Respectful Insolence

In my eagerness to pivot back to an area of my interest after having had a little fun with anti-vaccine cranks, I ignored a paper to which several of my readers referred me over the last few days. Many of them had first become aware of it when everybody’s favorite smugly condescending anti-vaccine crank, Ginger Taylor, started pimping it on her blog. Before that, it apparently popped up on the only anti-vaccine site almost as loony as Age of Autism, namely SaneVax, and it wasn’t long before this paper started making the rounds of the anti-vaccine crankosphere, showing up at Gaia Health, and then just yesterday the anti-vaccine propaganda blog Age of Autism. It was at that point that I decided that I had made a mistake in not taking a look at this article; so I was more than happy to do so. Given that most of the blogs I’ve seen pimping this article include the entire abstract, I think I’ll do the same thing, so that there’s at least a hope that a skeptical word will show up on Google searches for this article or for the author’s name:

Do aluminum vaccine adjuvants contribute to the rising prevalence of autism?

Tomljenovic L, Shaw CA.

Neural Dynamics Research Group, Department of Ophthalmology and Visual Sciences, University of British Columbia, 828 W. 10th Ave, Vancouver, BC, Canada V5Z 1L8.

Abstract
Autism spectrum disorders (ASD) are serious multisystem developmental disorders and an urgent global public health concern. Dysfunctional immunity and impaired brain function are core deficits in ASD. Aluminum (Al), the most commonly used vaccine adjuvant, is a demonstrated neurotoxin and a strong immune stimulator. Hence, adjuvant Al has the potential to induce neuroimmune disorders. When assessing adjuvant toxicity in children, two key points ought to be considered: (i) children should not be viewed as “small adults” as their unique physiology makes them much more vulnerable to toxic insults; and (ii) if exposure to Al from only few vaccines can lead to cognitive impairment and autoimmunity in adults, is it unreasonable to question whether the current pediatric schedules, often containing 18 Al adjuvanted vaccines, are safe for children? By applying Hill’s criteria for establishing causality between exposure and outcome we investigated whether exposure to Al from vaccines could be contributing to the rise in ASD prevalence in the Western world. Our results show that: (i) children from countries with the highest ASD prevalence appear to have the highest exposure to Al from vaccines; (ii) the increase in exposure to Al adjuvants significantly correlates with the increase in ASD prevalence in the United States observed over the last two decades (Pearson r=0.92, p<0.0001); and (iii) a significant correlation exists between the amounts of Al administered to preschool children and the current prevalence of ASD in seven Western countries, particularly at 3-4months of age (Pearson r=0.89-0.94, p=0.0018-0.0248). The application of the Hill's criteria to these data indicates that the correlation between Al in vaccines and ASD may be causal. Because children represent a fraction of the population most at risk for complications following exposure to Al, a more rigorous evaluation of Al adjuvant safety seems warranted.


If you want to read the whole article, it’s available as a PDF file on a website called the Office of Medical and Scientific Justice (OMSJ). I thought I knew all the major quackery websites out there, but somehow I had never come across this one before. It appears to be a doozy, posting a glowing review of the anti-vaccine movie whose misinformation and pseudoscience I deconstructed three weeks ago, attacks on Brian Deer for his exposing Andrew Wakefield for the fraud he is, and, in a classic case of crank magnetism, a heapin’ helpin’ of anthropogenic global warming denialism.

Already, things aren’t looking too good.

Still, I pride myself on always going straight to the source when examining studies like this that are being bandied about the anti-vaccine underground. Who knows? Maybe I’ll find something to change my mind. True, it’s highly unlikely, but you never know. I was, however, curious just who the authors are. Christopher Shaw, I had heard of before. He was featured in the anti-vaccine propaganda movie The Greater Good and gave a talk at the anti-vaccine conference in Jamaica featuring Andrew Wakefield in January. His co-author Lucija Tomljenovic is apparently a postdoctoral fellow who was also a speaker at that very conference, giving two talks there.

So let’s get to the meat of the article, such as it is. Personally, after reading it a thought kept going through my head, namely that chemistry journals (particularly journals devoted to inorganic chemistry) probably shouldn’t be publishing medical articles. The editors and peer reviewers, so enamored with an apparently strong correlation, fell for the oldest crank gambit in the book: Confusing correlation with causation. Perhaps the most irritating part of the article is how Tomljenovic and Shaw misuse and abuse Hill’s criteria, a famous set of nine criteria postulated by Sir Austin Bradford-Hill for assessing the plausibility and likelihood of a particular correlation indicating causation. I discussed Bradford-Hill’s criteria before when Andrew Weil also misused and abused them.

Perhaps the silliest aspect of this article is Table I, in which Tomljenovic and Shaw try to convince you that the inflammatory aspects of various autoimmune diseases share aspects with inflammation provoked by aluminum adjuvants. Of course, I’d be shocked if some autoimmune diseases didn’t share some aspects of inflammation provoked by aluminum adjuvants or even vaccines in general. Inflammation is a common process that can be provoked by many things. I could tell you that the cytokine profiles that Tomljenovic and Shaw point to as being so “similar” to cytokine profiles due to aluminum adjuvants are the same sorts of cytokine profiles that result from almost any sort of injury. If, for example, as a surgeon I cut open your abdomen in order to rearrange your anatomy for therapeutic intent, I bet I could find studies with cytokine profiles that I could tenuously compare to cytokine profiles due to vaccination with aluminum-containing vaccines. For example, Tomlijenovic and Shaw point out that inflammatory bowel disease results in “Increased NLRP3 inflammasome complex signaling and NLRP3-dependent over- production of IL- 1β, IL-6, IL-18, TNF- α and reactive oxygen species (ROS) in MS, EAE, Type 1 diabetes mellitus [164-166] and animal models of IBD [167],” while the aluminum adjuvant can similarly “activate the NLRP3 inflammasome complex and NLRP3- dependent cytokines [33,34,172].” This is not in the least bit surprising, given that the NLRP3 system is activated by a wide range of “danger signals.”

In fact, perusing the chart I’m struck by how tenuous the resemblances between inflammation due to autoimmune diseases and inflammation due to aluminum adjuvants is. Presumably this is the best these two could come up with, and their best just isn’t all that convincing. None of this stops the not-so-dynamic duo from including autism and Gulf War Syndrome on their list. The latter they characterize as being “specifically recognized as ‘Autoimmune/inflammatory syndrome induced by adjuvants,” which is news to me given that I thought the emerging consensus was that Gulf War Syndrome probably doesn’t exist as a single distinct syndrome but rather as many health problems with different etiologes, much less is it recognized as some sort of autoimmune syndrome caused by vaccine adjuvants. After all, none of the anthrax vaccines soldiers received prior to going to the Gulf used squalene adjuvants. Meanwhile, autism spectrum disorders are listed in the chart as being “linked to Al-adjuvanted vaccines.” I suppose that’s true in the literal sense in that anti-vaccine activists have linked ASDs to Al-adjuvanted vaccines, but what Tomlijenovic and Shaw are doing is what lawyers like to call assuming “facts not in evidence.” Again, there is no solid evidence linking vaccines, whether Al-adjvanted or not, to autism, and several large epidemiological studies that have utterly failed to find a link between vaccines and autism. Where were the peer reviewers here?

The “evidence” in the paper consists mainly of Tomlijenovic and Shaw comparing increasing ASD prevalence to the increasing number of vaccines in vaccine schedules in various countries, their argument being that increasing doses of aluminum through vaccines correlates with increasing prevalence of ASD. Basically, they collected data on ASD diagnoses for children from ages 6-21, from 1991-2008 from the US Department of Education Annual Reports for ASD prevalence. Next, they tried to correlate the autism prevalence in this group with the cumulative aluminum dosage they received before age 6 through the pediatric vaccination schedule. They then basically did the most simplistic analysis imaginable, plotting the minimum, mean, and maximum aluminum exposures against ASD prevalence. Can you say “ecological fallacy”? Sure, I knew you could.

To recap, because I haven’t had to discuss it in a while, the ecological fallacy can occur when an epidemiological analysis is carried out on group level data rather than individual-level data. In other words, when the group is the unit of analysis, the chances of finding a false positive correlation go way, way up, as happened with a bad study trying to correlate vaccines with infant mortality. As Epiwonk once described it:

To make this jump from group-level to individual-level data is The Ecological Fallacy, which can be defined simply as thinking that relationships observed for groups necessarily hold for individuals.

The ecological fallacy was first described by the psychologist Edward Thorndike in 1938 in a paper entitled, “On the fallacy of imputing the correlations found for groups to the individuals or smaller groups composing them.” (Kind of says it all, doesn’t it.) The concept was introduced into sociology in 1950 by W.S. Robinson in 1950 in a paper entitled, “Ecological correlations and the behavior of individuals,” and the term Ecological Fallacy was coined by the sociologist H.C. Selvin in 1958. The concept of the ecological fallacy was formally introduced into epidemiology by Mervyn Susser in his 1973 text, Causal Thinking in the Health Sciences, although group-level analyses had been published in public health and epidemiology for decades.

Add to this the fact that, for all the authors’ claims that they controlled for confounding factors, by falling for the ecological fallacy they allowed huge confounders into their analysis. Even worse, they appeared to make no attempt to control for birth cohort other than to remove vaccines from their calculations that hadn’t been introduced into the schedule at the time the children were vaccinated. (How nice of them.) In any case, although the diagnostic criteria used for autism and ASDs were set in 1994 in the DSM-IV, screening in schools, increased availability of services, and decreasing stigma to a diagnosis of autism led to an explosion in autism diagnoses. The way to control for this would have been to examine much more narrowly defined birth cohorts. They didn’t. They used a single 15-year period. They also did nothing more than look for a linear correlation between aluminum dose and autism prevalence, citing r = 0.92, instead of calculating r2. The authors are incredibly impressed by this (and apparently so were the reviewers), even though it’s not so hard to produce high Pearson coefficients for a lot of seeming correlations that in fact don’t have anything to do with each other. The most heinous example I can recall is a ham-handed attempt to correlate abortion rates with breast cancer incidence.

Tomlijenovic and Shaw’s article does exactly the same thing, only slightly slicker.

Given how common papers like this are from anti-vaccinationists are, I sometimes think it would be fun to play a game I’d like to call “Name That Correlation!” What other correlations with the increase in autism diagnoses can we find over the last 20 or 30 years? Let’s see. Personal computer use has been rising since the 1980s. Perhaps that’s the cause of autism! More similar to Tomlijenovic and Shaw’s time frame, Internet use has exploded since the early 1990s. Back in 1990, few people had Internet access or e-mail addresses. (As hooked in as I am now, believe it or not, I didn’t have Internet access back then, either.) Now almost everyone does, and Internet access has become truly mobile via smartphones like the iPhone, Blackberry, and Android handsets. I bet a nice correlation between Internet usage and autism diagnoses could be constructed. Come to think of it, mobile phones, although first introduced in the 1980s, didn’t really begin to take off until the mid-1990s. In the early 1990s, mobile phones were uncommon because they were so expensive and coverage was very spotty. Now, the nearly everybody owns one. The time frame of Tomlijenovic and Shaw’s study fits the time frame of the rise of mobile phone use almost perfectly!

Finally, Tomlijenovic and Shaw misuse and abuse Bradford-Hill’s criteria. For example, they list criteria numbers one and two as being satisfied for aluminum and autism. Those are strength and consistency. The problem with these criteria is that they aren’t supposed to be evaluated by one study. They conclude their association is strong because they have a high Pearson correlation coefficient, but their study is an outlier. It’s not correct to say that the correlation is strong based on the totality of the evidence. Ditto for consistency, as, again, their study is an outlier, and, quite frankly, citing DeLong’s execrably embarrassing study as a study that found a correlation between vaccine uptake and autism does not help their case. They also try to convince readers that one of Bradford-Hill’s other criteria, such as biological rationale and coherence, have been met because of their attempt to make the tortuous vague resemblances between cytokine profiles they constructed seem like strong evidence for biological plausibility. Even worse, they try to use their confusion of correlation with causation as an argument that there is a temporal relationship between the purported cause and the effect. No, it’s not. In fact, they have not convincingly met any of Bradford-Hill’s criteria, much less eight out of nine.

None of this stops them from calling for–you guessed it!–more research:

Clearly, we cannot draw definite conclusions regarding the link between Al adjuvants and autism based on an ecological study such as the present one and hence the validity of our results remains to be confirmed. A case control study with detailed examination of vaccination records and Al body burden measurements (i.e., hair, urine, blood) in autistic and a control group of children would be one step toward this goal. Nonetheless, given that the scientific evidence appears to indicate that vaccine safety is not as firmly established as often believed, it would seem ill advised to exclude pediatric vaccinations as a possible cause of adverse long-term neurodevelopmental outcomes, including those associated with autism.

Notice the wording. “It would seem ill-advised to exclude vaccines” and “vaccine safety is not as firmly established as often believed.” It’s the old anti-vaccine tactic of sowing fear, uncertainty, and doubt about vaccines based on highly dubious science and then calling for more studies of a hypothesis that scientists, despite having looked extensively, have been unable to find any convincing evidence to support. The authors then communicate with sympathetic anti-vaccine bloggers in order to try to use their “science” to persuade government officials that more research is needed:

This study by Tomljenovic and Shaw provides convincing evidence of a strong relationship between the aluminum adjuvant frequently used in vaccinations and the increasing burden of childhood vaccinations. Even more significantly, it makes a highly plausible case for vaccines’ aluminum adjuvant as a cause of autistic spectrum disorders.

The only question is whether it should be considered a final determination. If one takes the view that only a double-blind placebo-controlled study can demonstrate the truth, then it will never be found. Conventional medicine refuses to do such studies in vaccinations. The claim is that it would be unethical to refuse the benefits of a vaccination. Of course, the consideration of harm from vaccinations is somehow not factored into the scenario. The results of this study, of course, demonstrate that the views of medical ethicists are strongly biased towards assumptions of the infallibility of their treatments.

Ah, I love the way anti-vaccine propagandists whine about basic ethical considerations in clinical trials and try to paint vaccines as somehow “privileged” in how they are treated.

Finally:

In personal communcation with Tomljenovic, I have been informed that they are doing animal experiments to further test the aluminum-adjuvant-as-an-ASD cause hypothesis. They would also like to do a human investigation involving comparison of individual medical records of vaccinations with aluminum body burdens. However, this is very costly and the funds are not yet available.

Great. It looks as though we have a new Mark and David Geier, only substituting aluminum instead of mercury. I guess we can look forward to a lot more bad science. Oh, well. I guess it will guarantee that I’ll have blogging material for years to come. Unfortunately.

Comments

  1. #1 Ajax
    December 8, 2011

    Kill me now.

  2. #2 Paul
    December 8, 2011

    I’m more than happy to be corrected, but to me it seems that the main finding of a positive correlation between ASD prevalence and cumulative Al dose has a lot to do with to this one sentence in their methodology:

    ‘This rationale for using cumulative amounts of adjuvant Al in our analysis is also supported by the following observation: Al has been shown to persist at the site of injection from several months up to 8–10 years following vaccination in patients suffering from macrophagic myofasciitis, an autoimmune disease linked to Al vaccine adjuvants [53].’

