I’m not sure whether to be flattered or apalled

Rather than post his thoughts here and contribute to the discussion we’re having, Jake Crosby of Age of Autism posted over at Respectful Insolence the following

You trust these references?
1.Autism Spectrum Disorder: No causal relationship with vaccines DOI: 10.1111/j.1440-1754.2007.01239.x
2.DeStefano F (2007). “Vaccines and autism: evidence does not support a causal association”. Clin Pharmacol Ther 82 (6): 756–9 doi:10.1038/sj.clpt.6100407. PMID 17928818.

So reference two is made by Frank DeStefano who lied to the editor of a medical journal about his earlier VSD findings showing a stronger link between autism and thimerosal when he directed the CDC National Immunization Program. And reference one is made by Larry Pickering, the NIP director’s senior advisor. Let’s not forget that private contractor who was paid to destroy the raw data used by Verstraeten, who sent an email containing tables showing really high relative risks of autism from thimerosal exposure asking his collegues(including DeStefano) how to lower them, despite his efforts, and how the CDC also sent the rest of the VSD overseas to the Brighton Collaboration to avoid FOIA requests, held an illegal closed meeting with vaccine manufacturers, and conducted a series of drop-dead awefully bad epistudies including one done by Verstraeten while he was working for GlaxoSmithKline, using a failing HMO and another that was too small to show any associations, has an ACIP dominated by pharmaceutical company representatives, carries out projects paid for by pharmaceutical companies and at least up until recently worked under a presidential administration loaded with members who had strong ties to pharmaceutical companies, especially Eli Lilly, which invented thimerosal. You know, you don’t have to simply believe something just because the CDC says so. That’s what skepticism is all about, independent verifiability.
Posted by: Jake Crosby | April 4, 2009 3:41 AM

 

Now, I’ve tried to maintain very cordial tone throughout these posts because I want to be respectful to the people who have ASD, and their parents and loved ones. My understanding is that Mr Crosby has Aspergers syndrome, an ASD. Here my line. I’m sorry for any suffering Mr Crosby has had because of his ASD, but being sensitive and respectful to his condition does not extend to his absolutely ridiculous ad hominem

You’ll note he has provided no references for any of his rather extraordinary claims. I will not address the tinfoil hat claims, I have seen no evidence of them, and without evidence, this is  “Poisoning the well.”

At the end there, he says skepticism is about independant verifiablility. I agree, but I also pointed out in my last post, that multiple indepedant investigators HAVE verified what I lay out in this blog. Infact, the only thing no one has been able to verify independantly is what Mr Crosby claims in his blog post – that mercury caused his Aspergers.

He specifically comments that we don’t need to believe the CDC. Luckily, I never quoted the CDC, and the article we’ve been working from includes data from the, IOM, Cochrane collaboration, and a variety of other independant investigators.

It’s odd that he choose to impugn Larry Pickering, since the entire article makes no new claims, and references multiple other people. Larry Pickering basically delivered us a bunch of other articles, wrapped up in one package. Attacking him doesn’t help Mr Crosby anymore than attacking the mailman for delivering bad news.

I was indeed hoping that Age of Autism would get involved in the discussion here, I think on average, they are so badly informed, that if they did try to discuss the evidence, we would be able to unmask the extent to which they have bent the truth to argue their point of view.

And to anyone reading Mr Crosby’s article, I would remind you, an anecdote and a belief does not evidence make.

Advertisements
Explore posts in the same categories: Medicine

Tags: , ,

You can comment below, or link to this permanent URL from your own site.

33 Comments on “I’m not sure whether to be flattered or apalled”

  1. John H. Says:

    My take is that his comment is mostly guilt by association. If you accept that “big pharma” is evil and wants to destroy us, then being funded by them is likewise evil. Sure, they have an agenda and money corrupts (viz, Wakefield), but it’s a favorite of the pro-disease set to lump the CDC in with the Evil Vaccine Conspiracy (i.e., big pharma).

    I didn’t catch the ad hominem, but then, I’m new here.

  2. Jake Crosby Says:

    Hi, I posted on Orac’s blog because I comment there occasionally representing the opposition. I have never heard of your blog before that night, and I had already gotten used to posting on his blog, but I will post on yours.

    The information I have provided is pretty much verifiable, the first from a letter DeStefano sent to the editor-in-chief of a medical journal lying about his first earlier VSD findings, calling the second draft which showed weaker autism associations his first, on it he is listed as acting director, a copy is posted here.
    http://www.neurodiversity.com/weblog/article/108/

    The study he denies exists is right here:
    http://www.safeminds.org/legislation/foia/ThimerosalVSDstudy001.pdf

    The graphs and emails Verstraeten is speaking of his here:
    http://www.safeminds.org/Generation%20Zero%20Pres.pdf

    The final Verstraeten study is described here:
    http://www.uninformedconsent.org/Press_release_2004_06.html

    Some of the COIs of the ACIP members are described here, and Simpsonwood:
    http://www.rollingstone.com/politics/story/7395411/deadly_immunity/

    The secret Simpsonwood meeting by top public health officials and vaccine manufacturer representatives violates every sunshine law:
    http://www.accessreports.com/statutes/sunshine.htm

    The rest can pretty much be found in “Evidence of Harm” by David Kirby. former White House Budget director, Mitch Daniels, for example was a Lilly exec.

