The Citations Are Not What They Seem · 2006-07-24 13:15


Significant Misrepresentations
Mark Geier, David Geier & the Evolution of the Lupron Protocol
(Part Seven) • Related articles

In their articles and presentations about the “Lupron protocol” and its scientific justification, Mark and David Geier have cited many peer-reviewed journal articles by reputable academics at prestigious institutions. Closer examination of these references, however, yields many discrepancies between the Geiers’ representations of their authors’ claims and conclusions, and those expressed in the actual articles.

An Unnatural Bond

Dr. and Mr. Geier’s claim that testosterone binds to mercury in the body is central to their proposals to facilitate chelation of mercury from the body by means of testosterone suppression. In their first application to patent the “Lupron protocol,” they stated:

It is known in the art that mercuric chloride binds and forms a complex with testosterone in subjects (See, Cooper et al., The Crystal Structure and Absolute Configuration of the 2:1 Complex between Testosterone and Mercuric Chloride, Acta Crystallogr B., 1968, 15:24(7):935-41).

The Geiers elaborated on this claim in their presentation at the 2005 Autism One conference, displaying a Powerpoint slide containing two figures excerpted from Cooper et al.

David Geier: And even more than that, we discovered that testosterone and mercury complexed classically in the body. You’re looking at your testosterone here — that’s these folded, sheety things. They form long strands, like little threads. And what mercury does, that’s these blackened-in balls here, it comes in and binds one string of testosterone to another one. So you take something that was a linear string and make it two-dimensional, so now it’s in effect a testosterone-mercury sheet. And this is something that makes for the idea of when you do chelation, or for build-up of testosterone in the body, shows that it’s going to be very tough to get rid of both of them. There should be testosterone in the body, and lots of mercury embedded in that.
Mark Geier: And incidentally, this was seen by x-ray crystallography. It’s the ultimate way of seeing things. It’s a way of seeing molecules. It’s the same way they got the structure of DNA. So that’s really what it looks like.

Intrigued by the unusual claim that testosterone and mercury bonded into “sheets” in the human body — a claim supported by a single article published almost forty years ago — Blogger Prometheus obtained a copy of The Crystal Structure and Absolute Configuration of the 2:1 Complex between Testosterone and Mercuric Chloride and learned that the crystal in question was created:

…by dissolving equimolar amounts of testosterone and mercuric chloride in minimal hot benzene…

— a condition that does not occur “in subjects” or “classically in the body,” as Dr. and Mr. Geier had claimed, but in artificial laboratory conditions.

Although anecdotal reports suggest that the Geiers have “backed down” from their claim that mercury and testosterone “complex” to form “sheets” in the body, there is no indication that any change has been made to their applications to patent the “Lupron protocol,” the scientific justification for which wholly relies on this pseudo-theory. Also, a video in which they make this assertion remains online, linked from an introduction that hails their pseudo-discovery.

They’ve found that testosterone actually binds to mercury, increasing its toxicity and keeping it in the body.

With this claim, the Geiers continue to encourage parents to consent to invasive testing and pharmaceutical treatment of their autistic children for a condition that actually occurs only once in a blue moon.

A 24-Year Old “Child”?

In their first article advocating the administration of anti-androgens to autistic children, The Potential Importance of Steroids in the Treatment of Autistic Spectrum Disorders and Other Disorders Involving Mercury Toxicity,, Mark and David Geier cited George M. Realmuto and Lisa Ruble’s Sexual Behaviors in Autism: Problems of Definition and Management (Journal of Autism and Developmental Disorders, Vol. 29, No. 2, 1999).

Realmuto and Ruble have described a case report of an autistic child that highlights the difficulties of managing severe behavioral disorders in autistics. The authors reported that after failure of behavioral and educational programs, leuprolide, an injectable anti-androgen, resulted in suppression of the autistics’ severe behavioral disorders and retention in his community placement. Follow-up by the authors for almost three years showed no abnormal physical effects. The dosage administered to the child was tapered over that period to a low but effective dose.