    So what this is saying is that the authors are making the assumption that for all individuals, the compound effectively accumulates with no elimination from the body, and that assumption is based on observations associated with macrophagic myofasciitis (MMF).

    I don’t know anything about MMF, but some Info from WHO:
    http://www.who.int/vaccine_safety/topics/aluminium/questions/en/index.html

    Q4. Does everyone vaccinated with an aluminium-containing vaccine have the MMF lesion?
    A. Since muscle biopsies have only been carried out in patients with myopathic symptoms, there is currently no information on whether the characteristic localized histological pattern would be found in the healthy population after vaccination. It has been suggested that there might be a predisposed subset of individuals with impaired ability to clear aluminium from the deltoid muscle. Whether this reflects macrophagic dysfunction, or the tail-end of a normal population distribution of aluminium clearance and local tissue response, has not been determined.

    It seems in general we don’t really know a lot about MMF, but it appears to be quite rare. From the MJA:

    Macrophagic myofasciitis is characterised by the presence of sheets of macrophages in striated muscle, a few lymphocytes and inconspicuous muscle fibre damage. It is due to the persistence of vaccine-derived aluminium in the muscle at the injection site and the myofasciitis is localised to the injection site. Since macrophagic myofasciitis was first described in 1993,1 more than 200 cases have been identified in France, with only a few cases reported from other countries.2 This is the first case of macrophagic myofasciitis reported in Australia.

    Macrophagic myofasciitis associated with vaccine-derived aluminium.
    Shingde M, Hughes J, Boadle R, Wills EJ, Pamphlett R.
    Med J Aust. 2005 Aug 1;183(3):145-6.
    PMID: 16053418 [PubMed – indexed for MEDLINE] Free Article
    Related citations

    Could it be possible that in fact most people don’t retain aluminium adjuvant in the tissues in the long-term? From Lindblad 2004:

    In vivo clearing of aluminium adjuvants
    Mammalian organisms are constantly being exposed to aluminium compounds in the environment. As a consequence aluminium is found in the blood and serum of humans and animals whether or not they have been vaccinated using aluminium adjuvants. The major source of this aluminium is apparently oral intake with food and drinking water. Martyn et al.,74 based on a study in Britain, calculated the average daily intake of aluminium by humans to be 5–10 mg. Individuals with normal renal functions would excrete this aluminium uptake with the urine. In contrast to other metallic ions, such as Zn++ and Mg++, aluminium apparently does not act as an essential trace element or coenzyme in normal metabolism. The clearing in vivo of aluminium adjuvants has been investigated in rabbits using adjuvants prepared from the isotope 26Al.75 Blood and urine excreted 26Al was followed using accelerator mass spectroscopy for a period of 28 days. As early as 1 h after i.m. injection radioactive-labelled Al could be detected in the blood and approximately threefold more 26Al was excreted from animals vaccinated with aluminium phosphate than those vaccinated with aluminium hydroxide. Thus, it appears that interstitial fluid containing organic acids with an alpha-hydroxy carboxylic acid, which is able to chelate Al, react more readily with aluminium phosphate than with aluminium hydroxide.75 It is of interest that following injection of adjuvant containing 0.85 mg Al the normal plasma concentration of Al in rabbits (30 ng Al ml–1) only rose approximately 2 ng Al ml–1 during the experiment. Flarend75 calculated that a similar Al dose injected into humans, provided similar clearing kinetics existed, would lead to an estimated increase of serum Al of only 0.04 ng Al ml–1, which is equal to 0.8% above the normal level of approximately 5 ng Al ml–1. Based on these figures it appears unlikely that the amount of aluminium administered via vaccination would contribute significantly to the general exposure of humans to aluminium or to the serum levels of aluminium.

    Aluminium compounds for use in vaccines.
    Lindblad EB.
    Immunol Cell Biol. 2004 Oct;82(5):497-505. Review.
    PMID: 15479435 [PubMed – indexed for MEDLINE] Free Article
    Related citations

    Is cumulative Al dose really the right biomarker to use in any case, when the entire basis of your study is predicated on this assumption? As for the correlation coefficient – 0.92 – that seems really high. The coefficient of determination (r2) is 84% – so 84% of the variance is ASD prevalence is due to differences in Al exposure? That is really quite amazing – we can explain nearly all of the variation in ASD by in vivo aluminium. Wow! What about other effects? Could genetics play a role? Twin studies, for example have shown somewhere between 40-80% heritability for ASD, suggesting a good proportion of the variance in the disorder is due to non-environmental factors.

    Then, regarding the plot (Figure 1) specifically, is that really the most trustworthy line of best fit one could find? There are effectively 3 values along the x-axis (for each exposure – min, mean and max) so not much variation to observe a legitimate trend.

    I would be interested to hear what others think.

  3. #3 Todd W.
    December 8, 2011

    Re: Gulf War Syndrome and adjuvants, perhaps they are referring to the discredited idea that squalene adjuvants cause GWS.

  4. #4 SomeGuyWanderingBy
    December 8, 2011

    I bet a nice correlation between Internet usage and autism diagnoses could be constructed.

    I point to Susan Greenfield and I point to the entry of China into the Korean war, that’s all.

  5. #5 Denice Walter
    December 8, 2011

    … citing r, not r-square…. where was I?

    Just a couple of things, the OMSJ ( “scientific justice”?)
    is the project of one Clark Baker, who has been known far and wide for his “investigations” of “corruption” amongst scientists *especially* those who deny the existence/ seriousness of the HIV and AIDS. He was a police officer in LA who has ascended to bigger and better “crime” stopping in academia and the medical world all through a rented mailbox . He has been a subject of discussion amongst those who combat drivel replacing data concerning HIV/AIDS. Oh yes!

    On Gulf War “Syndrome”: various hypotheses have been trotted out in Woo-topia about illnesses Gulf War veterans suffered ( at first, limited to the first war, now both). Gary Null has been “investigating” these illnesses and has come up with a multi-factorial “theory” that involves ( what else!) contaminated, immune-suppressing vaccines given to the enlisted, contamination from burning oil, contamination from Uranium, and contamination( bad food, bad air, no supplements). He has even created a “documentary” on this very subject, “Killing Our Own” ( he comes up with such catchy titles, “AIDS, Inc”, “Vaccine-nation”,” Autism: Made in the USA”, ad nauseum and more on the way).

    Interestingly enough, the two aforementioned investigators *know* each other! Will wonders ever cease?

  6. #6 t_p_hamilton
    December 8, 2011

    HIV-causes-AIDS deniers as well!

  7. #7 palindrom
    December 8, 2011

    Denice @5 — This gives a whole new meaning to the “Null hypothesis”.

  8. #8 trrll
    December 8, 2011

    Is cumulative Al dose really the right biomarker to use in any case, when the entire basis of your study is predicated on this assumption?

    This kind of correlative study that cherry-picks one out of probably thousands of environmental factors that increased over the time period is obviously much worthless. But with respect to this one technical issue, I don’t see a big problem. One could also reasonably used cumulative dose based upon a probabilistic model in which there is some risk of an adverse outcome associated with each exposure (although in this case, number of injections would be a better measure), or something like a linear model such as is often used for radiation exposure, in which each molecule carries some small degree of risk.

    Of course, this does not redeem the overall stupidity of the paper. I was particularly amused by the use of the old antivaccinationist shibboleth that exposure by injection is more dangerous than exposure from diet. To justify this, they point out that only a fraction of oral exposure is absorbed (while neglecting mentioning that due to the high dietary exposure, that fraction is still much greater than vaccine exposure), and also arguing that maybe the Al persists for long periods of time at the site of injection, only being slowly absorbed into the bloodstream. This might be relevant if the adverse effect being studies was something like ulcers at the injection site, but to be neurotoxic, it has to get to the brain, which means that it has to get into the bloodstream. So if a large fraction of the Al is tied up in deposits at the site of injection, being absorbed only slowly, that means that the blood levels will be low (in which case, obviously, vaccine derived Al in the blood will be will be dwarfed by Al derived from exposure, which is pretty much continuous).

    Basically, they are making the same argument (Al is poorly absorbed into the bloodstream) for dietary Al and injected Al, but in the one case they use it to dismiss dietary Al, and in the other case they try to use it to argue that vaccine Al is more dangerous than would reasonably be expected given the tiny doses involved.

    I agree that this is likely a case in which a chemical journal did not have access to reviewers with the biological and epidemiological expertise to realize that the paper is garbage.

  9. #9 Scott Cunningham
    December 8, 2011

    Wow. What a case of one true cause of all disease they’ve got going. Aluminum causes autism, Gulf War syndrome, and MMF? And nobody noticed until now? We should ask Aluminum what it knows about the assassination of JFK. Dammit Aluminum, why did you do it?! Why?!

    It’s amazing to me how anti-vaxers aren’t perturbed by the way the vaccine ingredient and mechanism of vaccine injury are constantly shifting targets. (Bowel virus! Foetal parts! Thimerosal! Formaldehyde! DNA! Al3+!) Never mind that the discoveries of their Brave Maverick Doctors (TM) are all wildly inconsistent with each other, as long as they reject the enormous body of research showing vaccines don’t cause autism, they believe it.

  10. #10 Composer99
    December 8, 2011

    Well, I’m glad the…

    Neural Dynamics Research Group, Department of Ophthalmology and Visual Sciences, University of British Columbia

    … is on the job doing epidemiology looking for causal factors in developmental disorders.

    Those opthamologists and their mad epidemiological skillz. Whew!

  11. #11 MD1970
    December 8, 2011
  12. #12 Science Mom
    December 8, 2011

    MD1970, I rebutted that already as did others. Why don’t you stick with your objections to vaccine safety and justify a study that you propose instead of necromancing posts. You also seem unaware of these: http://www.cdc.gov/vaccinesafety/Activities/CISA.html

    and:

    http://www.nap.edu/catalog.php?record_id=12211

    Now stop dodging and follow through.

  13. #13 novalox
    December 8, 2011

    @md1970

    Suggest you stop spamming old posts.

  14. #14 Science Mom
    December 8, 2011

    Bugger off MD1970 and stay on topic, you have already derailed another thread so keep it there.

    This study is precisely what the Geiers have done with thimerosal. Their use of paediatric vaccine schedules as opposed to what the children actually received mirrors the Geiers’ use of vaccines sold and autism prevalence. That’s just one problem and given what these hacks Shaw and Tomljenovic have published, it’s not surprising how they abuse epidemiology to play to their base.

  15. #15 sceptinurse
    December 8, 2011

    At Denice,

    I went to high school with him. I haven’t kept in touch and didn’t realize he was up to this level of nutcaseness (is that word?).

    Ugh, now I feel dirty.

  16. #16 ron
    December 8, 2011

    Since vaccines keep people alive and living people consume more fossil fuels than dead people, vaccines cause global warming. I should write a paper.

  17. #17 Rory
    December 8, 2011

    ‘Scientific justice’ sounds like an ’80s action movie with Chuck Norris as a scientist who takes an evidence-based approach to cleaning up the streets.

  18. #18 BB
    December 8, 2011

    The authors don’t seem to know why an adjuvant is included in vaccines.

  19. #19 MD1970
    December 8, 2011

    @Science Mom,
    Wannabe- your blog is rubbish.

  20. #20 Militant Agnostic
    December 8, 2011

    A case control study with detailed examination of vaccination records and Al body burden measurements (i.e., hair, urine, blood) in autistic and a control group of children would be one step toward this goal.

    Sounds like a job for Doctor’s Data Labs*

    *The test results you want to see when want to see them. Positive results gauranteed.

  21. #21 MikeMa
    December 8, 2011

    Sounds like a job for Doctor’s Data Labs*

    *The test results you want to see when want to see them. Any and all results possible depending on the fee.

    FIFY

  22. #22 Science Mom
    December 8, 2011

    @Science Mom,
    Wannabe- your blog is rubbish.

    And you’re a stinky poopy-head nah nah nah nah nah.

    FFS, is that what you have to resort to? Keep up the good work, you’re such a credit to your religion.

  23. #23 AllieP
    December 8, 2011

    The aluminum hypothesis is an especially amusing one, given that formula-fed babies (which is something like 75-85% of the population), ingest many thousands of times the amount of aluminum as is in the sum total of their under-two vaccines, and even exclusively breastfed babies ingest more. And though there are plenty of people protesting the use of baby formula, it’s not the autism folks, and the people who DO protest do not do so on the grounds of autism.

  24. #24 herr doktor bimler
    December 8, 2011

    Sounds like a job for Doctor’s Data Labs*

    The main author has his own company for that:
    CAS is a founder and shareholder of Neurodyn Corporation, Inc.
    The company investigates early state adult neurological disease
    mechanisms and biomarkers.

  25. #25 MartinM
    December 8, 2011

    The “evidence” in the paper consists mainly of Tomlijenovic and Shaw comparing increasing ASD prevalence to the increasing number of vaccines in vaccine schedules in various countries, their argument being that increasing doses of aluminum through vaccines correlates with increasing prevalence of ASD.

    It’s even worse than that. They look at changes over time only in the US data. The international data is used the same way that terrible Generation Rescue ‘study’ did it a couple of years ago, looking only at prevalence vs estimated exposure by country. And this study makes the same elementary mistakes that one did, too.

    For starters, they’ve got at least one of the vaccine schedules badly wrong. They have the UK schedule giving three doses of HepB vaccine by the age of two months; in fact, HepB isn’t on the UK schedule at all. It’s given only to high-risk groups. That one mistake leads them to overestimate exposure by the age of 2 months by a factor of about 2, and exposure by 6 months by about 40%.

    More damningly, however, their prevalence values are all over the place. All prevalences below in cases/10,000 of population.

    They report an ASD prevalence of around 12 in Finland and Iceland; neither figure is correct. The figure for Iceland comes from a ten-year-old study which clearly states that it’s looking at the severe end of the spectrum; Asperger’s syndrome isn’t included at all, for example. A more recent study estimates a prevalence of 54.2 – more than four times higher. And that study looked only at cases with existing diagnoses, which means it’s likely an underestimate.

    The figure for Finland also comes from an older paper which makes it clear that high-functioning cases are likely missed. And again, there’s a more recent study giving a higher figure; this time 84.

    And the same pattern continues. They give a prevalence of 53.4 for Sweden; a more recent study gives 80 – in two-year-olds alone.

    Their figure of 62.5 for Australia is particularly amusing, coming as it does from a study whose conclusion is that “…the prevalence of ASD in Australian children cannot be estimated accurately from existing data.” That figure is lifted from a table of nine different values, for each combination of three different (consecutive!) years and three different age groups. The figure they chose to use is the largest of the nine.

    In short, it’s the usual trick. Cherry pick the figures you want to get the results you’ve already decided on. Boring.

  26. #26 Chris
    December 8, 2011

    MD1970:

    Wannabe- your blog is rubbish.

    Which can be also said of your ignorant comments. Have you figured out what a standard deviation of a normal curve is yet?

