Misplaced Pages

fixed --Hroðulf (or Hrothulf) (Talk) 12:40, 14 August 2006 (UTC)

You know, I thought there would be no NPOV controversy by using a dictionary definition of orthomolecular, but I now see that dictionaries are part of the conspiracy, too, part of the ongoing problem with the refusal by some editors to accept WP:V and WP:RS as a standard. I'm okay with the Hroðulf version. -- Cri du canard 12:54, 14 August 2006 (UTC)

LOL. How did you manage to recruit the dictionary, by the way? I told it not to go to the bad part of town after dark. --Hroðulf (or Hrothulf) (Talk) 13:55, 14 August 2006 (UTC)

Different facts for different folks Stedmans Online. Search / Search in Definition: "Sorry, but the Stedman's Online Medical Dictionary doesn't recognize this term." Orthomolecular alone :"orthomolecular(,) orthomolecular psychiatry(,) orthomolecular therapy" Thanks, Hroðulf, but I was not amused at all. This going to be a really long haul to answer all the ugly "referenced" innuendo, blatant mischaracterizations and "radical skepticism" by long time, POV warring, often anti-scientific, commercially compliant parties, including many of those in Canard's polemic references, even if "official" or "authoritative". The seismic lines and commercial POV run that deep.--TheNautilus 15:57, 14 August 2006 (UTC)

Nautilus isn't being especially coherent in his response, but he seems to be implying that I made up the Stedmans definition. Here it is online, word for word as I quoted it, though experience has taught me that Nautilus doesn't ever apologize for making hotheaded accusations. -- Cri du canard 18:00, 14 August 2006 (UTC)

Perhaps some people don't agree that we need a sense of humour sometimes. In any case, either Stedman's made an error, or answers.com made an error in scraping it. That is ok, because a group of POV editors at Misplaced Pages can collaborate to fix it, and make an NPOV definition. --Hroðulf (or Hrothulf) (Talk) 19:45, 14 August 2006 (UTC)

Definitions

The weak one is controversial enough: "Medicine should pay attention to optimal nutrient levels in the treatment of every disease, lest medicine find itself actually treating subclincal malnutrition, when it thought it was treating pathology." Years ago I read an article pointing out the very high prevalence of untreated malnutrition in acute patients (it said essentially that the skeleton in the hospital closet, was too often the patient). But the "orthodox" idea of what constitutes "good nutrition" has changed a lot over those years. It's not just the RDA for ill people anymore. I've mentioned the extremely fortified enteral feedings which are becoming routine in ICU's--- they probably deserve a "bullet" in the orthomolecular claim section, and I'll get around to it eventually. Those canned feedings with with all those mono additives didn't exist just ten years ago, and anybody trying to implement them would have accused of orthomolecular quackery. Arginine?! Hmmm. And EPA used to be synonymous with snake oil. If fact, EPA is actually a large fraction of cold water snake oil, so there you go. The very idea of using it for rheumatism! Lock up those snake oil salesmen. We want Vioxx.

So what do we learn from our double blind trials? The GISSI study found no effect from vitamin E in 11,000 people with heart disease. Aha, that proves the orthomolecular quacks are wrong about vitamin E. Okay. But the same study found a drop of 30% in cardiac mortality and 20% in overall mortality, from omega-3 supplementation. This is a larger effect than any statin trial has yet found. And what does that show? Well, for too many people it shows that omega-3 supplementation can't be an orthomolecular therapy. Since it works. ;) But not to worry: when it comes to actual physician practice, fish oil is still TREATED as though it was orthomolecular (since most cardiac patients are on a statin and a minority on fish oil supplements, rather than the other way around). So I suppose it works out in the end. Fish oil will need to be made a lot more expensive and drug-ified before it's used very much. Powerful medicine needs to be expensive-- we all know that instinctively, do we not. And they're working on that. I mentioned OMECOR.

The strong version of the orthomolecular belief is the idea that most diseases have their origins in malnutrition, or at least can be managed by diet and nutritional therapy alone, if the patient cooperates (especially true for chronic conditions). These heretical ideas have their origin in studies of disease incidences in populations eating various diets, such as the China Study. And in shorter term tests of things like the DASH diet and the Mediterranean diet. In short, believers in the strong version of orthomolecular medicine are guilty of feeling about diet and nutrition, much the same way as orthodox medical people feel about their drugs. The cads. So what are we going to do about them? My suggestion is that we just remember that everybody tends to overrate the tools they're most familar with. I personally can't convince myself that there's more bad thinking on one side than the other. Too many times I've seen a grossly obese patient with 4 obesity-related diseases, 11 pill bottles, 3 polypharmacy-related problems, 1 drug reaction, and a partridge in a pear tree. And if you've done much internal medicine, so have you. In such a world, one wonders if orthomolecular thinking is really contributing the harm which its critics suggest.

