Dr. Jane Hightower is a San Francisco physician who has been described in media reports as someone who’s “made something of a cottage industry” out of anecdotally linking various and sometimes vague symptoms of illness to elevated mercury levels, that she suggests come from eating seafood. If you have “intermittent stomach upset,” “headache,” “fatigue,” “trouble concentrating” or “hair loss,” and you visit Dr. Hightower, you inevitably come away with a diagnosis of toxic mercury exposure.

She’s published a new book titled Diagnosis Mercury that stops short of suggesting all the world’s ills are created by mercury, and of course, that fish are the dangerous delivery agents to blame for a proliferation of health problems. Initially, two things are clear from the book; it’s not going to win any literary awards, and the vein of conspiracy that runs through it is in line with exaggeration and paranoia exploited by eco-activists and animal rights extremists for years.

With that in mind, it should be noted that Hightower insists she is an independent voice with no activist agenda. However, in the preface she thanks the Mercury Policy Project, an organization developed by The Tides Center, which describes itself as a “nonprofit fiscal sponsor to forward-thinking activists and organizations.” What’s more, Hightower is currently featured on the website of Natural Resources Defense Council (NRDC), “the nation’s most effective environmental action group.” She talks about the need to get the word out about mercury and how, “of course, we need NRDC and others to work with people in the field, and to take it to the masses.” No activist agenda?

You might expect a doctor who claims to be a cutting edge expert on mercury to lead with her best material, grab the readers from page one and suck them into a tale of “money, politics and poison,” but she doesn’t. Instead, she starts by retelling a tired old story from 1970 about how the U.S. Food and Drug Administration recalled canned tuna from store shelves (p 1). What she doesn’t tell you on page one is that in the end, less than 23% of the cans tested exceeded the federal mercury limit of 0.5ppm during that recall. And the case has no relevance in 2008 because the updated mercury in seafood limit is 1.0 part per million, meaning that closer to 0% would have exceeded the limit today. The use of this nearly 40-year old scene-setter is commonly found and purposely unexplained by activist media.

Beyond page one, readers find chapters chock full of Hightower’s self-aggrandizement and reliance on media attention rather than professional recognition as a measure of her success. When she’s not name dropping, like suggesting her colleague “was no ordinary clinician,” but rather the dermatologist who had come up with Proactive “for which she was frequently seen in television infomercials,” she’s relaying tales of how one reporter compared her work to “the discovery of AIDS” (p 3, 29).

Hightower goes on ad nauseam about her contact with local media and her preparation for an interview on ABC’s 20/20. At one point she admits telling 20/20 she would not do the interview unless they paid her friend to work on the piece as a field producer (p 23). So, while Hightower stood to gain in the long run from the publicity, her friend stood to gain immediately. Some might call that a conflict of interest or a case of pay-for-play, not quite the journalistic standards you would expect from a venerable news magazine.

Not quite the standards you would expect from a physician either, when she later describes talking reluctant patients in to participating in her self-promotion; “When I sent letters to my patients offering them a chance to give their opinion on the mercury issues on national television it got mixed reviews. Many just did not want to do it” (p 27).

But, undeterred, Hightower convinces reluctant patients to be interviewed. At one point she writes about a patient, who was also a doctor,who during a break in the taping of the interview “said she did not think she should be on the show” because she “felt uncomfortable” (p 32). But like any good doctor who has sworn an oath to, “respect the privacy of my patients, for their problems are not disclosed to me that the world may know,” she allows producers to “finally [talk] her into continuing with the interview” (p 32).

Later, she notes that to avoid undue influence while working on the mercury issue she “tried to keep a relatively low profile beyond my hospital” (p 35). Perhaps realizing the ridiculous nature of this comment she follows it up writing, “except for being taped for… 20/20.” To reflect on this for a moment, we have a physician who has decided to take her work directly to the national media rather than first to a peer-reviewed scientific journal, who writes that she was attempting to keep a “low profile.” And she makes no bones about circumventing the traditional science-based medical process for research and evaluation.

Hightower writes, “Medical and scientific journal editors explicitly ask authors not to release data to the press before scientific publication. But when public health was at risk the doctor or the scientist had an obligation to notify the public of a potential hazard. So I decided to make public the mercury levels I was finding in a set of patients” (p 16). Let’s review; because a handful of her patients had elevated mercury levels, Hightower determined that there was evidence of a risk to public health and took it upon herself to inform the masses.

