151: A PREMED STUDENT WAS BUTCHERED BY A DERMATOLOGIST WHO PRESCRIBED ACCUTANE

She wrote me an email and I interviewed her.

Rachel’s email:

Hello Dr. Yoho,

I read your book last year and valued your insights. I was interviewed by Tim Alexander for his documentary, “Legal Death in Drugs we Trust” and recently listened to your interview with him.

I am Rachel, a magna cum laude graduate in premedical biological sciences from UC Santa Cruz with advanced biosciences post-baccalaureate studies in pharmacology, toxicology, physiology, microbiology, and human genetics from UC Berkeley. Like you, I was a rock climbing enthusiast, but unfortunately I can’t climb now because I’m permanently disabled. I was “born into medicine” – my entire family are nurses or doctors. My grandfather was the physician for the King of Afghanistan and the Afghan Olympic team. I was taught from a young age to trust doctors because my father is an internist.

I excelled in school and was accepted for competitive research positions, TAships and internships. I was supposed to be a veterinarian or medical doctor by now. Despite my potential, I have been physically disabled and mostly housebound / bedbound for the past 8 years and living a nightmare of severe chronic pain and illness with a wide array of incurable symptoms. I’ve tried many treatments with no signs of improvement. My prognosis is dismal.

I was first injured by Gardasil (HPV vaccine) at age 20 and subsequently by drugs used to treat the various issues I developed. I had severe cystic acne, brain fog, mood swings, cognitive issues, dissociative periods, memory problems, severe depression and anxiety, etc. I was gaslit by doctors and prescribed several psychiatric medicines for the neuropsychiatric effects of the HPV vaccine. I had reactions to isotretinoin that I was prescribed for cystic acne.

Yoho note: Accutane is the original brand name for this drug, but the manufacturer was repeatedly sued and took it off the market in 2009. Patients were becoming psychotic, committing suicide, and having many other horrendous side effects including “rhabdomyolysis,” or muscle degeneration. Some courts have absolved generic manufacturers of liability for drug harms, claiming that the original manufacturer did the studies and was the sole responsible party. See the “Prozac and relatives” chapter of Butchered by “Healthcare” for more. Only generic Accutane remains on the US market.

I was concerned about taking isotretinoin because of the lawsuits but my dermatologist (who shared an office with my father) reassured me that all lawsuits had been dropped and isotretinoin had recently been “scientifically proven” to cause no ill effects. He promised me it was very safe at a “low dose” and that he had prescribed it thousands of times with no problems. While taking the medication, I felt mostly fine. My dose was low, my monthly bloodwork was all normal, and I had no headaches, digestive problems, or signs of organ toxicity, so I did not foresee any problems. However, I since discovered that this medicine has a latent toxic potential. It may cause widespread stem cell death, DNA damage, and mitochondrial damage. The resulting symptoms and adverse health effects may occur months or even years after discontinuation.

That’s exactly what happened. The real nightmare started months after my last pill. After three months, I developed intermittent tremors and collapsed in a yoga class. Four months later, I developed random migrating pains and periods of weakness while rock climbing. Six months after my last pill, I woke up suddenly one day unable to walk. I felt like I was hit by a bus and had the onset of the crippling problems that I still have today. These were both neurological (memory problems, myalgic encephalomyelitis / CFS, migraines, cognitive issues, brain fog, low blood pressure, POTS, neuropathy, dizziness, weakness, visual snow) and musculoskeletal (severe tendon, ligament, joint, bone, and muscle damage). Before this, I was able to do two-finger pull-ups, V5 boulder problems, 5.11d top-ropes and 5.10 sport climbs. But within 24 hours, I was almost entirely bed-bound and unable to walk or to use my hands. I experienced partial paralysis in my hands and could not move my fingers or grasp anything for several weeks. My neuropsychiatric and cognitive abilities dramatically changed—according to a neurologist, my memory had declined from significantly above average to now in the lowest 20th percentile. 

No doctor I saw believed this was possible. It was not a risk that dermatologists seem to know about. For years, I was gaslit by medical professionals and even my own family. I was homeless for periods because my family didn’t believe my illness or symptoms were real. I found, however, there are many thousands – perhaps millions – of young people like me who developed serious health problems months or sometimes years after stopping isotretinoin.

