Talk:Abram Hoffer/Archive 1

Pioneered?

I've removed the claim that Hoffer "pioneered the use of double blind randomized, controlled tests (RCT) in medicine" as other sources disagree with this statement ("the modern era of randomized controlled trials (RCTs) began in the late 1940s with the pioneering work of Bradford Hill" JAMA. 1998 Jan 28;279(4):319-20.). MarcoTolo 21:58, 11 February 2006 (UTC)[reply]

Generally speaking, this entry needs significant improvement across the board. Fact checking, atribution, wikification, sentences that are more than eight words long - you name it. MarcoTolo 21:58, 11 February 2006 (UTC)[reply]

POV

There was a huge slant in this article, implying Hoffer was some sort of quack and his theories were ridiculous. It was an obvious and grotesque slant and I've made some edits here and there but only changed a few words to return the article to a neutral stance and one that is supportable through honest (rather than very, very selective) research. Gingermint (talk) 04:10, 19 June 2011 (UTC)[reply]

Sign, sign... breaking my mind...

I thought you did a pretty good job on the general edit, made it more readable and concise. I do feel that the sign and the "pioneered dbRCT" objection are a little trigger happy.

Re dbRCT pioneers, both could have legitimate claims of various flavors of "first". RCT is a less stringent claim than dbRCT. This paper,[1], shows a first Lancet dbRCT article in 1955. I think Altschul, Hoffer, Stephen first presented their paper in 1954, published 1955. Probably both claims would need careful specific language as "firsts" and probably will suffer the same hijinks as patent priority: i.e. dates of tests - start & finish, vs date of first public presentation vs date of nat'l journal publication; PhD ("science") vs MD ("medicine"); Europe vs North America etc. As the paper also mentions earlier RCT-like "experiments" occurred, so it would seem likely a "specification(s) battle" to be first. I merely used "pioneered", not "first" since that has so much baggage. (In 19th century US, there were many pioneers, lots had arrow shirts ;) Hoffer's status as a dbRCT pioneer is somewhat important since many "mainstream" character assassins love to imply that orthomed doesn't understand what a dbRCT is whereas critical and knowledgeable orthomeds (ie. seasoned MD+PhD) probably tire of hearing pedagogical catechisms from less experienced quarters. (I've covered this a little elsewhere)

The books and links actually do reasonably cover the article so I think you need to discuss your questions very specifically. With some additional reading, you may find your questions answered. Also others have criticized (on similar articles) more specific refs and links, as too numerous or POV pushing. I am going to include more general Hoffer biblio links, but I won't be surprised if this only stirs the pot with some others. As for wikification, etc any improvements are welcome. If you have specific problems or stmts, let's see them.

Okay, I can see your point about the "disputed" tag - I suppose I tend to be touchy when the references for any article link to a single site with a clear pro or con viewpoint. On the other hand, this can also be the result of a nascent article that hasn't aged yet. Conceeding that "disputed" may be overkill at this point, I'll amend it to a "research in process" tag for the time being while the article is maturing. MarcoTolo 23:57, 17 February 2006 (UTC)[reply]

Personal account removed

I've removed this insertion made by IP 24.108.199.11 with the edit summary "The comment are factual as the result of my meetings with Dr. Hoffer in Victoria. This may be varied by Fran or Dr. Hoffer" from the article for discussion. [2] The text was incorrectly placed inside ref tags, although it doesn't verify the statements it was sourcing. And, edits to Wikipedia must be attributable to reliable sources and cannot be original research. The statements may be accurate, but must be sourced to something other than a personal account. SandyGeorgia (Talk) 03:44, 10 April 2007 (UTC)[reply]

NOTE: Dr. Hoffer does NOT use the term megavitamins. More accurately, when he consults with his patients, he will recommend "Opti-Doses"...Optimum doses. The reason is clear. He prescribes the amount of vitamins based on a patients needs based on his/or hers individual clinical picture.

This may be varified by Dr. Abram Hoffer, of Victoria, British Columbia, Canada

SandyGeorgia (Talk) 03:44, 10 April 2007 (UTC)[reply]

quackwatch

Quackwatch is apparently a website run by a single retired pychiatrist with axes to grind. In no way does it qualify as "the medical community". Drjem3 (talk) 15:00, 9 May 2010 (UTC)[reply]

This issue has been discussed ad nauseum on Wikipedia. Clearly, Quackwatch is not the NEJM or the BMJ, but these publications don't normally address extreme fringe claims; for our purposes, Quackwatch is generally considered to be a reliable source on matters of fringe medicine. Keepcalmandcarryon (talk) 14:05, 10 May 2010 (UTC)[reply]

I repeat my statement. Unless you can show me some sort of survey that supports your assertions of "most" physicians, as opposed to the more neutral "many". To many in the medical profession, Quackwatch.com is almost like a cult of true-believers. Anyway, definitely NOT a definitive source, but people with an agenda. Provide us with some more definite source and we can talk. BTW-- not that it really matters here too much, but are you a physician ? I am. PhD researcher too. I am definitely not in the "most". This aside-- your statements are definite "original research". Better that the article reflect a more NPOV.

Also, why did you revert my section on "megadose" niacin therapy, complete with cites to the New York Times and the NEJM. This is pretty much standard current therapy in hypercholesterolemia and hyperlipidemia ? This is not controversial. True, it falsifies your assertion that megadose vitamins are somehow "fringe medicine". In at least this case, Dr Hoffer's work is totally mainstream.

How many other 50-plus year-old drug therapies are still "standard of care" in a major area of medicine ? Not many. True, docs now add a statin, but otherwise, it is pretty much what Hoffer and his coworkers developed. IIRC, Hoffer even had the original patent on time-release niacin, a version of which was used in the NEJM trial. Not only that, but, deliberately or not, you confute work done with the retinoids (e.g.) with Dr Hoffer's, which IIRC, did not involve these compounds at all. Drjem3 (talk) 21:54, 10 May 2010 (UTC)[reply]

Almost forgot-- You need a reference for your assertion that megadose whatever does not prevent cancers. Otherwise, you are committing the sin of "original research" again. Drjem3 (talk) 22:06, 10 May 2010 (UTC)[reply]

Our respective professions and opinions should be of no importance to this article.

Translation: " I'm not a physician ". So why should anyone credit your unsupported and definitely-OR opinion about what is "fringe" medicine, about what "the medical community" thinks, or your assertion that my position is somehow "fringe" ? True, everyone is equal here. but some are a little more equal than others. Seriously--"experts" like me are sought out because we know the literature. As recounted below, I also have some personal experience here that is technically OR (and thus unusable on the page ). But it does guide me to the literature. Drjem3 (talk) 21:15, 11 May 2010 (UTC)[reply]

It's clear that you have a fringe position on this issue, but it should be no impediment to effective editing as long as you don't attempt to portray the subject in light of your own opinions. Keepcalmandcarryon (talk) 19:52, 11 May 2010 (UTC)[reply]

More original research-- without being there how would you know what is "fringe" and what is not? I could not make this assessment and I am right in the middle of it, as much as anybody is. So I may be forgiven for questioning your ability to do so. Again, you dodge the original question-- where is your citation WRT cancer.? Otherwise, "original research" again. No more of these obfuscations-- I'll wait over here while you go get it... Drjem3 (talk) 21:15, 11 May 2010 (UTC)[reply]

Also, as stated below, I removed a section consisting almost entirely of BLP violations. I've moved the following comment by User:Immunize:

I feel that quackwatch is a reliable source. In fact, I believe the claims above to be libelous. Is there any reliable source that would support your claim that Dr Barret is not board certified? I think not. Immunize (talk) 14:54, 11 May 2010 (UTC)[reply]

Drjem3, do not use the talk page or Wikipedia in general to continue real-world disputes. Keepcalmandcarryon (talk) 20:00, 11 May 2010 (UTC)[reply]

Straw and more obfuscation Anyway, please argue the issues, if you can. Drjem3 (talk) 20:48, 11 May 2010 (UTC)[reply]

I will point this out again - Quackwatch is a suitable source for quackery claims, like OM and OMP. I believe there's even an arbcom hearing somewhere. No editor may use their own opinion or experience to adjust an article - that is original research and inappropriate. Please cite reliable sources that deal with the subject directly - in other words, the articles have to specifically state Hoffer's ideas were valid. It's not enough to mine articles to claim support, they must be explicit. Brief summaries of the mainstream opinion are sometimes appropriate. WLU (t) (c) Wikipedia's rules:^simple/_complex 00:52, 12 May 2010 (UTC)[reply]

Not in the real world.

Cite it.

Stop doing this then.