The “child” discussed in this article, whose “severe behavioral disorders” were ultimately lessened by long-term administration of Lupron, was in fact a young man diagnosed with both autism and schizophrenia. At the age of 21 he began to masturbate publicly and become sexually aroused by small children. At the age of 24, following various unsuccessful efforts to help him to express his sexual urges in a safe and appropriate manner, the young man and his guardian agreed to the administration of anti-androgen medication. After an ineffective trial of flutamine, Lupron Depot was administered. The predictable result was a significant decrease in libido and elimination of the sexual behavior problems that had jeopardized his ability to live successfully in the community. However, the drug regimen was no panacea.

Follow-up for 3 years demonstrated this individual no longer exhibited public masturbatory behaviors. While inappropriate sexual behaviors subsided, aggressive, destructive and at times psychotic symptoms continued and at times worsened as measured by daily detailed counts of episodes of property destruction, physical assault of staff, and report of auditory hallucinations… While sexual behavior decreased, other problematic behaviors did not, suggesting that sexual behaviors did not correlate with aggressive behaviors.

Numerous ethical questions were raised by the authors, including how consent to treatment can be appropriately determined, the relative importance of the “right” to community placement versus the right of sexual expression, the need for effective means to distinguish inappropriate behavior from predatory behavior in cognitively disabled persons, and the significance of parental anxiety over autistic children’s sexuality. The authors also observed that:

Like many individuals with autism, he experienced delayed puberty onset…

— an observation that, albeit unsubstantiated, went completely unreported by Dr. and Mr. Geier.

A Catch-All Category

To support their assertion that autistic individuals disproportionately experience precocious puberty, Mark and David Geier have cited Siraj Siddiqi et al., Premature sexual development in individuals with neurodevelopmental disabilities (Developmental Medicine and Child Neurology 1999 Jun;41(6):392-5). This study was mentioned in A Clinical and Laboratory Evaluation of Methionine Cycle-Transsulfuration and Androgen Pathway Markers in Children with Autistic Disorders as well as in David Geier’s presentation at the 2006 Autism One conference. During that presentation, Mr. Geier augmented his discussion with a Powerpoint slide in which two passages from the article were highlighted in red.

This is a study out of the University of Iowa looking at about 16,000 patients with neurodevelopmental disorders. They found 32 had a diagnosis of premature puberty. And to give you an idea of the background rate, according to this study, and they quote the NIH here, one in ten thousand children, maybe one in five thousand children has premature puberty. So this study alone shows twenty times as much premature puberty in children with neurodevelopmental disorders relative to the background frequency.

Unfortunately, Mr. Geier failed to include pertinent information that might have enabled his audience to gain an accurate understanding of the findings of the University of Iowa study. Although autism was included in the range of diagnoses encompassed in the category “neurodevelopmental disabilities,” none of the thirty-two children diagnosed with precocious puberty was autistic — a fact made quite clear in Table One.

Of the 32 children diagnosed with precocious puberty (out of 15,719 records of neurodevelopmentally disabled individuals), only one boy had a diagnosis of central precocious puberty — a fact made quite clear in Table Three.

Indeed, the authors of this study pointed to the need for extra care in the diagnosis of precocious puberty in boys, who represent approximately 80% of all persons diagnosed with autistic spectrum disorders. Premature development of secondary sexual characteristics in boys almost invariably indicates a lesion or tumor, rather than an otherwise-unexplainable glandular hyperfunction.

While at least 60% of cases (of precocious puberty) are idiopathic in girls, a central or peripheral lesion can be found in most affected boys… Boys in the general pediatric population who show signs of early puberty are much less likely to have so-called idiopathic precocious puberty than girls; this trend needs to be kept in mind when making diagnostic management decisions.

The Siddiqi study ended with an informative passage discussing prejudices and misconceptions about the sexual development of disabled individuals that raises questions directly relevant to discussion of the “Lupron protocol.”

Historically, the sexuality of individuals with major neurodevelopmental disabilities and/or mental retardation have unfortunately been ignored or denied. In American society, ambiguous and conflicting cultural messages strain dialogue on sexuality. The culture tends to regard individuals with learning disabilities as asexual; or, if they display overly affectionate behavior, as hypersexual. Each inappropriate label creates anxiety for families and caregivers with the additional worry about sexual abuse and unwanted pregnancy. Child-abuse literature clearly recognizes that people with learning disability are at high risk for physical, sexual and emotional abuse. It is not clear whether the presence of precocious puberty adds to abuse risk or to related parental anxiety.

