I was originally going to write about Dr. Oz’s show yesterday, entitled What Causes Autism? But then I started watching and realized that I just didn’t have the constitutional fortitude to sit through the whole thing. Sorry to let you down, but there are some blogging tasks that I just can’t handle, at least on some days, particularly Dr. Oz’s faux outrage at one point. Last night was just one of those days. I was too tired and just not in the mood. Maybe I’ll do it later. In the meantime, I’m going to do something that I don’t do very often, namely use a new post to answer a comment. The reason I choose to do so is because I think that comment reveals such a fundamental misunderstanding of science so profound that I think it’s worth commenting on.

Remember our old friend Dr. Jay Gordon, pediatrician to the stars’ children, in particular Evan, Jenny McCarthy’s child? I’ve butted heads on this blog with “Dr. Jay” on and off since 2005. The reason, as regular readers of this blog know, is because Dr. Jay is an apologist for the anti-vaccine movement. Worse, he has allowed himself to be co-opted time and time again by anti-vaccine activists. In particular, he’s one of the handful of go-to pediatricians that reporters can count upon to spread fear, uncertainty, and doubt (FUD) about vaccines, thus providing them with juicy anti-vaccine quotes. And spread FUD he does, with gusto. Over the years, both here and by e-mail, I’ve had exchanges with Dr. Jay in which he repeatedly asserts that his 30+ years of “clinical experience” that have led him to think that vaccines cause regressive autism trumps the numerous epidemiological studies that have not only failed to find the link but failed spectacularly, to the point where we can conclude that vaccines almost certainly have nothing to do with autism. Over time, I (and you, my dear readers) have tried and tried again to educate Dr. Jay, to no avail. No matter how many times we try to explain the concepts of confirmation bias and that correlation does not necessarily imply causation, it all seems to fall on deaf ears.

Yesterday, it was falling on deaf ears yet again. Dr. Jay’s been sparring with some of my readers in the comments of a post from two days ago in which I had some fun dismantling a self-congratulatory anti-vaccine rant by Dr. Suzanne Humphries. In the course of this sparring, he’s been laying down a lot of the classic Dr. Jay nonsense that we’ve come to know and love over the past six years. Then, 201 comments in, I saw this:

No, I do not contribute a lot of “science” to these discussions as you define that word because we disagree about the definition. Science is not a monolithic entity consisting only of double blind randomized control research. It can also consist of the aggregated wisdom and experience of researchers, doctors and others. I add what I can and listen closely to your responses. The time I’ve spent at RI has changed the way I look at vaccines, autism, epidemiology and science in general. It may not be noticeable to some of you but it’s true nonetheless. I’m going to let you in on a secret while throwing you more red meat: You could learn as much from me as I learn from you.

What, I wonder, could I possibly learn from Dr. Jay? How to toss aside science in favor of crunchy, touchy-feely reliance on “personal clinical experience”? Perhaps? How to cater to rich Hollywood stars whose arrogance of ignorance lead them to come to conclude that the University of Google will teach them all they need to know about vaccines to the point that the value of their opinions regarding the risk-benefit ratio of vaccines are equal to that of the conclusions of scientists and physicians who have dedicated their entire careers to studying vaccines and/or autism? Come to think of it, Dr. Jay seems to think that his “personal clinical experience” trumps the conclusions of scientists and physicians who have dedicated their entire careers to studying vaccines and/or autism!

Besides, Dr. Jay’s attacking a straw man version of science commonly used by those who favor the pseudoscience of alternative medicine and/or anti-vaccine beliefs, namely that medical science is only double-blind randomized clinical trials (RCTs). True, RCTs are considered the highest form of clinical evidence, but science is far more than RCTs. Science includes the entire spectrum, all the way from investigations of biochemical reactions, to animal studies, to clinical trials of varying degrees of rigor, to huge epidemiological studies. When coming to conclusions, scientists try to synthesize all of that evidence, particularly the more recent, highest quality evidence together systematically. Science is also not a word, as Humpty Dumpty would put it, that “means just what I choose it to mean–neither more nor less.” Or what Dr. Jay chooses it to mean. Science actually has a definition, and, while philosophers of science might disagree on many of the details, there is broad agreement that science is a method that seeks to develop principles and theories about how nature works that are reproducible, informative, and predictive. It is not, as Dr. Jay asserts, the “aggregated wisdom and experience of researchers, doctors, and others.”

After all, “experience” and “wisdom” can profoundly mislead. Why have so many people thought for so long that homeopathy “works,” that it is anything more than water? It’s because “personal clinical experience” can make it appear that homeopathy works, thanks to the normal human cognitive shortcomings that lead us to easily confuse correlation with causation and mistake regression to the mean for an effect due to treatment. It’s the same sort of “experience” and “wisdom” that led physicians for centuries, all just as confident as Dr. Jay, to believe that bloodletting could help or even cure a large number of ailments. “Personal clinical experience” is what misleads practitioners into believing that reiki works, even though reiki is nothing more than faith healing that substitutes Eastern mystical beliefs in a “universal energy source” for the Christian god as its basis. “Personal clinical experience” is what led Dr. Jay to mistakenly believe that vaccines cause autism and a large number of other problems.

Dr. Jay also has another fundamental misunderstanding of science:

Medicine changes. HRT, statin therapy, surgical techniques and efficacy and more. Someday we’ll view our current vaccine schedule the way Dr. Halsey and others taught us to view the use of thimerosal as a preservative: Not the safest way to do things.

