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Saturday, January 25, 2014

From's Respectful Insolence

By Orac
June 11, 2012

A couple of weeks ago, I was horrified to learn of a new “biomed” treatment that has been apparently gaining popularity in autism circles. Actually, it’s not just autism circles in which this treatment is being promoted.

Before the “autism biomed” movement discovered it, this particular variety of “miracle cure” has been touted as a treatment for cancer, AIDS, hepatitis A, B and C, malaria, herpes, TB, and who knows what else.

I’m referring to something called MMS, which stands for “miracle mineral solution.” As I pointed out when I discovered its promotion for various maladies, and then later, when I discovered its promotion at the yearly antivaccine quackfest known as Autism One, MMS is a form of bleach.

It’s industrial strength bleach, actually, 28% sodium chlorite in distilled water. Before use, MMS is frequently diluted in acidic juices, such as orange juice, resulting in the formation of chlorine dioxide (ClO2), which is, as the FDA characterized it in its warning about MMS, “a potent bleach used for stripping textiles and industrial water treatment.”

You might be thinking now: Orac, that’s a really nutty idea! Why on earth would anyone think that bleach would be a cure for anything other than stains? Well, as far as I can figure out, besides being told by God that MMS is a cure-all, a man named
Jim Humble based his decision to bleach people’s diseases away on the use of ClO2 as an antimicrobial in water supplies.

Of course, as I’ve pointed out before in detail, just because something kills bacteria in water or in a dish does not make it a good antibiotic. It’s the same reason that colloidal silver is quackery. Colloidal silver is actually a pretty good topical antibiotic, but taking it internally, it’s impossible to achieve plasma levels adequate to have antimicrobial effects without undue toxicity. The same principle is in effect here.

ClO2 works very well as a water disinfectant, but trying to achieve plasma levels equivalent to those required to disinfect water is a straight line to toxicity, and failing to do so leaves all toxicity and no potential benefit.

More importantly, the hidden assumption behind Humble’s selling of MMS as a miracle cure is that the diseases he’s targeting are all due to microbes. Even if MMS were an effective antimicrobial and antibiotic (leaving aside the claims about how it can be useful for pretty much all bacteria, viruses, and parasites), this rationale is utter nonense when it comes to cancer and autism.

While a few cancers have their origins in infectious diseases (H. pylori leading to stomach cancer or human papilloma virus leading to cervical cancer, for example), by the time the cancer has developed it’s too late. Getting rid of the microbe won’t reverse the cancer.

What really seemed to hit a nerve, though, was a presentation by Kerri Rivera (see for yourself at the Autism One quackfest, in which she advocated MMS as an autism treatment).

When I first wrote about it, the video wasn’t posted yet, but now it is (see part 1, part 2, part 3, part 4) so that you can see for yourself that the talk is no different than what could be expected based on her handouts and her previous talks. That alone was bad enough, but she also advocated giving MMS to autistic children in the form of enemas, in essence claiming that bleach enemas can cure autism.

Even worse (if that were possible), Rivera advocates “fever therapy” and views fevers after bleach enemas to be a good thing, a sign that the treatment is “working,” much as Jim Humble gives MMS to treat adults in increasing doses until they start to feel ill. Indeed, Rivera even exults about how much she loves “fever therapy” and how it “wakes up the immune system.”

In addition to the bleach enemas, she recommends a “72-2″ protocol that involves making children drink dilute bleach every two hours for 72 hours.

In fact, posts by myself and
others (such as Emily Willingham) about forcing autistic children to undergo bleach enemas in a vain attempt to “bleach the autism away,” as I put it, hit such a nerve that there is now a petition signed by over 1,500 people entitled No bleach enemas to “cure” autism in children!

Well, I guess there’s nothing that quacks won’t defend, because various advocates and quackery apologists are coming out of the woodwork to defend Rivera and her MMS protocol. For instance, Jim Humble himself has placed a counter-petition on that reads:

"Stop telling people that MMS is bleach because it is not. Because there are some mothers that don’t realize that Emily is wrong and they may never help their child to attain normalcy."

So, there! You evil skeptics! You’re preventing parents from “recovering” their children from autism using bleach enemas! Stop it with your damned skepticism and insistence on science-based medicine! We believe MMS cures autism, and that’s enough!

The petition also has only 31 signatures at this reading.

In any case, when looking for someone to defend the indefensible when it comes to autism quackery, there’s only one place to go; so I went there. Yes, I’m referring to the antivaccine propaganda blog Age of Autism, where the ever-reliable Julie Obradovic wrote a piece about the Autism One quackfest entitled
Autism One: Is there a doctor in the house?

Ms. Obradovic is unhappy, too. She’s unhappy about the blogosphere’s take on Kerri Rivera and her bleach enemas:

"Sometime that night I saw a nasty article already on the Internet about Autism One. To start the conference, there was one slamming it and The Chicago Sun Times. Now to end it, there was one slamming it and the parents who attend.

A blogger, who hadn’t attended the conference, but instead was regurgitating another blogger (who hadn’t attended the conference either), wrote an entire article about the inability to “bleach” the Autism out of a child. She was referring to MMS, a treatment being used for gut problems in some children that hadn’t even been presented yet. It was on schedule for the next morning.