In light of the culturally-based tendency to marginalize and pathologize the sexual and reproductive lives of disabled individuals, and the common incidence of anxiety over disabled children’s sexual development, might some doctors and parents be more willing to speculatively medicate an autistic child with a drug that directly inhibits sexual development, than they would if the child were not autistic? Might the promulgation of an exaggerated perception of risk for precocious puberty in autistics needlessly increase parental anxiety, and thereby detract from the well-being of everyone in the family?

A Mistaken Psychiatrist

Dr. and Mr. Geier have frequently referred to Sylvie Tordjman, Pierre Ferrari, et al., Androgenic Activity in Autism, by (American Journal of Psychiatry 1997 154: 1626-1627), to demonstrate that a significant percentage of autistic individuals have higher-than-average levels of testosterone; this study is mentioned in The Potential Importance of Steroids in the Treatment of Autistic Spectrum Disorders and Other Disorders Involving Mercury Toxicity,, A Clinical and Laboratory Evaluation of Methionine Cycle-Transsulfuration and Androgen Pathway Markers in Children with Autistic Disorders, and in both the Geiers’ 2005 and 2006 Autism One presentation. During the 2006 presentation, David Geier displayed a slide featuring several paragraphs from the article, and offered a brief summary of its conclusions:

And then if that wasn’t bad enough, focusing now in on autism specifically, this comes from Dr. Tordjman in France. They looked at one inpatient clinic of twelve pre-pubertal age autistics, and found four of them were showing signs of premature puberty. And then when they looked at the levels in the blood, they found that three of nine had levels more than two standard deviations above age and sex matched controls. So that this is telling us that autistics at an enormous rate — four of twelve versus one in five thousand or one in ten thousand — had premature puberty signs. And furthermore, if you test in their blood, they should have high levels of testosterone.

Mr. Geier here makes a broad and insupportable generalization based on a study with an extremely small sample size and a suspect evaluation process. The one autistic child identified by this group of psychiatrists as having “precocious secondary sexual characteristics” was a ten-year old boy entering puberty at a normal age, beyond the age for a diagnosis of precocious puberty. Whereas the nine autistic subjects were divided into three groups based on their levels of aggressive behavior, the control group of 62 “normal subjects” was not also divided into groups based on their levels of aggressive behavior. None of the truly prepubertal autistic children in the study had any endocrine abnormality.

Although this tiny study lends support to an association between high levels of testosterone and aggression, it is insufficient to establish prevalence of high levels of testosterone in autistic subjects in general. Androgenic Activity in Autism illustrates the perils that can befall doctors who attempt to render professional opinions outside their areas of specialization. It is worth noting that Androgenic Activity in Autism was published as a letter to the editor of a psychiatry journal, rather than a full-fledged article in a journal whose editors submit articles to peer review by endocrinologists.

The Deceptive Digits

Each of Dr. and Mr. Geier’s articles and presentations on the “Lupron protocol” have included references to the work of British researchers Dr. Simon Baron-Cohen, John Manning and their colleagues on the possible relationship between fetal testosterone levels and the development of autism. From The potential importance of steroids in the treatment of autistic spectrum disorders and other disorders involving mercury toxicity:

In considering testosterone levels among autistic children, Manning et al. have investigated prenatal testosterone levels in children with autistic spectrum disorders [22,23].

Footnotes 22 and 23 of that article referred to two studies:

The 2nd to 4th digit ratio and autism, by JT Manning, Simon Baron-Cohen, Sally Wheelwright, and G. Sanders (Developmental Medicine and Child Neurology 2001 Mar;43(3):160-4); and
2nd to 4th digit ratios, fetal testosterone and estradiol, by S. Lutchmaya, Simon Baron-Cohen, P. Raggatt, R. Knickmeyer, JT Manning (Early Human Development 2004 Apr;77(1-2):23-8)

After citing these references, Dr. and Mr. Geier offered a summary of the conclusions supposedly reached by the authors of both articles:

The authors examined 72 children with autism, including 23 children with Asperger syndrome (i.e. these children have less serve autistic disorders), 34 siblings, 88 fathers, 88 mothers, and sex and age-matched controls. The authors demonstrated that the more severely affected the children were the higher the levels of prenatal testosterone.

