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{{short description|Form of alternative medicine}}
{{POV|date=April 2008}}
{{cs1 config|name-list-style=vanc}}
'''Megavitamin therapy''' is the use of large amounts of ]s, often many times greater than the ] (RDA) in the attempt to prevent or treat many types of ]s.
{{Infobox pseudoscience
|image =
|image_width =
|caption =
|claims = Health effects from very high doses of vitamins.
|topics = ]s, ]s
|origyear = 1930s
|origprop =
|currentprop =
|notableprop = Frederick Klenner, ]
}}
{{Alternative medicine sidebar |fringe}}
⚫ '''Megavitamin therapy''' is the use of large doses of ]s, often many times greater than the ] (RDA) in the attempt to prevent or treat ]s. Megavitamin therapy is typically used in ] by practitioners who call their approach ].<ref>{{cite journal |vauthors=Zell M, Grundmann O |title=An orthomolecular approach to the prevention and treatment of psychiatric disorders |journal=Adv Mind Body Med |volume=26 |issue=2 |pages=14–28 |date=2012 |pmid=23341413 }}</ref> Vitamins are useful in preventing and treating illnesses specifically associated with dietary vitamin shortfalls, but the conclusions of medical research are that the broad claims of disease treatment by advocates of megavitamin therapy are unsubstantiated by the available evidence.<ref name="isbn1-55009-213-8">{{cite book |vauthors=Aaronson S, etal |title=Cancer medicine 6 (Frei, Emil; Kufe, Donald W.; Holland, James F., eds) |publisher=BC Decker |location=Hamilton, Ont |year=2003 |pages= |isbn=978-1-55009-213-4 |chapter=Cancer medicine |chapter-url=https://archive.org/details/cancermedicine60002unse/page/76 }}</ref><ref name=References1990>{{cite journal |author1=Nutrition Committee |author2=Canadian Paediatric Society | date=1990| title = Megavitamin and megamineral therapy in childhood. Nutrition Committee, Canadian Paediatric Society | journal = CMAJ | volume = 143 | issue = 10 | pages = 1009–1013 | pmid = 1699646 | pmc = 1452516 }}</ref> It is generally accepted that doses of any vitamin greatly in excess of nutritional requirements will result either in toxicity (vitamins A and D) or in the excess simply being metabolised; thus evidence in favour of vitamin supplementation supports only doses in the normal range.<ref>{{cite web | url=http://healthyeating.sfgate.com/body-excess-vitamin-b-c-might-consume-3056.html | title=What Does Your Body do to Excess Vitamin B or C That You Might Consume?| date=16 June 2012}}</ref><ref>{{cite web | url=http://www.webmd.com/vitamins-and-supplements/nutrition-vitamins-11/fat-water-nutrient | title=Vitamins & Supplements Center – Nutritional, Herbal, Dietary, and More - WebMD}}</ref><ref>Novella, S: ''Medical Myths, Lies, and Half-Truths: What We Think We Know May Be Hurting Us'', ]</ref> Critics have described some aspects of orthomolecular medicine as ] or even ].<ref name="autogenerated3">{{cite journal |author=Jarvis WT |title=Food faddism, cultism, and quackery |journal=Annu. Rev. Nutr. |volume=3 |pages=35–52 |year=1983 |pmid=6315036 |doi=10.1146/annurev.nu.03.070183.000343}}</ref><ref name=Jukes1990>{{cite journal |author = Jukes TH | year =1990 | title = Nutrition Science from Vitamins to Molecular Biology | journal = Annual Review of Nutrition | pmid = 2200458 | volume = 10 | issue = 1 | pages = 1–20 | doi = 10.1146/annurev.nu.10.070190.000245| doi-access = free }} A short summary is in .</ref><ref name="autogenerated2">{{cite journal | author = Braganza, S.F. |author2=Ozuah, P.O. | year = 2005 | title = Fad Therapies | journal = Pediatrics in Review | volume = 26 | issue = 10 | pages = 371–376 | doi = 10.1542/pir.26-10-371 | pmid = 16199591}}</ref> Research on nutrient supplementation in general suggests that some nutritional supplements might be beneficial, and that others might be harmful;<ref>{{cite journal |title=NIH State-of-the-Science Conference Statement on Multivitamin/Mineral Supplements and Chronic Disease Prevention |journal=NIH Consens State Sci Statements |volume=23 |issue=2 |pages=1–30 |year=2006 |pmid=17332802 |url=http://consensus.nih.gov/2006/2006MultivitaminMineralSOS028main.htm |access-date=2009-02-18 |archive-date=2009-02-21 |archive-url=https://web.archive.org/web/20090221024345/http://consensus.nih.gov/2006/2006MultivitaminMineralSOS028main.htm |url-status=dead }}</ref><ref>{{cite journal |vauthors=Huang HY, Caballero B, Chang S, etal |title=The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults: a systematic review for a National Institutes of Health state-of-the-science conference |journal=Ann. Intern. Med. |volume=145 |issue=5 |pages=372–385 |date=2006 |pmid=16880453 |url=http://www.annals.org/cgi/pmidlookup?view=reprint&pmid=16880453 |doi=10.1001/archinte.145.2.372}}</ref><ref>{{cite journal |vauthors=Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C |title=Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases |journal=Cochrane Database Syst Rev |volume=2012 |issue= 3|pages=CD007176 |year=2012 |pmid=22419320 |doi=10.1002/14651858.CD007176.pub2|pmc=8407395 |hdl=10138/136201 |hdl-access=free }}</ref> several specific nutritional therapies are associated with an increased likelihood of the condition they are meant to prevent.<ref name="AmJEpidem2009">{{cite journal |vauthors=Satia JA, Littman A, Slatore CG, Galanko JA, White E |year = 2009 |title = Long-term Use of {beta}-Carotene, Retinol, Lycopene, and Lutein Supplements and Lung Cancer Risk: Results From the VITamins And Lifestyle (VITAL) Study | journal = American Journal of Epidemiology | volume = 169| issue = 7| pages = 815–828| doi = 10.1093/aje/kwn409 | pmid = 19208726 | pmc=2842198}}</ref>