    Also, George W. Bush’s daddy served on the Lilly Board of directors, and used his vice presidency to petition for banned FDA drugs to be sold to third world countries, Alan Arza former Dep. HHS secretary went to work for Eli Lilly right after, Rumsfeld served on the board of Amylin pharmaceuticals, Lilly’s partner company, and Bush appointed Lilly Chairman Sidney Taurel on his counter-terrorism committee. There were also attempts made by former republican Senate majority leader Bill Frist to slip the Eli Lilly protection ryder into a counter-terrorism act. He got campaign contribution dollars from Lilly.

    The evidence of harm by thimerosal is supported by at least dozens of studies, one of which I make reference describe in that article you link of mice becoming autistic after thimerosal injections. Have you ever heard of autistic mice before that? No, in fact autism in people was unknown before thimerosal was even invented.

    You used only two references to support your claims, both from CDC officials. The IOM is no better, officials in a January 2001 meeting are documented to be talking about how they are encouraged to affirm the safety of vaccines no matter what and that they will not change the vaccine program at all.
    http://www.putchildrenfirst.org/media/6.4.pdf

    In the meeting notes, you can find “SmithKline Beecham” next to Dr. Johnston’s name, and “financial push to approve vaccines, decisions made” next to Dr. McCormick’s name, “vaccine should be continued” next to Dr. Medoff’s name, and next to another doctor’s name is the word “Merck $5000”
    http://www.putchildrenfirst.org/media/6.25.pdf

    The IOM has been colluding with the CDC and pharmaceutical companies all along! Cochrane is just a British version of the IOM, the British government is more in line with pharmaceutical companies than the US, giving up its vaccine policy-making program to the pharma-insider dominated JCVI. They are not independent.

    The analysis you posted was coauthored by Pickering, so I will respond to him, not to those “other sources” he mentions.

    None of these are Ad Hom attacks, an Ad Hom attack is like Paul Offit mentioning Don Imus’s racist comments about the Rutgers womens’ basketball team in his book “Autism’s False Prophets,” which does not directly pertain to the subject. What I’ve mentioned however, are all real issues, that pertain to transparency, integrity, corruptibility and COIs.

    Anyway, I know you feel that anecdotes are inadequate because they do not reflect anything at the population level like epistudies. However, wouldn’t thousands of parents seeking compensation after watching their children regress from vaccines be equivalent, even if its not officially written-up in a pharma-funded journal such as pediatrics?

  3. Jake Crosby Says:

    Hi, I submitted a response a little while ago, but I do not see it here. Will it be uploaded?

  4. Jake Crosby Says:

    I mean, I submitted it again, but a page came up saying that it will not accept it because it was a “duplicate,” so I assume it went through, right?


  5. It went through, the default settings on wordpress just flag any post with many links as potentially spam, I had to approve it individually, I will respond to it when I leave the hospital – commenting via ipod, rather than computer is too difficult.

  6. Jake Crosby Says:

    Oh okay, no problem. I just provided all the links because I felt you had a point about the hypocrisy of pointing out the flaws in one’s references while providing none of my own, so here they are. Thanks for approving it.

  7. Jake Crosby Says:

    Whitecoattales,

    I read you are a third year medical student, and I’m quite curious. In the article of mine that you cite, I talk about being helped tremendously by vitamins(gasp!). How often is that mentioned in medical school? Would you be more likely to prescribe an autistic child B-12? Or Risperdal which has killed 31 children so far?

    “From 1993 through the first three months of 2008, 1,207 children given Risperdal suffered serious problems, including 31 who died. Among the deaths was a 9-year-old with attention deficit problems who suffered a fatal stroke 12 days after starting therapy with Risperdal.”
    http://www.nytimes.com/2008/11/19/health/policy/19fda.html

    Of course, I disapprove of the article because it seems to put the lives of children with ADD above those with autism, touting lack of FDA approval as the core issue:

    “At least 11 of the deaths were children whose treatment with Risperdal was unapproved by the F.D.A. Once the agency approves a medicine for a particular condition, doctors are free to prescribe it for other problems.”

    let alone the 20 others…


    • Hey I’m on call today so I won’t be able to do alot of active stuff on the blog today.

      But briefly Jake: I’ve seen no evidence for vitamins helping autism. The symptoms of B-12 deficiency are not at all those of autism.

      Theres no evidence of mega-vitamins of any sort helping anyone. Vitamins are useful for supplementing things that are absent from your diet. People on diets that aren’t greatly balanced – vegetarians, atkin’s dieters, medical students living on ramen – can use a multivitamin to make sure they don’t miss anything. People who are at risk for osteoporosis can supplement with calcium and vitamin D.

      There is a problem with using New York Times articles as references. Gardiner Harris is not a scientist. That is a not a controlled study, That’s a newspaper article, with a pretty huge bias.

      In my evidence article I discuss expert opinion as the lower form of evidence. NYT articles are below expert opinion.

      There is alot wrong with this article but it almost deserves its own post. When I have more time we’ll get into all of it, for now I’ll leave you with one point.

      You quote 1207 children from 1993-early 2008 with serious problems, 31 dead. But you fail to put this number in context. Per the article, 389,000 children/teens were on the drug last year alone.
      I don’t have the numbers in front of me, I’ll try to look them up at my leisure, but I’m fairly certain more people have died from aspirin.
      Additionally, I don’t see autism mentioned anywhere in that article, so I’m not sure why you feel it relevant.

      As for your original question, I would be more likely to refer an autistic child to a specialist, so that they could recieve care from someone who is absolutely capable of delivering the best care.

  8. trrll Says:

    In the article of mine that you cite, I talk about being helped tremendously by vitamins(gasp!). How often is that mentioned in medical school?

    Doctors learn about vitamin deficiencies in medical school, although actual vitamin deficiencies are uncommon in the US. Nevertheless, it is not uncommon for a doctor to prescribe a vitamin, particularly one with low overdose risk like B-12, either to eliminate vitamin deficiency as a possibility, or as a low-cost, benign placebo.