During Dr. and Mr. Geier’s presentations at both the 2005 and 2006 Autism One conferences, a Powerpoint slide was displayed featuring a figure excerpted from The 2nd to 4th digit ratio and autism, and their summary of the British researchers’ findings.

The horizontal axis of the chart identified the ten different subject groups that had been tested. The vertical axis, consisting of a scale from .93 to 1.00, was labeled, at top left, “Lower testosterone/higher estrogen”; at bottom left, “Higher testosterone/lower estrogen.”

In 2005, Dr. and Mr. Geier described the significance of this research to their own work.

David Geier: So first window into this field, this is from Dr. Baron-Cohen — anybody heard Mark Blaxill, he’s the one, “geeks get lucky” hypothesis.
Mark Geier: And he thinks that autism is too much maleness. And you know what? He’s right. He doesn’t understand it, but he’s right.
DG: There’s a certain amount of truth. It’s a risk factor. What he looked at was high testosterone in prenatal testosterone levels, versus low ones here. Here are your autistic children, minus out the Asperger’s, very very low. Here are your Asperger’s —
MG: Very high.
DG: Very very high.
MG: He made this graph upside down; I don’t exactly know why.
DG: Here are your autistics, here are your Asperger children. Interestingly enough, you look around in the family of autistics, they also tend to have higher levels of testosterone. ‘Cause here are your controls from families who have no autism in the family. So, it looks like that there’s a risk factor for having high testosterone in developing autism.
MG: See, it’s too much maleness.
MG: [responding to question from audience] That wasn’t studying vaccines, that was just the association between testosterone levels and the chance of getting an autistic child. The more testosterone you have, the more chance you have, and the more severe, the more testosterone. Nothing to do with vaccines.

A year later, David Geier offered a similar explanation:

An interesting piece of evidence that we looked at was levels of testosterone in autistics. This is work by Dr. Baron-Cohen who’s from England, some people may have heard of him, he’s the one who says that autism is just too much maleness. But in reality, when you look at his data, he does have significant evidence showing that testosterone is a problem in autism. Specifically looking here at, first, autistic children versus non autistic children; there is significantly more testosterone and lower estrogen in autistic children versus these controls. Within autism, he looked at Asperger Syndrome versus autism full spectrum, minus out AS here is Asperger’s, so the more severe the autistics, the higher levels of testosterone. And then he observed even within families, when you look at siblings of autistics versus control siblings, significant difference. Fathers have more, mothers have more than families who don’t have autism.

You might come away from this saying, testosterone causes autism. But that’s not what these slides are saying. What they’re saying is that testosterone is a risk factor for autism. We all think about as risk factors that, of course, the mercury exposure, that’s a risk factor, how much you got and how soon; the issue of glutathione, how much you have and how much ability you have to excrete mercury; but this data is suggesting that testosterone is also a risk factor. And the reason we can deduce that from this particular graph is that when you look at autistic children here, the fathers of autistic children have as much as their children. Something is different regarding exposure; we know these autistic fathers don’t have autism. And what we think is happening is — these children have high testosterone; thimerosal or mercury is thrown into the mix, and that equates to autism.

Firsthand examination of the studies to which Dr. and Mr. Geier were referring, however, reveals significant discrepancies between their characterization of that research, and the researchers’ own conclusions.

The Geiers’ summary of these studies in The potential importance of steroids in the treatment of autistic spectrum disorders and other disorders involving mercury toxicity —

The authors examined 72 children with autism, including 23 children with Asperger syndrome (i.e. these children have less serve autistic disorders), 34 siblings, 88 fathers, 88 mothers, and sex and age-matched controls. The authors demonstrated that the more severely affected the children were the higher the levels of prenatal testosterone.

