Respectful Insolence

Yesterday, I had a bit of fun while taking on a serious topic, namely yet another study that failed to find a link between mercury in vaccines and autism. Fortunately, though, I wasn’t the only one. Oh, no, not by any means.

Liz Ditz has done what she does best and provided a comprehensive linkfest of reaction to the study.

A few of my favorites from the list:

  1. They DID a study! (Photon in the Darkness)
  2. More evidence that mercury in vaccines doesn’t cause autism (Science-Based Pharmacy)
  3. The Long Awaited CDC Trial on Thimerosal and Autism (NeuroLogica Blog)
  4. New thimerosal/autism paper – signal vs noise (Autism Blog)

While I did predict some of the likely attacks that will greet this paper (the pharma shill gambit and complaints about its excluding children with genetic conditions known to result in autism), I forgot one. Yep, predictably, that poor, clueless, deluded kid Jake Crosby dubbed it tobacco science. Of course, he doesn’t bother to explain why he thinks it’s “tobacco science.” I bet he can’t.

Finally, I wonder what happened to our old friend Dr. Jay Gordon. He hasn’t weighed in on the study yet. I wonder if he’ll actually read my post. I wonder if he’ll think this study is “tobacco science,” too. I wonder if he’ll have the intellectual honesty to bow under the weight of the overwhelming evidence, of which this study is just the most recent and a particularly strong piece, and finally admit that mercury in vaccines did not cause the “autism epidemic.”

Yeah, I’m calling him out.

Comments

  1. #1 MikeMa
    September 14, 2010

    In spite of calls for ‘Nail in Coffin’, the commenters on some of these articles are raving. Rather a sad state when science can’t even defend itself with, you know, science.

    It would appear that after having moved the goalposts across the state from ‘Arrrgghhh, mercury!’ to ‘Too many too soon’ to ‘The toxins’ and retreating into ‘Mommy science’, they moved them back to mercury and had them smashed. The demolition seems to have had little impact on the True Believers(tm) but I’d hope fewer folks take them seriously.

  2. #2 Denice Walter
    September 14, 2010

    It appears that the goalposts may shift in a new direction: Heckenlively (Age of Autism; 9/13/10 ) writes how he and Handley “swap stories about intriguing rumors of a retroviral connection to autism which might also explain some of the health problems of mothers of many of the children”.

  3. #3 René Najera
    September 14, 2010

    I wonder if he’ll have the intellectual honesty to bow under the weight of the overwhelming evidence, of which this study is just the most recent and a particularly strong piece, and finally admit that mercury in vaccines did not cause the “autism epidemic.”
    I’ll put down a dollar he won’t. It is my opinion that opining on this will affect his bottom line one way or another. If he attacks, then his fellow physicians will (continue to?) mock him. If he doesn’t attack, his anti-vaccine colleagues will (continue to?) mock him. I’d hate to be in his shoes, where he has to be anti-science and pro-science all in the same day. I’d go nuts!

  4. #4 Calli Arcale
    September 14, 2010

    Oh jeez — Denice, they’ll have found pure gold there. “Do you fear your child may be autistic? Do you feel depressed, tired, achy, or run-down all the time? We have your answer!” They can exploit both autism *and* Chronic Fatigue Syndrome all at once.

  5. #5 Liz Ditz
    September 14, 2010

    Thanks for the mention!

    Judging by Dr. Jay’s tweets to me and his other 6,000 followers (here’s one and two), Dr. Jay seems to think the paper has significant weaknesses (in methodology and population characteristics) and the authors have significant biases and conflicts of interest.

    I wonder if he will come here to argue further.

  6. #6 ababa
    September 14, 2010

    Awesome, another study that says the same thing for antivaxers to ignore and continue to claim “no studies have been done”. They must have an standard action plan for trying to discredit new studies that do not support their beliefs by now, they get tons of practice.

    I’m wondering now what’s the point. Everyone that is going to be convinced probably has been convinced by now.

  7. #7 MikeMa
    September 14, 2010

    @ababa,
    The ‘no studies done’ will continue to resonate because the studies they want done are the unethical vax vs no vax kind. Stupid knows no bounds.

  8. #8 ababa
    September 14, 2010

    And if unvaxed vs. vaxed were done and didn’t say what they wanted, they would go back to the same rhetoric. Part of me thinks that the more studies, the more it will convince the fence sitters, but there is so much disinformation out there it’s nothing more than noise to some of them.

    I hate to see it when a new parent shows up on the local forums proudly proclaiming they have “done their research and decided to not vax”. This is followed by the usual requests for how to navigate a “religious” exemption and pediatricians that will tell them what they want to hear. Oh and those horrible, horrible handouts and waivers they are asked to sign. If you have done your freaking research then why is it a problem to sign a form that says you are aware of the risks of not vaccinating. I thought that was the whole point of them doing their research.

    Why is it such a hard concept to grasp that you do not go to the doctor for them to just tell you what you want to hear? You pay them for their opinion, not your opinion.

  9. #9 RickK
    September 14, 2010

    Question: Exactly what vaccines did Hannah Poling receive, and did any of them have any mercury?

  10. #10 Sastra
    September 14, 2010

    I wonder if he’ll have the intellectual honesty to bow under the weight of the overwhelming evidence, of which this study is just the most recent and a particularly strong piece, and finally admit that mercury in vaccines did not cause the “autism epidemic.”

    My guess is that he’ll deny that he ever actually said any such thing. It was always a suggestion and there’s nothing wrong with suggesting things it’s how science works isn’t it?

    He was just sayin’, is all.

  11. #11 Charles
    September 14, 2010

    Has Joe Mercola weighed in yet? He’s my wife’s favorite doctor in the whole wide world… Nine months of strep throat and he still refused to take her tonsils.

  12. #12 Chris
    September 14, 2010

    RickK, here is an article that gives you that information. According to that article the vaccines would have been about 2000-2001, and the only one that would have had thimerosal was DTaP (none of the other viral vaccines ever contained thimerosal, the Hib was free in 1999… go to the FDA page on thimerosal, “Thimerosal in Vaccines” for the table as I am at the max link level). At that time it would probably have been thimerosal free.