    Returning to whitecoattales’ discussion of levels of evidence, a single anecdotal report is the lowest level of evidence. This is never more true than for autism, where in clinical trials the frequency of “responding” to placebo is not uncommonly as high as 30-40%. Autism treatment has frequently been led astray by extremely positive case studies of treatments that proved to be equivalent to placebo in clinical trials. The high frequency of placebo response probably reflects the variable course of autism, with sudden progress often separated by long period of apparent stasis, as well as the fact that many people with autism are constantly receiving one kind of therapy or another, so when progress does occur, the therapy gets the credit whether or not it is actually responsible.

    As for Risperidal, it is one of the few pharmacotherapies approved for autism, and one of the few that has consistently shown benefits in controlled trials. It is, nevertheless, a drug with some serious hazards, and while it has been shown to have some benefit, it is very far from a cure.

    However, it is worth noting that the same mechanism whereby placebo treatments come to be overvalued can apply to anecdotal reports of adverse events. Physicians are encouraged to report any adverse event that occurs in the course of a drug therapy. Drugs that are approved for a condition are often used in a large number of individuals, which means that there will inevitably be some serious adverse events that are purely coincidental. If anything, the FDA tends to by hypervigilant with respect to adverse events, and many drugs carry “black box” warnings of adverse effects that have not actually been shown statistically to be due to the drug.

  9. Michael Says:

    I think we need to state something very clearly about any medical product, be it an invasive device or pharmaceutical–there are always risks, however minor. Risperidal is not a miracle drug overall, but it is useful in treating some cases of autism, not curing the autism itself, but controlling certain aggressive symptoms. But there are risks, always will be for any drug.

    Without disputing whether the 1207 children who had serious side effect actually had those side effects from the drug, those adverse effects is a tiny percentage compared to the 389,000 children who took the drug without adverse effects. That’s a risk of 0.31%, a very small number compare to all those who benefited from drugs. As of today, I know of no drug with a 0% risk.

    On to the megavitamin theory. Other than the use of niacin to prevent some cardiovascular disease (which is based upon lots of clinical evidence backed by a physiological reason why niacin helps), there is no evidence that any vitamin, supplement, mineral, etc., taken in quantities beyond the daily amounts received in a balanced diet, prevent or treat any disease state. Megavitamin theories (often called orthomolecular medicine) is just woo.


    • Slight correction Michael – 1207 was serious adverse events of a 15 year span, 389,000 was people on it last year alone. So the risk is significantly smaller than 0.31%.

      • Michael Says:

        Well, I missed that. But luckily I erred overestimating the number. So, it’s more like 1 in 30,000 risk. I believe the risk of being killed while crossing the street is 1 in 48,000, same order of magnitude.

  10. Jake Crosby Says:

    First: slight correction, both the HMO that was failing and the one two small to replicate the results of Phase I of the Verstraeten study is one in the same, Harvard Pilgrim, my fault.

    Whitecoat, I find it incredible that you would dismiss the role B-12 plays in autism due to anecdotal reasons, since there are many kinds of B-12 deficiencies and since you yourself have stated that you do not accept anecdotes alone.

    The kind of deficiency you’re probably thinking is the autoimmune disorder, pernicious anemia, in which parietal cells in the stomach are destroyed causing an inability of the body to produce a protein essential to metabolizing B-12, known as Intrinsic Factor.

    The kind implicated in autism is an inhibition of the B-12 methylation pathway, also crucial to metabolizing B-12. As a result, autistic people including myself benefit from administration of methyl B-12, especially when injected, and suffer from a lack of it.

    Anyway, whitecoat, since you say you don’t see any evidence linking B-12 to autism, I will provide you with some. Here are two studies from the American Journal of Clinical Nutrition, lead by Professor of Pediatrics at the University of Arkansas School of Medical Sciences Dr. Jill James, that mention impaired methylation as a pathological contributor. In the abstract, it does not mention B-12 directly, but in the studies themselves, which I assume you have access to because I’m still in college and I can access them, B-12 is listed as a primary example of a vitamin whose metabolic pathways are pervasively hindered if not blocked in autistic children unlike controls.
    http://www.ncbi.nlm.nih.gov/sites/entrez

    Anyway, this study from Tufts Medical School suggests that B-12 deficiencies cause vascular cognitive impairment in the brain, in the proceedings of the National Academy of Sciences.
    http://www.pnas.org/content/105/34/12474

    And this study from the University of Pennsylvania School of Medicine implicates vasoconstriction in the pathology of autism, published in the Journal of Neurology.
    http://www.uphs.upenn.edu/news/News_Releases/aug06/autbldvsl.htm

    I can provide you with more if you like, such as studies by Northeastern University neuropharmacologist Dr. Richard Deth?

    What’s great about B-12 is that it gets to the root of the problem and does not cause any side-effects like anti-psychotics. I don’t know how severe those 1207 cases are, but I had terrible anxiety and disturbing thoughts when I was first put on this as a child, and then when my parents were told to put me on this later by a psychiatrist dismissing their “anecdotal” evidence, I suffered the same problems again. Luckily I was only put on it for two months and two weeks respectively.