— implied that both articles pertained to a single population of study subjects; that the researchers had succeeded in accurately determining fetal testosterone levels for all of these subjects; and that they had correlated those levels with the severity of those subjects’ autistic symptoms. However, the two articles referred to different studies and different subjects; only Manning and Baron-Cohen co-authored both.

The 2001 article, The 2nd to 4th digit ratio and autism, discussed a physical trait that generally differs between men and women. Males have, on average, longer 4th digits relative to their 2nd digits (i.e. low 2D:4D) than do females, who have on average higher 2D:4D. Since digit length is prenatally determined, and since males generate more testosterone in utero than females, low 2D:4D digit ratio is positively correlated with prenatal testosterone levels. Since males represent 80% of individuals diagnosed with autistic spectrum disorders, Manning, Baron-Cohen and their colleagues sought to determine whether there might also be a correlation between a low 2D:4D digit ratio and the presence of ASDs at varying degrees of severity. The researchers speculated that,

A trait which is set in utero and which is correlated with prenatal testosterone would provide an alternative way to investigate a testosterone linked aetiology for autism.

They also warned their readers that:

It is not possible to directly test the prenatal testosterone levels of children and adults… [H]igh levels of prenatal testosterone do not invariably result in the autistic phenotype.

They concluded:

Low 2D:4D in children is associated with an increased risk of autism. This may be because 2D:4D ratio is itself related to high prenatal testosterone, but we have no direct evidence for this. In addition to the genes or conditions which give rise to low 2D:4D ratios there may be another factor(s) which precipitates the autistic phenotype… We conclude that low 2D:4D ratio may serve as one possible marker of autism. Low 2D:4D may also implicate prenatal testosterone in the aetiology of autism, possibly for genetic reasons. This remains to be explored.

Although this study contributed to the growing weight of evidence suggesting a relationship between high prenatal testosterone levels and autism, it did not prove causality, and it did not prove that any of the subjects in the study had indeed experienced atypically high levels of fetal testosterone. It certainly does not support the assertion that post-natal suppression of testosterone production in autistic subjects might result in the mitigation of autism per se.

The 2004 article, 2nd to 4th digit ratios, fetal testosterone and estradiol, by Lutchmaya, Baron-Cohen et al, described a study of two-year-old children whose mothers had undergone routine amniocentesis during pregnancy, and for whom accurate measures of fetal testosterone were therefore available. This group of researchers measured the children’s digit lengths, and compared that information to each child’s level of fetal testosterone. They referred to Manning et al’s study regarding the possible relationship between low 2D:4D ratio and autism. However, none of the subjects in the new study had been diagnosed with an autistic spectrum disorder. The 2004 study concluded that low 2D:4D ratios are associated with high fetal testosterone, but only suggested that high fetal testosterone might be associated with autism.

As described above, Dr. and Mr. Geier’s interpretations of these studies were augmented by a chart that supposedly illustrated the findings of The 2nd to 4th digit ratio and autism:

Although Dr. and Mr. Geier originally excerpted the chart from The 2nd to 4th digit ratio and autism, the chart displayed in their Powerpoint presentation differed in a significant aspect from Figure One of that article.

Dr. and Mr. Geier had deleted the caption:

Mean 2D:4D ratios and standard error bars of each of the ten groups tested. Autistic-AS, children with autism with AS removed from sample.

Whereas the left axis of the chart had originally been labeled, “Mean 2D:4D,” Dr. and Mr. Geier had deleted that label and replaced it with “Lower testosterone/higher estrogen” and “Higher testosterone/lower estrogen.” The summary above the chart on Dr. and Mr. Geier’s Powerpoint slide stated unequivocally that the study reported in The 2nd to 4th digit ratio and autism had found a direct relationship between levels of fetal testosterone and the severity of autistic symptoms, when this was not the case; as noted above, the investigators in that study had clearly stated that it was impossible to directly test the prenatal testosterone levels of their subjects.

