Last week, I wrote about how Gwyneth Paltrow and Goop had doubled down on quackery and antivaccine misinformation by featuring “holistic psychiatrist” Dr. Kelly Brogan as one of the keynote speakers and prominent panelists at its upcoming in Goop Health Summit in New York in late January. At the time, I noted the copious evidence on her website that she is indeed antivaccine and took note of an e-book that she had recently written. At the time, I briefly alluded to the e-book and some of the nonsense therein and promised that I wanted to look at it in more detail. Brogan became even more unfortunately relevant when SXSW announced the advisory panel for its 2018 SXSW Wellness Expo, and it included Dr. Brogan:
— SXSW (@sxsw) December 7, 2017
This is the post where I will do that.
Here, I will focus on the 23-page e-book that Dr. Brogan authored entitled Vaccines and Brain Health. Some of Dr. Brogan’s fans might think it unfair of me to characterize her as “antivaccine,” but her e-book provides copious evidence that this characterization is accurate, as you will see. You can get an idea of where Dr. Brogan is coming from right from the very first paragraph, in which she proclaims:
As a passionate believer in the power of informed consent, I feel that we have a right to know the full breadth of available data so that we’re empowered to make our own decisions about our bodies and our children. As a practicing psychiatrist, my major concern is how vaccines affect brain health, behavior, and cognition. As a mother and a woman, I bring special entitlements to the conversation about bodily integrity, health choice freedom, and autonomy. To make your own judgment, it’s important to understand how vaccines work, who is recommending them, and why – and to ask questions. Because no one should be threatened by the process of further inquiry.
Excuse me, Dr. Brogan, but I think you have a typo. I think you meant “misinformed consent,” that perversion of informed consent favored by antivaxers in which the risks of vaccines are amplified by many orders of magnitude and their efficacy downplayed by orders of magnitude, all through the citation of pseudoscience and misinformation, as well as the misrepresentation of real studies. Note how she also invokes “health freedom,” another favorite trope of the antivaccine movement in which children are basically viewed as the parent’s property without rights of their own as autonomous beings separate from the parents.
Dr. Brogan seems especially proud of a “peer-reviewed” article that she published, “Psychobiology of Vaccination Effects: Bidirectional Relevance of Depression,” in which she tries to link vaccination to depression. Not surprisingly, this publication was in a bottom-feeding alternative medicine journal, but even by that standard it’s not very good. Yes, I actually did look up the article, simultaneously grateful and angry that my university has a e-subscription to the journal. To say that the article is speculative is to insult speculation, which is a valid activity in science. Speculation based on solid existing science is how promising new hypotheses are generated to be tested. That’s not what Dr. Brogan does, however. Her article is chock full of citations and discussions of what to readers of this blog will be familiar as antivaccine pseudoscience, with many of the citations also familiar as having been deconstructed here before. Examples include Theresa Deisher’s dubious research claiming to have shown that DNA from the cell lines (derived from fetuses used to grow virus to manufacture vaccines is taken up by neurons and recombines with their DNA to provoke neuroinflammation, Tomljenovic and Shaw’s fear-mongering about aluminum adjuvants, Laura Hewitson’s execrable Macacque monkey study (later redone, with a result showing no correlation between thimerosal-containing vaccines and behavioral changes) of the vaccine schedule, and Stephanie Seneff’s laughably supported claims that glyphosate and GMOs and/or vaccines (she can’t seem to make up her mind) predispose children to autism. You get the idea. The quality of a speculative review article on a scientific topic is judged largely by the quality of the science cited and how that science is woven together to suggest hypotheses. Dr. Brogan fails on both counts.
Continuing her lack of scientific critical thinking skills, Dr. Brogan writes in her e-book:
Perhaps even more compelling is an April 2017 scientific article, the first of its kind, that compared age-matched vaccinated and unvaccinated children to determine if there were significant differences in the diagnoses of acute and chronic illnesses. Researchers polled the parents of over 650 homeschooled children, aged either 6 or 12. In this mostly-Caucasian group, 39% of children were unvaccinated, 31% partially vaccinated, and 30% fully vaccinated. Using sophisticated statistical analyses to control for other variables, researchers determined the likelihood of acute and chronic illnesses with respect to vaccination status.