    Not only do Risperdal and drugs like it cause acute problems, but also chronic, long-term, neurodegeneration. Here is a study done on macaque monkeys(macaques share 93% of our DNA), comparing brain weights of monkeys given anti-psychotics compared to controls showing an 8-11% reduction in the non-placebo group, published in the Journal of Neuropsychopharmacology. Only a lack of B-12 can cause this.
    http://www.nature.com/npp/journal/v30/n9/full/1300710a.html

    Aside from the painful childhood memories I have of the holistic doctor my parents took me to plunge a big needle of this vitamin into my leg every week, B-12 really helped me. Besides, now they have those extra-small syringes that may sting a little at the worst, so that problem has pretty much been resolved.


    • I was hoping to find time to reply to your other claims by now, but I’m afraid that’ll have to wait, this one really needs adressed right away.

      The kind of deficiency you’re probably thinking is the autoimmune disorder, pernicious anemia, in which parietal cells in the stomach are destroyed causing an inability of the body to produce a protein essential to metabolizing B-12, known as Intrinsic Factor.

      You are entirely incorrect. B-12 deficiency is B-12 deficiency, the signs of pernicious anemia are the same as metabolic problems leading to B-12 deficiency

      Your first link is not 2 links to studies from AJCN, but the frontpage of pubmed, please repost those links

      …B-12 deficiencies cause vascular cognitive impairment in the brain…

      The article you link to says that B-12 deficiency causes hyperhomocysteinemia and vascular cognitive impairment in mice. That’s actually the title. This is not causing autism.

      Hyperhomocysteinemia is a type of hypercoaguable state – that means more likely to clot – vascular cognitive impairment is cognitive impairment caused by a series of “small strokes”. MRI of autism is not consistent with many small strokes so this paper doesn’t help you.

      And this study from the University of Pennsylvania School of Medicine implicates vasoconstriction in the pathology of autism, published in the Journal of Neurology.

      The link is not to a study but a press release. Without a study I have no idea what actual science took place, but even if we agree that “vasoconstriction” is the issue – that has nothing to do with B-12, even if this were a journal article, its a nonsequitor

      Not only do Risperdal and drugs like it cause acute problems, but also chronic, long-term, neurodegeneration. Here is a study done on macaque monkeys(macaques share 93% of our DNA), comparing brain weights of monkeys given anti-psychotics compared to controls showing an 8-11% reduction in the non-placebo group, published in the Journal of Neuropsychopharmacology. Only a lack of B-12 can cause this. (Emphasis mine)

      I agree this study shows long term use of antipsychotics in monkeys shows an increase in brain weight. It is indeed possible that this effect happens in people as well although thats unknown as yet, NONE of that has anything to do with B-12. I don’t know how you got from “decreased brain volume” to “b-12” the authors don’t even mention vitamins.

      For the nonscientists still following along
      All the articles posted show no link from B-12 to autism. One of them links B-12 to problems in the brain or elsewhere. One of them links autism to problems with vessels in the prain. One of them links antipsychotic medicine to decreased brain volume in monkeys but in NO WAY involves B-12.

      B-12 deficiency can cause sleep disturbance, tiredness, macrocytic anemia, sensory problems related to dymyelinating in the spinal cord (including numbness and tingling, and a problem with balance called ataxic gait), it can even cause symptoms of mania and psychosis. It’s important to notice even if some of these symptoms can be present in autism, they are not caused by B-12 deficiency in autism, unless you have autism AND b-12 deficiency.

      • DDW Says:

        I think this is what he is referencing. Its far too late for me to read it tonight, though.
        “Efficacy of methylcobalamin and folinic acid treatment on glutathione redox status in children with autism.” Am J Clin Nutr. 2009 Jan;89(1):425-30. Epub 2008 Dec 3.

        P.S. Your blog seems promising. As a MSII, I look forward to seeing how it develops.

  11. Jake Crosby Says:

    Don’t forget this earlier one:

    “Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism.”
    http://www.ncbi.nlm.nih.gov/pubmed/15585776?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

    Whitecoat said:
    “B-12 deficiency is B-12 deficiency, the signs of pernicious anemia are the same as metabolic problems leading to B-12 deficiency.”

    Pernicious anemia is only one kind of B-12 deficiency. Its deficiency is being studied as a possible causative role in other neurological disorders too, so obviously symptoms related to B-12 absorption issues are considered to have enough variation and non-specificity by scientists that its role in other illnesses is worth studying.

    “That’s actually the title. This is not causing autism.”

    I’m not saying it supports autism directly, it is merely part of the biological mechanism.

    “MRI of autism is not consistent with many small strokes so this paper doesn’t help you.”

    This is another assumption you make, and who said I mentioned MRI? There are many forms of scans, maybe I was referring to sonograms, and considering your relative dismissive attitude towards evidence without even looking at it suggests you don’t even know of anyone who has looked for these abnormalities.

    “Without a study I have no idea what actual science took place”

    This is on the University of Pennsylvania School of Medicine’s website, so I think it’s a pretty well-done study. Why don’t you use your medical school account to access it online? It’s in the Archives of Neurology (not “journal,” sorry), which is an AMA medical journal.

    How could you say it has nothing to do with B-12? The previous study you responded to shows results that are consistent with vascular cognitive impairment, which is consistent with the results from this study.

    “Only a lack of B-12 can cause this. (Emphasis mine)” That was to make the point that simply taking B-12 doesn’t cause brain depletion, whereas taking anti-psychotics do, not to say that B-12 deficiency alone can cause this, but that I’ll admit was a stupid choice of words on my part…

    “I agree this study shows long term use of antipsychotics in monkeys shows an increase in brain weight.”

    I’m going to assume “increase” is a typo, like how my final sentence in that last paragraph of mine you quoted was poor wording since you state it shows a decrease throughout the rest of your post.