It struck me as really odd that something most people at the conference didn’t even know much about had already been completely scrutinized by people who seem loathe the mere idea of medically treating a child with Autism (with anything but pharmaceuticals, apparently). It seemed obsessive and premature, to say the least, and it was eerily reminiscent of what happened with other interventions in the past."

What other interventions are those? OSR, an
industrial chelator that Boyd Haley tried to sell as a supplement to be used to treat autistic children, at least until the FDA finally stopped it? Chelation therapy itself, which can kill?

"There are certain treatments that one doesn’t have to experience for oneself, and talks that one doesn’t have to attend oneself, to realize that they are fetid, stinking piles of horse droppings."

From what I can tell, Ms. Obradovic is referring to a
post by Kristina Chew, which cited my earlier post about Ms. Rivera’s MMS talk. Whichever posts Ms. Obradovic is referencing, one thing is clear. There are certain treatments that one doesn’t have to experience for oneself, and talks that one doesn’t have to attend oneself, to realize that they are fetid, stinking piles of horse droppings.

It wasn’t hard to glean what Kerri Rivera was going to say from her previous talks, her blurb about her Autism One talk, and her handouts. It was even easier to come to the educated opinion that what Ms. Rivera does to autistic children is pure quackery and quite likely child abuse. No wonder she practices in Mexico, the land where quacks who would be shut down in the U.S. go avoid pesky things like laws and regulations regarding medicine and the standard of care.

Note also Ms. Obradovic’s framing of the issue. To her, it’s not a matter of bloggers like myself being outraged because quacks like Kerri Rivera exist and subject autistic children to bleach enemas until they have diarrhea, calling that diarrhea “good” as long as it’s “detox diarrhea.”

It’s not a matter of us being puzzled and alarmed at how parents could buy into this quackery. Our criticisms, to her, are not a matter of our wanting to protect children who make up an especially vulnerable population, autistic children. Oh, no.

To Ms. Obradovic, supporters of science-based medicine attack quacks like Ms. Rivera because we “loathe the mere idea of treating a child with Autism” with anything other than pharmaceuticals. This is, of course, utter nonsense, but I have no doubt that Ms. Obradovic really believes it.

So, in answer, I will assure her that I personally do not “loathe the mere idea of treating a child with Autism” with anything other than pharmaceuticals.” In fact, I don’t care whether a treatment for autism—or anything else for that matter—is pharmaceutical or otherwise. I only care that the treatment be based on sound science and supported by well-designed clinical trials.

"What I do loathe is the idea of treating a child with autism with a therapy that has not one whit of scientific evidence to support its plausibility, is potentially dangerous, and, at the very minimum, subjects autistic children to what is likely torture for many..."

What I do loathe is the idea of treating a child with autism with a therapy that has not one whit of scientific evidence to support its plausibility, is potentially dangerous, and, at the very minimum, subjects autistic children to what is likely torture for many of them (enemas, even leaving aside the question of bleach) with no prior evidence that they are likely to benefit from the treatment.

In brief, I loathe the idea of subjecting children, be they autistic or neurotypical, to such rank quackery. Come up with a plausible non-pharmaceutical treatment for autism with some real science—not crank rationales—behind it, and I’ll be interested and possibly even support doing clinical trials if the preclinical evidence is compelling enough.

In other words, I go where the evidence leads me, and it sure doesn’t lead me to MMS.

Apparently not Ms. Obradovic, who proceeds to tone troll:

"But mostly, the article irritated me for its tone. The author’s message was clear: parents who try these treatments are gullible, dangerous, and/or don’t love their children, and the people who pass them off are snake oil salesmen."

Some of these are straw men; others are not. The biggest straw man of all is that we claim that parents who try these treatments are gullible and/or don’t love their children. The parents might be gullible, or they might just be insufficently scientifically sophisticated to recognize quackery. No one that I know of claims that these parents don’t love their children.

On the other hand, we do say that the people who pass such treatments off are snake oil salesmen, because they are, although it’s an insult to snake oil to compare MMS to it. And that’s OK. We’re coming to a conclusion we consider reasonable based on the evidence. It doesn’t matter whether someone like Jim Humble or Kerri Rivera actually believe in their snake oil. It’s still snake oil. I’m sorry if Ms. Obradovic is offended to read that, but it’s the truth.

Moreover, the actual purveyor of this snake oil, Ms. Rivera herself, is pretty pathetic when it comes to defending MMS. This can be best seen in
her response to an open letter by Autismum criticizing her use of MMS to treat autistic children. Autismum’s open letter is a blistering attack on MMS quackery that concludes:

"Your “treatment” is abuse. It lacks plausibility. It lacks humanity. You advocate dosing autistic children with your over-priced poison to treat the fantasy symptoms of candida such as, “laughter for no reason.” I love it when my 46 lb., four year old Welsh boy laughs even if I can’t tell what’s tickling him. I won’t do a thing to prevent that."

