megavitamin therapy".

In fact, hyperbaric oxygen chambers allow for a greater exposure to oxygen than would normally be theoretically possible. Put into more technical language, a hyperbaric chamber allows for partial pressures of oxygen within the lung that wouldn't be possible without active pressurization.

While this isn't the only mechanism of action for HBOT (for instance, the increased overall pressure has therapeutic value when treating decompression sickness), it's the main one, and the one which most of the various explanations of HBOT as an autism treatment hinge upon. Specifically, increased partial pressure is increased effective in-lung exposure to oxygen, and this is supposed to increase oxygen content in the bloodstream, increase oxygen flow to the brain, etc., etc.

Oxygen qualifies as a drug when used this way. As with vitamins, it's quite possible to overdose on it. This is known by a variety of names, but the most common of these are "oxygen toxicity" (for the phenomenon) and "oxygen poisoning" (for the medical condition).

Frankly, oxygen poisoning can be nasty. At lower levels, oxygen is a very good thing. At higher levels... it isn't. In fact, oxygen has neurotoxic properties at high enough doses, and these doses are acheivable even without a hyperbaric chamber.

So, if that's the case, why is it that that we don't see autistic children vomitting, suffering from tunnel vision and shortness of breath, convulsing, twitching, and generally showing the symptoms of oxygen poisoning after HBOT? The answer is actually rather simple -- and says a lot about the people peddling HBOT for autism.

The partial pressure of a gas within a mixture is equal to the percentage of the mix formed of that gas times the total pressure of the gas. So, for instance, the partial pressure of oxygen in a gas mixture which contains 20% oxygen and is held at 1 bar (normal atmospheric pressure) is .2 bar. Doubling either the percentage of gas or the overall pressure of the mix will also double the partial pressure of oxygen, yielding a partial pressure of .4 bar.

It's worth noting that a partial pressure of up to about one bar (depending on altitude, weather patterns, and just about anything else that effects atmospheric pressure) is achievable without pressurization -- 1 bar is the partial pressure of oxygen in a pure oxygen "mix" at normal atmospheric pressure. Keep that in mind as I continue.

A recent paper, using fairly typical practice for HBOT treatment for autism, used a 24% oxygen mix at 1.3 bar of pressure. Doing the math, this yields a partial pressure of about .31 bar... or roughly equivalent to what could be acheived by using a 31% oxygen mix without the hyperbaric chamber. It's actually pretty trivial to go to a SCUBA supply shop and buy a tank full of a mix that's richer in oxygen than that.

Of course, typical air is roughly 21% oxygen, meaning that the gas they used was only trivially different from room air in terms of oxygen content; the increase in partial pressure was almost entirely achieved by a raise in pressure.

While this sort of level is typical in practice, however, it's worth noting that I've seen documentation of much more "intense" regimens, ranging up to 100% oxygen at 1.5 bar. Caveat emptor -- and beware oxygen poisoning.

Finally, I suppose I should also mention that there's a second theorized action mechanism, involving gas transport via blood plasma (as opposed to the hemogloboin-based transport of red blood cells), which is increased substantially under hyperbaric conditions. This mechanism is equally implausible for reasons which are much harder to explain, but I should probably mention it in the interest of fairness.

Still -- 1.3 bar isn't enough pressure to make much of a difference there, either.

A Quick Note On The H1N1 Shot

I just got my H1N1 shot. I don't feel any more autistic.

That is all.

Some Recent Advocacy Efforts

Fellow bloggers Kim Wombles, Thelma, and Louise have started an effort to form a new autism organization, one which actually looks pretty good... if still young. I hold out great hopes for their efforts.

Edit: I somehow managed to miss Kathleen's involvement with the project. She deserves a mention as well. Again -- good luck!

At the same time, the anti-disease group PKIDs has released a pretty spectacular set of videos on the horrific costs that the decision not to vaccinate can impose on families. Sullivan of LBRB has blogged on them here, complete with embedded video.

