Why not just castrate them? (Part 6): The State of Maryland finally takes “emergency action” against Mark Geier and his Lupron protocol for autism

One of the most persistent myths is one that’s been particularly and doggedly resistant to evidence, science, clinical trials, epidemiology, and reason. It’s also a myth that I’ve been writing about since a couple of months after the beginning of this blog. Specifically, I’m referring to the now scientifically discredited myth that the mercury-containing thimerosal preservative that used to be in quite a few childhood vaccines causes autism. The myth began in the late 1990s and was later fed by the publication of David Kirby’s book Evidence of Harm, which was basically a paean to various brave maverick doctors who promoted the claim that mercury in vaccines cause autism. Among the “scientists” promoted by David Kirby were the father-son team of Mark and David Geier. Mark Geier is a physician who also has a PhD and represents himself as a medical geneticist; his son David has no medical degree, leading to my wondering from the very beginning how it was that he got away with helping his father evaluate and treat autistic children, in essence practicing medicine without a license. (Stay tuned to find out more.)

The Geiers are most infamous for their “Lupron protocol,” which I first wrote about back in 2006 in one of the earliest posts on this blog after I moved from Blogger to ScienceBlogs. In my ever inimitable fashion, I entitled it Why not just castrate them? The reason is the nature of their “treatment” for autism. If you want the details, read my original post (which, hard as it is for me to believe, is over five years old now), including its relatively recent updates in which the mainstream media notices and in which the Geiers franchised their quackery. The short version is that, somehow some way, Mark Geier got the idea in his head that testosterone contributes to autism. That in and of itself isn’t woo, given that scientists have from time to time hypothesized that very thing. What made the Geiers’ conclusions quackery is their explanation. Basically, Geier claimed that testosterone binds mercury from vaccines, making it harder to get rid of the mercury using chelation therapy. Never mind that the only paper showing testosterone binding to mercury did it in benzene (hint: your blood is not benzene) under extreme conditions. What was worse, however, was the Geiers’ “solution” to this problem, which was to add to the autism quackery known as chelation therapy another potentially harmful form of quackery, namely chemical castration using Lupron, a drug that shuts down the production of sex hormones, including testosterone. It’s a drug that’s used to treat metastatic prostate cancer, a treatment that replaced the old treatment for metastatic prostate cancer, namely surgical castration. (Not coincidentally, it’s also used to chemically castrate sex offenders.) Even worse still, the Geiers somehow got away with a highly unethical clinical trial in which they packed the Institutional Review Board overseeing it with their cronies.

For over five years, I’ve been wondering just how in the world the Geiers got away with such unethical pseudoscience and how they got away with it for so long. I couldn’t figure it out. Not only did they ply their quackery on autistic children, but David Geier appeared to be functioning as a “diagnostician,” somehow fooling the State of Maryland’s Autism Commission into appointing him as a member, even though he completely lacked expertise to be practicing medicine and does not have a medical or clinical degree of any kind. (I really, really would like to know how that happened.) Meanwhile, the Geiers appeared to be playing fast and loose with insurance companies by making lots of diagnoses of “precocious puberty,” a very uncommon diagnosis. Truly, I wondered what was wrong with the State of Maryland…until yesterday afternoon. For it was yesterday afternoon when online acquaintances, not to mention some of you, my readers, started sending me the news that Mark Geier has had his medical license suspended by the State of Maryland, as outlined in this 48-page court order. Kathleen Seidel, as usual, is already on the case as well.

Yes, the Maryland State Board of Physicians has finally acted. All I can say is: It’s about time the State of Maryland pulled the wings off of this quack. Let’s take a look at some of the relevant sections of the order. First, here’s the money section, namely the summary statement, which I cite nearly in its entirety:

The Respondent misdiagnosed autistic children with precocious puberty and other genetic abnormalities and treated them with potent hormonal therapy (“Lupron Therapy” or “Lupron Protocol”), and in some instances, chelation therapy, both of which have a substantial riskof both short-term and long-term adverse side effects. The Respondent’s treatment exposed the children to needless risk of harm.

The Respondent, in addition to being a physician, is certified as a genetic counselor. His assessment and treatment of autistic children, as described herein, however, far exceeds his qualifications and expertise. The extensive and extensive batteries of laboratory studies the Respondent initially orders, many of which he orders to be repeated on a monthly basis, are outside the standard quality of care for a work-up for an autistic patient or to determine the underlying cause of autism. The Respondent failed to conduct adequate physical examinations of any of the patients and in several instances, began his Lupron Protocol based merely on a telephone consultation with the child’s parent and the results of selected laboratory tests he ordered. The Respondent’s omission of a comprehensive physical examination constitutes a danger because his treatment is based on a diagnosis that requires documentation of sexual development beyond that expected for the age of the child. Moreover, his treatment may constitute more of a risk to a child with an underlyingl medical condition.

The Respondent failed to provide adequate informed consent to the parents of the autistic children he treated. In one (1) instance, he misrepresented that his treatment protocol had been approved by a federally approved IRB.

[…]

The Respondent endangers autistic children and exploits their parents by administering to the children a treatment protocol that has a known substantial risk of serious harm and which is neither consistent with evidence-based medicine nor generally accepted in the relevant scientific community.