    Especially since Sallie Bernard could not find any DTaP with thimerosal in 2001 for the Burbacher study.

  13. #13 Chris
    September 14, 2010

    RickK, here is the table I used. I believe the Polings have always blamed the MMR vaccine, which never contained thimerosal.

  14. #14 Prometheus
    September 14, 2010

    Scene: an ancient crypt in a long-abandoned graveyard in Northwest Romania. Fog drifts slowly along the ground, occasionally swirling into fantastic shapes that seem to writhe in agony. The view slowly pivots and shifts until we are inside the crypt, finally ending with an elevated view of an intricately carved marble sarcophagus and a short, thin, stooped man dressed in a ragged black suit standing beside it.

    As we watch, the lid of the sarcophagus slowly slides off with a terrible, low grinding noise, revealing a figure shrouded in black. The figure slowly sits up and pulls back the shroud revealing…”Mercury-causes-autism”

    Mercury-causes-autism (MCA): “And so, Renfield, the time is at last ripe for my return?”

    Renfield: “Yes, my master! The book will be released today, ready to confuse the masses!”

    MCA: “What title did you choose?”

    Renfield: “I called it ‘Age of Autism’, master. The publisher thought that would reach those most susceptible to your powers.”

    MCA: “Good, Renfield. You have done well. Now, to my castle to prepare for the next phase.”

    Suddenly, the crypt is flooded with bright light; Renfield cringes and Mercury-causes-autism raises his cape to shield his eyes.

    MCA: “YOU! Where did you come from? I thought you were dead!”

    Price et al (Price): “Not dead; not sleeping either, just very, very busy. I’ve come to nail you back into your coffin, you blood-sucking fiend!”

    MCA (shrinking back into his sarcophagus with a wail): “I’ll be back! You can never destroy me completely! As long as there are desparate parents to exploit, I’ll be lurking, waiting to return!”

    Price (advancing to MCA’s sarcophagus): “Then this will just have to be the latest in a series of good-byes for us.”

    The camera view shifts to shadows on the wall as PRICE pounds a paper stake through the heart of MCA, which we see only in shadow.

    Prometheus

  15. #15 Dangerous Bacon
    September 14, 2010

    Orac: “I wonder if he’ll have the intellectual honesty to bow under the weight of the overwhelming evidence, of which this study is just the most recent and a particularly strong piece, and finally admit that mercury in vaccines did not cause the “autism epidemic.”

    Sastra: “My guess is that he’ll deny that he ever actually said any such thing. It was always a suggestion and there’s nothing wrong with suggesting things it’s how science works isn’t it?”

    It’s a bit more than a “suggestion”.

    Jay Gordon in the Huffington Post: “Mercury in vaccines causes autism and other brain injury.”

    Jay (again on HuffPo) has pointed to “excellent research” supporting a thimerosal-autism link, citing a study by that most Excellent of Researchers, Mark Geier.

  16. #16 MikeMa
    September 14, 2010

    @Dangerous Bacon,
    I expect Dr Jay will be by here to let us know what he really meant to say was somewhat different than was quoted on HuffPo which took his words out of context, Yeah, right.

  17. #17 RickK
    September 14, 2010

    Chris – thank you very much!

  18. #18 A Nonny Moose
    September 14, 2010

    Mostly off-topic:

    I come at what I know of research, specifically clinical trials, differently than most here. I’m an attorney that has as part of my client base small pharma companies with drug candidates in various clinical trial phases (and some still in pre-clinical testing). I have in the past also sat on an IRB for a local hospital district.

    As a result of that, I get e-mails advertising all kinds of different conferences on this topic or that when it comes to drugs and medical devices (from a legal perspective). The one I just received, which I’m assuming is referring to the Hannah Polling case, nearly made me want to scream

    In a decision that will reverberate as part of the vaccine-autism debate and that may have great consequences for manufacturers and defense counsel, the family of a child alleged to have developed autism as a reaction to receiving vaccinations has been awarded more than $1.5 million dollars. As reported by CBS News, it is expected that the family will also receive $500,000, or more, per year for the rest of the child’s life. This is the first time an award has been made for such an autism claim, and the significance of this decision for manufacturers is great, as there are about 4,800 vaccine-autism claims already in the federal vaccine court.

    It goes on to talk about how their conference will include a “special session” to discuss this development and how to defend vaccine-autism suits.

    I e-mailed them back and asked why I would want to attend their conference when their e-mail misrepresents the facts so blatantly. I’m not expecting a reply.

  19. #19 MI Dawn
    September 14, 2010

    @Prometheus: you, sir, have just won 1000 internets. Well done!

  20. #20 zackoz
    September 14, 2010

    OT, but it’s just been announced that Oprah will make a royal visit to Australia soon.

    The press coverage here has been entirely fawning and uncritical.

    One can hope that some journalist will have the gumption to question her critically about her attachment to woo and antivax nonsense, but I’m not holding my breath.

  21. #21 air max 2009
    September 14, 2010

    EXPERIMENTAÇÃO, pretende ser simples, mas cabe dizer que ainda possuo centenas de cartões. Reproduzo um novo que me foi oferecido por um amigo, a chefiar então uma Delegação de Propaganda médica. Um dos objectos a oferecer aos médicos contactados era um cartão de chamadas de número mais reduzido. O sistema foi usado por diversas firmas nos seus lançamentos.
    Permito-me reproduzir então o cartão novo que me foi oferecido e uma cabine telefónica, já adaptada, não a mais moderna, por esta ser demasido alta para a fotografar.

  22. #22 Dangerous Bacon
    September 14, 2010

    “Reproduzo um novo “

    I usually spray for that.

  23. #23 daedalus2u
    September 14, 2010

    Cali, CFS and autism do have the same cause, low nitric oxide. You only get autism from low nitric oxide in utero, you only get CFS after you are born.

  24. #24 Liz Ditz
    September 15, 2010

    I don’t quite understand why the anti-vaccination forces have been so quiet on this study.

    My surmises:

    A perceived need to focus on promoting the Blaxill / Olmstead book, and spreading misinformation about the Poling compensation ruling.

    A perceived need to continue to spread the Attkisson…well, at best, misrepresentations about the Poling decision

    and

    they may have been caught flat-footed by the release of the paper.