So what do we do, here? If we let the orthomolecular people coopt the Mediterranean diet and fish therapy, is it not just a slippery slope from there to 50 grams of vitamin C IV? How are are we going to stop it? I dunno. How did we stop orthodox medicine from running away with itself with expensive and dangerous treatments which didn't do much good? :) I suggest we just apply those brakes to orthomolecular therapy, so that it becomes the moderate and wise practice that we all know and love in standard medical practice. Not so hard, is it? SBHarris 17:23, 14 August 2006 (UTC)

Disputed

"Proponents argue that these claims come from clinical observation often from physicians with a lifetime of general practise." The cited sources don't seem to be talking about the specific claims, given that they were written before the Princeton Brain Bio Center existed; "these claims" is inappropriate, then. Can someone either rewrite this sentence for accuracy, or find a real supporting cite, or delete the sentence? -- Cri du canard 17:52, 14 August 2006 (UTC)

I agree that unless the sentence is reworded, it should be removed. Addhoc 18:00, 14 August 2006 (UTC)

Reworded . This assertion stands alone and does not need to be chronological with Princeton Brain Bio Center. Lumos3 21:38, 15 August 2006 (UTC)

POV tag

I was the one who re-added the POV tag a week ago. While the article is far from perfect, and there continue to be problems with POV-pushing edits, I don't have problems with the current NPOV status, and I'm pleased to see that OM proponents have, for the most part, been more willing to compromise on edits in the last week than in previous hard-line incarnations. I hope that that continues after I stop watchdogging the article daily. Does anyone believe there are still POV problems? If not, I'll remove the tag once the article stops being changed hourly. -- Cri du canard 18:30, 14 August 2006 (UTC)

Conclusions "shown" vs. "found" vs. "suggested"

In medicine, the word "shown" is a fairly powerful one, and is properly reserved only for the tightest conclusions based on the multiple studies of the sort that produce the best evidence (meta analysis of level 1 studies-- see evidence based medicine). Authors rarely use the word "shown" with regards to their own work. Conclusions are generally presented more modestly as "suggested." Other people referring to the authors' own conclusions from single studies generally use the neutral words "found" or "finding." As in Author A et al. "found" in study X that Y was true. Or the "findings" of study Y do not agree with the "findings" of similar study X.

Generally it's a symptom of severe bias to write that studies which conclude things you don't agree with, "suggest" so-and-so (a less confident and robust conclusion), while at the same time writing that studies of the same quality which find the opposite, actually "show" the opposite so-and-so conclusion. It's also not a good idea to use the phrase "not shown" to describe causation for a finding with a certain nonsigificant p value, if you wouldn't have been equally prepared to use the word "shown" if the study p value had instead made significance. This also is bias-- less well recognized, but just as real.

The article on orthomolecular medicine actually does show this type of bias, with the word "show" being used only in connection with negative studies, and the word "suggest" being reserved for positive studies which tend to support orthomolecular or pro-nutrient-therapy ideas. I have tried to fix this, but have been accused of WP:POINT, which is a Wikispeak for somebody who tries to illustrate a problem by showing somebody else what it would be like to be on the receiving end of the sort of bias that they are generating. Generally such direct illustrations are frowned upon, but on the other hand, something must be done for people who don't seem to get it, even with such direct and heavyhanded illustration. I therefore suggest that somebody else take this matter in hand, and carefully read the article and edit it to conform to a neutral statement of the conclusions of various studies. As noted, I generally like to use the word "finding" to refer to study conclusions, since it's rather neutral, like the use of the world "statement" or "conclusion," rather than the often hackle-raising term "claim." SBHarris 21:42, 14 August 2006 (UTC)

Can a study or treatment be "orthomolecular" without anyone admitting it?

I submit that the answer is not only "yes", but actually "yes, and usually this is the case." Orthomolecular has become something of a dirty word, associated with pseudoscience, Pauling's claims about vitamin C, and (maybe even worse) with scientology's pushing of niacin for psychiatric problems (alas, L. Ron Hubbard was a fan of this one). Movements and philosophies suffer guilt by association just as people do. Voluntary eugenics got such a bad name that it had to be renamed genetic counseling, and so on. Probably at this point, orthomolecular medicine needs a facelift name, like nutritional medicine, or metabolic medicine. Meanwhile it's stuck with baggage.<g> Do scientific papers use orthomolecular ideas without presenting themselves as orthomolecular papers? Of course they do! Use of the very word is a ticket to the rejection pile of a respectable journal, so nobody is going to use it if they don't have to. But a number of common medical treatments, including all diet therapy, and even such things as inhalation of pure oxygen for cluster headaches, or magnesium therapy for ecclampsia, qualify under Pauling's definition. Does anybody really think that that obstetrition says to himself (herself), "I'm going to inject this woman with a mere MINERAL to treat her high blood pressure, in an attempt to SUBVERT the very basis of the scientific thinking and the drug monopoly, BWAA-HAH-HAH!!!" No. Medicine doesn't work like that. Instead, the doctor simply loses the label and uses what works. If you told him he was an orthomolecular doctor for the moment, he'd probably deny it. SBHarris 22:10, 14 August 2006 (UTC)

I think it's telling that only the quacks voluntarily associate themselves with "orthomolecular." The question becomes what distinguishes orthomolecular medicine from mainstream medicine, and the answer is the sort of quackery seen on orthomed.org accusing mainstream medicine of conspiracies to suppress good treatment by insisting on double-blind studies. That way lies pseudoscience.

