Orthomolecular medicine
Encyclopedia
Orthomolecular medicine is a form of complementary and alternative medicine that seeks to maintain health and prevent or treat diseases by optimizing nutritional intake and/or prescribing supplements. The approach is sometimes referred to as megavitamin therapy
as the practice evolved out of, and in some cases still uses, doses of vitamin
s and minerals
many times higher than the recommended Dietary Reference Intake
. Orthomolecular practitioners may also incorporate a variety of other treatment modalities into their approaches, including dietary
restriction, megadoses of non-vitamin nutrients, and mainstream pharmaceutical drugs. Proponents believe that non-optimal levels of certain substances can cause health issues beyond simple deficiency and see balancing them as an integral part of health.
The term "orthomolecular" was coined by Linus Pauling
to mean "the right molecules in the right amounts" (ortho is Greek for "right"); thus orthomolecular medicine focuses on using the right nutritional molecules in the right amounts for the individual. Proponents state that treatments are based on patients' individual biochemistries.
Critics have described some aspects of orthomolecular medicine as food faddism
or quackery
and there is research suggesting that certain nutritional supplements are harmful with several specific vitamin therapies linked to increased risk of cancer, heart disease, and death.
Amongst the individuals claimed posthumously as orthomolecularists are Max Gerson
, who developed a diet that he claimed could treat diseases, which the American Medical Association's 1949 Council on Pharmacy and Chemistry found ineffective; and the Shute brothers, who attempted to treat heart disease with vitamin E
. Several concepts now claimed by orthomolecularists, including individual biochemical variation and inborn errors of metabolism
, debuted in scientific papers early in the 20th century.
In 1948, William McCormick theorized that vitamin C
deficiency played an important role in many diseases and began to use large doses in patients. In the 1950s, Fred R. Klenner
also used vitamin C
megadosage as a therapy for a wide range of illnesses, including polio. Irwin Stone
claimed organisms that do not synthesise their own vitamin C due to a loss-of-function mutation have a disease he called "hypoascorbemia". This term is not used by the medical community, and the idea of an organism-wide lack of a biosynthetic pathway as a disease was not endorsed by Stone's contemporaries.
In the 1950s, some individuals believed that vitamin deficiencies caused mental illness. Psychiatrists Humphry Osmond
and Abram Hoffer
gave people having acute schizophrenic
episodes high doses of niacin
, while William Kaufman used niacinamide. While niacin has no known efficacy in psychiatric disease, the use of niacin in combination with statins and other medical therapies has become one of several medical treatments for cardiovascular disease.
In the late 1960s, Linus Pauling
introduced the expression "orthomolecular" to express the idea of the right molecules in the right amounts. Since the first claims of medical breakthroughs with vitamin C by Pauling and others, findings on the health effects of vitamin C have been controversial and contradictory. Pauling has been criticised for making overbroad claims.
Later research branched out into nutrients besides niacin and vitamin C, including essential fatty acid
s.
, alcoholism
, allergies, arthritis
, autism
, bee sting
s, bipolar disorder
, burns
, cancer
, the common cold
, depression
, drug addiction, drug overdose
, epilepsy
, heart diseases, heavy metal toxicity
, acute hepatitis
, herpes, hyperactivity, hypertension
, hypoglycemia
, influenza
, learning disabilities, mental and metabolic disorders, migraine
, mononucleosis
, mushroom poisoning
, neuropathy & polyneuritis (including multiple sclerosis
), osteoporosis
, polio, an hypothesised condition called "pyroluria", radiation sickness
, Raynaud's disease, retardation
, schizophrenia
, shock, skin
problems, snakebite
, spider bite
, tetanus toxin and viral pneumonia
.
. In the 1950s, he attempted to treat schizophrenia with niacin, although proponents of orthomolecular psychiatry say that the ideas behind their approach predate Hoffer. Carl Pfeiffer of the Pfeiffer Treatment Center
continued Hoffer’s approach, believing that for “every drug that benefits a patient, there is a natural substance that can achieve the same effect". According to Hoffer and others who called themselves "orthomolecular psychiatrists", psychiatric syndromes result from biochemical deficiencies, allergies, toxicities or several hypothetical contributing conditions which they termed pyroluria, histadelia and histapenia. These purported causes were said to be found during an "individual biochemical workup" and treated with megavitamin therapy
and dietary changes including fasting
. These diagnoses and treatments are not accepted by evidence-based medicine.
s, dietary mineral
s, protein
s, antioxidant
s, amino acid
s, ω-3 fatty acids
, ω-6 fatty acids
, medium chain triglycerides
, dietary fiber
, short and long chain fatty acids, lipotropes
, systemic and digestive enzyme
s, other digestive factors, and prohormones to ward off hypothetical metabolism
anomalies at an early stage, before they cause disease.
Orthomolecularists say that they provide prescriptions for optimal amounts of micronutrients after individual diagnoses based on blood tests and personal histories. Lifestyle and diet changes may also be recommended. The battery of tests ordered includes many that are not considered useful by medicine.
retail products and naturopathic
textbooks.
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. The survey reported uses in the previous twelve months that include orthomolecular related uses: Nonvitamin, nonmineral, natural products 18.9%, Diet-based therapies 3.5%, Megavitamin therapy 2.8%.
Another recent CAM survey reported that 12% of liver disease patients used the antioxidant silymarin, more than 6% used vitamins, and that "in all, 74% of patients reported using CAM in addition to the medications prescribed by their physician, but 26% did not inform their physician of their CAM use." The use of high doses of vitamins is also common in people who have been diagnosed with cancer, although usage depends of the type of cancer and ranges from 26% to 35% among prostate cancer
survivors up to 75% to 87% in breast cancer
survivors.
. The lack of scientifically rigorous testing of orthomolecular medicine has led to its practices being classed with other forms of alternative medicine and regarded as unscientific. It has been described as food faddism
and quackery
, with critics arguing that it is based upon an "exaggerated belief in the effects of nutrition upon health and disease." Orthomolecular practitioners will often use dubious diagnostic methods to define what substances are "correct"; one example is hair analysis
, which produces spurious results when used in this fashion.
Proponents of orthomolecular medicine contend that, unlike some other forms of alternative medicine such as homeopathy
, their ideas are at least biologically based, do not involve magical thinking
, and are capable of generating testable hypotheses. Orthomolecular is not a standard medical term, and clinical use of specific nutrients is considered a form of chemoprevention (to prevent or delay development of disease) or chemotherapy (to treat an existing condition).
(B3), cholecalciferol
(D) and tocopherol
(E). Evidence does not support the efficacy of orthomolecular medicine in treating cancer or psychological health and its claims have been criticized by most medical organizations, including the American Cancer Society
, the American Psychiatric Association
, the National Institute of Mental Health
, the American Academy of Pediatrics
, CHAMPUS
, and the Canadian Paediatric Society
. The American Medical Association
describes as "myths" the ideas that adequate nutrition is not readily achievable with normal food, all food grown with pesticide is poisonous, all food additives are poisonous, vitamin and mineral deficiencies are common, that the cause of most disease is poor diet, which can be prevented by nutritional supplements.