    So far I’ve only caught one response from the “autism is TOO vaccine injury” camp, a post from the UK team of John Stone and Clifford Miller, who jointly write the blog “Child Health Safety” (they are also, individually, published at Age of Autism).

    http://childhealthsafety.wordpress.com/2010/09/14/mercury-denialism-pediatrics/

    If you would like to join in the fray, Stone and Miller are posting comments at the Science-Based Pharmacy site:

    http://sciencebasedpharmacy.wordpress.com/2010/09/13/more-evidence-that-mercury-in-vaccines-doesnt-cause-autism/

  25. #25 EK
    September 15, 2010

    daedalus2u – is there evidence supporting either of those assertions, whatever hypothetical plausibility aside?

  26. #26 sophia8
    September 15, 2010

    daedalus2u – I occasionally have to use an NO spray for angina, and I haven’t noticed any difference at all in either my Aspergers symptoms or my chronic tiredness.

  27. #27 Fresh Purple
    September 15, 2010

    No case from Dr. Jay yet to argue further then?

    I was under the impression that most of the leading health organizations including the CDC and the NIH say that there is no relationship between vaccines and autism. Is there any factual evidence to state otherwise?

  28. #28 daedalus2u
    September 15, 2010

    EK, there is a lot of evidence. On my blog I have a lot about autism (linked to on my nym). I have also blogged about CFS and NO in a separate blog.

    http://www.chronicfatiguetreatments.com/wordpress/treatments/chronic-fatigue-syndrome-nitric-oxide/

    There has been nothing published about the physiology of CFS and autism that does not fit with a low NO hypothesis. There is a lot more on both that I have not put on my blog yet.

    A “NO spray” that you are using for angina is very likely not supplying NO. It is more likely an organic nitrate, such as nitroglycerin. Nitroglycerin is not a nitric oxide donor. It is often called that in the literature but that characterization is not correct. Authentic NO has a lifetime of seconds in the body, nitroglycerin has effects that persist for hours. Those persistent effects cannot be due to nitroglycerin acting as an NO donor.

    I think it is much more likely that nitroglycerin is simply triggering ischemic preconditioning and that is why there is pain relief in angina. That pain relief may be purely symptomatic. Nitroglycerin doesn’t seem to prolong life. Nitroglycerin does trigger migraine, which is pretty clearly ischemic preconditioning in the brain. The time scale of GTN triggered migraine (hours after taking GTN) make it clear it can’t be due to GTN being a NO donor.

    If GTN is acting to trigger ischemic preconditioning, it is acting to lower NO levels (the ischemic preconditioned state is triggered by low NO) and it will make Asperger’s and CFS worse.

    Authentic NO does make Asperger’s better (my personal experience before I knew I had Asperger’s and before I had formulated the low NO hypothesis of ASDs).

  29. #29 Vicki
    September 15, 2010

    I’m fairly sure the poster in Portuguese at 21 is a comment/link spammer.

  30. #30 bluedevilRA
    September 15, 2010

    daedalus, I hate calling people out but your comments seem pretty woo-like. It is a plausible hypothesis to be sure, but without any studies to actually demonstrate the efficacy of NO for ASD and CFS, I do not think such claims are reasonable at this point.

    CFS is a tricky thing to study, but I would imagine that a trial of NO efficacy for ASD would be relatively easy to create (provided there is an appropriate delivery system for NO). Also, aren’t nitrates converted to NO in the body as the mechanism of action for vasodilation?

  31. #31 daedalus2u
    September 15, 2010

    Bluedevil, as far as I know, there is only a single method for administering NO, the method I am working with. The physiology of NO/NOx is such that it is likely that there will be no other methods.

    The mechanism of action of GTN is not via release of NO. That is pretty well established by the reliable parts of the literature. The mechanism of GTN is not fully understood but that it is not a simple release of NO is known.

    Other methods claimed to be effective for administering NO are not effective. L-arginine is not effective in the long term because physiology upregulates asymmetric dimethylarginine and arginase. Intravenous sodium nitroprusside does provide prompt IV NO, and is equivalent to authentic IV NO, but authentic NO has a half life of seconds to minutes and so it has to be administered continuously. Sodium nitroprusside is administered continuously, but that can only happen in a hospital setting. In that hospital setting SNP is completely effective at causing vasodilatation and there is never “resistance” to the vasodilatating effects of SNP. However there is down-regulation of the normal production of NO upstream of the normal release of NO and so there can be tremendous rebound effects in trying to wean people off SNP because the normal sources of NO that do the normal regulation of vascular tone have been turned off.

    A clinical trial of NO on ASDs would be straightforward to do, but it requires a clinic and funding, something which I don’t have. I am trying to work with people to do such a trial, but people with access to clinics of ASD individuals don’t have the NO background to understand where I am coming from.

    You are right, it does sound “woo-like” to people who don’t understand the breadth and depth of NO physiology. I am not using any non-mainstream physiology in my analysis and understanding of what is going on. I have simply put all the mainstream physiology together into a model that is 100% consistent with all the data, but it is not consistent with the interpretations of the data that many mainstream researchers have come up with. It is compatible with their data which is more important.

    If you are prepared to show me it is “woo” by talking about it at the level of physiology, that is fine. But don’t tell me it is woo simply because some “expert” has not said it isn’t woo (which is what your demand for a clinical trial showing efficacy amounts to).

  32. #32 daedalus2u
    September 15, 2010

    I do have “evidence” for an effect on CFS. My business partner’s son developed ARDS from pneumonia and was hospitalized for a few days in ICU. He survived, having lost ~30 pounds. He was told by his doctors that maybe in 6 months he would be back to a shadow of his former self. ARDS very commonly does cause CFS among people who survive. I had his dad send him some of our bacteria which he used diligently because (as his dad said) “he was shook up, like he almost died”, to which I replied he almost did die, ARDS has a fatality rate of ~20-30%. It can progress to multiple organ failure via mitochondrial dysfunction. I discuss the physiology of that on my blog.