If proponents of nutritionally-based medicine adopted a different name, but didn't adopt the orthomolecular rhetoric, it would still be something different than orthomolecular medicine. What makes orthomolecular medicine orthomolecular medicine is the pseudoscientific rhetoric and insistence on unsubstantiated claims. That some of the kitchen-sink cures they've tried happen to coincide with good medicine doesn't vindicate orthomolecular medicine, because things like Omega-3 were determined through good science, not through orthomolecular posturing. -- Cri du canard 22:35, 14 August 2006 (UTC)

A lovely piece of circular, self-justfying rhetoric. Whether something "is" OM is simply determined by the definition of OM, not by someone's value judgement of whether it is "posturing" or not. --Michael C. Price 22:55, 14 August 2006 (UTC)

I agree -- and since OM defines itself as opposed to mainstream medicine and good science, it's clear that a mainstream medical double-blind study is not OM. -- Cri du canard 23:41, 14 August 2006 (UTC)

That statement "OM defines itself as opposed to mainstream medicine and good science" shows how totally POV you are. It would be wise of you not to continue this dicussion before you lose what ever credibility you still have. --Michael C. Price 23:57, 14 August 2006 (UTC)

Hey, Kunin said it and orthomed.org endorsed it and Nautilus or his predecessor put it in the Wiki article, not me. I never would have found the article where Kunin defines OM as opposed to mainstream medicine and double-blind studies and the Hippocratic Oath if an OM proponent hadn't pointed it out. If you want to talk about credibility, perhaps you should look in the mirror and stop making bogus accusations of vandalism and stop writing edits like "it is this meaning of orthomolecular that Bruce Ames used" when citing to an article where Ames never uses the word orthomolecular. -- Cri du canard 00:07, 15 August 2006 (UTC)

I see you are being very careful not to quote Kunin directly as saying "OM defines itself as opposed to mainstream medicine and good science". Very wise. BTW it's Pauling's definition that is relevant since it is accepted by critics and supporters alike that Pauling defined OM, not Kunin. --Michael C. Price 00:13, 15 August 2006 (UTC)

I've quoted Kunin directly multiple times in response to your false charges of vandalism (which you still haven't apologized for, or backed up with an official complaint). I'm not going to clutter the talk page repeating myself. And forgive me for thinking that a cite that an OM proponent recommended entitled "Principles That Identify Orthormolecular Medicine: A Unique Medical Specialty" on a site called orthomed.org might have something to say about the definition of orthomolecular medicine. Where's your email to orthomed.org complaining that they're part of the conspiracy to discredit orthomolecular medicine by printing Kunin's article? Cri du canard 00:18, 15 August 2006 (UTC)

Well, since you ask, if I write such an email, will that make a difference to you in this debate? I actuallly probably should write to them and point out that Kunin, despite his M.D., seems to have some misconceptions at least about orthodox medical practice. I choked a bit (for example) when I read his idea that standard medicine is against the idea of offering "false hope" by treating the incurable. I mean, has the man been to a modern oncologist? My general experience is that anybody with a solid tumor who can walk into an outpatient office under their own power, can generally get some kind of chemotherapy from an oncologist, whether there's good-quality randomized evidence that it's life-extending or even life-quality extending in that circumstance and for that tumor, or not. Chemotherapy will be "offered," not as cure, but as paliation (see hope). It will cost a lot more than vitamin C, to be sure. But the insurance company will pay, the patient will have hope, the oncologist (who buys the chemo and charges the huge markup to deliver it) will make the money (newsflash: oncologists would go broke if they didn't ever use chemo), and everybody is happy. All in all, paliative chemo is a lot more like "orthomolecular medicine" than anybody (on either side of this debate) wants to admit--- except for the prices. Science is sort of secondary; it's not really denigrated so much as ignored.

As for the rest of the essay, Dr. Kunin sounds like he'd be a lot happier as a naturopath than a medical doctor. Hydrotherapy as "orthomolecular"? As in whirlpools? What? Acupuncture? Hypnotherapy? Somehow I don't think all of this is what chemist Pauling intended. This is one guy's views and it's up on orhomed.org, which appears to be the website of the people who publish J. Orthomolecular Med. (Although the website itself defines orthomolecular medicine as correcting individual balances in biochemistry, and that sounds a lot more like Pauling). Perhaps orthomed.org merely needs a disclaimer about editorials? Surely they know that this Dr. Kunin fellow is being purposefully inflammatory when he says medicine is only interested in treating symptoms, but not cures? How about if I email them about that? For Kunin actually goes on to say that medical doctors don't listen to their patients, and question their honesty regarding reports of symptoms. Now, either M.D.s are obscessed with symptoms, or they aren't. One can't have this both ways, you know. :) In any case, I'm curious as to why material from this essay counts as official orthomolecular doctrine, any more than every idea in some editorial essay by some doctor in the back of JAMA (Journal of the American Medical Association) should be taken as the official view of "allopathy." SBHarris 02:12, 15 August 2006 (UTC)

Well, the Kunin article is the very first link on the front page of the Orthomolecular Medicine Online webpage run by the Journal of Orthomolecular Medicine, ahead even of the Pauling article that you say it disagrees with. (The other non-Pauling article on the front page is this plainly pseudoscientific collection of questionably-documented anecdotes that also identifies orthomolecular medicine as opposed to mainstream medicin (as do you) by both of you using the slur "allopathy"). I think orthomed.org is a bunch of quacks, but they're the head quacks of the whole quack discipline, and, as such, I trust their definition of orthomolecular medicine more than yours. But it's now official: according to the pro-OM advocates on this page, there are no reliable sources on orthomolecular medicine, because everyone from JAMA to medical dictionaries to the Canadian government to prominent OM advocates is conspiring to spread misinformation about orthomolecular medicine. -- Cri du canard 03:50, 15 August 2006 (UTC)