Straw. The record shows that I merely questioned your unprovable OR assertion about "the medical community", changed the again-unprovable "most" physicians to the more diffuse "many", and asked you to provide a better source for your claims than one questionable website. You have yet to provide this. I noted that a paper on retioids and cancer had nothing to do with Dr. Hoffer's work. I also provided an example of one case in which Hoffer's work directly resulted in a significant therapeutic advance. Thus falsifying your claims. Your response to these entirely-reasonable things was complete obfuscation, of which this is just one more example. Drjem3 (talk) 04:41, 12 May 2010 (UTC)[reply]

I've respaced per WP:TALK - please stop breaking the conversation, particularly in ways that are so disruptive to being able to tell who said what. Drjem3's original set-up can be found here and I'll admit the current version makes little sense, but at least you can tell what I said versus what he said.

Wikipedia is not a battleground. We are expected to assume good faith and be civil - so please calm down and discuss with references to reliable sources and the policies and guidelines. As discussed below, on wikipedia Quackwatch is a reliable source for fringe claims, though peer-reviewed sources are preferred when available. I've linked to the arb hearing, and I'm not using my own opinion to reference the page - I cited quackwatch. If you want an extensive discussion of the mainstream community considering orthomolecular medicine and orthomolecular psychiatry to be suspect, I will refer you to those pages. There is a plethora of sources (I read the OM page recently and it was quite apparent). WLU (t) (c) Wikipedia's rules:^simple/_complex 13:18, 12 May 2010 (UTC)[reply]

BLP violations removed

Please note that this article is about Abram Hoffer. It is not a forum for attacking medical professionals or journalists. Keepcalmandcarryon (talk) 19:48, 11 May 2010 (UTC)[reply]

Pot-kettle, combined with a straw-arguement. Or maybe I am just being throughly trolled. Anyway, for the moment, I will "assume good faith". In fact, I am the one trying to keep this objective, with cites to NYT, NEJM, etc.. Do you imply these are "fringe"? Interesting. Significantly, in a prior reversion, you objected to the use of a website alone as a cite. I am merely doing the same. As for attacking medical professionals-- I am one.

"Original research" follows: Ever meet Dr Hoffer ? I have been following his work since the 1970's and used to run into him at Society for Free Radical Biology and Medicine meetings. Nobody there thought his stuff was "fringe". Far from it-- he was pretty-universally honored as one of the originators of the field. Drjem3 (talk) 20:36, 11 May 2010 (UTC)[reply]

There are many reliable sources that state Hoffer's work is considered quackery. That's all wikipedia asks for. WLU (t) (c) Wikipedia's rules:^simple/_complex 00:48, 12 May 2010 (UTC)[reply]

There are also many publications in the main-stream scientific literature indicating Hoffer was right about many things and in fact research continues to this day at places like the National Cancer Institute, etc.. I have posted the links to the papers here here and can continue to do so ad nauseum. But everytime I try to post anything to the article, my post gets reverted. This article throughly lacks NPOV.

As for the claims about "the medical profession" "or the medical community". Through and complete original research. In fact, something for which there is not and can never be any means of authentication, the fundamental requirement on wikipedia. My own OR observation: I'm a physician myself-- most docs never heard of Dr. Hoffer. So how can "the medical community" ( whatever that is ) have an opinion one way or another ? And yes, fringe parties like Quackwatch make claims. But this is opinion pure and simple and should be reported as such. Just the facts.

Again OR: The few docs that for some reason know about Dr Hoffer tend to admire him as a pioneer, if only for discovering and developing the use of high-dose naicin for hypercholestrolemia, etc.. The majority of the persons reading this will eventually die of either atherosclerotic heart disease or stroke. If an editor does not understand the relevance of this to Dr. Hoffer's work, they should educate themsleves before posting here.

Like all scientific pioneers, he didn't get many of the details right. Further, much of what he did do has been throughly politicised. This means it has attracted the usual true believer types, which is why we are having this discussion. BTW, my personal opinion is that he picked the wrong mechanism ( adrenochrome ), but was throughly right about oxidative mechanisms being involved in psychiatric disorders, a point on which there is also a large body of research. Sorry if I again sound exasperated. But I have followed the rules here, documenting everything and responding to any issues with even more documentaion. About time other editors did the same. Drjem3 (talk) 15:20, 13 May 2010 (UTC)[reply]

Actually, reviewing sources you do seem right about that, much of his work does seem respectable. However, we can't claim "Hoffer was vindicated because X done after his death found out he was right" - but we can use sources that state this explicitly. In other words, we can't do the heavy lifting ourselves, the sources must be explicit. One thing I will ask - if you have a source, could you forward it to me via e-mail (if you have it in PDF format) or post a full-text link here? Right now you don't appear to have an e-mail address enabled. It looks like Hoffer made a lot of claims, some of which were substantially true (i.e. niacin to treat heart disease) and others were less well recieved (vitamins can treat schizophrenia). Again, the only way to sort this out is via the sources.

The way we demonstrate the opinion of "the medical community" is by citing sources - the more sources we have that say "Hoffer was a quack" or "Hoffer was a genius" or "Hoffer was right about some things and wrong about others" then the more indication of where the neutral position is found. Quackwatch is one valid source (and I believe restricts itself to the claims about mental illness) but I'm having trouble finding third-party sources to date. Much of what I've seen is stuff published by Hoffer himself, claiming miraculous results for nutrition-as-medicine. But I can't claim anything systematic here.

Regarding hypercholesterolemia, if he found the effect, but didn't develop it into a treatment, then he gets some credit for the observation (and that should be noted here) but he shouldn't get credit beyond the original observation. But again, sources are what we need. Explicit sources that attribute information to Hoffer directly. I've only found two full-text articles on pubmed, and both are by Hoffer, not about him (and one is a letter to the editor). Some newspaper obits would be nice, they usually do a reasonable job of portraying his impact as well as controversy in a nice, brief thumbnail sketch. WLU (t) (c) Wikipedia's rules:^simple/_complex 16:23, 13 May 2010 (UTC)[reply]

May 2010

A few issues:

Phrases such as "The relevance of this to Dr. Hoffer's work is unclear" and "This is essentially Hoffer's fifty-plus year-old treatment program with the addition of a statin" are editorial commentary. They are inappropriate and will be removed.

As far as I know, Dr. Hoffer never worked with the retinoids. Therefore this sentence is not relevant and should be removed entirely. Should have done this in the first place and not wimped around. BTW, the dermatologists use tretinoin (11-cis retinoic acid, IIRC ) to treat squamous cell carcinomas. Which shows how complicated even this issue is.Drjem3 (talk) 23:05, 11 May 2010 (UTC)[reply]

The concept of original research: a controversial and now quite fringe claim, such as that vitamins can cure or prevent cancer, should be noted as such, and this would not be original research.

Calling this "fringe" is merely your personal opinion (i.e. OR), absent some sort of 'reliable source" (see below) that also says it. The fact that you call me "fringe" also reflects on your judgement in this issue-- If you only knew. Anyway, don't care how much you beleive it-- you still need some reliable outside source that meets the rules. As I have noted, quackwatch.com is not really enough. Drjem3 (talk) 23:05, 11 May 2010 (UTC)[reply]

On the other hand, using recent research to argue that Hoffer was "right" on one point or another can easily become synthesis and original research. My interpretation is that Drejm3 has indeed synthesised unless the sources clearly link Hoffer to the trial results. The NEJM article does not.

Yea, and few papers cite Darwin or Einstein any more. In fact, most citation lists don't go back more than a decade, usually a lot less. This means nothing-- there is a direct chain between the NEJM paper and Hoffer and Osmonds original work.

Hoffer was not a personal acquaintance of mine, but the reliable sources seem to indicate that he is best known for his discredited claims on niacin and schizophrenia.

