Orthomolecular Medicine

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Orthomolecular medicine

From Wikipedia, the free encyclopedia

Orthomolecular medicine

Alternative medicine / fringe therapies

Claims Health effects of dietary supplements, particularly vitamin megadoses.

Related fields aturopathy

Original proponents !inus "auling #coined term$

%e&H '(())*+

Orthomolecular medicine- isa form of complementary and alternative

medicine aimed at maintaining health through nutritional

supplementation and based on the assertion that there is an optimum

nutritional environment in the body and that diseases reflect

deficiencies in this environment.

0reatment for disease, according to this vie1, calls for the "correcting of

imbalances or deficiencies based on individual biochemistry" by use of

substances natural to the body, such as vitamins, minerals, amino acids,

trace elements and fatty acids.2+3 Fe1 medical or scientific e4perts support

this approach56* even the accuracy of calling the orthomolecular approach a form of

medicine has 7een 8uestioned since the -)*(s.9

0he approach is sometimes referred to as megavitamin therapy- 7ecause its practice

evolved out of, and in some cases still uses, doses of vitamins and minerals many times

higher than the recommended dietary intake. Orthomolecular practitioners may also


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incorporate a variety of other styles of treatment into their approaches, including

dietary restriction, megadoses of non-vitamin nutrients and mainstream

pharmaceutical drugs.[1][9] Proponents argue that non-optimal levels of certain

substances can cause health issues beyond simple vitamin deficiency and see

balancing these substances as an integral part of health.[1]

!he term "orthomolecular" as coined by #inus Pauling to mean "the

right molecules in the right amounts" $ortho is %ree& for "right"'.--

"roponents of orthomolecular medicine hold that treatment must 7e 7ased on each

patient:s individual 7iochemistry.--2

0he scientific and medical consensus is that the 7road claims of efficacy advanced 7y

advocates of orthomolecular medicine are not ade8uately tested as drug therapies.6 ;t

has 7een descri7ed as a form of food faddism and even 8uackery.-+ "roponents point to

mainstream sources that have pu7lished research supporting the 7enefits of nutrient

supplementation-3-6 and to instances 1here conventional medicine uses vitamins as

treatments for some diseases.

Ho1ever, some vitamins have 7een linked to increased risk of cancer and death.-*-9

-) 0he scientific consensus vie1 is that for normal individuals, a 7alanced diet contains

all necessary vitamins and minerals, and that routine supplementation is not necessary

a7sent specific diagnosed deficiencies.(

Contents hide

- History and development

&cope


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2 Orthomolecular psychiatry

+ "rinciples

3 "revalence

6 %edical and scientific reception

6.- %ethodology

6. vitamin =

6.+ ?se in A;'&

6.+.- 'eaths resulting from illegal vitamin trials in &outh Africa

6.3 Alleged institutional 7ias

* &ee also

9 Citations

) Further reading

).- &upport

). Criticism

-( =4ternal links

-(.- &upport

-(. Criticism

History and developmentedit

;n the early (th century, some doctors hypothesised that vitamins could cure disease,


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and supplements 1ere prescri7ed in megadoses 7y the -)2(s.- 0heir effects on health

1ere disappointing, though, and in the -)3(s and 6(s, nutrition 1as de@emphasised in

standard medical curricula.- Riordon:s organiation cite figures from this period as

founders of their movement, although the 1ord BorthomolecularB 1as coined 7y

!inus "auling only in -)6*.

Amongst the individuals descri7ed posthumously as orthomolecularists are %a4 erson,

1ho developed a diet that he claimed could treat diseases, 1hich the American %edical

Association:s -)+) Council on "harmacy and Chemistry found ineffective52 and the

&hute 7rothers, 1ho attempted to treat heart disease 1ith vitamin =.+ &everal concepts

no1 cited 7y orthomolecularists, including individual 7iochemical variation-2 and

in7orn errors of meta7olism,-36 de7uted in scientific papers early in the (th

century.

;n -)+9, William %cCormick theoried that vitamin C deficiency played an important

role in many diseases and 7egan to use large doses in patients.* ;n the -)3(s, Fred R.