Translation: They thought me mad–mad, I tell you! But I’ll show them! I’ll show them I was right! They’ll see. They’ll see I wasn’t mad!

Yes, medicine does change. It changes in response to new science, new evidence, new clinical trials. The process is messy, and it often takes longer than one might wish, but change does come in response to new evidence. But that’s the key. Change in medical practice is driven by scientific evidence. What drove changes in the use of HRT? Evidence that HRT could increase the risk of breast cancer and appears not to decrease the risk of heart disease. What has driven changes in statin therapy? Evidence. What has driven changes in surgical technique? Evidence. Well, evidence and technology. Dr. Jay has no evidence to support his anti-vaccine apologia; he simply asserts that, because medicine changes, someday scientists will reject the current vaccine schedule as being unsafe. it’s a prediction made based on nothing more than Dr. Jay’s personal opinion and his fervent wish. Particularly telling is this exchange, in which Dangerous Bacon asks:

Which one of those cited examples (or changes in any other facet of medicine) came about because of anecdotes and Internet-fueled fears in direct opposition to scientific evidence, Jay?

Jay responds:

Initially, Bacon, all of them. “Scientific evidence” can fall apart under greater scrutiny.

Dr. Jay’s said some really silly things, but that has to rank right up there. Dr. Jay seems to think that scientific evidence falls apart under “greater scrutiny” from conspiracy mongers on the Internet. This is, of course, utter nonsense. The “scrutiny” that comes from Internet conspiracy mongers tends to be the “scrutiny” that creationists apply to evolution, that anthropogenic global warming denialists apply to AGW, that HIV/AIDS denialists apply to HIV science.

Or the “scrutiny” that anti-vaccine activists apply to vaccine science on the Internet.

But, hey, despite his utter cluelessness with regard to science and science-based medicine, I still feel in a benevolent mood, so I’ll ask Jay (and I know he’ll be reading sooner or later):

  • What specific scientific evidence do you have to support your claim that the current vaccine schedule is unsafe?
  • What specific scientific evidence do you have to support your claim that vaccines cause autism?
  • What specific scientific evidence do you have to support your claim that vaccines cause asthma and all the other problems that you attribute to them?

Inquiring minds want to know!

Actually, it’s truly depressing to see a fellow physician who so misunderstands science, who relies on anecdotes and personal feelings rather than scientific evidence, and who defends dangerous pseudoscience like that of the anti-vaccine movement. I’ve tried for well over five years, but apparently I’ve failed. Some people just aren’t reachable.

Comments

  1. #1 lilady
    February 25, 2011

    Here’s my positive vote for Kristen’s honesty (and integrity and competence as a mother).

  2. #2 Matthew Cline
    February 25, 2011

    @Jay Gordon:

    I posted a link to an excellent article. Terbutaline for PTL used to be standard of care based on “scientific” studies. Now, it’s wrong.

    By the scare quotes, do you mean to imply that the original studies were somehow flawed, and terbutaline would never have become the standard for care if the studies had been done right?

    Also, regarding the two mothers commenting here whose breastfed children were still hospitalized by the rotavirus: do you consider them to be statistical outliers (“the exception which proves the rule”), or do you think there’s some reason that their breastfeeding wasn’t sufficient?

  3. #3 Jay Gordon, MD, FAAP
    February 25, 2011

    The quote marks around scientific are my feeble attempt at humor. The studies supporting the use of terbutaline were probably well done enough, and may have suffered from the “decline effect.”

    It’s highly unusual for a healthy breastfeeding child to be hospitalized in my practice. I’ve thought harder about it and I think I have actually had a couple kids admitted for diarrhea and dehydration over the past ten years who tested positive for diarrhea.. The numbers below indicate tens of thousands but there’s no data in the first article for BF vs formula fed babies. I have articles which show the benefit of BF but don’t want this held for multiple links. Maybe using the word “dot” in the second and third articles will work.

    http://www.idsociety.org/Content.aspx?id=16604

    http://www dot ncbi.nlm.nih.gov/pubmed/17133157

    http://www.nfid.org/publications/pediatric_archive/rotavirus dot html

    Jay

  4. #4 DrDuran
    February 25, 2011

    Terbutaline for PTL used to be standard of care based on “scientific” studies. Now, it’s wrong.

    Yes, but they were proved wrong by scientific studies, not by some asshole who thinks he what he knows trumps all.

  5. #5 Dedj
    February 25, 2011

    “I’m terribly sorry you had to go through that frightening experience and even sorrier that I was insensitive enough to argue with you about it. ”

    You didn’t just argue with her, but made an entirely unsupported accusation of dishonesty.

    You, sir, have a very peculiar way of being ‘civil’.

  6. #6 Pablo
    February 25, 2011

    I think it might be wise for jay to go hide under a rock for a while. This whole thread originates from the premise that he is clueless, and as time carried on, instead of disavowing anyone from that notion, he only served to reinforce it. Of course, not satisfied with being a clueless git, he then had to go on to show hmself to be a senseless dick.

    Sometimes it is wise to step away, and hope that when you come back, people will overlook your past indescretions. In this case, it is so aggregious that I wouldn’t count on it, but it’s better than sticking around and pouring gas on the flames.

  7. #7 Kristen
    February 25, 2011

    Dr. Jay,

    I could be wrong, but that read like the most insincere and condescending apology I have ever seen. My apologies if you weren’t being disingenuous, but it seemed a little forced.
    What you have said has not upset me in the least, actually. What a person says is a testament to that ones character IMHO.