That was the flashy stuff that drew the media attention. BTW, my friend and coworker Dr Proctor ( who also knew Dr Hoffer ) credits Hoffer and Osmond's Adrenchrome hypothesis, "however controversial" and arguably wrong in its details, as being technically the first direct expression of the concept of "Redox signaling". This is the concept that free radicals, etc. figure in cell signaling. That is, they had the right idea, but their proposed mechanism was (er) shakey. This being five decades ago, they can be forgiven for messing up some of the mechanistic details. See ["http://www.redoxsignaling.com/hx-redox-signaling.htm"| Hidden History of Redox Signaling]. Because it is a website, I have not cited this material in the article. Still, if you can cite quackwatch.com as your primary source, I should be able to cite this as one of my secondary ones. Drjem3 (talk) 23:05, 11 May 2010 (UTC)[reply]

We should certainly mention the 1955 article on cholesterol and niacin, on which Hoffer was the middle author, and we do. However, it's important to keep in mind that a Soviet Russian group had published on the same topic several years earlier and that several researchers in Italy and elsewhere published almost simultaneously with Altschul, Hoffer and Stephen. "OMM" practitioners are keen to lionise Hoffer, and he undoubtedly deserves respect and accolades. However, this is a Wikipedia biography; we must concentrate on encyclopaedicity. Keepcalmandcarryon (talk) 21:32, 11 May 2010 (UTC)[reply]

Certainly arguable. But the treatment entered clinical medicine via Hoffer and his coworkers. Also author order means little. Anyway, Hoffer and Osmond detected the effect first in their patients. The paper cited represents the refined verson. In fact, so refined that it is pretty-much the present-day standard of care. Drjem3 (talk) 23:05, 11 May 2010 (UTC)[reply]

Author order is generally seen as quite important, though whether this was the case in 1955, I'm not sure. The important thing to do is to verify claims using reliable sources while avoiding original research, in a neutral manner that gives due weight to the mainstream opinion. In this case, the mainstream opinion is orthomolecular medicine and psychiatry wildly outstrip their research base, and rest on shaky foundations and assumptions. WLU (t) (c) Wikipedia's rules:^simple/_complex 00:47, 12 May 2010 (UTC)[reply]

So the "mainstream opinion" among doctors is that psychiatry is "fringe medicine" ? I'm sure my shrink friends will get a hoot out of this one. Not to mention my god-daughter, the psychiatry resident. Drjem3 (talk) 05:07, 12 May 2010 (UTC)[reply]

Hoffer is greatly respected in free radical research because of his pioneering efforts, as is his coworker Linus Pauling, who even has a research institute devoted to this area named after him at the University of Oregon. In retrospect, both scientists were right about some things aand arguably wrong about others. That is just the way science works.

BTW, clearly you know the wikirules, as do I. Why don't you follow them ? After repeatedly reverting well-reference stuff, you keep repeating what is essentially "Original research", providing only a 1. rather discredited 2. website as an authority.

You know very well either characteristic makes something not an acceptible source. In fact, you have previously involked this very point against another editor, objecting when he used a website as a source. When you get called on this, you don't provide a better cite, but obfuscate and repeat your assertion. So we go round and round. Look, if your assertions about "orthomolecular medicine" ( in some ways an obsolete term ) are so universally agreed-upon among we physicians, surely you can find something else to support your OR assertions.Drjem3 (talk) 03:38, 12 May 2010 (UTC)[reply]

As I said in a previous post, read my comment as "orthomolecular medicine and orthomolecular psychiatry", not as a comment on mainstream psychiatry. Hoffer may be respected for basic research on free radicals, but as far as I know he is less respected on matters of psychiatry. As for my revert, WP:OR means no syntheses - in other words, no "Hoffer said vitamins were good. X study found that vitamins were good. Therefore Hoffer was right." We should be citing medically reliable sources to support claims in ways that respect the scientific consensus as well as secondary sources (for medical articles - this means review articles and meta-analyses). However, parity does allow quackwatch to be used for fringe claims and the orthomolecular approach fits and is recognized for this.

I've done a bit of preliminary digging and haven't found much on Hoffer. I'll keep looking but it'll take time. WLU (t) (c) Wikipedia's rules:^simple/_complex 13:37, 12 May 2010 (UTC)[reply]

Wikipedia:Verifiability

It helps to recount the rules:

Questionable sources " Questionable sources are those with a poor reputation for checking the facts, or with no editorial oversight. Such sources include websites and publications expressing views that are widely acknowledged as extremist, or promotional, or which rely heavily on rumor and personal opinion. Questionable sources should be used only as sources of material on themselves, especially in articles about themselves; see below for the restrictions on using self-published sources in this way. Questionable sources are generally unsuitable for citing contentious claims about third parties. " Drjem3 (talk) 23:05, 11 May 2010 (UTC)[reply]

If this refers to Quackwatch, see WP:FRINGE and WP:PARITY. Quackwatch has long been recognized as an appropriate source for articles that are considered quackery. Orthomolecular medicine, and purveyors of such quackery, are such pages. Stephen Barrett is a recognized and award-winning authority on quackery and claims that are outside mainstream science and evidence - like orthomolecular medicine or psychiatry.

If this is about another source, then you'll have to identify which one. WLU (t) (c) Wikipedia's rules:^simple/_complex 00:45, 12 May 2010 (UTC)[reply]

Ah, so psychiatry is "outside mainstream medicine and evidence". My shrink frineds would disagree. BTW, you are not a physician. How can you know what is mainstream and what is not ? Have trouble with this myself sometimes. As for Dr Barrett-- in some circles he is frankly considered rather over the top, on a mission from god, and not very credible.

Deja vu all over again-- I'm back on usenet battling trolls. English Translation: "I can't find another source that agrees with Dr Barrett". Just perhaps, this indicates that Dr Barrett is not exactly mainstream or very credible. Drjem3 (talk) 04:17, 12 May 2010 (UTC)[reply]

More: First, you are using a partisan website ( quackwatch.com ) as your primary source. In general, this is forbidden, as you well know, since you used this very argument to slap down another editor who said something you disagreed with. Surely, if you are right about Hoffer's work you can come up with another more authoritative source. Second, quackwatch has been seriously questioned as to its veracity, fact-checking, its extremist nature, in fact, the whole laundry list. I can provide sources ad infinitum. This is sufficinet reason for excluding it as a source. In return, all you have is your repeated assertions that it is OK.

An editorial comment: This sort of frustrating round and round argument is why experts often abandon wikipedia, though all it would really take is for everyone to follow the rules. Also see Larry Sangers editorial [3] Drjem3 (talk) 03:59, 12 May 2010 (UTC)[reply]

I don't have a lot of time, but first - Quackwatch has generally been frowned upon as a reference (ArbCom search, in Barrett v. Rosenthal it was described as "partisan"). It doesn't seem necessary to cite it given the other sources available, although if there weren't any it could be acceptable per WP:PARITY. We also need to be careful about original research, which Keepcalm (and possibly WLU) still don't seem to completely understand. Citing Hoffer's 1955 article as a source for him being part of the team that discovered niacin's effect on cholesterol is not OK because it does not say that paper started it. The 1955 paper is a good convenience link. I added a 2006 Drug Discovery book way back when which specifically noted Altschul and Hoffer as being the discoverers of the effect [4], and it should be readded. Similar original research occurs when mainstream articles which don't discuss orthomolecular medicine are used to criticize it, as is done with the Satia et al 2009 article, which needs to be removed. II | (t - c) 06:58, 12 May 2010 (UTC)[reply]

Only two of the arbcom links are relevant - Barrett v. Rosenthal and Wikipedia:Requests for arbitration/Yoshiaki Omura; the latter is only a talk page link, not a finding or judgement by arbcom itself. The other references are in workshops and the like. The only relevant one therefore is BvR, which does describe the site as "partisan" but does not forbid its use. WP:PARITY would suggest it is useful on pages that make non-mainstream claims (i.e. orthomolecular medicine and psychiatry). A more relevant place to look for clarification on this would probably be the WP:RSN; there are 9 results and I'll have to dig through them to find a consensus. But I do agree - if other, better sources are available, then they are preferred. I don't really have any other replies to II right now - I haven't looked at the page proper in detail. The comment about the Satia reference is a good one - I would support judicious use of sources that do not mention Hoffer's opinion, as a way of briefly indicating where the mainstream opinion contradicts his. This may be such a case, but I'll have to review in more detail. Orthomolecular claims in general though, are not considered supported, valid, or useful - megadoses of vitamins are not generally considered of general use as treatments and are associated with increased death rates. But again, that's preliminary without having dug through the details.

Replying to Drjem3 - my use of "orthomolecular medicine and psychiatry" applied "orthomolecular" to both "medicine" and "psychiatry". In other words, my statement should be read as "Stephen Barrett is a recognized and award-winning authority on quackery and claims that are outside mainstream science and evidence - like orthomolecular medicine or orthomolecular psychiatry." You also have no idea whether I am a physician or not, but that's irrelevant - pages are never adjusted on the basis of personal experience or knowledge - only on what can be verified in reliable sources. You could be a doctor or a typing chimpanzee, as long as your edits are verified by reliable sources your real-life identity doesn't matter. Experts and doctors should be able to verify their edits easily by having access to lots of sources as well as the expertise to reference and use them. Barrett's site is also award-winning and mentioned by JAMA as a solid source, is favourably mentioned by the FDA (twice) and cited as a reference by the CDC.

Since this page is not a forum, the only issue I see is whether quackwatch is a reliable source. I believe it is, I'll dig through the RSN discussions to see if I can get an official opinion. WLU (t) (c) Wikipedia's rules:^simple/_complex 12:48, 12 May 2010 (UTC)[reply]

Finally, some sense. This whole area is quite complicated and controversal. That is, it needs to be presented with an NPOV. After minor NPOV alterations-- "most" to "many", etc. got reverted. I cited the NEJM article (e.g.) to give factual balance to the wildly-one-sided and definitely OR assertions in the article. I did not do the citation chain back to Hoffer and Osmond because any attempt to give balance to the article got reverted. Friendly persuasion seemed ineffective. So why waste my time ?