I put "allopathy" in quotes for a reason. As for the rest, surely you overstate. The head quacks have to be homeopaths and Hulda Clark parasite zappers and various "energy field" workers and so on. Not people who got the dose or the type of vitamin E wrong. And about whom we will hardly be dumbfounded if they turn out to be right about selenium as a major cancer preventive. There is physics, physiology, biochemistry, and so on, and othomolecular medicine fits right in there, though it may not be right in all it says. To disparage it as the head of quack disciplines denotes just an amazing lack of perspective about the variety and nature of quacsk. Perhaps you need more education about what the REAL "alternative" practitioners are saying. The crazies. Start with, you know, the guy who invented the term "allopath" and those who still follow him. SBHarris 05:41, 15 August 2006 (UTC)

Meanwhile you fail to address my main point, that this debate is irrelevant to the editing of the article. -- Cri du canard 00:18, 15 August 2006 (UTC)

So why did you raise the subject of Kunin's definition in the first place? --Michael C. Price 00:30, 15 August 2006 (UTC)

I didn't raise it. You and other editors raised it first by falsely accusing me of "vandalism" by falsely accusing me of misrepresenting and misquoting the article. And these false accusations continue to be made, in contravention of WP:CIVIL and WP:NPA. -- Cri du canard 01:51, 15 August 2006 (UTC)

You raised it first in this thread. --Michael C. Price 07:15, 15 August 2006 (UTC)

This debate is utterly moot to the article and I'm not going to continue it. The article currently makes the NPOV statement that some OM proponents point to these studies, it makes the NPOV statement that not all of the studies are universally accepted, and it makes the NPOV statement that none of the studies explicitly endorse orthomolecular reasoning, and some explicitly reject it. These are all neutral, verifiable statements. Whether the studies are "really" OM (or, as I demonstrate, not really OM) is a POV statement that doesn't belong in the article. Misplaced Pages is about verifiability, not truth. -- Cri du canard 23:47, 14 August 2006 (UTC)

Bullshit. Misplaced Pages is about truth. Verifiability is a minimum requirement for the addition of material to WP. However, articles are to be edited to a higher standard of truth. It is well known to public relations experts, marketing directors, political spin doctors and propagandists that any particular collection of "verifiable facts" can be sculpted to "prove" almost anything. Although frequently done in our society, such sculpting is usually morally wrong. I beleive that Misplaced Pages can and should rise above this level of "point-of-viewism" and strive to tell the truth.

I perceive your edits to be an attempt to sculpt a particular viewpoint by carefully adjusting your collection of "verifiable facts" to discredit OM. I resent this, as I think we should focus on telling the truth. linas 01:06, 15 August 2006 (UTC)

The problem, sir, is that your perception of the truth differs mightily from mine (and from mainstream medicine's, and, I believe, from reality, but that's neither here nor there). That's why there is a WP:NPOV and WP:V policy. I may not like your claims, and think they're quackery, but so long as they're verifiable, they get to go in the article. I merely ask for the same courtesy. Your complaint is with Misplaced Pages policies, not me, and I wish you'd stop being abusive towards me for being the messenger that the majority viewpoint doesn't agree with your pseudoscientific views.

Now, do you have a specific comment about a specific part of the article, or did you just want to call me names and curse at me on the talk page? -- Cri du canard 01:51, 15 August 2006 (UTC)

Original research connection

Please see and regard this edit by Michael ].

Disregarding his highly incivil block threats that he made after I tried to correct him, I think this sould be discussed, rather than resorting to revert warring like Michael.

By including this quote we are trying to imply that a leading critic of OM has actually verified part of it, which is blatently absurd and POV. The claims make no claim of OM, and appear to be fairly uncontroversial nutrion claim. This is in fact quote mining and an attempt to confuse the reader. Jefffire 10:45, 15 August 2006 (UTC)

The overlap of OM with other fields is being discussed elsewhere (i.e. directly above) on this talk page. --Michael C. Price 10:52, 15 August 2006 (UTC)

What is discussed on this page is OR. Unless you can verify that the claim is OM, your inclusion is specious, non-neutral, and an exercise in decieving the reader. Jefffire 11:04, 15 August 2006 (UTC)

I would also suggest that issueing a 3rr warning to an editor after they make one revert, when you have made three, is hypocrisy and immensely incivil. Jefffire 11:08, 15 August 2006 (UTC)

Restoring lost sourced quotes is not uncivil. I suggest that repeatedly deleting them is. --Michael C. Price 11:13, 15 August 2006 (UTC)

This quote was obviously misplaced and misattributed. The sentence about mainstream science was properly referenced, the "balancing quote" does not address the issue of the general view of current mainstream science and as included implied wrongly that the original source was equivocal in its assessment - it wasn't Gleng 11:28, 15 August 2006 (UTC)

MichaelCPrice, you have misused the 3RR warning again, this time by placing it on my talk page. I have made only ONE revert. Stop misusing warnings. As to your argument about being "from the same website," that was not my summary, nor anyone elses, as far as I can see. You are concocting a straw man argument. -- Fyslee 11:37, 15 August 2006 (UTC)

So explain how the deletion of a counter-balancing sourced quote from the same website is justified? --Michael C. Price 11:46, 15 August 2006 (UTC)

Copy edit of Bruce Ames section

Having given the Bruce Ames section a bit of a copy edit partially based on WP:WTA, could I question the relevance of this section? Addhoc 11:38, 15 August 2006 (UTC)

Yes, now that you have removed a lot of relevant information (or example that Ames tests megadoses of nutrients on animal models, or that his papers covered the same focus on coenzyme binding as in Pauling's original OM paper), I guess the relevance of what is left may be questioned. --Michael C. Price 11:44, 15 August 2006 (UTC)

Firstly, I didn't remove megadose. Secondly, what does animal model actually mean? Is he studying rodent physiology or something? Also, I consider your linkage of Ames and Pauling to be editorialising. Addhoc 11:50, 15 August 2006 (UTC)

You removed "high doses". If you looked at Ames' papers you would know whether it was on rodents or not. And you would know that he is giving the equivalent of megadoses to the animals. Look them up yourself. Stating that there is a degree of overlap between two papers is not editorialising. Ames has received an award from the Linus Pauling institute, so clearly he is not shy about the connection. --Michael C. Price 11:57, 15 August 2006 (UTC)

Ok, I reworded and swapped high and large, but I don't consider this very significant. My concern about "animal models" is that it constitutes jargon, which is advised against in WP:WTA. Possibly you are correct about stating overlap. However your usage of the phrase "as indeed" would be defined as editorializing in the terms of WP:WTA. Regardless, I am not convinced about the relevance of this paragraph. Addhoc 12:08, 15 August 2006 (UTC)

How about if you just wikify animal model for people who don't know the term? I don't know that this is any more a "jargon" science term than (say) DNA or black hole. Anybody reading the article can be assumed to know some basics. SBHarris 17:16, 15 August 2006 (UTC)

Large/high/megadose is important because it indicates that Ames is investigating the effects of >RDA doses. If you are concerned about jargon then modify it to make it clearer ("improve don't delete"). --Michael C. Price 12:23, 15 August 2006 (UTC)

"Ames has received an award from the Linus Pauling institute,..." Yes? So what! You would have a point if Ames awarded them a prize, but he didn't. Prizes are often given for various reasons, in this case to award someone whom they feel is helping their cause. I can imagine Ames behaved himself and accepted the prize (did he have any choice?!), without rudely pointing out the errors of his "benefactors."

The Ig Nobel Prize is another example of a prize given for an interesting reason - to make fun of the unwilling and unfortunate recipient. -- Fyslee 12:36, 15 August 2006 (UTC)

Ok, my position is the paragraph is not relevant and consequently I propose its deletion. Addhoc 12:48, 15 August 2006 (UTC)

Overlap between nutritional science and OM

As far as any overlapping between accepted nutritional science and the work of orthomedical practitioners, it is rather irrelevant to the issue of pseudoscience, but still should be dealt with here in its own section. This might resolve some of the disputes here.

Of course there is overlapping, and this applies to nearly all areas of pseudoscience and dubious claims. It can't be any other way. Of course the believers also believe in some sensible things. Duh! That doesn't make them any less guilty for believing in their pseudoscientific ideas or making their dubious claims. On the contrary, they misuse the sensible aspects to trick people into believing their nonsense is also sensible.

To ensure that the areas of overlap are not misused here by believers in OM, they should be pointed out and clearly labeled as sensible science, while continuing to point out the errors of OM. It is these areas of contention and dubious claims that prevent sensible nutritionists from accepting OM with open arms. -- Fyslee 12:37, 15 August 2006 (UTC)

The problem is that the line between "dubious claims" and "sensible science" keeps shifting from year to year. They keep moving the little sucker. And nutritionists are generally to be found on the reactionary side of it, whereever it is, and orthomolecular people on the future side (mainly because they favor supplements of everything). I am old enough to remember when nutritionists advised figuring out ways to drink the water you boiled your stringbeans in, to get your folate, and certainly not to take a folate PILL. Those things were dangerous, since they could mask pernicious anemia, you know. It was actually illegal to make a megadose folate pill, and still is. After a while, when it became apparent that neural tube birth defects weren't going to be stopped by people drinking the string bean water, the nutritionists okayed supplements for the high-risk population (premenopausal women) who refused string bean water. But not for anybody else, particularly not senior citizens, because that would be wholesale population vitamin supplementation, and we're all against that. Then there was a giant catfight between the FDA and the USDA about adding folate to the food supply. The nutritionists generally sided against the idea, citing all that dementia which would be hidden by people with B12 deficiency, taking folate. (All this time, B12 level blood tests are the most common nutritional test orthodox doctors actually do-- the irony). Then the USDA won, and added folate is now in your flour. And then the nutritionists suddenly, and magically, SHUT UP. Even made little noises of approval after a time. For now, mass population supplementation had been turned into good old garden-variety food-fortification (yawn), like thiamin and iodine, and it's no longer even an issue. And it certainly was never orthomolecular, no, no, no. A nearly identical battle happened over the idea of fortifying infant milk-replacement formulas with DHA. This was a crank idea right up until the moment the government decided it wasn't. With the US government deciding it wasn't nutty, long after some other governments had decided oppositely. You see the difficulty? Somebody has to take the progressive side on these issues, and (looking at history) I don't see it being the nutritionists (though I wish it was, because I generally like nutritionists). So who, then? SBHarris 16:59, 15 August 2006 (UTC)