    At his two month checkup, his doctors were shocked by his recovery. He had gained 9 pounds, had resumed his normal life, had returned to a PhD program at Yale, had gone hiking and by every measure they tested he was “better than normal” for someone his age (low 30’s). They had never seen such a recovery and called it a “miracle”. I was surprised at the degree of recovery too. I had a complete physiological basis for why I thought it would help but didn’t know what the magnitude of the response would be.

    I appreciate this is an anecdote. To me, an anecdote is data of extremely limited statistical significance but is still positive and non-zero. To many people an anecdote is taken as evidence that what ever treatment the anecdote is being used to justify is wrong, that an anecdote has negative probative value. This is a wrong understanding of anecdotes.

  33. #33 Tom
    September 15, 2010

    Daedalus2u,

    You are proposing a panacea for a condition that has many different genotype/phenotypes, many of which result in neuronal synapse/signaling alterations. How would NO administration address such developmental anomalies?

  34. #34 Orange Lantern
    September 15, 2010

    My first reacton to reading the study was “Whoopdie doo, another beating of the dead horse.”

    But I love the timing with the AoA book coming out that is mercury-focused. And man, I forget how much underground mercury militia there still is. Between comments on news articles to Crosby getting all whipped up – seriously, is there no aspect of the alleged vaccine-autism link that they can let go? Does everything about vaccines have to cause autism?

  35. #35 Todd W.
    September 15, 2010

    @Orange Lantern

    Does everything about vaccines have to cause autism?

    Yes, even the dihydrogen monoxide.

  36. #36 EK
    September 15, 2010

    daedalus – in other words, you have a very neat and compelling (and maybe promising) hypothesis, but no evidence, aside from personal anecdotes. Making claims like those you have above, in this context, is irresponsible.

  37. #37 squirrelelite
    September 15, 2010

    @Lizditx 24,

    Thanks for maintaining your list of cross-references.

    The Sept 13 thread on Science Based Pharmacy is a hoot!
    Especially, one commenter named childhealthsafety.

    Sullivan points out:

    As is clearly pointed out above, it doesn’t matter if the (failed) poor excretor hypothesis were true.

    If it were true, there would be a higher prevalence of autism amongst for children with the same exposure to mercury.

    I know this will sound harsh, but you need to understand what a confounding factor is. Your use of the term is clearly in error.

    and childhealthsafety says:

    There is. The autistic group has a higher prevalence of autistic conditions than the controls.

    Well, duh!
    ROTFL

  38. #38 bluedevilRA
    September 15, 2010

    daedalus, I think we both agree on the meaninglessness of anecdotes. They are the absolute lowest form of observation and really cannot be counted as evidence.

    Regarding NO, it is true that I am relying upon experts in biochemistry and cell physiology for my knowledge. In medical school, we don’t exactly carry out experiments ourselves. However, your theory would clash against what is mainstream thinking about NO. Smooth muscle cells vasodilate in response to NO. Inorganic nitrates are believed to be converted to NO in the body because they clearly result in vasodilation through this pathway.

    So how exactly would NO be administered without causing vasodilation? Or is that part of your mechanism for symptom improvement? Furthermore, my description of your theory as woo-like is based on you proposing it for pretty much every vaguely described, spectrum disorder.

  39. #39 Orange Lantern
    September 15, 2010

    Indeed, Todd, you may be on to something. I have yet to meet an autistic child who has not been exposed to dihydrogen monoxide.

    Could that be the missing variable in the formula?

    Birth + dihydrogen monoxide – rhubarb = autism?

    Not quite right… should I divide by NO?

  40. #40 Scott
    September 15, 2010

    @ bluedevilIRA:

    Ultimately, he’s just got a hypothesis. One which is exceedingly unlikely to be true to the extent claimed. Then he complains that he can’t get anybody to pay attention, but presents it as proven fact anyway.

    That turned out to be the summary last time daedalus and I went around on how crankish the NO fixation is, at least.

  41. #41 Liz Ditz
    September 15, 2010

    the following is my absolute favorite post on Price et al., from a Hollywood gossip magazine:

    Jenny McCarthy — Childhood Vaccines DO NOT Cause Autism! It’s Time for You to Renounce Your Claim. Children’s Lives Are at Stake!

    http://www.hollywoodlife.com/2010/09/14/bonnie-says-jenny-mccarthy-childhood-vaccines-autism/#comments

  42. #42 daedalus2u
    September 15, 2010

    No, we do not agree. Anecdotes are not “meaningless”. If you don’t have the expertise to evaluate an anecdote, then yes, you should not attempt to do so. You should leave such evaluation to those who do have the expertise to evaluate them. They are data of very low statistical power. That statistical power is not zero. It is certainly not negative.

    NO/NOx levels are under active control. Perturbing them artificially is exceedingly difficult because physiology responds. Inhaled NO has essentially no effect on vascular tone but it does reduce pulmonary hypertension. The reason is because the inhaled NO is destroyed in the lung. It never gets outside the lung as NO.

    What is “irresponsible” about factually talking about NO on a blog? Am I selling NO treatments? Am I telling people to not do what their doctors tell them? Am I suggesting abandoning any known effective treatments for the treatments I am not selling? Have I said anything that you can show to be false?

    In science, nothing can be proven correct. It can only be proven incorrect and then only with data. If you have some data that shows what I am saying about NO is incorrect, I would be very happy to know what that data is. I would like actual citations, not stuff you half remember from school years ago.

  43. #43 Scott
    September 15, 2010

    @ daedalus:

    What I think he’s complaining about (and I agree) is that you consistently present these NO ideas in terms which imply they are proven (to the extent anything can be in science) rather than speculative without strong supporting data.

    For example,

    CFS and autism do have the same cause, low nitric oxide. You only get autism from low nitric oxide in utero, you only get CFS after you are born.

    This is presented as a factual statement. It is NOT presented as an interesting idea, with some weak data (i.e. the mentioned anecdotes) supporting it. This sort of language could only be justified with very solid data supporting it – e.g. the aforementioned clinical trials.

  44. #44 EK
    September 15, 2010

    daedalus – you stated:

    “CFS and autism do have the same cause, low nitric oxide. You only get autism from low nitric oxide in utero, you only get CFS after you are born.”

    you back up these claims by referencing personal anecdotes and biological plausibility, and then admit that both are are untested (but you don’t think this is a prerequisite for making said claims, or defending them as factually accurate). I take this to say that you either disagree entirely with the standards of evidence promoted on this site (and elsewhere), or just think that they ought not to apply in your particular case.