== Multivitamin vs megavitamin ==
Frequently used in ] and ], megavitamin therapists also may employ nutrients{{Fact|date=May 2008}} such as ], ], ], ], natural ], ] ] ] or short chain ].
Megavitamin therapy must be distinguished from the usual "vitamin supplementation" approach of traditional multivitamin pills. Megavitamin doses are far higher than the levels of vitamins ordinarily available through western diets. A study of 161,000 individuals (post-menopausal women) provided, in the words of the authors, "convincing evidence that multivitamin use has little or no influence on the risk of common cancers, cardiovascular disease, or total mortality in postmenopausal women".<ref name="WHI">{{cite journal |vauthors=Neuhouser ML, Wassertheil-Smoller S, Thomson C, etal |title=Multivitamin use and risk of cancer and cardiovascular disease in the Women's Health Initiative cohorts |journal=Arch. Intern. Med. |volume=169 |issue=3 |pages=294–304 |date=2009 |pmid=19204221 |doi=10.1001/archinternmed.2008.540 |pmc=3868488 }}</ref>

⚫ Nutrients may be useful in preventing and treating some illnesses,<ref name = ACS>{{cite web | url = http://www.cancer.org/docroot/ETO/content/ETO_5_3X_Orthomolecular_Medicine.asp?sitearea=ETO | title = ACS : Orthomolecular Medicine | accessdate = 2008-04-04 | format = | work = | publisher = ] | date = 2007-06-19}}</ref><ref>Lakhan SE, Vieira KF (2008) . Nutr J 7: 2. doi:10.1186/1475-2891-7-2 PMID 18208598</ref> but the conclusions of medical research are that the broad claims of disease treatment by advocates of orthomolecular medicine or megavitamin therapy are unsubstantiated by the available evidence.<ref>Stuart Aaronson ''et al.'' , 2003, ''BC Decker Inc'' ISBN 1–55009–213–8, Section 20, p76</ref><ref name=References1990>{{cite journal | author = Nutrition Committee, Canadian Paediatric Society | year = 1990 | title = Megavitamin and megamineral therapy in childhood | journal = CMAJ | volume = 143 | issue = 10 | pages = 1009–1013 | url = http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1452516 | accessdate = 2008-04-04 | pmid = 1699646}}</ref><ref name=ACS/> The ] stated in 1997 that "much of the dietary intervention stressed by alternative healers is prudent and reasonable", but described as a "myth" the idea that "most diseases are caused by faulty diets and can be prevented by nutritional interventions".<ref name=AMA> ''American Medical Association'' June 1997, Accessed 21 March 2008</ref> Critics have described some aspects of orthomolecular medicine as ] or even ].<ref name="autogenerated3">{{cite journal |author=Jarvis WT |title=Food faddism, cultism, and quackery |journal=Annu. Rev. Nutr. |volume=3 |pages=35–52 |year=1983 |pmid=6315036 |doi=10.1146/annurev.nu.03.070183.000343}}</ref><ref name=Jukes1990>{{cite journal | author = Jukes, T.H. | year = 1990 | title = Nutrition Science from Vitamins to Molecular Biology | journal = Annual Review of Nutrition | volume = 10 | issue = 1 | pages = 1–20 | doi = 10.1146/annurev.nu.10.070190.000245}} A short summary is in .</ref><ref name="autogenerated2">{{cite journal | author = Braganza, S.F. | coauthors = Ozuah, P.O. | year = 2005 | title = Fad Therapies | journal = Pediatrics in Review | volume = 26 | issue = 10 | pages = 371–376 | doi = 10.1542/pir.26-10-371 | pmid = 16199591}}</ref> Research on nutrient supplementation in general suggests that some nutritional supplements might be beneficial, and that others might be harmful;<ref>{{cite journal |title=NIH State-of-the-Science Conference Statement on Multivitamin/Mineral Supplements and Chronic Disease Prevention |journal=NIH Consens State Sci Statements |volume=23 |issue=2 |pages=1–30 |year=2006 |pmid=17332802 |url=http://consensus.nih.gov/2006/2006MultivitaminMineralSOS028main.htm}}</ref><ref>{{cite journal |author=Huang HY, Caballero B, Chang S, ''et al'' |title=The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults: a systematic review for a National Institutes of Health state-of-the-science conference |journal=Ann. Intern. Med. |volume=145 |issue=5 |pages=372–85 |year=2006 |month=September |pmid=16880453 |url=http://www.annals.org/cgi/pmidlookup?view=reprint&pmid=16880453 |doi=10.1001/archinte.145.2.372}}</ref><ref name="Cochrane2008">{{cite journal |author=Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C |title=Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases |journal=Cochrane Database of Systematic Reviews |issue=2 |pages=CD007176 |year=2008 |doi=10.1002/14651858.CD007176}}</ref> several specific nutritional therapies are associated with an increased likelihood of the condition they are meant to prevent.<ref name="AmJEpidem2009">{{cite journal | authors = Satia JA, Littman A, Slatore CG, Galanko JA, White E | year = 2009 | title = Long-term Use of {beta}-Carotene, Retinol, Lycopene, and Lutein Supplements and Lung Cancer Risk: Results From the VITamins And Lifestyle (VITAL) Study | journal = American Journal of Epidemiology | volume = | issue = | pages = | doi = 10.1093/aje/kwn409 | pmid = }}</ref> A recent study analyzing over 161,000 individuals (post-menopausal women) provided, in the words of the authors, "convincing evidence that multivitamin use has little or no influence on the risk of common cancers, cardiovascular disease, or total mortality in postmenopausal women".<ref name="WHI">{{cite journal |author=Neuhouser ML, Wassertheil-Smoller S, Thomson C, ''et al'' |title=Multivitamin use and risk of cancer and cardiovascular disease in the Women's Health Initiative cohorts |journal=Arch. Intern. Med. |volume=169 |issue=3 |pages=294–304 |year=2009 |month=February |pmid=19204221 |doi=10.1001/archinternmed.2008.540 |url=}}</ref>