Nonetheless, the misrepresentation of scientific data was useful in that it created the impression that the cited research gave greater support for the Geiers’ speculations than it actually did. This fits the established pattern described (and rejected) by Judge James A. Beaty in the case, Doe vs. Ortho-Clinical Diagnostics, Inc.:

Dr. Geier’s methodology consisted of attempting to connect various individual studies that had developed the existence of certain findings… [O]n its face, all these study results, when pieced together, would seem to support Plaintiffs’ general causation theory, as offered by Dr. Geier, that RhoGAM could cause autism.

However, upon being subjected to extensive cross examination, much of Dr. Geier’s analysis, based upon his collective review of a motley assortment of diverse literature, proved, in the Court’s view, to be overstated… This Court must find more than the “hypothesis and speculation,” engaged in by Dr. Geier in this instance, in order to allow Dr. Geier to rely upon the methodology he used in forming a conclusion based upon his review of the literature presented to the Court. In any event, Dr. Geier’s conclusion in this matter is not supported even by the literature he presented to the Court… Thus, while Dr. Geier’s presentation of the literature as part of his methodology might at first glance appear convincing, the disconnected literature he presents does not add up to the opinion and conclusion that Dr. Geier is offering.

Shouldn’t parents hold Dr. and Mr. Geier to the same high standard when considering whether to subject their autistic children to the “Lupron protocol”?

‡ ‡ ‡ ‡ ‡

On July 17, Professor Simon Baron-Cohen responded to my request for comment on the “Lupron protocol.”

I am aware that the Geiers are citing our work to justify their treatments involving lowering testosterone levels in autism. I have never advocated for this treatment, and indeed am opposed to such treatments on two grounds: ethical (manipulating hormones affects many systems in the body and mind, many of which do not stand in need of ‘treatment’) and safety (such treatments may carry risks, many of which are unquantified).

to Part Eight:
Bibliographic Mergers & Acquisitions

Comments


  1. Oh excellent Kathleen. I got an email from an editor of Hormone Research (par accident – he hit the reply to all) and the gist was – this needs an investigation- so what are we going to do about it. I live in hope that the ‘real’ scientists will do what ‘real’ scientists are supposed to do – conduct some real tests with proper controls. But note that this again diverts scarce funds from more useful endeavours. I wonder if Papa Doc and Baby BA rely on that. Maybe the Hormone Research people might have a bit of funding and a nice post graduate student available.

    — Alyric    2006-07-24 18:54    #

  2. The Geiers are just none-too bright. That might explain why Dr. Mark stopped practicing as an ob-gyn and why the son seems to have dropped out of grad school without so much as a Masters Degree.

    I notice that Erik, apart from his website (FAIR autism media) isn’t doing as much promotion for the Geiers online now. That’s good news for the people he might have helped the Geiers rope into their nasty biz. Is there an attorney general or someone who needs to be contacted now?

    Any ideas? Maryland licensing board or something?

    What will it take to get SAFE MINDS and the rest to totally distance themselves from these vultures. We see that Jim Moody used to be their lawyer but dropped out on some flimsy excuse, and Moody is part of SAFE MINDS.

    — tennis anyone    2006-07-24 20:18    #

  3. “What will it take to get SAFE MINDS and the rest to totally distance themselves from these vultures.”

    I predict they will quietly if not admitedly do so.

    — Joseph    2006-07-24 21:18    #

  4. Bingo!
    That axis label change is surely a career-killer. Academic malfeasance without further debate. Lovely catch.

    — Chris Borthwick    2006-07-25 01:05    #

  5. Mark Geier: “And incidentally, this was seen by x-ray crystallography. It’s the ultimate way of seeing things. It’s a way of seeing molecules.”

    Almost sounds as if they performed the x-ray crystallography work or they were at least in the room.

    I think Prometheus suggested they may not have read anything more than the Acta Crystallographica abstract but the crystal structure images used in their slide doesn’t look like something either of the Geiers could put together.

    I doubt David would know the difference between an angstrom and androgen so they must have borrowed the figures from the full paper and therefore were aware of the conditions required to form mercury testosterone sheets.

    Of course it’s possible that they were able to prepare sheets of mercury-testosterone in the laminar flow fume hood in the basement and demonstrate how Lupron might cleave the molecule allowing the inorganic mercury to form a new compound with chelation agents such as DMSA.