Dlenner also tried vitamin C megadosage as a therapy for a 1ide range of illnesses,including polio.9 ;r1in &tone stated that organisms that do not synthesise their o1n

vitamin C due to a loss@of@function mutation have a disease he called Bhypoascor7emiaB.

) 0his term is not used 7y the medical community, and the idea of an organism@1ide

lack of a 7iosynthetic path1ay as a disease 1as not endorsed 7y &tone:s contemporaries.

2(

;n the -)3(s, some individuals 7elieved that vitamin deficiencies caused mental illness.

- "sychiatrists Humphry Osmond and A7ram Hoffer gave people having acute

schiophrenic episodes high doses of niacin,2- 1hile William Daufman used

niacinamide. While niacin has no kno1n efficacy in psychiatric disease, the use of niacin

in com7ination 1ith statins and other medical therapies has 7ecome one of several


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medical treatments for cardiovascular disease.222

;n the late -)6(s, !inus "auling introduced the e4pression BorthomolecularB-- to

e4press the idea of the right molecules in the right amounts.-- &ince the first claims of

medical 7reakthroughs 1ith vitamin C 7y "auling and others, findings on the health

effects of vitamin C have 7een controversial and contradictory.2+23 "auling:s claims

have 7een criticised as over7road.26

!ater research 7ranched out into nutrients 7esides niacin and vitamin C, including

essential fatty acids.2*

&copeedit

According to A7ram Hoffer, orthomolecular medicine does not purport to treat all

diseases, nor is it Ba replacement for standard treatment. A proportion of patients 1ill

re8uire orthodo4 treatment, a proportion 1ill do much 7etter on orthomolecular

treatment, and the rest 1ill need a skillful 7lend of 7oth.B29 evertheless, advocates

have said that nutrients can prevent,2) treat, and sometimes cure a 1ide range of

medical conditions, including> acne,+( alcoholism,+- allergies, arthritis, autism, 7ee

stings, 7ipolar disorder, 7urns, cancer,++2 the common cold, depression, drug

addiction, drug overdose, epilepsy, heart diseases, heavy metal to4icity, acute hepatitis,

herpes, hyperactivity, hypertension, hypoglycemia, influena, learning disa7ilities, mental

and meta7olic disorders,++ migraine, mononucleosis, mushroom poisoning, neuropathy

E polyneuritis #including multiple sclerosis$, osteoporosis,+3 polio, an hypothesised

condition called BpyroluriaB, radiation sickness, Raynaud:s disease, mental retardation,

schiophrenia,+ shock, skin pro7lems, snake7ite, spider 7ite, tetanus to4in and viral

pneumonia.+6

Orthomolecular psychiatryedit

%ain article> Orthomolecular psychiatry


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Hoffer 7elieved that particular nutrients could cure mental illness. ;n the -)3(s, he

attempted to treat schiophrenia 1ith niacin, although proponents of orthomolecular

psychiatry say that the ideas 7ehind their approach predate Hoffer.+*+9 According to

Hoffer and others 1ho called themselves Borthomolecular psychiatristsB, psychiatric

syndromes result from 7iochemical deficiencies, allergies, to4icities or several

hypothetical contri7uting conditions 1hich they termed pyroluria, histadelia and

histapenia. 0hese purported causes 1ere said to 7e found during an Bindividual

7iochemical 1orkupB and treated 1ith megavitamin therapy and dietary changes

including fasting.+) 0hese diagnoses and treatments are not accepted 7y evidence@7ased

medicine.3(

"rinciplesedit

According to A7ram Hoffer, BprimitiveB peoples do not consume processed foods and do

not have BdegenerativeB diseases.3- ;n contrast, typical BWesternB diets are said to 7e

insufficient for long@term health, necessitating the use of megadose supplements of

vitamins, dietary minerals, proteins, antio4idants, amino acids, @2 fatty acids, @6 fatty

acids, medium@chain triglycerides, dietary fi7er, short and long chain fatty acids,

lipotropes, systemic and digestive enymes, other digestive factors, and prohormones to

1ard off hypothetical meta7olism anomalies at an early stage, 7efore they cause disease.