==History== ==History==
In the 1930s and 1940s, some scientific and clinical evidence suggested that there might be beneficial uses of vitamins ], ] and ] in large doses. Beginning in the 1930s, the Shutes in Canada developed a megadose vitamin E therapy for cardiovascular and circulatory complaints, naming it the "Shute protocol".<ref name="pmid18911314">{{cite journal |author=VOGELSANG A, SHUTE E, SHUTE W |title=Some medical uses of vitamin E |journal=Med World (New York) |volume=161 |issue=2 |pages=83–9 |year=1948 |month=February |pmid=18911314 |doi= |url=}}</ref> Tentative experiments in the 1930s<ref>{{cite journal|last=Jungeblut|first=CW|date=1937|title=VITAMIN C THERAPY AND PROPHYLAXIS IN EXPERIMENTAL POLIOMYELITIS |journal=The Journal of Experimental Medicine|volume=65|pages=127-146|url=http://jem.rupress.org/cgi/content/abstract/65/1/127}}</ref> with larger doses of vitamin C were superseded by ]'s development of ] intravenous vitamin C treatments in the 1940s.<ref name="pmid18147027">{{cite journal |author=KLENNER FR |title=The treatment of poliomyelitis and other virus diseases with vitamin C |journal=South Med Surg |volume=111 |issue=7 |pages=209–14 |year=1949 |month=July |pmid=18147027 |doi= |url=}}</ref> William Kaufman, MD, PhD, published articles in the 1940s that detailed his treatment of arthritis with frequent, high doses of niacinamide.<ref name="pmid13060032">{{cite journal |author=KAUFMAN W |title=Niacinamide therapy for joint mobility; therapeutic reversal of a common clinical manifestation of the normal aging process |journal=Conn State Med J |volume=17 |issue=7 |pages=584–9 |year=1953 |month=July |pmid=13060032 |doi= |url=}}</ref> In the 1930s and 1940s, some scientific and clinical evidence suggested that there might be beneficial uses of vitamins C, E, and niacin in large doses. Beginning in the 1930s in ], a megadose vitamin E therapy for cardiovascular and circulatory complaints was developed by ] and colleagues, named the "Shute protocol".<ref name="pmid18911314">{{cite journal |vauthors=Vogelsang A, Shute E, Shute W |title=Some medical uses of vitamin E |journal=Med World (New York) |volume=161 |issue=2 |pages=83–89 |date=1948 |pmid=18911314 }}</ref> Tentative experiments in the 1930s by ]<ref>{{cite journal |last=Jungeblut |first=CW |year=1937 |title=Vitamin C Therapy and Prophylaxis in Experimental Poliomyelitis |journal=The Journal of Experimental Medicine |volume=65 |pages=127–146 |doi=10.1084/jem.65.1.127 |pmid=19870585 |issue=1 |pmc=2133474}}</ref> with larger doses of vitamin C led to Frederick Klenner's development of ] intravenous vitamin C treatments for polio and other viruses in the 1940s.<ref name="pmid18147027">{{cite journal|author=Klenner, Fred R. |title=The treatment of poliomyelitis and other virus diseases with vitamin C |journal=Southern Medicine & Surgery |volume=111 |issue=7 |pages=209–214 |date=1949 |pmid=18147027 }}</ref> William Kaufman published articles in the 1940s that detailed his treatment of arthritis with frequent, high doses of niacinamide.<ref name="pmid13060032">{{cite journal |author=KAUFMAN W |title=Niacinamide therapy for joint mobility; therapeutic reversal of a common clinical manifestation of the normal aging process |journal=Conn State Med J |volume=17 |issue=7 |pages=584–9 |date=July 1953 |pmid=13060032}}</ref> Rudolf Altschul and ] applied large doses of the immediate release form of ] (Vitamin B<sub>3</sub>) to treat ].<ref>{{cite journal |vauthors=Altschul R, Hoffer A, Stephen JD |title=Influence of nicotinic acid on serum cholesterol in man |journal=Arch. Biochem. Biophys. |volume=54 |issue=2 |pages=558–559 |date=1955 |pmid=14350806 |doi= 10.1016/0003-9861(55)90070-9}}</ref><ref name="pmid13792994">{{cite journal |vauthors=Altschul R, Hoffer A |title=The Effect of Nicotinic Acid on Hypercholesterolæmia |journal=Can Med Assoc J |volume=82 |issue= 15|pages=783–785 |date=1960 |pmid=13792994 |pmc=1938010}}</ref> In a 1956 publication entitled ''Biochemical Individuality'', ] introduced concepts for individualized megavitamins and nutrients.<ref name="isbn0-87983-893-0">{{cite book |author=Williams, Roger Lawrence |title=Biochemical Individuality |publisher=McGraw-Hill |location=New York |year=1998 |isbn=978-0-87983-893-5 }}</ref> Megavitamin therapies were also publicly advocated by ] in the late 1960s.<ref name="isbn0-399-50764-7">{{cite book |author=Stone, Irwin |title=The healing factor: "vitamin C" against disease |publisher=Perigee Books |location=New York |year=1982 |isbn=978-0-399-50764-9}}</ref>


