May 21 2009

Chemical Castration for Autism – The Latest Atrocity

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Mark and David Geier are a father and son team that have been pushing the claim that autism results from mercury poisoning from vaccines. They have produced a string of junk science, denounced by mainstream scientists for terrible methodology, reasoning, and statistics. They portray themselves as mavericks, but in my opinion they are just terrible and dangerous scientists.

Their latest atrocity raises their medical mischief to new levels.  For several years now they have been pushing their testosterone hypothesis of autism. They claim, in short, that autism is caused by mercury poisoning, primarily from vaccines. Children with autism, especially boys, have high testosterone, which is partly the cause of their symptoms. But also the testosterone binds to mercury, preventing it from being removed from the body by chelating agents.

They have therefore conducted a study with the drug Lupron in addition to chelation. Lupron is a powerful drug that lowers testosterone levels. It is used for rare disorders associated with premature or high testosterone, or to treat prostate cancer in some men. It is also used as a form of chemical castration for sex offenders.

Each component of the Geiers claims are not only not proven, the scientific evidence is against them. It is pretty clear now from multiple studies that there is no association between mercury or vaccines and autism. Autism is not a form of mercury or heavy metal poisoning. Chelation therapy, which itself is risky, is of not benefit in autism. And high testosterone levels do no cause autism.

The scientific community has soundly rejected the Geier’s claims and renounced their practice. Pediatric endocrinologists, autism experts, and neurologists are nothing short of horrified at the abject and dangerous pseudoscience they are inflicting upon their patients.

Now the Geiers are setting up clinics across the country as little franchises to treat as many children as they can with their Lupron and chelation. They also have at least one patent application for their treatment.

Their clinics have all the hallmarks of dangerous quack clinics – their claims are miraculous, they are against mainstream scientific opinion, they dismiss legitimate scientific criticism with conspiracy theories and talk of persecution, and they target a vulnerable population.

Of course, some parents of autistic children are desperate for a treatment that will improve the lives of their children. The Geiers and their accomplices are offering a “miracle cure”, and dismiss criticism with the usual fallacies, claiming they are being picked on because they blew the whistle on vaccines.

It is also not surprising that many parent believe their children are being helped by the Lupron therapy. There are two reasons for this that have nothing to do with the treatment being effective against autism. The first is placebo effect. Children with autism are still undergoing development and they do often improve just as a natural consequence of maturation. Any improvement will be credited to whatever treatment parents are currently giving.

But there is also a huge psychological incentive to perceive an improvement even where one does not exist. The more radical, risky, and expensive a treatment is, the more parents feel the need to justify their decision by perceiving a benefit. Plus parents want their children to improve. I have seen this result in parents (and also patients themselves) reporting a clear improvement when objective measures showed no improvement at all.

The second source of apparent improvement in children treated with Lupron is that Lupron, given at the doses the Geiers are using, which is 10 times the dose used for childhood conditions of excess testosterone, do amount to chemical castration. Testosterone is a masculine hormone that increases energy, aggression, and sexuality.  Castrated males become more docile, calm, and less sexual.

It is therefore no surprise at all that the children treated with Lupron show these exact responses – decreased aggression and sexual behavior, like masturbation. Therefore all the Geiers have demonstrated is that if you chemically castrate young boys they will exhibit the predictable behavior changes of that hormonal change – they will become less aggressive and sexual. This says absolutely nothing about the role of testosterone in autism, nor is it evidence for an effect of Lupron on autism itself. To claim otherwise is rank pseudoscience.

It is also worth pointing out that the anti-vaccine community has exhibited gross hypocrisy when it comes to the Geiers. They decry every trivial connection between researchers, regulators, and industry as a fatal conflict of interest. Yet the Geiers have performed research overseen only by them and their hand-picked colleagues (not true independent oversight), they are setting up franchises to push their treatment before it is vetted scientifically, and they have a patent application for their treatment – all clear and profound conflicts of interest. Yet the anti-vaxxers just love the Geiers, who they see as maverick heroes.

The entire affair is extremely disturbing. In my opinion, the Geiers are pushing an unscientific and unethical treatment on helpless children. Lupron has serious side effects, and can interfere with normal development. There is no independent evidence to show that the treatment is safe and effective, let alone that it has a favorable risk/benefit profile.

Unfortunately, in the current climate and with the health-freedom laws spreading throughout the states, there is little that can be done to stop even grossly substandard care. Apparently, one only needs to make astounding promises and claim to be the victim of persecution in order to be shielded from the standard of care.

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Orac’s take on the issue

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