Wednesday, December 19, 2007

Comment-Dr. Miles

This item was emailed to this blog.-AR

If you read Dr. Miles' paper, they make a blanket statement in the discussion that their study confirms no link between thimerosal and autism. Problem is they never stratify or control for all the other potential thimerosal doses received subsequently by children who's mothers got thimerosal-free Rhogam.

If you keep selecting the right subsets you will never find statistically significant data in this issue, just keep finding larger heterogenous populations with only one vaccine exposure controlled for and you will never find statistical significance. Its all the vaccines as little hits along the way with and without thimerosal in the wrong envrionmentally challenged populace (aluminum and other toxins will still be slowly removed) that is causing the problem and thimerosal is adding a additional fire to the situation. You can't look at one insult at one point in time on this spectrum of repeated insults along the way and then conclude there is no relationship.

But for clarity, let me model her approach in a similar way in which I could convince people that radiation is not associated with cancer by analogy (follow the parenthetical relations)
Some of you may know there is a recent publication indicating that medical diagnostic radiation is potentially going to be linked to or causative in 2% of US cancers in the next several decades. Thats a very disturbing thing and as a radiologist, I will not do as a so many pediatrics colleagues and tell you that radiation (vaccination) is without harm, in fact its is over used just like vaccines in a myopic world of convenient medicine rather than a thoughtful judicious way in many cases.

But lets say I published this research to prove radiation in medical imaging is safe would you believe me?"We studied kids with childhood leukemia (autism) {who also had 36 x-rays of various body parts (vaccines) in their first 3 years of life} who were in utero during an abdominal X-ray (Rhogam with Hg) and compared them to another group of children {who also had 36 x-rays in the first 36 months} who had an in utero exposure to a maternal abdominal gamma-scintigram (rhogam without thimerosal). We find there is no difference in the rates of leukemia, therefore we conclude that X-ray radiation is not associated with childhood leukemia." Yeah, right what about the percent insult difference of 36 similar insults versus 35 plus one sightly different insult. The degree of insult change or index is not significantly different therefore we conclude that you were not insulted.

Medical radiation is similar to vaccines, it has a risk and should not be pursued unless there is a clinical need. Boosters are never proven to be needed before being given in individual cases, simplest point to keep making; there is no clinical evidence on individual basis that any of my kids ever needed more than one dose of a vaccine, the labs were never checked. There clearly never needed hepatitis B at birth, mumps could have waited etc.

That whole hep B thing really burns me up, its like me telling you to have your daughter get a mammogram at 3 (want to get a good baseline now don't we?)!!!! OH and by the way if you are a BRCA carrier who has a genetic impairment of DNA repair enzymes that affect the breast increasing the risk of cancer, there is NO way radiation to your breast at a critical development period would ever increase your risk of cancer (just like there is no way a vaccine or heavy metal at the right time in development would be linked to adverse outcomes). MEDICINE IS LITTERED with analogies where protective action were made for much fewer people to avoid continued iatrogenesis, the recent gadolinium (heavy metal) toxicities in MRI in THOSE WHO CAN'T DETOXIFY HEAVY METALS is the same damn issue.

I wish I had time to debate the ninnies that keep denying the need to protect the vulnerable by screening them simply because it would appear to be an admission of guilt.

Edward Fogarty, M.D.


ANB said...

Medical radiation is similar to vaccines, it has a risk and should not be pursued unless there is a clinical need.

Do you believe the same thing for IV chelation? That it has a risk, and should not be pursued unless there is a proven need?

EFFIIIMD said...

Yes, IV chelation is potentially dangerous as a generally unnecessarily rapid form of non-specific metals redistribution. It should be ideally reserved for in-patient hospital use with access to laboratory monitoring of the redistributions of critical metals and minerals so as to avoid cardiac arrest. Convenience and lack of training have led to alternative practitioners to try this and in recent memory a 5 year old child died from this approach in PA. IV chelation is really only warranted for an acute metal toxicity, often such rare heavy metal toxicities occur in adults in industrial settings or children with lead ingestion. Transdermal, transrectal, and oral routes are safer; allowing much slower redistribution and should be encouraged not discouraged and can be done cheaply orally through certain high alginate food sources and other sources such as chitin fiber from shellfish for maintenance. The major problem with the idea of ANY form of chelation is that 99% of MDs won't even investigate if its use is warranted in any form of treatment, its too hot culturally and the knowledge base is not there in almost all MDs to even determine if its warranted-no apart of training in a culture that is ultimately quite dependent on pharmaceutical companies to do most of the biochemistry thinking for physicians-just ask a few how statins really work and all the downstream important biochemical effects of HMG-coreductase and you will see what I am talking about.

Interestingly, all radiologists give IV chelation agents every day often in an outpatient setting, as gadolinium chelates for IV contrasted MRIs and DMSA and DTPA in nuclear medicine among others. So if a person in establishment medicine believes IV chelation has no role in healthcare, he or she obviously has no idea they are prescribing a form of it when ordering an MRI with contrast or a renal scintigram (actually most physicians don't realize radiologists are basically tracking metals through the human body to determine pathology-our usual agents are iodine, technetium, gadolinium, thallium, indium and biologically based calcium as well as barium for oral use). Basically there is a huge information void in US medicine for understanding of metals and their impact on biochemistry. Improving function in people with high heavy metal half-lives due to poor metal detoxification needs to be a goal of medicine across the age spectrum, the global impact of toxic metals accumulation on all of us is woefully understudied as there is a general capital bias against funding such research-its generally not patentable and often will implicate major corporations in this country as having negative impacts on health all around us (oil, gas, coal, pharmaceuticals, electronics, even my field of medical imaging and the military with depleted uranium getting dosed out to soldiers in theater in the middle east for half of the last 15 years).

I am not as much one to say that we can avoid all of these things as many benefits are outweighing risks as a general statement, its just that an ever increasing body of knowledge is showing that there are certain individuals at a concerning enough prevalance who are likely heavy metal horders across all ages and much of this impacts neuorpscyhiatric functions (autism, alzheimer, depression, schizophrenia and other more specific disease such as Parkinson's seem to be significantly related to various detoxification impairments or exposure input/output discrepancies in an epigenetic fashion). Therefore improving the science and understanding of treating these exposures should be paramount in medicine, but there is no academic or industry research support for it. My greatest concern is for all of our troops who are inhaling depleted uranium, which as an external agent is a weak radiotoxicant but internal the alpha emissions of uranium become 20 fold more damaging to DNA, the genotoxic dose to young women and men over in Iraq right now will be rearing an infrequent but quite ugly head in the next generation that once again will be understudied for economic reasons. Soldiers ought to be coming home with a maintenance oral chelation of low dose chronic nature to lower long term radiation dose to tissues by pulling ihaled uranium out of their bodies. Cutting the biological half-life from 15 years to 2 years in this instance would lower the radiation dose at least 7 fold. But what do I know?

ANB said...

Are you actually calling Dr. Miles a "ninnie"? You're making my job awfully easy.

EFFIIIMD said...

Sorry, unclear antecedent-I meant you. Is it your "job" to deny the need for protecting vulnerable patients from idiosyncratic responses to medical interventions?