29

Orthomolecularists say that they provide prescriptions for optimal amounts of

micronutrients after individual diagnoses 7ased on 7lood tests and personal histories.2

- !ifestyle and diet changes may also 7e recommended. 0he 7attery of tests orderedincludes many that are not considered useful 7y medicine.3(

"revalenceedit


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Orthomolecular medicine is practiced 7y fe1 medical practitioners.332

A survey released in %ay, ((+ 7y the ational Center for Complementary and

Alternative %edicine focused on 1ho used complementary and alternative medicine

#CA%$, 1hat 1as used, and 1hy it 1as used in the ?nited &tates 7y adults age -9 years

and over during ((. 0he survey reported uses in the previous t1elve months that

include orthomolecular related uses> onvitamin, nonmineral, natural products -9.)G,

'iet@7ased therapies 2.3G, %egavitamin therapy .9G.3+

Another recent CA% survey reported that -G of liver disease patients used the

antio4idant silymarin, more than 6G used vitamins, and that Bin all, *+G of patients

reported using CA% in addition to the medications prescri7ed 7y their physician, 7ut

6G did not inform their physician of their CA% use.B33

=ven though the health 7enefits are not esta7lished, the use of high doses of vitamins is

also common in people 1ho have 7een diagnosed 1ith cancer.36 According to Cancer

Research ?D, cancer patients should al1ays seek professional advice 7efore taking such

supplements, and using them as a su7stitute for conventional treatment Bcould 7e harmful

to their health and greatly reduce the chance of curing or controlling their cancerB.3*

%edical and scientific receptionedit

%ethodologyedit

Orthomolecular therapies have 7een criticied as lacking a sufficient evidence 7ase forclinical use> their scientific foundations are too 1eak, the studies that have 7een

performed are too fe1 and too open to interpretation, and reported positive findings in

o7servational studies are contradicted 7y the results of more rigorous clinical trials.3

39 Accordingly, Bthere is no evidence that orthomolecular medicine is effectiveB.

"roponents of orthomolecular medicine strongly dispute this statement 7y citing studies


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demonstrating the effectiveness of treatments involving vitamins, though this ignores the

7elief that a normal diet 1ill provide ade8uate nutrients to avoid deficiencies, and that

orthomolecular treatments are not actually related to vitamin deficiency.-( 0he lack of

scientifically rigorous testing of orthomolecular medicine has led to its practices 7eing

classed 1ith other forms of alternative medicine and regarded as unscientific.3)6(6-

;t has 7een descri7ed as food faddism and 8uackery, 1ith critics arguing that it is 7ased

upon an Be4aggerated 7elief in the effects of nutrition upon health and disease.B662

6+ Orthomolecular practitioners 1ill often use du7ious diagnostic methods to define

1hat su7stances are BcorrectB5 one e4ample is hair analysis, 1hich produces spurious

results 1hen used in this fashion.-(

"roponents of orthomolecular medicine contend that, unlike some other forms of

alternative medicine such as homeopathy, their ideas are at least 7iologically 7ased, do

not involve magical thinking,63 and are capa7le of generating testa7le hypotheses.66

Orthomolecular is not a standard medical term, and clinical use of specific nutrients is

considered a form of chemoprevention #to prevent or delay development of disease$ or

chemotherapy #to treat an e4isting condition$.6*

'espite a lack of evidence for its efficacy, interest in intravenous high dose vitamin C

therapy has not 7een permanently e4tinguished, and some research groups continue to

investigate 1hether it has an effect as a possi7le cancer treatment.696)


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I increase overall mortality.*+ utritional treatments are not generally accepted as

7eing helpful for psychological health.*3 ;ts claims have 7een criticied 7y most

medical organiations, including the American Cancer &ociety, the American "sychiatric