In his post, however, Sullivan wrote the following:

For any who wish to comment that this has nothing to do with autism, I agree. Unfortunately, the autism community is one of the biggest sources of misinformation about vaccines and vaccine preventable diseases. If I can help PKIDs a bit with this post, I see that as a good thing.

I have to somewhat disagree. Ideally, he is right -- this shouldn't have anything to do with autism. His comment that the autism community is one of the biggest sources of misinformation about vaccines and vaccine preventable illnesses, however, hits the nail on the head.

The instant vaccines entered the autism discussion, the two became connected. Despite the fact that the connection is purely artificial, a product of quackery and delusion, it is very real... and very horrifying.

Watch those videos. I'm particularly fond of the Hib, Hepatitis, and pneumococcal disease videos, but the others are generally pretty good as well.

This is what groups like DAN and Generation Rescue are telling people to risk rather than accept a percieved risk of having their kids turn out like us. This is what they are telling people is better than autism when they advise parents not to vaccinate their children.

Frankly, I find that phenominally insulting.

Edit: Corrected a typo ("However" was missing an e).

A Little Gem

I came across the following quote while reading Snodgrass, 1992 as part of my research into quackery:

Methylation of mercury compounds increases their ability to enter the CNS and
also prolongs their stay in the body. Since mercuric ions can be biomethylated
by cobalamins, persons taking large doses of folate and B12 may be more likely
to be harmed by mercury should they contact it. (p. 51-52)

The irony here is pretty spectacular.

Reference:

Snodgrass, S. R. (1992). Vitamin neurotoxicity. Molecular Neurobiology, 6, 41-73.

Vaccination Quackery Revisited

The following is adapted from an e-mail I recently sent. The response I got was... "interesting".

I am a scientist by training. When asked scientific questions, I tend to answer them as a scientist. Scientific questions, like the question of whether vaccines cause autism, are not about belief. They are about evidence and facts -- and the fact is that the courses of action suggested by the anti-vaccination movement kill people. Worse, the advice and propoganda in question kill people, and not only the people who take it. This is why I take the time to study something before I comment on it or talk about it. I'm aware that bad advice and bad information kills.


I am not joking about this. I consider this sort of thing to be a (literally) deadly serious matter. I also don't make unqualified or categorical statements in this sort of matter without a lot of very strong evidence.


England has recently seen a resurgance of measels, resuling in considerable suffering and death. Australia has seen a tragic pertussis outbreak. A very large number of illnesses and deaths here in the US can be directly attributed to vaccination refusal. This is without breaking herd immunity -- and the thought of that happening (what happened in a small segment of Australia), frankly, scares me.


In addition to this, this sort of thing creates and exacerbates the problem of what are known as nocebo and harmful observer-expectency effects. To give you an illustration of how powerful nocebo effects can be, chemotherapy trials have been known to cause the control group (who are not recieving real drugs) to lose hair, start vomitting, and generally suffer all of the negative side-effects of chemotherapy... despite having only been given a saline drip.


This happens purely because said controls expect it to. It's not an effect of the drug, which they haven't been given.


Now, if this can happen with a saline drip (which is about as harmless as it gets), just what makes people think vaccines are immune from this? Things get worse when harmful observer-expectancy effects are factored in. Expectancy effects have killed people.


Of course, all of the above consequences could be forgiven if there were a legitimate danger the anti-vaccination groups were warning against. Leaving aside just how insulting the "don't vaccinate your kids because vaccines cause autism" rhetoric is (and how, exactly, do you think it makes autistic individuals feel when they see parents going on national television and advising other parents to risk both their children's lives and the lives of other people's children rather than risk having a child like them?), there is also the matter of the truth of these claims, which are pretty much universally bunk.


To provide an illustration of just how bad it is, the e-mail which provoked the original version of the above linked me to this website. I didn't have time (or the stomach) to go through and debunk everything said there, but I did provide an example to give her some idea of just how bad its information is.


The site's first citation to "prove" that flu shots are dangerous (and thereby presumably the one they regard as "best") is a paper by Mark and David Geier, which was published in 2003 in the Journal of American Physicians and Surgeons.


The authors of that study are infamous quacks who are guilty of academic fraud and who make their living by chemically castrating children. The "journal" it was published in is an infamous hotbed of quackery which, among other things, has published politically-motivated articles claiming that abortion causes breast cancer and that shaking your baby is safe (and that shaken-baby syndrome doesn't exist), racist articles with utterly absurd claims about illegal immigrants (e.g. this one), and articles condemning both the practice of science-based medicine (e.g. this one) and peer-review (e.g. this one).


And this is without going into the methodological quality of the article (poor) or any of the scientific tactics I'd use to demonstrate that the article was utterly, totally meaningless.


That is just one example. Think about it.

Megavitamin Stupidity, Part Two

As I observed in a previous post, people tend to think of the effects of having not enough of a vitamin, but tend to ignore the effects of having too much. As such, I've compiled a list of some of the known effects of the latter. This is not intended to be a comprehensive list or anything -- just a simple list of some of the health hazards of having too much of a vitamin in your system. It's not even a full list of the effects of every vitamin, just the few that were easiest to find data on. As I note below, my research methods for this were not anything special.

It's also worth noting that there are differences between chronic and acute vitamin toxicity. Acute toxicity generally requires a higher dose of the vitamin in question, while chronic effects occur from a lower dose over a longer period of time. Both can present substantial health risks.

Finally, parenteral administration is generally more dangerous than oral. There are a number of safeguards that normally prevent the body from absorbing a massive overdose of certain vitamins that don't necessarily apply to "vitamin shots" (thiamine comes to mind here).

My research strategy was hardly anything to write home about -- I went down to NSU's medical library and checked out a textbook. This isn't information that's hard to come by... unless you're trying to get it from the various fad "health gurus", from DAN doctors, or from other, similar sources.

So, without further ado...

• An overabundance of vitamin A is associated with hair loss, ataxia, bone and muscle pain, cheilitis, conjunctivitis, headache, liver damage, hyperlipemia, hyperostosis, membrane dryness, itching, pseudotumor cerebri, various skin disorders, and visual impairment. Vitamin A also acts as a teratogen, but this usually isn't relevant to the use of DAN-reccommended megavitamin supplements (i.e. I've never heard of a DAN protocol being used to treat a pregnant woman).
• Vitamin D poisoning can result in hypercalcemia, hypercalciuria, anorexia, nausea, vomitting, thirst, polyuria, muscular weakness, joint pains, diffuse demineralization of bones, disorientation, and irreversable calcification of the heart, lungs, kidneys, and other soft tissues. The vast majority of the death-by-vitamin-overdose case reports I've read (which may or may not be a representative sample) have been due to hypervitaminosis D.
• Vitamin B3 overdose effects depend on the specific form of the vitamin involved. Nicotinic acid toxicity is associated with vasodilation, burning or stinging sensations in the face and hands, nausea, vomiting, diarrhea, hyperpigmentation of the skin, abnormal glucose tolerance, hyperuricemia, peptic ulcers, hepatomegaly, and jaundice. Nicotinamide overdose has been known to cause liver damage and may cause cancer (further research was required according to the textbook I read, which was published in 2001. I have not conducted a search for more recent information).
• Chronic overdose of Vitamin B6 has been associated with neuropathy (motor, sensory, and peripheral), vesicular dermatosis, loss of reflexes, impaired touch sensation in limbs, dizziness, nausea, breast discomfort or tenderness, and photosensitivity.

This is nowhere near a complete list, even from within the sole book which served as my reference. Think on that.

Reference:

Rucker, R., Suttie, J., McCormick, D., & Machlin, L. (Eds.). (2001). Handbook of Vitamins (3rd Ed., Revised and Expanded). New York, NY: Marcel Dekker, Inc.