  27. #27 herr doktor bimler
    December 8, 2011

    In their Figure 1, the authors are plotting ASD incidence in each year (1991-2008) against total aluminium content for the pediatric schedule *in that year*. Not (as you might expect) the aluminium exposure for the ASD cases themselves, according to the pediatric schedules of 6 to 21 years previously, but no, that same year.

    In effect they are looking for a correlation between the number of people who developed ASD decades earlier, and the number of vaccinations given to other children, in the current year. This is an interesting model of causality!

    During the period 1991-2008, reported ASD rises steadily (as indeed does the total population). The authors define three sub-periods (according to two changes in the pediatric vaccination schedule), then argue that the criteria for that division is causing the rise, even though it’s a continuous increase rather than forming three neat plateaux as their hypothesis predicts.

    This really is incredibly bad.

  28. #28 lilady
    December 8, 2011

    Oh Cripes. I (stupidly) took the time to read Ginger Taylor’s blog…including her chronological diary (descent into woo), of her experiences with her young son diagnosed with autism.

    Ginger is also heavily into religion and takes every opportunity to discuss her Christian belief system:

    “So in “Autism in God’s Economy” over the next six days I will discuss a few things that the Bible tells us about God’s perspective on those with Autism and on the rest of us. This series is predicated on the deity of Christ and the inerrancy of Scripture, which may be controversial ideas to some of my regular visitors. If they are to you, I invite you to read on none the less, and take a look at what God of the Bible says. If you are a professing Christian, then this is an important series for you to read no matter how autism affects you.” (Autism in God’s Economy: The Least of These-April 30, 2007)

    What a non-issue this “macrophagic myofasciitis” is. It is a symptom looking for a disease or disorder. It hasn’t been linked to M.S. or GWS…so it’s time to link it to autism.

    The anti-vaxers having run through the “usual suspects” (antigens, immune-system disorders, “too many too soon”, squalene, formaldehyde, chopped up aborted babies, thimerisol and measles vaccine chronic colitis) are now pinning their hopes on traces of aluminum in vaccines being linked with autism.

    Now, if they could just convince a few members of Congress to demand and fund an aluminum adjuvant-associated-autism study….

  29. #29 Orac
    December 8, 2011

    Holy crap. I didn’t even notice that in Figure 1. I must have mentally just assumed that they were doing at least right enough that they’re not comparing vaccine schedules in the same year as autism diagnoses. I probably just unconsciously filled in what I assumed they did, maybe because I couldn’t believe they would be that idiotic to do it the way you describe.

    Mea culpa. I should have noticed. I guess I just gave these two clowns the benefit of the doubt. They clearly don’t deserve it.

  30. #30 TBruce
    December 8, 2011

    @Science Mom,
    Wannabe- your blog is rubbish.

    Are those stories about children dying of SSPE making you a little – umm – uncomfortable?

  31. #31 herr doktor bimler
    December 8, 2011

    I must have mentally just assumed that they were doing at least right enough that they’re not comparing vaccine schedules in the same year as autism diagnoses.

    They’re explicit (section 3.2) that they’re calculating “Al exposure from vaccines in the US vaccination schedule from 1991 to 2008″.

    Since macrophagic myofasciitis was first described in 1993,1 more than 200 cases have been identified in France, with only a few cases reported from other countries.2
    IIRC most of those 200 French cases were identified by the same research group. Evidently it’s something you need to be trained to observe. Like UFO abductions.

  32. #32 Chris
    December 8, 2011

    I believe the layman’s term for macrophagic myofasciitis is “sore arm.

  33. #33 BKsea
    December 8, 2011

    My first reaction was how could an inorganic chemistry journal publish this? But, it looks like it is not at all unusual. In fact, this article appears in a special issue that could probably give Orac enough bloggin material for a month.

    Other “highlights” of the issue include an article about aluminum-containing deodorants causing breast cancer and aluminum chelation therapy for alzheimers.

    Presumably, this was once a respectable journal…

  34. #34 MikeMa
    December 8, 2011

    @Chris,
    Us laymen thank you:)

  35. #35 Militant Agnostic
    December 8, 2011

    herr doktor bimler

    IIRC most of those 200 French cases (of macrophagic myofasciitis) were identified by the same research group. Evidently it’s something you need to be trained to observe. Like UFO abductions.

    Well duh – Obvioulsy macrophagic myofasciitis is due to an immune reaction to the alien implants placed during UFO abductions.

  36. #36 MartinM
    December 8, 2011

    Given the serious, obvious flaws in the paper, I wonder if Orac’s ‘friend’ would consider it worthwhile to submit a comment eviscerating it.

  37. #37 trrll
    December 8, 2011

    @ MD1970

    Orac’s minions-
    Suggest you read @116 from@SCR-
    http://scienceblogs.com/insolence/2011/03/for_the_anti-vaccinationists_out_there_t.php

    Yes, that comment is also very stupid, but this is not a general discussion of flagrantly stupid things that people have said. Try to stay on topic.

  38. #38 herr doktor bimler
    December 8, 2011

    I believe the layman’s term for macrophagic myofasciitis is “sore arm.”
    Here Chris links to an earlier discussion of MMF, in which it was mentioned that Gherardi’s group — the discoverers of the condition — are now reduced to publishing in Medical Hypotheses.

    My first reaction was how could an inorganic chemistry journal publish this?
    The References list cites a 2009 paper in this same journal, from Gherardi’s group, again reporting the MMF epidemic.
    In fact Gherardi et al. and MMF turn up in the References 5 times (including the Medical Hypotheses paper).

    MartinM. @25: Cherry pick the figures you want to get the results you’ve already decided on.

    To extend the fruit metaphor: the authors are taking figures (e.g. from the Icelandic study of autism) that are explicitly labelled “These are Oranges: Do not mix with Apples”, and comparing them with apples anyway.

  39. #39 Narad
    December 8, 2011

    Yes, that comment is also very stupid, but this is not a general discussion of flagrantly stupid things that people have said.

    The law of the instrument presumably applies.

  40. #40 Edith Prickly
    December 8, 2011

    I believe the layman’s term for macrophagic myofasciitis is “sore arm.”

    You mean like the one I’ve got now after getting my flu shot? Yeesh. For people who are so dismissive of science, alties sure like sciencey-sounding names for ordinary aches and pains.

  41. #41 Ross Coe
    December 8, 2011

    Never fails, when provacs get nervous about vaccine studies, the start twisting the truth until its unrecognizable. They talk complete nonsense about anything but the subject at hand and conclude with” see antivaxxers are wrong”. Look around, measles and chicken pox outbreaks all over. Parents aren’t listening to dolts like ORAC, they aren’t stupid enough to. They are taking back the ever shrinking rights of parents to choose whats best for their children and the trend is growing rapidly. Pharma paid antagonists like ORAC are heroes to the blind sheeple who need a leader like Jim Jones. Careful what ORAC offers you, it might be deadly.

  42. #42 Ren
    December 8, 2011

    Ah, yes. If only there was an Epidemiology Night School where these ophthalmologists could learn about the ecological fallacy?

    If only.

  43. #43 lilady
    December 8, 2011

    @ Ren: C.A. Shaw is not an ophthalmologist…according to the University of British Columbia website:

    DR. CHRISTOPHER A. SHAW
    # B.S. (UC Irvine)
    # M.Sc., Ph.D. (Hebrew U. of Jerusalem)
    # Professor
    # Ophthalmology and Visual Sciences

    Current research interests:
    My laboratory’s key focus over the last few years has been on the unusual neurological disease of Guam and the Western Pacific, ALS-parkinsonism dementia complex (ALS-PDC). I view this disease as a kind of neurological Rosetta Stone able to unlock some of the key questions in neurological disease research. For example: what are the causes of ALS, Parkinson’s, and Alzheimer’s and what are the pre-clinical stages of each? Our approach has been to create an in vivo animal model in which we can look at behavioural changes in motor and cognitive functions, as well as systems, cellular and biochemical modifications as the disease process emerges over time. We have identified a novel class of neurotoxins in the course of our initial studies and are now beginning to understand the toxic mechanisms of action that lead to the death of neurons in the spinal cord and brain. The overall goal of this work is to identify key etiological factors involved in sporadic neurological disease and the early stages of the disease process. From the first could come effective prophylaxis; from the latter, early phase treatment before irreversible damage to the CNS has been done.

    A second theme to our work is to seek potential therapeutic agents for existing neurological disease states using the above, and other, animal models. In particular, we are focusing our attention on progranulin, a neuroepithelial growth factor, and on a class of molecules called ginsenosides. Preliminary data with progranulin suggests that the molecule can exert powerful neuroprotective effects and perhaps even reverse early phase neurodegeneration.

    The last aspect of our work, and one that is still emerging, is to look at the potential for compounds such as aluminum to be neurotoxic. We are interested in the types of aluminum compounds that can cause neurodegeneration, their route of administration, the impact of dose and duration, and the crucial but largely unexplored aspects of age and sex. These studies are just beginning, but show great promise to help us understand the origin of neurological disorders as diverse as autism spectrum disorder and Alzheimer’s disease.

    I doubt that this Ph.D who heavily into “aluminum” and the value of ***”ginsenosides” medicines would benefit from Ren’s night school epidemiology classes.

    Ginsenosides are being developed by Neurodyn Corporation, Inc., the corporation identified by herr doktor bimler as being founded by C.A. Shaw who is also a shareholder in the corporation.

    Sound familiar? Can you say Burzynski and antineoplastons?

  44. #44 ebohlman
    December 8, 2011

    Given how common papers like this are from anti-vaccinationists are, I sometimes think it would be fun to play a game I’d like to call “Name That Correlation!” What other correlations with the increase in autism diagnoses can we find over the last 20 or 30 years?

    I do not believe that the relationship between autism incidence and the length of basketball shorts has been adequately explored. Just eyeballing, I’d say r>=.95 in this case.

    I think it was Joseph of the old “Autism Natural Variation” blog who posited a reasonable causal connection between rising Internet usage and rising autism incidence: it made it a lot easier for parents who thought there was something a little off about their kid’s development to find other parents with the same concerns. This would then lead them to raise the issue of autism with their kids’ doctors, who might not have otherwise considered it if the presentation were non-stereotypical.

  45. #45 MD1970
    December 8, 2011

    Really glad Orac and his minions have absolutely no influence on vaccine
    policy-just frustrated, arrogant blowhards.
    I will give them credit for at least posting links.

  46. #46 ebohlman
    December 8, 2011

    MartinM: All the editors at SBM should submit such comments.

  47. #47 Narad
    December 8, 2011

    Really glad Orac and his minions have absolutely no influence on vaccine
    policy-just frustrated, arrogant blowhards.
    I will give them credit for at least posting links.

    Great! Try this one.

  48. #48 The Very Reverend Battleaxe of Knowledge
    December 8, 2011

    Really glad Orac and his minions have absolutely no influence on vaccine
    policy-just frustrated, arrogant blowhards.
    I will give them credit for at least posting links.

    Boy, that’s some million-candlepower projection there! What does the tail of a normal distribution look like again, genius?

  49. #49 MD1970
    December 8, 2011

    I’m new to the blog, the tone is repellent-actually it brings out the worst in people.
    As for having an impact in the real world, it’s like watching a train wreck.
    There’s hardly any honest questioning or acceptance of anything except the DOGMA.

  50. #50 Lawrence
    December 8, 2011

    You’ve never been to AoA have you?

  51. #51 lilady
    December 8, 2011

    MD1970: If you find it so distasteful to read Orac’s blog and to read our comments…why do you?

  52. #52 herr doktor bimler
    December 8, 2011

    absolutely no influence on vaccine policy

    Shh there, MD1970. The Pharma companies are paying us well to organise the concerted pressure on journals and regulatory agencies that keeps the alt-med messages suppressed. Don’t let them know they’re wasting their money!

  53. #53 Dangerous Bacon
    December 8, 2011

    Back in the comments for the recent RI thread about an antivaxer denouncing research because it failed to fit her biases, we had a couple days ago pD speculating about how aluminum adjuvant in vaccines is trouble because we haven’t “evolved” with it, thus provoking a cytokine storm or some such and causing autism. This struck me as a weird claim given that aluminum was not invented in a mad scientist’s lab a few decades ago, but is the third most common element in the earth’s crust, an element we have been exposed to for eons.

    Now I know why pD suddenly got brought up aluminum – this poorly thought out paper making the rounds of antivaxer sites.

    Never mind the many, many exotic organisms that have appeared in America for example in recent decades, or the tons of new chemicals and devices coming on the scene, any of which we didn’t “evolve” with – it’s gotta be aluminum because, well

    It’s gotta be the vaccines.

    And so the antivaxer world turns.

  54. #54 Chris
    December 8, 2011

    MD1970:

    There’s hardly any honest questioning or acceptance of anything except the DOGMA.

    Do you or do you not accept the concepts of a normal distribution and standard deviation?

  55. #55 Narad
    December 8, 2011

    I’m new to the blog, the tone is repellent

    Not repellent enough, clearly.

  56. #56 W. Kevin Vicklund
    December 8, 2011

    This struck me as a weird claim given that aluminum was not invented in a mad scientist’s lab a few decades ago, but is the third most common element in the earth’s crust, an element we have been exposed to for eons.

    I was wondering a couple months ago why aluminum acted as an adjuvant. My speculation is that it is actually an evolved feature of the immune system. Consider: aluminum is present in most soils and dirt, but is not utilized by the body. Therefore, the presence of aluminum is a signal of something gone wrong, most likely a dirty wound. A stronger/quicker immune response in such a situation might be positively selected.

    Note that this is of course mere speculation, running into the murky grounds of evo-psych.

  57. #57 The Very Reverend Battleaxe of Knowledge
    December 8, 2011

    Note that this is of course mere speculation, running into the murky grounds of evo-psych.

    Not really, WKV. It would probably be impossible for silicon (usually as the dioxide) to trigger anything—too inert. Aluminum is the next element in abundance, our body has no use for it—perfect signal that something’s not right. What’s the next element in crustal abundance that our bodies don’t use? Titanium? Maybe somebody should test that as an adjuvant. The antivaxxers would obviously be just as happy to denounce titanium as aluminum, of course, but it’d be an interesting experiment. (The decline of whitewall tires didn’t effect a reduction in autism, but evidence has nothing to do with the matter anyway, I guess.)

  58. #58 Chris
    December 8, 2011

    I keep wondering if these people ever played as kids. How do you go through childhood without scraping a knee, hand or arm in the dirt? Have they ever jumped off the jungle gym into the surrounding sand? Have they ever been scratched by aluminum swing sets or chain link fence?

    I remember a period in my childhood where I had to use the fingernail brush to get the dirt off of my knees, which usually had a healing scab. There are days in spring and summer that I still have to do that, but that is usually after a day of gardening. While I do wear gloves, I often stray away from the knee pad.

  59. #59 Pinkamena, Panic Pony
    December 8, 2011

    I think MD is using the wrong numbers in its name, there – should be 20/20. Nopony who is that convinced of a grand conspiracy involving us is sober.

