It contains relatively little scientific argument, consisting instead mainly of ad-hominem muck-raking and "you can trust us" assertions of the supposedly superior authority of big wealthy institutions. But even where it strays into actual science it contains major errors.
Before examining those errors you should be aware that Offit's book uses a very peculiar system of citing which gives no citation indications on the text pages, but only in a back section. This peculiar system (which I've never seen in any other document) is ideal for when you wish to deceive readers about what is genuinely evidence-based and what is mere false assertion -- as in the following examples.
One of the errors is Offit's notion that mercury removal could not possibly enable recovery from mercury-induced injury. Offit's reasoning is that "Once a brain cell is damaged by a heavy metal like mercury, it is permanently damaged" (page 145). And so removing the mercury cannot reverse the "damage". And "therefore" chelation for autism cannot work and must be mere quackery.
Firstly, let us for the moment take as accepted Offit's false notion that "damage" of neurons must be involved in autism. Immediately after this critique of the science he presents his scare-anecdote about an utterly irrelevant case of incompetent misuse of EDTA: "And then the unthinkable happened....." (Arrgghh!!!). Curiously he gives twelve citations for that ONE utterly irrelevant scare-drivel anecdote, and yet in respect of his key assertion about damaged cells, there is no citation of evidence whatsoever. But of course that's not really a problem as it is the Infallible True Prophet Offit who is proclaiming it, in whom the reader has been given total faith by this stage; and it's a fair bet that the twelve drivel citations were padded in there to hide the non-existent evidence about "damage", for that's how such propaganda trickery always works (see e.g. the UK COT's deliberately deceitful statement against vitamin B6).
All manner of body cells have extensive systems in place for repairing themselves. They're doing it all the time. So on quite what basis does Offit assert that neurons "damaged" by mercury cannot be "repaired"? And why does he cite no evidence for this key, highly-heretical assertion?
But anyway, Offit errs more fundamentally, by making that false assumption that mercury neurotoxicity works only by "damaging" neurons, with no other neurotoxic processes involved. You will see in my 1993 paper there is not the slightest hint of it involving neurons being "damaged", nor indeed any "damage" being involved in autism causation at all. Rather autism is difference, not disorder (-- as the book's very own dedicatee "real heroes" Kathleen Seidel and Camille Clark would very much agree!). I can only guess that logical consistency is as alien to Dr Offit as is evidence-basing of his key assertions.
In reality mercury has potential to affect neurons via its pro-oxidant effect, and via its interference with all the enzyme pathways that involve zinc (in other words just about all of them). And last but not least, as my update review explains, mercury binds to DNA and thereby reduces gene-expression, which the antiinnatia theory had already indicated would cause autism.
The mechanism by which mercury causes autism therefore does not involve any damaging of neurons. So lowering the mercury levels, such that the DNA has less of it binding and inhibiting the gene-expression required for normal development, would indeed enable recovery, providing it is done before the brain has become too fixed by maturation. Offit's reasoning is therefore doubly incorrect.
[Temporary note: I am busy at the moment but will come back to add yet more false arguments his book presents against chelation. His case consists entirely of falsehoods, unbecoming of such a highly-qualified researcher.]
You can also see that on page 115 (refs page 269) Offit cites the Nelson and Bauman paper but fails to give the citation of the Bernard et al which it attempted to debunk, nor any mention of the authors' later resounding rejoinder. I leave you to form your own judgement about this selective mentioning of only one side by such a highly-qualified multi-millionaire. Especially given the seriousness of the subject, potentially trying to deprive tragic victims of a valuable therapy, and Dr Offit's heavy financial interest in the question of the safety of vaccines.
Offit deploys that misinformation there in a second false argument in terms of autism and mercury poisoning being "two disorders". And yet an elementary knowledge of mercury toxicity tells us that there is far from "one disorder" that constitutes "mercury poisoning". I can only guess this heroic multi-millionaire was too busy struggling to make ends meet to find the time to properly study what he was publishing about.
A third false argument of Offit is his comparison of autism epidemiology with other epidemiology (on pages 110-111). He states that epidemiology of effects of certain vaccines was able to show up even the causation of some very rare hazards (intussusception, thrombocytopenia, and Guillain-Barré syndrome) resulting from them, and "therefore" the epidemiological studies of autism would have this same power to utterly rule out even very slight involvement of vaccines. Personally I think the autism data is too unclear to resolve whether or not there is rare harm caused by vaccines anyway, but that's beside the point.
What is the point here is that the epidemiology of autism is affected by two starkly obvious major complications which did not affect the epidemiology examples cited by Offit. Firstly, autism is very far from being something that can be clearly "yes/no" identified as can the above-named three conditions. Secondly, the autism epidemiology data has huge variance, far from all of it explained, but reasonably suspected to be caused by some changes of awareness and of diagnosis, and not least by other environmental factors such as dental mercury (as my update review will make clear).
That is, the autism data has a huge level of "noise" in it preventing hearing of the exquisite signal that Offit claims could be clearly not heard. Or in another analogy, the autism data is a very crude unfocussable lens through which to search for the tiny pinpoint he claims ought to be visible if vaccines even rarely caused autism. So again, we see a crudely incorrect argument from this highly-qualified, highly-awarded author who has made millions from touting his medical products.
(Whether Offit's legal-liability-exempt profitmaking products are a quackery scam is besides the point, but in view of all the above one does have to wonder -- and indeed it does turn out that the rotavirus that he's earned millions from has been judged unneeded by 27 of 29 nations, and was only accepted in the US thanks to himself voting it in.)
And Offit's "rotavirus vaccine may be linked to a small increase in a life-threatening type of bowel obstruction, U.S. health officials said on Wednesday..... ."
In 2009, the American Academy of Pediatrics presented the “President’s Certificate for Outstanding Service” award to Dr Paul Offit.
See also my important further article