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It was actually me, Lumos3, who created this page but somehow I became logged off during the session and it didnt get recorded.

Preliminary review of Orthomolecular medicine

My preliminary review of Orthomolecular medicine is totally unfavorable.

The primary problem seems to be that this article is nothing but a stub article hiding behind a lot of verbiage. Major portions of the Orthomolecular medicine viewpoint are simply not documented in this article. I got absolutely nothing out of this article other than a bunch of commonly held generalities..

The article states: The substances may be administered by diet, dietary supplementation or intravenously, for example. What is that supposed to mean? I have no idea. As far as I know, diet has absolutely nothing to do with Orthomolecular medicine. Intravenous treatments would seem to require professionalized care, while dietary supplementation says self-care.

This article totally fails SQG#3. The proponent's viewpoint is largely missing. No wonder that opponents have yet to attack this article. There is nothing to prove or attack as it is presently written. -- John Gohde 23:35, 22 May 2004 (UTC)

Compliance Audit of 6/01/04

This article was recently subjected to a compliance audit by the Wikiproject on Alternative Medicine. We have a master list of 20 Key Questions that are designed to measure the compliance of CAM articles to our Standards of Quality Guidelines.

Overall, this article created a negative impression. The primary problem seems to be that this article is nothing but a stub article hiding behind a lot of verbiage. Major portions of the Orthomolecular medicine viewpoint are simply not documented in this article. I got absolutely nothing out of this article other than a bunch of commonly held generalities.

Orthomolecular medicine was the first article to be audited. It was also the first to pass our audit. The answers to 4 questions indicated non-compliance to our standards of quality quidelines. This resulted in a passing grade of 80%.

1. No footnote to support the health claim that RDA is inadequate.
2. No explanation of therapeutic effects.
3. No listing of effective medical conditions treated.
4. Did not recommend complementary treatment.

The Physical mode of action was determined to come from proper nutrition. -- John Gohde 05:45, 1 Jun 2004 (UTC)

Why was this article listed under "evidence of effectiveness"?:

• Creagan ET, Moertel CG, O'Fallon JR. Failure of high-dose vitamin C (ascorbic acid) therapy to benefit patients with advanced cancer. A controlled trial. N Engl J Med. 1979 Sep 27;301(13):687-90. PMID: 384241 Abstract

Read the abstract. The researcher's conclusions are:

"One hundred and fifty patients with advanced cancer participated in a controlled double-blind study to evaluate the effects of high-dose vitamin C on symptoms and survival. The two groups showed no appreciable difference in changes in symptoms, performance status, appetite or weight. the survival curves essentially overlapped. we were unable to show a therapeutic benefit of high-dose vitamin C treatment.".

I fail to see how this is evidence for effectiveness in any way -- in fact it is quite the opposite. Sheesh. Mortene 10:32, 6 Jun 2004 (UTC)

Implying a "balanced diet" is not enough - POV?

In the section Relation to conventional medicine there's a phrase I find implies that diet isn't enough, but without citing any references etc:

However most conventional doctors have little knowledge of the concepts of orthomolecular medicine and tell patients that a balanced diet will provide all the nutrition a person needs to be healthy.

It seems to me it wouldn't hurt with either some rephrasing, or an expansion as to why diet alone isn't sufficient (and perhaps also why OM non-followers find diet is enough).

The problem here is that a basic tenet of Orthomolecular medicine is that a balanced diet does not provide enough vitamins. I would agree that the sentace is pov. It really neeeds to split into two parts one saying that many doctors have limited knowlage of orthomolecular medicine and another saying that the conventional medical view is that a blanaced diet is sufficientGeni 12:03, 15 Nov 2004 (UTC)

Also, in this sentence:

Proponents point to an almost zero level of deaths caused by overdosing of vitamins compared to the significant numbers from pharmaceuticals.

What is "almost zero"? "Significant numbers"? It seems very vague.

11:42, 15 Nov 2004 (UTC)

It has to be vague becuase exact numbers are hard to define. There have been a very small number of deaths from vitamin overdoesing but the total number probably isn't even into triple figures.Geni 12:03, 15 Nov 2004 (UTC)

Evidence

I have just conducted a (brief) literature review, looking for randomised placebo-controlled trials. Unfortunately, there are very few. Those that I did find, I have added to the article. (None of them supported megavitamin usage.) I didn't bother to add the numerous case reports, most of which showed harm arising from megavitamin use. Axl 20:00, 14 Dec 2004 (UTC)

The Gastrointestinal Origin of Mental Illness?