    Anyhow, tone troll, here’s your pearls and your fainting couch. Have at it.

  60. #60 ken
    December 8, 2011

    Excess aluminum in the soil can be toxic to growing roots of crops.

    http://www.spectrumanalytic.com/support/library/ff/Soil_Aluminum_and_test_interpretation.htm

  61. #61 ken
    December 8, 2011

    @Chris- comment in moderation because of link.
    Look up aluminum in soil. Can be toxic to growing roots of crops.

  62. #62 Chris
    December 8, 2011

    ken, where do you grow plants in soil that does not have feldspars?

  63. #63 Denice Walter
    December 8, 2011

    -btw- Clark Baker has another project: the HIV Innocence …*Group* ( see website/ also on OMSJ). Don’t worry someone is already on *his* case.

    Be that as it may. As I survey the world of woo in my seven league boots, I stumble upon the same *personae non grata* and obsessive hypothesis spinning over and over. A better man than I remarked that if you look past the smoke and mirrors, you’ll find a *very small* coterie of anti-vaccinationists, AIDS denialists, or whatever else the nonsense may be, masquerading as a large group of qualified, dissident scientists.

    And this remarkably small group of rabble rousers is incestuously inter-connected: look closely @ AoA, NVIC, the Canary Party, NJCVC, EBCALA, SafeMinds, and you’ll see the same names listed in many places. Similarly, if you go beyond the group ( e.g. like anti-vaxx) you’ll continue to see linkage to other groups**. Needless to say, these groups all share “data, studies, and information”. Marks are told that thousands of professionals agree about this data which might indeed be true- depending on how you define “thousands” and “professionals”. And “true”.

    Increasingly, these groups advise their adherents to eschew the mainstream media and choose alternative media instead-“Don’t empower the Man!”: thus entrenched perspectives become more encapsulated. New media outlets ( an expanded NaturalNews and the ProgressiveRadioNetwork) speak beyond health issues, proselytising outre economics/politics to go with your out-there life science. I have sneaking suspicion that a few people will become even more rich whipping their audiences into a frenzy about the corrupt elite 1%ers after making money scaring the same faithful followers about cancer and vaccines.

    ** looks great as a Venn or flow chart.

  64. #64 Chris
    December 8, 2011

    ken, what part of aluminum being the third most abundant element on this planet’s crust did you not comprehend? And it is also the most common metal element on the crust.

    Here is some reading for you: Public Health Statement for Aluminum:

    Aluminum is the most abundant metal in the earth’s crust and it is widely distributed.

    Aluminum is a very reactive element and is never found as the free metal in nature. It is found combined with other elements, most commonly with oxygen, silicon, and fluorine. These chemical compounds are commonly found in soil, minerals (e.g., sapphires, rubies, turquoise), rocks (especially igneous rocks), and clays.

  65. #65 melior
    December 8, 2011

    Al your woo are belong to us.
    You have no chance to survive make your time.
    For great (medical and scientific) justice!

  66. #66 mark
    December 8, 2011

    I guess I had better stop eating chocolate–kaolinite (a clay clay mineral) is a common ingredient.

  67. #67 herr doktor bimler
    December 8, 2011

    ken, where do you grow plants in soil that does not have feldspars?

    Bringing us back to the promotion of zeolite — an alumino-silicate material — as the new wonder product for removing that nasty aluminium from your body:

    http://scienceblogs.com/insolence/2011/11/has_mike_adams_had_a_sudden_attack_of_co.php

    Also Alison’s blog:
    http://sci.waikato.ac.nz/bioblog/2011/11/years-ago-when-my-old.shtml

  68. #68 melior
    December 8, 2011

    The Board of Health would like to remind you that ASD-repelling aluminium foil hats are for external use only.

  69. #69 The Very Reverend Battleaxe of Knowledge
    December 8, 2011

    The Board of Health would like to remind you that ASD-repelling aluminium foil hats are for external use only.

    Well there’s your problem! </Adam Savage>

  70. #70 palindrom
    December 8, 2011

    mellor and Very Reverend Battleaxe @63 and 64:

    Aluminum foil just doesn’t do the trick:

    http://www.stopabductions.com/

    This is funny at first glance, but on reflection I think it must be simply awful for these poor folks to have the thoughts they do. If the hat helps them find some peace, then by all means, they should wear it!

  71. #71 Composer99
    December 8, 2011

    MD1970:

    Please state clearly what you feel is being dogmatically propounded and unquestionably accepted here at Respectful Insolence with regard to the topic of this post.

    Are you objecting to Orac’s deconstruction of this paper? If so, feel free to show how Orac’s criticisms are invalid or how the paper stands up to scrutiny.

  72. #72 David N. Brown
    December 9, 2011

    “Global warming is caused by a decrease in the number of pirates…”

    Hmm. That COULD happen. For example,the pirates’ activities could raise the price of fossil fuels, thus leading to less production of greenhouse gases, and conversely fewer pirates could lower gas prices and lead to more greenhouse gases. It certainly makes more sense than “immune disfunction” being a “core” feature of autism!

    David N. Brown
    Mesa, Arizona

  73. #73 Darwy
    December 9, 2011

    As much as I hated taking epidemiology, I have to admit it was a very important class for my degree. Obviously Shaw and co. don’t share those views.

  74. #74 herr doktor bimler
    December 9, 2011

    I’m beginning to think that aluminium is the Mitt Romney of alt-neurology. No-one can think of any particular point in its favour as an explanation for various neurological conditions, but all the other environmental-toxin theories are much, much crazier. Also there is a general feeling that it’s been around for long enough to deserve a turn.

  75. #75 Viking Warrior Princess
    December 9, 2011

    @ Ren
    If only there was then I could learn as well…
    not that I think they’ll give a rats ass if there was one.

  76. #76 rork
    December 9, 2011

    Autism alert:
    Where I live, we can see Canadian TV (CBC), which is a blessing usually. David Suzuki has a show called “The Nature of Things” which historically has been OK. He usually feels like the real thing – one of us.

    Last night the show devoted an hour to “The autism enigma”, and did not do a terribly good job of being skeptical. Hell, that’s too understated – there was no skepticism at all pretty much.
    And it’s a show that a hell of allot of people probably watched, at least in Canada.

    Suzuki may have gotten into water over his head. Maybe he hasn’t been around high-stakes science as practiced now enough. For example, ability to judge metabolomics experiments is not something you pick up off the streets, and anybody who’s been near that sort of research knows to bring a shovel AND wear hip boots, just in case. Derrick MacFabe on propionic acid got allot of time too. Many other threads were in the weave of the show though, so it’s daunting.

    It’d be nice if even a shred of what got talked about would be useful in treating, preventing or understanding autism, but I’m not sure how much hope to have. I was more hopeful there is promise in gut flora research for other disorders.

  77. #77 rork
    December 9, 2011

    Maybe I wasn’t fair to blame Suzuki entirely. He may not have that much control.
    “written and directed by Marion Gruner (Pharma Sutra) and Christopher Sumpton (Pedal Power), produced by Christopher Sumpton, Robin Benger (Sex Scandals in Religion, Five Roads to Freedom), and Marion Gruner. “

  78. #78 dzu
    December 9, 2011

    There has been an interesting discussion regarding i.v aluminum and infant development.

    In case you are interested they(vaccine
    at in theory some babies can get lasting brain damage if they are given 20mcg/kg aluminium intravenously for more than 10 days.

    For an infant this could be around 50mcg per day for more than 10 days lets say a total of 1000mcg over a 20 day period.

    At that dose they do get measurable lasting neurolgical impairments. Apparently aluminum if ingested is very much non-toxic but if it is injected it quite neurotoxic.

    A quote from the study:

    “In infants fed intravenously for 10 or more days, those receiving the standard solutions had a major (10 point) deficit in their Mental Development Index and were twice as likely to have a Mental Development Index below 85″

    http://www.nejm.org/doi/full/10.1056/NEJM199705293362203#t=articleResults

    Now they say the thing is that with the new vaccine schedule infants could in theory get as much as 1200mcg in one single day just from vaccines at 2 months if age.

    http://thinktwice.com/aluminum.pdf

    So if the findings of the study are valid you would expect some vulnerable children to get alumium induced brain damage from vaccines if aluminum from vaccines has similiar pharmacokinetics as from i.v nutrition.

    Not sure what to think about this. I don’t think you can’t draw conclusions about autism from that, but it seems to show that aluminum is only of low toxicity if it is eaten.

  79. #79 Chris
    December 9, 2011

    dzu, do you know the difference between the amount of fluid there is in a vaccine versus an intravenous feeding solution? Did you the difference between where the needle in a vaccine goes into and where the feeding solution needle goes into?

    And seriously, how many vaccines are given ten days straight?

    Really, think about the comparison. Tell us why it applies.

  80. #80 dzu
    December 9, 2011

    Hello Chris,

    I have no idea if it applies. I just think that it seems that injected aluminum is of high toxicity compared to aluminum in foodstuff.

    The vaccines are never given 10 days straight i would say. They are often given in one single day.

    I personally don’t think one single dose is necessarily much safer than the same dose spread over 2 weeks.

    Why do you think the amount of fluid matters?

    Personally i don’t think the above text proves anything but aluminum via a needle under certain circumstances can indeed cause brain damage in certain infants.

    Not sure how different the aluminum from vaccines will behave compared to the i.v nutrient aluminum.

    So i really can not answer your question!

  81. #81 Bronze Dog
    December 9, 2011

    Feldspar. Kaolinite. I might have to get back into Dwarf Fortress. I remember the days when bauxite was the only magma-safe stone. And a joke I made that DF was a sinister plot to get players to learn geology.

    (Fair warning: Psychobabble ahead!)

    I also feel like bringing up a hypothesis I had about the anti-vaxxer obsession with aluminum: They’re obsessed with it’s “badness” it because of cultural biases, not any actual attributes. Aluminum is associated with cheapness. It’s used for packaging that you throw away, while other metals are usually reserved for durable goods you keep. “Aluminum Christmas Trees” were a fad denounced by A Charlie Brown Christmas, associating them with commercialization and fakeness. Metallic aluminum is created by artificial processes, and somehow they associate that artificiality with its much more natural ionic form.

    Another extension of the idea that comes to mind: It’s a common fantasy game trope to have the ‘element’ of metal be opposite of ‘wood’ or ‘nature’ and when nature is believe to be inherently good or beneficial, its supposed opposite is bad. Though I suppose other elements get a pass: Iron because its necessity in hemoglobin is obvious, and zinc, probably because the average person doesn’t encounter pure, metallic zinc, just vitamins and alloys. Of course, some metals are known for having toxic effects (as always, at certain doses) like lead, mercury, and arsenic. They use that one small grain of truth, mix it with the naturalistic fallacy, and extrapolate that aluminum would be toxic because it’s a metal.

    Though, for cultural reasons, those biases are negated for “precious” metals: Gold (often naturally metallic) was associated with immortality. IIRC, Chinese alchemists used mercury in quackery because it could dissolve gold, and thus it was allegedly significant for granting immortality or longevity. Everyone here is probably familiar with peddlers of colloidal silver as a panacea. Aluminum used to be a precious metal due to its rarity in metallic form, but since we learned to mass produce it, it’s anything but precious, and thus it’s now a “base” metal in our culture.

    It certainly seems like a plausible hypothesis for me.

  82. #82 Bronze Dog
    December 9, 2011

    dzu, there’s more variation to injection than just sticking in a needle. Last I checked, IV fluids are intravenous: Into a vein, and thus into the blood stream. Vaccines tend to be intramuscular: Injected into a muscle, not into the bloodstream.

    The amount of fluid (and the amount of aluminum in the fluid) matters because, contrary to what altie culture says, the human body does not operate like a bunch of binary toggle switches. The dose makes the poison, and one dose of aluminum in an IV fluid is not necessarily equivalent to one dose of aluminum in a vaccine. Chronic and prolonged exposure is also different from acute exposure. If someone is talking about toxicity and doesn’t bring up the importance of dosage, he’s probably lying to you or parroting a lie.

    This is stuff that you should be asking about.

  83. #83 dzu
    December 9, 2011

    viewing this rational and logical one can only deduct from this:

    – if the above study findings are valid
    – if the aluminum from vaccine has the same neurotoxicity as the aluminum from i.v nutrients

    some infants will get aluminum induced brain damage from the current vaccine schedule.

    if not nothing may happen.

  84. #84 Chris
    December 9, 2011

    dzu:

    Why do you think the amount of fluid matters?

    You seriously don’t know? Here, try this: take shot glass and fill it with vodka, and drink it. Now go and do some typing. Save the file, and go to bed.

    On the next evening, drink the entire bottle of vodka. Go and type something, safe the file. Go to bed.

    The next day, read what you wrote in both files. Will there be a difference?

  85. #85 Chris
    December 9, 2011

    dzu, where does the needle of a vaccine go?

  86. #86 dzu
    December 9, 2011

    Chris, the aluminum (mcg/kg) is the infant weight i think not the vaccine or nutrient weight. xxmcg/kg is always the same dose doesn’t matter where it came from.

    It’s like 10ml/kg body weight of vodka =700ml for an adult doesn’t matter if you choose to dilute it or not.

  87. #87 Todd W.
    December 9, 2011

    @dzu

    First off, route of administration is very important to consider in your two examples. Parenteral nutrition given by IV goes straight into the bloodstream, meaning that any aluminum in the solution is readily transported throughout the body. A vaccine, on the other hand, is injected into either the muscle tissue or just under the skin. That means, that any aluminum in the vaccine must make its way out of the tissue and into the bloodstream for there to be any neurological damage.

    Second, compare the amounts (I’ve linked to a little bit I wrote about aluminum, among other ingredients, in vaccines). You admit that vaccines are not given steadily over the course of, say, 10 days, but do state that they are all given in a single day. How many aluminum-containing vaccines, using the recommended schedule as a guide, would be given in a single day? How much aluminum does that actually amount to, and how much of that enters the bloodstream over what period of time?

  88. #88 TBruce
    December 9, 2011

    dzu:
    I checked your reference thinktwice.com and noticed a few co-author names like Russell Blaylock and Meyer Eisenstein. They are notorious antivax crazies. Robert Kennedy Jr is also cited, despite his proven reputation for twisting the facts. Neil Z Miller, the website author, has a degree in psychology, not in any medical or biological field. As far as I’m concerned, this website is worthless propaganda and can’t be trusted.

  89. #89 Chris
    December 9, 2011

    dzu, there is a difference. The equivalent of fluid in a vaccine is a fraction of a shot glass. The amount of fluid in an IV solution is at least that of a bottle of vodka.

    Also, drinking an entire bottle of vodka call kill you. So please don’t do it. The issue is how much can the kidneys and liver handle.

    The point is the dose makes the poison.

  90. #90 Science Mom
    December 9, 2011

    At that dose they do get measurable lasting neurolgical impairments. Apparently aluminum if ingested is very much non-toxic but if it is injected it quite neurotoxic.

    That is false, dietary aluminium is essentially the same as IM and IV injected aluminium, the difference is, is that dietary aluminium is not readily taken up by the gut and is more rapidly excreted. However, human total body burden is from dietary sources, not other sources. You are also taking that study to be completely accurate, it isn’t. The authors did not include several other sources of aluminium in their subjects and they also did not control for the types and severity of illnesses of the neonates. You would know this if you followed up by reading the comment here:

    http://www.ncbi.nlm.nih.gov/pubmed/9324646

    If the link doesn’t work for you, you may access it from the NEJM main page.

    Now they say the thing is that with the new vaccine schedule infants could in theory get as much as 1200mcg in one single day just from vaccines at 2 months if age.

    Are you aware that you are drawing a comparison between IV and IM aluminium? The latter is much more slowly absorbed into the bloodstream, so much so that it can’t even be detected above basal levels in rabbits (a good model for infants by the way). Not only that but the tissue uptake for aluminium puts the brain dead last.

  91. #91 Bronze Dog
    December 9, 2011

    Got a comment in moderation, but I’ll go ahead and make another comment I was thinking about to go with what I said about the dose making the poison, and it’s fitting since Chris brought up alcohol.

    The dose makes the poison. Humans are not a collection toggle switches. There’s a dose-response curve: If a certain dose is bad, a smaller dose should be safer, and a bigger dose should be worse. There’s also a difference between chronic, prolonged, and acute exposure.

    I could kill myself if I bought a bunch of alcoholic drinks and just kept on chugging. That would be acute alcohol poisoning, and it takes a significant number of drinks. If, however, I took the same number of drinks over a much longer period of time, it’d be much easier to survive the night.

    But, there’s also a way to kill yourself even if you space out the drinks. Liver failure, for example. If someone drinks over a certain level for a long enough period of time, they’ll have toxic effects from chronic exposure.

    The problem with the anti-vax community is that they like to lie about dosage, either overtly, like measuring a one-time dose against the danger level for daily chronic dosage, or by omission, that is, choosing not to mention the importance of the dose, effectively arguing that toxicity is an all-or-nothing thing.

    For the type of overt lie I mentioned: Let’s say it takes about X alcoholic drinks a day, every day for a year, for me to develop a liver problem. If, however, I were to have X+1 drinks for a New Year’s Eve party, but otherwise avoid drinking that year, about the only thing I’d really have to worry about are the dangers of operating heavy machinery under the influence and a hangover in the morning. Many anti-vaxxers, however, essentially argue that one night of drinking leads to liver failure the next day.

    Now put that sort of ridiculous idea of toxicity into context: Aluminum is the third most common element in Earth’s crust. Our bloodstreams probably absorb more from everyday ingestion of normal foods than we get from injections. And if you assert there’s a difference between injection and ingestion, how does an aluminum ion know how it got into the bloodstream? It should be the dose of aluminum that ends up in the bloodstream that matters, not how it got there.

  92. #92 TBruce
    December 9, 2011

    dzu:
    Please note that the NEJM study was done on premature infants, who have much less body mass and total blood volume than a healthy term infant, let alone a 2 month old.
    Also premies have marginal renal function because their kidneys have not yet matured. This allows the aluminum to accumulate in the bloodstream to dangerous levels. This would be much less an issue in a term infant with normal renal function.
    Aluminum has been recognized as a hazard in adults as well as children with renal impairment for many years. It’s simply not a concern in those with healthy kidneys.
    Also, giving an aluminum solution intravenously will give much higher blood levels and therefore will overwhelm marginal kidneys. IM aluminum is released slowly, with lower blood levels attained. The kidneys will be better able to deal with this.

  93. #93 dzu
    December 9, 2011

    That is false, dietary aluminium is essentially the same as IM and IV injected aluminium, the difference is, is that dietary aluminium is not readily taken up by the gut and is more rapidly excreted.

    That is what i meant. It is hard to get an neurotoxic effect from dietary sources because the absorption via the gut is very poor unlike i.v.

    You are also taking that study to be completely accurate, it isn’t. I am not taking it to be completly accurate that is why i said “if the study is valid” i do infact not know if it is accurate.

    Are you aware that you are drawing a comparison between IV and IM aluminium?

    Of course i am. That is why i said “if if the aluminum from vaccine has the same neurotoxicity as the aluminum from i.v nutrients”

    The latter is much more slowly absorbed into the bloodstream, so much so that it can’t even be detected above basal levels in rabbits (a good model for infants by the way). Not only that but the tissue uptake for aluminium puts the brain dead last.

    Do you have a study where brain concentrations from i.v and s.c are compared? That would be really interesting.
    I haven’t found anything worthwhile i looed up the ld50 of
    some other toxic metals and s.c and i.v were often in quite similiar ranges. For example if it is released more slowly e.g over a period of several weeks i don’t see much of a difference since the nutrients since the alum in the study was spread over 10 days.

  94. #94 dzu1
    December 9, 2011

    @ sciencemom

    generally i agree we don’t really know how to compare i.m vs i.v or s.c

    Generally s.c, i.v and i.m is supposed to have a (neuro)toxic effect while p.o isn’t. which means p.o does not accumulate in neural tissue easily whereas the other administration routes do.

    ld50 and i.v and i.m however don’t need to differ that much for example, i looked up certain lead compounds where ld50 from i.v and i.m didn’t differ much.

    The metabolism of injected aluminum and accumulation infants in neural tissue in infants hasn’t been studied i believe.

    Do you know of an animal study where this has been compared directly?

  95. #95 Beamup
    December 9, 2011

    There’s no credible way any effects on the brain could be different for varied exposure sources EXCEPT by how much is ultimately absorbed into the bloodstream. Which really does make the entire question laughable since the exposure from dietary sources is so hugely greater than that from vaccination.

  96. #96 LW
    December 9, 2011

    dzu1, did you read comment #2?

  97. #97 Science Mom
    December 9, 2011

    generally i agree we don’t really know how to compare i.m vs i.v or s.c

    Actually we do but requires some literature searching on your part; there’s only thousands of studies available. I think the problem you may have, as others do is that the information is not in a single or even a few studies, you have to pour through a lot of information.

    Generally s.c, i.v and i.m is supposed to have a (neuro)toxic effect while p.o isn’t. which means p.o does not accumulate in neural tissue easily whereas the other administration routes do.

    Again, false. Once aluminium hits the bloodstream and dietary aluminium does, just not as quickly as IV or even IM, it is all distributed the same way, first to skeletal, then organs then brain. Toxic levels of aluminium are very difficult to achieve; dialysis patients (i.e. those with little or no kidney function) are particularly prone.

    The metabolism of injected aluminum and accumulation infants in neural tissue in infants hasn’t been studied i believe.

    In infants, no, in bunnies, mice, rats and adults, yes. There are also copious amounts of data involving animal studies and case reports of aluminium toxicity. Even with high dosages (orders of magnitude above vaccines), most cases of adverse neurological symptoms are reversible upon removal of aluminium sources. I found studies on PubMed, you can too. You can start here for a review and hundreds of citations: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2782734/?tool=pubmed

  98. #98 dzu1
    December 9, 2011

    @ beamup

    apparently not look at the above study, how could the infants fed i.v formula get neuro damage then? There is concern that i.v nutrients can cause problems that way compared to food. The point seems to be that absorption is incredibly poor if taken orallly but nearly 100% if given via needle.

    @ LW

    This may or may not apply to a 70kg adult.

    2-3kg infants get an adult dose of aluminum in the vaccine. Then they can get up to 4-5 vaccines on one single day(unusual for an adult) So there is a dramatic difference of course. You cannot compare that with an adult because of the low body weight and the fact that multiple vaccines are given at once.

    The absorption of aluminum is good if given i.m see here:
    http://www.ncbi.nlm.nih.gov/pubmed/12184363

  99. #99 Chris
    December 9, 2011

    So exactly how are preemies equivalent to your average three month old infant or a one year old baby? How exactly does the aluminum salts in a hepatitis b vaccine equate to ten days of IV solution?

  100. #100 dzu1
    December 9, 2011

    @sciencemom

    i disagree here. Please read the literature regarding this:

    http://journals.cambridge.org/download.php?file=%2FNRR%2FNRR3_01%2FS0954422490000105a.pdf&code=5e1d3ca39bdc2a519ea5704c1f57a0b3

    or google: Nutritional Aspects of Aluminium Toxicity

    i will quote from the work:


    Intramuscular administration Infants receiving routine periodic vaccinations against diphtheria, pertussis and tetanus are exposed to Al, which is contained in these vaccines as an adjuvant. May et al. (1986) NUTRITIONAL ASPECTS OF ALUMINIUM TOXICITY 125 found that the Al concentration in these vaccines ranged from 34 to 505 pglml. Thus, an infant receiving 0.5 ml of a vaccine might receive as much as 250 pg Al intramuscularly. However, the tissue deposition and excretion of A1 in these infants have not been studied. Thus, findings presently available indicate that oral or enteral intake of Al is associated
    with tissue accumulation only in the case of inadequate renal function while parenteral
    intake by either the intravenous, intraperitoneal or subcutaneous routes may be associated
    with tissue accumulation regardless of renal function.

    So they clearly write the it will accumulate in tissue only if injected.

    Further they write:

    TISSUE EFFECTS OF ALUMINIUM: EXPERIMENTAL EVIDENCE
    The effects of Al accumulation in various tissues have been studied. These tissues for which findings are available include bone, parathyroid glands, liver, kidney and brain. The results of these studies have considerable clinical significance in helping to evaluate the role of A1
    in the pathogenesis of a variety of disease states

    Then they write:


    Tissue accumulation
    There is little evidence from the published literature that Al administered orally or enterally accumulates in tissue if renal function is normal

    So it’s pretty obvious from that, that it will generally only accumulate in neural tissue if injected.

    Regards

  101. #101 dzu2
    December 9, 2011

    @sciencemom

    i disagree here. Please read the literature regarding this:

    http://journals.cambridge.org/download.php?file=%2FNRR%2FNRR3_01%2FS0954422490000105a.pdf&code=5e1d3ca39bdc2a519ea5704c1f57a0b3

    or google: Nutritional Aspects of Aluminium Toxicity

    i will quote from the work:


    Intramuscular administration Infants receiving routine periodic vaccinations against diphtheria, pertussis and tetanus are exposed to Al, which is contained in these vaccines as an adjuvant. May et al. (1986) NUTRITIONAL ASPECTS OF ALUMINIUM TOXICITY 125 found that the Al concentration in these vaccines ranged from 34 to 505 pglml. Thus, an infant receiving 0.5 ml of a vaccine might receive as much as 250 pg Al intramuscularly. However, the tissue deposition and excretion of A1 in these infants have not been studied. Thus, findings presently available indicate that oral or enteral intake of Al is associated
    with tissue accumulation only in the case of inadequate renal function while parenteral
    intake by either the intravenous, intraperitoneal or subcutaneous routes may be associated
    with tissue accumulation regardless of renal function.

    So they clearly write the it will accumulate in tissue only if injected.

    Further they write:

    TISSUE EFFECTS OF ALUMINIUM: EXPERIMENTAL EVIDENCE
    The effects of Al accumulation in various tissues have been studied. These tissues for which findings are available include bone, parathyroid glands, liver, kidney and brain. The results of these studies have considerable clinical significance in helping to evaluate the role of A1
    in the pathogenesis of a variety of disease states

    Then they write:


    Tissue accumulation
    There is little evidence from the published literature that Al administered orally or enterally accumulates in tissue if renal function is normal

    So it’s pretty obvious from that, that it will generally only accumulate in neural tissue if injected.

    Then you said the neurotoxicity would be completely reversible in animals even in high doses. Well it depends on how you define neurotoxicity being reversible. I am sure that many obvious severe toxic effects can be reversed but we are talking about pretty subtle neurocognitive effects here which can not be measured easily in animal studies. In the preterm infant study the mild effects were lasting.

    Regards

  102. #102 Science Mom
    December 9, 2011

    The absorption of aluminum is good if given i.m see here:

    I suggest you read the study.

    2-3kg infants get an adult dose of aluminum in the vaccine. Then they can get up to 4-5 vaccines on one single day(unusual for an adult) So there is a dramatic difference of course. You cannot compare that with an adult because of the low body weight and the fact that multiple vaccines are given at once.

    Yes you can because exposure is expressed as mcg or mg/Kg body weight. Bear in mind that while the U.S. infant vaccine schedule has 4-5 jabs recommended, not all contain aluminium and also aluminium can be reduced with combination vaccines.

  103. #103 Beamup
    December 9, 2011

    apparently not look at the above study, how could the infants fed i.v formula get neuro damage then? There is concern that i.v nutrients can cause problems that way compared to food. The point seems to be that absorption is incredibly poor if taken orallly but nearly 100% if given via needle.

    Because the volume of the solution is enough that the total dose is large.

  104. #104 dzuagain
    December 9, 2011

    http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=201.323

    WARNING: This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum.

    Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 [micro]g/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.

    http://www.fda.gov/ohrms/dockets/98fr/E6-2727.htm

    Many drug products used routinely in parenteral therapy may contain levels of aluminum sufficiently high to cause clinical manifestations. Generally, when medication and nutrition are administered orally, the gastrointestinal tract acts as an efficient barrier to the absorption of aluminum, and relatively little ingested aluminum actually reaches body tissues. However, parenterally administered drug products containing aluminum bypass the protective mechanism of the gastrointestinal tract, and aluminum circulates and is deposited in human tissues.

    Aluminum toxicity is difficult to identify in infants because few reliable techniques are available to evaluate bone metabolism in premature infants. Techniques used to evaluate the effects of aluminum on bone in adults cannot be used in premature infants. Although aluminum toxicity is not commonly detected clinically, it can be serious in selected patient populations, such as neonates, and may be more common than is recognized.

    Ok lets do the math:

    They write:


    including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 [micro]g/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity

    A 3kg child can get CNS toxicity at 13.5mcg/day from parentel administration according to the FDA.

    A child can get up to 1200mcg aluminum injected at 2 months of age in one single day(see vaccine schedule)

    That’s equal to 88 days of 13.5mcg of parental not cosidering different pharmacokinetics of an intramuslcular administration.

    It’s far from a low dose looking at it that way.

  105. #105 d zu
    December 9, 2011

    Look here is what the FDA says:

    http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=201.323

    WARNING: This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum.

    Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 [micro]g/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.

    http://www.fda.gov/ohrms/dockets/98fr/E6-2727.htm

    Many drug products used routinely in parenteral therapy may contain levels of aluminum sufficiently high to cause clinical manifestations. Generally, when medication and nutrition are administered orally, the gastrointestinal tract acts as an efficient barrier to the absorption of aluminum, and relatively little ingested aluminum actually reaches body tissues. However, parenterally administered drug products containing aluminum bypass the protective mechanism of the gastrointestinal tract, and aluminum circulates and is deposited in human tissues.

    Aluminum toxicity is difficult to identify in infants because few reliable techniques are available to evaluate bone metabolism in premature infants. Techniques used to evaluate the effects of aluminum on bone in adults cannot be used in premature infants. Although aluminum toxicity is not commonly detected clinically, it can be serious in selected patient populations, such as neonates, and may be more common than is recognized.

    http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=201.323
    WARNING: This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum.
    Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 [micro]g/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.
    http://www.fda.gov/ohrms/dockets/98fr/E6-2727.htm
    Many drug products used routinely in parenteral therapy may contain levels of aluminum sufficiently high to cause clinical manifestations. Generally, when medication and nutrition are administered orally, the gastrointestinal tract acts as an efficient barrier to the absorption of aluminum, and relatively little ingested aluminum actually reaches body tissues. However, parenterally administered drug products containing aluminum bypass the protective mechanism of the gastrointestinal tract, and aluminum circulates and is deposited in human tissues.
    Aluminum toxicity is difficult to identify in infants because few reliable techniques are available to evaluate bone metabolism in premature infants. Techniques used to evaluate the effects of aluminum on bone in adults cannot be used in premature infants. Although aluminum toxicity is not commonly detected clinically, it can be serious in selected patient populations, such as neonates, and may be more common than is recognized.
    More studies if anyone is interested:
    http://www.ncbi.nlm.nih.gov/pubmed/1608913
    Aluminium is widely used as an adjuvant in human vaccines, and children can often receive up to 3.75 mg of parenteral aluminium during the first six months of life. We show that intraperitoneal injection of aluminium adsorbed vaccines into mice causes a transient rise in brain tissue aluminium levels peaking around the second and third day after injection. This rise is not seen in the saline control group of animals or with vaccine not containing aluminium. It is likely that aluminium is transported to the brain by the iron-binding protein transferrin and enters the brain via specific transferrin receptors.
    http://journals.cambridge.org/download.php?file=%2FNRR%2FNRR3_01%2FS0954422490000105a.pdf&code=a43fb9376b4301ab3592b187924f0996
    Intramuscular administration
    Infants receiving routine periodic vaccinations against diphtheria, pertussis and tetanus
    are exposed to Al, which is contained in these vaccines as an adjuvant. May et al. (1986)
    found that the Al concentration in these vaccines ranged from 34 to 505 pglml. Thus, an
    infant receiving 0.5 ml of a vaccine might receive as much as 250 pg Al intramuscularly.
    However, the tissue deposition and excretion of A1 in these infants have not been studied.
    Thus, findings presently available indicate that oral or enteral intake of Al is associated
    with tissue accumulation only in the case of inadequate renal function while parenteral
    intake by either the intravenous, intraperitoneal or subcutaneous routes may be associated
    with tissue accumulation regardless of renal function.

    Ok lets do the math:
    They write:

    including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 [micro]g/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity

    A 3kg premature neonate can get CNS toxicity at 13.5mcg/day from parental administration according to the FDA.
    A premature neonate can get up to 1200mcg aluminum injected at 2 months of age in one single day(see vaccine schedule)
    That’s equal to 88 days of 13.5mcg of parental aluminum not considering different pharmacokinetics of an intramuscular administration.

    It’s far from a low dose looking at it that way. Actually it could reach neuro damage levels.

    Regards

  106. #106 Science Mom
    December 9, 2011

    The point seems to be that absorption is incredibly poor if taken orallly but nearly 100% if given via needle.

    I forgot to mention that even though absorption with IV and eventually IM injection of aluminium is almost 100 %, the vast majority is excreted within 24 hours and continues to do so with very little tissue uptake. Please refer to the review I linked to.

  107. #107 lilady
    December 9, 2011

    Er..not all preterm babies receive vaccines at birth. Single antigen Hepatitis B #1 along with HBIG (hepatitis B immune globulin) is the only one given to preterm infants at birth to infants whose mothers are chronic hepatitis B carriers.

    From the CHOP (Children’s Hospital of Philadelphia) website:

    Special Considerations for Preterm Infants

    Any baby born before the 37th week of pregnancy is considered to be preterm. About 12 percent of births in the U.S. are preterm.
    Maternal antibodies

    Preterm babies acquire lesser quantities of antibodies through the placenta than full-term babies. Since these antibodies are present at lower levels, they do not last as long as those of full-term babies. Because preterm infants rely on their own immune systems for protection sooner than full-term babies, it is important that they receive needed vaccinations so they can protect themselves against disease.
    Chronologic age

    Vaccines should be given according to a baby’s chronologic age — the time since delivery.
    Hepatitis B vaccine

    Preterm infants of mothers infected with hepatitis B should receive the hepatitis B vaccine at or shortly after birth. Preterm infants of mothers who are not infected with hepatitis B should also get the vaccine; these babies require the vaccination 1 month after birth.

    If the baby weighs less than 2,000 grams, the dose should not be counted as part of the hepatitis B series, and the baby should start the 3-dose series 1 month after birth.

    Preterm babies discharged before 1 month of age may get the vaccine at discharge as long as they are considered medically stable and have been consistently gaining weight.

    In both cases, later doses should be given at least 4 weeks after the dose at 1 month. The third dose should be given at least 16 weeks after the first dose and at least 8 weeks after the last dose, but not before 6 months of age.
    Vaccines typically administered at two months

    In addition to hepatitis B, 2-month-old babies require vaccination against diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b, pneumococcus, and rotavirus. Preterm infants should receive these vaccines at the chronologic age of 2 months, even if they are still hospitalized.

    These vaccines should continue to be given at the appropriate chronologic ages according to the Centers for Disease Control and Prevention’s vaccine schedule, until each series is completed.
    Other vaccines

    Other vaccines should also be given according to the recommended schedule; these include vaccines for measles, mumps, rubella, varicella, and hepatitis A.

    Influenza vaccine is not recommended until 6 months of age. At 6 months of age, the baby may get the inactivated version of the vaccine. Healthcare workers and family members in contact with a baby less than 6 months old should be immunized to lessen the baby’s chance of being infected with influenza.

    Updated: December 2010

    Preterm babies receive IV hydration fluid with electrolytes for particular disorders and then receive receive breast milk and/or extra caloric formula through bottle feeding or infant gavage tube feeding…as tolerated…for weight gain.

  108. #108 dzuu
    December 9, 2011

    @ sciencemom

    That is not what the literature says. Signficant amounts get deposited if it is given via needle but not if it is given orally. Please see here:

    http://journals.cambridge.org/download.php?file=%2FNRR%2FNRR3_01%2FS0954422490000105a.pdf&code=a43fb9376b4301ab3592b187924f0996

    Regards

  109. #109 C. Sommers
    December 9, 2011

    Todd W. #83:

    Don’t be ridiculous. Th1Th2 has proven numerous times that intramuscular is the same thing as intravenous.

    *ducks behind desk*

  110. #110 LW
    December 9, 2011

    C. Sommers #96:

    Yeah, and Th1Th2 has proven numerous times that ingestion and inhalation are *also* the same things as intravenous.

  111. #111 lilady
    December 9, 2011

    @ C. Sommers
    @ LW

    Cut that out…now. You must never encourage the Thingy troll…besides the Th1Th2bot deserves some rest.

  112. #112 Professor Blackheart
    December 9, 2011

    The potential role of aluminium in Alzheimer’s disease

    “Aluminium is a trivalent cation that does not undergo redox changes. It has, nonetheless, been implicated in a variety of neurological disorders that have been associated with an increase in the formation of reactive oxygen species (ROS).”

    “The article discusses the role of aluminium in two mechanisms that have been linked to neurodegenerative disorders, including AD. Studies are summarized that describe how aluminium can potentiate iron‐induced oxidative events.

    Involvement of aluminium in inflammatory responses, mediated by interleukins and other inflammatory cytokines, is also discussed.

    Although a direct relationship between aluminium and AD has not been clearly demonstrated, a detailed mechanistic basis for the hypothesis that aluminium may exacerbate events associated with AD is clearly emerging.

    Research Highlights

    * Aluminium has been implicated as a possible cause of encephalopathy since 1976

    * Infants have shown impaired neurological development.

    * Aluminium has been shown to have an inflammatory action.

    * Some patients revaccinated for hepatitis B with vaccine preparations that contain aluminium adjuvants developed inflammatory nodules

    * A relationship between NFkB transcription factor and aluminium , which has also been implicated in gene expression profiling in ASD, has been established.

  113. #113 Krebiozen
    December 9, 2011

    I think one important thing here is that aluminum adjuvants in vaccines are almost insoluble so when injected IM or SC they stay there and only dissolve very slowly into the bloodstream. Aluminum dissolved in solutions given IV goes straight into the bloodstream, and potentially into the brain. Also worth noting is that preterm infants often have renal impairment which makes it more difficult to excrete aluminum.

  114. #114 lilady
    December 9, 2011

    I have a comment stuck in moderation, again, about IV hydration fluids and a vaccine administered at birth versus vaccines administered starting at 2 months of age.

  115. #115 Garn
    December 9, 2011

    I am an inorganic chemist and I used to review for this journal, back when it was more respectable.

    These guys need to go back to the drawing board. Al ions speciate in water, depending on the pH, to various oxides and hydroxides. The Al-oxygen bond is a very strong one, and once formed, is rarely broken so that the Al can bind to other sites, such as those on proteins.

    That’s mostly why Al is not found in biochemical cycles: nearly all of it in our water-and-oxygen saturated geo and biosphere takes the form of very unreactive Al-oxygen compounds. Those are largely completely insoluble (all those minerals in the earth’s crust, etc.) and just precipitate harmlessly out of any solution in which they form.

    You don’t get poisoned by exposure to Al in the earth’s crust because it’s all Al-oxygen compounds, too stable and unreactive to deliver Al to anything.

    The only Al species that are somewhat toxic are those that are organo-aluminums (Al-carbon bonds): these have different reactivities, and can survive long enough to enter cells and react with whatever may be there. No Al compounds that dissolve in water are organo-aluminums, so none of the adjuvant compounds are.

    You can inject Al-oxygen compounds directly into the bloodstream; they won’t react with biological molecules and large doses of them will just aggregate and precipitate out of solution.

    Too bad I don’t review for this journal anymore. Of course, in that case, you never would have read this oh-so-entertaining article.

  116. #116 Professor Blackheart
    December 10, 2011

    NFkB , Autism and Aluminium

    Aluminium and Alzheimer’s disease: the science that describes the link

    Christopher Exley

    p 155 , p313-314 ,p317, p320

    Aluminum as a toxicant

    A Becaria et al

    Department of Community and Environmental Medicine, Center for Occupational and Environmental Health
    Sciences, Irvine, CA

    Potential involvement of the transcription factor NF-κB in neurological disorders

    Barbara Kaltschmidt, Patrick A. Baeuerle, Christian Kaltschmidt
    Purchase
    Institute for Biochemistry, University of Freiburg

    Reactive oxygen intermediates (ROIs) are involved in many neurological diseases. Despite the toxic nature of these compounds, low concentrations of ROIs can function as signaling molecules. One target for their signaling function is the inducible transcription factor NF-κB. Predominantly in lymphoid cells, induction of NF-κB in response to oxidative stress leads to transcriptional activation of many genes which are relevant for pathogen defense. These include the TNF, IL-6, IL-8, GM-CSF, β-interferon, MHC class I and V-CAM genes. However, NF-κB is also abundant in various cell types of the nervous system, including neurons. We propose that NF-κB plays a role as a redox-controlled transcriptional activator also in cells of the nervous system and in that property may contribute to neurological disorders. Our finding that some neurons from healthy brain contain constitutively active NF-κB suggests a role of NF-κB in normal brain function as well.

  117. #117 dzu
    December 10, 2011

    @tbruce

    Please note that the NEJM study was done on premature infants, who have much less body mass and total blood volume than a healthy term infant, let alone a 2 month old.
    Also premies have marginal renal function because their kidneys have not yet matured

    Premature infants do get the same vaccines that healthly children do. Don’t forget that. The same dose might be perfectly OK for a normal healthly child

    Also, giving an aluminum solution intravenously will give much higher blood levels and therefore will overwhelm marginal kidneys. IM aluminum is released slowly, with lower blood levels attained. The kidneys will be better able to deal with this.

    Yes hopefully but when i looked this up i found that this hasn’t been studied yet. So how do you know this for sure?

    I think no one knows exactly how it would behave in the infant body.

    It is supposed to get deposited in tissues as well. The question is to what extent does it get deposited compared with aluminum from IV nutrition.

    Around 15mcg/day via IV parenteral nutrition(for prolongued time) in a premature infants will cause CNS toxic effects at least that’s what the FDA wrote.

    Now the same premature infants could get up to 1000+ mcg in one single day i.m or s.c.

    It is definitely known that aluminum given I.M (even in the form of the current adjuvant) will enter the brain.

    The question is how different the effect will be in terms of (neuro)toxicity compared with i.v nutrition.

    The same author from the above study (SHAW) has done 2 controversial studies with animals in the past and claimed that low doses of injected aluminum would cause measure neuro damage in mice. The adjusted for bodyweight the doses were around 1000mcg i think.

    Quite the same dose that an infant could get at 2 months of age.

    Aluminum adjuvant linked to Gulf War illness induces motor neuron death in mice.

    http://www.ncbi.nlm.nih.gov/pubmed/17114826

    Aluminum hydroxide injections lead to motor deficits and motor neuron degeneration

    http://www.ncbi.nlm.nih.gov/pubmed/19740540

    So he claims to induce neuro damage in mice at aluminum doses(adjusted for bodyweight mof course) commonly administered on the childhood vaccine schedule.

  118. #118 Science Mom
    December 10, 2011

    So he claims to induce neuro damage in mice at aluminum doses(adjusted for bodyweight mof course) commonly administered on the childhood vaccine schedule.

    If you actually read both of those Shaw studies, it is obvious that their methods are dodgy and they didn’t actually find any relevant differences in the groups. They’ve been discussed here.

    dzu, you keep making claims from a position of ignorance; do some homework first. I told you that there are no pat studies that directly answer your questions but the information is there. You can also try this: http://www.ncbi.nlm.nih.gov/pubmed/22001122

    @ Blackheart, is there some kind of point you would like to make with your Gish Gallop?

  119. #119 Dr. le Petomane
    December 10, 2011

    Here are some other interesting correlations for everyone’s enjoyment:

    http://www.businessweek.com/magazine/correlation-or-causation-12012011-gfx.html

  120. #120 TBruce
    December 10, 2011

    Premature infants do get the same vaccines that healthly children do. Don’t forget that. The same dose might be perfectly OK for a normal healthly child

    They do? While they’re in the ICN? I doubt it. Maybe someone involved with neonatal care could answer.

    Yes hopefully but when i looked this up i found that this hasn’t been studied yet. So how do you know this for sure?

    I don’t know for sure, but I believe it’s true for every substance that has been studied. It’s true for heroin. There’s a reason why IVDUs aren’t IMDUs.

  121. #121 dzu
    December 10, 2011

    @sciencemom

    you keep making claims from a position of ignorance; do some homework first

    You seem to forget that i was the one in our discussion who had to correct you several times.

    1. You told me that injected aluminum would be no more neurotoxic than ingested even though i had referenced a work where it was clearly said that injected aluminum would accumulate.

    2. Then you told me i.m aluminum would not be well absorbed.

    I had said it would.(i had linked to it as well)

    Then you had to correct yourself.

    3. Then you told me even serious toxicity would be reversible in animals despite studies showing that aluminum exposure in infants (animals and humans) even at low doses can cause subtle long lasting impairments.

    4. You told me the study on top could be applied to (premature) infants as well despite they talked about adults since it was express as mcg/kg. I think it’s not please think again. The aluminum dose in vaccines is quite the same for infants as for adult. So you didn’t know what you were talking about.

    etc. etc. etc.

    So who is talking from a point of ignorance here?

    You make pseudo-arguments and label the other person as ignorant.

    Did you even understand what were talking about?

    I personally don’t think it makes much sense to discuss this
    further.

  122. #122 dzu
    December 10, 2011

    They do? While they’re in the ICN? I doubt it. Maybe someone involved with neonatal care could answer.

    http://www.chop.edu/service/parents-possessing-accessing-communicating-knowledge-about-vaccines/age-groups-and-vaccines/special-considerations-for-preterm-infants.html

    They write:

    Vaccines typically administered at two months
    In addition to hepatitis B, 2-month-old babies require vaccination against diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b, pneumococcus, and rotavirus. Preterm infants should receive these vaccines at the chronologic age of 2 months, even if they are still hospitalized

  123. #123 lilady
    December 10, 2011

    @ TBruce: My comment # 107 about preterm infants in the NICU getting vaccine/vaccines is out of moderation. Preterm infants whose mothers are HBsAg positive do receive single antigen hepatitis B vaccine within 12 hours of birth. Recombivax and Engerix are single antigen hepatitis B vaccines and each of these vaccines contain 0.25 mg. aluminum hydroxide.

    For the majority of preterm infants whose mothers are not hepatitis B carriers, the hepatitis B vaccine is deferred. Other childhood vaccines are not given before one month of age…in keeping with the ACIP Recomendations.

  124. #124 Science Mom
    December 10, 2011

    You seem to forget that i was the one in our discussion who had to correct you several times.

    In your dreams. You mistake absorption with retention and continue to make a direct comparison between IV and IM.

    1. You told me that injected aluminum would be no more neurotoxic than ingested even though i had referenced a work where it was clearly said that injected aluminum would accumulate.

    It isn’t more neurotoxic, all forms of exposure accumulate. Are you confused about toxicokinetics too? The order of tissue retention is also as follows: bone > kidney > spleen > liver > heart > lymph > brain.

    2. Then you told me i.m aluminum would not be well absorbed.

    I had said it would.(i had linked to it as well)

    Then you had to correct yourself.

    Typical. Turn to lying when you can’t make your case. No, never said that, check my comment again. IM aluminium is very slowly absorbed from the injection site.

    3. Then you told me even serious toxicity would be reversible in animals despite studies showing that aluminum exposure in infants (animals and humans) even at low doses can cause subtle long lasting impairments.

    If you read some studies, you would know this; I gave you an excellent review, avail yourself of it. You are also taking the Bishop et al. study as gospel when you shouldn’t. It was highly flawed as in they didn’t control for a vast number of factors which would confound their results.

    4. You told me the study on top could be applied to (premature) infants as well despite they talked about adults since it was express as mcg/kg. I think it’s not please think again. The aluminum dose in vaccines is quite the same for infants as for adult. So you didn’t know what you were talking about.

    You are making the mistaken assumption that any aluminium exposure is toxic. I was also pointing out your continued error of expressing IV administration as comparable to IM. Aside from that, you aren’t making much sense.

    I personally don’t think it makes much sense to discuss this further.

    I think that would be a good move on your part until you actually read some full studies and stop Gish Galloping with abstracts that you a.)haven’t read and b.)don’t understand.

  125. #125 lilady
    December 10, 2011

    @ TBruce: It has been 35 years since I personally intermitently gavaged an infant…my son who was born with a submucous cleft palate and an inability to suck. Surprisingly, the process to begin to formula feed an infant in the NICU and upon release to home has not changed for infants born with congenital anomalies of the digestive tract.

    Enteral formula feeding is begun within the first few days of an infant’s life. If the anomaly is further down in the digestive tract, then a simple surgery to implant a G-Tube or a J-Tube is performed for either intermittent formula feedings or continuous (up to 18 hours a day) formula feedings.

    TPN is also used for extremely low birthweight babies and for infants who cannot absorb nutrients through the digestive tract. TPN is never used when enteral tube formula feeding is well tolerated, due to risks of electrolyte imbalances, maintenance of central lines and the risk of infection. Constant blood tests are also required to monitor the infants status and to decrease the risks inherent with long-term TPN.

    Medscape has an excellent website “Fluid, Electrolyte and Nutrition Management of the Newborn”

  126. #126 herr doktor bimler
    December 10, 2011

    Aluminium and Alzheimer’s disease: the science that describes the link
    Christopher Exley

    Exley… ah, there’s a familiar name. He wrote his undergraduate thesis about aluminium toxicity and has since built his career on it, so far linking aluminium with autism, alzheimers, multiple sclerosis, and (when used in antiperspirants) breast cancer*. Publishes regularly in Medical Hypotheses, and cited three times in the paper on which this post centres. Needless to say, he is much-sought-after as a speaker at anti-vax meetings.

    * Exley’s 2007 Anti-perspirants / breast-cancer paper was published by our friends at the Journal of Inorganic Biochemistry, and was picked up by all the usual suspects including the Daily Mail and Joe Mercola:
    http://scienceblogs.com/insolence/2011/10/antiperspirants_cause_breast_cancer.php

  127. #127 dzu
    December 10, 2011

    @sciencemom

    It isn’t more neurotoxic, all forms of exposure accumulate

    True but not all to the same extent.

    The order of tissue retention is also as follows: bone > kidney > spleen > liver > heart > lymph > brain.

    Could you please explain in more detail what you are trying to say with this ? I think it to be expected that less ends up in the brain than in other organs so why are mentioning this anyway?

    Thank you.

  128. #128 dzu
    December 10, 2011

    @sciencemom

    It isn’t more neurotoxic, all forms of exposure accumulate

    True but not all to the same extent.

    The order of tissue retention is also as follows: bone > kidney > spleen > liver > heart > lymph > brain.

    Could you please explain in more detail what you are trying to tell me with this quote?

    Thank you.

  129. #129 The Christian Cynic
    December 10, 2011

    Do I detect the rotten stench of dirty socks? (If not, a few of our crank-y trolls have remarkably similar formatting methods in addition to similar ideas and misconceptions.)

  130. #130 Chris
    December 10, 2011

    I am amazed that they ignore the much larger amounts of aluminum that is in food and air (about 7-9 mg per day for an adult, a fraction of that for babies) because they won’t equate absorption through mucus membranes and digestive track with intramuscular injection. But are quite willing to equate intravenous solutions given to premature babies, who are often underweight and medically fragile, to intramuscular injections given to healthy children.

    My layman’s understanding is that things get into the bloodstream faster through mucus membranes and the intestines than from muscle tissue. So that the bloodstream gets more aluminum salts from food and air, than from the muscle. Also, two month old babies that weigh between four and a bit over six kilograms are not the same as premature newborns that weigh between one and three kilograms, especially those that require IV fluids.

  131. #131 dzu
    December 10, 2011

    @ chris

    I didn’t equate premature babies with healthy children.

    I just mentioned the possibility that prematures who receive an aluminum injection could theoretically be at risk of having (neuro)toxic effects “IF” an intramuscular injection were of similiar toxicity as an i.v or s.c injection.

    The “IF” means that i don’t know if this would apply or not.

    Personally i don’t know how one could compare the two parenteral admnistration types.

    I have also no idea how a healthy normal child would react?

    Probably not the same way since they can excrete the metal much better. Just because i.v injections would be unsafe for a premature child with weak kidney function doesn’t mean that a normal baby would be at risk.

  132. #132 anonmom
    December 10, 2011

    @Chris- from the Merck Manual
    “Usually, however, most of the drug is absorbed from the small intestine. The drug passes through the intestinal wall and travels to the liver before it is transported via the bloodstream to its target site. The intestinal wall and liver chemically alter (metabolize) many drugs, decreasing the amount of drug reaching the bloodstream. Consequently, these drugs are often given in smaller doses when injected intravenously to produce the same effect.”
    They are talking about drugs- don’t know if this applies to aluminum.

  133. #133 Science Mom
    December 10, 2011

    It isn’t more neurotoxic, all forms of exposure accumulate

    True but not all to the same extent.

    Better with the honesty but still a ways to go with regards to exposure. An IM aluminium bolus stays at the site of injection and very slowly absorbs into the bloodstream. If you refer to the last link I gave you, you can see the comparison of dietary v. IM exposure. Dietary is higher overall.

    The order of tissue retention is also as follows: bone > kidney > spleen > liver > heart > lymph > brain.

    Could you please explain in more detail what you are trying to tell me with this quote?

    Yes, please refer back to your own link: http://www.ncbi.nlm.nih.gov/pubmed/12184363 And you can see the absorption rates along with tissue order of deposition and amounts, in addition to excretion rates of aluminium adjuvants administered to rabbits (again, a good model for human infants). It would take orders of magnitude higher aluminium concentrations, administered chronically for months to achieve neurotoxicity.

  134. #134 TBruce
    December 10, 2011

    Thank you lilady for the info.

    One point (among many) that dzu seem to miss is that intravenous injection or infusion is immediately introduced into the bloodstream – that’s, uh, kind of the point of IV administration. An IM or subq injection is a depot of liquid in the tissues. It needs to diffuse across tissue barriers and vascular walls before it enters the bloodstream. This slows down its aborption and results in a lower peak blood level. The speed of absorption will also depend on the solubility of the injected preparation. It also depends on the vascularity of the tissues, particularly small vessels. Mucous membranes such as nasal passages and oral membranes absorb quite rapidly. Muscle has fewer small vessels, so that absorption takes longer.

    There’s no reason why aluminum should be any different (except for possible metabolic changes, which I don’t know about, offhand).

  135. #135 Chris
    December 10, 2011

    And… so how much of the 1 mg of aluminum a child consumes each day gets into the bloodstream compare to the amount put into an arm muscle once every two or three months by the DTaP and pneumococcal vaccine?

    And how does it get from the small intestine to the liver? Is there some kind of pipeline that bypasses the entire blood circulatory system? And what about the aluminum in dust that is taken in by the lungs? How does that bypass the blood vessels?

  136. #136 Professor Blackheart
    December 10, 2011

    sciencemom

    @ Blackheart, is there some kind of point

    Yes … I thought that was quite obvious.
    Gish Gallop – meh.

  137. #137 Urban Psychiatrist Blackheart
    December 10, 2011

    The Christian Cynic

    No … you are suffering from internet paranoia.

  138. #138 herr doktor bimler
    December 10, 2011

    And how does it get from the small intestine to the liver?
    The portal vein, I imagine.

  139. #139 Chris
    December 10, 2011

    Thank you. It is a bit of a pipeline.

  140. #140 dedicated lurker
    December 10, 2011

    Isn’t aluminium primarily excreted by the kidneys? I’m only asking because I’m not sure how much gets to the liver in the first place.

  141. #141 lilady
    December 10, 2011

    I believe that “dedicated lurker” is correct about ingested aluminum primarily being excreted in the kidneys with only a small amount being transported to the blood circulation.

    The CHOP (Children’s Hospital of Philadelphia) Vaccine Education website has excellent information about aluminum in vaccines and ingested aluminum:

    Aluminum in Vaccines: What You Should Know

    ***Who knew that soy-based baby formulas have 4 X the amount of aluminum compared to regular baby formulas?

  142. #142 The Very Reverend Battleaxe of Knowledge
    December 10, 2011

    ***Who knew that soy-based baby formulas have 4 X the amount of aluminum compared to regular baby formulas?

    Uh, oh! Mul-Soy baby here. I guess that means I’m autistic, or schizophrenic, or Alzheimer-iffic, or whatever…have you seen my socks?

  143. #143 hardindr
    December 11, 2011

    Perhaps I have missed it, but has Orac posted on the recent New Yorker article about Ted Kaptchuk? http://www.newyorker.com/reporting/2011/12/12/111212fa_fact_specter It features a short quote from this blog. I would be interested in hearing his take on it.

  144. #144 lilady
    December 11, 2011

    @The Very Reverend Battleaxe of Knowledge: Mul-Soy baby, eh.

    I have an interesting story about Neo-Mul-Soy baby formula…which was re-formulated and missing chloride. Once my son was released from the NICU in 1976 and taking enriched calories dairy based formula, he developed a severe unsightly rash on his scalp which resulted in large patches of his blond peach fuzz hair pealing off with the skin atop his head. We tried a wee bit of cortisone cream on small areas of his scalp and it didn’t work.

    The doctor suggested that we switch to a soy-based formula, to see if that might resolve the problem and handed me samples of Neo-Mul-Soy. My son absolutely refused to take it…I tasted it and it made me gag. I then went and purchased another soy-based formula, which he accepted.

    In 1979 there was a major recall of Neo Mull Soy formula. It was implicated in many cases of infant hypercholeremic alkalosis. The recall resulted in many lawsuits against the manufacturer Syntex and caused Syntex to go out of business.

    P.S. My son slowly had dairy re-introduced and was on regular formula by age one.

  145. #145 Antaeus Feldspar
    December 11, 2011

    Perhaps I have missed it, but has Orac posted on the recent New Yorker article about Ted Kaptchuk? http://www.newyorker.com/reporting/2011/12/12/111212fa_fact_specter It features a short quote from this blog. I would be interested in hearing his take on it.

    Can’t speak for Orac, but here’s my two cents:

    1) We know of the existence of the Real Placebo Effect, RPE from here on, which is basically any means by which patients are perceived as getting better and the improvement is attributed to some medical intervention when the improvement actually came from some knowable factor other than the intervention (regression to the mean; confirmation bias of the idea “I’ll start to improve now that I’m on the meds”; experimenter’s confirmation bias that the tested intervention is having an effect; patient doing things differently now that they believe the meds are there to do the heavy lifting, etc.)
    2) Kaptchuk postulates a separate factor, the Magical Placebo Effect, MPE from here on, by which the mighty power of the mind achieves the feat of healing the body once the patient believes the intervention will heal them.
    3) Note that the only way the existence of the MPE could ever be verified is to completely rule out all forms of RPE. If RPE and MPE are both possible explanations in a given case, the one we actually know exists is a far more logical explanation than a phenomenon so far only postulated.
    4) Kaptchuk suggests that clinical practice should be changed to take advantage of the postulated MPE … under circumstances that practically throw up a blinking neon sign reading “RPE, ENTER HERE AND HAVE YOUR WAY!!!” What is the difference between giving the patient a sugar pill and saying, “here, this is a powerful medicine which will have a powerful effect that will make you better,” and giving the patient a sugar pill and saying “here, this is a sugar pill which is only a placebo BUT placebos are actually powerful medicine which will activate powerful effects that will make you better”??

    One can be charitable and believe that Kaptchuk is sincere, but his ideas still make sense only as a way for him to justify practicing interventions, such as acupuncture, that can’t be justified by science.

  146. #146 Science Mom
    December 11, 2011

    It isn’t more neurotoxic, all forms of exposure accumulate

    True but not all to the same extent.

    Better with the honesty but still a ways to go with regards to exposure. An IM aluminium bolus stays at the site of injection and very slowly absorbs into the bloodstream. If you refer to the last link I gave you, you can see the comparison of dietary v. IM exposure. Dietary is higher overall.

    The order of tissue retention is also as follows: bone > kidney > spleen > liver > heart > lymph > brain.

    Could you please explain in more detail what you are trying to tell me with this quote?

    Yes, please refer back to your own link: http://www.ncbi.nlm.nih.gov/pubmed/12184363 And you can see the absorption rates along with tissue order of deposition and amounts, in addition to excretion rates of aluminium adjuvants administered to rabbits (again, a good model for human infants). It would take orders of magnitude higher aluminium concentrations, administered chronically for months to achieve neurotoxicity.

  147. #147 Professor Blackheart
    December 12, 2011

    Differing Pathways

    I suppose one should be acutely aware of the varying clear and robust evidence of immune system dysfunction evident in some if not all ASD children. As emphasised by recent research collaboratively conducted by researchers at

    Department of Neurology and Semel Institute, David Geffen School of Medicine, University of California

    Banting and Best Department of Medical Research, Donnelly Centre, University of Toronto

    Institute of Psychiatry, King’s College London

    Department of Human Genetics, University of California Los Angeles

    “Our system-level analysis of the ASD brain transcriptome demonstrates the existence of convergent molecular abnormalities in ASD for the first time, providing a molecular neuropathological basis for the disease, whose genetic, epigenetic, or environmental aetiologies can now be directly explored.

    The genome-wide analysis performed here significantly extends previous findings implicating synaptic dysfunction, as well as microglial and immune dysregulation in ASD by providing an unbiased systematic assessment of transcriptional alterations and their genetic basis.

    We show that the transcriptome changes observed in ASD brain converge with GWAS data in supporting the genetic basis of synaptic and neuronal signalling dysfunction in ASD, whereas immune changes have a less pronounced genetic component and thus are most likely either secondary phenomena or caused by environmental factors.

    So could any component of a vaccine trigger aberrant NFkB response in genes related to autism. You might think so if you read these …

    Aberrant NF-KappaB Expression in Autism Spectrum Condition: A Mechanism for Neuroinflammation 2011

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3098713/

    NF-kB: a crucial transcription factor for glial and neuronal cell function

    http://www.cell.com/trends/neurosciences/abstract/S0166-2236%2896%2901035-1

    and finally this

    Expression Profiling of Autism Candidate Genes during Human Brain Development Implicates Central Immune Signaling Pathways

    http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0024691

    Perhaps it is linked to these or is another pathway ?

    Trends Immunol. 2009 Mar;30(3):109-16. Epub 2009 Feb 21.

    Linking allergy to autoimmune disease.

    http://www.ncbi.nlm.nih.gov/pubmed/19231288

    Division of Immunopathology, Department of Pathophysiology, Center for Physiology and Pathophysiology, Medical University of Vienna

    Type I allergy is a classical Th2-driven hypersensitivity disease based on IgE recognition of environmental allergens. Exposure of allergic individuals to exogenous allergens leads to immediate type inflammation caused by degranulation of mast cells via IgE-allergen immune complexes and the release of inflammatory mediators, proteases and pro-inflammatory cytokines.

    However, allergic inflammation can occur and persist in the absence of exposure to exogenous allergens and might paradoxically resemble a Th1-mediated chronic inflammatory reaction.

    We summarize evidence supporting the view that autoimmune mechanisms might contribute to these processes.

    IgE recognition of autoantigens might augment allergic inflammation in the absence of exogenous allergen exposure. Moreover, autoantigens that activate Th1-immune responses could contribute to chronic inflammation in allergy, thus linking allergy to autoimmunity.

    Int J Immunopathol Pharmacol. 2009 Oct-Dec;22(4):859-65.
    Autism spectrum disorders and mastocytosis.

    http://www.ncbi.nlm.nih.gov/pubmed/20074449

    “We report that the apparent prevalence of ASD in patients with mastocytosis, a rare disease occurring in 1/4,000 children and characterized by an increased number of hypersensitive mast cells in many organs, is about 1/10 or 10 times higher than the general population. A child with skin mastocytosis (urticaria pigmentosa), and regressive autism is presented to illustrate the point. Allergic, infectious, neuroimmune and environmental triggers may activate mast cells to release vasoactive, inflammatory and neurotoxic molecules.

    These could disrupt the gut-blood-brain-barriers, and/or activate susceptibility genes, thus contributing to brain inflammation and ASD.”

    “Allergic reactions might be caused by the vaccine antigen, residual animal protein, antimicrobial agents, preservatives, stabilizers, or other vaccine components (161).

    Children who have had an apparent severe allergic reaction to a vaccine should be evaluated by an allergist to determine the responsible allergen and to make recommendations regarding future vaccination.”

    Biochim Biophys Acta. 2010 Dec 28. [Epub ahead of print]

    Mast cell activation and autism.

    Tufts University School of Medicine

    http://www.ncbi.nlm.nih.gov/pubmed/21193035

    Molecular Immunopharmacology and Drug Discovery Laboratory, Department of Pharmacology and Experimental Therapeutics, Tufts University School of Medicine

    “Perinatal mast cell activation by infectious, stress-related, environmental or allergic triggers can lead to release of pro-inflammatory and neurotoxic molecules, thus contributing to brain inflammation and ASD pathogenesis, at least in a subgroup of ASD patients.

    There you go not so hard to understand.Especially if say aluminium was an allergenic.

    Aluminium allergy

    Veien et al

    The Dermatology Clinic, Vesterbro 99, Aalborg, Denmark

    13 children ranging in age from 1 to 13 years and 1 adult patient had positive patch tests to 2% Alcl3 in water. 13 of them had pruritic excoriated papules, 9 al sites of hyposensitization therapy with aluminium-bound pollen extracts, and 4 al sites of childhood immunization with an aluminium-bouud vaccine [Di-Te-Pot).

    Aluminium is most likely to sensitize when present in preparations used for immunization.

    Vaccination granulomas and aluminium allergy: course and prognostic factors

    Kaaber et al The Dermatology Clinic, Bredgade 30, DK-7400 Herning, Denmark

    21 children who had cutaneous granulomas following immunization with a vaccine containing aluminium hydroxide, and who had positive patch tests to aqueous aluminium chloride and/or to a Finn Chamber, were Followed for I to 8 years During the period of observation, the symptoms cleared in 5 children. Improved in 11, and remained unchanged in 5. The course of the granulomas could can (not) be correlated with sex or atopy. nor with intensity of the initial aluminium patch test. 4 children were patch tested again with aluminium.

    Ugeskr Laeger. 1992 Jun 29;154(27):1900-1.
    [Aluminum allergy caused by DTP vaccine].

    “Immunization of children who have been shown to be allergic to aluminium should be carried out with vaccines which do not contain aluminium.”

    Smart people those Danes

  148. #148 Moliva
    December 12, 2011

    Who knew that soy-based baby formulas have 4 X the amount of aluminum compared to regular baby formulas?

    Uh, oh! Mul-Soy baby here. I guess that means I’m autistic, or schizophrenic, or Alzheimer-iffic, or whatever…have you seen my socks?

  149. #149 MosesZD
    December 12, 2011

    I’m not going to apologize for Comcast. I had my run-ins with them when I first went cable. But once they replaced all the wires in my area of Nashville, they were fine and no worse than any other utility provider.

    But I will say this, until you’ve had Charter (St. Louis), you have no idea how bad, bad can get. My last straw was when I called them and the first thing they said was ‘do you have a router?’

    I’m like, that’s not relevant, there is NO SIGNAL TO MY MODEM! Could you test it, please?

    Charter: Do you have a router?

    Me: Could you send a signal to my modem, there are NO LIGHTS except the POWER LIGHT?

    Charter: Do you have a router?

    Me: NO! (lies)

    Charter: If you have a router it can interfere with the signal!!! So, do you have a router? (My router is about 15′ on a CAT5 cable away from the damn modem, so I don’t think so… And, yes, I did that because I got tired of the ‘router can cause interference’ bullshit when the system was down. I can just plug directly to the back of my PC to double check…)

    Me: Would you just please send the signal.

    Charter: Ok. {waits} You have no signal. Your modem is bad.

    Me: Send a tech.

    Charter: Our line is fine.

    Me: Send a tech, if the modem, I have a spare and he can hook it up. (I’m lying.)

    Charter: Ok

    THREE DAYS LATER: Tech shows up. The Disconnection Tech disconnected me when he disconnected Unit 1250… (I’m in 1248…)

    That’s not atypical.

    There were the constant fights about speed. I was paying for 12mps. I would get 9mps in the morning and 3mps at night. They told me my ‘router’ or ‘modem’ was over-heating. I asked them why it only over-heats at night…

    Another time they told me I had ‘too many stored IP addresses’ so that’s why I was slow in the evening… I asked them why I had too many at night, but not too many in the morning…

    I finally told one tech to stop with the excuses and adjust my bit-throttle algorythm. That they weren’t sending enough signal out to deal with the higher volume of TV/Internet traffic in the evenings.

    She said there was no such thing as bit-throttling. Even though they’ll run 54mps service on the same cable, with the same hardware, if I’m willing to pay over $100 a month instead of $59…

    And it’s not just me: PCWorld also ranked Charter’s cable Internet service as worst among 14 major Internet service providers. In addition, Charter High-Speed is rated 19 out of 22 cable ISPs on dslreports.com,and Consumer Reports indicated in their February 2008 issue that Charter’s television/Internet/telephone bundle collectively is the worst of all major national carriers.

    So Comcast… Hey, a few fights over some water in the cables causing intermittant signal loss and we were good. 20MPS, morning noon and night… And never a drop…

    But Charter… Damn, I went back to ATT. And I HATE ATT with a burning passion after all those years of them fouling up my business lines and director listings.

  150. #150 lilady
    December 13, 2011

    I smell Spam at # 148…

  151. #151 Dangerous Bacon
    December 13, 2011

    Hey, all you Xmas shoppers who are now doubting the wisdom of buying aluminum cookware sets (!!?!?!?) – here’s a great idea for the kids on your list, the book “Melanie’s Marvellous Measles”. Seeing as how party-poopers frown on actually sending germs through the mail, at least you can encourage the kiddies to reject vaccines and embrace disease:

    ht_p://naturematters.info/

    (By the way, I flew on Delta Airlines today, and was struck by the number of coughing passengers. Wonder how many took last month’s antivax PSA on Delta to heart and decided against getting flu shots.) :(

  152. #152 joshsmom
    January 13, 2012

    Interesting article about aluminum. Orac may be wrong.
    http://vactruth.com/2012/01/02/aluminum-fda-got-it-all-wrong/

  153. #153 Chris
    January 13, 2012

    Joshsmom, just post the title, journal and date of the papers that website cites. We are not interested in the opinions of those who do not understand that “the occurrence of aluminium in soil, air, water and food” from one 1991 paper is not real proof. Or any who believes the Simpsonwood myth.

    Did you ever read the information that Krebiozen, plus his further explanation? Or is your mind so closed that you cannot accept anything that goes counter to your beliefs?

  154. #154 W. Kevin Vicklund
    January 14, 2012

    Interesting article about aluminum. Orac may be wrong.

    Seeing as the author of that article doesn’t even know the difference between mcg and mcg/kg/day, I don’t think Orac has anything to worry about. Plus she’s totally ignorant of what the study actually did, and therefore most of her objections are moot.

  155. #155 Krebiozen
    January 14, 2012

    Blackheart,
    You are playing 6 degrees of separation with your citations. Autism might be linked to autoimmunity, autoimmunity might be linked to allergy, vaccines sometimes contain aluminum and aluminum sometimes causes allergies, therefore aluminum in vaccines causes autism? I could argue similarly that pollen causes autism, or peanuts. You are wildly speculating beyond the data.

    The kind of allergies cause by aluminum in vaccines result in local irritation, vaccination does not lead to elevated blood levels of aluminum, and more aluminum is absorbed from food and drink than ends up in the bloodstream from vaccines. Why is aluminum absorbed from breast milk not a problem but aluminum absorbed from an IM injection is, when they result in similar blood concentrations?

  156. #156 Krebiozen
    January 14, 2012

    Joshsmum,

    Interesting article about aluminum. Orac may be wrong.

    That is a stunningly ignorant article, like all the articles I have ever read on that website.

    It’s ironic that the author of that article points out that breathing air through the lungs is different to injecting it into a vein, yet then compares aluminum in IV parenteral nutrition solutions that are given day after day sometimes for months, with IM injections that are given every few months. She may be confused between the term “parenteral” which can refer to IM and SC injections and parenteral nutrition solutions which are only every given IV. That confusion is understandable since she quotes from ‘Aluminum Vaccine Adjuvants: Are they Safe?’ by L. Tomljenovic and C.A. Shaw which also erroneously equates IM, SC and IV routes of administration. Tomljenovic and Shaw also disingenuously refer to a study where 20 mg/kg/day IV aluminum chloride had adverse effects in rats, calling this “lower doses”. They also refer to 2.5 mg/kg/day as “very low doses of aluminum” that affected prenatally exposed rats. Yet they suggest that the 0.25 mg dose of aluminum in the hepatitis B vaccine given at birth may be neurotoxic. Average birth weight is greater than 3 kg, the hepatitis B vaccine in a 3 kg baby equates to 0.08 mg/kg/day given IM. Compare that to the “very low doses of aluminum” of 2.5 mg/kg/day they refer to, 30 times the vaccine dose, that affected prenatally exposed rats, or the “low dose” of 20 mg/kg/day, 240 times the vaccine dose, that had adverse effects in rats.

    Even worse, the author you refer to gets picograms and micrograms mixed up, when there is a million-fold difference between them, and quotes the FDA as having a limit of 5 picograms per kg per day. Perhaps this is some sort of error of copying and pasting, but the fact she has not corrected it surely means she is unaware of the difference. All I can find on the FDA website is a warning that “Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 µg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.” In case you are not aware pg = picograms, µg = micrograms and there are 1 million picograms to a microgram. Also on the FDA website, “The aluminum content of large volume parenteral (LVP) drug products used in total parenteral nutrition (TPN) therapy must not exceed 25 micrograms per liter ([micro]g/L).”

    Let’s take a look at the figures given. Over the first year of life an infant receives 4.225 milligrams or 4,225 micrograms of aluminum in vaccines injected IM or SC. This aluminum is slowly absorbed into the bloodstream over a long period, and never elevates blood levels out of the normal range, much less to toxic levels, as we know from various studies. An average 6 month old infant weighs 8 kg, so 4,225 micrograms over a year equates to 1.4 micrograms per kg per day. Even if this amount was given to a premature infant with impaired renal function, it would not be anywhere near a toxic level.

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