    If you have a reason to disbelieve my story please share it, I really want to know if I am wrong-it is important to me to be accurate.

    Han, Composer99, SC, lilady, Dedj, Chris and so many others,

    Thank You

    I try to be the first one to admit when I am wrong, especially here. I count it a privilege to converse with so many learned individuals. Due to the current complexity of my life it is highly unlikely that I would be able to hear diverse experts opine on things that fascinate me anywhere else (yay internet!). I have always been a slow learner, so my understanding of things is often incomplete but the commenters here point me in the right direction (nicely or not so nicely). I have always wanted to be a scientist, perhaps I will be someday, but for now this is enough.

    I appreciate you allowing me to share my experiences, I have had some extraordinary ones. It is my personality to give TMI (I make no apologies for that).*

    *Mushy, mushy comment, sorry. It has been a hard week and I get overly sentimental. I’m not looking for a pat on the back, just always tell what is on my mind. I don’t have much of an inner monologue. 😉

  8. #8 Denice Walter
    February 25, 2011

    @ John V., who says,”Pink Floyd goes out, autism comes in. You can’t explain that.”

    John, my dear, I believe that I *can* explain that:
    Pink Floyd , by constantly re-iterating the tragic fate of one Sid Barrett, whose mental illness reduced his nearly non-existent social skills to nought, enabled listeners to *cathartically* purge themselves of any self-isolating, repetitive, and non-communicative behaviors and, via a social network of fans, to discourage any such tendencies in their own offspring. When PF disbanded, the fans only had *old* material to play over and over, repetitiously and exclusively, in isolation. Thus, autism increased.

  9. #9 herr doktor bimler
    February 25, 2011

    Kristen, what you’re describing is not medically possible. […] Your child did not experience a 23% weight loss.

    Today I have learned that Dr Gordon believes in Listening to Parents and valuing their first-hand experiences, except for those times when he doesn’t.

  10. #10 Jay Gordon, MD, FAAP
    February 25, 2011

    You know, Kristen, the apology was sincere and in no way meant to be condescending.

    I will stay out of here for a while because the general tone gets so vicious, nasty, uncivil that
    I sometimes fall into the general rhythm and then feel terrible and wrong later. Again, I was wrong to doubt you, to lump you in with the rest of them and I am sorry.

    (DrDuran: “Yes, but they were proved wrong by scientific studies, not by some asshole who thinks he what he knows trumps all”)

    DrDuran, thanks for closing this on a nice high note.

    Jay

  11. #11 Drivebyposter
    February 25, 2011

    Today I have learned that Dr Gordon believes in Listening to Parents and valuing their first-hand experiences, except for those times when he doesn’t.

    Now now….everyone lay off of Dr. Jay.

    I’m sure he is sincere and honest and totally incapable of many things, one of which is condescension.
    And if his apology came across in such a manner, he is probably deeply grieved that you hate him so much to expect incivility from him.

  12. #12 drivebyposter
    February 25, 2011

    DrDuran, thanks for closing this on a nice high note.

    Jay

    Would be so much less ironic if you hadn’t said

    the general tone gets so vicious, nasty, uncivil…I was wrong to doubt you, to lump you in with the rest of them and I am sorry.

    [emphasis mine]

    Stop pretending that you aren’t a cunt, Jay.

  13. #13 Dedj
    February 25, 2011

    It’s so civil of Dr Jay to blame his dismissiveness and his baseless accusations on other people.

    Again.

    Dr Jay appears to have a profound misunderstanding of what civility is.

  14. #14 SC (Salty Current)
    February 25, 2011

    Hm. I actually think that Dr. Jay’s apology was sincere (don’t get me wrong – he’s shameless in many ways). It’s interesting that he equated an accusation of dishonesty with arguing. I think this is because he has a malformed idea of respect for parents in the context of his professional role.

    A pediatrician is supposed to be an expert in the medical care of children. That’s why parents entrust their children to pediatricians’ care, and it’s a heavy responsibility. It means listening to parents and children and appreciating their concerns, but it requires that your treatment and advice are based on the best available science, and that you make an effort to know about that and evaluate it as critically and fairly as you possibly can. It means being honest with yourself and with parents about the level of certainty of the science; and it means being able, including having the confidence in your expertise that can only come from an honest search for knowledge, to tell parents who honestly want the best for their children when their interpretations are wrong. Because you’re supposed to be an expert. They’re not. You’re not respecting people if they come to you and entrust your children to you because of your expertise and you don’t have or use it.

    Orac, you have given me an excellent weekend project. Thank you. (I may not succeed . . .)

    I hope you do.

  15. #15 DrDuran
    February 25, 2011

    Again.

    Dr Jay appears to have a profound misunderstanding of what civility is.

    Dr Jay seems to have a profound misunderstanding in general.

  16. #16 Anonymous
    February 25, 2011

    Dr Jay has M/U’s?! Maybe Kirstie Alley can explain Study Tech to him.
    http://www.lermanet.com/exit/mu_yawn.htm

  17. #17 Enkidu
    February 25, 2011

    Dr. Jay, the idea that breastfed babies NEVER get sick irkes the heck out of me. It’s over-promotion of small benefits that make moms like me cry small rivers when no milk comes out.

  18. #18 Matthew Cline
    February 25, 2011

    @Enkidu:

    Dr. Jay, the idea that breastfed babies NEVER get sick irkes the heck out of me.

