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Orthomolecular medicine

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Optimum nutrition and, most broadly, orthomolecular medicine is the term used by proponents to describe the controversial proposition that nutrition should be the primary means of prevention and treatment of diseases. Orthomolecular medicine asserts that many typical diets are insufficient for long term health; thus, orthomolecular medical diagnoses and treatment focus on use of natural substances found in a healthy diet such as vitamins, dietary minerals, enzymes, antioxidants, amino acids, essential fatty acids, dietary fiber and intestinal short chain fatty acids. Orthomolecular medicine holds that drug treatment should be used only for specific indications, with some orthomolecular proponents arguing against any drug treatment at all.

Orthomolecular medicine is a minority view held by a small number of medical practitioners. Orthomolecular proponents claim that some aspects of their discipline have support in scientific research), but critics of orthomolecular medicine note that these studies all come from conventional medical sources that don't subscribe to or claim to support orthomolecular doctrine, and, in at least some cases, explicitly reject claims of orthomolecular proponents that nutritional supplements are desireable.

Some orthomolecular proponents have been criticized for making far more sweeping claims, including claims that nutrition can cure or treat "alcoholism, allergies, arthritis, autism, epilepsy, hypertension, hypoglycemia, migraine headaches, depression, learning disabilities, retardation, mental and metabolic disorders, skin problems, and hyperactivity."

Orthomolecular treatments are utilized in both complementary and alternative medicine fields and, to a lesser degree, in conventional medicine.{fact} The controversial field of orthomolecular psychiatry deals with the use of orthomolecular medicine to treat psychiatric problems.

The orthomolecular field, although viewed by its supporters as science-based, remains controversial among mainstream medical opinion because of what organizations such as the American Cancer Society, National Institute of Mental Health and American Academy of Pediatrics call unsubstantiated claims. The latter organization even labelled orthomolecular medicine as a "cult" in 1976.

History

Orthomolecular megavitamin therapies, such as usage of tocopherols and ascorbates over 1 gram per day, date back to the 1930s.

Linus Pauling proposed the term "orthomolecular medicine" in 1968 in the journal Science. Linus Pauling defined orthomolecular medicine as "the treatment of disease by the provision of the optimum molecular environment, especially the optimum concentrations of substances normally present in the human body." or as "the preservation of good health and the treatment of disease by varying the concentrations in the human body of substances that are normally present in the body". He sometimes appended "and are required for health"

Method

In orthomolecular medicine, diseases are assumed to originate from multiple nonspecific causes, congenital and acquired. These causes give rise to biochemical aberrations, the accumulation of which results in symptoms and signs, from which the perception of a disease state follows. Clinically-apparent diseases may be described as fuzzy sets of biochemical anomalies. Clearly, it is advantageous for physicians to recognize and to correct patients’ small sets of biochemical anomalies at an early stage, before expansion of the anomalies results in recognizable diseases.

In practice, the orthomolecular doctor relies heavily on laboratory testing. In addition to standard clinical chemistries, orthomolecular doctors now employ a wide range of sophisticated laboratory analysis, including those for amino acids, organic acids, vitamins and minerals, functional vitamin status, hormones, immunology, microbiology, and gastrointestinal function. Many of the newer tests have not been accepted by conventional medicine.

Orthomolecular therapy consists in attempting to provide optimal amounts of substances normal to the body, most commonly by oral administration. In the early days of orthomolecular medicine, this usually meant high-dose, single-agent nutrient therapy. However, some ailments require the withholding of normal substances. Thus, "optimal" is a matter for clinical judgment. Most often, the orthomolecular practitioner employs multiple vital substances--amino acids, enzymes, non-essential nutrients, hormones, vitamins, minerals, etc.--in a therapeutic effort to restore those (or derivative substances) to levels statistically normal for healthy young persons.

Often supplementation with relatively large doses of vitamins is given and the name megavitamin therapy has become popularly associated with the field. Megavitamin therapy is the administration of large amounts of vitamins, often many times greater than the recommended dietary allowance (RDA). Short chained fatty acids are produced by fermentation of dietary fiber in the colon, then absorbed and utilized, often aided with a combination of probiotics, prebiotics and "glyconutrients" added to the diet.

The substances may be administered by changing the diet to emphasize certain elements high in nutrients, dietary supplementation with tablets, or intravenous injection of nutrient solutions.

Popularity

A survey released in May 2004] by the National Center for Complementary and Alternative Medicine focused on who used complementary and alternative medicine (CAM), what was used, and why it was used in the United States by adults age 18 years and over during 2002. According to this recent survey, mega-vitamin therapy was the 9th most commonly used CAM therapy (2.8%) in the United States during 2002 . Consistent with previous studies, this study found that the majority of individuals (54.9%) used CAM in conjunction with conventional medicine (page 6). "The fact that only 11.8% of adults sought care from a licensed or certified CAM practitioner suggests that most individuals who use CAM self-prescribe and/or self-medicate." (page 6).

Criticism and Relation to conventional medicine

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Orthomolecular medicine claims an evolving nutritional pharmacology that overlaps between natural medicine and conventional medicine. The International Society for Orthomolecular Medicine has many conventionally-trained doctors among its members and authors.

However, many conventional medical physicians regard most orthomolecular therapies as insufficiently proven for clinical use, and criticize leading orthomolecular proponents for making unsubstantiated claims such as Robert Cathcart's claim that Vitamin C is a legitimate treatment for SARS. Proponents contend that many conventional doctors have little familiarity with the detailed concepts and clinical background of orthomolecular medicine. Conventional medicine disputes the validity of most orthomolecular therapies based on the lack of authoritative studies and the results from some disputed studies. Proponents argue that the disputed studies used much lower doses, frequencies, duration or assimilable forms than they recommend or other special conditions, contamination, populations or statistical treatment often not clearly published in the documentation.

Linus Pauling has been criticized for making overbroad claims for the efficacy of Vitamin C but has received some support for modified claims in the last few years. (Ironically, contemporaries of Pauling report that he "frequently" suffered from colds.)

The relationship of conventional medicine to orthomolecular proponents has usually been adversarial, with the latter accusing conventional medicine of a conspiracy to suppress their discipline. Some health professionals see orthomolecular medicine as an encouragement for individuals to dose themselves with large amounts of vitamins and other nutritients in an unsupervised way, which may be damaging to health. Risks of unsupervised misuse or deliberate abuse may include peripheral neuropathy, ataxia, congenital abnormalities, spontaneous abortion, gouty arthritis or jaundice. Many physicians express concern that megavitamin and orthomolecular therapies used solely as alternative treatments can create dangerous delays in obtaining their conventional treatments, such as radiation and chemotherapy for cancer. For example, in a highly publicized Canadian case, the chemotherapy treatment of a 13-year-old cancer patient, Tyrell Dueck, was delayed, possibly fatally, because his religious parents were influenced by claims of orthomolecular cures for cancer.

Sometimes proponents claim partisan politics, pharmaceutical industry influence, and competitive considerations to be significant factors; on the other hand, many prominent orthomolecular proponents, such as Glen Dettman, sell lines of orthomolecular products. Some other orthomolecular therapies have been officially sanctioned within Europe and Japan, which have looser drug approval regulations than the United States Food & Drug Administration.

Notable orthomolecular doctors

Orthomolecular scientists

Reference links

  1. Orthomed.org Kunin Principles That Identify Orthormolecular Medicine: A Unique Medical Specialty - Richard A. Kunin, M.D. Accessed June 2006.
  2. Multivitamin use, folate, and colon cancer in women in the Nurses' Health Study. Giovannucci E, Stampfer MJ, Colditz GA, Hunter DJ, Fuchs C, Rosner BA, Speizer FE, Willett WC; Ann Intern Med" 1998 Oct 1;129(7):517-24 PMID: 9758570 Long-term use (>15 years) of folate-containing multivitamin supplements produced an almost 5-fold reduction in the incidence of colon cancer.
  3. Are dietary factors involved in DNA methylation associated with colon cancer? Slattery ML, Schaffer D, Edwards SL, Ma KN, Potter JD in Nutr Cancer 1997;28(1):52-62 PMID: 9200151
  4. Dietary intake of folic acid and colorectal cancer risk in a cohort of women. Terry P, Jain M, Miller AB, Howe GR, Rohan TE in Int J Cancer 2002 Feb 20;97(6):864-7 PMID: 11857369
  5. ^ Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. A randomized controlled trial. Nutritional Prevention of Cancer Study Group. Clark LC, Combs GF Jr, Turnbull BW, Slate EH, Chalker DK, Chow J, Davis LS, Glover RA, Graham GF, Gross EG, Krongrad A, Lesher JL Jr, Park HK, Sanders BB Jr, Smith CL, Taylor JR. JAMA 1996 Dec 25;276(24):1957-63 PMID: 8971064 200ug/d of selenium for 4.5 years resulted in a 17% reduction of totality mortality by over 11 years (in total), due to a 50% reduction of (all) cancer mortality, 37% reduction in (all) cancer occurrence
  6. Reduction of cancer mortality and incidence by selenium supplementation. Combs GF Jr, Clark LC, Turnbull BW in Med Klin 1997 Sep 15;92 Suppl 3:42-5. PMID: 9342915
  7. Reduction of cancer risk with an oral supplement of selenium. Combs GF Jr, Clark LC, Turnbull BW in Biomed Environ Sci 1997 Sep;10(2-3):227-34 PMID: 9315315
  8. Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin. Canner PL, Berge KG, Wenger NK, Stamler J, Friedman L, Prineas RJ, Friedewald W in J Am Coll Cardiol 1986 Dec;8(6):1245-55 PMID: 3782631 “With a mean follow-up of 15 years, nearly 9 years after termination of the trial, mortality from all causes in each of the drug groups, except for niacin, was similar to that in the placebo group. Mortality in the niacin group was 11% lower than in the placebo group (52.0 versus 58.2%; p = 0.0004).” Dose used = 2g – 3g/day for 6 years. The drop in mortality was only evident after 6-8 years.
  9. Associations of Mortality With Ocular Disorders and an Intervention of High-Dose Antioxidants and Zinc in the Age-Related Eye Disease Study: AREDS Report No. 13. AREDS Research Group (Authors: Traci E. Clemons, PhD; Natalie Kurinij, PhD; Robert D. Sperduto, MD.) in Arch Ophthalmol. 2004 May;122(5):716-26. PMID: 15136320 “Participants randomly assigned to receive zinc had lower mortality than those not taking zinc (RR, 0.73; 95% CI, 0.61-0.89).”
  10. E.g., Spencer JW, Jacobs JJ. Complementary/alternative medicine: an evidence based approach. Toronto: Mosley, 1999:134,137; The selenium shocker. University of California at Berkeley Wellness Letter 1997;13:8-9; http://www.news.cornell.edu/releases/Jan97/selenium.ssl.html
  11. e.g., Princeton Brain Bio Center. Brochure, distributed to patients. Skillman, N.J., 1983, The Center.
  12. http://www.tinussmits.nl/english/dynamic.htm?main=http://www.tinussmits.com/english/autism.htm
  13. http://www.canstats.org/readdetail.asp?id=542
  14. American Cancer Society 2006 "Orthomolecular Medicine has not been scientifically proven to help most of the conditions for which it is promoted. However, vitamins, minerals, and other supplements have been and continue to be studied to see if they can help or prevent many types of illness."
  15. Committee on Nutrition, American Academy of Pediatrics. Megavitamin therapy for childhood psychoses and learning disabilities. Pediatrics 58:910­912, 1976
  16. Definition of Orthomolecular medicine at www.orthomed.org Accessed June 2006.
  17. What is Orthomolecular Medicine?, Linus Pauling Inst.
  18. nccam.nih.gov
  19. nccam.nih table 1 on page 8
  20. http://www.canstats.org/readdetail.asp?id=542
  21. The Dark Side of Linus Pauling's Legacy by Stephen Barrett
  22. Padayatty SL et al, "Vitamin C Pharmacokinetics: Implications for Oral and Intravenous Use," Ann Intern Med. 2004 Apr 6;140(7):533-7.
  23. Douglas RM, Hemila H (2005). "Vitamin C for preventing and treating the common cold". PLoS Med. 2 (6): e168, quiz e217. PMID 15971944.
  24. James Lowell, Ph.D., Nutrition Forum May 1985.
  25. emedicine - Toxicity statistics, 2003
  26. PMID: 3153129
  27. PMID: 3737019
  28. Vitamin Therapy, Megadose / Orthomolecular Therapy, provincial BC Cancer Agency
  29. http://www.healthwatcher.net/Quackerywatch/Cancer/Dueck/index.html
  30. fibrinolytic activity of nattokinase, Miyazaki Medical College, Japan
  31. Coenzyme Q10, prescribed for CHF in Japan since 1974, AAFP

Bibliography

  • Abram Hoffer (1998) Putting It All Together: The New Orthomolecular Nutrition, McGraw-Hill, ISBN 0879836334
  • Abram Hoffer, M.D. with Linus Pauling (2004) Healing Cancer: Complementary Vitamin & Drug Treatments, CCNM Press, ISBN 1897025114
  • 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 0879831995
  • Melvyn R. Werbach, Jeffrey Moss (1999) Textbook of Nutritional Medicine, Third Line Press, ISBN 0961855096
  • Joseph E. Pizzorno, Jr., Michael T. Murray (November 2005) Textbook of Natural Medicine, 3rd edition, Churchill Livingstone, ISBN 0443073007 · 2368pp

See also

External links

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