In terms of acute illnesses, vaccinated children were significantly less likely to have had chicken pox, whooping cough (pertussis), and rubella (though the rubella incidence was not significant). Vaccinated children were more likely to have suffered from otitis media (ear infection) and pneumonia, and there was no difference between vaccinated and unvaccinated groups in terms of Hepatitis A and B, high fever, measles, mumps, meningitis, influenza, and rotavirus.
Now here’s where it gets interesting. Vaccinated children were significantly more likely to have been diagnosed with a variety of chronic diseases. Perhaps most alarmingly, children who had received vaccines had higher incidences of neurodevelopmental disorders, including learning disabilities, ADHD, and Autism Spectrum Disorder, at a rate of 10.5% compared to 3.1% of unvaccinated children.
I couldn’t help but chuckle as I read this passage, particularly the part about how the study used “sophisticated statistical analyses to control for other variables.” Why? Because I recognized the study instantly, before I even clicked on the link and knew that the study was anything but “compelling” and that the statistical analysis was anything but “sophisticated,” as was the study design itself. Dr. Brogan was citing an utterly awful study by Anthony Mawson, one of two that he published recently, purporting to show that unvaccinated children are healthier, with less neurodevelopmental disorders and chronic illnesses. Basically, it was an Internet survey that was published in 2016, retracted, and then rose from the grave again in 2017, only to be retracted again, only to be back online again after (or so it was joked at the time) Mawson’s check finally cleared. I also note that the study was funded by the rabidly antivaccine Children’s Medical Safety Research Institute (CMSRI), funded by Claire and Al Dwoskin.
The rest of the article follows a similar path. Basically, it’s an antivaccine greatest hits compilation. Ranting against a “one size fits all” approach? Yes, it’s there. “Too many, too soon”? It’s there too. There’s even that hoary oldie but not-so-goodie, the “no placebo” gambit:
Furthermore, the vaccine schedule is a one-size-fits-all approach that has never (not once) been studied in its ever-growing entirety. Additionally, vaccine formulations have never been studied against a true placebo for FDA approval. These studies can be even further compressed since the introduction of ‘fast- tracking’ in 1992, a method that pharmaceutical companies can pay extra for to accelerate FDA approval of their vaccine candidates, like Gardisil. These fast- tracked vaccines are often studied against false ‘placebos,’ like aluminum or another vaccine, raising the background rate of adverse events and ultimately making it impossible to identify the true risks of the vaccine relative to non- intervention. When they are, like in the Cowling et al study of the flu vaccine, the results are not industry-favorable – this study showed a 4x increase risk of non-flu infection after receiving the seasonal shot.
This is all nonsense, of course. What antivaxers mean when they say that vaccines aren’t tested against a placebo control is that many vaccine studies look at the vaccine versus vaccine minus the actual antigens. That means both control and the test vaccine groups receive whatever adjuvants are being used, such as commonly used aluminum hydroxide adjuvants. This is, of course, the most scientifically rigorous way to do such a trial: Use controls that have everything except the “active ingredient” of the vaccine in order to see if it is the antigens in the vaccine producing immunity to the disease being vaccinated against. The rationale, of course, is that we have copious data regarding the safety of aluminum adjuvants, meaning that a third group receiving a saline-only control is an unnecessary extra expense and waste of precious clinical trial volunteers. It would also be harder to justify a trial in which two thirds of the recipients are left potentially vulnerable to disease. However, antivaxers who fear aluminum and ascribe all sorts of evil to this particular adjuvant claim that the reason aluminum-containing placebos are used in some vaccine trials is to obscure adverse reactions due to the aluminum. Of course, for most vaccines, it’s not too hard to find randomized controlled clinical trials using saline-only controls. Whenever an antivaxer says that there are no studies using “correct” controls, they’re either lying, parroting antivaccine talking points, or ignorant.
Then there’s the (mis)use of epigenetics, a science frequently abused by quacks, to produce what I like to call the “special snowflake” gambit. In essence, Brogan claims we are all so unique that it is impossible to tell how any given person will react to a vaccine:
To suggest that a pharmaceutical product should be delivered to all persons regardless of age, weight, health status, and history is to ignore all of the advances of modern science that suggest that biochemical individuality is the key to health and wellness. Many studies have shown that people react differently to vaccines based on age, stress levels,22 health status,23 previous exposures,24 genetics,25,26 and other ‘host factors’ that we can’t quantify – like current mood!27 Yet there have been no efforts to tailor vaccines to specific physiologies. As each person contains a unique signature of interrelated characteristics, people can react in wildly different ways to the same vaccines.