A quick perousal of the history shows that other editors have experienced the same difficulty in introducing balance to the article, finally giving up. Arguably 'tendentious editing" at work. And yes, quackwatch is not a suitable source. Way too partisan and controversial. As for the anticancer aspects of vitamin-C, etc., contrary to claims, this continues to be a subject of some research. E.g,, this paper [5] from the National Cancer Institute in PNAS. Can't get more mainstream than that.

Finally, as I have repeatedly noted, experts have no special priviledges here. However, as I have also noted, we are valued because we know how things work and where the clean citations are. Which is why there is an "expert needed" tag. Anyway, I'm out of here for the moment with a sour taste in my mouth. Drjem3 (talk) 13:44, 12 May 2010 (UTC)[reply]

Again, please maintain civility. Calling or implying that other editors are stupid simply makes the page acrimonious, in addition to making it more likely your edit will get reverted simply out of pique. This is not usenet or other similar discussion boards, and flamewars are not appreciated. I am frustrated by your willingness to insert pointed jabs and near-insults into your posts, but I am making the effort to reply calmly and without rancor. Returning the favour is a very worthwhile investment that makes working together much easier. Wikipedia is a community, which means everyone must make an effort to get along, even with those we disagree. No-one likes angry mastadons.

Balance and bias are subjective things - we represent them by citing information using reliable sources, in relative prominence to the weight of the source (which incorporates who the publisher is, the impact factor - which can be tricky, the author, the audience, and how convergent the sources are). This is a difficult task to undertake and requires judgement and consensus on the part of editors. PNAS is a solid journal I believe, but Chen et al. was an in vitro study - with unclear implications for clinical trials in humans. It is also a primary source, which are not generally seen as suitable sources for medical articles (see WP:MEDRS#Respect secondary sources). It does not cite or refer to Abram Hoffer directly. This does not vindicate Hoffer or Pauling, and futher, there is no indication that vitamin C is now considered either a mainstream or adjuvant treatment for cancer. Vitamin C is actually considered a disproven treatment in at least some circles (and would only work at doses that near the toxic level, whether given orally or via intravenous drip; see here and here - not reliable sources, but do give interesting context and analysis). PNAS may be a mainstream source, but this preliminary bench work only shows that the modality is (again) being explored, not that it has any use in humans (and certainly not that it's now considered a chemotherapeutic option).

Inclusion of the NEJM reference is both dubious and unnecessary - niacin is now considered a mainstream, if potentially dangerous treatment for hypercholesterolemia. The use of the words "For example" to lead-in that sentence illustrates the problem here - if we must use something as an example rather than as a straight citation, that is an OR SYNTH, particularly when placed as to give the implication that it vindicates Hoffer and all his work. I've adjusted to indicate that it is now an accepted mainstream treatment, but what we really need is how Hoffer is specifically linked to niacin's utimate use to lower cholesterol. That will both settle the question on the talk page, and improve the main page. If his sole relationship was to discover the effect, then all that can really be said is that he discovered it and it's dubious whether he can then be linked to a successful treatment modality in a way that seems to make him look like a genius or prescient.

Quackwatch is still an acceptable source for fringe claims. If you wish to demonstrate your expertise and access to sources, please do so - but please only cite sources that are explicit in discussing Hoffer, and do not use them in a way that promotes an idea or ideology; I certainly accept that you may be more knowledgeable than I in medicine, but I also certainly have much greater experience on wikipedia than you do. Both of us have something to add to the page but it will require calm, respectful dialogue. WLU (t) (c) Wikipedia's rules:^simple/_complex 14:33, 12 May 2010 (UTC)[reply]

If a somewhat exasperated theme comes through, I apologize. Anyway, I never maintained another editor was "stupid", not even a hint. Likewise, I always attempted to "assume good faith" and "maintain civility", etc..

My objections were that the editor is overtly partisan, reverts any change in his article ( I forget what this abuse is called ), seems unable to compromise in the interest of NPOV, and that there is a lot of original research in the article. I also objected to the use of quackwatch as a source and asked that the editor provide another citation to back up his claims. This should have been a simple matter of searching (say) http://www.pubmed.com .

All I got back were more reversions, doubletalk and OR, which I also pointed out. And I well know the points you make. Originally, I was merely attempting to give a little balance to the article, e.g., changing OR "most physicians" to the more neutral "many physicians", etc.. I also pointed out that the relevance of one citation to Dr. Hoffer's work was unclear, since Dr Hoffer never worked with that particular groups of compounds. But I kept getting reverted. When I reminded the editor of "the rules" about NPOV, etc. he continued to flout them. My fault for rising to the bait. Out the door... Drjem3 (talk) 15:27, 12 May 2010 (UTC)[reply]

I appreciate your apology and civility; you may not have meant to imply another editor was stupid, but text-based communication is notorious for people taking offence when none was meant, particularly during acrimonious disputes, and doubly-so on wikipedia talk pages.

I don't believe page ownership is an issue - the issues that Keepcalmandcarryon was concerned with are the same ones that concern me - original research, and if Quackwatch is a reliable source (both of which I agree with him/her on). It is often very frustrating for new editors coming to a page to not be able to point out the "obvious" (i.e. The Matrix violated the third law of thermodynamics; Creationism is nothing but lying douchebaggery; Terry Goodkind is a hack fantasy author who resents his self-imposed ghetto - all points I tried to make within my first year on wikipedia). The only way of resolving the disputes is to find and summarize reliable sources in a neutral manner giving due weight to the mainstream opinion while avoiding original research and promotion of specific viewpoints. In other words, our core policies of WP:RS, WP:NPOV and WP:OR. There are many nuances, and it takes a while to grasp these policies, understand their implications and find the sources that are needed to properly write the page. But it does always come back to sources, they are the only way to resolve a dispute. We need mainstream, reliable sources that discuss Abram Hoffer; partisan sources can be used judiciously (and this goes both ways - sources that are critical of Hoffer, and sources that are highly supportive). It's always about the sources. WLU (t) (c) Wikipedia's rules:^simple/_complex 16:46, 12 May 2010 (UTC)[reply]

Quackwatch's reliability

Note the following discussions regarding Quackwatch:

Motion in Barrett v. Rosenthal that stated, in essence, Quackwatch is partisan, has a strong point of view, but is still a reliable source for fringe medical topics. Note also the discussion which is fairly nuanced and indicated that the BvR outcome should not be read to bar Quackwatch as a source.
RSN discussion 1
RSN discussion 2

I have to parse both RSN discussions before commenting, they're here in case anyone wants context right away. WLU (t) (c) Wikipedia's rules:^simple/_complex 12:59, 12 May 2010 (UTC)[reply]

Other issues with quackwatch aside, this is not "fringe medicine", not no way, not no-how. Rather, it is the subject of a lot of main-stream research by a lot of high-power researchers. E.g., I recommend a google search using "ascorbate" and "cancer". BTW, to avoid any "fringe" taint that might interfere with funding, the present " Society for Free Radical Biology and Medicine " started out as "The Oxygen Society". Changed the name about a decade ago, IIRC. Long after any taint had evaporated. Dr Hoffer was generally honored as one of the founders of the field. Drjem3 (talk) 14:03, 12 May 2010 (UTC)[reply]

Can you cite any sources that indicate it is currently considered a mainstream treatment? I can point to, for instance, this statement from the American Cancer Society that it is not, as well as this source stating it is considered disproven. Also note this statement by the British Columbia Cancer Agency, and though a trial for IV vitamin C in patients with no other options has been approved, currently the FDA does not consider it a viable treatment that I can tell. Many sources support the idea that vitamin C is not considered a worthwhile treatment for cancer, and while investigation is ongoing, there does not seem to be any proof that it actually works, or that it it is a mainstream modality. Also worth noting is the Mayo Clinic opinion, this article suggesting the jury is still out (but it's certainly not proven), and this article which also calls for research but states it is not proven. This illustrates the issue of many alternative medicine claims - long on claims, short on evidence. It is also the reason why many doctors and skeptics are skeptical - the evidence base just does not exist to support the idea's use as a treatment, but it is still promoted as a valid treatment (and often as a miracle treatment, as a cure for everything and all cancers). Sources must be used to make these points, but not here - this is a discussion for other pages. This page is about Abram Hoffer, and should not be used as a coatrack for the vindication of his beliefs (particularly when they may not be vindicated). WLU (t) (c) Wikipedia's rules:^simple/_complex 14:50, 12 May 2010 (UTC)[reply]

Currently, the treatment is "experimental" as primary treatment but of arguable benefit as a supplimental one e.g.,[6] . The big issue is why (say) vitamin-C works in some trials, but not in others. Early-on, there was a lot of finger-pointing, with different researchers blaming each other for doing trials wrong.

