A four-year old autistic boy, Noah Breakiron, is in the news for being cured of lead poisoning.
“We have a child here who is virtually indistinguishable from his peers and that’s certainly not what he was a year or two years ago,” added Pediatrician David Berger, MD.
The article also says,
Because the symptoms of autism and lead poisoning are so similar, Noah’s parents say they will never know which one came first, autism or lead poisoning.
Huh? A child might possibly have both autism and lead poisoning, but they are not the same, nor are the symptoms similar. Let’s review a list of possible symptoms of autism, as described on the Mayo Clinic page (not all autistic children will exhibit all these traits):
Fails to respond to his or her name Has poor eye contact Appears not to hear you at times Resists cuddling and holding Appears unaware of others’ feelings Seems to prefer playing alone — retreats into his or her “own world”
Starts talking later than other children Loses previously acquired ability to say words or sentences Does not make eye contact when making requests Speaks with an abnormal tone or rhythm — may use a singsong voice or robot-like speech Can’t start a conversation or keep one going May repeat words or phrases verbatim, but doesn’t understand how to use them
Performs repetitive movements, such as rocking, spinning or hand-flapping Develops specific routines or rituals Becomes disturbed at the slightest change in routines or rituals Moves constantly May be fascinated by parts of an object, such as the spinning wheels of a toy car May be unusually sensitive to light, sound and touch
Got that? Now let’s look at the symptoms of lead poisoning (list also from Mayo Clinic):
Signs and symptoms in children
The signs and symptoms of lead poisoning in children are nonspecific and may include:
Irritability Loss of appetite Weight loss Sluggishness Abdominal pain Vomiting Constipation Unusual paleness (pallor) from anemia Learning difficulties
Lead poisoning sure doesn’t look like autism to me; do those sound the same to you? And although learning difficulties may be present in addition to autism, they are not part of the DSM-IV diagnostic criteria for autism. Furthermore, there is absolutely no good evidence that autism is caused by lead poisoning.
Sure, there are a few toys with dangerous levels of lead out there. And toddlers do chew on toys. It’s possible for a child to get lead poisoning from toys, although leaded alkyd house paints used before 1978 are more common sources. The important thing to remember is that with any kind of poison, the danger is always in the dosage. Everyone, everywhere is exposed to and even carries minute, trace amounts of metals simply because they are ubiquitous in the environment. For example, I’m sure I have microscopic amounts of lead in my body, simply because I was alive for decades when leaded gasoline was used (it was banned in the US in 1996). But that doesn’t mean I have lead poisoning. So how is lead toxicity determined? By blood testing, as further described by the Mayo page:
Doctors use a blood test to detect lead poisoning. A small blood sample is taken from a finger prick or from a vein. Lead levels in the blood are measured in micrograms per deciliter (mcg/dL). An unsafe level is 10 mcg/dL or higher — a guideline set by the CDC.
And the treatment?
For more severe cases, your doctor may recommend treatment called chelation therapy in addition to removal from lead exposure. In chelation therapy, the medicine (chelating agent) you take binds with the lead so that it’s excreted in your urine. Doctors may treat some Class III cases and many Class IV cases with the oral drug succimer (dimercaptosuccinic acid).
Doctors treat lead levels greater than 45 mcg/dL of blood, which fall into Class IV or V, with a chemical called ethylenediaminetetraacetic acid (EDTA). EDTA is administered through injections in your veins (intravenously) and may be combined with the drug dimercaprol (BAL). Depending on your lead level, you may need more than one treatment. The therapy may not reverse damage that already has occurred in cases of severe lead intoxication.
A view of Dr Berger’s Web site for “Wholistic Pediatrics” describes that the well-established standard of a blood test is not preferred,
We are also concerned about heavy metal toxicity in our patients. Many people with chronic disorders have mercury, lead and other heavy metals accumulating in their body.
We have found that a chelation challenge test is the best way to identify the presence of toxic metals.
Unfortunately, the chelation challenge (provoked test) is not accurate for determining levels of heavy metals. Chelation not only collects but concentrates metals, which are then excreted in the urine at higher levels than would normally be present. The “chelation challenge” gives inflated lab results that do not accurately reflect the levels of heavy metals actually in the body, and thus is not a good diagnostic tool for heavy metal poisoning. It seems odd that a pediatrician would choose to use this test.
Care must be taken when giving treatments for heavy metal poisoning. The standard treatment is to remove lead from the environment. In cases of extremely high levels, intravenous chelation is used. It does not, however, undo all the effects of lead poisoning.
What kind of test was used to determine the lead levels in Noah? The article does not say, nor does it mention the type of chelation used. Did Noah have lead poisoning? Possibly. Did the chelation treatments given to him get rid of his autism? That’s doubtful. Without knowing more, it is impossible to comment upon the veracity of Noah’s medical diagnoses or the appropriateness of subsequent treatment. And that’s not really the point of this post.
The reason I mention this poorly-written story is that by chance or design, it links “lead poisoning” with “autism” and suggests that treatments for the former will eliminate the latter.
Like with any kind of therapy or treatment marketed for autism, we must remember that autism is a developmental disorder. The development of the child is slower or erratic compared to age-peers. However, that is not the same thing as developmental stasis. The continued acquisition of skills by autistic children are often attributed to the therapies given to them, rather than simply due to maturation. Autistic children who are not given the scores of dubious therapies also improve as they mature.
- Lead poisoning is detected through blood tests.
- Lead poisoning can cause learning difficulties, but is not the same thing as autism. The symptoms of lead poisoning and autism are very different.
- “Chelation challenge” tests are not accurate for assessing levels of heavy metals.
- Chelation can be used to remove heavy metals from the body, with intravenous EDTA reserved for high toxicity levels. However, removing those from the body does not undo all of the effects of severe heavy-metal poisoning.
- Chelation will not cure autism.
- Autistic children continue to grow and develop at their own rates, sometimes to the point that they do not require extra school services or therapies. At that point, they are autistic children who do not require extra school services or therapies. (Yeup, they’re still autistic.)
Chelation as a treatment to “cure” autism has a sad history; currently Dr Roy Kerry is to stand trial for the death of a 5-year old autistic boy, Abubakar Tariq Nadama, who died in 2005 from a chelation session. In that case, mercury was the perceived toxin. But as the evidence for autism-as-mercury-poisoning repeatedly fails to hold up under scientific scrutiny, in scores of studies around the world. Mercury-based thimerosal (preservative) in vaccines was removed back in 2002, so mercury cannot easily be blamed for the ongoing cases of autistic toddlers (yet people still keep trying, especially those who are emotionally invested in the idea or financially invested in selling their products). We’re already seeing the peddlers of bogus autism cures change their stories.
Doubtless the focus will be switched to lead. Lead contamination in toys has been a hot news topic, just as has autism. It’s easy for the two things to be conflated in the minds of concerned parents. If you search on the internet for treatments for lead poisoning, you will find an incredible number of things being sold, many of which are useless or dangerous. Although chelation is prescribed for severe cases of lead poisoning, it must be done with care; also in 2005, a 2-year old girl, Alyssa Renee Rodriguez died after she was given the wrong chelator. The numbers of news stories about lead poisoning simply create a ready market for the purveyors of unnecessary therapies and dubious cures. The World Wide Woo: Now Lead-Chelator flavored!