Dermatology organizations lie about the risks of this medication, and pharmaceutical companies fund fraudulent research disputing the risks and adverse effects. Patients are told by dermatologists that side effects are “reversible,” and that it is impossible to develop effects once the medicine is no longer in your body. This is simply not true. There are no FDA warnings about many of the permanent neurological side effects I experienced, or that side effects may start months or years after the drug’s discontinuation. This is just like fluoroquinolone antibiotics, which carry a warning about latent effects.

In 2019, I checked social media to see what dermatologists were saying about this. I wondered if they had since added new warnings or changed the way they inform patients. I was shocked at what I discovered—the American Academy of Dermatology has been organizing aggressive campaigns instructing dermatologists to use social media to “fight the online rumors” and “misinformation” about isotretinoin. And PubMed articles on how to combat the “false information” about isotretinoin have popped up in recent years. Articles about isotretinoin “misinformation” on TikTok, social media, and Facebook have been published, describing people spreading “false rumors” about the side effects. I found MANY dermatologists with prestigious medical degrees using YouTube, TikTok, Facebook, and Instagram—platforms which directly target children and youth—to promote and advertise isotretinoin. They falsely claim that the rumors about certain serious adverse events and long-term effects are “myths”.

These dermatologists and dermatological associations are using social media as an advertisement vehicle to push this harmful chemotherapy drug on children with a minor, often temporary skin issue. And I discovered that the roots of this corruption ran much deeper: pharmaceutical companies including Roche, Sun pharma, Dr. Reddy’s laboratories funded research that was used as marketing. The studies were poorly conducted and likely fraudulent, and these concluded that isotretinoin does NOT cause the inflammatory bowel disease OR neuropsychiatric disorders (depression, suicidality) that was being reported. Since then, the AAD guidelines for isotretinoin prescribing have changed to recently recommend this treatment as a first-line therapy instead of a last resort for all types of cystic acne. Additionally, they recommend it for mild to moderate acne. And so prescriptions have skyrocketed— today, the majority of users who are prescribed this toxic pill do NOT have severe or even deeply cystic acne. Most of them are teenagers.

Some dermatologists have even gone on record admitting to prescribing these pills “like candy,” to children “as young as 7 years old.” There are even case reports in medial literature recommending isotretinoin for infantile acne! The situation is entirely out of control. Every year, more kids and young adults in online support groups end their own lives due to their serious, irreversible health problems. Many are chronically ill and permanently bed-bound like me. Dermatologists with millions of followers on social media continue to laugh at the idea that their favorite pill could harm anyone, claiming it is “extremely safe”, as long as patients don’t get pregnant and take monthly labs. One Instagram-famous dermatologist told me to “go take accutane and die” when I debated his online promotion of the drug. Despite showing his false claims and his advice to “go die” to the state medical board, this dermatologist still has his medical license—and nearly 100,000 followers on Instagram. 

I have collected extensive data and wrote a literature review on this topic. I have hundreds of files of screenshots, videos, and social media comments of board-certified dermatologists promoting isotretinoin on social media. They make false claims about the low risks and claim that the long-term damage I have had personally and seen in other patients is just an “online rumor”/“myth” and not real. Furthermore, I learned through openpaymentsdata.cms.gov that the AAD leaders, board members, and journal editors have received $76 million from pharmaceutical companies between 2014 to 2020.

Upon discovering this extensive corruption and misinformation campaigns, I decided to organize advocacy efforts to expose these dangerous lies. First, I contacted numerous medical organizations, including the AMA medical ethics committee, the FDA, the AAD, and the ABD, dozens of times. Using dozens of pages of indisputable evidence, I complained about the dermatologists’ false claims and promotion of generic Accutane on social media. Over the course of several months, I sent dozens of emails to over 60 physician board members and leaders of these organizations. My father, Dr. Merrill Nisam, also sent emails pleading for this issue to be examined.

When we were both was stonewalled, I organized multiple survivors and family members of isotretinoin victims to send emails to these medical organizations. We begged them to address the issue. When that didn’t work, I created a petition against the dermatologists making false claims, and collected hundreds of signatures to send to medical organizations. Continuously ignored, we began using social media in a peaceful protest attempt to publicly call attention to the “social media celebrity” dermatologists’ lies. We included scientific evidence to explain the situation. I never received any responses. I was, however, told that the president of the AAD “knows all about me”. He sent an email to all AAD members nationwide, warning them about “Accutane trolls” who are “critical of perceived side effects”, and suggesting they ignore our efforts. He also instructed the member to contact law enforcement if anyone contacted them about the issue or criticized their medical claims.

