Talk:Orthomolecular medicine/Archive 5

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)

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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)

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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 Dr Reading http://www.gutandmentalillness.com

(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.gutandmentalillness.com Based on the writings of Psychiatrist Dr C.M. Reading

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, immune 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. --[69.178.31.177] 10 Jan 2006 (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^DO|^{Speak your mind} I doubt it 20:43, 19 January 2006 (UTC)

The addition of even more pro POV language is not helping.--John^DO|^{Speak your mind} 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..."

re pseudoscience: Many of the pioneers mentioned here were no mere 36 x 3.8 MSTPs. Yet historically they are often suddenly dismissed as crazed or ignorant cranks once they encounter forbidden turf yet while honoring the principles of science. I have specifically added the conventional medicine disagreement to the section. I separated the rebuttals by sentence, but those factors are crucial to understanding the current gap, why there is a such technical philosophy/opinion split. Without these stmts, it appears mysterious why the gap should exist. Unless, of course, they were, and many are, simply fools or frauds...hmmmm. The "litte detailed knowledge" part is perhaps no fun but that is pretty much the consenus from the "dark side", of course, and frankly, from some within conventional medicine (I personally got candid conversational versions of it 2x last month). Perhaps that sentence is the part you should hone or comment on. But I really don't think the average conventional doctor has spent that much time seriously studying this subject and its history, much less researching it and experimenting. Pauling's comment was that doctors then (ca 1990s) pretty much relied on authoritative pronouncements because of their busy schedules. 69.178.31.177 20 January 2006 (UTC)

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^DO|^{Speak your mind} I doubt it 11:41, 22 January 2006 (UTC)

Too shallow, read the serious OM article refs in the biochemical parts of the books. You're still being too dismissive (just like me for 30+ yrs) to grasp what is really there (still feeding the "little detailed knowledge" that you bristle over). In the IOM website I dislike Kunin's webpage probably the most, too inclusive of therapies (not the impacted fields) that are naturopathic not biochemical i.e.#13-17,20-24 (hydrotherapy etc...). 18, 19 light related are biochemical because of vitamin D (skin:10,000-50,000iu vs 200-400-600iu RDA) and retinal physiology at least. The grab bag of naturopathy is simply where most orthomolecular support exists. I might suggest studying enzymes and megavitamin applications to see if anything connects with your technical background at some level. Conventional medicine (ie Harrison's) sometimes actually acknowledges them in passing (after fruitlessly screwing with the clean angio, liver, kidney workups across several months, on the hypertensive 80 y.o. old lady's elephant-like ankle edema - what cheap vitamin(s) would you consider? - after Harrison's 12th ed.). Maybe find about the more useful forms of megavitamin-like things (ie mixed cartenoids, D3, gamma/mixed tocopherols for cardio, isoprenoids in cancer (K-2/mk-4, coQ10, delta tocotrienol 'E'), R-alpha lipoic acid, NAC. Some of this stuff is in alt med, foreign med, some is buried in the pharma patents). You wouldn't even get close to those nasty weeds (herbals). I would be very interested to see your individual comments on Kunin's 15 principles of OM though. Resolving the experimental science situation/discussion is going to take effort, the predrilled presumptions in your stmt are legion.— Preceding unsigned comment added by 69.178.31.177 (talk • contribs)

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^DO|^{Speak your mind} I doubt it 20:36, 22 January 2006 (UTC)

We are starting to talk past each other. You might drop the pseudoscience 'tude. Your summary is parochial to many, esp. real science and engineering types (they approach experimental design, measurement and statistical inference much differently, sometimes even by themselves). The captive pharma style dbRCTs, theoretically attempting to minimize systematic uncertainty, have a track record of being bankruptingly expensive, slow, clumsy, imprecise, low yield, manipulable, and often, dead wrong (ahem). Whither Baycol, Vioxx, among many? The loose number is that 5 of 6 studies don't get published. Is it tobacco science, again - 5 dropped, the bad one gets published? This alone can pick up 1 std deviation, never mind tame creative accounting, selective reporting and interpretation. LP actually pointed out some decent early dbRCTs, they were pretty much trashed w/o respect to their merits.

The dbRCT can never overcome seriously flawed experimental and therapeutic designs, a pathologically common problem in medicine (truth is in regular sciences many professional pretenders aren't very good at ED either). Here more small trials first are better, the investigator is still the big variable in the systematic uncertainty. dbRCT are simply unethical in many jurisdictions. Completely hijacked resources, disinformation and disruption have been long term problem - that is part of why alt med is an American cottage industry. Medicine was long recognized as a prof'l trade and an art. Now that pharma-Big Med proclaims itself the arbiter of science, it is structurally very close to a religion at its zenith; upset that the sacrifices are getting wise to the games. I agree that medicine will eventually eclectically recombine, hopefully, just not as messily as it is proceeding, and within my lifetime. I do think that new methodologies with cumulative case methods with "extreme amounts" of individual data will arise to reduce the misery of dbRCT. end of a little spleen. We obviously microcosmically portray some of the philosophical differences to be characterized.

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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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.

PS folks: I ask that you please rejoin/rebut this in another separate talk section / heading so it remains readable--69.178.31.177 01:55, 23 January 2006 (UTC)

Section Dispute

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

The International Society for Orthomolecular Medicine has many conventional doctors among its members and authors.

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

However, many conventional doctors, as yet, have little detailed knowledge of the concepts, research and clinical background of orthomolecular medicine.

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^DO|^{Speak your mind} I doubt it 05:25, 23 January 2006 (UTC)

Many conventional practitioners tell patients that a balanced diet will provide all the nutrition a person needs to be healthy.

no dispute--John^DO|^{Speak your mind} I doubt it 05:25, 23 January 2006 (UTC)

Orthomolecular physicians frequently measure actual deficiencies of essential nutrients in seriously ill patients.

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

Critics arguing against orthomolecular therapies point out that very high doses of certain nutrients may be toxic and can cause problems.

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

Proponents point to an almost zero level of deaths caused by overdosing with these nutrients, especially vitamins, compared to the significant number of deaths and iatrogenic injuries from pharmaceuticals, including a number of over-the-counter items.

A good response to the straw man--John^DO|^{Speak your mind} I doubt it 05:25, 23 January 2006 (UTC)

Orthomolecular claims in essence include an evolving, advanced nutritional pharmacology at the shifting junctions and overlaps between natural medicine and conventional medicine.

Unproven statement, especially the evolving advanced claims. --John^DO|^{Speak your mind} I doubt it 05:25, 23 January 2006 (UTC)

Some critics dismiss orthomolecular therapies as "unscientific" without expensive authoritative trials or based on negative results from nonrepresentative protocols.

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^DO|^{Speak your mind} I doubt it 05:25, 23 January 2006 (UTC)

Sometimes proponents claim ex cathedra statements, partisan politics and competitive considerations to be factors.

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

Proponents note that studies giving putative negative results use 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.

Again without pointing to studies that show positive results that use so called "correct" doses, frequencies, durations, etcetera.--John^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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^DO|^{Speak your mind} 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. [1] 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^DO|^{Speak your mind} 13:46, 23 January 2006 (UTC)

Dear John, I have thought about this. Orthomolecular medicine was founded by accomplished scientists. The words "pseudoscience" and "unscientific" are terms of disparagement when applied to a subject that has some form of evidence basis. After the first laboratory and clinical studies, "it is science," everything becomes a discussion of priority. The dbRCT, a prioritized form of evidence, in its various forms is a laborious, costly effort that typically far exceeds the resources of small groups; its definition basically excludes the individual researcher or clinician. The dbRCT does not define science or even scientific medicine. It is a premium tool that can even be abused; to my eyes clearly so with respect to the historical relationship between conventional medicine and embryonic orthomolecular medicine. In the spirit of fair coverage, "unscientific" was tolerated as a passing commentary representing the sentiment of many conventional doctors whose lack of detailed familiarity with OM is noted; it is *not* a central theme of OM. This would be the tail wagging the subject, albeit the tail in this case is much larger. The word "pseudoscience" used here would be simply a perjorative provocation. Many such opinions on orthomolecular medicine appear to be made based on hearsay or discredited reports.

