Wednesday, March 14, 2007

Lanced


Thank-you Dr. Michael Fitzpatrick.

The Lancet Neurology, Volume 6, Issue 4 , April 2007, Page 297
Autism and environmental toxicity

In Autism, Brain and Environment, recently reviewed in The Lancet Neurology, [1] Richard Lathe makes three interrelated claims: that there is an epidemic of autism; that this epidemic is caused by environmental toxins; and that the resulting defi cits can be rectifi ed by a range of biomedical treatments. Though these claims have some appeal among parents of autistic children (and among providers of treatments), this book reveals that they lack a scientific basis.

Though the concept of an “autism epidemic” has become a notion of faith among parent campaigners, most authorities in the field believe that the increased prevalence of autism can be readily explained by widening diagnostic categories and increased professional and public awareness. [2] Yet, without presenting evidence to challenge this consensus, Lathe concludes that the increase in prevalence “may be real”, dubs this “new phase autism”, and proceeds on the assumption that it is real.

Belief in an autism epidemic is linked to the conviction that environmental toxicity is of increasing importance in the causation of autism (which is inconsistent with the prevailing emphasis on genetic factors). [3] Though Lathe concedes that the clinical features of autism are distinct from those of mercury poisoning, he still speculates that exposure to mercury (notably in vaccines) is “far the most likely” explanation for the rise in cases of autism. This is contrary to the evidence that any environmental factor causing autism is likely to act in the earliest days of fetal life—and also contrary to the conclusions of the recent Medical Research Council inquiry (ignored by Lathe).[4]

On these insubstantial foundations, Lathe proceeds to endorse various investigations and treatments purporting to identify and correct the biochemical deficits alleged to result from environmental toxicity. Treatments include exclusion diets, multivitamins and enzymes, antibiotics and antifungals, and heavy-metal chelation therapy. The common features of these methods, apart from the absence of a coherent scientific rationale and vast expense, are a lack of evidence of efficacy or safety. Indeed, a 5-year-old autistic boy from the UK recently died undergoing chelation in a private clinic in the USA.

Mark Geier’s enthusiasm in his review of Lathe’s book [1] is understandable. While Lathe wonders whether high concentrations of testosterone may be associated with autistic behaviour, Geier (in collaboration with his son David) treats autistic children with a combination of chelation and leuprorelin (Lupron), a gonadorelin analogue that inhibits androgen production (and induces “chemical castration” in prostate cancer). Following a devastating critique by Kathleen Seidel, a parent activist in the USA, the Geiers’ report on the treatment of 100 children, according to their “Lupron Protocol”, was recently withdrawn from publication.

Michael Fitzpatrick
Barton House Health Centre, London UK
...
MF is a GP, father of an autistic son and author of MMR and Autism: What Parents
Need To Know, Routledge 2004.
1 Geier, MR. Evolving views on the causes of autistic spectrum disorders. Lancet Neurol 2007; 6: 212.
2 Roy Richard Grinker, Unstrange Minds: Remapping the World of Autism, Basic Books, 2007.
3 Veenstra-Vanderweele J, Christian SL, Cook EH. Autism as a paradigmatic complex genetic disorder. Annu Rev Genomics Hum Genet 2004; 5: 379–405.
4 Medical Research Council, Review of Autism Research: Epidemiology and Causes, December 2001.


For some inexplicable reason The Lancet Neurology had allowed Mark Geier to review Richard Lathe's book. This is Dr. Michael Fitzpatrick's brief review of the book and commentary on why Geier might have liked Lathe's book. It seems that Dr. Fitzpatrick was referring to this particular blog entry by Kathleen Seidel (and her work that went into it).





Autism Diva
jus

13 Comments:

Blogger LIVSPARENTS said...

"that there is an epidemic of autism; that this epidemic is caused by environmental toxins; and that the resulting deficits can be rectified by a range of biomedical treatments."

It really is a house of cards, innt it? If he interrelates them, his house falls down, donnit? (sorry, I'm listenin' to To Kill a Mockinbird and it's wearin' off on me). They gets along with the sense the got, huh? Scout, it could be that they're just iggnern't...

Let me rephrase it then:

that there is autism; that this could be caused in some by environmental factors; and that some deficits may be alleviated by a range of biomedical treatments.

See how much better it is without the spectors of epidemics and toxins...

8:30 AM  
Blogger Persephone said...

I just got the new issue of Discover last night. Cover story is on autism. I skimmed parts last night, as I wasn't up to really reading it.

And then I saw DAN! mentioned in a positive way. AD, I don't know many of these things, but Amy Yasko was listed and methylin.

The article is not on the Discover site yet.

10:55 AM  
Blogger María Luján said...

I do think that chapter by chapter the book presents some aspects important to consider and other open to controversy.
In this supposed “debate” almost nobody is giving a balanced/equilibrated view of almost nothing.

And I still am alone with all the medical conditions my autistic son has-beyond his ASD diagnosis.

11:34 AM  
Blogger Tom said...

“…that this epidemic is caused by environmental toxins; and that the resulting deficits can be rectified by a range of biomedical treatments.”

When I read about the mercury conspiracies, I’m struck by how there is never any discussion of all the gifts that come with autism. Surely a toxin like mercury can’t create such specific deficits and such remarkable abilities. After all, we are talking about an indiscriminate systemic exposure that would have to account for all the clinical features of autism.