    At least with regards to rotavirus, he’s probably not claiming that breastfed babies never get sick, but rather that breast-milk contains an anti-rotavirus protein:

    Human milk contains a 46 kDa mucin-associated glycoprotein, lactadherin, which binds specifically to rotavirus and inhibits its replication.

    Which isn’t to say that Gordon isn’t overselling the anti-rotavirus effectiveness of breast-milk.

  19. #19 lilady
    February 26, 2011

    Okay, now that we have all given Dr. Jay Gordon his just desserts about Rotavirus and Rotateq vaccine, can we move on?

    I’d like to move on to his “expert” on breastfeeding who writes about “Thrush identification and Treatment” on his website. I give Dr. Gordon high marks for pursuing certification as a lactation specialist, which certification is only available to licensed medical professionals. I question why he has chosen this particular person who has no medical knowledge (her BA and MA are in music..she’s pursuing a Ph.D in music education)…and she has a CBE (Certified Breast Feeding Educator) “certification”. Now trying to figure out what the heck is CBE certification is another “trip” on the internet. I found some information on this “certification” on the “Lacatation Consultant Services” website.

    Thrush (oral candidiasis albicams yeast infection) is a fairly common condition diagnosed in infants who are breast fed and formula fed. It can occur more frequently in infants and children who have taken courses of prescribed antibiotics recently. The first line of treatment is Nystatin and second line of treatment would be difulcam…for cases resistant to Nystatin drops in the mouth.

    According to Cheryl Taylor, BA, MA, CBE who manages the entire section on breastfeed on Dr. Gordon’s website,

    “Nystatin contains sugar to make it palatable, yeast feeds on sugar…”Difulcam (long harangue about possible side effects to mother and infant)… I prefer to begin with grapeseed extract as the first line of defense…Test have shown that GSE (grapeseed extract) is dramatically more effective than colloidal silver, iodine, tea tree oil and Clorox…

    I’m not a lawyer…but I question why this “mommy blogger” manages Dr. Gordon’s breastfeeding web pages. She is prescribing treatment for oral yeast infections, doesn’t that constitute a crime like practicing/prescribing treatment without a medical license?

  20. #20 A. Noyd
    February 26, 2011

    Jay Gordon (#412)

    I will stay out of here for a while because the general tone gets so vicious, nasty, uncivil that
    I sometimes fall into the general rhythm and then feel terrible and wrong later.

    Oh, sure, blame everyone else for you being a dickhole. If the environment here could so easily rub off on you, one would think you’d have developed a proper appreciation of science by now instead of clinging to misguided mimicry.

  21. #21 Militant Agnostic
    February 26, 2011

    Test have shown that GSE (grapeseed extract) is dramatically more effective than colloidal silver, iodine, tea tree oil and Clorox…

    Lilady wins the Silver Medal for the first sighting of colloidal silver quackery on Jay Gordon’s website.

  22. #22 Drivebyposter
    February 26, 2011

    Test have shown that GSE (grapeseed extract) is dramatically more effective than colloidal silver, iodine, tea tree oil and Clorox

    It’s nice that Jay’s site also implies that one can use bleach to cure thrush. That sounds like the FUN method.

  23. #23 lilady
    February 26, 2011

    I did some further internet research for citations (none were given by Cheryl Taylor BA MA CBE…doctor Gordon’s “expert” on breast feeding, diagnosing and treatment of oral candidiasis albicams) and keyed in the researcher who she cited “Dr. John Mainarich Bio Research Labs”. What came up was Livestrong.com. I visited the site to find all the research and products that contain the wonder drug GSE (grapeseed extract) along with references back to Jay Gordon’s website.

  24. #24 lilady
    February 26, 2011

    For reliable up-to-date information about “thrush” visit Healthy Children.org keying in “Thrush and Other Candida Infections”. Healthy Children.org is a site maintained by the American Academy of Pediatrics. I see nothing at this site that recommends any alternative medicine treatments such a grapeseed extract, etc.

    When I was in nursing school and did rotations in the hospital I saw many immunocompromised patients who had oral candidiasis albicams infections; treatment provided was via “swish and swallow” antifungal medications, as referenced in the article I cited.

    Further along in my career in public health we received reports of invasive candida albicams infections in immunocompromised (from cancer treatments and AIDs) children and adults…also addressed in the article.

    At the risk of incurring Dr. Gordon’s wrath and censure I will share my child’s experience with thrush. On her third birthday she awoke with a temperature of 103 F. and refused any fluids. She had a very reddened mouth and gums. She hadn’t had any recent antibiotics…in fact had never antibiotics prescribed for her. She had been weaned from the breast to the cup in early childhood and did not use a pacifier. I took her to an emergency room and because she didn’t have any tell-tale white spots in her oral cavity, was prescribed antibiotics. I finally reached her pediatrician the following day, when the white spots were apparent and she was put on Nystatin, which quickly cured her. Treatment recommendations from the AAP for childhood oral candidiasis albicams infection has not changed during the intervening thirty seven years.

  25. #25 Dangerous Bacon
    February 26, 2011

    “Lilady wins the Silver Medal for the first sighting of colloidal silver quackery on Jay Gordon’s website.”

    It’s worse than that, as noted here previously.

    Jay has an article up on his site (in the “alternative” treatments section on managing colds) in which it’s recommended that you give kids colloidal silver as an “immune system booster”.