    “For the nonscientists still following along
    All the articles posted show no link from B-12 to autism. One of them links B-12 to problems in the brain or elsewhere. One of them links autism to problems with vessels in the prain. One of them links antipsychotic medicine to decreased brain volume in monkeys but in NO WAY involves B-12.”

    First of all, you have not even cared to look up the studies directly implicating B-12 for yourself, so it makes no sense why you are even commenting on the next two studies I linked which were intended to indirectly implicate B-12 methylation impairment by further establishing a biological mechanism for autism that is an extension of the previous two studies.

    Secondly, I posted 5 studies, 2 of which directly implicate B-12 with autism, 4 provide a plausible biological mechanism for that relation, and all 5 show that methyl B-12 is considerably better for treating autism than Risperdal or any anti-psychotic drug for that matter.

    Third, that last one was not supposed to have anything to do with B-12, except to show that treating autism with anti-psychotics, though FDA-approved to treat autism, probably isn’t a good idea and that B-12 is much better. Risperdal’s only significantly greater benefit, given its patentability, is that it would be much more financially lucrative. That however, is profiting at the expense of autistic peoples’ health.

    ” they are not caused by B-12 deficiency in autism, unless you have autism AND b-12 deficiency.”

    You haven’t even looked into studies showing relations with the B-12 methylation pathway and autism, the links I posted may not have worked but a simple search on PubMed relating to “autism,” “Jill James,” and “B-12” would heave revealed results of the two studies I spoke of, including the one DDS found, and I haven’t even posted the studies done by Dr. Richard Deth yet.

    Yet in spite of all this evidence, some of which you haven’t bothered to examine, you’re saying methyl B-12 treatment for autism is not biologically plausible? That is consistent with what that video described as “close-mindedness,” posted on Orac’s blog of all places, and confirms my fears that nutrition is not given the priority in medical schools by instructors that it should have.


    • My time is limited, if you want me to take you seriously, post a reference appropriatly. Scientific article get posted with a DOI or URL link, and don’t post “science journalism”. If you post a link to a press release that doesn’t have a reference in it, I’m not going to scour archives of neurology looking for it.

      I’ll take a look at the articles referenced in your and DDW’s post now, and respond appropriately.

      I did not say you were talking about MRI. I was saying (in admittedly to few words) “I know MRI is good at detecting vascular lesions. You have shown a link that would result in vascular lesions IF B-12 deficiency is connectied to autism. Since MRI of autistic patients does NOT show vascular lesions, I will give less credence to this theory. ”

      As for sonograms, I have seen no evidence of sonograms being useful for anything in brains of adults. They are sometimes used to detect bleedig in the brains of babies who’s fonatanelles (Soft spot in the head) have not closed yet.

      How could you say it has nothing to do with B-12? The previous study you responded to shows results that are consistent with vascular cognitive impairment, which is consistent with the results from this study.

      No, it’s not consistent. The first study showed hyperhomocysteinemia, which leads to clots and small strokes in people. This leads to a characteristic MRI finding of widespread small vessel ischemic disease. The Penn Press Release talks about vasoconstriction, which is mediated by a bunch of other, completely unrelated factors.

      Just because the root vaso is in both doesn’t mean they are the same thing. Even if the penn study DID show vascular cognitive impairment, or ischemic disease, that wouldn’t be any proof of B-12 anything – LOTS of things cause vascular cognitive impairment.

      Secondly, I posted 5 studies, 2 of which directly implicate B-12 with autism, 4 provide a plausible biological mechanism for that relation, and all 5 show that methyl B-12 is considerably better for treating autism than Risperdal or any anti-psychotic drug for that matter.

      You have proven no such thing. You’ve shown the side effect profile of anti-psychotic medications is not kind. However you have shown nothing about the efficacy of anti-psychotics in autism. You have shown nothing about the efficacy of B-12 in autism.
      You have not shown a feasible link between b-12 and autism, and the belief that you have done so is only do to your lack of understanding of the evidence.

      I’ll agree with you that nutrition does not get enough priority in medical school. I did not pick up a close minded perspective, if someone shows me actual evidence of it, I will consider it. But what you’re implying are your best 2 articles, you didn’t post an appropriate reference too.

    • trrll Says:

      Unfortunately, your argument displays a type of flawed thinking that laymen frequently fall into when they start with an idea and start searching Google U for “evidence” to support it. In the absence of real understanding, it is easy to see connections that do not really make sense.

      Basically, your argument goes something like this, “B12 deficiency causes vascular cognitive impairment, and autism is kind of cognitive impairment. And somebody else has suggested that vasoconstriction is involved in autism, and that’s vascular, too, so it is reasonable to assume that lack of B12 causes autism.” Coupled with your personal perception that your own improvement was due to B12, it is easy to see how this must sound to you like compelling evidence.

      On the other hand, to somebody who is actually familiar with the details it looks like a string of non-sequiturs, because B12 deficiency is actually quite different from autism and vascular cognitive impairment is different from vasoconstriction. In particular, neurological damage due to B12 deficiency is associated with small hemorrhages. Autistic brains have been studied extensively by neuroanatomists–indeed, there is an Autism Brain Bank set up to provide autistic brain tissue to researchers–and there is nothing of the sort.

      At one time, some physicians gave B12 injections as a kind of “tonic” to patients who seemed “run-down.” This itself was the product of a kind of thinking–patients with pernicious anemia often feel run-down and they benefit from B12, so maybe B12 will help other people who feel that way. The practice has declined as it has become clear that it has no benefit except in patients for whom there is genuine B12 deficiency.