In the order, Mark Geiers’ numerous other offenses are listed, including his corrupt, crony-packed IRB overseeing his clinical trial, insurance fraud (billing insurance companies for services never rendered), failing to obtain informed consent, misdiagnosing children with “precocious puberty” in most egregious ways (such as diagnosing children who did not meet the age criteria for precocious puberty) and writing medical necessity letters based on this mistaken diagnosis, and misrepresenting himself as a geneticist. Basically, regarding this latter charge, Mark Geier claimed to be a geneticist, which is a “physician who evaluates a patient for genetic conditions, which may include performing a physical examination and ordering tests,” even though he is not a medical geneticist; rather, he is a genetic counselor, which is “an individual with a master’s degree who helps to educate the patient and provides an assessment of the risk of the condition recur in the family.” I know genetic counselors. I work with genetic counselors. They don’t diagnose genetic conditions; rather, they counsel patients after either a genetic diagnosis has been rendered or the patient has developed a condition (such as breast cancer at a young age) that might indicated a genetic predisposition to a disease. It turns out that Geier also misrepresented himself as a board-certified epidemiologist when he is not.

Particularly disturbing is the panoply of quackery to which Mark Geier submitted children in his care. Several case studies are described of children who were treated by Mark Geier. They include a battery of over 40 tests, spironolactone for misdiagnosed hyperaldosteronism, chelation therapy for “heavy metal toxicity,” Lupron, and methyl B12 drops for unclear and undocumented indications. One patient, patient F, a female, was given Femara, an aromatase inhibitor, which is used to treat estrogen receptor-positive breast cancer. It’s used mainly in post-menopausal women to shut down hormone production in the peripheral tissues. (It doesn’t work in premenopausal women because their ovaries make lots of estrogen, far more than the small amount made in peripheral tissues.) The presumed rationale, I have to guess, would be the same as in younger woman with breast cancer, where sometimes it is necessary to shut down ovarian hormone production and then to top it off by shutting down peripheral hormone production. My guess is that Geier somehow thought he needed to shut down not just ovarian sex hormone production in this girl but peripheral production as well. Why, I have no idea, but its profoundly idiotic and potentially harmful, particularly when combined with chelation therapy. Meanwhile, in other patients, Mark Geier proposed adding another anti-androgen drug, Androcur.

The abuse of autistic children was staggering. As a result, the Board made a finding of law:

Based on the foregoing facts, the Board concludes that the public health, safety or welfare imperatively require emergency action in this case, pursuant to Md. State Gov’t Code Ann. § 10-226 (c) (2) (i) (2009 Repl. Vol.).

That’s right, not just action but emergency action. I guess the State of Maryland has a different definition of “emergency,” given that the Geiers have been at this for at least six years, but I’ll take what I can get. At least when finally roused from its torpor, the Maryland State Board of Physicians recognized the Geiers for the threat to autistic children that they are and, as a result, ordered that Mark Geier’s license to practice medicine in the State of Maryland be summarily suspended. As a result, Mark Geier was required to surrender the following to the Board:

  • his original Maryland License D24250
  • his current renewal certificate
  • his Maryland Controlled Dangerous Substance Registration
  • all controlled dangerous substances in the Respondent’s possession and/or practice;
  • all Medical Assistance prescription forms
  • all prescription forms and pads in the Respondent’s possession and/or practice
  • any and all prescription pads on which his name and DEA number are imprinted

Excellent.

I only have a couple of remaining questions. First, what will be the response of the anti-vaccine movement. One thing I’ve noticed over the last couple of years, since the mainstream media first noticed his Lupron protocol is that the anti-vaccine movement seems to have distanced itself from the Geiers. They’re almost never mentioned anymore on Age of Autism these days, even though they used to be regular features there a couple of years ago. They’re not the headliners at the yearly Autism One quackfest anymore; they are, however, still listed as speakers for this year’s quackfest. One has to wonder whether they’ll be quietly disinvited now that Geier has had his medical license yanked, or whether Lisa Sykes will remove the Geiers’ epilogue from her book. Probably not, I’d guess. Most likely the Autism One organizers will see the loss of Mark Geier’s medical license as evidence of his cred as a “brave maverick doctor,” much as Wakefield’s cred remains high in the anti-vaccine movement. After all, just yesterday Teresa Conrick at AoA wrote a post blaming her child’s symptoms on “bizarre estrogen dominance.” One wonders how long it will be until she, too discovers Lupron, which suppresses estrogen as well as testosterone and Femara. After all, Conrick’s nonsense, which cherry picks disparate science and ties it all together incorrectly in only the way a newbie without understanding of biology can, isn’t at its heart any more ridiculous than the Geiers’ nonsense.

Be that as it may, I’m now left wondering how long it will be before the conspiracy theories come out. The most obvious one hasn’t hit the blogosphere yet, at least not as I write this. How long do you think it’ll be before an anti-vaccine loon claims that stripping Mark Geier of his medical license (just like another brave maverick doctor, Andrew Wakefield!) was a plot by the miltiary-industrial-pharma-CDC complex to distract attention from the case of Poul Thorsen. You know it’s coming sooner or later.

Finally, what of the metastatic deposits of Geier père et fils quackery in other states? After all, besides Maryland, the Geiers have spread their quackery to Kentucky, Missouri, Florida, Illinois, and Indiana. Will these states now act to shut down the Geier quack clinics there, known as ASD Centers, LLC? I know I’ve complained about how long it took the State of Maryland to do the right thing. Even so, I’m glad that the Board there finally acted. It’s time for the medical boards in these other states to do likewise. Mark and David Geier are a menace to autistic children.