⚫ ==Usage as therapy==
In 1954, Professor ] and ], MD, PhD, applied large doses of the immediate release form of ] (Vitamin B-3) to treat ] (high cholesterol).<ref name="pmid13792994">{{cite journal |author=ALTSCHUL R, HOFFER A |title=The effect of nicotinic acid on hypercholesterolaemia |journal=Can Med Assoc J |volume=82 |issue= |pages=783–5 |year=1960 |month=April |pmid=13792994 |pmc=1938010 |doi= |url=}}</ref> The 1956 publication of ] <i>Biochemical Individuality<i> introduced concepts for individualized megavitamins and nutrients.<ref name="isbn0-87983-893-0">{{cite book |author=Williams, Roger Lawrence |title=Biochemical Individuality |publisher=McGraw-Hill |location=New York |year=1998 |pages= |isbn=0-87983-893-0 |oclc= |doi= |accessdate=}}</ref> In the 1960s, biochemist ], author of ''The Healing Factor'', observed that vitamin C's utility in the megadose treatments of human disease parallels the amounts of ] physiologically produced in most animals and postulated humans' evolutionary loss of this capability. Megavitamin therapies were also publicly advocated by ] in the late 1960s.<ref name="isbn0-399-50764-7">{{cite book |author=Stone, Irwin |title=The healing factor: "vitamin C" against disease |publisher=Perigee Books |location=New York |year=1982 |pages= |isbn=0-399-50764-7 |oclc= |doi= |accessdate=}}</ref>
⚫ Although megavitamin therapies still largely remain outside of the structure of ], they are increasingly used by patients, with or without the approval of their treating physicians, often after recommendations by practitioners of orthomolecular and ].<ref name="pmid10893280">{{cite journal |vauthors=Richardson MA, Sanders T, ], Greisinger A, Singletary SE |title=Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology |journal=J. Clin. Oncol. |volume=18 |issue=13 |pages=2505–2514 |date=2000 |pmid=10893280 |doi= 10.1200/JCO.2000.18.13.2505}}</ref> The proposed efficacy of various megavitamin therapies to reduce cancer risk has been contradicted by results of one clinical trial.<ref name="pmid19116389">{{cite journal |vauthors=Lin J, Cook NR, Albert C, et al |title=Vitamins C and E and Beta Carotene Supplementation and Cancer Risk: A Randomized Controlled Trial |journal=J. Natl. Cancer Inst. |volume=101 |issue=1 |pages=14–23 |date=2009 |pmid=19116389 |doi=10.1093/jnci/djn438 |pmc=2615459}}</ref>


===Vitamin C===
Several orthomolecular megavitamin protocols have been publicized.<ref name="urlCancer Survival - Cancer Help">{{cite web |url=http://www.cancersurvival.com/help_pauling.html |title=Cancer Survival - Cancer Help |format= |work= |accessdate=2009-02-18}}</ref> While formal medical recognition of niacin therapy for hypercholesterolemia followed confirmation by William Parsons of the Mayo Clinic (1956) and the Canner study (1986), the success of several popular books since the 1980s has made the public more aware of niacin's role, in combination with other medications, for ]s (abnormal ] levels in the blood).<ref name="pmid18973399">{{cite journal |author=Sanford M, Curran MP |title=Niacin extended-release/simvastatin |journal=Drugs |volume=68 |issue=16 |pages=2373–86 |year=2008 |pmid=18973399 |doi= |url=}}</ref> Pauling's advocacy of megadoses of vitamin C for colds, beginning in the 1960s, and later for cancer, made millions aware of the concept of megavitamin treatment in disease. Pauling's vitamin C recommendations are lower than some modern recommendations.
⚫ {{Main|Vitamin C megadosage}}
The US ] for ] for adult women is 76&nbsp;mg/day and for adult men 90&nbsp;mg/day. Although ] was known for highly respectable research in chemistry and biochemistry, he was also known for promoting the consumption of vitamin C in large doses.<ref>{{cite journal | vauthors = Cameron E, Pauling L | title = Supplemental ascorbate in the supportive treatment of cancer: Prolongation of survival times in terminal human cancer | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 73 | issue = 10 | pages = 3685–9 | date = October 1976 | pmid = 1068480 | pmc = 431183 | doi = 10.1073/pnas.73.10.3685| bibcode = 1976PNAS...73.3685C | doi-access = free }}</ref> Although he claimed and stood firm in his claim that consuming over 1,000&nbsp;mg is helpful for one’s immune system when fighting a head cold, the results of empirical research do not align with this view. A meta-analysis concluded that supplementary vitamin C significantly lowered serum ], considered a risk factor for ].<ref>{{cite journal |vauthors=Juraschek SP, Miller ER, Gelber AC |title=Effect of oral vitamin C supplementation on serum uric acid: a meta-analysis of randomized controlled trials |journal=Arthritis Care & Research |volume=63 |issue=9 |pages=1295–306 |date=September 2011 |pmid=21671418 |pmc=3169708 |doi=10.1002/acr.20519 }}</ref> One population study reported an inverse correlation between dietary vitamin C and risk of gout.<ref>{{cite journal |last=Choi |first=Hyon K. |author2=Xiang Gao |author3=Gary Curhan |date=2009|title=Vitamin C Intake and the Risk of Gout in Men – A Prospective Study|journal=Archives of Internal Medicine |volume= 169 |issue= 5|pages=502–507|doi=10.1001/archinternmed.2008.606|pmid=19273781|pmc=2767211}}</ref> A review of clinical trials in the treatment of colds with small and large doses of Vitamin C has established that there is no evidence that it decreases the incidence of ]s.<ref>{{cite journal|last1=Hemilä|first1=Harri|last2=Chalker|first2=Elizabeth|date=2013-01-31|title=Vitamin C for preventing and treating the common cold|journal=The Cochrane Database of Systematic Reviews|volume=2013|issue=1|pages=CD000980|doi=10.1002/14651858.CD000980.pub4|issn=1469-493X|pmid=23440782|pmc=1160577}}</ref> After 33 years of research, it is still not established whether vitamin C can be used as a treatment for cancer.<ref>{{cite journal | last1 = Cabanillas | first1 = F | title = Vitamin C and cancer: what can we conclude--1,609 patients and 33 years later? | journal = Puerto Rico Health Sciences Journal |volume = 29 |issue = 3 |pages = 215–217 |year = 2010 |pmid = 20799507}}</ref>