This is the sort of spinning of science that makes individual points that are true and weaves them into a misleading argument that, because biology is complicated and there is variability in response to a medical intervention, we might as well throw up our hands and do nothing until we find out how to quantify exactly how each individual will react to any given intervention. In the case of vaccination, such an argument ignores the billions of doses of vaccine administered over many decades with an incredibly low rate of adverse reactions. Sure, vaccines are imperfect, and not everyone reacts the same to them, but what Dr. Brogan is doing here is the old denialist trip of sowing fear, uncertainty, and doubt (FUD), not providing a sober assessment of vaccine risks.
You know where she’s coming from when she invokes the “toxins gambit”:
All the flu vaccine components are potentially toxic; thimerosal is a mercurybased31 preservative, formaldehyde is a known carcinogen, gelatin and egg proteins are allergens, antibiotics are literally designed to kill cells, and I can’t even imagine how muscle cells respond to an influx of straight sugar.
I can. They do just fine. Again, this is yet another tactic favored by antivaccine activists, to invoke the scary-sounding chemical names of what is in vaccines, ignoring the adage that the dose makes the poison. An infant’s blood contains more formaldehyde than any vaccine, the normal byproduct of biochemical reactions, for instance. Doctors know that some components of vaccines are allergens, which is why people allergic to those components do not receive vaccines containing them. The amount of antibiotics in vaccines left over from the manufacturing process is minuscule. This is basically what I like to refer to as the “toxins gambit,” a commonly invoked antivaccine “greatest hit” that sometimes reaches ludicrous levels.
Of course, Dr. Brogan is also down with fear mongering over aluminum:
The most common vaccine ingredient, aluminum, is in at least 18 vaccines, including the HepB vaccine that’s ‘required’ for infants. Even though aluminum salts have been injected into people since the 1920s, a 2015 scientific review paper confirmed that we still don’t know how they work.32 Aluminum stays in the body for several years, and it has been linked to chronic fatigue and cognitive decline,33 among other disorders. A pubmed search for ‘aluminum’ and ‘human toxicity’ returns over 4200 studies. My colleague, Dr. Suzanne Humphries, has explored the nature of this toxicity extensively.
A 2011 study states that aluminum is a risk factor for autoimmunity, long-term brain inflammation, and associated neurological complications.34 In fact, aluminum has been so frequently documented as triggers for autoimmunity that a new term has been coined: Autoimmune/Inflammatory Syndrome Induced by Adjuvants (ASIA).35
Here’s a hint. If you invoke the work of Dr. Suzanne Humphries in a discussion of vaccines, you should immediately lose any debate. This is a woman who routinely refers to vaccines as “disease matter” and embraces the most ludicrous antivaccine nonsense out there. As for ASIA, it is a syndrome invented by Israeli antivaccine physician Yehuda Schoenfeld. There is no compelling evidence that it even exists as a syndrome, and it is not an accepted diagnosis.
Just when you think you’ve scraped the bottom of the barrel, though, Dr. Brogan scrapes harder:
Scientific evidence is mounting that shows the link between vaccines and sudden infant death syndrome (SIDS). Most infants die of SIDS at age 2-4 months, when babies are subjected to 11 shots containing 16 different vaccines.
No. Just no. (This is one of the more vile myths promoted by antivaxers.) She even invokes the ridiculous claim that countries with more vaccines on their recommended childhood vaccination schedule suffer higher rates of infant mortality, an argument that relies on major cherry-picking of data.
Then there’s this:
Many will argue that vaccines have been helpful to eradicate diseases like smallpox. However, it’s important to contextualize the onset of vaccines with the decline in disease mortality rates; for example, several vaccines were introduced when infectious diseases, like measles, were already declining for other reasons.
No again. This is what I like to refer to as the “vaccines didn’t save us” gambit. It relies on an incredibly intellectually dishonest argument.