Accordingly I don't think the word "unscientific" is relevant, applicable or suitable here - elementally not true and simply distracting. Because of this element of contention, most other issues will need to be treated outside this section.--69.178.31.177 21:34, 23 January 2006 (UTC)

I disagree, while it is true that "pseudoscience" and "unscientific" are terms of disparagement, they are also terms that are used by conventional medicine to criticize orthomed. Whether or not proponents such as yourself agree is immaterial as to the fact that they do characterize orthomed as such. NPOV entails description of both sides and adequate weight given to the majority opinion. These facts are not in dispute: 1) Conventional medicine views orthomed as unscientific and as pseudoscience, 2) Orthomed disputes this, 3)Orthomed is the very small minority in this debate. This accurately reflects the view of conventional medicine, which is the title of the section. Also, your edit eliminated the primary objection (lack of positive studies) and substituted the secondary objection (the presence of negative studies). Also by both characterizing the studies as disputed and explicitly disputing them in the next sentence, you are giving the proponents undue weight. This in essence sets up another straw man argument. Also, the argument that doctors are "unfamiliar" with orthomed implies that familiarity would lend to acceptance, which has not proven true. Conventional medicine's view of orthomed may not be central theme of the OM, but it is the central theme of this section. --John^DO|^{Speak your mind} 22:08, 23 January 2006 (UTC)

I redid the section without using "pseudoscience" or "unscientific" despite the fact that they are terms that accurately reflect the view of critics. --John^DO|^{Speak your mind} 22:22, 23 January 2006 (UTC)

John, Tired or I may have annoyed you, I apologize. You normally write with a little more balance.

"...they are also terms that are used by conventional medicine to criticize orthomed....they do characterize orthomed as such. NPOV entails description of both sides and adequate weight given to the majority opinion. These facts are not in dispute: 1) Conventional medicine views orthomed as unscientific and as pseudoscience"

In this context, especially if the label is scurrilous rather than precisely accurate (discussed 21:34, above), it is more appropriate to refer to the nature of the debate rather to repeat the insults verbatim.

"...3)Orthomed is the very small minority in this debate. This accurately reflects the view of conventional medicine, which is the title of the section."

Consensus science is an oxymoron. Science can be extremely contentious. The orthomed founders have unusually strong science backgrounds w.r.t. avg medical students. The section is "relation with..." not merely (ignorant as in lack of detailed knowledge) scurrilous "views of...".

"Also, your edit eliminated the primary objection (lack of positive studies)"

Factual error - Lack of dbRCT is not lack of studies, or even a lack of positive studies per se, perhaps "positive enough," recycle dbRCT discussions

"Also by both characterizing the studies as disputed and explicitly disputing them in the next sentence, you are giving the proponents undue weight.

A number of "disputed" studies are described *politely* as "disputed". Pauling himself, known for blunt precison and clarity, after digging up *some* of Moertel's hidden material, publicly stated Moertel's study as a "fraud". At the time, this was widely dismissed (me too) as sour grapes from an old man past the age of senility. Being older, more directly familiar with these kind of things, I have started a little background checking into Pauling and the Moertel-Pauling situation. Pauling, typically writing a book in a few months, still seems clear in 1986 as do his later interviews. In fact LP's writing style still so paralleled a friend from CalTech's speech, it is like talking to my friend. As for Moertel, now that I better understand OM and catching sandbagged tests (not OM), from what I have gathered, LP seems to have been a little overcautious in his criticism. "Mainstream"/govt'l tests of vitamins so typically compromise 1-3+ elements of the OM protocols that it is rare to see a direct test of the protocols best accepted to succeed. Deliberately running tests well below known threshholds without acknowledgement or claiming it as a valid repetition is widely viewed as scientific misconduct. Industrially, doing it subtlely to disparage a product's evaluation, is known as "sandbagging the test". In academia, carefully hiding it is called "fraud". Again given the section "relation..." and the continuing pattern (fact) and magnitude (fact) of the errors, some note seems obligatory, not just mere "balance". And yes, it is a scandal.

"...the argument that doctors are "unfamiliar" with orthomed implies that familiarity would lend to acceptance,"

Well, it would not be the first time and in fact I think the rate of infection associated with substantial knowledge is quite high. I cannot say that I personally have ever encountered a MD that was both critical and reasonably (conversationally) knowledgeable, whereas I have encountered several "converts". Frankly there seems to be an autoabort button planted during med school that shutdowns the analytical functions about this subject. I have read critical MDs, now online, that are fairly knowledgeable, some for 20 years. I have come to view some parts of their stmts to be hideously unfair, inaccurate and misleading. If I want to talk casually to a MD I need to speak his language or about an interesting non-medical topic. Otherwise, they just meltdown (I no longer mention any of this to long time personal friends, and we don't talk as often).

"Conventional medicine's view of orthomed may not be central theme of the OM, but it is the central theme of this section."

within the confines of fact, reasonable balance, avoiding gross mischaraterization and prejudical language. Also, "relation..." is not "view..."--69.178.31.177 04:02, 24 January 2006 (UTC)

I was not annoyed, but I admit to a certain fatigue this morning. If I was rude or imtemperate, you have my apology. I thought we were engaged in a lively discussion. As you may have already noticed, while I took a strong partisan position on the Talk page, I approached my edit of the article with what I hope to be balance and NPOV. I continue to contend that the dbRCT is the most authoritative type of study available currently to demonstrate efficacy. This is the reason my first attempt specifically mentions dbRCTs. While you have pointed out some problems with dbRCTs, your objections apply equally to all other types of studies. I don't see any other types of experiment design that can eliminate bias and demonstrate causality the same way a dbRCT does. And I don't understand why large organizations like the ISOM cannot do the required studies to prove efficacy. If dbRCT's can be done to assess gingko biloba for altitude sickness, why not orthomed? Yes, there is a systemic bias against unproven treatments. This reflects the scientific conservatism of the profession, a position that is unlikely to change. We just can't afford to be an "early adopters" when lives are at stake.--John^DO|^{Speak your mind} 05:00, 24 January 2006 (UTC)

Closer to consensus

I think we are fairly close to consensus. I had five minor disputes with your last edit. 1) I think the first two sentences need to flow together, if you like them to be separate sentences, the word However is a good compromise. 2) The orthodox view does not dispute "many" OM therapies. It disputes OM. 3) I am not sure "refrains" is the best word to describe the attitude of conventional medicine towards OM. The attitude is considerably harsher, but "disputes the validity of" is fairly toned down but still descriptive of the sentiment. 4) The issue of positive studies. I think authoritative is fine, but the word sufficient implies that some authoritative studies exist and conventional medicine does not consider any orthomolecular studies to be authoritative. 5) Lastly, I don't think the "adoption by conventional medicine" sentence is really accurate. The rift is considerably wider than that. Mention of nutritionally based therapy is considered tantamount to quackery. I don't see any evidence that there is any "adoption" going on at all, since any adoption of OM is treated as defection. While there is now some preventive nutrition, therapeutic nutritional supplementation is not at all accepted. While this article should not be a conventional medicine polemic against OM, the relationship between the 2 should be accurately characterized. --John^DO|^{Speak your mind} 12:24, 24 January 2006 (UTC)

re previous: ISOM is still a relative midget, NMD & OM are hardly monied specialties. Without actual facts, I would think that a ginko application might not have much required or contention like a cancer trial.

re SectPOV:

• "...as unproven." Since this is the term frequently used as a medical catchall, I think "insufficiently proven" better represents what an ordinary encyclopedia reader would most accurately understand and best represents the differences between CM and OM here. Since "unproven" is the category that includes grossly fraudulent and even dangerous products, it is too broad.
• "Proponents note that..." - hitting the trmt protocol range, etc, is a yes/no fact, not an opinion
• "negative studies" can imply harmful as well as absence of sufficient success
• "Adoption of orthomolecular therapies by conventional medicine has been generally slow." Both ways: reluctance based on conventional medicine view of merit, and decades slow even when proven (e.g. niacin)

re: Closer

1. ok
2. interesting situation: OM vs it's therapies. OM - pariah, ok. Therapy actually three cases: a) overlap (same therapy much much more conservative use B,E, K1, enzymes; b) official acceptance (niacin) c) bootleg (not exactly sure)
3. reject was too prejudicial, refrains is too mushy needs word/work
4. I can live w/o sufficient
5. "leakage"

Looks okay to bleary eyes. I think that should do for a while. Are we done on Section POV? --69.178.31.177 13:12, 24 January 2006 (UTC)

I thought this was in previously, "most" twice, although CM would like to generally disdain OM, can't avoid fact of overlaps and agreed authoritative support in some cases, as #2 above. --69.178.31.177 22:36, 24 January 2006 (UTC)

I think OM means more than just nutritional therapies. There is a certain methodology that is rejected by CM. There is a slight amount of overlap in the substances used, but the way they are used is different. But I don't object to most or the international reference.--John^DO|^{Speak your mind} 23:21, 24 January 2006 (UTC)

dark side

Assuming methodology is "next" on your list, current differential diagnostics would probably be started with the two nutritional / natural med textbooks, Pizzorno & Murray (2 vol, 3rd ed; pp*density is a little less than Harrison's) or Werbach & Moss (lightweight, quick), they cover some of the testing. Orthomed usually relies on what is integrated into NMD and what floats in from CM with adds on, rather than distinct OM diagnostics (no schools). OM psychiatry has more independent methodology but then you are another step or two out...how far are you going?