The section on Ames was clearly misleading. It cited two publications, one a review of the incidence of polymorphisms that affect metabolism of enzymes. There are many polymorphisms that might affect metabolism, and for most their actual impact is speculative not established; these polymorphisms are common though there is no grounds for supposing that everyone has at least one; however common polymorphisms are clearly adaptively neutral - this is the nature of natural selection, so that a polynorphism is very common is itself indicative that it has no significant deleterious consequences. Now this is a review that properly and accurately displays the polymorphisms that might be relevant to individual differences in responses to vitamins or, probably more relevantly, differences in susceptibility to deficiency. It does not constitute evidenmce of benefits of supplementation above normal levels, although it informs the discussion. The second study cited correlation between riboflavin levels and levels of a risk factor for cardiovascular disease - i.e. there is no data in this associating low levels of riboflavin directly with risk, and it would be illegitimate to make this leap. The conclusion of this study is that "Studies on deficient populations are needed to evaluate the utility of riboflavin supplementation in hyperhomocysteinemia."- the study is grounds for more research, not grounds for conclusions about the benefits of supplementation. The study simply did not substantiate the point made. It is important to be careful; a normal diet already has an excess of riboflavin, so a relative deficiency in metabolism may be irrelevant except in circumstances of dietary deficiency or in the presence of another relevant genetic mutation. Just because someone has a polymorphism that means that a metabolic step is relatively slow, this does not mean that "extra" is required.Gleng 12:55, 15 August 2006 (UTC)

The residual secrion on Ames is still not accurate. Reference 16 is misdescribed; this is not Ames' work, but a review of others, the work does not solely relate to vitamin B, and these are diseases not common polymorphisms that are referred to. Ames is not a nutritionist, certainly not a mainstream nutritionist, and doesn't work on "metabolic health". I think it is true that he doesn't use the term orthomolecular. I suggest scrapping this section; his views are clearly within mainstream scientific thinking (if not always generally accepted); he is apparently not a proponent of orthomolecular medicine, even if his research might be mis-cited as seeming to offer support for it.Gleng 15:35, 15 August 2006 (UTC)

I agree with your suggestion, the section should be scrapped. Addhoc 15:36, 15 August 2006 (UTC)

Weasel Words

I propose deleting the following bold text, to remove weasel words:

• Some orthomolecular proponents claim vindication because the American Heart Association dietary guidelines recommend two servings of fish per week for the general population, and to "consider" fish-oil supplements for patients with coronary disease who cannot obtain one gram of fish-derived omega-3 by dietary means.

• Proponents of orthomolecular medicine argue that its claims are asserted on the basis of clinical observation, often from physicians with a lifetime of general practise.

Addhoc 16:13, 15 August 2006 (UTC)

I agree with the second removal. Removing the six words in the first one, by themselves, however, changes the meaning of the sentence to falsely imply that the AHA guidelines have anything to do with OM. -- Cri du canard 21:47, 15 August 2006 (UTC)

Would you prefer the removal of the whole AHA paragraph? Addhoc 09:49, 16 August 2006 (UTC)

Please explain precisely what you mean by "Weasal words" in these contexts. You cannot apply a policy without saying how it applies in each case. Both statements are true and describe how Om sees itself. Lumos3 22:42, 16 August 2006 (UTC)

Of course, according to WP:AWW "weasel words are words or phrases that smuggle bias into seemingly supported statements without attributing opinions to verifiable sources" and "it is better to put a name and a face on an opinion than to assign an opinion to an anonymous source". Either some orthomolecular proponents should be replaced by their names or the statement should be removed. Addhoc 22:51, 16 August 2006 (UTC)

Merge Proposal

I have a problem with this article; I've looked on PubMed for "orthomolecular medicine" and this raises only 29 articles in all, including just 5 reviews. Of these, only one is in a properly authoritative source, and that is a review titled "Unproven methods in cancer treatment." Searching for just orthomolecular still gives only 218 items in all, but catches 24 reviews (including the 5 above). Of these 34, 6 are not in English and 2 have no authors listed; most appear to make at most passing reference to orthomolecular, only 3 have it in the title, many of the others are reviews of risks associated with large vitamin intake or reviews of "fads". Of the three reviews with orthomolecular in the title, one is from Pauling and two from the same group in Puerto Rico are follow ups of Pauling's review, and are specifically focussed on ascorbic acid. So there is a shortage of any V RS for this subject. I started searching because the definition of OM as given didn't make much sense to me and much of the dispute here might be attributed to a fundamental lack of clarity in what this is all about. The notion that insufficiency of essential nutrients in a diet can lead to disease is not controversial, is trivially and obviously true, and is part of mainstream science. The knowledge that some rare genetic diseases mean that affected individuals are unable to metabolise nutrients is also not controversial and is mainstream. The knowledge for instance that ascorbic acid is an antioxidant and that an excess of reactive oxygen species are linked to cell damage is also not controversial. So what about this whole area is noteworthy, as even the term appears essentially unused (for comparison, the term "molecular medicine" , although not exactly a conventional term appears in 4046 articles). It does appear to me that the notion of orthomolecular medicine (insofar as there is any peer reviewed science to inform the article) is inseparable from megavitamin therapy, i.e. the notion that there are health benefits for normal individuals in consuming certain vitamins at levels substantially higher than those conventionally regarded as adequate. I therefore suggest merging the articles, and restricting the focus to this single central issue.Gleng 14:56, 16 August 2006 (UTC)

Comment, there are over 100,000 Google hits and shows up on Google trends as only being in common usage in the last year or so. Addhoc 15:53, 16 August 2006 (UTC)

OK, it needs its own article on this basis - that it is a term that has spread into wide use among the public, (presumably through promotion of products bearing this label?), but that it is a term virtually unrecognised by the mainstream science community. This does seem a classic case of pseudoscientific jargon - attachment of a label that sounds scientific and profound, but which in fact is not recognised as meaningful by the scientific communityGleng 16:33, 16 August 2006 (UTC)

Perhaps a somewhat less derogatory, less inflammatory google trends search would be this one: http://www.google.com/trends?q=orthomolecular%2C+molecular+medicine together with the observation that as of right now, we have no article at all on molecular medicine. Another keen obserevation might be: http://www.google.com/trends?q=orthomolecular%2C+megavitamin+therapy which indicates that no one is searching for the term "megavitamin therapy", and that there have been zero press articles using the terms "orthomolecular" or "megavitamin therapy". Rah, bah, sis-boom-bah. linas 00:40, 17 August 2006 (UTC)

This is related to definitions, you know. Pauling defined orthomolecular originally as the right dose, or getting the right molecules in the right concentration for health . This would include withdrawing some phenylalanine from the diets from PKU suffers, and providing insulin to diabetics. However, Pauling's critics didn't and wouldn't hear him. What they HEARD was "megadose vitamin therapy" and they knew they were against that. Cassileth: "In 1968, the Nobel-prize-winning scientist Linus Pauling coined the term "orthomolecular" to describe the treatment of disease with large quantities of nutrients." Well, no, that wasn't what Pauling said. But nobody wanted to repeat or say what Pauling said, because part of what Pauling said was inarguable. So a straw man was set up, and 4 out of 5 medical societies came out against it. (The 5th one was composed entirely of dentists who recommend Sugar Frosted Flakes, and nobody paid any attention to them).

We have the same problem with this article. We can put down Pauling's definitions but we'll turn blue before we find any orthodox medical society who is really willing to debate the issue on Pauling's grounds. Instead, the issue gets redefined to "Megavitamin Therapy" yawn, and everybody's against it. And so am I, for the record. I personally only use just-the-right-dose vitamin therapy, whenever I give vitamins. How about you-all? SBHarris 02:16, 17 August 2006 (UTC)