An emerging concensus is that they all may have been right. That is, there are multiple undefined factors involved. One example is type of cancer. e.g, potential activity in neuroblastoma [7]. A key factor seems to be dose [8]-- the levels required are difficult to achieve by oral administration and IV or even intratumor [9] seems to be the way to go. An additional factor in antioxidant treatment of any sort is the presence of the powerful antioxidant uric acid in humans, but not the experimental animals. I just cited another paper [10] from the NCI as an example of how dose matters. BTW, I know a couple of the NCI principals and spent years as a cancer researcher at MD Anderson. Not asserting "authority", but just pointing out that I know where to look for the papers. The emerging concensus is that such compounds shut down tumor growth by something called redox signaling.

Anyway, far from being "fringe", this is a very active field of research. Try "ascorbate" and "cancer" as google search terms to get some idea. Drjem3 (talk) 16:08, 12 May 2010 (UTC)[reply]

Google hits are generally seen as unhelpful. This is not the page to discuss prospective treatments using intravenous vitamin C, this is the page to discuss Abram Hoffer. There may be many factors involved, but right now the treatment is not mainstream and should therefore not be discussed as anything but prospective for this reason - there are ample mainstream and reliable sources that state megadose vitamin C has been tested in the past, failed, and is not now used as a treatment modality. It may become one in the future, but wikipedia is not a crystal ball and should not be used to advocate or advertise for prospective remedies.

This page is for the discussion of Abram Hoffer, not his treatment modalities, not whether he was right, and not whether megadoses of vitamin C are an appropriate, safe, useful chemotherapeutic agent, or one that is superior to the current gold standard. If it is, investigation will reveal this, but the only thing that we can do is wait until the research is done. When mainstream, reliable sources indicate that vitamin C has a clinically meaningful and relevant role as a chemotherapeutic agent, it can go on the chemotherapy page. Until then it is a treatment considered substantially fringe, historically advocated for, currently unproven, but also under investigation. Emphasis should not be on the "under investigation" part, since there are thousands of treatments currently under investigation. And, again, this is the Abram Hoffer page, and should focus primarily on him. WLU (t) (c) Wikipedia's rules:^simple/_complex 16:33, 12 May 2010 (UTC)[reply]

Again, I was merely attempting to give a NPOV and show how this field is not "fringe". Sorry if I stepped on any toes. Perhaps I should have given a link to pubmed ( www.pubmed.gov ) to emphasisze the point that I was referring to articles on the subject in major journals. That said--Where Dr Hoffer's research ended up 50 years later is relevant if you are going to mention that research at all. Like omitting Einstein from any discussion of nuclear energy. Perhaps we ought to just give dates of birth and death, where he worked, etc., and leave it at that. But if you open the door to his work, you cannot maintain an NPOV without going into all aspects of it. Otherwise, it looks like a partisan hack job. Drjem3 (talk) 18:00, 12 May 2010 (UTC)[reply]

Ultimately it depends on what sources we can turn up. I've looked, and a lot of it is from the orthomolecular field - which I would characterize as a ghetto since it's a heavily walled garden of dedicated contributors who don't appear to adhere to rigorous patterns of research (clinical trials with large numbers of subjects randomized to different groups, with double- or triple-blinding and tracked drop-out rates) or publish in mainstream journals. The entire approach of "if some is absolutely necessary for life, then LOTS must be GREAT (and totally HARMLESS)" is what tends to rile people up - particularly since evidence is rolling in that LOTS can not only have acute toxicity effects (which is why no-one dines on polar bear liver), but also appears to cause premature death when taken chronically. Orthomolecular medicine simply is not mainstream, and a lot of mainstream bodies have produced documents to this effect. But it all comes down to what we can turn up in sources.

One thing I'm surprised to see is the lack of discussion regarding LSD - most of the google books sources that I looked into that didn't have "orthomolecular" or "total nutrition" in the title were about his LSD work. WLU (t) (c) Wikipedia's rules:^simple/_complex 18:47, 12 May 2010 (UTC)[reply]

I note that Quackwatch and Barrett have once again come under attack. As pointed out in the discussion to (successfully) amend the Barrett v. Rosenthal ArbCom decision, such attacks are a cardinal sign of a POV pusher whose views and understanding are screwed up. I'll add my comments here about that case and its amendment so that readers can get caught up on the changes to that ArbCom decision and thus get up to date so we don't hear so much repetition of a faulty "finding":

Quackwatch and myself (formerly Fyslee) were later vindicated by the Arbitration Committee:

As a result of this Request to amend prior case: Wikipedia:Requests for arbitration/Barrett v. Rosenthal: The amendment removed the false charge against me of having used "unreliable" sources (QW), and it vindicated QW by removing the description of it as being "unreliable". Justice was finally done after two years! Note that only the second motion (1.1) passed.

RS/N: Usage of Quackwatch as RS in medical quackery: The consensus is that it may be used as a source under the same rules and precautions that govern the use of any other RS. It is an obviously notable source that is highly regarded by the mainstream (no criticisms) and villified by the fringe/alternative side, which is to be expected because it exposes their unscientific practices, scams, and other illegal activities.

I hope that clears up some of the misunderstandings and misinformation voiced by User:Drjem3. I note that his violations of our BLP policy have been removed from this page, as required by that policy. I also note that he has gotten his misinformation from a very unreliable source, so unreliable that the author has been indefinitely banned from Wikipedia by the ArbCom and the community and his websites blacklisted as sources of any kind here. I suggest that Drjem3 read both the Quackwatch and Stephen Barrett articles very carefully, especially the sources, and note that they are held in high regard by all mainstream sources and only villified by quacks, scammers, and those who advocate unscientific and dubious practices. -- Brangifer (talk) 01:05, 13 May 2010 (UTC)[reply]

Er. " Maintain civility " and argue the issues. This just shows how throughly politicised this issue is. Interestingly, I have talked to Dr. Barrett on the phone a time or two. He was canvasing me to join one of his crusades that had relevance to my pharmaceutical expertise. Researched his background and turned him down. My opinion has not changed. YMMV and reasonable people may have different opinions, naturally.

Likewise, Can't say I wasn't warned by several experienced wikipedians to stay away from controversial articles and their hangers on. Didn't realize this was quite this controversial. Likewise, "The dogs bark, and the caravan moves on " -- In my defense. I am every much main-stream. More degrees than a thermometer, etc.. People often pay me big $$$$ for my opinions on pharmacological matters. Howabout you ?

Also, sorry about getting things out of order. While a long-term lurker, I haven't posted much on wikipedia until very recently. Still learning the subtle points. But I understand the rules well enough to spot a lot of violations. I suppose I asked too much for everyone else to follow them too. Again, this subject has attacted been throughly politicised and has thus attracted the usual true beleivers. So reasoned discussion seems futile. More education. Outta here. Drjem3 (talk) 16:41, 13 May 2010 (UTC)[reply]

Please stop bringing up degrees and qualifications - they are not relevant here, only the sources. You don't see me drawing attention to my six PhDs and ability to bend spoons through force of will - in part because I don't like to brag, but mostly because it is irrelevant. On a purely practical level, it also tends to piss people off since the Essjay controversy.

People tend to avoid articles like these because there's often a lot of new editors who come in, are outraged at the POV (in any direction) and start throwing around a lot of OR, bile and edit warring that is exhausting and disruptive. I for one avoid chronic fatigue syndrome for this reason. Alt med articles certainly attract a lot of cranks, outraged scientists, converted laypeople and linkspammers. The first step is to arrive at a mutual understanding of the policies and guidelines, then start producing the appropriate sources. I keep belabouring the point, but it keeps being relevant. If you can't source it, it shouldn't be here. Longstanding community opinion is that Quackwatch is a parity source that is reliable for fringe topics. Rather than wrangling over whether it is a good source or whether Barrett is a good person, we should be reading and summarizing it, and finding other sources to further expand the page. I think this type of discussion has gone on long enough so far, can we agree to start looking for actual sources? WLU (t) (c) Wikipedia's rules:^simple/_complex 17:01, 13 May 2010 (UTC)[reply]

Pretty much agreement, as I have expressed all along. Note that I was merely responding to a straw arguement coached in the form of a personal flame. Lots of that here. True, a total waste of time and rather undignified. Anyway, my (ex-) wikipedia-posting friends tell me that one frustration that experts experience here is playing totally by the rules, giving cites, authoritative references, etc.. And then seeing others not do so and not get chastized for it. Or worse, getting accused of OR, when a simple reading of a provided cite would show this is not the case. How much of this is simply wiki-strategy and obfuscation, etc. I do not know. Not to mention cliques and sockpuppets, etc. which allegedly abound around anything remotely controversial. Such is wikipedia.