I don't really have a list, I just browse and edit when I see something that I think needs editing. But we could probably clean up redox therapy sometime.--John^DO|^{Speak your mind} 03:56, 25 January 2006 (UTC)

OM tests

John - Searching for NPOV again. The sentiment that you state for CM is true, but the issue itself is debated and the language a little too prejudicial. Many of the tests used are either standard or similar, sometimes extended versions. 46+ blood panels, a number of the nutrients and many others are relatively the same. "Promiscuity of use" is a real difference. Some of the tests not validated with CM nevertheless have extensive science pedigrees, just not fully validated with CM. Some tests you are thinking of may be outside of OM range, one of the other, farther out naturopathic areas. Also competition tends to remove some junk, one analytical lab will dissect the others to achieve a commercial advantage. Not saying its perfect. They are trying to build additional useful data for diagnosis, trending and / or general OM recommendations.— Preceding unsigned comment added by 69.178.31.177 (talk • contribs)

Ok, but let's simplify to just "Many of the tests are not accepted by conventional medicine". The preceding text is a bit excessive and unclear for a lay reader who may not be up on the process of research. --John^DO|^{Speak your mind} 13:54, 26 January 2006 (UTC)

Germ Theory

disease has "multiple non-specific causes"... DOes that mean that the theory referenced here rejects teh germ theory of diseases? Or is it just referring to non-infectious diseases? Clarification needed in article. (I can't tell if it is harmless otherwise) Midgley 21:07, 28 January 2006 (UTC)

Purification Rundown

I have concerns about this Purification Rundown link. (1) it seems more like advertising or extraneous POV; (2) it is not a general orthomolecular medicine reference - it is a specific subject ref where the context of this article's development was for general refs to avoid endless is too-is not arguments that were trashing the page, see "References" above, early Jan 2006, between DocJohnny & 69...177; (3) I think that there are source and verifiability issues, (4) without that much knowledge of Scientology, much less its detox treatment ritual, following the P-R link and also google, I see two items that raise flags about the "orthomolecular purity" of this treatment. Just because a treatment might claim some orthomolecular roots, self described personnel or is described as such, does NOT make it a principled orthomolecular treatment. I think that an encyclopedia article would best focus on clear examples.

For an exaggerated example of this concern: There is a conventional medicine oncology treatment that uses injected vitamin C. The idea is that a daily shot of IM vitamin C roughly triples the cumulative body tolerance to Trisenox (arsenic trioxide) chemotherapy. There is no way you can call that whole treatment "orthomolecular medicine" even though it uses a long described (in orthomed) property of vitamin C. Perhaps a more accurate orthomed connection would be a comment in the Pur'n Rundown article that explores whether Pur'n Rundown was partly developed with material "borrowed" from orthomed or perhaps "Niacin" uses. Google ("Purification Rundown" + "abram hoffer") or + "orthomolecular" shows almost no hits (Abram Hoffer largely defines niacin and orthomed). I can think of dozens of specific treatments/links that might more clearly illustrate orthomed than this link. --69.178.31.177 12:22, 18 February 2006 (UTC)

# of orthomed practitioners, "normal" diets

"...is practiced by a few hundred physicians. It..."

The source of "hundreds of physicians" appears to be an old Barrett figure, at least over a dozen yrs old possibly several decades, by a notorious and sometimes scurrilous orthomed opponent, whom even some of his supporters here at Wikipedia have acknowledged a strong bias as simply pleasing to certain professional factions. I think that an objective # of practitioners statement would best be stated in perhaps the 2nd, 3rd paragraphs, or even a separate 4th paragraph with some sources. IMHO, the first paragraph is best oriented toward summarizng the description of the area.

Several points should be constructively considered here: (1) When is a conventionally trained doctor (in the US, DO or MD) being orthomolecular or an orthomlecular dr - 1 type of treatment, 2 types of treatments or everything - how do parts count? Especially when a previously recognized generic treatment is displaced by a less able (but highly advertised) pharmaceutical. There is no "ortho" school. And yes, success may mean mainstream absorption. (2) Naturopaths, 4 & 5 yr NMD/ND, duly licensed in a number of US states and a few DC essentially practice some degree of orthomolecular medicine in a number of cases (optimum nutrition) as probably do some psychology PhDs and other allied health professions. (3) What geographic area are we talking? I know of 3rd world MDs, educated in or influenced by NoAM, that apparently picked up on some Hoffer / Klenner results in the 50s/60s before Hoffer and Pauling really defined the field. (4) reference quality sourcing of an accurate, current estimate may be an interesting exercise. Actually the correspondence claims of Klenner, Shutes, et al might support "hundreds" as of the 1950s. (5) stmt placement can be distracting to the introduction of an article

"...and asserts that a normal diet is insufficient for health..." modified, "normal" certainly begs the question of whose normal.--69.178.41.55 10:00, 29 May 2006 (UTC)

POV tag

The article makes lots of wild claims of efficacy, but there's next to no balance suggesting skepticism, even though "orthomolecular" is a pseudoscientific term, and the regimen is criticized as quackery.[2] Article needs substantial cleanup. -- FRCP11 08:07, 4 June 2006 (UTC)

Actually the article is descriptive of orthomolecular medicine philosophy & practices and doesn't make "wild claims". This article was hashed out at length, reasonably amicably, in January with Doc Johnny, a conventionally oriented Aggie DO, see Talk section [3], [4],[5],[6] ,[7],[8], [9] above. I have read QW and its predecessors for over 25 years and have become a little disillusioned with them. I agreed that QW "Orthomolecular" objection / criticism link in January [10] as representative of a POV. Also they have been minded in court a number of times now to watch which way those other fingers point...--69.178.41.55 22:23, 4 June 2006 (UTC)

--pov-- --expert-- These tags simply assert a desire or pov without specific comment or edit, for verbiage that has been previously addressed and "medically" agreed. Incisive or constructive comments are welcome.--69.178.41.55 19:17, 6 June 2006 (UTC)

A NPOV article would note that most doctors consider this pseudoscience, and then report both sides. This article reports one side, with one buried link representing the other side without any text in the article. That Doc Johnny acceded to this POV violation does not mean that I have to. -- FRCP11 21:23, 6 June 2006 (UTC)

Counselor, your statements suggest that you have done very little investigation, much less open minded research, on this subject. What is your most controverted legal situation that public perception is very different and very prejudicial when you get into the details? Orthomolecular medicine, psych and megavitamin therapy (my current reply there) have a much different history than you have likely heard. Many orthomed pioneers, conventionally trained doctors and patients start out with sterling conventional backgrounds, and over the years/decades find themselves in a different position because they investigate, observe and measure. Most conventional doctors have very little background in high dose nutritional research, it seems to be their achilles heel and trial by (in nearly financially defunct, high cost advertisements in the printed media) unsupported "preliminary" press releases is common. One might agree with those things doctors *positively* know, pharmaceutical substance X does this -Y- with this side effect -Z-, for n=6000 subjects, but a *close inspection* of primary literature often shows the short comings in doctors' positions on orthomed. They are almost entirely focused on pharma products rather than the natural biochemistry, that's where the grant monies - federal and private - are, promotions etc. In fact a number of physician statements that I see in other Wiki articles on vitamins aren't even current with conventional refs, say Harrison's Principles of of Internal Medicine or Krause's but I have not had/taken time to chase them down. If you are going to persist, may I suggest you treat the subject seriously, look at the article references, as if you have a client that might really be innocent despite the lynch mob...For this article, what do you dispute? Who do you think might be "expert" on orthomolecular medicine vs just having an adversarial opinion? Have you actually read any of the orthomed references? They were chosen for availabililty such as in a metropolitan library or current purchase.

