Chronic fatigue syndrome hypothesis collapses further

Two years ago, a team of scientists announced with great fanfare that they'd found the cause of chronic fatigue syndrome: a mouse retrovirus called XMRV. There were many media reports and much excitement, and at least a dozen studies were launched to look for this virus in more patients. Unfortunately for patients, the findings turned out to be seriously flawed.

New results published this week seem to be the final nail in the coffin for the XMRV hypothesis. The editors at Science have taken the unusual step of publicly asking the authors of the 2009 study to retract their findings. As reported in the Wall St. Journal, Science sent a letter to the authors stating:

"At this juncture, Science feels that it would be in the best interest of the scientific community'' for the co-authors to retract the paper."

In addition, the editors published an "expression of concern" this week, which is their way of warning everyone that the results are wrong. Judy Mikovits, the leader of the study, steadfastly insists that she is right and all the others are wrong.

Despite Mikovits' claims, the evidence is very clear that she is wrong. Study after study has found no trace of the virus in CFS patients. Where Mikovits' original study found 67% of the patients had XMRV, followup studies found 0%. A set of three papers in the journal Retrovirology, published in December, showed conclusively that the finding was due to laboratory contamination. The XMRV virus turned up as a contaminant in cancer cell lines that are widely used in laboratory research. As I wrote in January:

"It turns out that a common tumor cell line called 22Rv1 is infected with MLV-X. It also turns out that all the XMRV sequences from human patients are far more similar to the exact same strain of MLV-X that is in the mouse cell line. The tumor cell line was in the lab doing the experiments: ergo, it's contamination. Elementary, my dear Watson."

Two new papers in Science this week found the same thing. One of them, titled "No Evidence of Murine-Like Gammaretroviruses in CFS Patients Previously Identified as XMRV-Infected" looked at patients who had tested positive for the XMRV virus, and found that they didn't have it all. The second study provides new detail on how the XMRV virus got into the cancer cell lines.

So why does Mikovits cling so fiercely to her claims? (She posted a long letter defending herself at the Whittemore Peterson Institute, where she works.) What she doesn't say is that she has gone far beyond her original findings: she and her institute are actively promoting the use of anti-retroviral therapies for CFS patients. As Nature News reported in March,

"The WPI owns a company that charges patients up to $549 to be tested for XMRV, and Mikovits believes that patients who test positive should consult their doctors about getting antiretroviral drugs normally prescribed to those with HIV."

This is a blatant conflict of interest, and it perhaps explains some of Mikovits' stubbornness.

It gets worse. As Trine Tsouderos reported last summer in the Chicago Tribune, Mikovits claimed at the Autism One conference that XMRV also causes autism. She has no evidence to support this startling claim. Mikovits stated to the Tribune that "unless we do something now this (XMRV) could be the worst epidemic in U.S. history."

Mikovits also believes there is a conspiracy against her. In March, she told Nature "I had no idea there was that much bias against this disease." Nonsense. The collapse of the evidence about XMRV and chronic fatigue syndrome is just science doing what it is supposed to do: when a study cannot be replicated, then the hypothesis is abandoned and we move on.

This is a classic tale of a scientist gone bad. Unfortunately for CFS patients, Mikovits is distracting attention from efforts to find the real cause. By speaking at the Autism One conference, she has joined the ranks of pseudoscientists and anti-vaccinationists. It's pretty clear now that she will never retract her findings, despite the pressure from the editors at Science. I can only hope that CFS patients, who are understandably desperate for a treatment, won't be fooled into taking ineffective and possibly harmful therapies based on the failed XMRV hypothesis.

Making money by making people sick

I’m a long-time fan of Quackwatch.org, an award-winning website built by Stephen Barrett, M.D. that covers a wide variety of questionable medical practices. I just discovered that Dr. Barrett has a sort of “Hall of Shame” page, listing some of the most egregious promoters of bad medicine and bad science. Everyone on this page has been involved with the promotion of questionable practices and products, some of them so outrageous that they’ve been the target of government enforcement actions. (Whatever conspiracy theoriest might say, the government doesn’t have the resources to go after most quacks.) Barrett helpfully tags each person with one asterisk for each enforcement action.

This is an excellent resource for anyone who might question a product that is being sold over the Internet. It’s also a good place to go if you’re skeptical about the advice offered by a self-proclaimed expert on any medical topic. Each name on Barrett’s list is linked to a more detailed page of useful facts about the person. Let’s look at what it says about Joseph Mercola, D.O., who operates a startlingly popular website dedicated to – well, let’s see.

Mercola is a major promoter of anti-vaccination myths, as I’ve written before, here and here and here. His latest anti-vax screed is an attack on Gardasil, the HPV vaccine, but I won’t discuss that today – Joseph Albietz dismantled it a few weeks ago over at Science-Based Medicine.

Mercola originally came to my attention because of his anti-vaccine activism. He maintains a special page devoted to this topic, which he states contains “vaccine news.” It should really be called “anti-vaccine news”, because that’s what it contains; it’s a font of misinformation. Essentially he claims that every vaccine is bad for you, and that vaccines are little more than a huge government-industrial conspiracy to make money for Big Pharma. Instead of getting vaccinated, he argues, you should try his all-natural treatments instead. Great idea! If everyone followed his advice, who knows how many people would die of preventable infectious diseases? I wonder if Mercola really believes his own anti-science propaganda, or if he knows it is bogus and just doesn’t care.

Regardless of whether he is sincere or not, what Mercola does really well is to promote his own products. A 2006 Business Week article pointed out that Mercola “is a master promoter, using every trick of traditional and Internet direct marketing to grow his business,” and comparing him to “the old-time snake oil salesmen of the 1800s.” That’s exactly what he is, but he uses the modern tools of internet advertising to turn his particular brand of snake oil into a very successful business.

He sells hundreds of “natural” products and makes countless claims for them, most of which are either unproven, medically vague, or irrelevant. He still sells the very same products that the FDA warned him about: he merely changed the way he advertises them. The FDA doesn’t really have any power to regulate supplements – all it can do is prevent specific claims about curing disease. Clever snake-oil salesmen like Mercola can easily circumvent the FDA with a few simple edits to their websites.

For example, Mercola was warned about a product called Chorella in both the 2005 FDA warning letter and the 2006 warning letter, but he’s still selling Chorella on his site. He claims that it will “boost your immune system”, “purify your blood and clean away toxins,” promote tissue repair, and countless other unsupported claims. All of these claims are marked with an asterisk (*), and if you scroll down you’ll find that he qualifies his claims with this:

“*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.”

This disclaimer appears below the instructions on how to buy the product, of course.

Mercola knows how to diversify his product line, too: he even has his own brand of cookware, which he claims will help you avoid the nasty toxins that are getting into your food during cooking. What, you didn’t know? Mercola says we should throw out all of our stainless steel, aluminum, and Teflon cookware because these materials will make you sick – unlike his cookware, which he says is “made from the earth's natural minerals and water” among its many other virtues. What, and aluminum isn’t a natural mineral? This stuff is almost hilarious, but unfortunately some people believe Mercola’s wacky claims. His cookware site claims that aluminum causes Alzheimer’s disease (wrong), that Teflon causes multiple types of cancer (wrong again), that stainless steel causes narrowing of the blood vessels (wrong again), and on and on.

Oh, I see it’s dinner time. Better fry up some synthetic fish sticks in my Teflon skillet and then eat them with my stainless steel fork. Yum.