    It’s possible…

    — notmercury    2006-07-25 07:34    #

  6. “Mark Geier: And he thinks that autism is too much maleness. And you know what? He’s right. He doesn’t understand it, but he’s right.”

    Oh man. What an arrogant thing to say. Personally, I don’t mind arrogance if there is something to back it up. But arrogance and incompetence sprinkled into a pot of money-grubbing snake oil salesmanship is simply intolerable.

    Kathleen, I hope you used a bunch of purell after paging through their mess.

    — Bartholomew Cubbins    2006-07-25 10:52    #

  7. “Bingo!
    That axis label change is surely a career-killer. Academic malfeasance without further debate. Lovely catch.”

    LOL!

    These clowns can sacrifice chickens at midnight while dancing in a circle with SAFEMINDS and chanting “down with Big Pharma” and the mercury militia (or at least a portion) will continue to follow them.

    It doesn’t matter, because it’s near impossible to convert the unconvertable.

    — anonimouse    2006-07-25 13:01    #

  8. Worse than chickens, they can sacrifice children’s health and still be worshipped as gods. But a chunk of their income is based on their credibility outside the mercury militia, and that’s getting harder to maintain all the time. It will be harder for new people to become converts, too, based on what is known about the Geiers now. Dyed in the wool antivaxers and mercury phobes will continue to love the Geiers and even sacrifice their own children’s health on the altar of Geier greed and “hope.”

    Sally Bernard has to maintain some kind of thin mantle of reasonableness in order to maintain her place as head of CAN, I think… though it appears she bought her way to being pres. maybe she can keep buying her way even with her other organization, SAFE MINDS touting the Geiers as heroes.

    — Ms Clark    2006-07-25 14:47    #

  9. Unbelievable cherry picking. And the change of the axis label thing in that chart reminds me of something Prometheus told me once: To a man whose only tool is a hammer, everything looks like a nail.

    Is this a case of “If the original axis label doesn’t quite prove what you want it to, hammer away at it, and reshape it so that it does”?

    — Do'C    2006-07-25 16:08    #

  10. The Geiers aren’t the only ones to take Simon Baron-Cohen out of context. Ken Aitken tried to use his work to prove the case for a massive increase in regressive autism. Aitken misrepresented a pilot study of a new screening instrument (Baird G, Charman T, Baron-Cohen S, Swettenham J, Wheelwright S, Drew A (2000) A screening instrument for autism at 18 months of age: a 6-year follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 2000 Jun, 39(6):694-702) as proof of a massive increase in regressive autism because the pilot only picked up 10 subjects out of 16,235 children but failed to identify a further 40 autistic children. Finding 6 in 10000 out of an actual incidence of 30 in 10000 in a particular birth cohort does not prove that the other children are victims of regression. This was a just pilot study for a screening test, not a full scale case finding exercise using the latest diagnostic techniques.

    I am told that the authors were furious at this misrepresentation of their work but did not go public. I do not know if this is because they think that the likes of the Geiers and Aitken are beneath them and they do not wish to dignify their arguments with a rebuttal. If so, I think they are mistaken. I hope they appreciate the service you are doing them, Kathleen, in taking on these academic low-lifes.

    — Mike Stanton    2006-07-27 16:24    #

  11. Thanks to everyone for visiting, and for following this series.

    Al, without having read the email to which you refer, I’m guessing that the “investigation” of which the editor wrote might be an investigation of the article itself, rather than of the claims made by its authors—that is, how it came to be published and then republished, in spite of the demonstrable irregularities in the byline and with the IRB.

    Tennis Anyone, I’m guessing that Dr. Geier doesn’t do too much OB/GYN work these days because in 1994, he and his business partner had to pay $1,850,000 to satisfy a Maryland malpractice judgment. That's a major chunk of change. Under the circumstances, it might have been a little difficult to get their malpractice policy renewed. As for the Maryland Attorney General’s office, I welcome ANYONE who reads these articles to call the AG's attention to them. I’ve been too busy writing the articles themselves to get to that yet.

