A plausible link is emerging between widely used childhood medicines and the risk of developing allergies and especially asthma. But you'd never know it from listening to federal health authorities or reading the mainstream press.
The latest case in point: USA Today this week is tackling the roots of allergies and examining new treatments based on the idea that children may be getting too little -- not too much -- exposure to allergens.
"To head off allergies, expose your kids to pets and dirt early. Really." That was the headline on the front-and-center page 1 story Monday by Steve Steinberg.
"The new approach to allergy prevention and treatment arises from a paradox," Steinberg writes. "Known as the hygiene hypothesis, it suggests that growing up in cities and suburbs, away from fields and farm animals, leaves people more susceptible to a host of immune disorders, including allergies and asthma."
The article goes on to ask: "What about urban life is triggering a rash of allergies and autoimmune diseases? It's a good question, and not an easy one to answer." (Disclosure: I was an editor at USA Today in the 1980s.)
While the hygiene hypothesis may help explain the huge rise in allergies and asthma, particularly among children, since 1980, there could be more going on here than an absence of cows and cornfields.
Just last week researchers reported a possible link between antibiotics and asthma -- "A new study has found that infants younger than 12 months who have had antibiotics may be more likely to develop asthma when they get older," the Salt Lake Tribune reported.
This was not some flaky anti-antibiotic study -- it was done by researchers at the University of British Columbia and published in CHEST, the journal of the American College of Chest Physicians. The researchers reviewed seven studies that compared kids who got antibiotics before age one with kids who didn't get any, and they were careful to report only an "association," not proof of a cause-and-effect relationship.
In fact, antibiotic use may simply be a marker for kids who tend to have more infections -- that could be the real link to developing asthma.
But if you're going to ask why "a host of immune disorders, including allergies and asthma," are rising, you really cannot overlook the iatrogenic hypothesis -- the idea that medicine might be at least partly responsible for a problem medicine is trying to solve.
A related possibility -- warning, here comes the third rail of American public health policy -- is that vaccines may play a role, and for a similar reason. If the immune system gets stimulated too early and too often but never by the real thing -- say, by the chicken pox vaccination rather than by chicken pox itself -- it could get stuck in battle mode and start attacking its own tissues.
That might lead to allergies, asthma and a host of other autoimmune disorders like juvenile rheumatoid arthritis, skin disorders, juvenile diabetes -- and, conceivably, autism, if autism reflects the outcome of an autoimmune inflammatory process in the brain.
No question, mainstream medical authorities call this idea junk science. But independent researchers keep saying the darnedest things. The latest case in point: A study in January showing that European kids who follow the so-called anthroposophic lifestyle -- which severely restricts use of such medicines as antibiotics and fever reducers -- have a lower risk of developing allergies.
Again, it's just a study, but then again, the study was in the Journal of Allergy and Clinical Immunology, the peer-reviewed, scientific journal of the American Academy of Allergy, Asthma and Immunology.
The overlooked last sentence of the researchers' press release reads: "Early use of antibiotics and fever reducers, along with the measles, mumps and rubella vaccination were also associated with increased risks of several allergic symptoms and doctor's diagnoses."
There you have it -- a responsible report of a possible allergy risk not just from antibiotics and fever reducers but from the MMR vaccine, which every child in America is supposed to get. Coincidence of not, the MMR came into wide use around 1980, and in the mid-1990s, the CDC moved the recommended age forward to 12 to 15 months, from 15 to 18 months.
This study fits with something we reported last fall from Homefirst, a medical practice in Chicago that follows a similar philosophy and has thousands of never-vaccinated children. The group's medical director, Dr. Mayer Eisenstein, said he couldn't think of a single case of autism in children who had never been vaccinated. Ditto asthma.
The asthma rate among Homefirst patients is so low it was noticed by the Blue Cross group with which Homefirst is affiliated, according to Eisenstein.
"In the alternative-medicine network which Homefirst is part of, there are virtually no cases of childhood asthma, in contrast to the overall Blue Cross rate of childhood asthma which is approximately 10 percent," he said.
"At first I thought it was because they (Homefirst's children) were breast-fed, but even among the breast-fed we've had asthma. We have virtually no asthma if you're breast-fed and not vaccinated."
Several studies have suggested a link between vaccines and asthma while others -- notably one conducted by the Centers for Disease Control and Prevention -- do not. The CDC study, as we've noted before, eliminated never-vaccinated kids from consideration, allegedly because their medical records were inherently unreliable.
But note: The study above that found an association between antibiotics and asthma used control groups of kids who never, ever got any antibiotics. That's the kind of comparison federal health authorities seem to be assiduously avoiding when it comes to studying possible autoimmune risks of all kinds from vaccines.
When that happens, it's up to the press to dig deeper than pets and dirt. Really.