Association, the ational ;nstitute of %ental Health,3( the American Academy of

"ediatrics,*6 CHA%"?&, and the Canadian "aediatric &ociety. 0he American %edical

Association descri7es as BmythsB the ideas that ade8uate nutrition is not readily

achieva7le 1ith normal food, all food gro1n 1ith pesticide is poisonous, all food

additives are poisonous, vitamin and mineral deficiencies are common, that the cause of

most disease is poor diet, 1hich can 7e prevented 7y nutritional supplements. **

&imilarly, the American Cancer &ociety comments that the current scientific evidence

does not Bsupport use of orthomolecular therapy for most of the conditions for 1hich it is

promoted.B &ome supplements have e4hi7ited 7enefits for specific conditions, 1hile a

fe1 have 7een confirmed to 7e harmful5 the consumption of nutritious foods is the 7est

recognied method to o7tain vitamins, minerals, and nutrients crucial for good health.2

arrie Cassileth, an adviser on alternative medicine to the ational ;nstitutes of Health,

stated that Bscientific research has found no 7enefit from orthomolecular therapy for any

disease,B3 and medical te4t7ooks also report that there is Bno evidence thatmegavitamin or orthomolecular therapy is effective in treating any disease.B*9

A -)*2 task force of the American "sychiatric Association unanimously concluded>

0his revie1 and criti8ue has carefully e4amined the literature produced 7y megavitamin

proponents and 7y those 1ho have attempted to replicate their 7asic and clinical 1ork. ;t

concludes in this regard that the credi7ility of the megavitamin proponents is lo1. 0heir

credi7ility is further diminished 7y a consistent refusal over the past decade to perform

controlled e4periments and to report their ne1 results in a scientifically accepta7le

fashion. ?nder these circumstances this 0ask Force considers the massive pu7licity 1hich


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they promulgate via radio, the lay press and popular 7ooks, using catch phrases 1hich are

really misnomers like Bmegavitamin therapyB and Borthomolecular treatment,B to 7e

deplora7le.*)

;n response to claims that orthomolecular medicine could cure childhood psychoses and

learning disorders, the American Academy of "ediatrics la7elled orthomolecular

medicine a BcultB in -)*6.9(

"roponents of orthomolecular medicine counter that some vitamins and nutrients are no1

used in medicine as treatments for specific diseases, such as megadose niacin and fish oil

for dyslipidemias, and megavitamin therapies for a group of rare in7orn errors of

meta7olism.- A revie1 in the Annals of ;nternal %edicine concluded that 1hile some

therapies might 7e 7eneficial, others might 7e harmful or interfere 1ith effective medical

therapy.9- A recent study of over -6-,((( individuals provided, in the 1ords of the

authors, Bconvincing evidence that multivitamin use has little or no influence on the risk

of common cancers, cardiovascular disease, or total mortality in postmenopausal

1omen.B9 A recent meta@analysis in JA%A suggested that supplementation 1ithcom7inations of antio4idant vitamins #7eta@carotene, vitamin A, and vitamin =$ may

increase mortality, although 1ith respect to 7eta@carotene this conclusion may 7e due to

the kno1n harmful effect in smokers.92

&afetyedit

;n the ?nited &tates, pharmaceuticals must 7e proven safe and effective to the satisfactionof the F'A 7efore they can 7e marketed, 1hereas dietary supplements must 7e proven

unsafe 7efore regulatory action can 7e taken.9+ A num7er of orthomolecular

supplements are availa7le in the ?& in pharmaceutical versions that are sometimes 8uite

similar in strength and general content, or in other countries are regulated as

pharmaceuticals. 0he ?& regulations also have provisions to recognie a general level of


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safety for esta7lished nutrients that can forgo ne1 drug safety tests. "roponents of

orthomolecular medicine argue that supplements are less likely to cause dangerous side@

effects or harm, since they are normally present in the 7ody.3 &ome vitamins are to4ic

in high doses*( and nearly all #1ith the possi7le e4ception of


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responsi7le.)3)6 0o distinguish 7et1een these possi7ilities, a num7er of randomied

controlled trials 1ere performed and meta@analysis of these controlled clinical trials have

not sho1n any clear 7enefit from any form of vitamin = supplementation for preventing

chronic disease.)*)9))-(( Further clinical studies sho1 no 7enefit of vitamin =

supplements for cardiovascular disease.-(- 0he current position of the ational

;nstitutes of Health is that there is no convincing evidence that vitamin = supplements

can prevent or treat any disease.-(

eyond the lack of apparent 7enefit, a series of three meta@analyses reported that vitamin

