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Orthomolecular medicine

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Optimum nutrition and, most broadly, orthomolecular medicine is the term used by proponents to describe the controversial proposition that use of natural substances found in a healthy diet such as vitamins, dietary minerals, enzymes, antioxidants, amino acids, essential fatty acids, dietary fiber and intestinal short chain fatty acids (SCFA) in the prevention and treatment of diseases. Orthomolecular medicine focuses on the role of proper nutrition in relation to health. Optimum nutrition asserts that many typical diets are insufficient for long term health. Nutrition comes first in orthomolecular medical diagnoses and treatment, drug treatment is used only for specific indications.

Orthomolecular medicine is defined as the provision of the optimum molecular constitution, especially the optimum concentration of substances that are normally present in the body, for the purposes of treating disease and preserving health. Orthomolecular medicine is a minority view held by a small number of medical practitioners, some aspects of which have some support in scientific research (e.g. the role of optimal nutrition in preventing cancers). It forms part of a science based debate on the role of nutrition in health and has not gained acceptance as a therapy in established medicine. Orthomolecular treatments have frequently been first introduced when conventional medicine offered neither solution nor hope . However, leading orthomolecular proponents have been criticized for making far more sweeping claims, including claims that nutrition can cure "alcoholism, allergies, arthritis, autism, epilepsy, hypertension, hypoglycemia, migraine headaches, depression, learning disabilities, retardation, mental and metabolic disorders, skin problems, and hyperactivity."

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

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

History

Orthomolecular therapy dates back to the early 1950s when a few psychiatrists began adding massive doses of nutrients to their treatment of severe mental problems.

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

Method

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

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

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

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

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

Popularity

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

Criticism and Relation to conventional medicine

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

However, many conventional medical physicians regard most orthomolecular therapies as insufficiently proven for clinical use. Proponents contend that many conventional doctors have little familiarity with the detailed concepts and clinical background of orthomolecular medicine. Conventional medicine disputes the validity of most orthomolecular therapies based on the lack of authoritative studies and the results from some disputed studies. Proponents note that the disputed studies used much lower doses, frequencies, duration or assimilable forms than they recommend or other special conditions, contamination, populations or statistical treatment often not clearly published in the documentation.

The relationship of conventional medicine to Orthomolecular proponents has been sometimes technically adversarial. Some health professionals see orthomolecular medicine as an encouragement for individuals to dose themselves with large amounts of vitamins and other nutritients in an unsupervised way, which may be damaging to health. Rare risks of unsupervised misuse or deliberate abuse may include peripheral neuropathy, ataxia, congenital abnormalities, spontaneous abortion, gouty arthritis or jaundice. Many physicians express concern that megavitamin and orthomolecular therapies used solely as alternative treatments, if unsuccessful, may create dangerous delays in obtaining their conventional treatments, such as radiation and chemotherapy for cancer.

Sometimes proponents claim partisan politics, pharmaceutical industry influence, and competitive considerations to be significant factors. Some other orthomolecular therapies have been long recognized and officially sanctioned within Europe and Japan.

Notable orthomolecular doctors

Orthomolecular scientists

Reference links

  1. Orthomed.org Kunin Principles That Identify Orthormolecular Medicine: A Unique Medical Specialty - Richard A. Kunin, M.D. Accessed June 2006.
  2. Orthomed.org Wund Orthomolecular Medicine Revisited , Ray C. Wunderlich, Jr., M.D. Accessed June 2006.
  3. 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.
  4. 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
  5. 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
  6. Observations On the Dose and Administration of Ascorbic Acid When Employed Beyond the Range of a Vitamin in Human Pathology
  7. Alpha-Lipoic Acid (Thioctic Acid): My Experience
  8. Reduction of Cholesterol and Lp(A) in Regression of Coronary Artery Disease: A Case Study
  9. Coenzyme Q10: A Novel Cardiac Antioxidant (1997)
  10. Princeton Brain Bio Center. Brochure, distributed to patients. Skillman, N.J., 1983, The Center.
  11. Committee on Nutrition, American Academy of Pediatrics. Megavitamin therapy for childhood psychoses and learning disabilities. Pediatrics 58:910­912, 1976
  12. http://www.quackwatch.org/01QuackeryRelatedTopics/ortho.html
  13. Definition of Orthomolecular medicine at www.orthomed.org Accessed June 2006.
  14. What is Orthomolecular Medicine?, Linus Pauling Inst.
  15. http://www.quackwatch.org/01QuackeryRelatedTopics/pauling.html
  16. nccam.nih.gov
  17. nccam.nih table 1 on page 8
  18. emedicine - Toxicity statistics, 2003
  19. PMID: 3153129
  20. PMID: 3737019
  21. Vitamin Therapy, Megadose / Orthomolecular Therapy, provincial BC Cancer Agency
  22. The Truth About the Drug Companies by Marcia Angell
  23. fibrinolytic activity of nattokinase, Miyazaki Medical College, Japan
  24. Coenzyme Q10, prescribed for CHF in Japan since 1974, AAFP

Bibliography

  • Abram Hoffer (1998) Putting It All Together: The New Orthomolecular Nutrition, McGraw-Hill, ISBN 0879836334
  • Abram Hoffer, M.D. with Linus Pauling (2004) Healing Cancer: Complementary Vitamin & Drug Treatments, CCNM Press, ISBN 1897025114
  • Pauling, Linus (1986) How to Live Longer and Feel Better, W. H. Freeman and Company, ISBN 0-380-70289-4
  • Roger J. Williams, Dwight K. Kalita (1979) Physician's Handbook on Orthomolecular Medicine, Keats Publishing, ISBN 0879831995
  • Melvyn R. Werbach, Jeffrey Moss (1999) Textbook of Nutritional Medicine, Third Line Press, ISBN 0961855096
  • Joseph E. Pizzorno, Jr., Michael T. Murray (November 2005) Textbook of Natural Medicine, 3rd edition, Churchill Livingstone, ISBN 0443073007 · 2368pp

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