Wednesday, August 18, 2010

BLEACH: Chemistry v English (or "More Mineral Miracle Solution")

The story of 15-year-old Rhys Morgan's experience on a forum when he posted an FDA press release urging people to stop using Jim Humble's Miracle Mineral Solution is well documented - amongst others there is Rhys' own blog of course, and LizDitz provides a timeline history. The interview I did with Rhys for The Pod Delusion, which sets out the story and some of the human interest can be found here.

My minor involvement started fairly early on in media terms, but very late in Twitter terms! I had seen the hastag #bleachgate on Twitter and also references to 'MMS' and 'drinking bleach'.

As a chemist by trade who has (hopefully) gained some knowledge over the years, it sounded to me like someone was channelling the People's Medical Journal, aka The Daily Mail. Would people *really* be told to drink bleach for ailments, and worse still, actually do it?

After a bit of Googling, the story became clear, and indeed some hype and hyperbole had crept into what was otherwise a fascinating story.

I wanted to get a few thoughts (and maybe some chemistry....) into a blogpost to try and put things into perspective. This is not meant to piss on anyone's parade, but just to hopefully give some explanation as to how a story like this can evolve, and how it can suffer from distortion in the hands of the 'skeptic community' (ugh) just like any media outlet.

Firstly, a bit of chemistry and nomenclature (chemical names).

Like all bulk industrial chemicals, it has to start somewhere easy and reletavily abundant, in this case salt. Sodium Chloride (NaCl) is our friend - table salt, sea salt, rock salt, whatever is prety much all salt and necessary for us to live.

The salt is electrolysed to form Sodium Chlorate (NaClO3), which is a tremendously good weedkiller. 'Good' in this case meaning 'indiscriminate and powerful'. It was banned in EU in 2009, as its risk to humans outweighs its usefulness as a weedkiller, but it is still used extensively outside the EU due to its low cost.

To make sodium chlorite (NaClO2 or Miracle Mineral Solution as it is also called), Sodium Chlorate is reduced in a strong acid using a reducing agent (e.g. sulphur dioxide) to form Chlorine Dioxide (ClO2). ClO2 is explosive in >10% in air and difficult to transport, and so it is stablised making the solution alkaline and reducing the ClO2 with hydrogen peroxide to make Sodium Chlorite.

So there is the manufacturing process - sodium chloride -> sodium chlorate -> chlorine dioxide -> sodium chlorite.
The four products are very similar in structure, yet have completely different characteristics ranging from being necessary for life to being very toxic.

The websites selling MMS weren't advocating ingesting MMS (Sodium Chlorite). They were directing the user to mix it 1:1 with an acid (usually citric acid or similar) to form Chlorine Dioxide (ClO2). (Acidification to produce ClO2 is the standard industry practice for this product when it is used in cooling towers and industrial water systems as it is the ClO2 that is effective against slimes, moulds and bacteria living in the water supply, but as stated above, transport of ClO2 is difficult and dangerous, so Sodium Chlorite is transported to the site and acidified later).

So what about bleach? Bleach (as in household bleach for toilets) is Sodium Hypochlorite (NaOCl) made from the electrolysis of chlorine in brine. As shown above, these chemicals can look and sound similar, but have completely different characteristics. So when people use #bleachgate, they are (in my view, uninformedly) talking about Household Bleach (NaOCl) and not MMS, (NaClO2). Part of this is undoubtedly part of the Twitter hashtag thing of being able to encapsulate a story in as few precious characters as possible, but IMHO, the end result was a tabloid affair, that I would have railed against had it been in any of the main stream media outlets.

So where did the 'bleach' meme come from? The FDA press release is the answer - it describes the product as "an industrial bleach" and "a potent bleach used for stripping textiles". (I have no idea what stripping textiles is). The FDA is correct is saying it is *a* bleach, but that's not the same as saying it is 'bleach', because bleach already means something in people's minds and they use it as a pretty potent chemical for cleaning loos. For instance, everyone knows that lemon juice can bleach your hair - go out in the sun with lemon juice in your hair and it will bleach. It is *a* bleach - I should be able to drink some quite happily without being accused of 'drinking bleach'.

And what about the 'drinking' part? The websites advocate 'a few drops' - Jim Humble's own website states:
Begin with taking one drop of MMS each hour for at least 10 hours a day. The drop, of course, must be activated with 5 drops of lemon juice or 10% citric acid. You wait 3 minutes and then add 1/3 glass of water or juice and drink that. Do this every hour for 10 hours straight each day

So clearly 'drinking bleach' is not what is being advocated and not what Jim Humble (the supposed MMS guru) has divined - because it is neither being drunk nor is it bleach.

What about the concentration of ClO2 in the final dose? How does that compare with FDA guidelines? Time is not allowing me to do this as accurately as I'd like, so there may be mistakes in here (please correct them if you spot them).

MMS is sold as a 28% solution - I'm going to assume this is by weight, i.e. 28 g in 100 g of solution, I'm also going to assume the density of the solution = 1 g/cm3.

The users are told to use citric acid (in excess, so the amount doesn't matter) to produce the ClO2 – citric acid is a strong enough acid to do this. 28 g of NaClO2 in 100 ml is 0.25 mol (RMM=110), which means there is 2.5 mmol in 1cm3. Assume 20 drops in 1 cm3 (I think this is standard), which means each time you take the MMS you are getting 0.125 mmol of NaClO2 and hence the same of ClO2. This is then added to 1/3 glass of water or juice (I'm assuming that's 100ml, so you have a solution of 0.125 mmol of ClO2 in 100 ml, or 4.69 mg in 100 ml, or indeed, 46.9 mg/l. Compare this with the FDA limit of 0.8 mg/l and you'll see that Jim Humble is recommending about 60 times the FDA limit, and that this is to be taken every hour for 10 hours.

"The dose maketh the poison" as someone wise and important pointed out. Despite the fact that most people reading this blog have ingested ClO2 at some point (swimming pools, drinking water etc) it is still a completely crazy situation where someone is suggesting taking ClO2 in the form prescribed by Jim Humble. This is out and out quackery at its highest level - a huge amount of risk and absolutely no reward possible.

The story of Rhys' treatment on the Crohn's Forum website is indicative how alt-med react when presented with scientific facts, and that this is a product which the ASA, MHRA, and Trading Standards should all be made aware of - I can't really imagine it being banned, but at least controlled somehow and the people making the nonsense claims given a penalty.

So in my view, the story is fascinating, from lots of angles, but most importantly the complaints are valid and worthwhile, even if somewhere along the way, the Twitterati hyped the story to the point where it might have been quite at home in the Daily Mail.


Friday, August 13, 2010

Pod Delusion: Miracle Mineral Solution

Here's this week's episode of the Pod Delusion, which contains a short interview I did with Rhys Morgan, who got thrown off the Crohn's Forum website for posting an FDA Warning about a product called Miracle Mineral Solution which had been promoted as a suitable treatment for Crohn's diseases on the site.

You can read more about the story at Science Based Medicine, NoodleMaz, PodBlack (and lots of others) and follow Rhys' story on his own blog at TheWelshBoyo.

(I think it's worth mentioning, James O'Malley kindly upgraded my humble PhD to that of a medic on the podcast - I'm not a medic & wouldn't want to suggest that I am.)