      I understand that you credit B12 for your own improvement. But a single testimonial is not evidence. Given that the injections were clearly somewhat traumatic for you, you and your parents were probably strongly disposed to believe that there was some benefit. But in fact, you have no way of knowing that you would not have improved had you not received those injections, and results from placebo-controlled studies reveal that autistic patients sometimes do indeed sometimes show that kind of spontaneous improvement.

      So on the side of B12 we have an implausible “just-so story” based upon the fact that B12 deficiency can caused neurological problems that are clearly distinguishable from autism, and that’s about it. No evidence from clinical trials, just your own anecdotal experience. And on the side of risperidone we have multiple, randomized, double-blind, placebo-controlled trials showing benefits in autistic patients. Yes, risperidone has some nasty side effects. Some people can’t tolerate it at all, although the short-term adverse effects generally go away when the drug is stopped. And there are certainly real grounds to worry about the safety of long-term treatment of children with an antipsychotic. Still, from the standpoint of scientific evidence, it is really no contest.

    • DDW Says:

      I took a look at the studies by Dr. Jill James you referred to. The first concludes that the baseline plasma levels of methionine,S-adenosylmethionine (SAM), homocysteine, cystathionine, cysteine, and glutathione were decreased, while S-adenosylhomocysteine (SAH), adenosine, and oxidized glutathione were increased. They decided, “This metabolic profile is consistent with impaired capacity for methylation (significantly lower ratio of SAM to SAH) and increased oxidative stress (significantly lower redox ratio of reduced glutathione to oxidized glutathione) in children with autism.”
      On this basis, they decided to give B-12 injections and folinic acid supplementation to autistic children who displayed the baseline metabolic profile described above. This study found that, “intervention did not alter methionine, SAM, and SAH concentrations significantly even though methylcobalamin and folinic acid provide methyl groups for the methionine cycle.” It did find statistically significant results for glutathione:oxidized glutathione ratio, which was their indicator of “oxidative stress.” Taken at face value, all they have shown is that administering vitamin B-12, a substrate in the synthesis pathway of glutathione and a significant anti-oxidant itself, moves the glutathione:oxidized glutathione ratio towards “normal” in children with an initially abnormal ratio. They have presented no evidence to suggest this had any affect on behavior or the cognitive abilities of the kids.
      In regards to risperdal, I found this summary at the NIMH website with a link to the research article at the bottom. It suggests that anti-psychotics don’t harm cognition, and in fact may improve cognitive performance by reducing aggressive and distracting behaviors.
      http://www.nimh.nih.gov/science-news/2008/antipsychotic-does-not-harm-and-may-improve-cognitive-skills-in-children-with-autism.shtml


    • trrl and DDW have placed fairly thorough arguments to those claims I have not addressed specifically. Having read the articles you did not originally post a citation to, you still have not shown anything that suggests B-12 treatment for autism is plausible. You have no outcomes based research, you have no mechanism consistent with known findings.
      Per Orac’s video, I’m using my filter of evidence to ignore unproven, and implausible ideas.
      You bring up that argument, but you still haven’t actually addressed the original post. Rather address any of the evidence that I put forward, you’ve put forward a bunch of thoughts on conflict of interest, and ignored evidence.

      You impugned Larry Pickering – the author of a review article – but you did not dispute any of the data he presented, since he presented other peoples findings. Must I cite each of the studies he reviews individually to have that discussed? If I do, will you talk about the evidence they present?

      I’m not saying there are no conflicts of interest – lots of people in medicine have conflicts of interest. I’m saying that this does not suddenly make all research invalid. The articles that you accept also have conflicts of interest. You’re just selectively deciding what conflict of interest is “acceptable”, and you seem to be deciding it based on a point of view you already hold.

  12. czrpb Says:

    You say: “You’ll note he has provided no references for any of his rather extraordinary claims. I will not address the tinfoil hat claims, I have seen no evidence of them, and without evidence, this is “Poisoning the well.””

    Can you enumerate what is “extraordinary” and “tinfoil hat” about the claims being made? Thx!!


    • You know, you don’t have to simply believe something just because the CDC says so.

      – Tinfoil Hat. Jake says we should distrust the CDC. Who should we trust? His single anecdote.

      Extraordinary
      -The claim that no article on autism research cited by a review article is valid because the author of a review article might have a conflict of interest.
      -The claim that one or two badly done studies outweighs a large body of good evidence based on conflict of interest claims that are shady at best.
      -The claim that vaccines cause autism.

  13. czrpb Says:

    You said: ” – Tinfoil Hat. Jake says we should distrust the CDC. Who should we trust? His single anecdote.

    Extraordinary
    -The claim that no article on autism research cited by a review article is valid because the author of a review article might have a conflict of interest.”

    Thx! I do not want dispute the efficacy of vaccines so this reply/thread is off-topic and I do not expect an answer at this point.

    Regarding the CDC: My political philosophy is pretty anti-hierarchy so I am less likely to consider distrust of ANY large authoritarian hierarchy as “tin-foil”‘ish.

    Regarding conflict-of-interest: Not sure why suspicion of any conflict of interest is “extraordinary” — life is filled with them. And, a white coat does not for moral/ethical person make.


    • Never did I say “suspicion of any (emphasis mine) conflict of interest is “extraordinary”
      I said that Jake discounted 27 articles cited by, not written by Larry Pickering, becaues of Larry Pickering’s conflict of interest.

      Now, you can argue that Big Pharma corrupts. But how does Big Pharma corrupt people who are cited by someone who may have a conflict of interest?

      …less likely to consider distrust of ANY large authoritarian hierarchy as “tin-foil”‘ish.

      It’s not the concept of distrusting the CDC, it’s the rationale, including who he says we should trust.