    Joseph, I, too, wonder whether the circle of affluent plaintiffs’ advocates and junk-science financiers that call themselves SafeMinds will realize that the Geiers are becoming a liability to their cause, and to the welfare of their children. Considering that board member Jim Moody originally served as chief counsel in the Geiers’ defamation lawsuit against the authors of the 2003 article in Pediatrics that criticized their methodology and conclusions, then dropped the case—leaving them without a lawyer they felt was competent to represent them—I can’t help but suspect that Mr. Moody had more reasons to bail than the various problems that were mentioned in the documents filed with the court. Those problems don’t seem to have prevented him from doing radio interviews and making appearances at autism conferences and the recent Weldon press conference.

    Chris, anonimouse, Do’C—y’all got it. When I first held up the original chart side by side with the one the Geiers displayed in their Powerpoints, I just about choked. I can see them thinking they might be able to get away with that sort of thing if they were using old-fashioned slides that they took home with them, but to memorialize their alteration of the chart on a Powerpoint and make it available for the whole world to see? How long did they think no one would notice?

    Ms. Clark, wouldn’t it be nice if some of the CAN board could see beyond Ms. Bernard’s big bucks. But ain’t it the way of the world to not see beyond $$$—and to assume that people with wealth also have greater wisdom and intelligence than the common folks?

    Mike, I bet you’re right that reputable academics regard the mercury conspiracists as being not worthy of a reply. I hope that a few will read this series and realize that regardless of the dubious quality of their science, the Geiers are successfully persuading parents to subject their children to a drug regimen with unknown and potentially serious long-term side effects. That’s well worth addressing, and I wish more would stand up and speak publicly about it. But obviously, many have become aware that if you counter the Mercury Moms publicly, you will pay with an onslaught of hostile communications targeted at you and even at your family. I'm sure Professor Baron-Cohen is aware of this, so I’m especially grateful to him for being willing to go on the record with his opinion.

    — Kathleen Seidel    2006-07-29 16:48    #

  12. Just this morning, I found some material relevant to the subject of this article, in the Opinion of the Court in Militrano v. Lederle Labs, a case pertaining to an alleged DTaP vaccine injury. In that decision (published on November 3, 2003), Kings County (NY) Supreme Court judge J. Allen Hurkin-Torres stated:

    “A 1988 report relating to a study on adults notes that the safety and efficacy of the acellular vaccine still needed to be studied for infants (see Sekura, Clinical, Metabolic, and Antibody Responses of Adult Volunteers to an Investigational Vaccine Composed of Pertussis Toxin Inactivated by Hydrogen Peroxide, 113 J Pediatrics 806 [Geier affidavit, exhibit 8]). A May 1996 article, which notes that the whole cell vaccine is generally safe and effective, states that ”[r]ecommendations for the use of the DTaP for primary immunizations in children younger than 15 months await results from ongoing efficacy trials in Europe and elsewhere” (see Rosenthal, The Safety of Acellular Pertussis Vaccine vs Whole-Cell Pertussis Vaccine, 150 Archives of Pediatric & Adolescent Med 457 [1996] [Geier affidavit, exhibit 42]). Indeed, a 2001 article submitted by plaintiff notes that the merits of the new acellular vaccine with respect to potency is still a subject of debate (see Donnelly, Whole-Cell but Not Acellular Pertussis Vaccines Induce Convulsive Activity in Mice: Evidence of a Role for Toxin-Induced Interleukin-1á in a New Murine Model for Analysis of Neuronal Side Effects of Vaccination, 69 Infection & Immunity 4217 [2001] [Geier affidavit, exhibit 36]). Thus, many of the reports and articles relied upon by Dr. Geier cut against his unsubstantiated assertion that Lederle could have obtained FDA approval for an acellular vaccine with data available in 1990.

    “In sum, Dr. Geier’s conclusory and scattershot affidavit, which is undermined by many of the materials submitted in support of it, fails to demonstrate that a viable alternative to the whole cell pertussis component of the DTP-HIB vaccine could have been marketed at the time the vaccine was administered to the plaintiff here.”

    — Kathleen Seidel    2006-07-29 16:48    #