The Mother of All FDA Fails

The FDA has never required drug safety assessment for fetal germline impact, even though FDA staff understand that gestational exposures can adversely affect developing germ cells. We must end this catastrophic omission, while also granting all Americans access to their own prenatal medical records.

The Autism Epidemic: How Hormone Disruptors Blindsided Us Again

by Jill Escher

I’m a mom, investor, philanthropist, volunteer, ex-lawyer, Jewish girl from Beverly Hills, landlady, wife, mild shopaholic, disability housing advocate, Stanford alum, Cal alum, walk-lover, writer about nutrition, and I wear many other hats, but there are two things for present purposes that loom above all others: first, I was endocrine-disrupted in utero via intense doses of synthetic hormone drugs, and second, I am mother to two mysteriously neurodevelopmentally disabled (autistic) children.

And one more thing: my prenatal drug exposures, which were well intended by the pharma-happy medical establishment of the 1960s, but wildly reckless and foolhardy in hindsight, affected not just me but also my little tiny developing eggs, most likely causing my children’s bizarre and unprecedented abnormalities. How? By dysregulating the programming of my germ cells’ epigenome. The epigenome comprises all the countless millions of little chemical switches that provide the instruction book for the underlying DNA. In interfering with a highly conserved evolutionary process based on signaling by natural hormones with very particular chemical structures, those exposures shredded those instruction books.

These acute endocrine-disrupting drug exposures, which were common in the latter half of the 20th century in the form of countless prenatal pharmaceutical drugs, smoking, and persistent environmental chemicals like PCBs, DDT, and dioxin, affected untold tens of millions of fetuses. And their eggs.  And their sperm.  And therefore, the development of their later-conceived children. Children born roughly from the 1980s through today. The precise period coinciding with the epidemics of autism and related neurodevelopmental disorders.

The only difference between me and millions of others is that I have my prenatal records, and they don’t.  Almost no one has seen the records of what drugs they were exposed to in utero, even though the scientific community is in broad agreement that fetal exposures can and often do have lifelong health consequences, for ourselves and for our children. The lack of records is in itself a massive tragedy.

IMFAR, the world’s largest conference about autism, took place this week.  Thousands of researchers trying their darndest to figure out autism all converged in one place.  Lots of papers about genetics, some about environment, loads on early identification (who cares, it hardly matters), early intervention (in truth, it barely helps), brain scanning (won’t tell you much), but almost nothing on gene-environment interaction. Almost nothing on epigenetics.  And absolutely nothing on what could be causing so much de novo havoc in our kids’ genomes, or the horrible history of prenatal exposures of the 20th century.

Now, I know next year will be different. Slowly researchers are waking up to the idea that something weird is happening to our genes (and though I sound frustrated at the slow pace of progress, trust that I am exceedingly grateful to the many enlightened researchers with whom I have been working). And environmental epigenetics is bit by bit emerging as a likely culprit. But, unfortunately, the vast majority of autism research remains blinded by the passe, discredited view of genetics in which the genome is essentially imperturbable and protected from environmental influence. Indeed, the vast majority of autism research funding goes towards projects based on the broken, old, Mendellian genetic point of view.

As I think about my own synthetic chemical history, I wonder, “Couldn’t anyone have seen this coming? Isn’t is obvious that fake hormones would f*ck our egg and sperm and give rise to a generation of developmentally disfigured children?"

Well, I guess not. No one saw it coming. No one wanted to think about the germline.  Not the FDA, not the EPA, not the drugmakers, not the physicians. And while the catastrophic autism epidemic rages unabated, threatening to overwhelm our educational and social services systems, and imposing incalculable misery and cost on a mystified and burdened populace, it will take years to advance these ideas into the mainstream. 

On the other hand, maybe someone did see it coming.  In 1996, Colborn, Dumanoski and Myers published their landmark book on the immense and irreversible damage caused by endocrine disrupting chemicals, “Our Stolen Future.” Though they do not directly address autism or the germline, they issue this prescient warning about the unpredictable and devastating effects of hormone-disrupting chemicals:
“Judging from past experience, it may take a generation for the next nasty surprise to emerge. When it comes it will show up where we least expect it.... The safer bet, however, is that the surprise will be something never even considered.  If anything is certain, it is that we will be blindsided again.” (See p 242 paperback edition (emphasis mine).)
While the authors focus on the deleterious impacts on somatic cells, they perfectly characterize germline havoc as well, that hidden history precipitating today’s "nasty surprise."
“Hormonally active synthetic chemicals are thugs on the biological information highway that sabotage vital communication.  They mug the messengers or impersonate them.  They jam signals.  The scramble messages. They sow disinformation.  They wreak all manner of havoc. Because hormone messages orchestrate many critical aspects of development, from sexual differentiation to brain organization, hormone-disrupting chemicals pose a particular hazard before birth and early in life.” (Pp 263-64.)
The process of germline development depends on the appropriate delivery of precise chemical messages, including hormonal molecules. Impostor hormones hijack a fragile and unfathomably complex system that evolved over billions of years. Synthetic chemicals have derailed human evolution, upsetting the normal molecularly-controlled developmental processes necessary for normal sperm and egg development, and have invisibly unleashed an epidemic that threatens not only our budgets and culture, but also the very foundations of our humanity.

We've been blindsided, yes, but for how much longer must we remain blind?

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