A commentary in this week’s New England Journal of Medicine spotlights how easy it is to forget basic scientific principles even when you’re on the Harvard Medical School faculty.
In “The Long-Term Effects of In Utero Exposures — The DES Story“, Harvard faculty members Annekathryn Goodman, John Schorge, and Michael F. Greene (also an editor at the NEJM) attempt to label the now-banned synthetic estrogen diethylstilbestrol (DES) as an “endocrine disrupter” — just like enviro crank Theo Colburn tried to do with her 1996 book, “Our Stolen Future.” They wrote:
Chemicals that affect human fetal development are now called endocrine-disrupting chemicals, and an understanding of the changes caused by DES, the prototypical endocrine disruptor, has led to the identification of genetic pathways that govern the development of the reproductive tract… The lessons learned from the DES story are powerful. Endocrine disruptors may cause alterations in the reproductive tract that have severe consequences and form the basis of disease in adults decades later. Endocrine disruptors may come not only from ingested medicines, but potentially also from the environment through food. It is very difficult to recognize a teratogenic consequence of a prenatal exposure when the malformation does not manifest until 20 years later.” [Emphasis added]
First, DES was designed to be a hormone and it was. It was not some some treatment that inadvertently acted like a hormone or disrupted hormones. It functioned like it was intended. So DES is not an “endocrine disrupter” — especially as the enviros use the term.
DES was a drug that was administered in relatively high doses. In contrast, the endocrine disrupters of enviro fantasyland are manmade chemicals in the environment to which people are exposed to on a trace-level basis. There is no evidence that these have harmed anyone ever in a manner consistent with the endocrine disrupter hypothesis (a generous term for it).
It’s the dose that makes the poison and the therapeutic doses of DES administered to pregnant women turned out to be a poison for many. But the same is not so for manmade chemicals in the environment — or food, as the commentary’s authors intimate.
Ironically, Texas A&M researcher Stephen Safe compared the relative estrogenic activity in human exposures in a 1994 analysis. The highest — except for the birth control pill and hormone replacement therapy — was from the natural phytoestrogens in the diet. Synthetic chemicals, such as BPA were at much lower levels.
Drs. Goodman, Schorge and Greene should stick to teaching obstetrics and gynecology — and leave the junk science to others.