Similarly, the American Cancer Society
comments that the current scientific evidence does not "support use of orthomolecular therapy for most of the conditions for which it is promoted." Some supplements have exhibited benefits for specific conditions, while a few have been confirmed to be harmful; the consumption of nutritious foods is the best recognized method to obtain vitamins, minerals, and nutrients crucial for good health. Barrie Cassileth, an adviser on alternative medicine to the National Institutes of Health
, stated that "scientific research has found no benefit from orthomolecular therapy for any disease," and medical textbooks also report that there is "no evidence that megavitamin or orthomolecular therapy is effective in treating any disease."
A 1973 task force of the American Psychiatric Association unanimously concluded:
In response to claims that orthomolecular medicine could cure childhood psychoses and learning disorders, the American Academy of Pediatrics
labelled orthomolecular medicine a "cult
" in 1976.
Proponents of orthomolecular medicine counter that some vitamins and nutrients are now used in medicine as treatments for specific diseases, such as megadose niacin
and fish oil for dyslipidemia
s, and megavitamin therapies for a group of rare inborn errors of metabolism
. A review in the Annals of Internal Medicine
concluded that while some therapies might be beneficial, others might be harmful or interfere with effective medical therapy. A recent study of over 161,000 individuals 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." A recent meta-analysis
in JAMA
suggested that supplementation with combinations of antioxidant vitamins (beta-carotene
, vitamin A
, and vitamin E
) may increase mortality, although with respect to beta-carotene this conclusion may be due to the known harmful effect in smokers.
before they can be marketed, whereas dietary supplement
s must be proven unsafe before regulatory action can be taken. A number of orthomolecular supplements are available in the US in pharmaceutical versions that are sometimes quite similar in strength and general content, or in other countries are regulated as pharmaceuticals. The US regulations also have provisions to recognize a general level of safety for established nutrients that can forgo new drug safety tests. Proponents of orthomolecular medicine argue that supplements are less likely to cause dangerous side-effects or harm, since they are normally present in the body. Some vitamins are toxic in high doses and nearly all will cause adverse effects given high levels of overdosing for prolonged periods as recommended by orthomolecular practitioners. Forgoing medical care in favor of orthomolecular treatments can lead to adverse health outcomes.
Health professionals see orthomolecular medicine as encouraging individuals to dose themselves with large amounts of vitamins and other nutrients without conventional supervision, which they worry might be damaging to health. Potential risks of inappropriate vitamin and supplement regimes include an increased risk of coronary heart disease
, hypertension
, thrombophlebitis
, peripheral neuropathy
, ataxia
, neurological
effects, liver toxicity
, congenital abnormalities
, spontaneous abortion
, gouty arthritis
, jaundice
, kidney stone
s, and diarrhea
. In their book Trick or Treatment
, Edzard Ernst
and Simon Singh
conclude that "The concepts of orthomolecular medicine are not biologically plausible and not supported by the results of rigorous clinical trials. These problems are compounded by the fact that orthomolecular medicine can cause harm and is often very expensive."
pose no risk to health and are useful for the treatment and prevention of a broad list of conditions, including heart and circulatory diseases, diabetes and nephritis. Initial hopes for the usefulness of vitamin E in orthomolecular medicine were based on epidemiological studies suggesting that people who consumed more vitamin E had lower risks of chronic disease, such as coronary heart disease
. These observational studies
could not distinguish between whether the higher levels of vitamin E improved health themselves, or whether confounding variables (such as other dietary factors or exercise) were responsible. To distinguish between these possibilities, a number of randomized controlled trial
s were performed and meta-analysis
of these controlled clinical trials have not shown any clear benefit from any form of vitamin E supplementation for preventing chronic disease. Further clinical studies show no benefit of vitamin E supplements for cardiovascular disease. The current position of the National Institutes of Health
is that there is no convincing evidence that vitamin E supplements can prevent or treat any disease.
Beyond the lack of apparent benefit, a series of three meta-analyses reported that vitamin E supplementation is associated with an increased risk of death; one of the meta-analyses performed by the Cochrane Collaboration
also found significantly increased mortality for the antioxidant vitamins A
and beta-carotene
.
/AIDS
. However, high-dose vitamin C treatments have been studied clinically to treat AIDS patients without any positive result. An analysis
of fifteen clinical trials of micronutrient therapies by the Cochrane Collaboration
in 2005 found no evidence that such approaches either reduce symptoms or mortality in HIV-infected adults who are not malnourished, but found evidence, in one hospital, that giving vitamin A to infants with HIV may be beneficial. Vitamin A deficiency is found in children with HIV infection who may or may not have symptoms of AIDS. Vitamin A supplementation reduces morbidity and mortality in AIDS symptomatic children, but has no effect on asymptomatic children. It does not prevent HIV infection, cannot treat the chronic HIV infection, and will not cure AIDS.
has been extensively criticized for presenting his vitamin supplements as a treatment for AIDS and for testing them in illegal trials in South Africa
. A former associate of Linus Pauling, Rath now promotes vitamins as a treatment for HIV infection, describing treatment with effective antiretroviral drugs as toxic and part of a global conspiracy serving the financial interests of the pharmaceutical industry.} In a lawsuit that found against Rath, the South African Medical Association
blamed his vitamin products for several deaths. The World Health Organization
and two health agencies of the United Nations
also described Rath’s advertisements as “wrong and misleading” and “an irresponsible attack on ARV (antiretroviral) therapy.” The South African Centre for Social Science Research described the trials as "state sponsored pseudo-science". Rath's trials, conducted with the aid of AIDS denialist David Rasnick
, were declared unlawful by the Cape High Court; Rath, Rasnick and their foundation were barred from conducting further unauthorised clinical trials and from advertising their products.
The Journal of Orthomolecular Medicine
, founded in 1967 as the Journal of Schizophrenia, is the main publication of those involved in orthomolecular medicine. It was founded, as Abram Hoffer
wrote, because of the alleged conspiracy:
The scientific and medical community regards such claims of a conspiracy
as unsubstantiated. A review in the Journal of Clinical Oncology
described such conspiracy theories, which allege collusion amongst physicians against unconventional and unproven treatments, as a common theme in many forms of alternative medicine. Despite claims of conspiracy, the Linus Pauling Institute
's funding comes primarily from the National Institutes of Health
, and some orthomolecular therapies have been sanctioned in Japan
.
Megavitamin therapy
Megavitamin therapy is the use of large doses of vitamins, often many times greater than the recommended dietary allowance in the attempt to prevent or treat diseases...
as the practice evolved out of, and in some cases still uses, doses of vitamin
Vitamin
A vitamin is an organic compound required as a nutrient in tiny amounts by an organism. In other words, an organic chemical compound is called a vitamin when it cannot be synthesized in sufficient quantities by an organism, and must be obtained from the diet. Thus, the term is conditional both on...
s and minerals
Dietary mineral
Dietary minerals are the chemical elements required by living organisms, other than the four elements carbon, hydrogen, nitrogen, and oxygen present in common organic molecules. Examples of mineral elements include calcium, magnesium, potassium, sodium, zinc, and iodine...
many times higher than the recommended Dietary Reference Intake
Dietary Reference Intake
The Dietary Reference Intake is a system of nutrition recommendations from the Institute of Medicine of the U.S. National Academy of Sciences. The DRI system is used by both the United States and Canada and is intended for the general public and health professionals...