There are several ardent conventional med editor physicians that have participated on this article that seem to not have taken exception to the POV problem you now seem to see. Andrew73 is a Havard hematology/oncology fellow, Midgely is vociferously against non conventional therapies, Jfdwolff is a prolific Wiki conventional med editor. This is not some hidden hack article.--69.178.41.55 23:30, 6 June 2006 (UTC)

I've stated the basis for the tag. The article pushes a single point of view on the subject, and a fringe minority view at that. It thus violates WP:NPOV. Your counter-argument doesn't respond to the NPOV issue. Under NPOV, it's irrelevant whether that fringe minority view is "correct" in some Platonic way. In this particular instance, it's all but certain that the fringe minority isn't correct, but, in any event, WP:NPOV requires the majority view be accurately and fairly represented in proportion to the extraordinary claims made in this article. -- FRCP11 23:53, 6 June 2006 (UTC)

The article is studiously NPOV descriptive about the subject, *improvements* are welcome. (1) there are actually two orthomed critical links, the Washington U at St Louis link is simply slightly less blatant in its presentation. (2) The OM Relation to conventional medicine section is all about a large faction of "conventional medicine's" disagreement without hijacking the article's description. Doc Johnny put a lot of effort in to get it there and to document our respective points of view in Talk.--69.178.41.55 00:37, 7 June 2006 (UTC)

Dumped for cause

After FRCP11's slowdown in activity (oh, blocked on other matters) on Talk at Megavitamin therapy, I thought maybe some progress was being made. I started to consider modifying the tags in a spirit of compromise (moving in a ((POV check)) for the Controversy section in Megavitamin Therapies) instead of the 2 scarlet letters ((NPOV)), (expert)). However after finding this scurrilous tantrum "the pseudoscientists ensure that garbage like orthomolecular medicine" on his personal page and further investigating his professional b/g, connections & long running internet "pseudoscience" record (e.g. Vioxx liablity case (pharmaceutical) interests thru AEI), I will state his rather aggressive assertion of NPOV is a more than a little tattered. I am just dumping the tags, I am tired of the insults, too.--69.178.41.55 12:15, 9 June 2006 (UTC)

"alternative medicine"

Orthomolecular medicine has conventional and nonconventional aspects. In many cases it was developed by conventional doctors in the forefront of mainstream medicine of their time, and in many cases overseas, OM products and uses *are* conventional medicine. Also the placement of OM's standing with respect to (US) conventional medicine is secondary to its description in the 1st paragraph, so 2nd or 3rd paragraph seems more appropriate if not the "relation to conventional medicine" section.

Regarding "Relation to conventional medicine", I would appreciate your review of the "relation to CM" section's development in Talk [11] thru [12], [13] with Doc Johnny so that we can discuss improvements more productively. FYI two conventional medicine oldies that come immediately to mind are coQ10 (Japan) and serrapeptase enzymes (Japan and Europe).--69.178.41.55 08:56, 14 June 2006 (UTC)

added factual accuracy and pov tag

.. as the article is written in a POV and I don't believe it + it's unsourced = ie factual accuracy for me. revert only after prior discussion

The article is heavily sourced with 7 tomes or sets of books, as well as the external links that have substantial material and, at length, incorporate thousands of biomedical references. The article is primarily descriptive, written with an eye to NPOV and SPOV in conjunction with a number of real MD and DO types. Would you like to state what beliefs that it violates? I would appreciate a specific improvement or criticism to address. I would suggest reading the entire talk page above to avoid wasteful repetition. Thank you.--69.178.41.55 07:57, 19 June 2006 (UTC)

Why did you remove the "complementary and alternative" from the intro? ackoz 09:43, 19 June 2006 (UTC)

CAM's association to OM was modified and relocated to be the 7th sentence in the introductory section. Orthomed therapeutics have a presence in both CAM and conventional medicine. Often, conventional medicine conveniently forgets or overlooks who, what or when, when it accepts/absorbs something new. Not all orthomed is controversial since discoveries & treatments foundational or consistent with it substantially form the dawn of molecular medicine treatments found in conventional internal medicine texts. Because orthomed is so poorly understood by much of the population, the article first focuses on conceptualizing, defining and exemplifyng it to introduce it.--69.178.41.55 19:55, 19 June 2006 (UTC)

Honestly, do you earn your daily bread by selling orthomed preparations? ackoz 23:15, 19 June 2006 (UTC)

No. Do you have any specific factual, historical or textual disputes or improvements that you can articulate?--69.178.41.55 04:26, 20 June 2006 (UTC)

(reset indent) I would like to incorporate information from these articles/abstracts:

• PMID: 8364081
• PMID: 2234152
• PMID: 3153129
• PMID: 3737019
• Barrett S:Orthomolecular therapy, http://www.quackwatch.org/
• Nutrition Committee, Canadian Paediatric Society. Megavitamin and megamineral therapy in childhood. Canadian Medical Association Journal 143:10091013, 1990, reaffirmed April 2000.

I advise you, that www.quackwatch.org is listed on HONCode, and it is considered reliable among non-CAM physicians. I suggest we create a section called "Criticism", in which we summarise the majority POV on orthomolecular medicine. This will give the article a more NPOV, because there is a lot of criticism of the method, yet the article doesn't mention it sufficiently. ackoz 08:11, 20 June 2006 (UTC)

I have added a criticism section and those of your citations which criticise the application of multivitamins. Some are however reporting on dosage of a single vitamin or the effectiveness of one particluar treatment and do not criticise orthomolcular medicine in general. OM does not claim that vitamins and minerals can be applied indisciminantly or that they can treat everything. Removing POV tag Lumos3 09:09, 20 June 2006 (UTC)

I have reworked the criticism section. You should note, that only CAM supporters use the term "conventional medicine". I have also cited the BC Cancer Agency, which is: an agency of the Provincial Health Services Authority, provides a province-wide, population-based cancer control program for the residents of British Columbia. ::i.e. government source, valid an reliable, so please don't remove the citation. ackoz 09:50, 20 June 2006 (UTC)

Sigh, we have a long week ahead. There are a *lot* of preconceptions in these statements and errors in the references that we're going to have to cover one by one to get straightened out again. Let's take that first sentence, "Some health professionals see orthomolecular medicine as an encouragement for individuals to dose themselves with large amounts of vitamins in an unsupervised way,..." So surely blaming all ob/gyns for the coathanger abortionist down the way is then appropriate. These "side effects" are somewhat exaggerated examples of generally *not* doing vitamins the orthomolecular way, at least for the last 40 years, or more. Conventional medicine likes to test *single* vitamins, often of inferior forms (another discussion), without appropriate cofactors, and without balance or broad chemical spectrum in similar vitamins, a sure prescription for failure and problems. Then blame the molecule or the competition.

In a few cases conventional doctors *do* conventionally prescribe megavitamins w/o the balancing and cofactors, over which OM types shudder. I would observe very carefully which way those other four fingers point. Regarding "conventional medicine" there have been horrific arguments at Wikipedia over the best label for general use and to distinguish conventional med from other schools of medical thought. So although suggestions are welcome, it is a well worn(out) subject (see also "allopathic" etc) that hasn't resolved well.