Back on point: There is a lot of OR and hyperbolic statement in the article. Originally, I merely changed statements like "the medical community" (unverifiable) to "many in the medical community" (verifiable).* By the wikirules, the article needs some cites to this effect-- so I put in a [citation needed} tag. Plus I provided a a couple links and cites and pointed out that a cited article on the possible association between cancer and some retinoids probably had nothing to do with Dr Hoffer's work. This is because he never worked with these compounds.

That is it. For which small changes I seem to have drawn a full frontal attack, complete with personal flames. As for link sources, I have provided several authoritative ones in the discussion above and will put them in the article as soon as I am reasonably certain it just won't get reverted again. Which is why I have confined my comments to the discussion page. Drjem3 (talk) 19:57, 13 May 2010 (UTC)[reply]

Fact is, most doctors never even heard of this issue. Drjem3 (talk) 19:57, 13 May 2010 (UTC)[reply]

One issue that may frustrate researchers is our prohibition of summarizing primary sources (which for medical sources are reports on single experiments). We are supposed to use secondary sources (and recent ones at that) to draft our pages.

Those sockpuppets go both ways by the way, there's many a CAM promoter that gets blocked and a checkuser turn up sockpuppeting.

"The medical community" and "many in the medical community" are both problematic (the former is simply unlikely as no community speaks with a single voice, and the latter is weaselly).

As for the rest of the sources - they have to be explicit in discussing Hoffer and his work directly. Sources like the ones pointing out that vitamins have been associated with increased risk of death is a special application of WP:IAR that is used to give due weight to the mainstream belief that vitamins are primarily about deficiencies, not magic. It's the kind of edit that requires consensus and must be discussed. WLU (t) (c) Wikipedia's rules:^simple/_complex 20:32, 13 May 2010 (UTC)[reply]

Time for a teaching moment. "Vitamins" means a lot of different things, just like "chemicals". IIRC, Hoffer only worked with niacin and vitamin-C. these are compeletely-unrelated to the retinoids. Anyway, only one of the compounds in the paper ( retinol ) is a vitamin. As I noted, retinoids are commonly used by the dermatologists as adjunct treatment for skin cancer. Likewise, they do have anticancer properties in vitro and, IIRC, in experimental animal models. Thus, the paper noted is itself somewhat controversial and may represent a secondary effect of some sort, such as supression of the immune response to the tumor. Anyway, the reported effect is not large and may just be fortuitous. What drew my attention is that the editor seems to have obfuscated all this. Perhaps this was in the hope he could fool the uninitiated. More likely, he just did not know any better. Nothing wrong this this. If ignorance were bliss, I'd be the world's happiest person. But it does need correction.

Agree about secondary sources. The primary sources I gave were to counter the assertion that this is "fringe" medicine. No problem providing the odd commentary, review article, whatever. Drjem3 (talk) 22:04, 13 May 2010 (UTC)[reply]

As for quackwatch as a source, after looking the site and reading some of Dr. Barret's missives, I posted the following to the {Wikipedia:Reliable_sources/Noticeboard/Archive_32 site]:

A folk expression goes : " Even a blind hog finds the occasional acorn ". The fact that Barrett is occasionally right does not mean that he should be taken as "authoritative". In addition to the fact that Barrett has no research background at all, I am particularly concerned by the fact that he seems to dismiss out of hand such reasonably-well established medical practices such as acupuncture on the simple basis that " they don't make sense ". In fact, there is a fair amount of literature on how acupuncture works on a neurological basis e.g. [11] as well as its clinical utility e.g., [12]. A www.pubmed.gov search on "acupuncture" gives 15123 references, with 1708 review articles. The fact that he seems to be unaware of this extensive literature is a cause of concern. Similar objection can be made for many of his positions, which seem to reflect his personal opinion more than the science. There is also a 'cult-like ' atmosphere around quackwatch that is cause for concern. Anyway, much there seems more personal belief than the science. My recommendation is that anything in the established scientific literature should trump Quackwatch as a source. Drjem3 (talk) 21:04, 13 May 2010 (UTC).[reply]

Undent. Vitamins are considered, in mainstream medicine, to be things science have proven necessary for life. They are distinguished by being required in relatively small amounts - that is they are micro rather than macronutrients (fats, carbohydrates, protein). Unlike phytochemicals, they are required - people suffer or die without them. The best evidence evidence I know of suggests that we get adequate vitamins through a varied diet, and we're better getting them through diet than supplementation, which can be acutely or chronically toxic, with good evidence that over the long term supplementation can actually increase death rates. The best evidence supports chemotherapy, surgery and radiation for treatment of cancer; strong positive evidence of vitamins being useful would mean they would be incorporated into mainstream practice. Right now, evidence is mixed, equivocal and clinically unproven. Despite this, many complimentary and alternative medicine practitioners push them as miracle cures. I have generally no issue with this, except for when it diverts cancer patients from mainstream treatment and robs them of valuable time or money in their final days. That many practitioners also criticize and sneer at mainstream medicine unjustly while pimping their nostrums does irk me. Acupuncture itself, again, tends to aggregate on the following results - it doesn't matter where you put the needles. It doesn't matter whether you use real or fake needles. It doesn't matter whether you use needles at all. It doesn't matter where you pierce the skin. In all these cases, "real" and "placebo" acupuncture have been found useful in acute symptom relief in pain and nausea, but little else. Barrett, like many people who are interested in a strongly research-based medicine, are irked when extreme claims are made, and unjustified criticisms launched, in the name of "alternative medicine", when that term is really just a code for "unproven assertions" as real medicine integrates practices after they have been proven to work.

Mainstream sources should be used when available in preference to quackwatch, but QW is still a valuable and useful source for many articles and on many topics. It represents a strong point of view grounded in evidence-based medicine and skepticism. It's considered on wikipedia to be a suitable source for many medical topics, especially "alternative" ones. That is the consensus of the community. Certainly it is not the only source, but it does have its place.

Now, we should get down to the business of actually improving the page. We need reliable, secondary, independent sources that discuss Abram Hoffer's life and work. When I have the time, and am not bogged down on talk pages, I will try to find some and integrate them into the page. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:06, 14 May 2010 (UTC)[reply]

Teaching moment again. "vitamins" are an artificial historical construct from the early 20th century when a bunch of wildly-disparate deficiency syndromes e.g. pellagra, rickets, and scurvy, were formally identified and characterized. At the time, nobody knew what the missing nutritional factors were. So they were collectively classified as "vitamins", from the fact that such deficiency syndromes were sometimes lethal.

While the term "vitamin" is a convenient shortcut, these compounds are wildly disparate in the chemical structure, action, and toxicity. In fact, the only thing they have in common is that their dietary absence can cause a deficiency syndrome. E.g. most are non-toxic as a practical matter. This includes niacin ( which can have some liver toxicity at really high doses ) and vitamin-c, the compounds Hoffer worked with. OTOH, lipid-soluble ones such as vitamin-D and vitamin-A retinol have recognized real-life toxicicy, sometimes lethal. Confuting a toxicity study on some vitamin-A analogs with niacin or vitamin-c just because they are all dubbed "vitamins" is wildly inappropriate.

Also, your comment on not posting to archives is well-taken. Still learning the ropes here. I am posting it to the current discussion page. The validity of quackwatch should be an on-going issue. Because he agrees with their views, many editors are so ready to accord Dr. Barrett's bald-faced statements of his own opinion "authority" just because he is a physician. Anybody see the inconsistency here ? If he said this stuff in this way on Wikipedia itself, he would instantly be jumped upon, and rightfully so. Drjem3 (talk) 14:21, 14 May 2010 (UTC)[reply]

Vitamins are a category, that is defined by organic compounds needed in small amounts that do not provide energy or build structures. All constructs are essentially artificial, since the world just is and all categories are inherently human. Each one is unique in form, function and dietary requirement, which is why approaches like orthomolecular medicine, which believes a priori non-deficiency diseases can all be treated with vitamins rather than medicine (and that this approach is inhernetly superior to actual drugs), are considered questionable. Categorically saying all vitamins are beneficial and appropriate in all circumstances is as incorrect as saying all vitamins are toxic. Each compound must be treated unique, and the research base should be established before they are promoted as treaments for various conditions. Again, the over-stepping of the research base is what irritates people about orthomolecular medicine. Promoting vitamins (or any compound, intervention, implement or approach) as medicine before the scientific consensus is that they are effective, with an acceptable risk-to-benefit ratio is also wildly inappropriate. One of the big differences between CAM practitioners and mainstream medicine is the emphasis on rigor, convergent evidence, and changing one's mind once the evidence is in. For instance - has a homeopath ever changed their mind? I know of one, but this is despite hundreds of years as an intervention and millions of dollars spent on research. Meanwhile, thalidomide isn't used to treat morning sickness, tamoxifen is used to treat cancer, vioxx is off the market and we're now using an oral polio vaccine rather than injected. Research and treatment tends to change with evidence, CAM normally doesn't. Echinacea for instance - research demonstrated it was of no use in treating colds in 2005, but here's Gary Null in 2006 still promoting it.

Barrett's authority comes not from his position as a physician, but from the many awards and recommendations the site has garnered (which in turn comes from a mainstream approach that uses the scientific consensus rather than extremes of speculation).

There are a lot of rules, and a steep learning curve. You may be interested in this essay I wrote for new editors, it may help. WLU (t) (c) Wikipedia's rules:^simple/_complex 18:32, 14 May 2010 (UTC)[reply]

continued discussion

I note that your interpretation of "vitamins", etc. is not exactly what is commonly taught and move on. Ever have a college-level biochemistry course? Again, just trying to find out how much teaching I have to do here. And yes, I know all about main-stream cancer treatment <grin>. As I have noted above, even the NCI has on-going projects on the use of (say) vitamin-c to treat cancer. It is also recommmended in papers in main-stream journals as adjuvant treatment. I have given some cites above. This matter is by no means settled. The fact that some on the edge have siezed upon this doesn't necessarily mean it does not work.

Anyway, I did what I should have done originally and looked up what Barrett really says. Nothing in there about "The medical community" etc. that I can find, just a recitation of the APA report, etc.. That is, the editor misstated his alleged source. I. e., we have been had. Barrett does mention the use of high-dose niacin in hypercholestrolemia. But he neglects to mention this this came directly out of Hoffer's work. Interestingly, he neglects to mention psychotherapy as a questioned treatment. IIRC, there is an ongoing controversy about whether this is mostly a placebo effect or not. Again, his pronouncements should be viewed on their own, using the same standards you would use for any wikipedia editor. 23:19, 14 May 2010 (UTC)

That's all very well and good, but what matters isn't our bare assertions but the sources we use. Frankly, the amount of "teaching" you have to do is zero since sources are what matters. The NCI has vitamin C as an investigational treatment, but nothing is proven and in fact previous investigations have found it to be worthless. Whether that will change will take time but right now it's not a front-line or even adjuvant treatment, it's investigational. Further, in the 10 years since some of those cites, the progress hasn't been revolutionary. And finally there's a large number of sources I cited that point to vitamin C being considered disproven and not a worthwhile treatment. Again, large dose vitamins have limited use, not miracles.

Yes, everything should be according to the sources. So start citing. WLU (t) (c) Wikipedia's rules:^simple/_complex 00:58, 15 May 2010 (UTC)[reply]

By " teaching " I mean how far back in the sources do I need to go ? I.e. to give an example on (IIRC) the "authentication" page, am I required to do the equivalent of providing a source indicating that Paris is the capital of France? Or can we assume that everyone knows from their experience and education that this can be easily authenticated, if called. I suspect that a lot of the problem here is experts flat don't know how far up to start the authentication chain. I.e, do they have to refer everyone to a college-level textbook or just assume they have read one. Similarly, do editors know enough to know that these are complicated issues without pat answers.

And no, this is not a putdown. Everyone is dumb in some subject, as I have proved here with my procedural stumbles. As for vitamin-c, as one of my citations notes above, it is nominated as adjuvant treatment in at least one secondary source in a respectable journal. This should be enough. OR-- It seems to be part of pretty much one of the things cancer patients generally get, " Just in case". The attitude is "Anyway, it does no harm " and "seems to make people feel better..". I haven't tracked some other citations down, but they seem to say the same thing. BTW, much state of the art cancer treatment is technically "experimental". Even in regular medical practice, 17% or more of all prescriptions are written for "off-label" use. Says so right here in my PDR.

I am still waiting for a citation to "the medical community.., etc". Again, it does not seem to be on quackwatch.com. Keepcalmandcarryon tells us it is there. But I cannot find it and he has not seen fit to use it in the article as a citation. Also, the links hypercholesterolemia and hyperlipidemia discuss high-dose naicin as standard treatment and go into some detail about these conditions. Drjem3 (talk) 03:01, 15 May 2010 (UTC)[reply]

If information is easy to source, then source it. If anyone challenges a claim, it is up to the replacing editor to source it. If you've got college-level textbooks, they are great, appropriate sources. Vitamin C is still unproven, and considered disproven by some. "Anyway, it does no harm" in no way means it is effective. I've provided citations showing vitamin C isn't a mainstream treatment. We shouldn't go into some detail about high-dose niacin here; at best Hoffer's role in developing it should be briefly described, but again as far as I know he noticed the phenomenon but others developed it - meaning it's a coatrack to include it here. But again and finally - find sources explicitly discussing Hoffer, and use them, that'll solve everyone's problems. WLU (t) (c) Wikipedia's rules:^simple/_complex 11:25, 15 May 2010 (UTC)[reply]

The abstract of this paper [13] from the Karolinska Institute ( the guys who decide the Nobel prize ) on the history of the use of niacin in treatment of hypercholestrolema/hyperlipidemia notes: " The Canadian pathologist Rudolf Altschul discovered 50 years ago that nicotinic acid in gram doses lowered plasma levels of cholesterol.", referring to his work with Dr Hoffer. Check it out. Drjem3 (talk) 22:49, 15 May 2010 (UTC)[reply]

Post: " A review [14] from the Karolinska Institute on the history of the use of niacin in treatment of hypercholestrolema/hyperlipidemia notes: " The Canadian pathologist Rudolf Altschul discovered 50 years ago that nicotinic acid in gram doses lowered plasma levels of cholesterol.", referring to this work. Drjem3 (talk) 23:02, 15 May 2010 (UTC)[reply]

Link to entire paper: " REVIEW: Nicotinic acid: the broad-spectrum lipid drug. A 50th anniversary review" [15]. Quote: " In the landmark study of 1955 Altschul et al. [3] reported that nicotinic acid in gram doses lowered plasma cholesterol in normal as well as hypercholesterolaemic subjects. ". Ref 3 is his paper with Dr. Hoffer. Any questions ? Drjem3 (talk) 23:40, 15 May 2010 (UTC)[reply]

Note about reversion. I put the emphasis in to make certain the other editors did not miss it and have removed it. No slam intended-- without some knowledge of your background knowledge, I just do not know how far up the authentication chain I need to go. Similarly, there is absolutely nothing controversial about the use of high-dose niacin in hypercholesterolemis/hyperlipidemia. In fact, this has been non-controversial almost since it was discovered. For a long time, it was the only treatment available. The most superficial reading of the above review article or a dozen others I can provide should establish this.

So how can I be accussed of 'coatracking" something that is long-established "standard of care". I.e., I am not pitching something controversial under the guise of a bio, but merely showing just how important a figure Dr. Hoffer is in clinical medicine. Possibly, you-all confute the controversy surrounding Hoffer's other work to mean this is also controversial. Unfortunately, some may also be reluctant to postulate Dr. Hoffer was right in this one instance, less this be used to pitch his other stuff. Anyway, without this addition, this article lacks requisite NPOV. Drjem3 (talk) 01:01, 17 May 2010 (UTC)[reply]

[Wikipedia:Coatrack]

"Wikipedia policy specifically prohibits articles whose primary purpose is to disparage a particular person or topic. Articles about a particular person or topic should not primarily consist of criticisms of that person or topic."

How many times is Hoffer mentioned in that article? WLU (t) (c) Wikipedia's rules:^simple/_complex 20:13, 17 May 2010 (UTC)[reply]

Fact picking

Often the main tool of a coatrack article is fact picking. Instead of finding a balanced set of information about the subject, a coatrack goes out of its way to find facts that support a particular bias.

"A common fact picking device is listing great amounts of individual peoples' quotes criticizing of the nominal subject, while expending little or no effort mentioning that the criticism comes from a small fraction of people. That small fraction thus gets a soapbox that is far larger than reality warrants."

Ed note: The article does not represent the general attitude of the medical and scientific community has toward Dr. Hoffer, who is arguably primarily known for his niacin and hypercholesterolemia work. Rather it apparently represents the attitude of persons whose primary purpose ( rightfully or wrongly ) is attacking the use by others of his other work with megavitamin therapy. Coatracking by any reasonable interpretation.

"Even though the facts may be true as such, the proportional volume of the hand-picked facts drowns other information, giving a false impression to the reader."

"The coats hanging from the rack hide the rack—the nominal subject gets hidden behind the sheer volume of the bias subject. Thus the article, although superficially true, leaves the reader with a thoroughly incorrect understanding of the nominal subject. A coatrack article fails to give a truthful impression of the subject."

