Holford is, generally, pretty anti-drug: for example, he has co-authored a book on how ‘food is better medicine than drugs’, and gives an overly negative summary of the potential usefulness of Alzheimer’s drugs and statins. I was therefore very surprised to see Holford arguing that secretin is “Worth considering” as a treatment for autism (Holford New Optimum Nutrition for the Mind, p.336).
You might expect that - as Holford thinks secretin is ‘worth considering’ as an autism treatment - the evidence as to its benefits would be remarkably strong. However, you would be disappointed. As far as drugs go, the evidence on secretin for autism is pretty clear - and it’s negative. A 2005 Cochrane review found that there is “no evidence that single or multiple dose intravenous secretin is effective across a range of outcomes, and [secretin] should not currently be recommended or administered as a treatment for autism”. Quackwatch notes some potential adverse effects of this drug.
As Dr Edwin Cook describes in his recent Autism Omnibus testimony, when he tested secretin as an autism treatment against a placebo, “saltwater was slightly better than secretin.” This is, as Cook rather charmingly understates the point, “not what one looks for.” Because of this lack of evidence, secretin is not licensed as a treatment for autism and therefore - when used in this way - has to be prescribed ‘off-label’ (a practice that Holford’s co-author Jerome Burne has been very critical off).
Secretin is thus an autism treatment which does not have reliable evidence of efficacy, which does have the potential to cause adverse effects (before one even takes into account the damage done by subjecting people on the autistic spectrum to additional, and pointless, medical interventions in order to inject the secretin), and which is - with good reason - not licensed as a treatment for autism. So, why on earth does Holford think that secretin is ‘worth considering’ as an autism treatment? Surely this is an excellent example of a case where a drug doesn’t work, and may worsen one’s situation - but here, unlike with many drugs, Holford thinks that treatment with this secretin is ‘worth considering’.
See also a follow-up post, on Secretin and off-label drug use
3 responses so far ↓
Shinga // June 24, 2007 at 6:30 pm
I’m having severe misgivings about some of the quality of the research if it is leading to recommendations that secretin is “worth considering”. It is hard to accept that as a reasonable outcome of a comprehensive survey of the literature.
Jon // June 24, 2007 at 7:53 pm
Thanks Shinga. The closest thing to a reference given by Holford is a URL for the homepage of the Autism Research Institute’s website. The Institute is involved in Defeat Autism Now!, and the website has a frankly scary array of weird and wonderful treatments which they push (sorry - maybe I should say ’suggest’) for autism.
Holford doesn’t specify which report on the site shows that secretin is worth considering. What I have seen, though, does not fill me with confidence as to their research quality.
For example, The Institute have come up with an impressively novel excuse (I can’t bring myself to say ‘hypothesis’) as to why secretin is shown to be an ineffective autism treatments in double-blind RCTs: a “negative placebo effect“. I was trying to get a sense of the Institute’s response to the trials which show secretin to be ineffective, but the closest thing I could find was a letter from Rimlaud.
One more nugget from the Institute’s website that I think is worth posting: they do discuss safety concerns about secretin. While trying to argue in favour of its use, the Institute’s article states that: “It is possible that the problems described above [when secretin was administered] may not be caused by secretin but instead by the panic and stress experienced by a child who is held down by adults while an IV needle is inserted.” I hope I’m not alone in finding the idea of a child being caused considerable distress - by being held down so that an IV dose of an ineffective drug could be administered - rather disturbing.
I could have done some kind of survey of the Institute’s research - but it already feels as if this ‘research’ has been using my eyeballs as a tool to beat me over the head. And, to be honest, if Holford doesn’t go to the effort of referring to which part of the Institute’s (big, hard to navigate) website supposedly backs up his view, I can’t be bothered to inflict reading this whole website on myself.
One more thing re. the Institute - the article they carry on how autism is a type of mercury poisoning is a wonderfully Orwellian attempt to ignore the inconvenient facts about these two conditions. The table explaining how the symptoms of autism are the same as the symptoms of mercury poisoning, in particular, would be rather funny, if these people weren’t advocating certain ‘treatments’ for children. Off-topic, I know, but the article is such a classic I thought it would be worth sharing…
Shinga // June 25, 2007 at 8:17 am
I had a quick flick through the references in that last mercury poisoning paper. I see that most of those references are to methylmercury.
Ethyl alcohol (ethanol) widely consumed. You may experience a wide variety of effects at small doses but adapt rapidly to the point where you can adapt to large doses.
Methyl alcohol. Very much more likely to kill you in doses as low as teaspoons.
Alcohol v. methanol (wood alcohol).
The same difference between ethylmercury and methylmercury. You can not extrapolate from methylmercury to ethylmercury.
To paraphrase Father Ted on the issue of perspective: “these cows are near. Those (gestures to field) are far away. Near. Far away”.
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