. Orthomolecular practitioners may also incorporate a variety of other treatment modalities into their approaches, including dietary
Diet (nutrition)
In nutrition, diet is the sum of food consumed by a person or other organism. Dietary habits are the habitual decisions an individual or culture makes when choosing what foods to eat. With the word diet, it is often implied the use of specific intake of nutrition for health or weight-management...
restriction, megadoses of non-vitamin nutrients, and mainstream pharmaceutical drugs. Proponents believe that non-optimal levels of certain substances can cause health issues beyond simple deficiency and see balancing them as an integral part of health.
The term "orthomolecular" was coined by Linus Pauling
Linus Pauling
Linus Carl Pauling was an American chemist, biochemist, peace activist, author, and educator. He was one of the most influential chemists in history and ranks among the most important scientists of the 20th century...
to mean "the right molecules in the right amounts" (ortho is Greek for "right"); thus orthomolecular medicine focuses on using the right nutritional molecules in the right amounts for the individual. Proponents state that treatments are based on patients' individual biochemistries.
Critics have described some aspects of orthomolecular medicine as food faddism
Food faddism
The phrases food faddism and fad diet originally referred to idiosyncratic diets and eating patterns that promote short-term weight loss, usually with no concern for long-term weight maintenance, and enjoy temporary popularity...
or quackery
Quackery
Quackery is a derogatory term used to describe the promotion of unproven or fraudulent medical practices. Random House Dictionary describes a "quack" as a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, knowledge, or...
and there is research suggesting that certain nutritional supplements are harmful with several specific vitamin therapies linked to increased risk of cancer, heart disease, and death.
History and development
In the early 20th century, some doctors hypothesised that vitamins could cure disease, and supplements were prescribed in megadoses by the 1930s. Their effects on health were disappointing, though, and in the 1950s and 60s, nutrition was de-emphasised in standard medical curricula. Orthomolecularists claim several figures from these early days of enthusiasm about nutrition as founders of their movement, although the word "orthomolecular" was coined by Linus Pauling only in 1967.Amongst the individuals claimed posthumously as orthomolecularists are Max Gerson
Max Gerson
Max Gerson was a German physician who developed the Gerson Therapy, an alternative dietary therapy, which he claimed could cure cancer and most chronic, degenerative diseases. Gerson described his approach in the book A Cancer Therapy: Results of 50 Cases...
, who developed a diet that he claimed could treat diseases, which the American Medical Association's 1949 Council on Pharmacy and Chemistry found ineffective; and the Shute brothers, who attempted to treat heart disease with vitamin E
Vitamin E
Vitamin E is used to refer to a group of fat-soluble compounds that include both tocopherols and tocotrienols. There are many different forms of vitamin E, of which γ-tocopherol is the most common in the North American diet. γ-Tocopherol can be found in corn oil, soybean oil, margarine and dressings...
. Several concepts now claimed by orthomolecularists, including individual biochemical variation and inborn errors of metabolism
Inborn error of metabolism
Inborn errors of metabolism comprise a large class of genetic diseases involving disorders of metabolism. The majority are due to defects of single genes that code for enzymes that facilitate conversion of various substances into others...
, debuted in scientific papers early in the 20th century.
In 1948, William McCormick theorized that vitamin C
Vitamin C
Vitamin C or L-ascorbic acid or L-ascorbate is an essential nutrient for humans and certain other animal species. In living organisms ascorbate acts as an antioxidant by protecting the body against oxidative stress...
deficiency played an important role in many diseases and began to use large doses in patients. In the 1950s, Fred R. Klenner
Fred R. Klenner
Frederick Robert Klenner, was an American medical researcher and doctor in general practice in Reidsville, North Carolina. From the 1940s on he experimented with the use of vitamin C megadosage as a therapy for a wide range of illnesses, most notably polio. He authored 28 research papers during...
also used vitamin C
Vitamin C
Vitamin C or L-ascorbic acid or L-ascorbate is an essential nutrient for humans and certain other animal species. In living organisms ascorbate acts as an antioxidant by protecting the body against oxidative stress...
megadosage as a therapy for a wide range of illnesses, including polio. Irwin Stone
Irwin Stone
Irwin Stone was an American biochemist, chemical engineer, and author. He was the first to use ascorbic acid in the food processing industry as a preservative, and originated and published the hypothesis that humans require much larger amounts of Vitamin C for optimal health than is necessary to...
claimed organisms that do not synthesise their own vitamin C due to a loss-of-function mutation have a disease he called "hypoascorbemia". This term is not used by the medical community, and the idea of an organism-wide lack of a biosynthetic pathway as a disease was not endorsed by Stone's contemporaries.
In the 1950s, some individuals believed that vitamin deficiencies caused mental illness. Psychiatrists Humphry Osmond
Humphry Osmond
Humphry Fortescue Osmond was a British psychiatrist known for inventing the word psychedelic and for using psychedelic drugs in medical research...
and Abram Hoffer
Abram Hoffer
Abram Hoffer was a Canadian biochemist, physician and psychiatrist. Hoffer developed a theory that nutrition and vitamins may be effective treatments for schizophrenia...
gave people having acute schizophrenic
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
episodes high doses of niacin
Niacin
"Niacin" redirects here. For the neo-fusion band, see Niacin .Niacin is an organic compound with the formula and, depending on the definition used, one of the forty to eighty essential human nutrients.Niacin is one of five vitamins associated with a pandemic deficiency disease: niacin deficiency...
, while William Kaufman used niacinamide. While niacin has no known efficacy in psychiatric disease, the use of niacin in combination with statins and other medical therapies has become one of several medical treatments for cardiovascular disease.
In the late 1960s, Linus Pauling
Linus Pauling
Linus Carl Pauling was an American chemist, biochemist, peace activist, author, and educator. He was one of the most influential chemists in history and ranks among the most important scientists of the 20th century...
introduced the expression "orthomolecular" to express the idea of the right molecules in the right amounts. Since the first claims of medical breakthroughs with vitamin C by Pauling and others, findings on the health effects of vitamin C have been controversial and contradictory. Pauling has been criticised for making overbroad claims.
Later research branched out into nutrients besides niacin and vitamin C, including essential fatty acid
Essential fatty acid
Essential fatty acids, or EFAs, are fatty acids that humans and other animals must ingest because the body requires them for good health but cannot synthesize them...
s.
Scope
According to Abram Hoffer, orthomolecular medicine does not purport to treat all diseases, nor is it "a replacement for standard treatment. A proportion of patients will require orthodox treatment, a proportion will do much better on orthomolecular treatment, and the rest will need a skillful blend of both." Nevertheless, advocates have said that nutrients can prevent, treat, and sometimes cure a wide range of medical conditions, including: acneAcne
Acne is a general term used for acneiform eruptions. It is usually used as a synonym for acne vulgaris, but may also refer to:*Acne aestivalis*Acne conglobata*Acne cosmetica*Acne fulminans*Acne keloidalis nuchae*Acne mechanica...
, alcoholism
Alcoholism
Alcoholism is a broad term for problems with alcohol, and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the detriment of the drinker's health, personal relationships, and social standing...
, allergies, arthritis
Arthritis
Arthritis is a form of joint disorder that involves inflammation of one or more joints....
, autism
Autism
Autism is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old. Autism affects information processing in the brain by altering how nerve cells and their...
, bee sting
Bee sting
A bee sting is strictly a sting from a bee . In the vernacular it can mean a sting of a bee, wasp, hornet, or yellow jacket. Some people may even call the bite of a horse-fly a bee sting...
s, bipolar disorder
Bipolar disorder
Bipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or...