So how did Ms. Rivera respond?
With a non-response, actually:

"You have your science all wrong. The websites that you site are incorrect. I wish you and your son all the best. Wonderful hearing your opinion. Everyone has one, be it informed or misinformed.

This is nothing more than argument by assertion. Ms. Rivera seems to think that simply asserting that her critics “have their science all wrong” is enough. She doesn’t explain how we allegedly have our science wrong. She doesn’t provide anything resembling decent scientific or clinical evidence to support her position and show that we are wrong. She doesn’t even make a minimal attempt at a science- or evidence-based counterargument.

I’ll close by noting that there might be some reason for hope. Even if the quackfest known as Autism One has no filters when it comes to allowing dangerous quackery to be presented, apparently Ms. Rivera’s—shall we say?—novel treatment strategy using bleach enemas brought out some actual skepticism, at least about MMS, in the comments after
Ms. Obradovic’s defense of quackery. Some examples follow.

First, someone named
Fielding J. Hurst, who in an earlier comment declared himself a believer in “biomed” treatments:

"Chlorine Dioxide is the important part of this discussion. Your copy/paste is on Sodium Chlorite. Chlorine Dioxide has been shown to cause impaired thyroid and kidney function, as well as cause neurological impairment.

Also, there is a big difference in killing external pathogens and ingesting it. Bleach kills the pathogens by poisoning them, that doesn’t mean it’s a good idea to ingest it."

WHAT ABOUT ALL OF THAT GOOD BACTERIA IN THE GUT PROMOTED BY OTHER BIO-MED TREATMENTS THAT WORK? CAN SOMEONE NAME ME A BLEACH RESISTANT GOOD BACTERIA? I spent a decade healing my daughter’s gut issues that I can easily see undone quickly with this stuff.

If we can’t agree that it’s not a MIRACLE, can we at least agree that IT’S NOT A FRICKIN’ MINERAL. SOLUTION, yes. At least a little truth in the name.

My favorite tidbit from the Archbishop Humble … IT’S NOT REAL DIARRHEA! Thank goodness. Fake Pseudo Diarrhea is very good for you. It’s a sign of a miracle in progress."

OK, there’s no actual evidence that the “other” biomed treatments “work” any better than MMS, but at least most of them aren’t bleach. Oh, wait. They are things like hyperbaric oxygen, chelation therapy, bizarre diets, supplements and other things equally potentially harmful. Never mind.

At least Mr. Hurst realizes that MMS is quackery—unlike all that other quackery. That’s a start. Perhaps that skepticism will blossom and spread to a lot of the other autism “biomed” quackery out there.

Then there’s someone by the name 'tiredmom':
"I believe that autism is a fully-recoverable gut disorder, that the children are suffering and deserve treatment. That being said, I think that there is A LOT of snake oil in the biomed world of autism. Autism is awful and parents are desperate and will try anything. I have also observed that we don’t demand a lot from whoever comes out with a new product. We don’t demand that they prove anything to us because they are one of the few who are telling us that they believe in our kids and are trying to help.

I have had parents admit to me that certain doctors or supplement people asked them to endorse their products or program and gave them free supplies. I think we have to become a lot more skeptical. I don’t believe we can always trust other parents’ opinions.

While there are many biomed treatments that help and even recover children, many children get better in the early years without any intervention, but if the parent is trying a certain biomed protocol at the time or even therapy they will credit that."

I was amazed that there was actually a comment recognizing that some autistic children improve on their own, and that many parents trying biomedical woo mistakenly attribute such improvement to the quackery du jour they’re using. Unfortunately, the vast majority of comments were more supportive, at least tolerating Ms. Rivera’s quackery, like this comment by RisperDON’T:

"Whatever happened to the Mercury apologists, “The dose makes the poison?” Gone?

Naysayers trashed and got OSR removed from the market for its origin as a waste water treatment before revision for human use by one of the nation’s leading University chemists.

Fluoride was suggested as a pesticide early on.

And many FDA approved (and off label use) drugs today have known toxicity including death (e.g. chemo) and those who refuse it are considered the quacks."

This is, of course, a typical fallacy used by defenders of quackery: Because real science-based medicine has side effects and complications, criticizing pseudoscientific treatments for their potential side effects is unfair.

I am impressed, however, that Ms. Obradovic managed to restrain herself from pointing out how some chemotherapies still used (nitrogen mustards like cyclophosphamide and melphalan) had their origins as chemical warfare agents.

Be that as it may, the difference is, of course, that these real medical treatments have scientific evidence and clinical trials showing that they work, how they work, and that the benefits outweigh the risks. MMS has nothing of the sort.

In the end, regardless of what other “biomedical” treatments are beloved at Autism One, I keep holding out hope that the organizers of Autism One would be able to realize that there are some things that are so beyond the pale that they don’t belong even at Autism One.

I agree with Sullivan and Emily on this count that the organizers of Autism One should renounce such quackery, in particular Kerri Rivera. Unfortunately, I also realize that this will never happen because, apparently, offering “hope” to parents of children with autism requires never “judging” and remaining “open-minded.”

Unfortunately, we all know what happens when you are too open-minded. Your brains fall out.

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