How does a mercury proponent explain autistic qualities like hyperlexia and strong auditory and visual memory? What about those autistics with high IQs? A neurotoxin does not selectively induce apoptosis and promote certain other neuronal processes.

2:25 PM  
Blogger María Luján said...

Tom
I bought the book and I read it. I consider that the book has not been properly commented by Dr Firtzpatrick.For me, the book does not present the things the way Dr F presented.However, I disagree also with, for example, the analysis of the epidemiology-chapter4- The book has 11 Chapters. and I consider the work of Kathleen in terms of criticisms of Dr Geiers, excellent.
Many of us are spectors of a "war" that is not ours, with ideas we do not share- but we suffer the consequences- and with misrepresentations that we do not share- from ND or extreme versions of biomed.
I am very interested about what autistic adults think, feel and have to say. ALSO I have a very sick autistic child to whom the proper treatment of his concomitant medical problems has been extremely important for his happiness and well being. I do think that a true activism movement- national or international- is impossible without autistic adults and without parents of autistic people. I think it would be nice to find some common space where differences could be properly discussed and what we share could be more specifically designed.
I do think that the overall issue of environment in autism is very much difficult to be reduced to only some specific insult.
Sorry Mrs Clark, I apologize if you consider this post not appropiate here. I thought it was important to clarify in relation to my comment of Dr F comments.

3:40 PM  
Blogger bigwhitehat said...

This post has been removed by the author.

6:56 PM  
Blogger bigwhitehat said...

So he wants me to starve my boy, put him in voodoo therapy and sue sombody?

I think I'll stick with teaching him to live in a cold cruel world.

6:58 PM  
Blogger Autism Diva said...

Maria,

You are welcom to post anything you like here, really long comments might be better to put on your blog and then give a link here, but Autism Diva would never remove even a really long comment of yours, they are fine, they are just hard to digest and understand when they are long.

Autism Diva is really sorry that your child has been so ill, and happy that you love him so much. We all hope you find some really good answers for yourself and your answers may also help others, but Autism Diva doesn't think the answer to autism lies in environmental toxins or viruses or bacteria. The rate of autism has been stable for many, many years, any increase may be accounted for by changes in selection of mates, and the fact that socially odd women and men may have an easier time of procreating now than in the past (maybe).

Autism Diva sees the big future of autism research in genes that regulate the way the mind is built, like neurexin and HOXA1 and PTEN and others that may not have been discovered yet and their interactions with other genes.

Dr. Joseph Piven gave a presentation at the MIND institute this evening showing how often it is that parents of autistic kids are of the BAP. He showed how the odds of having multiple autistic kids increased quite a bit when both parents were BAP as opposed to one or none.

That says to me that there's a lot of kids that are mainly autistic because of traceable genes. How "environment" impacts them, Autism Diva has no idea, but whatever the environmental factors are, some of them should come out in the CHARGE study.

Big White Hat, the guy Lathe, who wrote the book, is reported (and verified with the Scots authorities) to be a convicted child molester. (He claims to have gone through some therapy and put it all behind him.) hmmm. Starving is probably the least that some kids have to worry about around some of these "autism professionals." Be thankful that you have such a good head on your shoulders that you haven't been sucked into the arena where these slimeballs are hanging around.

Persephone.

Ugh. The Discover magazine is a mess from what I hear. So sad that they'd promote quackery in such a blatant way. (RNA drops??)

9:39 PM  
Blogger abfh said...

I am so totally not renewing my Discover subscription.

The mercury nincompoops can have their woo-loving websites and their conspiracy-blathering Yahoo lists, but when they start taking over my favorite geek magazines, they are WAAAY over the line. Grrr.

I'll be blogging about this as soon as they put the article online.

11:09 PM  
Blogger abfh said...

Actually I'm so annoyed that I probably won't wait until they put it online, even though I usually prefer to give my readers links to whatever I'm blogging about.

7:30 AM  
Blogger Vandychick said...

The April issue of Parenting magazine has an article about asd. It's basic tone is that there is a LOT of hype out there right now and you shouldn't believe all of it. Pretty balanced coverage, although they do plug Autism Speaks at the end.

this mag is in many, many waiting rooms. Maybe the word will finally get out about the epidemic.

12:02 PM  
Blogger Vandychick said...

Or lack thereof, I meant to add!

Is there a test one can take to determine if you are BAP? I have suspicions about my engineer husband...

12:04 PM  
Blogger Autism Diva said...

abfh, from what Autism Diva has heard the Discover magazine article is pretty toxic. Your blog will be a helpful antidote, no doubt.

vandychick, hopefully you've read the latest blog entry, there's a BAPQ from Hurley et al (including Piven) and it looks like SBC is using his AQ to diagnose BAP, if a parent scores on the pale side of Asperger's on the AQ, maybe they are necessarily BAP?

Autism Diva wonders if the BAPQ is not really measuring Asperger's/HFA in parents on the high end of the BAP scale (especially where they also are high on the "aloof" measurement).

4:27 PM  

Post a Comment

Links to this post:

Create a Link

<< Home

glass-banner
aut viam inveniam aut faciam