, burns
Burn (injury)
A burn is a type of injury to flesh caused by heat, electricity, chemicals, light, radiation or friction. Most burns affect only the skin . Rarely, deeper tissues, such as muscle, bone, and blood vessels can also be injured...
, cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
, the common cold
Common cold
The common cold is a viral infectious disease of the upper respiratory system, caused primarily by rhinoviruses and coronaviruses. Common symptoms include a cough, sore throat, runny nose, and fever...
, depression
Clinical depression
Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...
, drug addiction, drug overdose
Drug overdose
The term drug overdose describes the ingestion or application of a drug or other substance in quantities greater than are recommended or generally practiced...
, epilepsy
Epilepsy
Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...
, heart diseases, heavy metal toxicity
Heavy Metal Poisoning
Heavy Metal Poisoning is a song by American rock band Styx. It was included as the fifth track on their 1983 studio album Kilroy Was Here.The song in the story of Kilroy Was Here has the character of Dr Righteous preaching the evils of rock and roll...
, acute hepatitis
Hepatitis
Hepatitis is a medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ. The name is from the Greek hepar , the root being hepat- , meaning liver, and suffix -itis, meaning "inflammation"...
, herpes, hyperactivity, hypertension
Hypertension
Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...
, hypoglycemia
Hypoglycemia
Hypoglycemia or hypoglycæmia is the medical term for a state produced by a lower than normal level of blood glucose. The term literally means "under-sweet blood"...
, influenza
Influenza
Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae , that affects birds and mammals...
, learning disabilities, mental and metabolic disorders, migraine
Migraine
Migraine is a chronic neurological disorder characterized by moderate to severe headaches, and nausea...
, mononucleosis
Infectious mononucleosis
Infectious mononucleosis is an infectious, widespread viral...
, mushroom poisoning
Mushroom poisoning
Mushroom poisoning refers to harmful effects from ingestion of toxic substances present in a mushroom. These symptoms can vary from slight gastrointestinal discomfort to death. The toxins present are secondary metabolites produced in specific biochemical pathways in the fungal cells...
, neuropathy & polyneuritis (including multiple sclerosis
Multiple sclerosis
Multiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...
), osteoporosis
Osteoporosis
Osteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis the bone mineral density is reduced, bone microarchitecture is deteriorating, and the amount and variety of proteins in bone is altered...
, polio, an hypothesised condition called "pyroluria", radiation sickness
Radiation Sickness
Radiation Sickness is a VHS by the thrash metal band Nuclear Assault. The video is a recording of a concert at the Hammersmith Odeon, London in 1988. It was released in 1991...
, Raynaud's disease, retardation
Retardation
Retardation is the act or result of delaying; the extent to which anything is retarded or delayed; that which retards or delays. In particular, it can mean:-In engineering:* Negative acceleration in mechanics Retardation is the act or result of delaying; the extent to which anything is retarded...
, schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
, shock, skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
problems, snakebite
Snakebite
A snakebite is an injury caused by a bite from a snake, often resulting in puncture wounds inflicted by the animal's fangs and sometimes resulting in envenomation. Although the majority of snake species are non-venomous and typically kill their prey with constriction rather than venom, venomous...
, spider bite
Spider bite
A spider bite is an injury resulting from the bites of spiders or other closely related arachnids.Spiders are active hunters and rely heavily on their bites to paralyze and kill their prey before consuming it. They also bite in self defense...
, tetanus toxin and viral pneumonia
Viral pneumonia
Viral pneumonia is a pneumonia caused by a virus.Viruses are one of the two major causes of pneumonia, the other being bacteria; less common causes are fungi and parasites...
.
Orthomolecular psychiatry
Hoffer believed that particular nutrients could cure mental illnessMental illness
A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture. Such a disorder may consist of a combination of affective, behavioural,...
. In the 1950s, he attempted to treat schizophrenia with niacin, although proponents of orthomolecular psychiatry say that the ideas behind their approach predate Hoffer. Carl Pfeiffer of the Pfeiffer Treatment Center
Pfeiffer Treatment Center
The Pfeiffer Treatment Center is a U.S. clinic devoted to orthomolecular psychiatry and medical research particularly pertaining to autism and pyroluria, and the neurobiology of criminal behavior.- About the Center:...
continued Hoffer’s approach, believing that for “every drug that benefits a patient, there is a natural substance that can achieve the same effect". According to Hoffer and others who called themselves "orthomolecular psychiatrists", psychiatric syndromes result from biochemical deficiencies, allergies, toxicities or several hypothetical contributing conditions which they termed pyroluria, histadelia and histapenia. These purported causes were said to be found during an "individual biochemical workup" and treated with megavitamin therapy
Megavitamin therapy
Megavitamin therapy is the use of large doses of vitamins, often many times greater than the recommended dietary allowance in the attempt to prevent or treat diseases...
and dietary changes including fasting
Fasting
Fasting is primarily the act of willingly abstaining from some or all food, drink, or both, for a period of time. An absolute fast is normally defined as abstinence from all food and liquid for a defined period, usually a single day , or several days. Other fasts may be only partially restrictive,...
. These diagnoses and treatments are not accepted by evidence-based medicine.
Principles
According to Abram Hoffer, "primitive" peoples do not consume processed foods and do not have "degenerative" diseases. In contrast, typical "Western" diets are said to be insufficient for long-term health, necessitating the use of megadose supplements of vitaminVitamin
A vitamin is an organic compound required as a nutrient in tiny amounts by an organism. In other words, an organic chemical compound is called a vitamin when it cannot be synthesized in sufficient quantities by an organism, and must be obtained from the diet. Thus, the term is conditional both on...
s, dietary mineral
Dietary mineral
Dietary minerals are the chemical elements required by living organisms, other than the four elements carbon, hydrogen, nitrogen, and oxygen present in common organic molecules. Examples of mineral elements include calcium, magnesium, potassium, sodium, zinc, and iodine...
s, protein
Protein
Proteins are biochemical compounds consisting of one or more polypeptides typically folded into a globular or fibrous form, facilitating a biological function. A polypeptide is a single linear polymer chain of amino acids bonded together by peptide bonds between the carboxyl and amino groups of...
s, antioxidant
Antioxidant
An antioxidant is a molecule capable of inhibiting the oxidation of other molecules. Oxidation is a chemical reaction that transfers electrons or hydrogen from a substance to an oxidizing agent. Oxidation reactions can produce free radicals. In turn, these radicals can start chain reactions. When...
s, amino acid
Amino acid
Amino acids are molecules containing an amine group, a carboxylic acid group and a side-chain that varies between different amino acids. The key elements of an amino acid are carbon, hydrogen, oxygen, and nitrogen...
s, ω-3 fatty acids
Omega-3 fatty acid
N−3 fatty acids are essential unsaturated fatty acids with a double bond starting after the third carbon atom from the end of the carbon chain....
, ω-6 fatty acids
Omega-6 fatty acid
n−6 fatty acids are a family of unsaturated fatty acids that have in common a final carbon–carbon double bond in the n−6 position, that is, the sixth bond, counting from the methyl end.The biological effects of the n−6 fatty acids are largely mediated by their conversion to n-6 eicosanoids...