  45. #45 Happy Camper
    September 15, 2010

    Just in! Another child dead from pertussis in California and yet nothing from Jay.

    http://latimesblogs.latimes.com/lanow/2010/09/ninth-infant-confirmed-dead-from-whooping-cough-in-state-epidemic.html

  46. #46 bluedevilRA
    September 15, 2010

    @daed, do I detect some condescension there? Just because I questioned your theory is not grounds for responding with rudeness. Anecdotes are not data. They cannot be analyzed in a statistical fashion because they are not collected in such a manner. As evidence, they are meaningless.

    They can be useful for prospective purposes. Obviously many scientific discoveries have come from scientists observing something anecdotally and then studying that phenomenon to prove it. You are at this first stage and no where near the last stage. I am not saying you are not on to anything, though I find the broadness of its potential to be unlikely. I am trying to keep an open mind, but I also don’t want my brain to fall out as they say.

    So enough quibbling, back to my original point. How are nitrates not a good delivery of NO? The mechanism clearly seems to be mediated by NO, so why not use this as a delivery?

    Scott summarized nicely. My criticism of it being woo-like (in addition to the cure-all of non-specific spectrum disorders) is based on the fact that the conclusion has been made on your end without the evidence to back it up. The burden of evidence is on you because you are making the claims. I accept the much larger body of evidence to suggest that NO is a potent vasodilator as delivered by various means. It has many uses in medicine but I have yet to see evidence of it being useful for ASD/CFS/ete.

  47. #47 jen
    September 15, 2010

    ANonnyMoose @18: Bummer… It must be a drag about that brain damage thing actually paying out for vaccine-damaged victims, eh?

  48. #48 John
    September 15, 2010

    Jen,

    @18 is complaining out the lies in the advertisement he quoted (the award was for vaccine damage, but not autism). I’m sure it’s a bummer for you that people notice those lies, but you can’t blame them for doing so. Me, I’m glad that the award was given – but it’s a shame that the few vaccine-damaged children must wait in line behind all the frauds to get the money they deserve, isn’t it?

  49. #49 gaiainc
    September 15, 2010

    jen, what in the heck are you talking about? What brain damage thing paying out for vaccine-damaged victims?

    And for the last fricking time, immunizations do have risks associated with them. The Vaccine Court has a whole fricking table of them for which they pay out. We all know this. We also all know that it is more dangerous to get into your car and drive some place than it is is get an immunization. 33,000+ motor vehicle fatalities aka deaths last year in the US. Less than 5000 claims total filed with the Vaccine Court since the mid-1980’s of which not all were paid out.

    Gah!

  50. #50 ebohlman
    September 15, 2010

    Guess who’s now writing for AoA? Yep, it’s Barbara Loe Fisher, doing a hit piece on Amy Wallace.

  51. #51 squirrelelite
    September 15, 2010

    So her hot new topic is the lawsuit she filed last November and which was dismissed in March ?!?!?

    Or, is she warming up for this Thanksgiving’s character assassination cartoon when she states about Amy Wallace:

    She, Offit and Wired magazine have feasted on the shattered lives of vaccine injured children and their parents to sell magazines.

    Or, perhaps she just got around to reading Amy Wallace’s recounting of the story from August.

    http://www.amy-wallace.com/2010/08/31/reporting-on-health-covering-vaccines/#more-514

  52. #52 daedalus2u
    September 15, 2010

    Scott, when you say a hypothesis is exceedingly unlikely to be true, what is your basis for that? Do you know of some data that contradicts it? That is the standard for prior plausibility. A hypothesis does not have a low prior plausibility if it is consistent with all prior data. No correct idea ever has a low prior plausibility. People may erroneously believe that a correct idea has a low prior plausibility. That is a mistake on the part of the people who erroneously believe the correct idea has low prior plausibility. Many people thought special relativity had a low prior plausibility. Lord Kelvin was on record saying that heavier than air flight was impossible. Lord Kelvin didn’t have a scientific basis for his belief that heavier than air flight was impossible because it isn’t.

    If you know of no data that contradicts a hypothesis, you can have no “scientific” judgment as to the prior plausibility of that hypothesis.

    You are asking for data like the anti-vax people are asking for, a vaccine/no vaccine trial. Such a trial has not been done and can’t be done because it is unethical and won’t be done no matter how much they whine about wanting one and needing one “to be sure”.

    Autism is (mostly) due to differential neurodevelopment in utero. Doing a low-NO/high-NO trial of pregnant women would be highly unethical. It won’t be done prospectively because it is highly unethical. There is no animal model of autism.

    All science is “only” a hypothesis, no matter how strongly stated. I think that anyone who knew as much about NO as I do would come to exactly the same conclusions. I don’t attribute special magic powers to myself, but I have read a great deal of the NO literature, many thousands of papers. That is thousands. I have probably read a thousand papers on autism. CFS, not so many, only hundreds. So how much have you read about those things? How much of the literature is inconsistent with a low-NO hypothesis? Since I have read the literature and you haven’t, you can’t have an informed opinion as to how much of the data in the literature is inconsistent with the low-NO hypothesis of CFS or of autism.

    I have written a great deal about autism which is on my blog, which you have not read and understood and are not prepared to discuss. I linked to my blog write-up on CFS, which you haven’t read and understood either.

    There are no shortcuts in science. You either understand it, or you don’t. If you don’t understand it, then you can’t have a scientific opinion about it. You may have a non-scientific opinion, or a pseudoscience opinion, but you can’t have an opinion based on facts and logic if you don’t have the facts. Non-scientific opinions are not what are called “hypotheses”. They are called guesses.

    My snarkyness is because I want to have a discussion based on the facts, and no one here wants to bother learning what those facts are. They want to play “gotcha” by putting up an impossible standard goalpost, just like the anti-vax crowd. They want a PhD in NO physiology from google-U in a half hour. I am more than ready to meet people more than half way, even 99% of the way. It takes 10,000 hours to become expert in something. You could easily read my entire blog in 100 hours, but you don’t want to do that.