1. Multivitamin use, folate, and colon cancer in women in the Nurses' Health Study. Giovannucci E, Stampfer MJ, Colditz GA, Hunter DJ, Fuchs C, Rosner BA, Speizer FE, Willett WC; Ann Intern Med" 1998 Oct 1;129(7):517-24 PMID: 9758570 Long-term use (>15 years) of folate-containing multivitamin supplements produced an almost 5-fold reduction in the incidence of colon cancer.
2. Are dietary factors involved in DNA methylation associated with colon cancer? Slattery ML, Schaffer D, Edwards SL, Ma KN, Potter JD in Nutr Cancer 1997;28(1):52-62 PMID: 9200151
3. Dietary intake of folic acid and colorectal cancer risk in a cohort of women. Terry P, Jain M, Miller AB, Howe GR, Rohan TE in Int J Cancer 2002 Feb 20;97(6):864-7 PMID: 11857369
4. Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. A randomized controlled trial. Nutritional Prevention of Cancer Study Group. Clark LC, Combs GF Jr, Turnbull BW, Slate EH, Chalker DK, Chow J, Davis LS, Glover RA, Graham GF, Gross EG, Krongrad A, Lesher JL Jr, Park HK, Sanders BB Jr, Smith CL, Taylor JR. JAMA 1996 Dec 25;276(24):1957-63 PMID: 8971064 200ug/d of selenium for 4.5 years resulted in a 17% reduction of totality mortality by over 11 years (in total), due to a 50% reduction of (all) cancer mortality, 37% reduction in (all) cancer occurrence
5. Reduction of cancer mortality and incidence by selenium supplementation. Combs GF Jr, Clark LC, Turnbull BW in Med Klin 1997 Sep 15;92 Suppl 3:42-5. PMID: 9342915
6. Reduction of cancer risk with an oral supplement of selenium. Combs GF Jr, Clark LC, Turnbull BW in Biomed Environ Sci 1997 Sep;10(2-3):227-34 PMID: 9315315
7. Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin. Canner PL, Berge KG, Wenger NK, Stamler J, Friedman L, Prineas RJ, Friedewald W in J Am Coll Cardiol 1986 Dec;8(6):1245-55 PMID: 3782631 “With a mean follow-up of 15 years, nearly 9 years after termination of the trial, mortality from all causes in each of the drug groups, except for niacin, was similar to that in the placebo group. Mortality in the niacin group was 11% lower than in the placebo group (52.0 versus 58.2%; p = 0.0004).” Dose used = 2g – 3g/day for 6 years. The drop in mortality was only evident after 6-8 years.
8. Associations of Mortality With Ocular Disorders and an Intervention of High-Dose Antioxidants and Zinc in the Age-Related Eye Disease Study: AREDS Report No. 13. AREDS Research Group (Authors: Traci E. Clemons, PhD; Natalie Kurinij, PhD; Robert D. Sperduto, MD.) in Arch Ophthalmol. 2004 May;122(5):716-26. PMID: 15136320 “Participants randomly assigned to receive zinc had lower mortality than those not taking zinc (RR, 0.73; 95% CI, 0.61-0.89).”
9. Orthomolecular psychiatry. Varying the concentrations of substances normally present in the human body may control mental disease,Science 1968 Apr 19;160(825):265-71.(PMID 5641253)
10. Definition of Orthomolecular medicine at www.orthomed.org Accessed June 2006 and What is Orthomolecular Medicine?, Linus Pauling Inst.
11. ^ Cassileth BR. Alternative medicine handbook: the complete reference guide to alternative and complementary therapies. New York: W.W.Norton & Co., 1998:67.
12. ^ "Vitamin Therapy, Megadose / Orthomolecular Therapy" British Columbia Provincial Health Services Authority 2000
13. Lamm DL, et al. Megadose vitamins in bladder cancer: a double-blind clinical trial. Journal of Urology 1994 Jan;151:21-26.
14. Cite error: The named reference qw was invoked but never defined (see the help page).
15. American Cancer Society 2006 "Orthomolecular Medicine has not been scientifically proven to help most of the conditions for which it is promoted. However, vitamins, minerals, and other supplements have been and continue to be studied to see if they can help or prevent many types of illness."
16. Nutrition Committee, Canadian Paediatric Society. Megavitamin and megamineral therapy in childhood. Canadian Medical Association Journal 143:1009 1013, 1990, reaffirmed April 2000.
17. Bruce N Ames, Ilan Elson-Schwab and Eli A Silver (2002). "High-dose vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity (increased Km): relevance to genetic disease and polymorphisms". American Society for Clinical Nutrition. 75: 616–658. Retrieved 2006-08-12.
18. http://www.juvenon.com/pdfs/june05_ames-prescrip.pdf
19. http://reason.com/amesint.shtml
20. Bruce N Ames, Ilan Elson-Schwab and Eli A Silver (2002). "High-dose vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity (increased Km): relevance to genetic disease and polymorphisms". American Society for Clinical Nutrition. 75: 616–658. Retrieved 2006-08-12.
21. ^ Age-associated mitochondrial oxidative decay: improvement of carnitine acetyltransferase substrate-binding affinity and activity in brain by feeding old rats acetyl-L- carnitine and/or R-alpha -lipoic acid. Liu J, Killilea DW, Ames BN in Proc Natl Acad Sci U S A 2002 Feb 19;99(4):1876-81 (PMID 11854488)
22. ^ Memory loss in old rats is associated with brain mitochondrial decay and RNA/DNA oxidation: partial reversal by feeding acetyl-L-carnitine and/or R-alpha -lipoic acid. Liu J, Head E, Gharib AM, Yuan W, Ingersoll RT, Hagen TM, Cotman CW, Ames BN in Proc Natl Acad Sci U S A. 2002 Feb 19;99(4):2356-61. (PMID 11854529)
23. ^ Feeding acetyl-L-carnitine and lipoic acid to old rats significantly improves metabolic function while decreasing oxidative stress. Hagen TM, Liu J, Lykkesfeldt J, Wehr CM, Ingersoll RT, Vinarsky V, Bartholomew JC, Ames BN in Proc Natl Acad Sci U S A. 2002 Feb 19;99(4):1870-5. (PMID 11854487)
24. http://www.juvenon.com/pdfs/june05_ames-prescrip.pdf
25. http://reason.com/amesint.shtml
26. Google search for Bruce Ames orthomolecular
27. Cite error: The named reference pauling1968 was invoked but never defined (see the help page).
28. ^ High-dose vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity (increased K(m)): relevance to genetic disease and polymorphisms. Ames BN, Elson-Schwab I, Silver EA in Am J Clin Nutr 2002 Apr;75(4):616-58 (PMID 11916749) Abstract:As many as one-third of mutations in a gene result in the corresponding enzyme having an increased Michaelis constant, or K(m), (decreased binding affinity) for a coenzyme, resulting in a lower rate of reaction. About 50 human genetic dis-eases due to defective enzymes can be remedied or ameliorated by the administration of high doses of the vitamin component of the corresponding coenzyme, which at least partially restores enzymatic activity. Several single-nucleotide polymorphisms, in which the variant amino acid reduces coenzyme binding and thus enzymatic activity, are likely to be remediable by raising cellular concentrations of the cofactor through high-dose vitamin therapy. Some examples include the alanine-to-valine substitution at codon 222 (Ala222-->Val) in methylenetetrahydrofolate reductase (NADPH) and the cofactor FAD (in relation to cardiovascular disease, migraines, and rages), the Pro187-->Ser (DNA: 609C-->T) mutation in NAD(P):quinone oxidoreductase 1 and FAD (in relation to cancer), the Ala44-->Gly (DNA: 131C-->G) mutation in glucose-6-phosphate 1-dehydrogenase and NADP (in relation to favism and hemolytic anemia), and the Glu487-->Lys mutation (present in one-half of Asians) in aldehyde dehydrogenase (NAD + ) and NAD (in relation to alcohol intolerance, Alzheimer disease, and cancer).
29. (PMID: 15681105)
30. Riboflavin as a determinant of plasma total homocysteine: effect modification by the methylenetetrahydrofolate reductase C677T polymorphism. Hustad S, Ueland PM, Vollset SE, Zhang Y, Bjorke-Monsen AL, Schneede J in Clin Chem 2000 Aug;46(8 Pt 1):1065-71 PMID: 10926884 The riboflavin-tHcy relationship was modified by genotype (P = 0.004) and was essentially confined to subjects with the C677T transition of the MTHFR gene . CONCLUSIONS: Plasma riboflavin is an independent determinant of plasma tHcy.
31. Bruce N Ames, Ilan Elson-Schwab and Eli A Silver (2002). "High-dose vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity (increased Km): relevance to genetic disease and polymorphisms". American Society for Clinical Nutrition. 75: 616–658. Retrieved 2006-08-12.
32. Google search of Bruce Ames website for orthomolecular
33. Bruce Ames on the Idea Channel
34. Zey.com