, medium chain triglycerides
Medium chain triglycerides
Medium-chain triglycerides are medium-chain fatty acid esters of glycerol.MCTs passively diffuse from the GI tract to the portal system without requirement for modification like long-chain fatty acids or very-long-chain fatty acids. In addition, MCTs do not require bile salts for digestion...
, dietary fiber
Dietary fiber
Dietary fiber, dietary fibre, or sometimes roughage is the indigestible portion of plant foods having two main components:* soluble fiber that is readily fermented in the colon into gases and physiologically active byproducts, and* insoluble fiber that is metabolically inert, absorbing water as it...
, short and long chain fatty acids, lipotropes
Lipotropic
Lipotropic compounds are those that help catalyse the breakdown of fat during metabolism in the body.Choline is the major lipotrope in mammals and other known lipotropes are important only insofar as they contribute to the synthesis of choline....
, systemic and digestive enzyme
Digestive enzyme
'Digestive enzymes' are enzymes that break down polymeric macromolecules into their smaller building blocks, in order to facilitate their absorption by the body. Digestive enzymes are found in the digestive tract of animals where they aid in the digestion of food as well as inside the cells,...
s, other digestive factors, and prohormones to ward off hypothetical metabolism
Metabolism
Metabolism is the set of chemical reactions that happen in the cells of living organisms to sustain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments. Metabolism is usually divided into two categories...
anomalies at an early stage, before they cause disease.
Orthomolecularists say that they provide prescriptions for optimal amounts of micronutrients after individual diagnoses based on blood tests and personal histories. Lifestyle and diet changes may also be recommended. The battery of tests ordered includes many that are not considered useful by medicine.
Prevalence
Orthomolecular medicine is practiced by few medical practitioners, but megavitamin treatments are increasingly found in over the counterOver-the-counter drug
Over-the-counter drugs are medicines that may be sold directly to a consumer without a prescription from a healthcare professional, as compared to prescription drugs, which may be sold only to consumers possessing a valid prescription...
retail products and naturopathic
Naturopathic medicine
Naturopathy, or Naturopathic Medicine, is a form of alternative medicine based on a belief in vitalism, which posits that a special energy called vital energy or vital force guides bodily processes such as metabolism, reproduction, growth, and adaptation...
textbooks.
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. The survey reported uses in the previous twelve months that include orthomolecular related uses: Nonvitamin, nonmineral, natural products 18.9%, Diet-based therapies 3.5%, Megavitamin therapy 2.8%.
Another recent CAM survey reported that 12% of liver disease patients used the antioxidant silymarin, more than 6% used vitamins, and that "in all, 74% of patients reported using CAM in addition to the medications prescribed by their physician, but 26% did not inform their physician of their CAM use." The use of high doses of vitamins is also common in people who have been diagnosed with cancer, although usage depends of the type of cancer and ranges from 26% to 35% among prostate cancer
Prostate cancer
Prostate cancer is a form of cancer that develops in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, there are cases of aggressive prostate cancers. The cancer cells may metastasize from the prostate to other parts of the body, particularly...
survivors up to 75% to 87% in breast cancer
Breast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...
survivors.
Methodology
Orthomolecular therapies have been criticized as lacking a sufficient evidence base for clinical use: their scientific foundations are too weak, the studies that have been performed are too few and too open to interpretation, and reported positive findings in observational studies are contradicted by the results of more rigorous clinical trials. Accordingly, "there is no evidence that orthomolecular medicine is effective". Proponents of orthomolecular medicine strongly dispute this statement by citing studies demonstrating the effectiveness of treatments involving vitamins, though this ignores the belief that a normal diet will provide adequate nutrients to avoid deficiencies, and that orthomolecular treatments are not actually related to vitamin deficiencyAvitaminosis
Avitaminosis is any disease caused by chronic or long-term vitamin deficiency or caused by a defect in metabolic conversion, such as tryptophan to niacin...
. The lack of scientifically rigorous testing of orthomolecular medicine has led to its practices being classed with other forms of alternative medicine and regarded as unscientific. It has been described as food faddism
Food faddism
The phrases food faddism and fad diet originally referred to idiosyncratic diets and eating patterns that promote short-term weight loss, usually with no concern for long-term weight maintenance, and enjoy temporary popularity...
and quackery
Quackery
Quackery is a derogatory term used to describe the promotion of unproven or fraudulent medical practices. Random House Dictionary describes a "quack" as a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, knowledge, or...
, with critics arguing that it is based upon an "exaggerated belief in the effects of nutrition upon health and disease." Orthomolecular practitioners will often use dubious diagnostic methods to define what substances are "correct"; one example is hair analysis
Hair analysis
Hair analysis may refer to the chemical analysis of a hair sample, but can also refer to microscopic analysis or comparison. Chemical hair analysis may be considered for retrospective purposes when blood and urine are no longer expected to contain a particular contaminant, typically a year or less...
, which produces spurious results when used in this fashion.
Proponents of orthomolecular medicine contend that, unlike some other forms of alternative medicine such as homeopathy
Homeopathy
Homeopathy is a form of alternative medicine in which practitioners claim to treat patients using highly diluted preparations that are believed to cause healthy people to exhibit symptoms that are similar to those exhibited by the patient...
, their ideas are at least biologically based, do not involve magical thinking
Magical thinking
Magical thinking is causal reasoning that looks for correlation between acts or utterances and certain events. In religion, folk religion, and superstition, the correlation posited is between religious ritual, such as prayer, sacrifice, or the observance of a taboo, and an expected benefit or...
, and are capable of generating testable hypotheses. Orthomolecular is not a standard medical term, and clinical use of specific nutrients is considered a form of chemoprevention (to prevent or delay development of disease) or chemotherapy (to treat an existing condition).
Views on safety and efficacy
In general, the vitamin megadoses advocated by orthomolecular medicine are unsupported by scientific consensus. Some vitamins are toxic in high doses, including niacinNiacin
"Niacin" redirects here. For the neo-fusion band, see Niacin .Niacin is an organic compound with the formula and, depending on the definition used, one of the forty to eighty essential human nutrients.Niacin is one of five vitamins associated with a pandemic deficiency disease: niacin deficiency...
(B3), cholecalciferol
Cholecalciferol
Cholecalciferol is a form of vitamin D, also called vitamin D3 or calciol.It is structurally similar to steroids such as testosterone, cholesterol, and cortisol .-Forms:Vitamin D3 has several forms:...
(D) and tocopherol
Tocopherol
Tocopherols are a class of chemical compounds of which many have vitamin E activity. It is a series of organic compounds consisting of various methylated phenols...
(E). Evidence does not support the efficacy of orthomolecular medicine in treating cancer or psychological health and its claims have been criticized by most medical organizations, including the American Cancer Society
American Cancer Society
The American Cancer Society is the "nationwide community-based voluntary health organization" dedicated, in their own words, "to eliminating cancer as a major health problem by preventing cancer, saving lives, and diminishing suffering from cancer, through research, education, advocacy, and...
, the American Psychiatric Association
American Psychiatric Association
The American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential worldwide. Its some 38,000 members are mainly American but some are international...
, the National Institute of Mental Health
National Institute of Mental Health
The National Institute of Mental Health is one of 27 institutes and centers that make up the National Institutes of Health...
, the American Academy of Pediatrics
American Academy of Pediatrics
The American Academy of Pediatrics is the major professional association of pediatricians in the United States. The AAP was founded in 1930 by 35 pediatricians to address pediatric healthcare standards. It currently has 60,000 members in primary care and sub-specialist areas...
, CHAMPUS
Champús
Champús is a drink popular in Peru, Ecuador and southwest Colombia , made with maize, fruits such as lulo , pineapple, quince or guanábana, sweetened with panela and seasoned with cinnamon, cloves and orange tree leaves.In Peru it is drunk warm, and apple, guanábana and quince is used instead of lulo...
, and the Canadian Paediatric Society
Canadian Paediatric Society
The Canadian Paediatric Society is a national association of paediatricians, committed to working together to advance the health of children and youth by nurturing excellence in health care, advocacy, education, research and support of its membership....
. The American Medical Association
American Medical Association
The American Medical Association , founded in 1847 and incorporated in 1897, is the largest association of medical doctors and medical students in the United States.-Scope and operations:...
describes as "myths" the ideas that adequate nutrition is not readily achievable with normal food, all food grown with pesticide is poisonous, all food additives are poisonous, vitamin and mineral deficiencies are common, that the cause of most disease is poor diet, which can be prevented by nutritional supplements.
Similarly, the American Cancer Society
American Cancer Society
The American Cancer Society is the "nationwide community-based voluntary health organization" dedicated, in their own words, "to eliminating cancer as a major health problem by preventing cancer, saving lives, and diminishing suffering from cancer, through research, education, advocacy, and...
comments that the current scientific evidence does not "support use of orthomolecular therapy for most of the conditions for which it is promoted." Some supplements have exhibited benefits for specific conditions, while a few have been confirmed to be harmful; the consumption of nutritious foods is the best recognized method to obtain vitamins, minerals, and nutrients crucial for good health. Barrie Cassileth, an adviser on alternative medicine to the National Institutes of Health
National Institutes of Health
The National Institutes of Health are an agency of the United States Department of Health and Human Services and are the primary agency of the United States government responsible for biomedical and health-related research. Its science and engineering counterpart is the National Science Foundation...
, stated that "scientific research has found no benefit from orthomolecular therapy for any disease," and medical textbooks also report that there is "no evidence that megavitamin or orthomolecular therapy is effective in treating any disease."
A 1973 task force of the American Psychiatric Association unanimously concluded:
This review and critique has carefully examined the literature produced by megavitamin proponents and by those who have attempted to replicate their basic and clinical work. It concludes in this regard that the credibility of the megavitamin proponents is low. Their credibility is further diminished by a consistent refusal over the past decade to perform controlled experiments and to report their new results in a scientifically acceptable fashion. Under these circumstances this Task Force considers the massive publicity which they promulgate via radio, the lay press and popular books, using catch phrases which are really misnomers like "megavitamin therapy" and "orthomolecular treatment," to be deplorable.
In response to claims that orthomolecular medicine could cure childhood psychoses and learning disorders, the American Academy of Pediatrics
American Academy of Pediatrics
The American Academy of Pediatrics is the major professional association of pediatricians in the United States. The AAP was founded in 1930 by 35 pediatricians to address pediatric healthcare standards. It currently has 60,000 members in primary care and sub-specialist areas...
labelled orthomolecular medicine a "cult
Cult
The word cult in current popular usage usually refers to a group whose beliefs or practices are considered abnormal or bizarre. The word originally denoted a system of ritual practices...
" in 1976.
Proponents of orthomolecular medicine counter that some vitamins and nutrients are now used in medicine as treatments for specific diseases, such as megadose niacin
Niacin
"Niacin" redirects here. For the neo-fusion band, see Niacin .Niacin is an organic compound with the formula and, depending on the definition used, one of the forty to eighty essential human nutrients.Niacin is one of five vitamins associated with a pandemic deficiency disease: niacin deficiency...
and fish oil for dyslipidemia
Dyslipidemia
Dyslipidemia or dyslipidaemia is an abnormal amount of lipids in the blood. In developed countries, most dyslipidemias are hyperlipidemias; that is, an elevation of lipids in the blood, often due to diet and lifestyle. The prolonged elevation of insulin levels can lead to dyslipidemia...
s, and megavitamin therapies for a group of rare inborn errors of metabolism
Inborn error of metabolism
Inborn errors of metabolism comprise a large class of genetic diseases involving disorders of metabolism. The majority are due to defects of single genes that code for enzymes that facilitate conversion of various substances into others...
. A review in the Annals of Internal Medicine
Annals of Internal Medicine
Annals of Internal Medicine is an academic medical journal published by the American College of Physicians . It publishes research articles and reviews in the area of internal medicine. Its current editor is Christine Laine...
concluded that while some therapies might be beneficial, others might be harmful or interfere with effective medical therapy. A recent study of over 161,000 individuals 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." A recent meta-analysis
Meta-analysis
In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of effect size, for which a weighted average might be the output of a meta-analyses. Here the...
in JAMA
Journal of the American Medical Association
The Journal of the American Medical Association is a weekly, peer-reviewed, medical journal, published by the American Medical Association. Beginning in July 2011, the editor in chief will be Howard C. Bauchner, vice chairman of pediatrics at Boston University’s School of Medicine, replacing ...
suggested that supplementation with combinations of antioxidant vitamins (beta-carotene
Beta-carotene
β-Carotene is a strongly-coloured red-orange pigment abundant in plants and fruits. It is an organic compound and chemically is classified as a hydrocarbon and specifically as a terpenoid , reflecting its derivation from isoprene units...
, vitamin A
Vitamin A
Vitamin A is a vitamin that is needed by the retina of the eye in the form of a specific metabolite, the light-absorbing molecule retinal, that is necessary for both low-light and color vision...
, and vitamin E
Vitamin E
Vitamin E is used to refer to a group of fat-soluble compounds that include both tocopherols and tocotrienols. There are many different forms of vitamin E, of which γ-tocopherol is the most common in the North American diet. γ-Tocopherol can be found in corn oil, soybean oil, margarine and dressings...
) may increase mortality, although with respect to beta-carotene this conclusion may be due to the known harmful effect in smokers.
Safety
In the United States, pharmaceuticals must be proven safe and effective to the satisfaction of the FDAFood and Drug Administration
The Food and Drug Administration is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments...
before they can be marketed, whereas dietary supplement
Dietary supplement
A dietary supplement, also known as food supplement or nutritional supplement, is a preparation intended to supplement the diet and provide nutrients, such as vitamins, minerals, fiber, fatty acids, or amino acids, that may be missing or may not be consumed in sufficient quantities in a person's diet...
s must be proven unsafe before regulatory action can be taken. A number of orthomolecular supplements are available in the US in pharmaceutical versions that are sometimes quite similar in strength and general content, or in other countries are regulated as pharmaceuticals. The US regulations also have provisions to recognize a general level of safety for established nutrients that can forgo new drug safety tests. Proponents of orthomolecular medicine argue that supplements are less likely to cause dangerous side-effects or harm, since they are normally present in the body. Some vitamins are toxic in high doses and nearly all will cause adverse effects given high levels of overdosing for prolonged periods as recommended by orthomolecular practitioners. Forgoing medical care in favor of orthomolecular treatments can lead to adverse health outcomes.