    You want to judge the truth value of my statement by the tone with which I state it? Please, have a little self-respect.

  53. #53 EK
    September 15, 2010

    daedalus – I at least am not stating that your hypothesis is implausible. I am stating that there is no empirical support for the claims that you make, which you admit, and which I’d conclude is a problem. The bickering over prior plausibility, I think, is irrelevant.

  54. #54 daedalus2u
    September 15, 2010

    EK, no. You have defined “empirical evidence” to be a clinical trial of a certain type. That is the same definition that the anti-vax people are using when they say there is no “empirical evidence” that vaccines do not cause autism because there is no vaccinated/unvaccinated clinical trial.

    That is not what “empirical evidence” means. Empirical evidence is data. There is plenty of data that supports a low-NO hypothesis of autism. The male excess supports a low-NO hypothesis because higher NO is associated with estrogen and lower NO is associated with testosterone.

    That there is a higher incidence of autism in males is empirical data
    That there is higher NO levels in females due to estrogen is empirical data
    That there is lower NO in males due to testosterone is empirical data.

    A combination of empirical data is also empirical data.

    There is empirical data that low NO causes autism.

    Everything that is known about the physiology of autism supports the low-NO hypothesis. When you combine many pieces of empirical data using Bayesian statistics, and all of them are in one direction, the final plausibility can be very high, or rather the probability that low NO is not associated with autism becomes very low.

  55. #55 EK
    September 15, 2010

    daedalus – I think that you have redefined “empirical evidence” to mean something more akin to “prior plausibility,” and I think that there is a reason the two are usually distinguished, so I’m not sure how to respond. The ‘anti-vaxers,’ etc., are also making strong claims lacking empirical evidence, based on lots of thinking, pattern-finding, and terribly convincing personal anecdotes. I don’t know why you are using this analogy, but I’m not sure that your approach isn’t more comparable to theirs (though I’d grant that your hypothesis is probably far more plausible, and maybe worth exploring).

    Your hypothesis has not been tested. Period. I think this is not a good basis on which to make the types of claims you’ve made above.

  56. #56 Drivebyposter
    September 15, 2010

    Where is Dr. Jay. I haven’t seen him around for a while. Maybe I just haven’t been looking in the right comments sections though.

  57. #57 a-non
    September 15, 2010

    20+ posts about the virtues (or lack thereof) of nitric oxide? Holy comment thread hijacking, Batman!

  58. #58 Orange Lantern
    September 16, 2010

    Eh, the trolls seem to have quieted down as of late. You should have been here for the rhubarb thread.

    Wouldn’t it be nice if an antivaxer would actually critique the study with intellectual honesty and engage in insightful debate? Pipe dream…

  59. #59 EK
    September 16, 2010

    oops – sorry..

  60. #60 Chris
    September 16, 2010

    Orange Lantern, you should go by Skeptic Blog where Paul King has laid out his objections to the study. He did get upset that some of us (cough… cough…me) asked for documentation backing up his contention. I have since found out that he is part of a group (Geier) that have a novel form of biomedical treatment (chemical castration).

    Plus, there the Dynamic Duo (John Stone and Clifford Miller) from the oddly named “childhealthsafety” blog are putting amusing comments on at the Science Based Pharmacy

  61. #61 DLC
    September 16, 2010

    So.. This far we’ve come and no mercury-autism link, no vaccine-autism link. It’s a dead hypothesis.
    It’s pushing up the daisies.
    it’s rung down the curtain and joined the choir invisible!
    it is an Ex -Idea.
    The Mercury-Autism link hypothesis wouldn’t voom if you put 20,000 volts through it!

    and any moment now the crowd of Antivax Vikings will dash in and start singing.

  62. #62 Lawrence
    September 16, 2010

    @daed – You are interpreting data in the way that you want it be interpreted. Until there are controlled studies done, your hypothesis is no better or no worse than any other hypothesis out there (neither proven or unproven – it just exists).

    As such, I can intepret the data to be that unicorns exist, but they are invisible, because no one can see them. So, prove to me that unicorns don’t exist.

  63. #63 daedalus2u
    September 16, 2010

    EK, again, no. Empirical evidence is data. You are asking for and only accepting data of a narrow and specific type, a prospective clinical trial. The presence or absence of specific data of a certain type does not affect the truth value of a statement. The statement is true or not independent of what ever data there may be.

    A hypothesis is “tested” and “confirmed” when the hypothesis makes predictions and when those predictions are not falsified by data. The low-NO hypothesis of autism predicts that autism will be associated with insomnia, increased sensitivity to stress, disruptions in social pathways, decreased levels of certain brain metabolites. These predictions are born out in the literature. How is that not “confirmation” of the hypothesis?

    If you knew the literature on the physiology of mercury and autism, you would know that the anti-mercury people are cherry-picking that literature to produce their disingenuous “arguments” that “mercury causes autism.” They are ignoring vast sections of the literature that would have to be wrong for the “mercury causes autism” idea to be correct. If the “mercury causes autism” idea was correct, then the data in many hundreds of papers on mercury physiology, dating back decades, would have to be wrong. Not the conclusions of those papers, but the data.

    If you knew the literature on the physiology of NO and autism, you would know that I am not cherry-picking that literature to produce my arguments. There is no data in the literature that has to be wrong for the low-NO hypothesis of autism to be correct.

    NO physiology is at least 4 or 5 orders of magnitude more complicated than mercury physiology. PubMed has 32,000 citations on mercury. Until it has at least 300,000,000 on NO physiology, I think our knowledge of mercury physiology will be more complete than our knowledge of NO physiology. So far there are only 100,000 citations on NO. We are a long way from having what I consider to be a good understanding of NO physiology.

    Until you know the NO literature, the only basis you have for evaluating the low-NO hypothesis of autism is a social reaction to the tone of how I articulate it. Because I am articulating it in a positive and confident tone, and you don’t know and understand the data that leads me to be so positive and confident, you consider that my tone is inappropriate and therefore that the idea is implausible and wrong. This is the arrogance of ignorance that Prometheus has written about.

  64. #64 colmcq
    September 16, 2010

    @deadalus 2

    hi

    Can you post any links to evidence that support your claims plz

    ta

  65. #65 bluedevilRA
    September 16, 2010

    Apologies to all for the thread hijacking. I did not anticipate such a protacted debate with daedalus. I thought he would just provide some citations, allow me to read the literature, and then we could all move on. I would still be skeptical because the hypothesis is largely unproven, but at least I would be aware of what he was talking about.

    Currently, however, daedalus is just arguing that he is the only person in the world with enough understanding of the NO pathway to be able to interpret the literature. Science is not furthered by claiming intellectual superiority over others. Most readers of RI have had some chemistry, biochemistry, etc and I think many of us are more than capable of reading a scientific paper. Show us some of these papers then. You still have not explained (with evidence) how nitrates taken by heart patients result in vasodilation and how this is different from your proposed ideas.

    Furthermore, your description of austim (insomnia, social disruption, sensitivity to stress, decreased brain metabolites) also fits the criteria for depression in many cases. Is depression another disorder that is caused by deficiency in NO? Your blog suggests that Alzheimer’s is also caused by a deficiency in NO. You then go on to say that a majority of the populace has a deficiency in NO. Really? What is the evidence for that? If this is truly the case, then you better to get work on that cure!

  66. #66 Scott
    September 16, 2010

    Scott, when you say a hypothesis is exceedingly unlikely to be true, what is your basis for that?

    My basis is the fact that you claim NO as the single cause and treatment for a dizzying array of conditions with no generally accepted connection between them. For one? Sure. Two? Less likely. The more claims you add to your hypothesis, the less likely they all are to be true. That’s all I’m saying.

    Do you know of some data that contradicts it? That is the standard for prior plausibility…

    No, that is the standard for concluding that a hypothesis is false. Prior probability is a lot squishier. The rest of this paragraph similarly misunderstands the entire idea.

    You are asking for data like the anti-vax people are asking for, a vaccine/no vaccine trial. Such a trial has not been done and can’t be done because it is unethical and won’t be done no matter how much they whine about wanting one and needing one “to be sure”.

    No, actually we’re not demanding such data in order to not rule out your ideas. We’re demanding it before you can present it as proven fact.

    How much of the literature is inconsistent with a low-NO hypothesis? Since I have read the literature and you haven’t, you can’t have an informed opinion as to how much of the data in the literature is inconsistent with the low-NO hypothesis of CFS or of autism.

    “Nothing in the literature is inconsistent” just means that the hypothesis cannot be ruled out. Which I’m not claiming. It doesn’t begin to rise to the level required to make the sorts of statements you’ve made – that calls for direct testing of the hypothesis.

    I have written a great deal about autism which is on my blog, which you have not read and understood and are not prepared to discuss. I linked to my blog write-up on CFS, which you haven’t read and understood either.

    Read, understood, doesn’t rise to the level of evidence necessary to support the claims.

    There are no shortcuts in science.

    And yet, you’re trying to skip over the entire process of testing hypotheses before concluding they are correct. ALL serious hypotheses are consistent with the literature. If not, they would already be ruled out.

    What you have is the absolute minimum to even call it a hypothesis. Once you’ve confirmed that there’s nothing in the current literature refuting it, you MUST then go on to test NEW predictions that have not yet been tested. That is the ONLY way to distinguish between all the myriad hypothesis in play, since they are ALL consistent with the existing body of literature.

    That there is a higher incidence of autism in males is empirical data
    That there is higher NO levels in females due to estrogen is empirical data
    That there is lower NO in males due to testosterone is empirical data.

    A combination of empirical data is also empirical data.

    There is empirical data that low NO causes autism.

    This is not a valid argument. Empirical data that low NO is associated with autism, sure. But “causes”? When you went through something with as many associations as gender to get there? No way in the world you can make that claim.

  67. #67 Sauceress
    September 16, 2010

    #51

    She, Offit and Wired magazine have feasted on the shattered lives of vaccine injured children and their parents to sell magazines

    Bugger!! There goes my latest, supposedly indestructable, irony meter in a furious blaze of psychedelic warning lights and smoke.

    Time to revert back to the one-use-only throw away model methinks.

  68. #68 daedalus2u
    September 16, 2010

    “Deficiency” is not the right term. Low-NO is the right term. Yes, depression is also caused by low NO. The reason there are so many common symptoms between depression and autism is because they both share the final common pathway of low NO.

    What basis do you have for saying that my assertion that there is a common cause between Alzheimer’s and autism makes that assertion less likely to be correct? Other than your feeling that it is? If two disorders have common symptoms isn’t it more likely that the two disorders share common pathways that are causing those common symptoms?

    Shared common symptoms occur because of shared common pathways. All of the low NO disorders share common symptoms caused by that low NO. Each individual is different, so the details of the course of specific disorders in a specific individual depend on the details of the physiology of that individual, and there are a lot of details.

    Anything that causes low NO in utero will tend to shift the phenotype of the developing fetus more toward the autism end of the autism spectrum. The autism spectrum is not a line on which autism and autism-like symptoms show up as discrete points. It is poly-dimensional and rather complicated with arbitrary thresholds of “severity” according to the definition in the DSM. There are not one-to-one correspondences between the definitions of autism and autism-like and the effects produced by low NO.

    Autism is a consequence of neurodevelopment. Neurodevelopment is change in neuroanatomy over time. What the original neuroanatomy was, what environment that brain continues to develop in, and the NO status during that neurodevelopment determines in large part the course of that neurodevelopment. If the NO status is low, the individual will tend to develop more in an autism-type path, if the NO status is higher the individual will tend to develop more in a less autism-like path.

    I have lots of links and discussion on my blog, and really if you want to discuss this in any detail, that is where the discussion should be moved. If you don’t want to discuss it in detail, that is fine. The discussion is not going to be settled on the basis of rhetoric. Nothing in science ever is.

  69. #69 Scott
    September 16, 2010

    What basis do you have for saying that my assertion that there is a common cause between Alzheimer’s and autism makes that assertion less likely to be correct? Other than your feeling that it is? If two disorders have common symptoms isn’t it more likely that the two disorders share common pathways that are causing those common symptoms?

    Basic probability. There is some chance that low NO causes Alzhemiers. There is some chance that low NO causes autism. The probability that it causes both is lower than either alone. The probability that it causes them and depression too is similarly lower than the probability that it causes both Alzheimers and autism. Et cetera.

    The discussion is not going to be settled on the basis of rhetoric. Nothing in science ever is.

    And yet you declare that it is fact without doing the science necessary to demonstrate that. Sure sounds like trying to settle it based on rhetoric to me.

  70. #70 Prometheus
    September 16, 2010

    Seventy comments and still no response from “Dr. Jay”. Amazing!

    Orac, you must be using the wrong bait; “Dr. Jay” usually rises to studies showing that vaccines don’t cause autism the way a trout rises to a fly. Have you considered switching to a black midge or caddis?

    Or maybe “Dr. Jay” is busy formulating his next foot-in-mouth defense of the indefensible?

    Don’t know, don’t care – I’m just enjoying the (relative)peace and sanity his absence brings. “Dr. Jay” is one of those people who, when they leave a conversation, makes it feel as though someone rational has just arrived.

    Prometheus

  71. #71 MI Dawn
    September 16, 2010

    But, but, but, Prometheus. Dr Jay is a busy, busy, busy doctor! He doesn’t have time to comment because he’s too busy caring for his very healthy, organically fed, breastfed, never vaccinated patients. How mean can you be? Leave Jay alone! (runs off sobbing)

    /snark

    Ow. That made my brain hurt. Personally, I’ve been rather amused that the usual trolls on all the threads haven’t had much to say. Wonder why? Maybe they are trying to find out everyone on the paper who has ebil Big Pharma connections of any kind (Jake seems to be really good at that, maybe they’ll give that job to him).

  72. #72 Lawrence
    September 16, 2010

    Actually, we’ve been almost troll-free for a week now (knock on wood). Must be some kind of woo-vacation or holiday.

  73. #73 Chris
    September 16, 2010

    Lawrence, have you seen the homeopathy threads? It has metastized over to Dr. Novella’s blog.

  74. #74 PharmacistScott
    September 16, 2010

    If you want to argue about what epidemiology is or isn’t, and what the Price trial does or does not say, the battle is on in the comments over at Science-Based Pharmacy.

    http://sciencebasedpharmacy.wordpress.com/2010/09/13/more-evidence-that-mercury-in-vaccines-doesnt-cause-autism/

  75. #75 daedalus2u
    September 16, 2010

    I thought of another example, what is the empirical evidence for evolution? Is there any direct empirical evidence for evolution? I don’t think there is except maybe in bacteria. But evolution among the most, if not the most certain hypothesis in science. The example of direct evolution of E coli is a very minor part of the data that supports evolution. The theory of evolution was “fact” long before that research was done.

    I subscribe to the Stephen Jay Gould definition of “fact”.

    In science, “fact” can only mean “confirmed to such a degree that it would be perverse to withhold provisional assent.” I suppose that apples might start to rise tomorrow, but the possibility does not merit equal time in physics classrooms. Stephen Jay Gould.

    I appreciate that people who do not share my knowledge base will not necessarily share the conclusions that knowledge base makes perverse to withhold provisional assent on.

  76. #76 Science Mom
    September 16, 2010

    If you want to argue about what epidemiology is or isn’t, and what the Price trial does or does not say, the battle is on in the comments over at Science-Based Pharmacy.

    OMH, if I hadn’t seen John Stone around, I would swear that was a Poe. I don’t know how anyone could possibly be that thick and confused and still manage to type.

  77. #77 jenbphillips
    September 16, 2010

    Is there any direct empirical evidence for evolution? I don’t think there is except maybe in bacteria.

    *facepalm*

  78. #78 dt
    September 16, 2010

    I wonder why Dr Jay is so busy.
    His patients are so healthy they don’t need visits. And they don’t get vaccines. So what the hell does he do that means he can’t come here, right now dammit!

  79. #79 Drivebyposter
    September 17, 2010

    Maybe Dr. Jay is practicing his slam dunk from the free throw line.


    I apologize to the Erving family for that joke

  80. #80 colmcq
    September 17, 2010

    the science based pharmacy thread is hillarious

  81. #81 Chris
    September 17, 2010

    Yes, the Miller/Stone tag team of insanity is always amusing.

  82. #82 Orac's Wackosphere
    September 19, 2010

    So, Orac, now you have to resort to begging people (like Dr. Gordon) to comment on your blog? Desperate much?

  83. #83 Chris
    September 19, 2010

    OW, How exactly can “Finally, I wonder what happened to our old friend Dr. Jay Gordon.” be considered begging?

    Would you like us to teach you how to use a dictionary?

  84. #84 T. Bruce McNeely
    September 20, 2010

    Wacko:

    The word you are looking for regarding Dr. Gordon is “challenge”, something he has not risen to.

    With 81 comments in 3 days, I don’t think there’s any need to “beg” for comments.

  85. #85 Calli Arcale
    September 20, 2010

    daedalus2u @ 75:

    I thought of another example, what is the empirical evidence for evolution? Is there any direct empirical evidence for evolution?

    There is plenty of empirical evidence beyond bacteria, though indeed, none of it is of the “some guy in a lab watching an animal turn into some other animal” variety that Creationists seem to expect. The timescales are wrong for that, and anyway, it’s a misunderstanding of the whole concept.

    The evidence that was used to convince people of evolution before DNA was discovered included existing knowledge of animal and plant husbandry, Mendel’s experimental observations of heritable traits, and a few new fields of research: taxonomy, embryology, and paleonotology. The influence of taxonomy is important; in the Victorian period, there was an explosion in cataloging, and a constant race to find more things and determine where they fit in the overall picture. This fits beautifully in with evolution, of course, but you can make a taxonomy fit anything if you’re creative enough. No, the key wasn’t taxonomy itself but the explosion it drove in obsessively detailed observations of various living creatures, which created a large dataset in which to observe common traits. Darwin’s finches on the Galapagos often get the credit, but one could as easily credit the barnacles that he spent so many years studying.

    None of these things prove evolution, in and of themselves, any more than the phases of Venus prove heliocentrism. But they are all important pieces of the puzzle, and they are empirical data.

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