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Relation to mainstream medicine

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Essentially all orthomolecular researchers have PhDs or MDs in the medical field. Most of them have published in mainstream academic journals. However, after the broad claims of niacin treating schizophrenia and vitamin C treating cancer were not substantiated by randomized controlled trials, some of them were shunned from the academic community. The researchers often claim that their approach will be adopted by mainstream medicine.[1] Some recent medical research suggests that the importance of nutrients are underestimated. Bruce Ames has called Linus Pauling and Roger Williams pioneers in "biochemical nutrition".[2] Some have suggested that medicine's hostile, reactionary attitude toward nutrients is not based purely on science, and that now, partly due to Pauling's work, the use of vitamins past their minimum amounts is a respectable hypothesis.[3]

Methodology

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Orthomolecular medicine claims to rely on evidence. Dr. Abram Hoffer claims that he conducted some of the first double-blind tests in psychiatry. However, Hoffer criticizes double-blind studies, claiming that the sample sizes are rarely large enough, the trials don't last long enough, and that the placebo effect is an important factor in treatment.[4]

Micronutrient perspectives

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Orthomolecular medicine revolves around micronutrients, and they believe that with the proper balance of these, many diseases can be treated and sometimes even cured. Nutrients are often prescribed in combinations, although certain nutrients are believed to have certain definite effects on the body (e.g. niacin and schizophrenia, vitamin C and cancer).

Vitamin C

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Main articles: Vitamin C megadosage and Vitamin C

Orthomolecular practitioners have endorsed vitamin C as a treatment for polio, colds, cancer, and other illnesses, as well as a supplement for treating schizophrenia. These endorsements, based mainly on observational studies, case reports, and hypotheses that are based on the results of other's in vitro experiments, and have proven controversial. Randomized trials focused on vitamin C's ability to prevent and treat colds and cancer have produced disappointing results, but these studies have all used oral vitamin C when orthomolecular medicine prefers intravenous vitamin C. A comprehensive review of the evidence for vitamin C and the cold detected a minor effect (8% in adults, 14% in children) in preventing the cold, but not treating it, and a substantial effect (50%) in preventing it in extreme environments.[5][6] Recent research has demonstrated that intravenous vitamin C, preferred by orthomolecular medicine, produces blood plasma vitamin C levels up to 70 times higher than oral vitamin C.[7] This research suggests that previous trials using oral vitamin C would not have detected any effects produced by very high concentrations of vitamin C. The idea that such effects might exist is supported by the finding that high levels of vitamin C selectively kill cancer cells in tissue culture.[8] A recent historical study of the past ten years has found three patients whose tumors shrank after receiving intravenous vitamin C along with other alternative and conventional treatments. The authors of the study claimed that the case studies "only significant treatment" for these patients was vitamin C.[9][10] However, this is far from conclusive, and studies are currently planned at the McGill University.[11] [A summary of vitamin C and cancer (PMID 15695476 and PMID 16808775) -- here so I don't have to clutter up my bookmarks anymore.]

Orthomolecular history of vitamin C

Research using vitamin C as a treatment for illness dates back to the 1930s, soon after it was synthesized.[12] During this time Dr. Claus W. Jungeblut published a series of papers in which he observed vitamin C, infused intracerebrally, mitigating the effects of poliomyelitis.[13][14] Subsequently McCormick and Klenner began using vitamin C, preferably intravenously. Both reported success in treating a wide variety of illnesses. McCormick theorized that vitamin C could play a role in cancer and heart disease. Irwin Stone postulated, based on the fact that most animals synthesize large amounts of vitamin C, that humans genetically suffer from hypoascorbemia. This conclusion seems to be accepted by many orthomolecular practitioners today.[15]

In 1971 Linus Pauling published Vitamin C and the Common Cold,[16] followed by a paper reviewing the evidence for vitamin C and the cold.[17] Subsequently, Pauling began to research vitamin C's effect on cancer with oncologist Ewan Cameron, and the two published several papers, the most significant of which was a trial of 100 cancer patients treated intravenously with 10/g of ascorbate for 10 days and then orally thereafter.[18] This trial was restudied based on some concerns raised over the first, with similar, and actually more significant, results.[19] In 1979 Cameron and Pauling published Cancer and vitamin C, a collection of their papers. In response to their work the Mayo Clinic conducted two randomized controlled trials on vitamin C and cancer, which were published in The New England Journal of Medicine.[20] Neither used intravenous vitamin C. Pauling attempted to publish a rebuttal in the New England Journal of Medicine, but it was rejected.[21] Instead, Pauling published his response in Chemistry in Britain.[22]

In 1991 an article entitled "Vitamin C gets a little respect" appeared in Science magazine.[23] In 1996, the author of his obituary remarked that "the connection between vitamin C and cancer has became a respectable topic", noting that a 1990 NIH conference in Washington DC was focused on it.[24] As noted above, research in vitamin C is continuing, but new trials testing intravenous vitamin C have not yet occurred.