And so on. My point is that without perspective, this is a completely coatracked article. Drjem3 (talk) 02:42, 17 May 2010 (UTC

More: Scientists are allowed to be wrong, often are wrong, and their scientific reputations are not particular besmirched by what they get wrong. The classic example is astronomer Fred Hoyle, who never believed in the big bang theory, a term he invented as a put-down. Rather, he is honored as one of the originators of nucleosynthesis, as a scientific gadfly who set the criteria for proving the Big Bang, and as a science fiction writer. Same with Dr. Hoffer, some of whose work ( right or wrong is a secondary issue ) has unfortunately become extremely politicised. Drjem3 (talk) 14:09, 17 May 2010 (UTC)[reply]

Carlson, 2005 mentions Hoffer once, as second author of a study. He's not mentioned in the body, he's not discusssed. This is not an appropriate source to claim he revolutionized hyperlipedemia treatment. If you want this information included, you should find a source that discusses his involvement in developing this as a treatment. He gets credit for being part of the team that discovered high-dose niacin therapy, but he doesn't get credit for it becoming a mainstream treatment with this source. If you want this information in the article, you need to find a better source. WLU (t) (c) Wikipedia's rules:^simple/_complex 20:11, 17 May 2010 (UTC)[reply]

Hoffer's contributions to therapeutics

Dr. Hoffer continued in this field long after his original paper. E.g., with Dr. Altschul [16], where they review the history of the field to about 1960. Note that this is a secondary source. Among other things, Altschul and Hoffer note the AMA council on drugs has recommended high-dose niacin for hypercholesterolemia and others have described plaque regression. Another paper from Hoffer and a different set of co-workers [17] introduced time-released nicotinic acid to the therapeutic armamentarium. IIRC, Dr Hoffer held the patent on this.

With the addition of a statin, this is essentially the same treatment used to this day, fifty years later. E.g., the recent NEJM article and this editorial [18] ) which notes: " Together, the results available to date provide support for the concept that the use of statins to reduce LDL cholesterol to target levels with the subsequent addition of a drug to raise HDL cholesterol levels (niacin), rather than a drug to lower LDL cholesterol levels (ezetimibe), is a more effective treatment for patients at high cardiovascular risk."

That is, Dr Hoffer not only discovered this treatment, he perfected it. BTW, it is not custom to cite a complete discovery chain. In fact, most of the time, journal articles go back only five years or so. Finally, experts are given no special priviledges here. But neither is obtuseness or POV-pushing. Drjem3 (talk) 21:22, 17 May 2010 (UTC)[reply]

" Rudolph Altschul and Abram Hoffer at the University of Saskatchewan discovered in 1955 that high dses of nicotinic acid lowered serum cholesterol levels in humans, It was the first drug ever used for this purpose,....." back with link later Drjem3 (talk) 05:23, 19 May 2010 (UTC)[reply]

Why did you accuse me of edit-warring when I merely posted your requested cites to the main article ? There is absoluely no justification for either your reversons or for this accusation. I figure I just got suckered. Ah well, I should have known better.

Also, FYI here is a review article [19] on " Redox-Directed Cancer Therapeutics ". This is the ultimate evolution of Hoffer and Pauli's work with cancer. As I have repeatedly noted, this is a very currently-active area of cancer research. Anyone who maintains it is somehow "quackery" is simply wrong. Or at least needs to provide us with similar cites defending this position. Sauce for the goose, etc. Drjem3 (talk) 14:22, 19 May 2010 (UTC)[reply]

Sources

[20]
[21]

I used these sources to write this version of the research page. These sources are reliable (university and scholarly press) and secondary (not written by Hoffer himself, not the initial publications that are described in the text) and require no interpretation or explanation in order to be meaningful - all we need to do is summarize the sources that verify the . There is no need to cite later research, research neither performed by, nor discussing Hoffer, to "prove" that he was correct. Hoffer wasn't interested in niacin to treat high cholesterol - he was exploring the area as part of his interest in schizophrenia. It also contextualizes Hoffer's research at the time, and in relation to later research, as well as discussing the research community's reaction to the findings. Rather than a dump of primary sources that need to be synthesized and summarized to come to a conclusion, these sources are explicit. I'd like to do the same thing with vitamin C, when I get the time. WLU (t) (c) Wikipedia's rules:^simple/_complex 19:41, 19 May 2010 (UTC)[reply]

[22]
[23]

Revert

I'm very curious why the page is being reverted [24]. The later version (on the right in the diff) contains three sources to verify that megavitamin therapy is not considered credible. The earlier version (on the left) contains no sources for that point, as well other chunks of unsourced text. Is there a reason for the revert? And how is the dissociative identity disorder talk page relvant here? WLU (t) (c) Wikipedia's rules:^simple/_complex 20:15, 17 January 2012 (UTC)[reply]

Drjem3 asked me to reply to this issue, as well as on dissociative identity disorder. Here first. While recently partially-supplanted by high-dose statins, Hoffer's "megavitamin" use of time-release niacin is standard of care in dyslidemias. As for (e.g.) "megadose" use of vitamin-C, see

Although you seem to miss this distinction, "vitamins" are a fairly diverse group of compounds. Nucleophilic (talk) 23:58, 19 January 2012 (UTC)[reply]

"Pharmacologic doses of ascorbate act as a prooxidant and decrease growth of aggressive tumor xenografts in mice" At: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2516281/?tool=pubmed PNAS is one of the "Big Three" scientific journals.Nucleophilic (talk) 14:33, 20 January 2012 (UTC)[reply]

Changes of Terminal Cancer Patients' Health-related Quality of Life after High Dose Vitamin C Administration full text at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2693571/?tool=pubmed.

"In functional scale, the patients reported significantly higher scores for physical, role, emotional, and cognitive function after administration of vitamin C (p<0.05). In symptom scale, the patients reported significantly lower scores for fatigue, nausea/vomiting, pain, and appetite loss after administration of vitamin C (p<0.005)." Nucleophilic (talk) 14:44, 20 January 2012 (UTC)[reply]

Gupta SC, Hevia D, Patchva S, Park B, Koh W, Aggarwal BB., Upsides and Downsides of Reactive Oxygen Species for Cancer: The Roles of Reactive Oxygen Species in Tumorigenesis, Prevention, and Therapy. Antioxid Redox Signal. 2012 Jan 16. http://www.ncbi.nlm.nih.gov/pubmed/22117137 "Interestingly, ROS have also been implicated in the chemopreventive and anti-tumor action of nutraceuticals derived from fruits, vegetables, spices, and other natural products used in traditional medicine...." Nucleophilic (talk) 05:28, 22 January 2012 (UTC)[reply]

Díaz B, Courtneidge SA. Redox signaling at invasive microdomains in cancer cells. Free Radic Biol Med. 2012 Jan 15;52(2):247-56. http://www.ncbi.nlm.nih.gov/pubmed/22033009 "...In a similar fashion, redox signal specificity during cancer cell invasion can be regulated by targeting reactive oxygen generation to invasive microdomains such as invadopodia..." Nucleophilic (talk) 05:47, 22 January 2012 (UTC)[reply]

Niacin is not standard care, it is a single option that has the possiblity of a permanent adverse effect - complete loss of smell.

Vitamin C is not a standard of care in cancer, and primary source studies in mice can not be used on wikipedia to say anything about treatments in humans. Quality of life changes in humans, again in primary sources, doesn't mean vitamin C is a chemotherapeutic agent. Also useless is asking people at a conference if they use vitamin C to treat cancer.

Final comment - researchers can be right about specific things, and wrong about others. Linus Pauling was correct about his theories on the nature of chemical bonds. To date it looks like he was wrong about vitamin C preventing or treating cold or cancer. Hoffer being right about niacin reducing blood lipids does not mean he was right about treating schizophrenia through vitamins. WLU (t) (c) Wikipedia's rules:^simple/_complex 15:35, 29 February 2012 (UTC)[reply]

This – “Niacin…has the possiblity of a permanent adverse effect - complete loss of smell.” – is preposterous. That’s your big comeback for niacin not being the standard of care? Citation please?

Re: He was proven right recently

There have been breakthrough studies published in medical journals done that prove that Dr. Abram Hoffer's works are valid. Watch these videos of newscasts which prove the efficacy of his studies.

You need to update this wikipedia site because it works for bipolar, depression, and in my case - schizophrenia.

Orthomolecular Medicine - supplementation at high dosages works to eliminate symptoms of mental illness.

He was right and anyone who says otherwise - namely the Quakery site - is committing a great injustice. — Preceding unsigned comment added by 99.245.222.181 (talk) 18:27, 25 January 2012 (UTC)[reply]

Youtube is not a reliable source, unless there is a review article published in a peer reviewed journal to substantiate these claims, the page shouldn't change. WLU (t) (c) Wikipedia's rules:^simple/_complex 15:29, 29 February 2012 (UTC)[reply]

Cause of Hoffer's death

What did he die from?Fletcherbrian (talk) 02:24, 6 October 2014 (UTC)[reply]

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I was wondering whether the following source would suffice as a secondary source:

^[1]

References

^ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3929699/

[1] ttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3929699/

[1]