    It’s bad enough that adults put themselves at risk of permanent skin discoloration and other serious side effects under the delusion that colloidal silves will work wonders for them, but to subject children to this is in my view unconscionable. From NCCAM’s website:

    “There is a lack of evidence for effectiveness and a risk for serious side effects from colloidal silver products. The FDA does not consider colloidal silver to be safe or effective for treating any disease or condition…Argyria (blue-gray skin discoloration from silver deposition) is permanent and cannot be treated or reversed. Other side effects from using colloidal silver products may include neurologic problems (such as seizures), kidney damage, stomach distress, headaches, fatigue, and skin irritation. Colloidal silver may interfere with the body’s absorption of some drugs”

    Variation in the amount of silver contained in supplements could also place children at heightened risk of side effects.

    Do any of these warnings about using colloidal silver appear on Jay’s website? I haven’t seen them.

    In addition, Jay describes treating ear infections with homeopathic remedies.

    “I like to put mullein/garlic oil in the ears hourly for a day or two and give pulsatilla 6X or 12C (homeopathic strength–the range I have given indicates homeopathic ignorance… but it works) or lachesis homeopathically hourly for two days.”

    His site also contains a denialist article blasting water flouridation as “a massive toxicological experiment”.

    Dr. Jay Gordon, Crank Magnet.

  26. #26 lilady
    February 26, 2011

    Orac, I posted about two hours ago regarding Nystatin; did this techie deficient lilady mess up…again?

    @ Dangerous Bacon: I cede my Silver Medal to you, for cruising Dr. Gordon’s website for other mention of colloidal silver and mullein/garlic oil. I prefer my garlic to be ingested in food recipes…garlic is a separate food group on my food pyramid.

  27. #27 Composer99
    February 26, 2011

    Dr Jay @402:

    Quote-mining. I’m not sure that word means what you think it means. I posted a link to an excellent article. Terbutaline for PTL used to be standard of care based on “scientific” studies. Now, it’s wrong.

    And from the evidence posted by the blogger you linked to, Dr Jay, that is no doubt the case. Neither Orac nor other serious commenters here will deny that standards of care change and evolve in response to new and updated scientific evidence – indeed, such a response is held up as one of the strengths of science-based medicine.

    However, where the quote-mining comes in is because you represented the article as just being about an old standard of care ‘biting the dust’ based on new evidence.

    However, another thrust of the article, ironically given your position on vaccines & autism, is summed up in this sentence, which I have cut & paste from it (although someone else already did upthread):

    The truth is (whether they are willing to admit it, or not) many OB/GYNs prescribe terbutaline because they want to do something/feel helpless/hope the mother will feel better because she is doing something/think maybe it reduces contractions so they will get less calls (it doesn’t). All of these are the wrong reasons to prescribe a medication.

    You (or anyone else) may feel free to correct me on this next point, but unless I am mistaken terbutaline is available by prescription only. So for a woman to be taking it, she needs a prescrition from an OB/GYN who is ignoring the scientific evidence in favour of their personal experience, patient expectations, anecdotes, and the like.

    This is analagous to a certain California pediatrician who persists in ignoring the scientific evidence regarding the etiology of ASDs and the safety/efficacy of vaccines in favour of his personal experience, patient expectations, anecdotes, and the like.

    In short, the article favours Orac’s position more than it does yours.

    I conclude that the accusation of quote-mining – or at least misrepresention of the blog post you linked to – stands.

    (Here is a re-link to the arcticle linked to by Dr Jay.)

  28. #28 lilady
    February 26, 2011

    I just visited the ACOG (American Congress of Obstetricians and Gynecologists)…the credentialing medical association for U.S. Obs/Gyns. On their front page is a link to the FDA Drug Safety site. On the FDA Drug Safety is “New Warning Against use of Terbutaline to Treat Preterm Labor” (February 17, 2011). It provides the scientific data about the drug and the history of the FDA issuing advisories about the “Off Label” use of the drug for preterm labor.

    As Orac and a number of posters have stated numerous times, “science” has been proven wrong….after further intensive scientific studies.

  29. #29 Lawrence
    February 27, 2011

    God forbid this woman walk into Jay’s practice –

    http://www.cnn.com/2011/HEALTH/02/26/measles.exposure/index.html?hpt=T2

  30. #30 lilady
    February 27, 2011

    There are presently four confirmed or suspected case of measles in Boston. The index case is a woman who works at the French Consulate there. (See Boston Globe Measles Cases February 26, 2011). Public health nurses have already set up clinics to provide immunizations. There isn’t any history of recent airplane travel that’s be reported by the Globe…yet.

  31. #31 LW
    February 27, 2011

    “God forbid this woman walk into Jay’s practice”

    Lawrence, are you kidding? This is the ideal opportunity for his patients to obtain natural immunity! It’s time for a measles party! And with any luck, they can trigger an outbreak and infect everyone around them who is not immune, whether unimmunized, too young to have been immunized, immunocompromised, or simply a vaccine failure. A win all around!

    Except for the possible deaths, grave complications, and permanent brain damage, of course.

  32. #32 Enkidu
    February 27, 2011

    @Matthew Cline: I was over-generalizing; I know in this case Dr Jay was specifically referring to rotavirus, but I’m sure if asked he’d be happy to list many other diseases breastfed babies never get.

    Also from his quote: “I do see rotavirus but in breastfeeding babies, in healthy families it rarely needs in-office care let alone inpatient care. And I never give the rotavirus vaccine. Again, breastfeeding babies do not need it.” I wonder if this means that Dr Jay does not see any formula-fed babies?