Niacin

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Main article: Niacin

Orthomolecular practitioners endorse niacin (either nicotinic acid or nicotinamide) as a treatment for schizophrenin. Dr. Abram Hoffer has reported success in alleviating the symptoms of psychiatric patients by maintaining them on multi-gram doses of niacin. Hoffer believes that some people are niacin dependent, and has reported that their symptoms return when they are taken off niacin.[25] Other researchers have observed similar results.[26]

Vitamin E

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Vitamin E has been mainly used to treat heart disease, a practice pioneered by the Shute brothers. Intravenous vitamin E has reportedly helped to heal diabetic lesions.[27]

Zinc

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An early paper focused on zinc's importance in the hippocampus.[28]

Conditions

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This section describes what combinations of nutrients may be used to treat specific diseases.

Childhood disorders

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Disorders such as autism, learning delays, and other developmental problems are often discussed in orthomolecular research. Practitioners have advocated using B5 for children facing learning disabilities and possibly brain retardation. Early papers in the Journal of Orthomolecular Medicine comment on celiac disease, which is now beginning to be recognized as underdiagnosed.[29] Others have suggested that autism could be caused by nutritional deficiencies and problems.[30][31] A set of vitamins has reportedly improved conditions for Down's Syndrome patients.[32]

Psychology

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Main article: Orthomolecular psychiatry

Orthomolecular medicine recognized over thirty years ago that tryptophan could enhance mood and alleviate psychological insability.[33] In 2006 a paper confirmed this effect.[34] Food allergies have also been implicated in mental illness.[35]

Micronutrient deficiency

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The idea that nutrient deficiency is rare has been called a common myth by orthomolecular medicine, based on the US governments studies of nutrition.[36] USDA surveys, as well as the US National Health and Nutrition Examination Survey, have shown that much of the US population is deficient in vitamins and minerals. Orthomolecular medicine attributes major diseases to these deficiencies, but go beyond that in stating that, because of biochemical individuality, some people are extremely deficient. Roger Williams has called for an effort to help people achieve "supernutrition" rather than mediocre, or adequate, nutrition.[37] Low serum B12 levels have been observed in psychiatric patients.[38]

Toxicity

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Concerns have been raised about potentially toxic effects of high dosages of vitamins. However, deaths from vitamin overdose are rare to the point of nonexistence. Water-soluble vitamins, which are the focus of orthomolecular medicine, are quickly flushed out of the system. Megadosing of fat-soluble vitamins is not generally recommended. Trace minerals can be more toxic, but orthomolecular medicine does not seem to advocate mineral megadosing. Orthomolecular medicine has noted concerns about issues of copper in Wilson's disease and manganese in Parkinson's disease.[39]

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Orthomolecular medicine also targets environmental health and food allergy issues which have an impact on the body's ability to function. Issues include lead toxicity,[40] which is sometimes tested through hair analysis,Cite error: A <ref> tag is missing the closing </ref> (see the help page).