      And, a white coat does not for moral/ethical person make.

      You know I hear this one alot. It’s sad that my profession no longer carries the moral weight it once had – I feel that a few bad apples have spoiled it for everyone. However none of this makes anyone on the “vaccines do cause autism” side MORE trustable, which is generally the implication.

      • czrpb Says:

        Hi! Excellent! Thanks for helping me. Of course, this is now far off the vaccine topic, but I enjoy a good discussion, so… grin!

        I will start with this, you said: “However none of this makes anyone on the “vaccines do cause autism” side MORE trustable, which is generally the implication.”

        Yes, agreed. Again, I am not questioning vaccines.

        You said: “Now, you can argue that Big Pharma corrupts. But how does Big Pharma corrupt people who are cited by someone who may have a conflict of interest?”

        Say a known Holocaust denier recommend a Germany history book to you. Is it logical to make an suppositions regarding the book? Is it reasonable?

        I do not really want to argue the studies themselves are affected, but the argument and any specific citation may be cheery-picked. In short, if you suspect the person, you suspect they usage of studies, not necessarily the studies themselves. Right?

        You said: “It’s sad that my profession no longer carries the moral weight it once had – I feel that a few bad apples have spoiled it for everyone.”

        I think this is as it should be. What reason is a Dr. a greater authority on morality than ethics? I can imagine why in the past: They were generally the more “educated” there for they were probably more likely to have read widely, include topics outside medicine but within the realm of morals/ethics. I can also imagine that having to take ethics courses might increase sensitivity or awareness. But, in my area — Computer Science — we also took ethics courses; and I am pretty sure I would not consider my fellow CS major any more moral/ethical or aware. Finally, medicine has gone hyper-specialized like all fields: Why would we expect a researcher in a very specialized area to be more morally/ethically aware? You often hear that say being a Astrophysicist does not give one greater insight into politics. Why would a medical degree?

      • czrpb Says:

        Hi! Sorry about my poor grammar! If I am unclear, please tell me where I will try to be clearer.

      • trrll Says:

        I do not really want to argue the studies themselves are affected, but the argument and any specific citation may be cheery-picked. In short, if you suspect the person, you suspect they usage of studies, not necessarily the studies themselves. Right?

        And if one wished to provide evidence of this, rather than simply engaging in vague ad hominem mud-slinging, one could readily do so, by pointing out examples of studies that are not accurately summarized in the review, or important studies supporting a contrary conclusion that are not cited. But he does not do this (and indeed, cannot, because they do not exist).

  14. John H. Says:

    I have a couple questions for the vaccine doubters, related to “trust”:

    1. The claim is made that scientists can’t be trusted to make safe vaccines. So, if we are to produce better vaccines, who will do the research, if not these same scientists?

    2. Given your lack of trust, how will you know when we really have safe vaccines? Whose word will you accept?

    Do you expect a whole new breed of scientist to emerge that can’t be corrupted and has no ties to potential COIs (“big pharma,” etc.)? Really?

    • czrpb Says:

      Hi!

      (Again, I am not disputing vaccine safety, so I am replying to this from a somewhat different perspective. I can of course shut-up if you wish! wink!)

      You said: “1. The claim is made that scientists can’t be trusted to make safe vaccines.” My personal view is not distrustful of scientists *per se* but the hierarchy in which they are embedded and its influence: And my distrust rises exponentially with one’s level is the hierarchy.

      You said: “2. Given your lack of trust, how will you know when we really have safe vaccines? Whose word will you accept?” My view: When there are many independent reviews of their safety and monitoring is in place AND organizational transparency AND review and monitoring of the organization itself. whitecoattails wrote in this post: “At the end there, he says skepticism is about independant verifiablility. I agree, but I also pointed out in my last post, that multiple indepedant investigators HAVE verified what I lay out in this blog.” Independent verification of vaccine safety is great to hear! I assume there is on-going independent verification? And I assume there is independent review/monitoring of possible organizational influence/bias: I think these studies/reports would go far in quieting some people.

      You said: “Do you expect a whole new breed of scientist to emerge that can’t be corrupted and has no ties to potential COIs (”big pharma,” etc.)?” I expect governmental departments not to be influenced yes: FDA and food/drug manufacturers; NIH/CDC and insurance, health corps, and drug manufacturers; military and defense corporations; Congress and lobbyists of all sorts, etc.

      • John H. Says:

        I don’t disagree with your perspective at all. My post *was* addressed to “vaccine doubters” AKA rabid anti-vaxxers.

        When there are many independent reviews of their safety and monitoring is in place AND organizational transparency AND review and monitoring of the organization itself.

        Of course, but your statement seems to stem from the assumption that these things aren’t being done, already. Alternatively, when (and how) will we know when all these safeguards are in place? Would we take some politician’s word for it? *grin* I wouldn’t, necessarily.

        The lack of transparency and trust are tough questions, and I don’t know the answers, but I’m also not yet seeing that we have the mechanism by which we can safely bolster our confidence. Who gets the final say? I sincerely hope it isn’t someone like Jenny McCarthy.

  15. Jake Crosby Says:

    “Basically, your argument goes something like this, “B12 deficiency causes vascular cognitive impairment, and autism is kind of cognitive impairment. And somebody else has suggested that vasoconstriction is involved in autism, and that’s vascular, too, so it is reasonable to assume that lack of B12 causes autism.” Coupled with your personal perception that your own improvement was due to B12, it is easy to see how this must sound to you like compelling evidence.”