===Vitamin E===
Other treatments include orthomolecular oral dosing schedules for an early treatment of colds,<ref name="urlThe Vitamin C Foundation - Cold Cure">{{cite web |url=http://www.vitamincfoundation.org/surefire.htm |title=The Vitamin C Foundation - Cold Cure |format= |work= |accessdate=2009-02-18}}</ref> and for bowel tolerance for more established colds.<ref name="pmid7321921">{{cite journal |author=Cathcart RF |title=Vitamin C, titrating to bowel tolerance, anascorbemia, and acute induced scurvy |journal=Med. Hypotheses |volume=7 |issue=11 |pages=1359–76 |year=1981 |month=November |pmid=7321921 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/0306-9877(81)90126-2}}</ref>
The US ] for ] for adult women and men is 15&nbsp;mg/day. The US Food and Nutrition Board set a ] at 1,000&nbsp;mg (1,500 IU) per day derived from animal models that demonstrated bleeding at high doses.<ref name="DRItext">{{cite book | last1 = Institute of Medicine | title = Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids | chapter = Vitamin E | publisher = The National Academies Press | year = 2000 | location = Washington, DC | pages = 186–283 | doi = 10.17226/9810 | pmid = 25077263 | isbn = 978-0-309-06935-9 | chapter-url = https://www.nap.edu/read/9810/chapter/8| author1-link = Institute of Medicine }}</ref> In the US, the popularity for vitamin E as a dietary supplement peaked around 2000, with popular doses of 400, 800 and 1000 IU/day. Declines in usage were attributed to publications of meta-analyses that showed either no benefits or negative consequences from vitamin E supplements.<ref>{{cite journal |vauthors=Kim HJ, Giovannucci E, Rosner B, Willett WC, Cho E |title=Longitudinal and secular trends in dietary supplement use: Nurses' Health Study and Health Professionals Follow-Up Study, 1986-2006 |journal=J Acad Nutr Diet |volume=114 |issue=3 |pages=436–443 |date=2014 |pmid=24119503 |pmc=3944223 |doi=10.1016/j.jand.2013.07.039 }}</ref><ref>{{cite journal|last1=Eidelman |first1=RS|last2=Hollar |first2=D|last3=Hebert |first3=PR|last4=Lamas|first4=GA| last5=Hennekens|first5=CH|title=Randomized trials of vitamin E in the treatment and prevention of cardiovascular disease|journal= Archives of Internal Medicine|date=2004|pmid=15277288| doi=10.1001/archinte.164.14.1552|volume=164|issue=14|pages=1552–56|doi-access=}}</ref><ref name=Abner2011>{{cite journal | vauthors = Abner EL, Schmitt FA, Mendiondo MS, Marcum JL, Kryscio RJ | title = Vitamin E and all-cause mortality: a meta-analysis | journal = Current Aging Science | volume = 4 | issue = 2 | pages = 158–70 | date = July 2011 | pmid = 21235492 | pmc = 4030744 | doi = 10.2174/1874609811104020158 }}</ref><ref name=Curtis2014>{{cite journal |vauthors=Curtis AJ, Bullen M, Piccenna L, McNeil JJ |title=Vitamin E supplementation and mortality in healthy people: a meta-analysis of randomised controlled trials |journal=Cardiovasc Drugs Ther |volume=28 |issue=6 |pages=563–73 |date=December 2014 |pmid=25398301 |doi=10.1007/s10557-014-6560-7 |s2cid=23820017 }}</ref><ref name=Miller2005>{{cite journal | vauthors = Miller ER, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E | title = Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality | journal = Annals of Internal Medicine | volume = 142 | issue = 1 | pages = 37–46 | date = January 2005 | pmid = 15537682 | doi = 10.7326/0003-4819-142-1-200501040-00110 | s2cid = 35030072 }}</ref><ref name=Bjelakovic2014>{{cite journal | vauthors = Bjelakovic G, Nikolova D, Gluud C | title = Meta-regression analyses, meta-analyses, and trial sequential analyses of the effects of supplementation with beta-carotene, vitamin A, and vitamin E singly or in different combinations on all-cause mortality: do we have evidence for lack of harm? |journal = PLOS ONE| volume = 8 |issue = 9 |pages = e74558 |date = 2013 |pmid = 24040282 |pmc = 3765487 | doi = 10.1371/journal.pone.0074558 | bibcode = 2013PLoSO...874558B | doi-access = free }}</ref>


===Niacin===
⚫ ==Usage of therapy==
The US ] for ] for adult women is 14&nbsp;mg/day and for adult men 16&nbsp;mg/day. Niacin is available as a prescription product, either immediate release (500&nbsp;mg tablets; prescribed up to 3,000&nbsp;mg/day) or extended release (500 and 1,000&nbsp;mg tablets; prescribed up to 2,000&nbsp;mg/day). In the US, niacin is also available as a ] at 500 to 1,000&nbsp;mg/tablet. Niacin has sometimes been used in combination with other ]s.<ref name=TabletLabel> Updated March 14, 2013. Page accessed Feb 11, 2016</ref> Systematic reviews found no effect of niacin on ] or death, in spite of raising ] (HDL) cholesterol. Reported side effects include an increased risk of ].<ref name=Kee2014>{{cite journal | vauthors = Keene D, Price C, Shun-Shin MJ, Francis DP | title = Effect on cardiovascular risk of high density lipoprotein targeted drug treatments niacin, fibrates, and CETP inhibitors: meta-analysis of randomised controlled trials including 117,411 patients | journal = BMJ | volume = 349 | pages = g4379 | date = July 2014 | pmid = 25038074 | pmc = 4103514 | doi = 10.1136/bmj.g4379 }}</ref><ref>{{cite journal | vauthors = Schandelmaier S, Briel M, Saccilotto R, Olu KK, Arpagaus A, Hemkens LG, Nordmann AJ | title = Niacin for primary and secondary prevention of cardiovascular events | journal = The Cochrane Database of Systematic Reviews | volume = 2017 | pages = CD009744 | date = June 2017 | issue = 6 | pmid = 28616955 | doi = 10.1002/14651858.CD009744.pub2 | pmc = 6481694 }}</ref><ref>{{cite journal | vauthors = Garg A, Sharma A, Krishnamoorthy P, Garg J, Virmani D, Sharma T, Stefanini G, Kostis JB, Mukherjee D, Sikorskaya E | title = Role of Niacin in Current Clinical Practice: A Systematic Review | journal = The American Journal of Medicine | volume = 130 | issue = 2 | pages = 173–187 | date =2017 | pmid = 27793642 | doi = 10.1016/j.amjmed.2016.07.038 | doi-access = free }}</ref>
⚫ An American ] in the late 20th century, the evolving megavitamin therapy are integrated with orthomolecular and ]. Although megavitamin therapy still largely remains outside of the structure of ], they are increasingly used by patients, with or without the approval of their treating physicians.<ref name="pmid10893280">{{cite journal |author=Richardson MA, Sanders T, Palmer JL, Greisinger A, Singletary SE |title=Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology |journal=J. Clin. Oncol. |volume=18 |issue=13 |pages=2505–14 |year=2000 |month=July |pmid=10893280 |doi= |url=http://jco.ascopubs.org/cgi/content/full/18/13/2505}}</ref> In the 21st century, proposed megavitamin therapies with vitamin C are being evaluated for their possible use in cancer, but clinical results have shown no effect on treating or reducing the risk of cancer.<ref name="pmid19116389">{{cite journal |author=Lin J, Cook NR, Albert C, ''et al'' |title=Vitamins C and E and beta carotene supplementation and cancer risk: a randomized controlled trial |journal=J. Natl. Cancer Inst. |volume=101 |issue=1 |pages=14–23 |year=2009 |month=January |pmid=19116389 |doi=10.1093/jnci/djn438 |url=}}</ref>

==Criticism and side effects ==
The effectiveness of various megavitamin therapies has been disputed by results of clinical trials, including about safety, definition and validation of efficacy.<ref name="WHI"/><ref name="pmid19116389"/> For example, some critics claim that there is no evidence that ingesting once a day supplements of 1 to 3 grams of Vitamin C is significant in treating the common cold for ordinary people. Reviews and re-examinations by Colchrane Collection author, Harri Hemilä, have meticulously documented that many previous "expert" statements on vitamin C have suffered from serious mathematical errors, selection bias, and misinterpretation,<ref name="Hemilä">Hemilä H. Univ. of Helsinki, Dissertation, Faculty of Medicine, Dept. of Public Health. 2006.</ref> and that even these infrequent, intermediate "megadoses", although much lower than the dosages recommended by vitamin C megavitamin advocates,<ref>, , accessed online 27 Feb 2008.</ref> do show statistically significant benefit. There has been more general agreement that such intermediate dosages may help some stressed or compromised subpopulations.<ref name="Hemilä"/> The orthomolecular advocates publish, and use, much higher, more frequent oral dose recommendations for vitamin C, in the 40 to 100+ grams per day range for treating ] and around 150 grams per day for flu.<ref> Cathcart RF, , ''Medical Hypotheses'', 7:1359-1376, 1981.</ref>

The term "megavitamin therapy" itself was criticized by opponents of ] in the early 1970s as misleading, because they believed the term falsely implied therapeutic benefit, because of still unresolved disputes over scientific rigor and efficacy for the early 1950s treatment of a carefully specified type of acute schizophrenia.<ref></ref><ref>Lipton M and others. Task Force Report on Megavitamin and Orthomolecular Therapy in Psychiatry. Washington D.C., 1973, American Psychiatric Association.</ref><ref> In Reply To Task Force Report on Megavitamin and Orthomolecular Therapy in Psychiatry. Canadian Schizophrenia Foundation. August 1976</ref>

Some megadose vitamin uses, often older pharmaceutical ones such as neonatal use of synthetic ], "a synthetic lipid soluble product which was once called vitamin K<SUB>3</SUB>",<ref> FDA, Environmental Assessment: Vitamin K Active Substances, Section 2.4.3.2. Animal Toxicity,
"Phylloquinone and menaquinone are nontoxic to animals even when given in large doses. For example, mice receiving a single oral dose of 15-25 g phylloquinone/kg BW showed no adverse effects (Molitor and Robinson, 1940).</REF><REF> DrugBank, ''Vitamin K3'', University of Alberta</REF>
<REF>, Innvista </ref> can cause toxicity. In the specific case of synthetic K<sub>3</sub>, large doses may cause ], which occurs when the red blood cells die more quickly than the body can reproduce. In addition, K<sub>3</sub> speeds liver damage, producing jaundice, deafness, and severe neurological problems, including retardation in infants. There is no record that the other two, natural series of Vitamin K, have produced toxic levels.<REF> FDA, </REF><REF>CA Burtis, ER Ashwood, DE Bruns (2005) ''Tietz Textbook of Clinical Chemistry and Molecular Diagnostics'', p. 1089, Elsevier-Saunders; 4th ed. ISBN 0721601898 "The use of high doses of naturally occurring vitamin K (K<sub>1</sub> and K<sub>2</sub>) appears to have no untoward effect; however, menadione (K<sub>3</sub>) treatment can lead to the formation of erythrocyte cytoplasmic inclusions known as Heinz bodies and hemolytic anemia....As no adverse effects associated with vitamin K consumption from food or supplements have been reported in humans or animals, the U.S. Institute of Medicine has reported that a quantitative risk assessment cannot be performed, and thus a UL cannot be derived for vitamin K"</REF> The pharmaceutical synthetic, K<sub>3</sub>, is now banned in most countries for neonatal or general human use. These were previously conventional medical therapeutics, not orthomolecular type megavitamin treatments.

The ] establishes a maximum intake level for most vitamins, at which no adverse effects should occur including many infrequent or minor effects. These are part of the ] (UL) recommendations. Extremely high dose vitamin A for previous conventional pediatrics and dermatology practices,<REF></REF> beyond orthomolecular therapy ranges, have been deprecated by some medical organizations of minor political units as ineffective and potentially toxic.<ref name="bccancer"></ref> Administration of very large doses of ],<ref> Penniston KL, Tanumihardjo SA (2006) The acute and chronic toxic effects of vitamin A. ''Am J Clin Nutr.'' 83:191-201. PMID: 16469975</ref> ], ], and ] (]) may have ]s .


==See also== ==See also==


Related topics
* ] * '']''
* ] * ]
* ] * ]
* ] * ]
* ]
⚫ * ]

Vitamin topics
⚫ * ]
* ] * ]
* ] * ]
* ] (toxic vitamin intake)
⚫ * ]
** ]

** ]
==Footnotes==
** ]
{{reflist}}
** ]


==References== ==References==
{{Reflist|2}}
* Abram Hoffer (1998) Putting It All Together: The New Orthomolecular Nutrition, McGraw-Hill, ISBN 0-87983-633-4
* Pauling, Linus (1986) How to Live Longer and Feel Better, W. H. Freeman and Company, ISBN 0-380-70289-4
* Roger J. Williams, Dwight K. Kalita (1979) Physician's Handbook on Orthomolecular Medicine, Keats Publishing, ISBN 0-87983-199-5
* Roger J Williams (1998) Biochemical Individuality: The Basis for the Genetotrophic Concept. 2nd ed. Keats Publishing. ISBN 0-87983-893-0
* Canner, P.L., Berge, K.G., Wenger, N.K., ''et al.'' Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin. J Am Coll Cardiol, 1986, 8: 1245-1255.
* Meyers, et al, Varying Cost and Free Nicotinic Acid Content in Over-the-Counter Niacin Preparations for Dyslipidemia, Annals of Internal Med. 2003 Dec 16;139(12):996-1002
* Guyton, J. R., Blazing, M.A., Hagar, J., ''et al.'' Extended-release niacin vs Gemfibrozil for the treatment of low levels of high density lipoprotein cholesterol. Arch Intern Med, 2000, 160: 1177-1184.
* Kamanna, V.S., Kashyap, M.L., Mechanism of Action of Niacin on Lipoprotein Metabolism, Current Atherosclerosis Reports 2000, 2:36-46
* Heady JA, Morris JN, Oliver MF. WHO clofibrate/cholesterol trial: clarifications. Lancet 1992; 340: 1405-1406.
* Frick MH, Elo O, Haapa K, ''et al.'' Helsinki Heart Study: primary prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease. N Engl J Med 1987; 317: 1237-1245.
* Irwin Stone (1972) The Healing Factor: Vitamin C Against Disease, GD/Perigee Books (Putnam Pub) ISBN 0-399-50764-7


==External links== ==External links==
* * at ]
*
*


{{Vitamin}}
{{Food chemistry}}
{{Nutritional pathology}}
{{Dietary supplement}}
{{alternative medicine}}
{{pseudoscience}}

{{DEFAULTSORT:Megavitamin Therapy}}
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Latest revision as of 18:43, 10 October 2024

Form of alternative medicine

Megavitamin therapy
ClaimsHealth effects from very high doses of vitamins.
Related scientific disciplinesvitamins, dietary supplements
Year proposed1930s
Notable proponentsFrederick Klenner, Linus Pauling
(Overview of pseudoscientific concepts)
Part of a series on
Alternative medicine
General information
Fringe medicine and science
Controversies
Classifications
Traditional medicine
Alternative diagnoses

Megavitamin therapy is the use of large doses of vitamins, often many times greater than the recommended dietary allowance (RDA) in the attempt to prevent or treat diseases. Megavitamin therapy is typically used in alternative medicine by practitioners who call their approach orthomolecular medicine. Vitamins are useful in preventing and treating illnesses specifically associated with dietary vitamin shortfalls, but the conclusions of medical research are that the broad claims of disease treatment by advocates of megavitamin therapy are unsubstantiated by the available evidence. It is generally accepted that doses of any vitamin greatly in excess of nutritional requirements will result either in toxicity (vitamins A and D) or in the excess simply being metabolised; thus evidence in favour of vitamin supplementation supports only doses in the normal range. Critics have described some aspects of orthomolecular medicine as food faddism or even quackery. Research on nutrient supplementation in general suggests that some nutritional supplements might be beneficial, and that others might be harmful; several specific nutritional therapies are associated with an increased likelihood of the condition they are meant to prevent.

Multivitamin vs megavitamin

Megavitamin therapy must be distinguished from the usual "vitamin supplementation" approach of traditional multivitamin pills. Megavitamin doses are far higher than the levels of vitamins ordinarily available through western diets. A study of 161,000 individuals (post-menopausal women) provided, in the words of the authors, "convincing evidence that multivitamin use has little or no influence on the risk of common cancers, cardiovascular disease, or total mortality in postmenopausal women".

History

In the 1930s and 1940s, some scientific and clinical evidence suggested that there might be beneficial uses of vitamins C, E, and niacin in large doses. Beginning in the 1930s in Canada, a megadose vitamin E therapy for cardiovascular and circulatory complaints was developed by Evan Shute and colleagues, named the "Shute protocol". Tentative experiments in the 1930s by Claus W. Jungeblut with larger doses of vitamin C led to Frederick Klenner's development of megadose intravenous vitamin C treatments for polio and other viruses in the 1940s. William Kaufman published articles in the 1940s that detailed his treatment of arthritis with frequent, high doses of niacinamide. Rudolf Altschul and Abram Hoffer applied large doses of the immediate release form of niacin (Vitamin B3) to treat hypercholesterolemia. In a 1956 publication entitled Biochemical Individuality, Roger J. Williams introduced concepts for individualized megavitamins and nutrients. Megavitamin therapies were also publicly advocated by Linus Pauling in the late 1960s.

Usage as therapy

Although megavitamin therapies still largely remain outside of the structure of evidence-based medicine, they are increasingly used by patients, with or without the approval of their treating physicians, often after recommendations by practitioners of orthomolecular and naturopathic medicine. The proposed efficacy of various megavitamin therapies to reduce cancer risk has been contradicted by results of one clinical trial.

Vitamin C

Main article: Vitamin C megadosage

The US Recommended Dietary Allowance for vitamin C for adult women is 76 mg/day and for adult men 90 mg/day. Although Linus Pauling was known for highly respectable research in chemistry and biochemistry, he was also known for promoting the consumption of vitamin C in large doses. Although he claimed and stood firm in his claim that consuming over 1,000 mg is helpful for one’s immune system when fighting a head cold, the results of empirical research do not align with this view. A meta-analysis concluded that supplementary vitamin C significantly lowered serum uric acid, considered a risk factor for gout. One population study reported an inverse correlation between dietary vitamin C and risk of gout. A review of clinical trials in the treatment of colds with small and large doses of Vitamin C has established that there is no evidence that it decreases the incidence of common colds. After 33 years of research, it is still not established whether vitamin C can be used as a treatment for cancer.

Vitamin E

The US Recommended Dietary Allowance for vitamin E for adult women and men is 15 mg/day. The US Food and Nutrition Board set a tolerable upper intake level (UL) at 1,000 mg (1,500 IU) per day derived from animal models that demonstrated bleeding at high doses. In the US, the popularity for vitamin E as a dietary supplement peaked around 2000, with popular doses of 400, 800 and 1000 IU/day. Declines in usage were attributed to publications of meta-analyses that showed either no benefits or negative consequences from vitamin E supplements.

Niacin

The US Recommended Dietary Allowance for niacin for adult women is 14 mg/day and for adult men 16 mg/day. Niacin is available as a prescription product, either immediate release (500 mg tablets; prescribed up to 3,000 mg/day) or extended release (500 and 1,000 mg tablets; prescribed up to 2,000 mg/day). In the US, niacin is also available as a dietary supplement at 500 to 1,000 mg/tablet. Niacin has sometimes been used in combination with other lipid-lowering medications. Systematic reviews found no effect of niacin on cardiovascular disease or death, in spite of raising high-density lipoprotein (HDL) cholesterol. Reported side effects include an increased risk of diabetes.

See also

Related topics

Vitamin topics

References

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  40. Garg A, Sharma A, Krishnamoorthy P, Garg J, Virmani D, Sharma T, Stefanini G, Kostis JB, Mukherjee D, Sikorskaya E (2017). "Role of Niacin in Current Clinical Practice: A Systematic Review". The American Journal of Medicine. 130 (2): 173–187. doi:10.1016/j.amjmed.2016.07.038. PMID 27793642.

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