References

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  1. ^ Williams, Roger J. Research Leading to the Acceptance of the Orthomolecular Approach
  2. ^ High-dose vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity (increased Km): relevance to genetic disease and polymorphisms
  3. ^ Attitudes About Micronutrient Supplements in American Academic Medicine
  4. ^ [http://orthomolecular.org/library/jom/1973/pdf/1973-v02n03-p107.pdf An Examination of the Double-Blind Method as It Has Been Applied to Megavitamin Therapy
  5. ^ Douglas RM, Hemilä H, Chalker E, Treacy B (2004) Vitamin C for preventing and treating the common cold.
  6. ^ Douglas RM, Hemilä H (2005) Vitamin C for Preventing and Treating the Common Cold. PLoS Med 2(6): e168 doi:10.1371/journal.pmed.0020168.
  7. ^ Annals of Internal Medicine. [Vitamin C Pharmacokinetics: Implications for Oral and Intravenous Use http://www.annals.org/cgi/content/full/140/7/533]
  8. ^ Chen Q, Espey MG, Krishna MC; et al. (September 2005). "Pharmacologic ascorbic acid concentrations selectively kill cancer cells: action as a pro-drug to deliver hydrogen peroxide to tissues". Proc. Natl. Acad. Sci. U.S.A. 102 (38): 13604–9. doi:10.1073/pnas.0506390102. PMC 1224653. PMID 16157892. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link)
  9. ^ Padayatty SJ, Riordan HD, Hewitt SM, Katz A, Hoffer LJ, Levine M (March 2006). "Intravenously administered vitamin C as cancer therapy: three cases". CMAJ. 174 (7): 937–42. doi:10.1503/cmaj.050346. PMC 1405876. PMID 16567755.{{cite journal}}: CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link)
  10. ^ Assouline S, Miller WH (March 2006). "High-dose vitamin C therapy: renewed hope or false promise?". CMAJ. 174 (7): 956–7. doi:10.1503/cmaj.060228. PMC 1405871. PMID 16567756.{{cite journal}}: CS1 maint: date and year (link)
  11. ^ Research backs theory that vitamin C shrinks tumours. The Independent, 28 March 2006
  12. ^ List of vitamin C studies beginning in 1935
  13. ^ Jungeblut, C.W. (1939). "A Further Contribution To Vitamin C Therapy In Experimental Poliomyelitis". Journal of Experimental Medicine. 70 (3): 315–332. doi:10.1084/jem.70.3.31 (inactive 2023-08-02).{{cite journal}}: CS1 maint: DOI inactive as of August 2023 (link)
  14. ^ List of Jungeblut's vitamin C papers
  15. ^ Klenner, FR. [1971] (1998) Observations On the Dose and Administration of Ascorbic Acid When Employed Beyond the Range of a Vitamin in Human Pathology. Reprinted in the Journal of Orthomolecular Medicine 13(4). Original paper published in 1971 Journal of Applied Nutrition
  16. ^ Google Books entry
  17. ^ Pauling L. (1971) The Significance of the Evidence about Ascorbic Acid and the Common Cold. PNAS.
  18. ^ Cameron E, Pauling L (1976) Supplemental Ascorbate in the Supportive Treatment of Cancer: Prolongation of Survival Times in Terminal Human Cancer
  19. ^ Cameron E, Pauling L (1978) Supplemental Ascorbate in the Supportive Treatment of Cancer: Reevaluation of Prolongation of Survival Times in Terminal Human Cancer
  20. ^ 1979 study, 1985 study
  21. ^ Hoffer, A. (1994) In Memoriam - Linus Pauling Journal of Othomolecular Medicine.
  22. ^ Pauling's bibliography
  23. ^ Barinaga, M. (1991). "Vitamin C gets a little respect". Science. 254 (5030): 374–376. doi:10.1126/science.1925592. PMID 1925592.
  24. ^ Dunitz, J.D. (1996). "Linus Carl Pauling". Biogr Mem Fellows R Soc. 42: 317–38, see page 334.
  25. ^ [http://orthomolecular.org/library/jom/1971/pdf/1971-v03n01-p041.pdf A Vitamin B3 Dependent Family
  26. ^ The Use of Mega Vitamin Therapy in Regulating Severe Behavior Disorders Drug Abuses and Frank Psychosis
  27. ^ Administration of Massive Doses of Vitamin E to Schizophrenic Patients
  28. ^ Zinc and Hippocampal Function
  29. ^ Orthomolecular Approach to Learning Disabilities
  30. ^ The Challenging Frontier-Part II:Current Research in the Field of Severe Childhood Mental Illness
  31. ^ [http://orthomolecular.org/library/jom/1972/pdf/1972-v01n02&03-p159.pdf Evidence for a Biological Basis of Infantile Autism]
  32. ^ Henry Turkel, B.A., M.A. (D.Sc.), M.D. Medical Amelioration of Down's Syndrome Incorporating the Orthomolecular Approach
  33. ^ [http://orthomolecular.org/library/jom/1972/pdf/1972-v01n02&03-p113.pdf The Relationship of Changes in Daily Tryptophane Consumption to Changes in Psychologic State]
  34. ^ Social behaviour and mood in everyday life: the effects of tryptophan in quarrelsome individuals
  35. ^ Psychiatric Syndromes Produced by Allergies: Ecologic Mental Illness
  36. ^ Orthomolecular.org Myths
  37. ^ [http://orthomolecular.org/library/jom/1972/pdf/1972-v01n02&03-p098.pdf "Supernutrition" as a Strategy for the Control of Disease]
  38. ^ The Use of Vitamin B12b in Psychiatric Practice
  39. ^ Keynote Speech - Frontiers in Trace Element Research
  40. ^ Subclinical Lead Toxicity
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