15/10/2005, Based on the writings of Nutritional Psychiatrist Dr C.M. Reading http://www.gutandmind.cjb.net/

(This article is not intended as replacement for medical treatment.)

Often overlooked in the development of many illnesses, especially mental illness and neurological disorders is the role of the gastrointestinal system. It is known that both our gut and brain originate early in embryogenesis from a clump of tissue called the neurcast, which appears and divides during foetal development. While one section turns into the central nervous system another piece migrates to become the enteric nervous system and thus form both thinking machines. Later the two nervous systems are connected via a cable called the vagus nerve. This nerve meanders from the brain stem through the organs in the neck and thoric and finally ends up in the abdomen. This establishes the brain gut connection. So it is from a correctly functioning gut that we enjoy neurological, psychological and immunological health.

It is currently known among gastroenterologists that children with neurological problems often exhibit gastrointestinal upset. Most medical practitioners associate that the function of the gut is reactive to the mind and not vice versa. This understanding is based of current neuro-gastroeneterology. The guts brain, the enteric nervous system (located in sheaths of tissue lining the esophageus, stomach and colon) is packed with nerves with neurotransmitters, neurons and proteins and support cells like those found in the brain. So when we feel emotional, the enteric nervous system in the gut likely responds to the mind in a certain manner. For example vomiting before an interview.

But contrary to what most people think, latest research indicates that the gut itself may affect the mind and hence how we feel. It is possible that problems with the guts brain - the 'enteric nervous system' and its immunological interactions may indirectly effect the human brain and central nervous system. In this way the gut may be in fact more responsible than we have imagined for our mental well-being...

Gastrointestinal causes of mental illness:

The human body, is an organism of 100 trillion (1014) cells and of this 90 trillion are prokaryotic (bacterial) and 10 trillion are eukaryotic ('human'). Each human cell supports 50-100 bacteria or bacterial descendants. The human gastrointestinal tract is the focal point for this maintaining this balance of bacteria in the body. An advanced array of immunological interactions and defenses constantly interplay between the body and gut to maintain the health of the individual. Infact, the human intestine is the largest organ of the immune system and comprises of millions of bacteria in symbiotic balance with the host. Specialised defences, not fully understood, are in place for the protection of the gut from infectious pathogens and therefore maintain the integrity of the gut mucosa.

Overuse of antibiotics, poor diet, stress, infection and inherited gut disorders such as celiac disease are known to contribute to weakened gastrointestinal health. When the balance of the gut is compromised there is increased risk of gut infection and possible breakdown of the immunological health of the body. So important is this balance, it is noted that 'The brain and body state' is achieved as a reward for looking after our micro flora - according to Evgeny Rothschild, (Science Spectra 6, 1996).

Recurrent gastrointestinal infection, gastritis, post antibiotic infection (colonization of bad bacteria), tropical sprue and inherited gastro-immunological disorders such as celiac sprue, non-celiac sprue and food intolerances may lead to the development of mental illness and disease. For example, current research into autism has postulated that a certain subset of children who had MMR vaccine may have developed a persistent gastrointestinal infection with the measles virus. This has been confirmed through colonoscopies of these children who exhibit inflammation in the small bowel. As a consequence, the poor health of their small bowel has caused these children to deteriorate neurologically.

When the gut can not eradicate a pathogen or suspected antigen correctly a cycle of deterioration occurs in the gut. Normally when a pathogen is acquired by the gastrointestinal tract an auto-immune response is triggered to eliminate this infection. Often diarrhoea, fever and vomiting occur and usually the infection is self limiting and the individual recovers. However, in a subset of people with weakened gastrointestinal systems either inherited or due to environmental factors, the immune response may be inadequate. This leads to persistent gastrointestinal illness. Often a long term immune response to a pathogen not eliminated correctly will trigger persistent inflammation. For example, often seen in cases of inflammatory bowel disease such as Ulcerative colitis, the immune system over-responds and the colon become chronically inflamed due to infection. Repeated inflammation sets in a cycle of deterioration of gut mucosa.

In the case of mental illness it is mostly likely that an insufficient gastro-immunological response occurs in the small bowel. No symptoms of gastrointestinal upset may occur except for mental illness. Repeated immune response due to infection or allergy may result in inflammation, particularly in the area of the small bowel and over time this may lead to damage of the mucosal villi and in turn increase mucosal permeability. With partial-atrophy (flattening) of the villi there is less absorption of food and less immune secretory factors from the villi (IgA, IgM, IgG) cells to prevent further infection. These villi are also responsible in secreting of digestive enzymes, but with greater pathogenic load and poor motility due to infection there is less enzyme release and hence digestion of ingested substances deteriorates. Due to this a cycle of malabsorption can set in, and with malabsorption there is less chance of epithelial repair. This is because epithelial cells are constantly replacing themselves and to do so require a constant nutrient supply. Without adequate and dense nutrition they can not replicate and this worseness mucosal integrity.

In this way, a vicious circle of inflammation, infection, allergy, permeability and malabsorption continues. Overtime, the immunological response of the small bowel may deteriorate, possibly due to autoimmune tendency to the bowel from the body. This may lead to small bowel bacterial overgrowth or candidiasis which in turn increase the leaky ness of the gut.

Once depleted and inflamed, the villi fail to protect the mucosal integrity and allow the intestine to become permeable to more substances. In this way, the small bowel may allow the undigested contents to 'leak' into the blood stream. As enzyme secretion diminishes, due to pathogenic and pancreatic overload there is an accumulation of absorbed undigested materials in the body. These easily cross through a more permeable gut and overload the liver and kidneys with greater than normal toxin levels. In particular, the phase one to phase two detoxification pathways of toxins in the liver can become insufficient for this load and chemical sensitivities may then develop. Without adequate detoxification the poorly digested toxins accumulate in the body.

Allergies to certain foods are often acquired from incomplete digestion and elimination. Allergies in turn also create nutrient deficiencies. In many gut related mental illnesses malabsorption develops both from allergies and poor enzyme release possibly due to pathogenic overload. Malabsorption creates severe disturbances in the body. Many mental patients are known to often exhibit low serum levels of B vitamins and minerals, especially vitamin B12 and B6 and zinc which are vital for normal the function of the brain and stability of mood. Recent studies have shown the many schizophrenics have poor taste and sense of smell - indicative of zinc deficiency.

In addition, the correct break down and digestion foods are required to produce the vitamins needed to create the hormone cortisol. Cortisol and related steroids can only be manufactured with adequate B vitamins, esp. B5, B1, B2, B3, Mg, ZN, and vitamin C.Hence, malabsoption prevents cortisol production in the body. Cortisol is an anti-inflammatory compound and is very important for the homeostasis of the body. With low cortisol the body can not fight allergies, infection or inflammation as well. Cortisol is also is important in mood regulation, stamina levels and blood sugar regulation. Low cortisol can result in mood swings, depression, paranoid and psychotic behaviour. Hypoglycemia results from food allergies, malabsorbtion, low cortisol, Candida, pancreatic overload - all which derive from digestive problems. Hypoglycemia can cause many mental problems such as anxiety, shaking, crying, panic and mood changes.

Insufficient break-down of the hardest to digest (and most commonly consumed) foods leads to incompletely digested fractions or peptides. With stressed detoxification systems these peptides can accumulate in the body. Certain peptides readily cross the blood brain barrier and interfere with brain functioning. Milk and bread exhibit peptides called exorphins from gluten and casein which act as opoids in the human brain and have psychoactive effects. Many psychotic patients have specific IgA antibodies to such peptides indicating that these fractions have accumulated in their brains. It is also possible that poorly digested food fractions may trigger an autoimmune response in the brain due to repeated cerebral allergy. It is postulated that the constant accumulation of such toxins as well as bacterial endotoxins overtime may deteriorate the blood brain barrier itself allowing for greater permeability of the brain to further toxins.

In children and young adults, opoids inhibit the normal maturation of the central nervous system. As the human brain, especially the frontal lobe, does not complete development until the age of 25, permanent damage to the brain often results from these opoids. This explains the rapid onset of autism in healthy children who suddenly deteriorate with severe developmental and learning disorders. Whilst with schizophrenia, this correlates with onset and worsening of symptoms seen in the late teens and early twenties of growing adults. It is likely that the developing brain is damaged from the build up of poorly digested food fractions. These once healthy individuals may have in fact acquired their mental illness through a poorly functioning gastrointestinal-immune system rather than inheriting mental illness. Further examples are of this are seen in Western Ireland which has a high incidence of both celiac sprue and schizophrenia. This also indirectly highlights the mechanism for the inheritance of schizophrenia, whereby inheritance of poor gut function is passed on (not necessarily the gene for dopamine excess) which slowly erodes the developing brain eventually causing mental symptoms.

The combination of the malabsorption of essential nutrients, allergies, low cortisol and accumulation brain opoids and insufficient detoxication to eliminate these toxins may overwhelm the ability of any individual to function normally. By initiating a chain of 'health breakdowns'(See the Gut and Mental illness flow chart diagram), a poorly functioning gastro-immunological system and its cumulative effects, ultimately result in mental illness. The path to recovery or prevention of such illness therefore lies in restoring the immunological balance of the gut.

Good gut management and gut repair can modify and manage many immune disorders outside the gut. Without gut repair and good gut ecology return of health is unlikely. The Below complementary treatments have assisted people with mental illness, learning disorders, hypoglycemia, autism, memory problems, chronic fatigue, bowel disease, auto-immune disease, arthritis and coeliac and latent cealiac disease. For treatment strategies see http://www.gutandmind.cjb.net/

Based on the writings of Psychiatrist Dr C.M. Reading (This article is not intended as replacement for medical treatment.)

Merging of megavitamin therapy

I disagree with the merging of these two articles. While megavitamin therapy is associated with orthomolecular medicine, it is a different concept and is not unique to ortho, and shares it own potential benefits and risks and should remain separate. I am not an advocate of either therapy. --Reflex Reaction (talk)• 16:56, 3 January 2006 (UTC)

Moertel refs: anti-vitamin C Shibboleths

• Creagan E. T., Moertel C. .G, O'Fallon J. R., Failure of high-dose vitamin C (ascorbic acid) therapy to benefit patients with advanced cancer. A controlled trial. N Engl J Med. 1979 27 September; 301(13):687-90. PMID 384241

Moertel's 1979/1985 opuses "refuting" Pauling and orthomolecular vitamin C use should be removed from the Orthomolecular refs on their own merits, including substantial chemo use. Technically, Creagan, Moertel et al (1979) simply did not come close to replicating Pauling and Cameron's work so it certainly did not specifically refute the EC+LP work. As for broadly discrediting vitamin C, previous clinical experience (E. Cameron & L. Pauling; FR Klenner) suggested that higher doses of intravenous vitamin C would be necessary with cancer, especially initially. With presumably chemo damaged patients (especially degraded intestinal, liver function and now resistant cell lines) Moertel was compelled to recognize some of the shortcomings of the 1979 trial, part of why there was a second trial, published 1985. It is unfortunate for us, the multitudes, that these parties could not work together to really identify the technical differences and allow the next generation to better understand those differences and questions more thoroughly.

Remaining differences btw even the 2nd Moertel trial and Cameron & Pauling include: lack of initial IV vitamin C to achieve high initial blood levels, oral form differences (neutralized AA-DHA-sorbitol solution, vs dry AA caps), less than 10 g/day AA, duration:(EC+LP) 200+ days avg lifetime continued trmt vs Moertel's abruptly halted ascorbate treatment after 72 days avg. Moertel used subsequent chemo after the AA halt and the ~2 year follow up was analyzed as "vitamin C results". No Mayo patients actually died while on vitamin C. A likely important protocol change, the patients subsequent survival after the AA halt only then was equal or worse than the controls. Unaddressed were population and dietary differences btw rural Scots and Minnesota. Any oxalate based excuse about IV ascorbate was not satisfactory even then - adequate water, B1, B6, Mg, methylene blue, dialysis, discontinuance, initial renal exclusion were readily available options. Also Cameron had demonstrated extended experience without renal stone formation problems by then.

One might get the idea Moertel et al were not trying to make a treatment succeed or constructively explain differences as much destroy Pauling and the proposed treatment substance. Moertel's refusal of communication prospective and retrospective, analysis methods, lack of data preservation/sharing, lack of IV vitamin C and general handling of Pauling by ambush appears consistent with prejudicial handling. Subsequent development work to date continues to show merit and mechanism on IV vitamin C, including Proceedings of the National Academy of Sciences (2005). Abram Hoffer continues to progress on adjuvant cancer treatments using 12+g/day oral C and strong multivitamin/antioxidant, multimineral regimes.

The continued use of the Moertel reference seems misplaced and misleading at this late date in the Orthomolecular category, especially since both Mayo studies heavily involved chemo treated patients, #1 before AA , #2 after AA. The Mayo-Moertel studies' priority even 20 years ago seems more a pro-institutional bias than careful science about the utility and potential merit of ascorbates in cancer treatment and orthomolecular medicine. I can't see its merit here. 69.178.31.177 9 January 2006 (UTC)

References

• Hickey, Steve & Roberts Hilary; (May, 2004), Ascorbate: The Science of Vitamin C, Lulu Press, Inc. ISBN 1411607244 (Note: Lulu (http://www.lulu.com/ascorbate) is a print on demand self-publishing house.)
• Levy, Thomas, MD JD; (September 2002), Vitamin C, Infectious Diseases, and Toxins, Xlibris Corporation (Paperback). ISBN 1401069630 (Note: Xlibris is a print on demand self-publishing house.)

I am not sure 2 self-published books really are notable enough in this context. There is also the commercial nature of these links to consider. While wikipedia guidelines are not completely clear, discussion is surely merited.--DocJohnny 19:09, 9 January 2006 (UTC)

Ok, I think that the narrow refs and endless specific argumentation need to go. Hickey & Roberts, Levy are referenced under "vitamin C". A good OM reference should describe, define or cover orthomolecular medicine generally or several of its more prominent topics. A lot of the specific vitamin stuff, for or against, should either be under the specific vitamin or some other specific article coverage. Therapeutic and orthomolecular vitamin C are also pretty well addressed by some of the references and Saul's site. The Pauling and Hoffer references are important for OM definition and historical reasons as founders. Here concise, descriptive and generally informative, not argumentative, seems appropriate. The basic "anti-"& cautionary material is readily accessible in 2 cautionary intro links, of the 4 links total. Hopefully all will find this a fair, descriptive, cleaner, more useful format. -- 10 Jan 2005 (UTC)

Relation to conventional medicine

This entire section shows a strong pro-POV. Statements that doctors "have little knowledge", and attacking the studies done, especially when no rigorous pro studies exist. The fact is that conventional medicine regards this as pseudoscience, and that is not really in the article.--John| I doubt it 20:43, 19 January 2006 (UTC)

The addition of even more pro POV language is not helping.--John| I doubt it 07:32, 20 January 2006 (UTC)

Without being argumentative, I am trying to concisely describe the nature of a beast, its claims, its impact, its controversy, its merits, its travails, its unpleasantries. from NPOV: "Debates are described, represented, and characterized, but not engaged in. Background is provided on who believes what and why..."

A look at Orthomolecular literature clears up things fairly quickly. This boils down to a tacit acknowledgment of the lack of scientific rigour in the field. An attitude of "If it's harmless and the patients report results, that means it works!" permeates the field. A brief overview of the Journal reveals attacks on double blind studies and worship of anecdote. And it is all so unnecessary. The nutrition industry is a huge industry. All it would take would be good outcome studies and this would all become mainstream. But we know that isn't likely to happen. --John| I doubt it 11:41, 22 January 2006 (UTC)

Biochemical models are of limited relevance to actual practice. The difference between "medical orthodoxy" and orthomolecular views is that of science vs. pseudoscience. As clinicians, we "orthodox" types may sometimes try unproven treatments based on theory on a case by case basis if the situation is unusual enough that data does not exist. But we don't generalize from one patient to general effectiveness. The difference is a fundamental one very well illustrated by that link above. Medicine is about outcomes, and outcomes studies are necessary before effectiveness is proven. What it would take to "connect to my technical background" are outcome studies. Prove your claims. Again, all it will take are outcome studies proving the orthomolecular methodology. For example, look at the claims regarding redox therapy. If high intravenous doses of vitamin C really cure cancer, do a placebo controlled double blind trial. If proponents did provide trials that proved their claims, this entire discussion would be moot. High dose vitamin C would be orthodox. Instead of definitive data, we are provided with a variety of biochemical justifications of why "it should work" and case reports saying "it does work". Why do proponents find scientific methodology (i.e. double blind placebo controlled trials) so onerous? Using precise biochemical language instead of more patient accessible language does not make it more scientific. As it stands orthomolecular medicine looks like snake oil gussied up with biochemistry. --John| I doubt it 20:36, 22 January 2006 (UTC)

Can you suggest what you think is NPOV for the two most unpalatable sentences in the section? --69.178.31.177 01:42, 23 January 2006 (UTC)

There are people who use scientific sounding language to obfuscate matters. Science is more than using scientific terminology. Science is seeking truth through research. If good experiments are hard to design, it just means we have to work harder, not abandon experimentation altogether. Merely asserting "flawed design" with no proof is pointless. The "small studies" that you mention are almost uniformly with no controls, subject to all of the problems above mentioned of dbRCTs and subject to observer bias, secondary gain, and placebo effect. In essence they aren't "small trials", they are anecdotes. There is also a difference between "real science" and engineering. Medicine is more akin to engineering and other applied sciences in that results have a real consequence. Engineers are also "parochial" in their obsession with their version of outcome studies. If anything they are even more conservative over innovation than physicians. As for dbRCT's, your claims are arguable, but no excuse for not doing them. "Captive pharma" and "tobacco science" are ad hominem and irrelevant and ignore the fact that the nutrition industry generates massive dollars as well. Again the objection seems to be "it might be corrupt so let's not do studies". Alternative medicine types seem to love pointing to Vioxx et al and ignore the fact it was these same studies that discovered their inadequacies. If "captive pharma" had approached these drugs with the same attitude as orthomolecular medicine, we would never have known about the dangers. After all, they were theoretically sound. "Big Med" is not a religion, it is a business, and that is enough for us to approach their work with some skepticism. But that does not invalidate research. It seems the essence of your argument is that research need not be done because it is too expensive or too difficult. My "pseudoscience 'tude" is not without reason. Act like scientists, and we will treat you as such. Glorify the anecdote and attack experimentation, and that 'tude is unlikely to change. Ok, end of diatribe on my part.--John| I doubt it 04:41, 23 January 2006 (UTC)

You think I am glorifying the anecdote. I am not. You misread me entirely. I am saying that there are other forms of testing besides the holy "big scale" dbRCT as currently implemented, that should be specifically assessed for the nature of the product, situation and application. I like lots of tests and data, especially some of my own. Multiple kinds of tests are harder to dodge, even crude tests. This is sort of like the Hubble telescope, $2b error, despite high price testing, it turned out a knowledgable amateur could have nailed the embarrassingly large optical error for ~$10. Pauling had a knack for it.

You say there are other forms of testing, but do not suggest any, and unless you mean to question the fundamentals of experimental design, you can't away from the fact that without blinding and adequate controls, bias will eliminate any demonstration of causality. There is a reason dbRCT's are necessary. And more data is always better all other factors being equal. You also cannot compare apples to oranges, which is why meta-analyses are always less significant. And they are only significant if the individual experiments are statistically significant. This is why analyses of 500 case reports yields little. Your analogy is strained and we both should know that "a knowledgeable amateur" could never have produced a mirror of those specifications anyway. Knowledgeable amateurs have always been adept at poking holes and pointing blame, but producing the results is something else altogether. --John| I doubt it 10:46, 23 January 2006 (UTC)

I do have some years of original research, experimental experiences, games from faulty vendor data and memory at a rough intersection between a number of Fortune 50s. I have nailed a number of hard to spot cases of experimental design rigging from academic/corp. research and other situations (serious technical action/personnel/contract changes ensued). Usually with a much simpler test or careful analysis. Sometimes with massive, cheap test data. Nominal "bs" dbRCT fail to automatically impress me, partly because of their designs. In reality I think dbRCTs are often oversold but do sometimes uniquely resolve issues. dbRCTs have become a rich man's game in medicine.

I will take you at your word concerning your criticisms of the pharmaceutical industry. Of course there are studies of dubious value. You aren't saying anything new. GIGO applies to dbRCT's as well. But that is a problem that applies to all experimentation. As to "rich man's game", it seems we are back to "it's too hard to do, so don't do it". Your statements thus far consist of unsupported allegations of "a better way" and unsupported allegations that "dbRCT's are oversold" sprinkled with warnings of corporate deception.--John| I doubt it 10:46, 23 January 2006 (UTC)

In many branches of engineering and science it is axiomatic that if the vendor controls the data (client accepts it), the vendor controls the client. Ditto lack of infomation. Medicine in this aspect is owned by pharma, you are naive to think otherwise. When a test design is successfully spiked, below the threshhold of detection, many kinds of inferential manipulation are possible. In essence, Moertel did this to Pauling below the *public's* threshhold of detection (understanding & absent/withheld data).

As is readily apparent not nearly all data is controlled by the industry, unless you invoke the boogeyman of conspiracy. Calling me naive does not prove it. As for Moertel and Pauling, another unsupported allegation that would have been easily remedied by research by proponents. If the higher doses really work, that is easily demonstrated. --John| I doubt it 10:46, 23 January 2006 (UTC)

Much corp. intelligence goes into achieving the max possible without detection. Welcome to the basic facts of life in corp. America. From a budget basis I think NIH has long failed to adequately test some OM, objectivity questions aside.

The lack of corporate benevolence is hardly a surprise. As for the NIH, again a few good outcome studies would spur them to action. --John| I doubt it 10:46, 23 January 2006 (UTC)

Often I think that there are cheaper, massively more productive ways to do more tests with more resolution, less customer sacrifice. You think you are the massive skeptic; in my eyes you are still too trusting. May we forgo the tree marking now?

I am not so trusting that I will believe that statement without proof. I have little interest in territorialism. If you truly demonstrated vitamin C cured cancer, I would line up to applaud you. You mistake me, I have nothing against any treatment if it works. But your treatments are unproven and your field does not seem interested in changing that. --John| I doubt it 10:46, 23 January 2006 (UTC)

I think I have established my approach to the wording of the paragragh, I would appreciate removal of the sign or your help to balance the NPOV. The article should forthrightly acknowledge the nature of the controversy.--69.178.31.177 08:07, 23 January 2006 (UTC)

I agree, see below for my suggestion. --John| I doubt it 10:46, 23 January 2006 (UTC)

15 Principles

Here is a list of 15 principles that identify the spirit" of Orthormolecular Medicine:

1. Orthomolecules come first in medical diagnosis and treatment. Knowledge of the safe and effective use of nutrients, enzymes, hormones, antigens, antibodies and other naturally occurring molecules is essential to assure a reasonable standard of care in medical practice.

Backed up with no outcome studies. Nutrition is important, yes. There is little evidence that all this supplementation does more than create expensive urine.--John| I doubt it 01:28, 23 January 2006 (UTC)

2. Orthomolecules have a low risk of toxicity. Pharmacological drugs always carry a higher risk and are therefore second choice if there is an orthomolecular alternative treatment.

Several "orthomolecules" have been shown to be very toxic. The artificial distinction between "natural" and pharmacological is dubious. --John| I doubt it 01:28, 23 January 2006 (UTC)

3. Laboratory tests are not always accurate and blood tests do not necessarily reflect nutrient levels within specific organs or tissues, particularly not within the nervous system. Therapeutic trial and dose titration is often the most practical test.

The first part is of dubious relevance since "nutrient" levels need to be associated with disease first. The second part is even more dubious and just asking for placebo effect.--John| I doubt it 01:28, 23 January 2006 (UTC)

4. Biochemical individuality is a central precept of Orthomolecular Medicine. Hence, the search for optimal nutrient doses is a practical issue. Megadoses, larger than normal doses of nutrients, are often effective but this can only be determined by therapeutic trial. Dose titration is indicated in otherwise unresponsive cases.

A good excuse to not do studies.--John| I doubt it 01:28, 23 January 2006 (UTC)

5. The Recommended Daily Allowance (RDA) of the United States Food and Nutrition Board are intended for normal, healthy people. By definition, sick patients are not normal or healthy and not likely to be adequately served by the RDA.

Unsupported blanket statement showing a lack of understanding of fundamental biochemistry. Depending on the actual illness, a person may need more/less or the same of "nutrients". These things would require research.--John| I doubt it 01:28, 23 January 2006 (UTC)

6. Environmental pollution of air, water and food is common. Diagnostic search for toxic pollutants is justified and a high "index of suspicion" is mandatory in every case.

Environment pollution may be common. But causality has to be demonstrated. And the methods used to "determine toxicity" must be proven.--John| I doubt it 01:28, 23 January 2006 (UTC)

7. Optimal health is a lifetime challenge. Biochemical needs change and our Orthomolecular prescriptions need to change based upon follow-up, repeated testing and therapeutic trials to permit fine-tuning of each prescription and to provide a degree of health never before possible.

Unsupported statement backed by little other than speculative data. Prove it first. Seems like an excuse for variable treatment methods.--John| I doubt it 01:28, 23 January 2006 (UTC)

8. Nutrient related disorders are always treatable and deficiencies are usually curable. To ignore their existence is tantamount to malpractice.

I would agree except that what is defined as "nutrient related disroders" are dubious and backed by little data.--John| I doubt it 01:28, 23 January 2006 (UTC)

9. Don't let medical defeatism prevent a therapeutic trial. Hereditary and so-called 'locatable disorders are often responsive to Orthomolecular treatment.

The first part can be used as justification for anything. The second is unfounded except by anecdote. Causality is again the issue.--John| I doubt it 01:28, 23 January 2006 (UTC)

10. When a treatment is known to be safe and possibly effective, as is the case in much 0 Orthomolecular therapy, a therapeutic trial is mandated.

A tantamount admittance that orthomolecular medicine is not proven. Not all treatments are safe. And informed consent should be a priority in treatments of questionable benefit regardless of safety. Any misrepresentation is fraud.--John| I doubt it 01:28, 23 January 2006 (UTC)

11. Patient reports are usually reliable, The patient must listen to his body, The physician must listen to his patient.

Ok. Except that the placebo effect has been amply demonstrated.--John| I doubt it 01:28, 23 January 2006 (UTC)

12. To deny the patient information and access to Orthomolecular treatment is to deny the patient informed consent for any other treatment.

