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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)