= supplementation is associated 1ith an increased risk of death5 one of the meta@analyses

performed 7y the Cochrane Colla7oration also found significantly increased mortality for

the antio4idant vitamins A and [email protected](2-(+-(3 A su7se8uent meta@analysis

found no mortality 7enefit from vitamin =, 7ut also no increase in mortality either.-(6

?se in A;'&edit

&everal articles in the alternative@medicine literature have suggested that orthomolecular@

related dietary supplementation might 7e helpful for patients 1ith H;


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'eaths resulting from illegal vitamin trials in &outh Africaedit

%ain article> %atthias Rath

%atthias Rath has 7een e4tensively criticied for presenting his vitamin supplements as a

treatment for A;'& and for testing them in illegal trials in &outh Africa.--2--+ A

former associate of !inus "auling, Rath has promoted vitamins as a treatment for H; asic

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Further readingedit

&upportedit


29/33

Williams Roger John5 Dalita '1ight D #-)*)$. A "hysician:s hand7ook on

orthomolecular medicine #Health science ed.$. e1 Canaan, Connecticut> Deats. ;& (@

9*)92@-))@3. OC!C 6((6+-.

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collection of papers presented at a symposium of the Orthomolecular %edical &ociety in

&an Francisco, %ay *I9, -)92, 1ith revisions and additional papers.B

"auling !inus #-)96$. Ho1 to live longer and feel 7etter. W. H. Freeman. pp. 2pp.

;& (@29(@*(9)@+. OC!C -*)3.

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nutrition #Revised ed.$. %cra1@Hill. ;& (@9*)92@622@+. OC!C 2+3-39-+.

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drug treatments. 0oronto> Canadian College of aturopathic %edicine. ;& -@9)*(3@

--@+. OC!C 3669-*.

%oss Ralph W #((($. Antio4idants against cancer. rooklyn> =8uino4 "ress. ;& -@

99-(3@9@+. OC!C +*962*(.

"iorno Joseph = Jr5 %urray %ichael 0 #ovem7er ((3$. 0e4t7ook of natural medicine

#0hird ed.$. =din7urgh> Churchill !ivingstone. p. 269. ;& (@++2@(*2((@*. OC!C

6-9*9633.

Criticismedit

arrett &tephen #-)9($. 0he health ro77ers > ho1 to protect your money and your life

#&econd ed.$. "hiladelphia> . F. &tickley. p. 3. ;& (@9)2-2@(2@(. OC!C 6))+-29.

Cassileth arrie R #-))9$. Alternative medicine hand7ook> the complete reference guide

to alternative and complementary therapies. e1 ork> W.W. orton. ;& (@2)2@

(+366@9. OC!C 26**)+*.

ender 'avid A #((2$. utritional 7iochemistry of the vitamins #&econd ed.$.


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Cam7ridge5 e1 ork> Cam7ridge ?niversity "ress. p. 2(. ;& (@3-@9(299@9.

OC!C 3()+93)+.

rater Walter #((3$. 0errors of the ta7le > the curious history of nutrition. O4ford5

e1 ork> O4ford ?niversity "ress. p. -(. ;& (@-)@9(66-@(. OC!C 6(92**3.

=4ternal linksedit

&upportedit

Journal of Orthomolecular %edicine, orthomolecular.org

Official 1e7site for the ;nternational &ociety of Orthomolecular %edicine, isom.eu

Orthomolecular %edicine Online

Criticismedit

iologically 7ased practices> an overvie1, ational ;nstitute of Health ational Center

for Complementary and Alternative %edicine

Food, health and 1ell@7eing in ritish Colum7ia. C "rovincial Health OfficerLs Annual

Report #((3$

&hould 1e B0hank odB for Julian WhitakerP, American Council on &cience and Health,

#-)))$

Recommendations of the CAHF task force on supplement a7use #-)9*$

Categories> Orthomolecular medicineFringe science

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