The responsible clinician is not responsible for supplying information about dubious treatments. This has been well established.--John| I doubt it 01:28, 23 January 2006 (UTC)

13. Inform the patient about his condition; provide access to all technical information and reports; respect the right of freedom of choice in medicine.

No argument there. But inundating the patient with technical jargon about molecular models and glossing over the lack of data supporting actual effectiveness is fraud.--John| I doubt it 01:28, 23 January 2006 (UTC)

14. Inspire the patient to realize that Health is not merely the absence of disease but the positive attainment of optimal function and well-being.

Ok.--John| I doubt it 01:28, 23 January 2006 (UTC)

15. Hope is therapeutic and orthomolecular therapies always are valuable as a source of Hope. This is ethical so long as there is no misrepresentation or deception.

The first is arguable. I agree with the second.--John| I doubt it 01:22, 23 January 2006 (UTC)

Thanks. Pretty conventional, so let's try to finish. I would like the article to be coherently OM descriptive perhaps so that OM might seem self-immolating to you. I think this is extensive detail readily available to aid any POV you may feel got slighted and yet preserve the concise quality Wiki usually misses.

Section Dispute

obviously I didn't refresh recently. working on it thanks— Preceding unsigned comment added by 69.178.31.177 (talk • contribs)

no dispute, but I am not sure they remain "conventional". Perhaps conventionally trained would be a better term.--John| I doubt it 05:25, 23 January 2006 (UTC)

This is POV and of little relevance. A better sentence would read However, conventional medicine disputes the concepts, research, and clinical efficacy of orthomolecular medicine.--John| I doubt it 05:25, 23 January 2006 (UTC)

no dispute--John| I doubt it 05:25, 23 January 2006 (UTC)

Not really. They do tests of questionable validity that purport to measure deficiencies. --John| I doubt it 05:25, 23 January 2006 (UTC)

This is a straw man. The major complain against orthomed is not toxicity but lack of efficacy.--John| I doubt it 05:25, 23 January 2006 (UTC)

A good response to the straw man--John| I doubt it 05:25, 23 January 2006 (UTC)

Unproven statement, especially the evolving advanced claims. --John| I doubt it 05:25, 23 January 2006 (UTC)

Critics deem orthomolecular therapies as unscientific based on the fact that they are without authoritative trials, and the trials that have been done are negative. The "nonrepresentative" is a hedge, since proponents can't point to any "representative" trials.--John| I doubt it 05:25, 23 January 2006 (UTC)

A factual statement of the proponents POV, but completely one sided.--John| I doubt it 05:25, 23 January 2006 (UTC)

Again without pointing to studies that show positive results that use so called "correct" doses, frequencies, durations, etcetera.--John| I doubt it 05:25, 23 January 2006 (UTC)

How about something like this? Although the International Society of Orthomolecular medicine has many conventionally trained physicians among its members, the field enjoys a contentious relationship with conventional medicine. Conventional medicine deems orthomolecular practices to be unscientific due to the lack of authoritative trials demonstrating efficacy. They also refer to several trials with negative results. Proponents dismiss the negative trials as lacking validity due to differences in dosage, frequency, and other factors. Critics refer to the continued lack of positive trials at any dosage or frequency. Proponents also dismiss the need for authoritative trials pointing to their patients' perceived benefit, a position also deemed unscientific by critics. --John| I doubt it 05:44, 23 January 2006 (UTC)

SectPOV

I attempted to better represent the conventional medical criticism of orthomed. I removed the toxicity claim and counterclaim as not representative. I also removed the section on nutrition and testing as having little relevance to the discussion. I attempted to represent the spirit of our discussion here in the short paragraph. Please continue to edit so we can achieve a consensus on NPOV. Despite our differences in opinion, I feel that is possible. --John| 12:55, 23 January 2006 (UTC)

I've got to run but I think it is overcut for a new reader concerning some questions frequently on their minds. The dbRCT issues have run amok in current edit, now I am uneasy. Too eager, will dismiss therapeutics that are in fact mainstreaming ie E-2000iu in Alzhiemers, D3 1000-4000iu in several med schools, K2 in cancer (Japan). I think we are out of balance. Btw what do you think of the 20yrs post-Pauling IV C work by H Riordan, MD. He was an interesting case in a clinical development but of course is cut short (stroke). --69.178.31.177 13:26, 23 January 2006 (UTC)

We could change the phrase to "scientific studies".--John| 13:46, 23 January 2006 (UTC)