Of course, if you’ve made what Dr. Brogan views as the horrific mistake of vaccinating your child, fear not! She offers you a way to fix it:
If you’re reading this and panicking (a natural reaction!) because you’ve been vaccinated, or you feel guilty for allowing your children to get vaccinated, the good news is that our bodies are remarkably forgiving. I’ve dedicated my clinical practice and beyond to helping people recover from psychiatric diagnoses, like depression, with proper nutrition, meditation practices, exercise, detox, supplementation, and mindset shifts. As it can be difficult and overwhelming to swap inflammatory habits, like stress and sugar, for nourishing ones, I have shared my approach in A Mind of Your Own (most of which is available in blog form for free on our site!) and created Vital Mind Reset Program to gently guide you towards radiant health. One of the best parts of this program is the supportive and energetic community that accelerates healing. Hundreds of people have reversed psychiatric diagnoses, reclaimed abundant energy, and felt their best.
It gets worse, though.
Dr. Kelly Brogan: Germ theory denialist
If there’s one aspect that unites much of alternative medicine, it is the denial of germ theory. I never used to believe that there were people who deny germ theory, often using newly understood complexities of how microbes interact with the body to make it sound as though microbes don’t cause disease. The idea is, in essence, the idea that microbes can’t cause disease unless the body is somehow compromised. Of course that’s true in some cases, but obviously not true in others. For instance, I doubt that all those 18 year old soldiers who died of the flu in the Spanish Influenza Pandemic of 1918 were in poor shape. As an aside, Bill Maher has frequently voiced similar opinions, namely that he can’t get the flu because he does all the right things.
Germ theory denialists frequently like to invoke a “deathbed confession” of Louis Pasteur, in which he supposedly “admitted” that the “microbe is nothing” and the “terrain is everything.” That’s exactly what Dr. Brogan does in her e-book:
Louis Pasteur, famous for his work on pasteurization and vaccination, later regretted his war on microbes.
No. He. Didn’t. At least, there’s no evidence that he ever did.
The claim that Pasteur’s last words were to admit that he was wrong is a myth long promulgated by quacks and germ theory denialists. Denying germ theory is a very common belief among HIV/AIDS denialists and antivaxers, which is why it is not surprising that Brogan goes down that path as well:
And what about contagion? Has it ever actually been proven that germs travel from one person to another and infect them? Does a yawn spread that way? What about women’s menstrual cycles syncing up when they live together? What about fear-induced illness, which is strikingly demonstrated in a study in which women who were convinced that they were inhaling “contaminated air” got sick when they saw others get sick from it – despite the fact that there was nothing wrong with the air. Then there’s people who only get symptoms of the cold when they believe themselves to be unwell at baseline; perhaps they sense not their immunological vulnerability, but the need for their body to take an opportunity to rebalance.
Yes, Dr. Brogan. It has been demonstrated many, many times that “germs” travel from person to person and infect them, causing disease. Where on earth did you get your medical degree? Consistent with her invocation of the myth of Pasteur’s deathbed recantation of germ theory, Brogan goes full Antoine Béchamp, only gussying up Béchamp’s idea that “the germ is nothing” and the “terrain is everything” (i.e., germs can’t make healthy people with an “inhospitable terrain” sick):
Germs as pathogens is a complex question that science has contributed rich literature to in the past two decades. With the dawn of the microbiome – our inner ecology that reveals not only our harmonious relationship to but our dependency on the very microbes we have demonized – everything about orthodox medicine should have changed. Including the discovery of so-called viruses embedded in our own genomic material, calling into question whether or not viruses actually exist in the way we have assumed. Has a discrete virus, deemed unable to exist independently, ever been visualized under electron microscopy – or are we still inferring? What about exosomes –the packets of genetic material that travel between the environment and our physiology and influence gene expression? Science is revealing that these exosomes look a little too much like viruses for our comfort, leaving us, once again seeing the enemy as a critical part of ourselves.
Béchamp, of course, was a scientist who lived around the same time as Louis Pasteur. He was the champion of a rival hypothesis. This idea acknowledged the existence of microbes and tried to explain their presence in the tissues where disease was present in a different way, a way that didn’t involve them being the main cause of disease. Basically, Béchamp’s idea, known as the pleomorphic theory of disease, stated that bacteria change form (i.e., demonstrate pleomorphism) in response to disease. In other words, they arise from tissues during disease states. Béchamp further postulated that bacteria arose from structures that he called microzymas, which to him referred to a class of enzymes. Béchamp postulated that microzymas are normally present in tissues and that their effects depended upon the cellular terrain. Ultimately, Pasteur’s theory won out over that of Béchamp, based on evidence, but Béchamp was influential at the time, and, given the science and technology in those days, his hypothesis was not entirely unreasonable. It was, however, superseded by Pasteur’s germ theory of disease and Koch’s later work that resulted in Koch’s postulates. Besides not fitting with the scientific evidence, Béchamp’s idea had nowhere near the explanatory and predictive power that Pasteur’s theory did. On the other hand, there is a grain of truth in Béchamp’s ideas. Specifically, it is true that the condition of the “terrain” (the body) does matter when it comes to infectious disease. Debilitated people do not resist the invasion of microorganisms as well as strong, healthy people. Of course, another thing to remember is that the “terrain” can facilitate the harmful effect of microorganisms in unexpected ways. For example, certain strains of the flu (as in 1918 and H1N1) are more virulent in the young because the young mount a more vigorous immune response.
Quacks, particularly those inclined to deny germ theory, also love the new science demonstrating the importance of the microbiome (the microorganisms that live on and in us), because they think it demonstrates that it’s the “terrain” that’s the problem. Here’s the thing. There’s nothing about germ theory that’s incompatible with the idea that there are also beneficial microorganisms living on and in us that can protect us from disease or accepting that disrupting this “microbiome” can make us more susceptible to disease. It’s not as though we haven’t known examples of this phenomenon for decades, namely how antibiotics can wipe out the colonic flora and leave us susceptible to C. difficile colitis. As I learned while reviewing for my surgery board exams, fecal transplants are becoming more and more accepted as a treatment for refractory C. difficile colitis.
Consistent with her germ theory denial, Dr. Brogan tells us that “holistic medicine” is a life without fear and that antibiotics are not needed:
In conventional medicine, the body is a faulty machine that needs to be monitored, tinkered with, and saved from itself through chemical and surgical interventions, the avoidance of which could spell disaster. Through the conventional lens, for example, it’s us versus the germs and if we get exposed to one, they get in and try to get us. Our only responsibility is to take antibiotics and symptom-managing over-the-counter drugs while we continue to punch the clock. If we choose not to take antibiotics, well then, infections can spread and even kill! It’s all about FEAR. The unexpected, the devastating, the fatal.
But there’s another story that you can ease into (or snap into in my case).
From this perspective, the body responds purposefully to it’s [sic] internal and external environment. Acute infectious illness – think coughing, diarrhea, sneezing, runny nose, night sweats – mobilizes cellular debris and can be seen as an effective and sophisticated method of detox when needed. In fact, based on our growing knowledge of the microbiome, some theorize that illness is simply a resonant activation of internal microorganisms when detox and recalibration are needed. We grow from the experience of acute illness in important ways – even if this means simply forcing you to pause and get into bed! In fact, you wouldn’t want to interfere with this, but rather support the body through it.
This is, of course, a straw man characterization of modern infectious disease theory, but it leads to scary conclusions, namely that you can heal yourself of dangerous infectious diseases through “detox” and tweaking your microbiome. It is inarguable that modern medicine uses too much antibiotics, but that overuse does not mean that antibiotics don’t save lives or that we can do without them.
SXSW and Goop should be ashamed
Between her HIV/AIDS denialism and her antivaccine views, I’ve only scratched the surface of Dr. Brogan’s quackery, some of which was documented in the Jezebel and Newsweek articles. On her blog, it’s not hard to find claims that antidepressants don’t work and that the root cause of depression is the gut (although it could also be the vaccines, if you believe her). Her anti-psychiatry hostility makes me wonder why she became a psychiatrist in the first place and whether she’s a Scientologist.
She also cites Dr. Nicholas Gonzalez as her mentor. As you might recall, Nicholas Gonzalez was a cancer quack who peddled a version of the Gerson therapy for cancer, complete with lots of supplements, juices, and, of course, coffee enemas to “detoxify” the liver and body. Through a cherry picked “best case series” of twelve patients with advanced pancreatic cancer treated with his protocol who did better than expected, his advocates finagled an NIH grant to do a randomized trial of his protocol. When the results were published, it was a disaster—for patients on the Gonzalez protocol, whose median survival was around one-third that of patients receiving standard-of-care. The Gonzalez protocol was, not unexpectedly, worse than useless for pancreatic cancer. Gonzalez, of course, made excuses for the failure of his protocol, but none of them could explain such a huge difference in outcomes between the two groups in the trial. None of this stopped him from, in his later years, claiming that he could have saved Steve Jobs if only Jobs had come to him.
She’s also very much into the quackery known as the German New Medicine which posits that cancer is actually the body’s healing reaction to some sort of internal conflict that the patient might not even be aware of and that this conflict must be dealt with in order to heal the patient. Actually, it’s not just cancer. German New Medicine is a theory of everything in medicine, postulating that all disease is due to a “shock experience that catches us completely off guard” and that the remnants of these psychic shocks can be visualized on CT as a “lesion that is clearly visible on a brain scan as a set of sharp concentric rings.” This is all utter twaddle, of course, as is the French bastard offspring of the German New Medicine, Biologie Totale. To Brogan, cancer therapy treatment “with chemotherapy and radiation not only disrupts a complex process that needs to actually be supported, but also it induces secondary harm, both psychically and physiologically. When we interfere and war with the body, we keep the fight alive – you can’t win the battle against yourself.” This is the sort of quackery that kills. Worse, Dr. Brogan portrays “resistance” to medication as a form of feminism.
I didn’t expect much from Goop, of course, given its hostility to science and its doubling down when criticized. However, some of us had some hope for SXSW, especially given that this will be its first health-related expo. So Kavin Senapathy contacted SXSW to express concern, and SXSW has responded to her complaints about Dr. Brogan. In essence, the organizers have pulled the “diversity of opinion” gambit and downplayed Dr. Brogan’s role in the SXSW Wellness Expo. I call BS:
For those following the controversy around @sxsw including Kelly Brogan on the Wellness Expo advisory board (People are criticizing organizers for including an anti-vaccine, HIV/AIDS denier on the board), SXSW issued a statement. More here: https://t.co/4ZsgCeCNvt pic.twitter.com/mismpTRfrd
— Kavin Senapathy (@ksenapathy) December 11, 2017
Again, I call BS. for one thing, here’s what SXSW says about its Advisory Board:
As part of the SXSW Wellness Expo, we’re honored to present our 2018 Wellness Expo Advisory Board who will help ensure that SXSW is bringing the most innovative companies, ideas, and trends to the exhibition.
And here’s what SXSW says about Dr. Brogan:
Kelly Brogan, M.D. is a Manhattan-based holistic women’s health psychiatrist, author of the International and New York Times bestselling book, A Mind of Your Own, and co-editor of the landmark textbook, Integrative Therapies for Depression. She is board certified in psychiatry, psychosomatic medicine, and integrative holistic medicine, serves as Medical Director for Fearless Parent, and is a founding member of Health Freedom Action.
Notice that there is nothing there about her being “just a consultant.” More importantly, Fearless Parent is a rabidly antivaccine group that was founded by New Jersey antivaccine activist Louise Kuo Habakus. I’ve discussed her before, and she features prominently in East Coast antivaccine activities.
Whether either of them is capable of it or not, Goop and Gwyneth Paltrow should be ashamed. By embracing Dr. Brogan, Goop has gone beyond what was mostly lifestyle “wellness” nonsense that probably didn’t do a lot of harm even as it sucked her customers’ wallets dry, straight into the sort of quackery that kills, like HIV/AIDS denialism, antivaccine nonsense, and cancer quackery. The SXSW Wellness Expo appears to be the first time that SXSW is putting on an expo devoted to health. That the only physician on the advisory board is Dr. Brogan does not bode well for even a minimal level of support in science for what is being peddled. I’m predicting that SXSW Wellness Expo will end up being a quackfest every bit as quacky as the Goop Summit, while Dr. Brogan profits. In the meantime, at Goop at least, I wonder what the celebrities who will also be appearing to give talks and participate in panels would think if they knew. Maybe they’re antivaccine too.
After I wrote the above, I found a great five-part series of videos on YouTube by Jeff Holiday deconstructing much of the nonsense that Dr. Brogan lays down. Unbelievably, she’s even worse than I thought just from reading her website and about her views in other places. I liked the series so much that I decided to tack the videos onto the end of this post.
Here’s Part 1: Muh Genes: