MMS (a.k.a., bleach) for autism: Just when I thought I was out…

The clip above says it all with respect to “miracle mineral solution” (a.k.a. MMS). Just when I thought I was out…they pull me back in. And, as Yoda would probably put it, back in I am one more time. (How’s that for mixing movie allusions?)

Let’s recap. MMS is bleach. Specifically, it is a 28% sodium chlorite in distilled water that generates chlorine dioxide when diluted with citric acid-containing or other acid-containing foods, as instructed. This is a chemical used for water purification that a quack—yes, quack—named Jim Humble has touted as a miracle cure for just about everything from cancer to AIDS to a wide variety of conditions, serious and not-so-serious. There is no currently known valid medical reason to give this chemical to anyone to treat anything. None of this is (or should be) in serious dispute from a strictly scientific, medical, or ethical standpoint.

The next fact that is not in serious dispute is that a woman named Kerri Rivera, operating out of a quack clinic in Mexico, has been touting MMS as a “biomedical” treatment for autism. As part of the treatment, she advocates feeding MMS to autistic children every two hours over the course of 72 hours (her “72-2 protocol”) and giving children MMS enemas three times a week. She admits that the side effects included at minimum diarrhea and fever. In fact, she says that the diarrhea is a good thing if it’s “detox diarrhea” and that the fever means the immune system is being stimulated, thus making it a good thing as well. What is also not in dispute is that Rivera brought this message of bleaching autism away to the yearly autism biomed quackfest known as Autism One last month, making even some die-hard supporters of autism quackery cringe. Again, there is currently no known valid medical reason to give this chemical to any autistic child to treat autism. Again, none of this is (or should be) in serious dispute from a scientific standpoint.

From a quack standpoint, not surprisingly, it is. More surprisingly, people who seem to think they are more “reasonable” are also unhappy at how much outrage has been expressed at the revelation that there are people out there who think it’s a good idea to feed children bleach and give them bleach enemas. More disappointing is that there are apparently people who, even though they more or less agree that there is no reason to feed children bleach or shoot it up their nether regions, are so very, very unhappy about the outrage supporters of science-based medicine feel over such child abuse.

One such person even wrote a long post that is in essence one long tone trolling, taking us all to task for “inflammatory” language in a post entitled OMG, Its Bleach! I was half-tempted to reply, “OMG, it really is bleach!” and leave it at that. But you all know me better.

The first complaint that we get is similar to other complaints about the focus on the MMS talk:

Take for example the latest craze gripping the blogosphere – an autism “treatment” that goes by the name of “Miracle Mineral Solution”, or MMS, that has been around for years but recently had a presentation at Autism One.

There were many presentations at Autism One that covered a wide range of subjects. But which presentation does the remnant of the old neurodiversity movement focus on and hold up as the poster child of the conference? MMS, of course, and how it is so dreadful that immediate action is needed to stop the horror.

Actually, MMS was the poster child for the Autism One conference…this year. In previous years, it was treatments like chelation therapy or chemical castration for autism. MMS earned that “honor” this year because it is the one treatment that so illustrates the utter quackery and lack of science behind the vast majority of Autism One. However, it is by far not the only quackery touted at Autism One. It’s not for nothing that I frequently refer to Autism One as a quackfest, because it is a quackfest. Chelation therapy, homeopathy, various unproven supplements, craniosacral therapy, Andrew Wakefield, and Mark and David Geier’s chemical castration with Lupron for autism. (A roundup of last year’s quackfest can be found here.) All of these quackeries, and many more, have been featured at Autism One over the years. This year alone, besides MMS quackery, we had the sorry spectacle of a Nobel Laureate reporting the results of his unscientific and unethical clinical trial in which autistic children were treated with long term antibiotics. I’ve been meaning to blog about his talk but have thus far been unable to locate a video of it online at the site where Autism One talks have been posted. (If anyone knows where it is, let me know.)

But, don’t you know, we skeptics are all too mean. We shouldn’t be getting worked up over MMS the way we are. At least, that’s what this post tells us. The first reason, according to MJ, is because, even if MMS doesn’t work and is probably a bad idea, it’s really not bleach! Seriously. That’s the argument the blogger, MJ, makes:

The first claim on the harm side is that MMS is bleach. Now, I don’t know about you, but when I think of bleach, this is the stuff that comes to mind.

[A picture that looks like a Chlorox bottle without the logo.]

MMS is not the same as this stuff.

This stuff is (typically) a mixture of (roughly) 5% sodium hypochlorite while MMS is 28% sodium chlorite. While the names sound quite similar, they are not the same thing nor do they have the same properties. The best thing you can say is that they are similar chemicals that do similar things.

I laughed heartily when I read this. MMS is not bleach because it’s not sodium hypochlorite? It’s not bleach even though they are similar chemicals that do similar things? Seriously? He even goes so far as to say:

A better and less confusing way to rewrite the sentence is that MMS is a bleach to indicate that it is a bleach in the technical and more generic sense of the word. As in (again, Wikipedia), a bleach is “a number of chemicals that remove color, whiten, or disinfect, often via oxidation.”

So no, MMS is not bleach in the common use of the word, but you might be able to say that MMS is a bleach.

Talk about a long run for a short slide. Talk about pedantry that is in essence a distinction without much of a difference! MMS is not bleach but it is a bleach? So calling MMS bleach is wrong and unnecessarily inflammatory? Regular readers know how much pedantry annoys me, and this is pedantry that would need to be diluted to homeopathic levels to make it cease to be annoying to me.

A lot of familiar arguments are then trotted out, such as how chlorine dioxide is used to purify water and how, if you’ve ever gone swimming in a swimming pool, you’ve gone “swimming in bleach.” Believe it or not, most people actually probably do know that the chemicals used in swimming pools are bleaches or bleach-like, given that the smell of a swimming pool is similar to that of bleach. It’s all a matter of two things here: the dose making the poison, the difference between swimming in something and drinking it (or having it shot up one’s nether regions), and the fact that there is no reason to think that using this particular form of bleach (I say this in deference to MJ’s pedantry) has any scientific plausibility whatsoever as a treatment for autism.

Particularly bad is the part of the argument where he says that the target for MMS is 1 ppm and that tap water can have up to 0.8 ppm chlorine dioxide. If that were the case, then way bother with MMS? Just give your kid tap water to cure autism! Of course, it’s not the case. All one has to do is to look at Rivera’s protocol, something MJ apparently didn’t bother to do. In any case, as has been explained before several times, in the comments of various posts (for instance, this one and this one—damn my inability to link directly to comments in the new blog!), given that chlorine dioxide is approved in drinking water up to a maximum concentration of 0.8 ppm (or 0.8 mg/L), if a child took in 1-2 L per day of water (the amount depends on weight), then that would be around 0.8 to 1.6 mg of chlorine dioxide per day. Rivera’s recommended protocol involves working the dose up to 8 to 24 drops per day (1 to 3 drops administered 8 times a day), depending on the child’s weight. Now, it’s been previously calculated that a drop of MMS contains roughly 10 mg of sodium chlorite, which generates around 8 mg of chlorine dioxide. This means giving children between 64 and 192 mg of chlorine dioxide per day, depending on the child’s weight. That’s up to 120 times what even an older child could reasonably expect to be exposed to through drinking tap water. And, of course, this neglects the fact that most children don’t drink just tap water; usually they drink other things and don’t drink nearly 1 to 2 liters of tap water in a day. Under real world conditions, the math would work out even worse than what I’ve estimated. This makes MJ’s conclusion even more wrong-headed:

So, the idea that giving this mixture to a child is some sort of child abuse or torture is just plain silly. If that level of exposure is torture, I would hate to see what these people would say about me letting my children spend hours in the pool everyday.

One notes how assiduously MJ avoids mentioning that part of Rivera’s protocol involves MMS enemas. One wonders why. Actually, one doesn’t at all. Doing so would call attention to his straw man argument that the characterization of MMS use as torture was based primarily on how parents feed MMS to autistic children in the hopes of curing them. That’s not what disturbed people the most (although it is plenty disturbing in and of itself). What disturbed people the most, and rightly so, is the administration of enemas to autistic children, who frequently have sensory issues that makes such sensations more distressing to them than even to neurotypical children. Indeed, giving neurotypical children enemas three or four times a week without a clear therapeutic rationale based on science could be characterized as child abuse. The situation is even worse for autistic children.

Sadly, MJ then repeats the nonsensical arguments previously used by the Phaelosopher, namely that, because real drugs have side effects, such as headache, fever, and nausea, then we shouldn’t be so concerned about side effects of MMS, which MJ admits are nausea, vomiting, diarrhea, symptoms of severe dehydration. He even admits that there is almost certainly no therapeutic benefit. Unfortunately, that admission doesn’t stop him from laying this jaw-dropper of a false equivalency on us:

So, the side effects of MMS are very similar to those that can happen when using other common treatments. Does that mean giving Aripiprazole to your child when it isn’t clear that there will be benefits “child abuse”? Does the medical profession’s constant overuse of antibiotics qualify as torture?

The mind boggles.

MJ also has no understanding of clinical trial ethics and science-based medicine. He ends up concluding that MMS probably doesn’t work, but asserting that there’s no evidence that it doesn’t work. He even appears to view this argument as a reason not to dismiss MMS or criticize the parents using it! However, he ignores that not only is there no prior plausibility for MMS as an autism treatment (i.e., no scientific reason to think that MMS would work to reverse autistic symptoms). This lack of at least a modicum of prior plausibility means is that, at least right now, it is unethical even to do a clinical trial unless there is some compelling supportive evidence, which there isn’t. The Helsinki Declaration regarding the protection of human subjects clearly states that, before a clinical trial is ethically justified, there has to be scientific reason to think a treatment of work in the form of preclinical studies (biochemistry, cell culture, and animal studies) supporting the use of the treatment. MMS fails on all these counts, which means that if it’s unethical even to do a clinical trial with MMS for autism, then it’s even more so to use MMS to treat autism in the absence of evidence. That’s why, when MJ pleads, “So, how about we all turn down the rhetoric a little?” my response is:

Hell, no!

Now can I get away from this topic for a while? Just a little while?