Health professionals see orthomolecular medicine as encouraging individuals to dose themselves with large amounts of vitamins and other nutrients without conventional supervision, which they worry might be damaging to health. Potential risks of inappropriate vitamin and supplement regimes include an increased risk of coronary heart disease
Coronary disease
Coronary disease refers to the failure of coronary circulation to supply adequate circulation to cardiac muscle and surrounding tissue. It is already the most common form of disease affecting the heart and an important cause of premature death in Europe, the Baltic states, Russia, North and South...
, hypertension
Hypertension
Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...
, thrombophlebitis
Thrombophlebitis
Thrombophlebitis is phlebitis related to a thrombus . When it occurs repeatedly in different locations, it is known as "Thrombophlebitis migrans" or "migrating thrombophlebitis".-Signs and symptoms:...
, peripheral neuropathy
Peripheral neuropathy
Peripheral neuropathy is the term for damage to nerves of the peripheral nervous system, which may be caused either by diseases of or trauma to the nerve or the side-effects of systemic illness....
, ataxia
Ataxia
Ataxia is a neurological sign and symptom that consists of gross lack of coordination of muscle movements. Ataxia is a non-specific clinical manifestation implying dysfunction of the parts of the nervous system that coordinate movement, such as the cerebellum...
, neurological
Neurology
Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...
effects, liver toxicity
Hepatotoxicity
Hepatotoxicity implies chemical-driven liver damage.The liver plays a central role in transforming and clearing chemicals and is susceptible to the toxicity from these agents. Certain medicinal agents, when taken in overdoses and sometimes even when introduced within therapeutic ranges, may injure...
, congenital abnormalities
Congenital disorder
A congenital disorder, or congenital disease, is a condition existing at birth and often before birth, or that develops during the first month of life , regardless of causation...
, spontaneous abortion
Miscarriage
Miscarriage or spontaneous abortion is the spontaneous end of a pregnancy at a stage where the embryo or fetus is incapable of surviving independently, generally defined in humans at prior to 20 weeks of gestation...
, gouty arthritis
Gout
Gout is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis—a red, tender, hot, swollen joint. The metatarsal-phalangeal joint at the base of the big toe is the most commonly affected . However, it may also present as tophi, kidney stones, or urate...
, jaundice
Jaundice
Jaundice is a yellowish pigmentation of the skin, the conjunctival membranes over the sclerae , and other mucous membranes caused by hyperbilirubinemia . This hyperbilirubinemia subsequently causes increased levels of bilirubin in the extracellular fluid...
, kidney stone
Kidney stone
A kidney stone, also known as a renal calculus is a solid concretion or crystal aggregation formed in the kidneys from dietary minerals in the urine...
s, and diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...
. In their book Trick or Treatment
Trick or Treatment
Trick or Treatment? Alternative Medicine on Trial is a 2008 book about alternative medicine by Simon Singh and Edzard Ernst. Singh is a physicist and the writer of several popular science books...
, Edzard Ernst
Edzard Ernst
Edzard Ernst is the first Professor of Complementary Medicine in the world, at the University of Exeter, England....
and Simon Singh
Simon Singh
Simon Lehna Singh, MBE is a British author who has specialised in writing about mathematical and scientific topics in an accessible manner....
conclude that "The concepts of orthomolecular medicine are not biologically plausible and not supported by the results of rigorous clinical trials. These problems are compounded by the fact that orthomolecular medicine can cause harm and is often very expensive."
Example: vitamin E
Orthomolecular proponents claim that even large doses of vitamin EVitamin E
Vitamin E is used to refer to a group of fat-soluble compounds that include both tocopherols and tocotrienols. There are many different forms of vitamin E, of which γ-tocopherol is the most common in the North American diet. γ-Tocopherol can be found in corn oil, soybean oil, margarine and dressings...
pose no risk to health and are useful for the treatment and prevention of a broad list of conditions, including heart and circulatory diseases, diabetes and nephritis. Initial hopes for the usefulness of vitamin E in orthomolecular medicine were based on epidemiological studies suggesting that people who consumed more vitamin E had lower risks of chronic disease, such as coronary heart disease
Coronary heart disease
Coronary artery disease is the end result of the accumulation of atheromatous plaques within the walls of the coronary arteries that supply the myocardium with oxygen and nutrients. It is sometimes also called coronary heart disease...
. These observational studies
Observational study
In epidemiology and statistics, an observational study draws inferences about the possible effect of a treatment on subjects, where the assignment of subjects into a treated group versus a control group is outside the control of the investigator...
could not distinguish between whether the higher levels of vitamin E improved health themselves, or whether confounding variables (such as other dietary factors or exercise) were responsible. To distinguish between these possibilities, a number of randomized controlled trial
Randomized controlled trial
A randomized controlled trial is a type of scientific experiment - a form of clinical trial - most commonly used in testing the safety and efficacy or effectiveness of healthcare services or health technologies A randomized controlled trial (RCT) is a type of scientific experiment - a form of...
s were performed and meta-analysis
Meta-analysis
In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of effect size, for which a weighted average might be the output of a meta-analyses. Here the...
of these controlled clinical trials have not shown any clear benefit from any form of vitamin E supplementation for preventing chronic disease. Further clinical studies show no benefit of vitamin E supplements for cardiovascular disease. The current position of the National Institutes of Health
National Institutes of Health
The National Institutes of Health are an agency of the United States Department of Health and Human Services and are the primary agency of the United States government responsible for biomedical and health-related research. Its science and engineering counterpart is the National Science Foundation...
is that there is no convincing evidence that vitamin E supplements can prevent or treat any disease.
Beyond the lack of apparent benefit, a series of three meta-analyses reported that vitamin E supplementation is associated with an increased risk of death; one of the meta-analyses performed by the Cochrane Collaboration
Cochrane Collaboration
The Cochrane Collaboration is a group of over 28,000 volunteers in more than 100 countries who review the effects of health care interventions tested in biomedical randomized controlled trials. A few more recent reviews have also studied the results of non-randomized, observational studies...
also found significantly increased mortality for the antioxidant vitamins A
Vitamin A
Vitamin A is a vitamin that is needed by the retina of the eye in the form of a specific metabolite, the light-absorbing molecule retinal, that is necessary for both low-light and color vision...
and beta-carotene
Beta-carotene
β-Carotene is a strongly-coloured red-orange pigment abundant in plants and fruits. It is an organic compound and chemically is classified as a hydrocarbon and specifically as a terpenoid , reflecting its derivation from isoprene units...
.
Use in AIDS
Several articles in the alternative-medicine literature have suggested that orthomolecular-related dietary supplementation might be helpful for patients with HIVHIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
/AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
. However, high-dose vitamin C treatments have been studied clinically to treat AIDS patients without any positive result. An analysis
Analysis
Analysis is the process of breaking a complex topic or substance into smaller parts to gain a better understanding of it. The technique has been applied in the study of mathematics and logic since before Aristotle , though analysis as a formal concept is a relatively recent development.The word is...
of fifteen clinical trials of micronutrient therapies by the Cochrane Collaboration
Cochrane Collaboration
The Cochrane Collaboration is a group of over 28,000 volunteers in more than 100 countries who review the effects of health care interventions tested in biomedical randomized controlled trials. A few more recent reviews have also studied the results of non-randomized, observational studies...
in 2005 found no evidence that such approaches either reduce symptoms or mortality in HIV-infected adults who are not malnourished, but found evidence, in one hospital, that giving vitamin A to infants with HIV may be beneficial. Vitamin A deficiency is found in children with HIV infection who may or may not have symptoms of AIDS. Vitamin A supplementation reduces morbidity and mortality in AIDS symptomatic children, but has no effect on asymptomatic children. It does not prevent HIV infection, cannot treat the chronic HIV infection, and will not cure AIDS.