    That’s not what I said. If you read carefully enough, you would see that the first two studies I have shown clearly display an association between B-12 methylation impairment and autism, showing the biological reason why autistic children benefit from it. The latter two merely showed how B-12 might be linked other aspects of the biological mechanism for autism. The last one was strictly for Risperdal.

    “They have presented no evidence to suggest this had any affect on behavior or the cognitive abilities of the kids.”

    It’s already had an affect on their behavior, but the study discovered the biological mechanism behind it and confirmed its scientific basis.

    “You have shown nothing about the efficacy of B-12 in autism.
    You have not shown a feasible link between b-12 and autism, and the belief that you have done so is only do to your lack of understanding of the evidence.”

    And yet you cite poorly done studies such as Verstraeten as evidence that thimerosal cannot cause autism? You have a skewed interpretation of what “evidence” is.

    “…and there is nothing of the sort. (cerebral vascular problems)”
    maybe because no one has looked.

    “They have presented no evidence to suggest this had any affect on behavior or the cognitive abilities of the kids.”

    The evidence had already come from benefit children experienced when they were taking the vitamin, this study proved the validity of those previously noted results.

    Whitecoat, your evidence for the effectiveness of Risperdal is no better than what you claim min is for methyl b-12, I’d like to see how well those kids have done on Risperdal after a much longer period of time instead of a mere 8 weeks and see just how much better they’ve turned out.

    “The big finding is that people with schizophrenia are losing brain tissue at a more rapid rate than healthy people of comparable age. Some are losing as much as 1 percent per year. That’s an awful lot over an 18-year period. And then we’re trying to figure out why. Another thing we’ve discovered is that the more drugs you’ve been given, the more brain tissue you lose. ”
    http://www.nytimes.com/2008/09/16/health/research/16conv.html?_r=1

    “drugs for schizophrenia,” that includes Risperdal, also used to treat autism.


    • Disappointing

      That’s not what I said. If you read carefully enough, you would see that the first two studies I have shown clearly display an association between B-12 methylation impairment and autism, showing the biological reason why autistic children benefit from it. The latter two merely showed how B-12 might be linked other aspects of the biological mechanism for autism. The last one was strictly for Risperdal.

      Showing an association between 2 things does not show causation. You have not shown the biological reason why autistic children benefit from them. Even the article where they treated patients with B-12 they showed that the B-12 level corrected, and that is all. They didn’t show that it improved any symptom or anything else.

      The only study on the subject was stopped early because… It didn’t work! Not any better than secretin, another pseudoscientific treatment for autism.
      http://notmercury.blogspot.com/2006/10/methyl-b12-no-better-than-secretin.html
      http://www.psychiatrictimes.com/display/article/10168/53131

      for further information, with sources.

      It’s already had an affect on their behavior, but the study discovered the biological mechanism behind it and confirmed its scientific basis.

      No. It didn’t. Nor did the study show a bioloigcal mechanism behind it. It did not confirm its scientific basis. None of these studies did any of these things. Everything you’ve said has been completely unscientific noise.

      And yet you cite poorly done studies such as Verstraeten as evidence that thimerosal cannot cause autism? You have a skewed interpretation of what “evidence” is.

      You haven’t shown a single study which says what you’ve said it says. You have shown no evidence of even understanding any of the articles you’ve cited! You’ve criticized a ton of studies I’ve cited, yet you haven’t discussed the methods, the results or the conclusions. You haven’t shown that you’ve even really read the articles.

      “…and there is nothing of the sort. (cerebral vascular problems)”
      maybe because no one has looked

      I recommend you go to pubmed.com and search for MRI and autism.

      I’m not doing your homework for you anymore, you’ve proven yourself incapable of understanding it. When a scientist looks at an MRI it’s very easy to see vascular disease. Its also very easy to see whats NOT vascular disease. There are also some interesting studies on diffusion tensor imaging, which show some interesting characteristic findings in autism. (Hint: I’m saying that they HAVE looked for it, and you’re wrong… again)

      The evidence had already come from benefit children experienced when they were taking the vitamin, this study proved the validity of those previously noted results.

      No study shows that. You are saying that your anecdotal experience is more important than all of the scientific evidence the other way. That’s not how science works.

      http://www.nytimes.com/2008/09/16/health/research/16conv.html?_r=1<

      I’ve already warned you, the new york times is not a scientific source, you cannot cite the new york times to prove a point.

      Also I did not dispute that antipsychotics might possibly contribute to the decrease in brain mass in schizophrenic patients. No such evidence has been produced for autistic patients. Some evidence has been produced for macaques.

      Whitecoat, your evidence for the effectiveness of Risperdal is no better than what you claim min is for methyl b-12, I’d like to see how well those kids have done on Risperdal after a much longer period of time instead of a mere 8 weeks and see just how much better they’ve turned out.

      Below are further references on risperidone and autism. I encourage you to read them. Then i sadly, fully expect you to do your thing – find a conflict of interest, or conspiracy theory for each author, to ‘discredit’ them, and credit your anecdotal experience.

      Paediatr Drugs. 2007;9(5):343-54. Review.
      PMID: 17927305
      J Pediatr Health Care. 2009 Mar-Apr;23(2):75-89.
      PMID: 19232924
      J Pediatr Health Care. 2009 Mar-Apr;23(2):75-89.
      PMID: 19232924
      Prog Neuropsychopharmacol Biol Psychiatry. 2009 Feb 1;33(1):11-5. Epub 2008 Nov 5.
      PMID: 19013209
      J Child Adolesc Psychopharmacol. 2008 Jun;18(3):227-36.
      PMID: 18582177

      For those following at home

      Jake: “No B12 really does help, I know it”
      WcT: Facepalm


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s


%d bloggers like this: