Reeves Strikes Again - "It's Your Uterus, Dearie!"

Just when you thought the nightmare on Clifton Rd (location of the CDC) was over, Bill Reeves rises from the crypt to once again assert "It's your uterus, dearie."

A 19th Century medical myth, "hysteria" or the case of the wandering womb, has once against metamorphosed into what passes for research in the pretzel-logic and sham research tradition into "CFS" perpetuated by Bill Reeves and Co.

Gynecological History in Chronic Fatigue Syndrome:
A Population-Based Case-Control StudyRoumiana S. Boneva, M.D., Ph.D.,1 Elizabeth M. Maloney, M.S., Dr.P.H.,1 Jin-Mann Lin, Ph.D.,1James F. Jones, M.D.,1 Friedrich Wieser, M.D.,2 Urs M. Nater, Ph.D.,1,3Christine M. Heim, Ph.D.,4 and William C. Reeves, M.D., M.Sc


In the January 2011 issue of "Women's Health" (what else? we all know CFS is a woman's disease, right? Let's just ignore the fact that Dr. David Bell's practice finds 50 % of his ME/CFS patients are male and many of them are or were children when they first became ill.) Reeves and the usual suspects like Jones, Heim and Nater once again get it backwards.

They note, or just try to infer, that women with a lot of gynecological problems are more likely to have "CFS". Therefore, those gynecological "abnormalities" must be causing the "CFS", right? It couldn't be that what causes "CFS", like retroviral and viral infections and maybe bacterial co-morbidities could be causing those gynecological "abnormalities", could it?

Reaching back into the good old days when not many had yet noticed that the CDC's Viral and Chronic Infectious Diseases Branch had nothing biomedical to say about ME/CFS, Reeves cites papers from as far back as 1986 to support his latest paper's thesis, but includes not a mention of the recent biomedical research that is so pertinent.

 Reminds me of the map makers of long ago who believed that if you sailed far enough west you would fall off the edge of the Earth.

  He can't resist citing himself and his co-conspirators a few times as well. He's still hawking his psychological pseudo-theories in the footnotes:


44. Heim C, Wagner D, Maloney E, et al. Early adverse experience
and risk for chronic fatigue syndrome: Results from
a population-based study. Arch Gen Psychiatry 2006;63:
1258–1266.
45. Heim C, Nater UM, Maloney E, Boneva R, Jones JF, Reeves
WC. Childhood trauma and risk for chronic fatigue syndrome:
Association with neuroendocrine dysfunction. Arch
Gen Psychiatry 2009;66:72–80.

I'm sure it's comforting to the parents of children with ME/CFS to know that the CDC has determined they must have sexually abused their children and/or traumatized them in some way, to cause them to get the disease. Let's just ignore the family studies that show that children with ME/CFS often have parents, especially mothers, who either have ME/CFS or MS and the high rate of autism occurring in those same families. Let's just ignore all the viral, retroviral and infectious disease research that has accumulated over the last 25 years. Let's pretend that the 2009 Science paper never happened. Prescient as always, Bill predicted the CDC wouldn't find XMRV, and by golly, they didn't.

I'm still waiting for the CDC and/or Reeves, maybe with the sponsorship of CAA, to do a study of "CFS" in the boys sexually abused by Catholic priests over the decades. Seems like the perfect cohort for testing the sexual abuse hypothesis, doesn't it? Maybe Suzanne Vernon could help design the study.

There is nothing scientific about this whole paper, although its writers go to great length to give the impression that there is. They wedge the idea of mental illness into it by noting a third group of mainly depressives with "insufficient fatigue", into the narrative and in the illustrative figures, but then go on to say that this group was not considered in the "analysis". Then why mention it at all? I guess they just couldn't warp the science enough to find a way to include this group but tried to infer "guilt by association" somehow.

"Participants who met some but not all three criteria
for CFS constituted the ISF (insufficient fatigue), a separate group that is not
included in the current analysis."

Sort of like saying "In our study of pumpkins and gourds, we wanted to include some carrots, since they are orange, ("some, but not all the criteria"), but they didn't meet the criteria of being produced by a vine. We're including the attributes of the carrots just in case. But we didn't include those "participants" in our "analysis".

Their "cohort" was the notoriously unrepresentative Wichita cohort, obtained by the Publisher's Clearing House method: random digit dialing to households with telephone numbers in the current phone book database. They couldn't just contact the physicians who have patients with the disease, could they? No, those doctors are "contaminated", according to the CDC. This "contamination" is of the mental type, of course, in that they follow Sir William Osler's recommendation that they listen to the patients in order to diagnose. He liked to say, "He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all." His best-known saying was "Listen to your patient, he is telling you the diagnosis," which emphasises the importance of taking a good history.

Instead they take their standards from the disability insurance industry which has a policy of declaring that doctors who actually see the patients can't possibly know more about them than their own on-staff doctors who only go through the files, never seeing the patient, but finding that the patient couldn't possibly have the disease since there are no "objective" findings.

Then they try to turn the weakness in their cohort selection into a positive, using the CDC's trademark pretzel-logic:

"A major strength of the study is its design as a population-based case-control
study, avoiding referral biases inherent to studies of CFS from
referral clinics and the use of convenience controls."

Uhhhhh..., right! Random digit dialing must be better than "referral biases" (what?) from "referral clinics". In other words, we're not going to let any patients with a bona fide diagnosis from a clinician who knows how to diagnose ME/CFS into any of OUR studies! Likewise, those damned "convenience controls". Our random digit dialing is inherently better!

There's one thing the CDC has been very effective at: keeping the disease "mysterious" and making sure that none of the tests, biological markers or treatments ever get tried and tested. Keeping them forever "experimental" means that no insurance, including Medicare, has to do the testing that would prove the biomedical abnormalities present. With no "objective" evidence of disease, the disability and health insurance companies usually don't have to pay up, neither for disability nor for treatment. Those who have the money to outlast them can win. It took Samuel Salomaa 8 years in court to win his disability claim against Life Insurance Company of America, despite having the support of CFS specialists, including Dr. Natelson. It took Clinton Merrick 13 years in the courts to win his CFS disability claim and punitive damages against the disability insurance companies that tried to rip him off. The infamous UnumProvident was a part of that case. Those who don't have the money to defend themselves are simply hung out to dry.

In addition to their bogus cohort, this study uses their bogus criteria/definition of the "syndrome". They say they used the "International Definition" and the "empirical definition". Both were invented to suit their purposes, with the input of the likes of Michael Sharpe from the psycho-quacks of UK. "International" actually means that the US and the UK got together and agreed on the best way to define the disease out of existence: by diluting it to include the depressed and the simply "fatigued".

Then they add a lot of boilerplate statistical mumbo jumbo, much ado signifying nothing. They make a big deal out of the "CFS cohort" having "significantly more" pregnancies that the controls. Actually the "CFS" women had 2.8 pregnancies each and the controls had 2. Why is having nearly 3 pregnancies "significantly more" than two? They go on to state that they didn't ask (it was all done with questionnaires) how many births, miscarriages, abortions or stillbirths any of these women had, essentially admitting that the number of pregnancies couldn't be interpreted to mean anything at all. Yet it was "significant".

None of their other "findings" were significant either, but they ended up concluding:

"In conclusion, the higher prevalence of gynecological conditions
and surgeries in women with CFS highlights the importance
of evaluating gynecological health in these patients." (Uhhhhh....wouldn't evaluating gynecological health be important for all women?)

Translation: "Give us some more money and we'll do some more bogus research" without ever seeing any patients who have the disease and without taking into consideration the Emory study that found XMRV in the reproductive organs of the female and male monkeys. It's not like they never heard of Emory. That's where they've done a lot of their "mind-body" "research", using money from the Chronic Viral and Infectious Disease Branch to not investigate the chronic viral and infectious aspects of the disease.

A little CYA and pseudo-humility amongst the hubris:

"Our findings are derived from a population-based study in
which most patients with CFS reported gradual onset of
symptoms and may not apply to women with sudden onset or
postinfectious fatigue. Participants in this study were somewhat
older than in other studies.8 A different participation
rate between cases and controls may also have introduced
selection bias."

 
Translation: After all that random dialing, they could only find 36 women with "CFS" in Wichita!

And where at CDC are the studies on "postinfectious fatigue"? Or "sudden onset", for that matter? No, no, no. No viral or infectious diseases here, folks. Just pre- and post-menopausal women who were sexually abused as children and are stressed out about it. That and their raging hormones, or hormones that don't rage enough.

Where are the studies of men who have this disease? Children? Maybe not enough men and children were home when the random digit dialing took place, hmmm?

The frosting on this rancid cake:
"We acknowledge Elizabeth Unger, M.D., and Daisy Lee of
the CDC and Suzanne Vernon, Ph.D., formerly of the CDC,
for their contributions to the study protocol."

About a year ago, in a public forum, Cort Johnson told me Suzanne Vernon, currently the "scientific advisor" for CAA, and Bill Reeves "hate each other" in one of Cort's many defenses and apologies for behavior disloyal and counter to the interests of ME/CFS patients by the CAA. I don't remember if that was before or after his editorial saying the CDC wasn't up to anything nefarious - they honestly believe they're right. Right! I didn't believe it then and I don't believe it now. I used to think Vernon was a "Trojan horse" in the CAA but now I realize she and Kim McCleary are in tandem harness, pulling in the same direction, in perfect harmony.

Now aren't all you guys with this disease happy to know your gynecological history is probably what caused your disease? Aren't we all glad that Bill Reeves, no longer at CDC, is still producing such wonderful research with the limited funds available?

Please, Bill, sail west and fall off the edge of the Earth. Take Suzanne, Kim and Elizabeth with you.

Open Letter to Dr. Elizabeth Unger, new Chief of Chronic Viral Diseases Branch

January 21, 2011

Dr. Elizabeth Unger

Chief of Chronic Viral Diseases Branch

National Center for Emerging and Zoonotic Infectious Diseases

Division of High Consequence Pathogens and Pathology

Centers for Disease Control and Prevention

Dear Dr. Unger,

Congratulations on your appointment to your new position. I wish you great success. Your future performance in this position will have a huge effect on my future and the futures of millions of Americans and others around the planet.

The only way I could see your future performance as a success would be if you will take the Chronic and Viral Diseases Branch of the National Centers for Emerging and Zoonotic Infectious Diseases in the direction of research into the viral cause(s) of the infectious neuroimmune disease called myalgic encephalomyelitis by the World Health Organization and trivialized by the CDC by calling it “chronic fatigue syndrome” for the last 20 years.

The NIH symbolically extended its middle finger into the faces of “CFS” patients when it moved “CFS” research to the Office of Women's Health, which has no labs, no recognition and no power to do anything positive about this disease. After 8 years of making recommendations to the Secretary of Health, virtually none of those recommendations have been acted upon and for many years, those suggestions have not even been acknowledged. This disease disables children, men and women.

You have it in your power to change the direction of “CFS” research, away from the marketing and public relations attempt to morph it into a form of mental illness – a direction it should never have been forced into by your predecessors. You can get this research, and the taxpayers' investment, back on target, or you can continue the bad faith pseudo-research of those who preceded you. This pseudo-research has benefited only the disability insurance industry - because it enables them to deny disability payments to patients - and the psychiatrists who have captured the field in lieu of any biomedical treatments being sanctioned by CDC.

From the time of the 1984 epidemic outbreak of this disease in Incline Village NV, where the attending physicians had brain scans showing punctate lesions similar to patients with that other infamous, retrovirally caused disease – HIV/AIDS - through the ensuing 27 years, researchers have continued to pile up the evidence that this is a disease caused by one or more viruses. Hundreds of physicians and their patients have noticed for decades that this illness has many of the same symptoms and signs of other viral diseases, such as influenza, chronic Epstein-Barr, and HIV/AIDS.

Yet the CDC called it “mass hysteria” in the 1980's. That was nonsense then and it's still nonsense.

Dr. Harvey Alter of NIH has said recently, if “CFS” is not caused by the retrovirus XMRV and/or related MLVs, it is still obviously a serious biomedical disease with a viral cause and we need to do the research to find out which virus(es) are responsible.

You, Dr. Unger, have the chance to stand on the shoulders of giants like Drs. Alter, Lo and Komaroff, or to sink back into the 19^th Century's misogyny and misdiagnosis that views this disease as a mental illness. I fervently hope you will do right by American taxpayers, persons who have ME/CFS and those who care about them.

Sincerely,

Lilly Cooper – American citizen with ME/”CFS” for 29 years

********************************************************************************************

eunger@cdc.gov (Elizabeth Unger)bzb8@cdc.gov (Beth Bell)
txf2@cdc.gov (Tom Frieden)
kathleen.sebelius@hhs.gov
dennis.mangan@nih.gov
francis.collins@nih.gov
anthony.fauci@nih.gov

XMRV Proof of Principle Studies = Clinical Trials Now

Are ME/CFS patients first and foremost lab animals or patients?

Apparently, it depends on your point of view.

With the news that XMRV, a newly discovered retrovirus may contribute to or be the cause of chronic fatigue syndrome, or myalgic encephalomyelitis, as it is called by the World Health Organization, some patients, doctors and researchers called for clinical trials of the drugs already developed for HIV/AIDS.

Courgnaud et al, Department of Medicine, University of Alberta, Edmonton, AB, Canada wrote, in a commentary on the Alter/Lo paper in PNAS:

"As we currently lack postulates to prove a causal association with a prevalent agent and a chronic disease with genetic predisposition, it would also be appropriate to conduct interventional studies. Indeed, the Helicobacter pylori hypothesis of peptic ulcer disease was only accepted after Barry Marshall showed that bacterial eradication with antibiotics cured peptic ulcer disease (21). Studies to gain proof of principle have been performed with antivirals in other chronic, idiopathic diseases linked to retroviral infection, such as primary biliary cirrhosis associated with mouse mammary tumor virus, another possible murine zoonosis (22). Trials using a combination of reverse transcriptase inhibitors led to significant improvements in clinical, histological, and biochemical outcomes in these patients, albeit with some evidence of viral resistance to therapy (23). Such studies are now feasible for CFS, because reverse-transcriptase inhibitors, such as
tenofovir and emtracitabine, and the integrase inhibitor raltegravir can inhibit XMRV (24). The caveats for conducting clinical trials in patients with CFS and MLV infection are that the potential benefits of treatment should outweigh the risks; also, studies should be conducted as randomized controlled trials with meaningful and feasible endpoints using robust therapies. At this juncture, studies to establish proof of principle are justified to determine whether safe antiviral regimens can impact on CFS and to determine whether xenotropic or polytropic MLV is causally associated with this debilitating disease."

On the other side of the argument Mary Kearney and Frank Maldarelli, HIV Drug Resistance Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland declared that :

“Such pressures are not justification for testing of therapies in an uncontrolled manner. Indeed, because they are of no help whatsoever to other patients, physicians, pharmaceutical companies, or regulatory agencies, such uncontrolled therapy works directly against the goal of providing effective therapy to the million or more individuals experiencing these serious conditions.”

OK, so some researchers, pharmaceutical companies and regulatory agencies have decided to wait and see. To them , the one million or more people who have CFS are to be the source of lab samples to be tested. Some researchers have predicted it will be at least ten years before treatment could become available. Others are still contesting whether XMRV is the cause of disease, or whether it is even a human pathogen.

In the meantime, physicians who have been trying to help CFS patients for decades look at this research and ask themselves and their patients, what have we got to lose?

Dr. Ila Singh has already found that three drugs developed for HIV/AIDS treatment are also effective in the lab against XMRV and the related MLVs that further research has found in CFS patients.

Physicians have been prescribing drugs “off label”, or for conditions the drug wasn’t developed or approved for, since forever.

When selecting a drug to prescribe for any ailment the physician never knows whether it will work for her/his patient until the patient tries it.

It wouldn’t be the first time a disease was proven to exist by its response to treatment. Barry Marshall, PhD, proved peptic ulcers were caused by bacteria, not stress, by infecting himself with that bacteria and then curing himself with antibiotics. He got a Nobel Prize in Medicine for it.

Physicians are ethically obligated to do the best they can for the individual before them. They tend to see patients as people who need treatment rather than potential contributors of lab samples. If they and the patient, after assessing the risks of the treatment and the risks of doing nothing, decide to try antiretroviral drugs, there is nothing unethical or zealous about it. They can do the same monitoring for these patients that they would do if the patient were HIV positive instead of XMRV positive. They can discontinue therapy if there are warning signals indicating they should.

A physician’s first responsibility is to the patient, not to research, regulatory agencies or pharmaceutical companies. To withhold reasonable treatment in an attempt to advance science would be unethical.

Haven't both medicine and research progressed past the "Tuskegee Mentality"?

From 1932 to 1972, when public outcry stopped the program, patients infected with syphilis were "observed" but not treated by the US Public Health Service in Tuskegee AL. At some point the CDC was created and took over the study.

From the CDC's account of the experiment:

[1969 CDC reaffirms need for study and gains local medical societies' support (AMA and NMA chapters officially support continuation of study).


1972 First news articles condemn studies.


1972 Study ends.


1973 Congress holds hearings and a class-action lawsuit is filed on behalf of the study participants.


1974 A $10 million out-of-court settlement is reached and the U.S. government promised to give lifetime medical benefits and burial services to all living participants. The Tuskegee Health Benefit Program (THBP) was established to provide these services.]

In 1947 penicillin was found to effectively treat syphilis, but it was not offered to the men in the study. Reminiscent of Nazi medical experiments, it was decided to observe the men until they died, do autopsies on them and pay for their burial.

From 1946-48 the US did the same thing in Guatemala except that it purposefully infected prisoners and mental patients with syphilis.

It bears repeating: A physician’s first responsibility is to the patient, not to research, regulatory agencies or pharmaceutical companies. To withhold reasonable treatment in an attempt to advance science, however misguided that attempt might be or however highly approved it might be by other researchers, would be unethical.

Prisoners and mental patients may lose their civil rights but they never lose their human rights, even as those rights are being abused. Persons with ME/CFS have long had their human rights abused and arguably, their civil rights as well. But more about that in another post.

Historical videos re: CFS on youtube

Crime of deception: XMRV epidemic the CDC calls 'CFS' (1 of 6)

Although this video is labeled with 'XMRV', that retrovirus is not mentioned in this video; XMRV and related MLVs have not yet been proven to cause ME/CFS. Nevertheless, "crime of deception" is still an adequate name for what the CDC has been doing since it was brought to their attention over 20 years ago that patients have lesions in their brains similar to those of HIV/AIDS patients, whom we know are infected with an infectious retrovirus.

As of 2011, the funding for research into the cause(s) of CFS is only $5 million, less than for hay fever or erectile disfunction. The possible reasons for this lack of an attempt to find the viral cause(s) and the attempt to divert biomedical attention from the disease are discussed in this series of 6 videos.

What the CDC and NIH Knew In 1984

1996 PRIMETIME LIVE Sick and Tired: Chronic Fatigue Syndrome

Right click for the youtube video where Dr. Philip Lee of NIH says CFS is probably caused by a virus or a retrovirus.