  33. #33 W. Kevin Vicklund
    February 27, 2011

    Quote-mining. I’m not sure that word means what you think it means. I posted a link to an excellent article. Terbutaline for PTL used to be standard of care based on “scientific” studies. Now, it’s wrong.

    And it turns out that it wasn’t science that was wrong, but rather our doc (jg) and his approach of using clinical experience. From the actual FDA press release:

    Terbutaline is FDA-approved to prevent and treat narrowing of the airways (bronchospasm) associated with asthma, bronchitis, and emphysema. The drug is used off-label for obstetric purposes, including treating preterm labor and treating uterine hyperstimulation. Terbutaline has also been used in an attempt to prevent recurrent preterm labor. There is no evidence, however, that use of terbutaline to prevent preterm labor improves infant outcomes. Serious adverse events, including maternal deaths, have been reported with such use in pregnant patients.

    Off-label use is based on clinical experience, jaygee’s favored method, not scientific studies. So what happened when they actually did do scientific studies for this usage?

    The decision to require a Boxed Warning and Contraindication is based on the FDA’s review of post-market safety reports of heart problems and even death associated with terbutaline use for obstetric indications, as well as data from medical literature documenting the lack of safety and effectiveness of terbutaline for preventing preterm labor, and animal data suggesting potential risks. Based on this information, the FDA concluded that the risk of serious adverse events outweighs any potential benefit to pregnant patients for either prolonged use of terbutaline injection beyond 48-72 hours or use of oral terbutaline for prevention or treatment of preterm labor.

    Had it gone through the normal route of clinical trials, it would probably never have made it past animal trials for this indication. Note that the studies do not call into question it’s FDA-approved use in asthma and the like, which were based on actual scientific studies.

    Seems your jig, doctor, was a little premature.

    [h/t lilady]

  34. #34 W. Kevin Vicklund
    February 27, 2011

    I have a comment in moderation limbo following up on lilady’s comment about ACOG, the FDA, and terbutaline. In essence, Doc JG is wrong about the standard of care being based on scientific studies, as off-label use is based on clinical experience. And it was scientific studies that showed that this clinical experience, the same clinical experience that the good doctor so heavily promotes, was wrong.

  35. #35 lilady
    February 27, 2011

    @ W. Kevin Vicklund: Right you are; I didn’t connect the dots properly regarding off-label versus licensed by the FDA for treatment…apologies.

    The FDA continual monitors how drugs are marketed by manufacturers and has “nailed” a number of them for direct to consumer advertising and information provided to doctors by drug reps about “off-label” usage. In recent years drug and medical device manufacturers have paid hundreds of millions dollars in fines.

  36. #36 Lawrence
    February 27, 2011

    Since they can track this outbreak back to Patient Zero – I wonder if any infected would be able to file a successful suite against that person?

  37. #37 lilady
    February 27, 2011

    Apparently France is playing “catch-up” due to major outbreaks of measles during the past two years. Measles only became a “mandatory notifiable disease” in 2005, thirty or more years behind the United States classifying measles as a “mandatory notifiable infectious disease”.

    An excellent report about measles outbreaks in France is available on the web at: “Spotlight on Measles 2010 Update on the Ongoing Measles Outbreak in France 2008-2010” (September 9, 2010). Of particular note is the high incidence of confirmed measles cases in unvaccinated or partially vaccinated individuals,the few cases “imported” from foreign countries and the under-reporting of suspect or confirmed cases by physicians.

  38. #38 NK
    February 27, 2011

    It’s worse than that, as noted here previously.
    Jay has an article up on his site (in the “alternative” treatments section on managing colds) in which it’s recommended that you give kids colloidal silver as an “immune system booster”.

    Have you tried colloidal silver? What’s your experience?

    It’s bad enough that adults put themselves at risk of permanent skin discoloration and other serious side effects under the delusion that colloidal silves will work wonders for them, but to subject children to this is in my view unconscionable. From NCCAM’s website:

    “There is a lack of evidence for effectiveness and a risk for serious side effects from colloidal silver products. The FDA does not consider colloidal silver to be safe or effective for treating any disease or condition…Argyria (blue-gray skin discoloration from silver deposition) is permanent and cannot be treated or reversed. Other side effects from using colloidal silver products may include neurologic problems (such as seizures), kidney damage, stomach distress, headaches, fatigue, and skin irritation. Colloidal silver may interfere with the body’s absorption of some drugs”

    There are FDA-approved antibiotics out there that can turn you blue. In fact, they can also can kill you, and if not death, you will end up looking like a burned victim (SJS/TEN). I would be worried about the other side effects you mentioned, and everyone is always so hyperfocused on a bluish tint when you can probably count the number of cases on one hand.

    Show me studies about the Colloidal silver causing the other side effects you mentioned. Please exclude silver salts, silver nitrate, and such. Also exclude author’s ideas/theories.

    NCCAM doesn’t seem to supply these.

    I took a look at the CDC (one of NCCAM’s references), and they don’t mention any of the side effects besides argyria.

    http://www.atsdr.cdc.gov/tfacts146.html

    Variation in the amount of silver contained in supplements could also place children at heightened risk of side effects.

    I’d like to see some case studies about the side effects in children from variation of the amount of silver.

    Do any of these warnings about using colloidal silver appear on Jay’s website? I haven’t seen them.

    Are these warnings backed by science?

  39. #39 Chris
    February 27, 2011

    NK:

    Show me studies about the Colloidal silver causing the other side effects you mentioned.

    First you must show that colloidal silver works as an antibiotic when taken orally and not just on surfaces.

  40. #40 Gray Falcon
    February 27, 2011

    NK:

    Have you tried colloidal silver? What’s your experience?

    You could ask the same about methamphetamine. The wise learn from personal experience, the foolish learn exclusively from it.

    There are FDA-approved antibiotics out there that can turn you blue. In fact, they can also can kill you, and if not death, you will end up looking like a burned victim (SJS/TEN).

    Antibiotics, in general, work when used correctly, and rarely produce severe side effects. It’s called risks vs. benefits, and is one of the most basic concepts out there.

    I would be worried about the other side effects you mentioned, and everyone is always so hyperfocused on a bluish tint when you can probably count the number of cases on one hand.

    Actually, we’re focused on the fact that colloidal silver doesn’t work. In other words, it’s a unnecessary risk without reward. You have to prove otherwise. Simple as that.

  41. #41 Militant Agnostic
    February 27, 2011

    NK “immune system booster” is usually a good sign of bullshit.

    The known effects of silver are antibiotic, not “boosting the immune system”. Boosting the immune system is usually not a good idea anyway.

  42. #42 Onkel Bob
    February 27, 2011

    Since they can track this outbreak back to Patient Zero – I wonder if any infected would be able to file a successful suite against that person?

    While invoking the standard IANAL disclaimer, I believe the common-sense defense that: the patient did not know he/she had a communicable disease, he/she was not specifically advised against travel, and that it’s an “act of god” will absolve him or her.

  43. #43 Matthew Cline
    February 27, 2011

    First you must show that colloidal silver works as an antibiotic when taken orally and not just on surfaces.

    Or, as a first step, show that the silver particles are able to pass through the stomach/intestinal lining into the blood.

  44. #44 NK
    February 27, 2011

    Or, as a first step, show that the silver particles are able to pass through the stomach/intestinal lining into the blood.

    Or the mucous membranes in the mouth perhaps?

  45. #45 NK
    February 27, 2011

    Oh, and if you are going to study sublingual administration and the stomach, you might as well study the colon/rectum as well.

  46. #46 D. C. Sessions
    February 27, 2011

    I wonder if this means that Dr Jay does not see any formula-fed babies?

    It’s simpler than that. Since Jay’s patients are all exclusively breastfed, any serious diarrheal illnesses must be due to some other cause. This follows from the fact that breastfed babies never get seriously ill from rotavirus.

    QED.

  47. #47 Chris
    February 27, 2011

    NK, if you are claiming silver kills bacteria and colloidal silver is an effective oral antibiotic, then what about this article: Bacterial Killing by Dry Metallic Copper Surfaces? Will you now switch to colloidal copper?

  48. #48 NK
    February 27, 2011

    NK, if you are claiming silver kills bacteria and colloidal silver is an effective oral antibiotic, then what about this article: Bacterial Killing by Dry Metallic Copper Surfaces? Will you now switch to colloidal copper?

    Excess copper is known to be toxic to the human body. Arsenic and Mercury kills bacteria as well. Hell, many toxic metals kill bacteria.

    I don’t get your point.

  49. #49 lilady
    February 27, 2011

    I usually don’t respond to trolls, but NK did you read the article provided by Chris and the silly nuances in her posting? Before you look at the link again, try to understand the difference between disinfectants and antiseptics.

    Everyone knows that copper bracelets (available on the internet) protect you from bacterial, viral diseases and…..

    BTW copper is a trace element in the body and used by the body to maintain stasis; silver is not a trace element.

    Chris and I are still waiting for citations from you about the effectiveness of colloidal silver against any microbe.

  50. #50 Sauceress
    February 27, 2011

    #441 Militant Agnostic

    Boosting the immune system is usually not a good idea anyway.

    We can’t expect woo worshippers to actually possess any genuine knowledge of basicimmune system mechanisms.

  51. #51 Chris
    February 27, 2011

    Thank you, lilady, I was trying to remember the word “antiseptic.”

    NK, bleach is also effective at killing bacteria, I just don’t think I want to consume it!

    (I listened a podcast about the copper killing bacteria, downloaded from http://www.virology.ws/2011/02/23/this-week-in-microbiology/ )

  52. #52 JohnV
    February 27, 2011

    @lilady

    There is a small amount of silver in the body. I’ll get the reference tomorrow at work (and the actual amount). We looked up a chart (sourced to some medical text book) because of a reviewer comment on a manuscript about the content of a particular mineral in a human.

  53. #53 dedicated lurker
    February 27, 2011

    Excess copper is known to be toxic to the human body.

    If you can’t metabolize copper at all it’s also a bad thing. Look up Wilson’s disease.

  54. #54 Sauceress
    February 27, 2011
  55. #55 Sauceress
    February 27, 2011

    Link fail.
    It was just the wiki on “cytokine storm”. Doubt NK is interested in detail anyway seeing as technical details often tend to interfere with belief.

  56. #56 lilady
    February 27, 2011

    @ dedicated lurker: Yes Wilson’s Disease can be a deadly disorder..but that doesn’t stop the “pushers” on the internet from marketing Colloidal copper. I must look into a business plan to market colloidal kryptonite on the internet

    Where is the runaway bride Dr. Gordon?

  57. #57 Tsu Dho Nimh
    February 27, 2011

    @305 Jay Wrote, “Kristen, I get a biased cohort because most of the families I see with autism come because they know I’ll support their belief that their child’s autism was triggered by vaccines and/or that I’ll support their desire to look outside conventional (proven) treatment for their children.

    It’s a walled garden. You get into a closed loop, spinning along, reinforcing each others beliefs, rejecting any conflicting information.

    It’s not just the cohort that is biased, Jay. It’s you.

  58. #58 Militant Agnostic
    February 27, 2011

    While we are waiting for NK to provide evidence of the efficacy of colloidal silver you can watch a colloidal silver entrepreneur versus the dragons.

  59. #59 Militant Agnostic
    February 27, 2011

    @456 quoting Jay @305

    It as if when Jay Gordon finds himself in a hole, and the backhoe isn’t working out for him, he sends for a bucketwheel excavator.

  60. #60 Dangerous Bacon
    February 27, 2011

    NK is upset that I criticized Jay Gordon for enabling colloidal silver quackery on his website. NK‘s first comeback is a classic wooist rejoinder:

    “Have you tried colloidal silver? What’s your experience?”

    Meaning that I can’t possibly have anything of value to say about a therapy unless I’ve tried it myself. Well, I haven’t slurped down any colloidal silver supplements. I also haven’t tried ear candling, burning off skin lesions with caustic bloodroot paste, drunk my own urine or tried the thousands of untested, unproven and potentially hazardous supplements on the market. I don’t need to be a guinea pig to know that it’s foolish to try to medicate myself with things not shown to have benefit, but to have harmful side effects – like silver supplements.

    “There are FDA-approved antibiotics out there that can turn you blue. In fact, they can also can kill you, and if not death, you will end up looking like a burned victim (SJS/TEN).”

    I don’t know about “turning you blue”, but yes, approved antibiotics have the potential for harm. The big difference between them and colloidal silver products is that antibiotics work.

    Did you get that, NK? They work. They save lives. People make rational choices to use them based on a risk/benefit ratio. It’s very hard to calculate such a ratio for colloidal silver supplements, since the known benefit is zero. The reason that mainstream medicine has been warning against internal silver consumption for at least half a century (and the FDA weighed in against it) is simple – without effectiveness, there’s no reason to risk the harm these products can cause.

    As for studies, you’ll find plenty of published papers in reference to animal and human toxicity due to silver here.

    What can explain the fascination of woo adherents with drugs and treatments discarded long, long ago by medical science? I have a feeling that if health experts, the CDC and the American Academy of Pediatrics suddenly decided vaccination was bad, the Mike Adamses, Gary Nulls and Jay Gordons of the world would do an equally rapid turnaround and decide that vaccination was a marvelous natural disease preventative worth promoting by brave mavericks like themselves, and that the medical establishment opposed it only because letting people get sick with infectious diseases means they can be prescribed lots of Big Pharma medicines.

  61. #61 Tsu Dho Nimh
    February 27, 2011

    @438 … just look up “argyria” on Google images.

    http://www.silvermedicine.org/argyria.html

    http://www.rosemaryjacobs.com/april27_2003.jpg is a nice picture.

  62. #62 herr doktor bimler
    February 27, 2011

    everyone is always so hyperfocused on a bluish tint when you can probably count the number of cases on one hand.

    There is this thing called “Google” which, when used judiciously, can reduce the use of words like “probably”, and also reduce the number of times one is wrong.

  63. #63 JohnV
    February 28, 2011

    this is pretty far off topic by now, but i figured since i mentioned it upthread i would actually dig out the reference.

    in the human body
    copper 72 mg / 70 kg
    mercury 6 mg / 70 kg
    silver: 2 mg / 70 kg
    gold: 0.2 mg / 70 kg
    uranium: 0.1 mg / 70 kg

    from http://web2.airmail.net/uthman/elements_of_body.html which is sourced to “Emsley, John, The Elements, 3rd ed., Clarendon Press, Oxford, 1998”

  64. #64 lilady
    February 28, 2011

    Lilady is not playing lawyer here but just a comment about legal culpability regarding the measles case in Boston. From what I have read she was not aware that she was infected with measles when she boarded the plane in France. Measles and some other vaccine-preventable diseases (pertussis) have a long prodromal (asymptomatic period) before the onset of symptoms. The measles prodromal period is at least 12 days… when a person can unknowingly infect others.

    I do know that in food-borne disease outbreaks caused by bacteria such as salmonella, hepatitis A and shigella, that people have successfully sued for damages. E.coli infections caused by undercooking of hamburgers have caused major organ failure and deaths and the fast food restaurants implicated, have been sued. Major egg producing distributors and pre-washed salad greens companies have been implicated in other food-borne multi-state outbreaks of infectious diseases. Not only have they been sued by individuals, they have been fined for unsafe practices, by regulatory food monitoring agencies.

    On the local level, if a determination is made that an individual restaurant caused a food-borne illness due to cross contamination of salads by raw eggs or chickens, deviation from safe food handling practices..such as safe temperature range for “holding” salads at buffets, cooking eggs and poultry completely or employing food handlers with a diarrheal illness, face major fines. (I tend to eat at home and am very selective in menu choices in restaurants).

    If a local health department has to provide immunizations for the patrons exposed to a food borne illness in a restaurant, they will also make a claim and collect for the costs associated with providing prophylactic treatment to restaurant patrons.

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