Also, although I have long accepted (or tolerated) the QW Orthomolecular article as a notable POV, fair warning that its basis is scientifically weak and contested, "experts" or not. We may get into this more later (SPOV issues). Also your QW Orthomolecular reference is redundant, please choose *one* (there is another of the exact same article linked at the bottom of the OM page (I thought it was more prominent there) that I left in 10 Jan 06 when I redid the whole Reference section and External links.--69.178.41.55 12:04, 20 June 2006 (UTC)

Megavitamin and orthomolecular therapies are unproven methods considered dangerous by mainstream scientists. Dangerous? Megavitamins typically have no reported deaths in a given year in the US, although conventionally recommended iron supplements will kill several, about 5-6 kids & adults in the US each year. (orthomolecular/megavitamin supplement makers are historically more careful about iron supplementation than conventional multiple vitamin makers for a number of reasons) "This compares with 59 deaths due to aspirin poisoning in 2003, 147 deaths associated with acetaminophen-containing products in 2003, and an average of 54 deaths per year due to lightning for 1990-2003."[14]

"Scientific research has found no benefit from orthomolecular therapy for any disease." (Cassileth) This statement is simply incorrect as presented here, by at least 20 to 50 years depending on how you count. The grand old man of orthomolecular medicine and editor-in-chief of Journal of Orthomolecular Medicine, Abram Hoffer, MD, PhD, postulated & discovered the lipid lowering properties of megadose niacin (vit B3) in 1954, and along with credible conventional co-authors, published the result in 1955, the first mainstream recognized megavitamin (later orthomolecular) therapy. This lipid lowering was confirmed by Dr William Parsons, a graduate medical fellow at the Mayo Clinic in 1956, further confirmed in the early 1960s for titrated patients with individual care by Dr Edwin Boyle, a section chief in the Miami National Inst of Health for a 90% reduction in cardiovascular mortality over 10 years. Boyle then consulted on the massive Coronary Drug Project (1966-1975) & which the Canner Study's analysis (1985) showed that 6 years of niacin treatment, even underdosed, at 2 g/d (vs 3 - 6 g/d clinically recommended) plain niacin, added an average of over 2 yrs of life for six years treatment in a 15 yr observation period.--69.178.41.55 15:04, 20 June 2006 (UTC)

Megadose vitamin therapy is believed to have started in the early 1950s when "a few psychiatrists began adding massive doses of nutrients to their treatment of severe mental problems." (Hafner) Only off about two decades. Actually several megavitamin therapies were developed and being actively used by a number of doctors, perhaps most notably including IV vitamin C in the 1940s by FR Klenner, far & away the largest megadose, and natural form RRR-tocopherols, vitamin E, by the Drs Shute in the 1930s.

Vitamin K: "Large amounts of vitamin K in pregnancy can cause jaundice in the newborn..." - Medical Letter (Anonymous). Toxic effects of vitamin overdosage. Medical Letter 1983;26 (667):72-74. This almost surely refers to the synthetics, either the vitamin K precursor, menadione aka (pro)vitamin K_{3, or one of the water soluble derivatives that metabolize to menadione. Human form vitamin K2 menaquinones (MK-4, MK-7, MK-9) were essentially commercially unavailable in 1983, are still expensive and not so common, and nontoxic at very high dosages. Phyto-, phylloquinone, vitamin K1, likewise has a low toxicity profile. "...menaquinones are nontoxic to animals, even when given in huge amounts." - Goodman & Gillman's Pharmacological Basis of Therapeutics (1996). Synthetic menadione, cheap to manufacture, has long been banned for human use in most countries because of neonatal (and adult) liver damage. Isoprene deficient menadione and its relatives would not be an orthomolecular choice. ...Dietary supplements high in vitamin K can block the effects of oral anticoagulants. Orthomed MDs apparently have their own algorithm for this, monitoring prothrombin times, titrating and/or using vitamin E.}

I have not fully picked apart the BC-CAC page yet, but hopefully you will agree that it is a fatal trend and an unfair quote, if not source. I respectfully suggest that you note that some of this issue *was* addressed in the "Relation to conventional medicine" section (and the January talk notes!) and try to recast "Criticism" constructively. Mainstream medical POV on orthomolecular medicine is notable, and can be described, but it will be reviewed for gross inaccuracy and priority.--69.178.41.55 05:14, 21 June 2006 (UTC)

Come on, you are a POV yourself. Wikipedia should reflect the mainstream view, which is NOT that one you are presenting here - the majority of physicians simply don't believe in orthomolecular medicine. BC - CAC is a government agency, a reliable source, however unfair to you. Moreover, I revert your last edits, if you object, I will take my cecil medicine book and beat you on your head with that, so that you finally learn that vitamine overdoses are not healthy. You must have spent two hours writing this BC-CAC criticism, but it is a reliable source anyway.

ackoz 06:44, 21 June 2006 (UTC)

This article is describing Orthomolecular medicine and needs to describe what proponents of this field see are its benefits. Other points of view can then be fairly described alongside it. You do a diservice to your medicine books. Dangers from overdoses of some vitamins are recognised and OM does not recommend these are taken without supervision. Others such as Vitamin C are some of the least toxic substances known to man. [15] Lumos3 10:27, 21 June 2006 (UTC)

Wrong, per WP:NPOV, the majority viewpoint should be the backbone of the article, and the most important minority viewpoints should be represented in the article. Read the Orthomolecular_medicine#Popularity section and the appropriate sourrce given. The majority of people don't use CAM methods, and the majority of healthcare professionals don't believe in it. Therefore, according to wikipedia's central (there are 3 main policies as you probably know) policy, the article should represent the skeptic or conventional medicine viewpoint on Orthomolecular medicine. And instead of criticism, there should be a section for Advocacy. ackoz 11:02, 21 June 2006 (UTC)

No you are wrong , read WP:NPOV#Fairness_and_sympathetic_tone . I know of no article that follows the lines you describe . Perhaps you'd like to give an example. I agree there should be a mention in the introduction that OM is a view held by a minority of practioners , but it represents a debate within science and its proposition should be fairly set out before oppossing views and evidence is presented. Lumos3 12:34, 21 June 2006 (UTC)

We are probably both wrong. But the fact that you or I know no CAM article that would follow the policy of WP:NPOV is caused by inevitable presence of CAM practitioners and supporters on wikipedia. Noone else is fanatic enough to edit articles that are rewritten 5 times a week by someone with strong pro-CAM POV. ackoz 12:55, 21 June 2006 (UTC)

Ackoz, you are using WP:NPOV to drive counterfactual points and promote clearly counterfactual opinions in a brief, simply descriptive article on Orthomolecular medicine that avoids most claims and counterclaims, *not* one on "Medical politics". Please try to briefly describe your perceived physicians' group view with NPOV and some degree of SPOV. Please also consider many doctors may generally not be as familiar with high dose vitamin literature details as might be desirable for this article (I personally hear this from MDs, too). High dose therapeutic nutrition is simply not well addressed in US medical education (I am looking closely at the US med education system for a good answer). After personally discussing niacin for dyslipidemias with about 20 MDs and PAs (socially), I still haven't found one that is really conversant about its use and properties despite its many superior aspects well documented in the conventional medical literature over the last 50 years - and that is one of the cheapest, easiest orthomolecular therapies to find and verify conventionally.

Your views on vitamin safety (and efficacy) may also reflect common industrial grade vitamers & supplements rather than the preferred orthomolecular versions (usually natural isomers in the oil solubles, more absorbable or active forms), usually not especially more expensive in the US if you shop around. Often medical papers' chemical specifications would not even meet standards in other technical fields. e.g. "vitamin E" papers, which blend of 64 possible optical isomers (R/S,R/S,R/S-toco---) were you talking about and was that the natural alcohol or one of 5-6 common esters and the main cofactors (Se, ascorbate, coQ10) were controlled too? Never mind the "inerts". Often surprisingly missing in *any* detail, *some* conventional researchers finally are acknowledging exact molecular entity and specification are important in vitamin clinical trials and reporting.--69.178.41.55 12:46, 21 June 2006 (UTC)

WP:NOR we are not here to discuss the education of practitioners on vitamin dosage. We are also not here to assess the credibility of clinical trials or discuss about the fact that most conventional researchers don't distinguish between different isomers of something. ackoz 12:55, 21 June 2006 (UTC)

from WP:NOR, "Like most Wikipedia policies, No original research applies to articles, not to talk pages or project pages,...". I was trying to conversationally illuminate points about orthomed data and common medical communication issues w/o being accusatory and address differences on vitamin safety, your perceptions of vitamin safety, and perhaps relieve self-imposed expectations of expertise. By the standard of your excited warning statements in "Criticism", one should hunt down almost EVERY pharmaceutical in Wiki and apply a black box as well as add a skull and crossbones for balance.--14:56, 21 June 2006 (UTC)

Ackoz, I have taken pains to address the last BC-CAC sentence in "Criticism" as a counterfactual POV statement by demonstration (the niacin/dyslipidemia example). There are more. The sentence, "Scientific research has found no benefit from orthomolecular therapy for any disease", is factually false & disparaging, stated in a semi-authoritative manner, takes undue space and is placed for undue attention, damaging to unfamiliar readers, and, well, provacative. I will respectfully ask again, please withdraw the last BC-CAC sentence.--69.178.41.55 15:58, 21 June 2006 (UTC)

Criticism section

This is just inadequate as a section from any point of view.

1. The list of risks does not say to which nutrients they apply or in what dosage.
2. The citations are only critical of some aspects of OM and not the whole field yet the reader is led to believe they condemn the whole.

Specifically

• • http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3153129&query_hl=1&itool=pubmed_DocSum PMID: 3153129 adds the caveat "Their application is exclusively justified in clinical situations under direct medical supervision"

• • http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3737019&query_hl=1&itool=pubmed_DocSum PMID: 3737019 admits that "There are six categories that require vitamin supplements and, in some cases, megadoses."

• • http://www.quackwatch.org/01QuackeryRelatedTopics/ortho.html Uses studies on some aspects of orthomolecular psychiatry, but does not discuss dosage and does not report on supportive studies.

Lumos3 16:09, 21 June 2006 (UTC)

appropriate sources

It would be more appropriate, if you could provide us with a source outside of orthomolecular medicine, that would say that there is "scientific research" in it. I dont imply that orthomolecular medicine is a pseudoscience, but you could create any pseudoscience you could wish (for instance petrotherapy - a scientific approach to treating abdominal cancer by eating rocks), and if you had enough, say, ten thousand followers, who are easy to find because people are just crazy and hope in everything when they get sick, you could build some webpages and your followers would put up some webpages and then you could use these webpages as a source for your statements about "scientific approach and research in petrotherapy".

I can do nothing with this argumentation you are using here, but to ask you, please try to find some outer source.

--ackoz 19:33, 21 June 2006 (UTC)

Read on the books referenced in the article and their scientific references. Ackoz, orthomolecular medicine's scientific foundations are those of orthodox molecular medicine. The pharmas pursue synthetic, *patentable* molecules, despite their toxicity and side effect issues. This situation began to diverge with the pharmas' divestment of most of their vitamin research as of the 1950s. The various pharma positions & campaigns have become more aggressive, pervasive and acrimonious with each decade since. The slow imposition of RCTs in the early 1960's, fiercely fought by US pharmas then, has become their mantra, a perverse (mis)representation of some accounting techniques as absolute requirements of Science itself, "incidently" marginalizing individual and small group research efforts and limiting direct criticism of the pharmas' proclaimed results. A more generalized view of scientific experiments tracks and evaluates different kinds of uncertainty in the totality & priority of the evidence. Mere formalsim is no protection against bad science anymore than big Accounting's protection of Enron shareholders. Both pharmas and the tobacco companies have been shown to abruptly terminate research with potentially negative results as they approach statistical significance, as well as the simple expedient of not publishing adverse results (some authors put the number at 5 out of 6 projects).

As far as "mainstream" science, Roger J Williams (Am Chem Soc, Biochemical Institute, UTexas), Volkers (Merck research) and Pauling (Caltech) were all considered mainstream for the bulk of their work. Certain commercial interests wish to rewrite history as well as science. However, the recent NIH rehabilitation of the "IV vitamin C for cancer" topic, clearly shows that Moertel seriously "erred" on the science part of megadose vitamin C in cancer. Large institutions (and their principals) do not make sharp, major U turns for trivial reasons.--69.178.41.55 06:20, 23 June 2006 (UTC)

---

Orthomolecular medicine is a science based study and represents a minority view among scientists. Its future growth and accetance will be based on evidence. Here are some centres of research and publication. Science is a debate not a doctine. Lumos3 22:51, 21 June 2006 (UTC)
Research institutes

• http://lpi.oregonstate.edu/ Linus Pauling Institute at Oregon State University

• http://www.drrathresearch.org/ Dr. Rath Research Institute

Journals publishing Orthomolecular research (among other nutritional research)

• http://www.ajcn.org/ The American Journal of Clinical Nutrition

• http://jn.nutrition.org/ The Journal of Nutrition:

Report

• http://www.npicenter.com/anm/templates/newsATemp.aspx?articleid=15698&zoneid=28 Report of the Independent Vitamin Safety Review Panel 2006-05-23

---

Lumos, I am not so sure that the "conventional scientists" are the big negative majority here - e.g. witness the Vitamin D Council (Victoria conference in Hoffer's "backyard".) Looks like some of the med school scientists are (have been) in near open revolt on vitamin D "megadoses" & RDAs (was 200 IU ~1992, now 400-800iu, might be 2000+iu if they rationalize with the other oil souble vitamins, up to 50,000iu in single monthly doses. Vitamin D3 in immune function, SAD, MS, cancer.

As dangerous as a practice as categorization & grouping is, I might still consider these groups as having distinct statistical characteristics: the established conventional doctors, perhaps separately the specialists, the med school faculty, the med students (what's going on, am I being adequately informed for the future?), the PhD medical researchers. I might also pass this along. Several months ago I was briefly talking with a medical school biochem prof/researcher working on potential pharmaceuticals (on a Friday afternoon-evening). When I mentioned "therapeutic natural substances", he was instantly all over me about herbals vs pharmaceuticals. When I clarified that I was talking about "vitamin-like substances" he immediately stopped, expressed interest and a cautiously optimistic note about plausibility and potential.--69.178.41.55 04:56, 23 June 2006 (UTC)

quiet creepy edits by 69 64

69, you remove a link from the article because you don't like it, and you give no reason in the edit summary and neither on the talk page. Do you consider that good editing? Or are you just here to babble about the miraculous effects of orthomolecular medicine? Please stop deleting the things you don't like from the article. ackoz 08:15, 23 June 2006 (UTC)

As usual, the facts statements your assertions need a little sharpening. (1) I didn't remove the link, someone apparently several thousand miles away did - I suggest that you learn how Whois works. (2) It *was* a redundant link, once is enough for loose opinion pieces, as I did previously suggest. (3) I haven't babbled about miracles either, I try to describe others' actions and their rationale. Try to find out what SPOV is. (4) I've been pretty patient about the outright counterfactual part, trying to give you a chance to improve your edits. (5) IMHO, you are abusing both NPOV to develop literally counterfactual points, presented as an authoritative source about a subject that you have no real b/g, and, now the RArb, policies. You are certainly jumping the gun, bypassing RfC. (6) I think you should attempt to improve your subject background first if you are going to be effective in this article.--69.178.41.55 09:53, 23 June 2006 (UTC)

I didn't bypass the RfC. ackoz 10:07, 23 June 2006 (UTC)

Well then, at least tell someone, like you did for RfArb, here and on the user talk page. I have been offline for over 36 hours and instead of you cooling off, I come back to an uproar.--69.178.41.55 11:01, 23 June 2006 (UTC)

Look, I have already stated my point: the article shouldn't look like this and noone is able to change it because you and Lumos3 will be here forever. I don't want no edit wars, so let's just ask the "elders" what they think about the rules. Thats why the RfArb. No uproar. --ackoz 11:11, 23 June 2006 (UTC)

A *lot* of conventional medical editors have accepted my edits without the problems on simple factuality in other far more contestable articles than we are having here. You appear (to me) to misquote Wiki rules to your convienence about a subject that you display little knowledge of the basic subject references or the subject's history. I use a simple rule in editing, I try to develop an article that is coherent to the overall facts. You are injecting counterfactual POV that even if you can source it serves no additional purpose except to falsely disparge the subject. Make accurate, balanced edits, - I'll easily respect them and try my best to improve them. Just ask the conventional medical doctors & scientists like: Andrew73, InvictaHOG (oh, you already did), Jfdwolffe, DocJohnny, Gleng, Tearlach, even Midgely. I recently got off someone else's RfC, 4 weeks making peace over far more drastic issues - you, never mind the RfC stage, after a few hours, want to start RfArb over corrections that I assiduously justified but you then exploded just because you "don't believe". You are treating us very poorly. Try this, *do your homework*. May I suggest that you withdraw the RfArb as totally premature.--69.178.41.55 11:35, 23 June 2006 (UTC)