Hightower recalls how her personal public health campaign was underway just, “nine months [after her] first mercury patient… had been identified” (p 24). If you take a look at Dr. Gary Myers’ landmark work on “nutrient and methyl mercury exposure from consuming fish” you will find he has spend twenty years forming his conclusion that the, “beneficial influence of nutrients from fish may counter any adverse effects of MeHg on the developing nervous system.”

Throughout the book, Hightower writes on the fact that her own colleagues express skepticism about her work with one suggesting, “there isn’t much here, and there is not enough cause-and-effect data that is significant” (p 39). She later admits as much in a discussion about her own patient survey. In recalling a conversation with then-EPA official Kathryn Mahaffey, Hightower remembers her saying “just stick to the numbers” because “we know people have symptoms, but this [cause and effect] was harder to prove” (p 84). So, here she is highlighting the fact that her own survey does not succeed in linking elevated mercury levels to the symptoms she claims they cause. Her survey merely concludes that eating fish that contain mercury can raise a patient’s mercury levels.

But the fact that Hightower hasn’t published a single article suggesting an association between eating commercial seafood and experiencing mercury-related symptoms can’t possibly be the source of her colleagues’ skepticism. She conspires that greater forces are at work – the “big business” canned tuna industry (p 96). When a delegate physician with the California Medical Association questions her resolution to place warning labels on canned fish and remove it from federal food programs, Hightower plots he might be a part of the tuna industry (p 95). She deems canned tuna, particularly albacore, a “mercury problem child” and the industry behind it unconcerned with public health (p 96). But she fails to mention that her own data shows this “mercury-laden seafood” to have an average mercury level of 0.2 micrograms/gram. That’s correct – the trace of mercury in canned albacore tuna, by Hightower’s own account, is 400% lower than the FDA limit of 1.0.

Hightower’s fascination and virtual preoccupation with her own perceived fame is omnipresent in the book and serves as a bit of a disconcerting distraction. In page after page and reference after reference she explains how patients contacted her after seeing her on TV. At one point noting that, “I thought I had certainly beamed to another universe when someone said, Did you see Headline News on TV? The ticker tape at the bottom announced your study, and you are in the paper today?'” (p 89).

At one point she writes that by “May of 2003, [she] was receiving many phone calls, emails, and letters from mercury-concerned individuals, the media, nongovernment organizations, physicians, and patients” (p 98, 99). It is becoming apparent that her media involvement is growing her patient base, a base that by her own admission has varied and sometime vague symptoms. Keep in mind these are not cancer patients or diabetes patients who come to her seeking treatment, they are people with generalized maladies that are undiagnosed and inevitably Hightower concludes the illnesses are due, at least in part, to some level of mercury toxicity from eating seafood.

Her diagnostic skills are stretched to the point of incredulity when she examines the case of an 81-year old Cree-Indian who died of “aspiration pneumonia” (caused by food getting it the lungs) (p 121, 122). He was studied as part of Canadian research of native people with health issues suspected to be the result of eating fish from mercury contaminated internal waterways. Hightower, who never met, examined or had any contact whatsoever with said patient suggests that “if the patient’s neurological system had been in tact, perhaps he would have been able to swallow his food without inhaling it, preventing aspiration pneumonia and subsequent death.”

In the absence of evidence of a mercury induced death, Hightower suggests that an 82-year old man who had been diagnosed with a “cardiac murmur,” “atherosclerosis,” “chronic lung disease” and “an enlarged heart” essentially choked on his food because mercury had so damaged his neurological system. Perhaps if he had tripped and fallen and suffered a broken hip, or got in a car wreck perhaps, she too would suggest that it wasn’t the incident that cost him his life, but rather the suspected neurological damage from mercury.

Hightower goes on to falsely claim that court battles resulted in warnings being required in restaurants and grocery stores for methylmercury in tuna. Any warnings that were posted were done so voluntarily pending the outcome of a canned tuna case and were not the result of a court order.

In the realm of her legal arguments Hightower writes that Judge Dondero cited a “fishing industry expert witness, [named] Dr. Louis Sullivan” regarding the unintended adverse health consequences of warnings. Hightower neglects to inform her readers that Dr. Sullivan isn’t just some fishing industry witness, Sullivan is the former Secretary of the Department of Health and Human Services, and was Secretary when the FDA implemented new food labeling regulations.

And while we’re talking about witnesses it should be noted that the California Attorney General tried the mercury in tuna case and chose not to use Hightower as a witness at trial or any of her research. Readers might find it curious to note that such a leading expert in diagnosing patients with mercury poising from seafood consumption would not be called or even referred to when the Attorney General in her own state is arguing (and losing) a case that appears to be based on assumptions that mirror her own.

Watch this space.