Deaths resulting from illegal vitamin trials in South Africa
Matthias RathMatthias Rath
Matthias Rath is a doctor, businessman, and vitamin entrepreneur. He earned his MD degree in Germany. Rath claims that a program of nutritional supplements , including formulations that he sells, can treat or cure diabetes, cardiovascular disease, cancer, and HIV/AIDS...
has been extensively criticized for presenting his vitamin supplements as a treatment for AIDS and for testing them in illegal trials in South Africa
South Africa
The Republic of South Africa is a country in southern Africa. Located at the southern tip of Africa, it is divided into nine provinces, with of coastline on the Atlantic and Indian oceans...
. A former associate of Linus Pauling, Rath now promotes vitamins as a treatment for HIV infection, describing treatment with effective antiretroviral drugs as toxic and part of a global conspiracy serving the financial interests of the pharmaceutical industry.} In a lawsuit that found against Rath, the South African Medical Association
South African Medical Association
The South African Medical Association is a trade union for doctors in South Africa. It is affiliated with the Congress of South African Trade Unions.-External links:* ....
blamed his vitamin products for several deaths. The World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
and two health agencies of the United Nations
United Nations
The United Nations is an international organization whose stated aims are facilitating cooperation in international law, international security, economic development, social progress, human rights, and achievement of world peace...
also described Rath’s advertisements as “wrong and misleading” and “an irresponsible attack on ARV (antiretroviral) therapy.” The South African Centre for Social Science Research described the trials as "state sponsored pseudo-science". Rath's trials, conducted with the aid of AIDS denialist David Rasnick
David Rasnick
David Rasnick is a chemist and biologist known for his work in the area of HIV/AIDS denial.-Education and views:David Rasnick received a Ph.D. in chemistry from Georgia Tech in 1978. In a 1998 interview, Rasnick stated that he had studied proteases and their inhibitors for twenty years...
, were declared unlawful by the Cape High Court; Rath, Rasnick and their foundation were barred from conducting further unauthorised clinical trials and from advertising their products.
Conspiracy theories alleged by orthomolecular medicine advocates
Advocates of orthomolecular medicine, including Pauling, Hoffer and Ewan Cameron have claimed that their findings are actively suppressed by a conspiracy of the medical community and the pharmaceutical industry. Hoffer wrote that "there is no conspiracy led and directed by a single person or by a single organization ... [h]owever, there is a conspiracy led and directed by a large number of professionals and their associations who have a common aim to protect their hard-earned orthodoxy, no matter what the cost to their opponent colleagues or to their patients".The Journal of Orthomolecular Medicine
Journal of Orthomolecular Medicine
The Journal of Orthomolecular Medicine was established in 1967 by Abram Hoffer. It publishes studies in nutritional and orthomolecular medicine...
, founded in 1967 as the Journal of Schizophrenia, is the main publication of those involved in orthomolecular medicine. It was founded, as Abram Hoffer
Abram Hoffer
Abram Hoffer was a Canadian biochemist, physician and psychiatrist. Hoffer developed a theory that nutrition and vitamins may be effective treatments for schizophrenia...
wrote, because of the alleged conspiracy:
- We had to create our own journals because it was impossible to obtain entry into the official journals of psychiatryPsychiatryPsychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
and medicine. Before 1967 I had not found it difficult to publish reports in these journals, and by then I had about 150 articles and several books in the establishment press.
The scientific and medical community regards such claims of a conspiracy
Conspiracy theory
A conspiracy theory explains an event as being the result of an alleged plot by a covert group or organization or, more broadly, the idea that important political, social or economic events are the products of secret plots that are largely unknown to the general public.-Usage:The term "conspiracy...
as unsubstantiated. A review in the Journal of Clinical Oncology
Journal of Clinical Oncology
The Journal of Clinical Oncology is a medical journal published 3 times a month by the American Society of Clinical Oncology , with a 2009 impact factor of 17.793...
described such conspiracy theories, which allege collusion amongst physicians against unconventional and unproven treatments, as a common theme in many forms of alternative medicine. Despite claims of conspiracy, the Linus Pauling Institute
Linus Pauling Institute
The Linus Pauling Institute is a research institute located at Oregon State University with a focus on health maintenance. The mission statement of the institute is three-fold. First, to determine the functional roles of micronutrients and phytochemicals in promoting optimal health and to treat or...
's funding comes primarily from the National Institutes of Health
National Institutes of Health
The National Institutes of Health are an agency of the United States Department of Health and Human Services and are the primary agency of the United States government responsible for biomedical and health-related research. Its science and engineering counterpart is the National Science Foundation...
, and some orthomolecular therapies have been sanctioned in Japan
Japan
Japan is an island nation in East Asia. Located in the Pacific Ocean, it lies to the east of the Sea of Japan, China, North Korea, South Korea and Russia, stretching from the Sea of Okhotsk in the north to the East China Sea and Taiwan in the south...
.
See also
- Fringe scienceFringe scienceFringe science is scientific inquiry in an established field of study that departs significantly from mainstream or orthodox theories, and is classified in the "fringes" of a credible mainstream academic discipline....
- Health freedom movement
- Junk scienceJunk scienceJunk science is a term used in U.S. political and legal disputes that brands an advocate's claims about scientific data, research, or analyses as spurious. The term may convey a pejorative connotation that the advocate is driven by political, ideological, financial, or other unscientific...
- Life extensionLife extensionLife extension science, also known as anti-aging medicine, experimental gerontology, and biomedical gerontology, is the study of slowing down or reversing the processes of aging to extend both the maximum and average lifespan...
- List of life extension related topics
- NutrigenomicsNutrigenomicsNutrigenomics is the study of the effects of foods and food constituents on gene expression. It is about how our DNA is transcribed into mRNA and then to proteins and provides a basis for understanding the biological activity of food components...
- OrthopathyOrthopathyOrthopathy or natural hygiene is an alternative medicine originating from the nature cure movement. It is a form of vitalism that considers self-healing the best and only cure for disease, and favours fasting as restorative and favours dietary and other lifestyle measures as preventative...
- PseudosciencePseudosciencePseudoscience is a claim, belief, or practice which is presented as scientific, but which does not adhere to a valid scientific method, lacks supporting evidence or plausibility, cannot be reliably tested, or otherwise lacks scientific status...
Support
- Journal of Orthomolecular Medicine, orthomolecular.org
- Official website for the International Society of Orthomolecular Medicine, isom.eu
- Orthomolecular Medicine Online
Criticism
- Biologically based practices: an overview, National Institute of Health National Center for Complementary and Alternative Medicine
- Food, health and well-being in British Columbia. BC Provincial Health Officer’s Annual Report (2005)
- Should we "Thank God" for Julian Whitaker?, American Council on Science and HealthAmerican Council on Science and HealthThe American Council on Science and Health is a nonprofit organization founded in 1978 by Dr. Elizabeth Whelan that produces peer-reviewed reports on issues related to food, nutrition, chemicals, pharmaceuticals, lifestyle, the environment and health...
, (1999) - Recommendations of the NCAHF task force on supplement abuse (1987)