Shortly after these advocacy attempts, the AAD issued a new position statement designed to fight the “myths” about the drug. It stated that the side effects are “temporary.” This statement has since been removed, but I have evidence in screenshots. My family started receiving threatening phone calls, and my father was harassed at his place of work and threatened with litigation for signing a petition against the false claims made by the AAD and dermatologists. My personal information was doxxed, and someone called my parents’ home at 3am and asked for me in an intimidating voice. I contacted Dr. Doug Bremner, who wrote a book called The Goose Who Laid the Golden Egg, about his experience with corporate intimidation and home invasions following his research on isotretinoin’s adverse effects on the brain. He was not surprised to hear about the harassment. Several other advocates have also reported receiving disturbing threats that forced some of them into silence.

Several Facebook groups have thousands of members who were harmed by Accutane and its generics. I’ve also spoken to hundreds of patients damaged by isotretinoin. None of them were fully warned about the long-term risks. All of them were told that side effects are “reversible upon discontinuation,” and that new or worsening effects after discontinuation of the drug is “impossible.” I have spoken to young victims of this scandal from America, the UK, Australia, New Zealand, Ireland, France, Hungary, Russia, Ukraine, Germany, Poland, Brazil, Chile, Mexico, India, Saudi Arabia, Italy, Pakistan, China, and even Afghanistan. Everywhere in the world where isotretinoin is prescribed, patients are misinformed about the risks and harmed. 

Sincerely,

Rachel

VIDEOS OF IRRESPONSIBLE DERMATOLOGISTS PROMOTING ACCUTANE:

1.    Dr. Mudgil stating side effects are transient (short clip, 40 seconds) 

2.   Dr. Mudgil: “6 months of pain for a lifetime of gain” (short clip, 15 seconds) 

3.   Dr. Spierings denies long-term effects (1 min) 

4.   Dr. Spierings claims she would never give a systemically harmful medication for acne (1 min).

5.   Pediatric dermatologist Dr. Carla Torres-Zegarra “I find myself sometimes giving Accutane like candy” (short clip) 

6.   Dr. Natalia Spierings: “I’ve given it to 7-year-olds” (short clip) 

7. Long list of effects Dr. Spierings denies (3 min) 

8.   Conversation between Dr. Torres and Dr. Spierings denying long-term effects (6-min conversation).

9.  Dr. Dray stating back and joint pain is “temporary.”

10.   Dr. Angelo Landriscina: “Just take the damn Accutane already, there is no reason to be afraid” (short clip).

11.   Dr. Marius Rademaker treating 6-month infant with Accutane for acne (short clip).  

12.   Dr. Julie Harper: “It’s hard to get too young for isotretinoin.”  

13.   Dr. Elizabeth Swanson: No “rules or regulations” about how young you can go (prescribed to 9-year-old).

14.   Dr. Julie Harper & Dr. Jonette Keri: “get that isotretinoin going sooner” (for mild acne). 

HERE is a link to Rachel’s full channel; to find the playlist, you can click on the “playlist” heading and look at individual video clips.

THE DERMATOLOGY CHARADE chapter from Butchered by “Healthcare”

I tried to become a dermatologist once. These specialists stay cleverly in their own world, avoid dealing with serious problems, and make a lot of money without losing sleep. It seemed like a masterful concept. I was an annoying young man, but through family connections and somehow conjuring a fragile veneer of charm, I got accepted into one of their most selective training programs. I thought this feat qualified me for the dermatologic lifestyle and wanted to spend my weekends hiking the Appalachian Trail. My mentors, however, thought I should spend 70 hours a week learning skin disease. After a year, they exposed me as a poseur and kicked me out.

I viewed it as a personal failure, but the whole time, I smelled something fishy. I was too close to see clearly and I had plenty of problems, so I could not put my finger on it. Like the dermatologists who were unsuccessfully trying to train me, I did not know the history.

The modern era for skin doctors started in the 1980s when the American Academy of Dermatology hatched a plan to contrive an epidemic of dangerous skin cancers. A Madison Avenue public relations firm charged them two million dollars to come up with the idea. The proposal was for them to disease-monger themselves from foolish pimple poppers into fierce cancer fighters. After this, they evangelized about patients coming to their offices to get a complete skin examination. This would supposedly prevent a plague of skin cancers. The USPSTF later exposed this idea as worthless and said the screening frenzy was cultivating lucrative skin surgery rather than preventing cancer.

To finish reading this chapter from Butchered by “Healthcare” about dermatology frauds, click HERE.

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