What I will suggest is an informal mediation with one of the conventional medical editors, perhaps like User:Gleng, an academic.--69.178.41.55 11:48, 23 June 2006 (UTC)

We will do that if the RfArb is rejected. Stop beating me with words like "doctors & scientists", academics etc. I am a doctor myself. I know User:Gleng. He has participated on Homeopathy for a long time. See where the article is now? Still has a NPOV tag and I didn't put it there. In fact I never edited that article. However, the main problem is that the reliable literature / sources are not defined. So the editors who are pro-Homeopathy will use homeopathic journals as a "reliable source", whereas for the rest of the world, the contents of that journals is just plain quackery. We will wait for the ArbCom, if they decide that we have to argue indefinetly about things we can't ever agree on, create extra-long articles bloating with many POVs, I will stop editing the article. If they decide that per NPOV, the article should contain the majority view (which is skeptic) as a backbone, I will start editing the article. Agree? ackoz 19:23, 23 June 2006 (UTC)

I cite my previous edit experience with all other "conventional medical" doctors & scientists that *I am a reasonable SPOV editor* where there is an ongoing scientific debate. I have previously managed to resolve differences with them through SPOV. Your words imply that you lump Orthomed in with alternative medicine in general, or more ludicrously, homeopathy, a huge error. Orthomolecular medicine is all about biologically based science and relatively cheap (unpatented) nutritive substances or nutraceuticals if you will. In fact, in orthomolecular eyes, "conventional medicine" is literally 10x, 100x, 1000x closer to homeopathy's 10^-30 than orthomed on over two dozen vitamin-like substances, so be careful. On occasion the orthomolecular prescription is substance withdrawal to reduce supply or (over) accumulation of certain substances, e.g. for PKU & galactosemia, sometimes conventional medicine already agrees. As for science, orthomed emphasizes inexpensive test design (which frequently suffer *multiple* known or knowable design flaws in conventional medicine/pharma trials) over the expensive accounting apparatus of pharmas required to test dangerous drugs or exotic molecules of little, unknown or negative benefits.

We probably agree on many things that you don't recognize. For example, vitamin E. An orthomed probably agrees that that (all-racemic) d,l-alpha-tocopheryl acetate (the cheapest, most common esterified synthetic with only 12% R,R,R-tocopheryl acetate, that is conventionally tested so often) doesn't work too well - said so 50+ years ago (Drs Shutes). Anyone familiar with the literature and history realizes that the R,R,R gamma-tocopherol fractions and other cofactors are big issues. Read the US pharmaceutical patents, and you will find some highly paid conventional (pharma) scientists that think R,R,R-delta-tocotrienol can kill cancer cells pretty efficiently and that alpha-tocopherol is worthless killing cancer cells but that the alpha-tocopheryl succinate is useful (pharmas patented a delta-tocotrienol derivative). Orthomeds just can't figure out why conventional medicine keeps repeating the same brain dead d,l-alpha tocopheryl acetate experiment failures for decades into this millenium, unless (1) it is a smear campaign or (2) the medical curricula are so deficient that no one knows. Those resources could productively answer a lot of other questions..69.178.41.55 03:39, 24 June 2006 (UTC)

Vitamin E (as d-alpha tocopheryl acetate) in prevention of heart disease, and the Shutes

COMMENT:

The comments above are just unfair in light of available evidence. Recently completed is a prospective randomized placebo controlled trial of RRR alpha tocopherol (just what the Shutes liked) in 4000 people followed for 7 years. The patients had heart disease and diabetes. Basically, RRR-alpha tocopherol (d-alpha = ddd alpha) was a bust. If anything people who took it had more heart failure (though this didn't seem to be too severe a problem). But as for the idea that it clears up coronary disease or prevents heart attacks, the best data available doesn't support that.

Here's the abstract of the study, which is called HOPE-TOO (HOPE-The Ongoing Outcomes = HOPE-TOO . It's an ongoing bit of the HOPE trial (Heart Outcomes Prevention Evaluation). This is the biggest, longest prospective blinded and placebo-controlled prospective trial of d-alpha tocopherol acetate.

"Effects of Long-term Vitamin E Supplementation on Cardiovascular Events and Cancer: A Randomized Controlled Trial" The HOPE and HOPE-TOO Trial Investigators* JAMA, Vol. 293, pp. 1338-47 (March 15, 2005).

ABSTRACT: Context: Experimental and epidemiological data suggest that Vitamin E supplementation may prevent cancer and cardiovascular events. Clinical trials have generally failed to confirm benefits, possibly due to their relatively short duration. Objective: To evaluate whether long-term supplementation with Vitamin E decreases the risk of cancer, cancer death, and major cardiovascular events. Design, Setting, and Patients: A randomized, double-blind, placebo-controlled international trial (the initial Heart Outcomes Prevention Evaluation [HOPE] trial conducted between December 21, 1993 and April 15, 1999) of patients at least 55 years old with vascular disease or diabetes mellitus was extended (HOPE-The Ongoing Outcomes [HOPE-TOO]) between April 16, 1999 and May 26, 2003. Of the initial 267 HOPE centers that had enrolled 9,541 patients, 174 centers participated in the HOPE-TOO trial. Of 7,030 patients enrolled at these centers, 916 were deceased at the beginning of the extension, 1,382 refused participation, 3,994 continued to take the study intervention, and 738 agreed to passive follow-up. Median duration of follow-up was 7.0 years. Intervention: Daily dose of natural source Vitamin E (400 IU) [d-alpha tocopherol acetate] or matching placebo. Main Outcome Measures: Primary outcomes included cancer incidence, cancer deaths, and major cardiovascular events (myocardial infarction, stroke, and cardiovascular death). Secondary outcomes included heart failure, unstable angina, and revascularizations. Results: Among all HOPE patients, there were no significant differences in the primary analysis: for cancer incidence, there were 552 patients (11.6%) in the Vitamin E group vs 586 (12.3%) in the placebo group (relative risk [RR], 0.94; 95% confidence interval [CI], 0.84-1.06; P = .30); for cancer deaths, 156 (3.3%) vs 178 (3.7%), respectively (RR, 0.88; 95% CI, 0.71-1.09; P = .24); and for major cardiovascular events, 1022 (21.5%) vs 985 (20.6%), respectively (RR, 1.04; 95% CI, 0.96-1.14; P = .34). Patients in the Vitamin E group had a higher risk of heart failure (RR, 1.13; 95% CI, 1.01-1.26; P = .03) and hospitalization for heart failure (RR, 1.21; 95% CI, 1.00-1.47; P = .045). Similarly, among patients enrolled at the centers participating in the HOPE-TOO trial, there were no differences in cancer incidence, cancer deaths, and major cardiovascular events, but higher rates of heart failure and hospitalizations for heart failure. Conclusion: In patients with vascular disease or Diabetes Mellitus, long-term Vitamin E supplementation does not prevent cancer nor major cardiovascular events and may increase the risk for heart failure.

---

FURTHER COMMENTIn the initial shorter duration version of the HOPE trial 3 years ago (>1800 patients per group), congestive heart failure (CHF) came closest of any endpoint to being greater in the d-alpha tocopherol acetate 400 IU group, with the RR 1.21 and confidence limits 1.0 - 1.46) p = 0.05. Hospitalization for CHF didn't come close to significance at p = 0.51. With larger numbers and longer followup, both these are now significant in the HOPE-TOO.

The interesting thing is that CHF is usually a consequence of coronary disease and old MIs. But the number of MIs and other coronary events really didn't come close to being significantly altered by the vitamin E in the full study above (which is the only one I have access to, right now). The closest of anything was stroke, which had a p of 0.2. None of the cardiac stuff was much different from RR =1, so it does NOT look like it was there, but just isn't showing above the noise due to power problems.

So what's going on with the CHF? I don't know. But this kind of "congestive heart failure" is not as bad as it sounds to the layman, if if doesn't increase deaths and doesn't result from any detectable increase in coronary events. It basically means retention of fluid in feet or lungs, and hospitalization means there's enough retention in the lungs to cause problems. We have no way to know if in this study, the extra cases were due to some global weakening of cardiac function, or just some odd changes in salt handling and retention (which would of course be less worrisome). We do know from this and many other studies that blood pressure and renal function (at least, of the gross filtration sort) are not affected at all by doses of vitamin E in this range. So it's a mystery. Still, I'm not going to pretend even this non-MI-related CHF is okay, although in many practices it would simply mean an adjustment of diuretic. The bottom line is the only thing vitamin E does for cardiac patients we can really be sure of, is something (somewhat) bad.

The main value of these studies is to show that vitamin E as the d-alpha form, in doses large enough to raise blood levels by 70%, has NO effect on heart disease progression. Or on diabetes progression. Not even a hint of it, in a placebo controlled study of many thousands of people extending many years. I have a whole book (by Wilfred Shute, M.D. with Harald Taub: _Vitamin E for Ailing and Healthy Hearts_ 1969, with the 11th paperback printing I have from 1977) claiming that this very d-alpha tocopherol in similar amounts, is a veritable cure-all for all cardiac ailments. These claims by the Shute brothers go all the way back to the 1940's. Every chapter of every health book since the Shutes started blowing this horn, has had an enormous amount of junk repetition of all these claims.

Well, these Shute claims appear to be wishful thinking. The real shame is that it's taken the "medical establishment" half a century to prove it. And no, there's still no good prospective evidence that vitamin E prevents cancer in humans, either. (Frankly, I'm a little more hopeful that selenium will prove out, there. And possibly even vitamin C.) Vitamin E per se in reasonable and traditional supplemental amounts (which 400 IU is) certainly doesn't affect onset of diabetes, or progression of diabetic renal disease. We know that from the HOPE trial also. I would have wagered a modest amount of money that this wouldn't be so, from what I know of oxidative mechanisms in diabetes. But I'd have been wrong. That's why we do these studies.

And no, the HOPE trial goes beyond showing that vitamin E just doesn't heal the diseased-of-heart (though the Shutes claimed just that). Most of the HOPE enrollees were not clinically ill, though they did have coronary disease. If vitamin E even slowed progression of those with disease, it would have been seen here. It wasn't. The idea that vitamin E prevents ONSET of coronary disease in totally healthy people who don't have any at all (if such adults exist in our society), even though it doesn't at all effect progression of disease in people who already have some, is very far fetched. I think it's grasping at straws, in fact. I don't believe it, and can't imagine why anybody would.

Here's the full text of the first phase of the HOPE trial, on the vitamin E trial side (as you know, there was another side looking at preventive effects of giving the ACE inhibitor ramepril): [[16]] Steve 16:55, 24 June 2006 (UTC)

Thanks Dr Harris, that is a data driven view of the Hope trials, there are other trials and analyses (sigh). An orthomolecular version might have been in the long expressed therapeutic ranges of 600-3200iu of RRR-alpha tocopherol along with an additional 20-45% mixed tocopherols with provision for oil soluble vitamins(-like) (especially K2, coQ10, and D3) and the C, Se cofactors along with some medical screening & classification. I think that the vitamin E devotees are also concerned about transport & enzyme activation (de-esterification) in damaged and degraded bodies, potentially an important statistical minus for tocopheryl acetate. I would respectfully comment on a series of articles, and biographies, that I have been peripherally interested in since the mid 80s, and unanswered vitamin E hypotheses that mainstream E research & reporting just barely has begun to address (include my comment on specific molecular entity). You are absolutely right that the Shute brothers, swore by the RRR-alpha-tocopherol label (d-alpha- then, pre IUPAC). That may have been one of their blind spots, and tragedy.

Starting in the 1980s (my perspective), the discussions of the effect of the other natural R,R,R- isomers (beta, gamma, delta tocopherol and the provitamin precursors, tocotrienols) began to surface for the public. One of the issues was the varied (declining) reported successes of the Shutes, that their claimed/seeming early success was fading into the 1960s. The question raised was whether the nature of the vitamin E preparations actually consumed changed (ie. -ol becomes -yl acetate; and that by the 1950s, the much more common gamma-tocopherol isomer was being methylated & diverted into alpha-tocopherol production rather than "left in", a freebie), since beta, gamma, delta tocopherols were not allowed to be "marked & discounted" as alpha equivalents, a financial disaster for the natural producers. At the very start, the Shutes, including the father, were using wheat germ oil (ugh) for their treatment, which has lots more gamma- than alpha- (less than 10-20% alpha?). Starting around 1939 Squibb marketed a popular/common "mixed tocopherols" that should have be easier to produce than purified alpha (I would also wonder if there was unlabeled substitution of isomer "equivalents" for alpha at first ca 1940s, nascent chemical suppliers can be a little loose in their outlook). The product alpha- purity of the 1930s through 1950s for different brands/sources would be an interesting retrospective, to achieve tocopherol separation at all was the minor chemical engineering miracle of "molecular distillation" (well, they were more proud of it than that), I believe associated with vitamin E (my unresearched impression). Anyway there is conjecture that the Shutes were blindsided by various commercial changes in the supply chain and their own mental lock-in to "alpha". I think the natural/orthomolecular problem is that the mainstream has taken over 20 years to even begin to recognize the need for trials to report correct compositional labeling of the active components as manufactured much less differentiate & address the -ol & isomers issues. A waste of many -yl acetate trials.

Anyway, various industry (including the pharmas) articles, patents have mentioned/discussed the varied properties of those other isomers in bits and pieces. But it has not been a timely, incisive well thought area of research, and here I fault the meds & feds too. Gamma tocopherol is being slowly recognized/proposed for a different set of properties possibly including inflammation and angina. Here's my kicker, and it's anecdotal: a *lot* of people when you check into it use(d) mixed tocopherols, including two of the biggest proponents in the business (J.I. Rodale and Roy Erickson) because their (often debilitating) persistent angina disappeared in days, weeks, or at lower dosages, years (YMMV). Although Rodale died of heart failure under stress, it was several standard deviations later than his father and siblings with apparently a higher quality of life. Erickson, obviously came to have a vested interest too with his highly specialized, mixed tocopherol line in the early 60s but claimed satisfaction for another 40+ years. I have never seen the kind of follow up that I think incisive medical/scientific investigators should given their focus on -yl esters and it is well nigh impossible for the small operators to do it credibly. I think you will see a lot of open skepticism from both sides, of both sides, until proper -ol & isomers trials are *finally* laid on the table.--69.178.41.55 02:52, 25 June 2006 (UTC)

Orthomolecular comments from above, continued

We would agree that the conventional medical view is briefly notable, partly as a fair warning. Conventional med does (should) not control the representation & definition of a subject (as you seek) that it studiously knows little about. There are simple, crucial orthomed experiments awaiting conventional, authoritative replication for almost 60 years that were simply ignored despite repeated confirmations - but as of 2005 things seem to be rewarming - give it another 10 years for glasnost! Use of "quackery" and "pseudoscience" on orthomed is erroneous and are violent pejoratives that will be taken to scientific task. Instead of playing the lottery, hoping for an orthomed pox, the decent thing to do is to withdraw the RfArb, which should not be there in the first place. Otherwise I am necessarily on defense, and that will be pointed.69.178.41.55 03:39, 24 June 2006 (UTC)

Pauling's definition

Pauling defined OM as the use of any molecule normally present in the human body. This would include application of supplementary amounts of normal human metabolites, not just those found in nutrition. Should this be included more specifically in the article? Lumos3 08:35, 23 June 2006 (UTC)

Did anybody say that "This would include application of supplementary amounts of normal human metabolites, not just those found in nutrition." or do you just assume that from the Pauling's definition? If its you assumption, then the answer is no per WP:NOR. If it's something you can find written somewhere, why not include? ackoz 08:44, 23 June 2006 (UTC)

Ackoz, a simple, accurate intrepretation of a direct statement in the English language is not WP:NOR. FYI, Linus Pauling Institute's statement on orthomed definition. Lumos, since Ackoz didn't catch it correctly, tersely improving sentences may be a good idea. But the article is starting to bloat with both pro & con, and we need to control bloat. One thing I would like to clean up is the list of orthomed docs, both for format (would like to use about 5 names per line - neatly, evenly spaced), and priority, i.e. Dettman is really an indirect link from Kalokerinos and not primary to this article (sorry, John).--69.178.41.55 11:12, 23 June 2006 (UTC)

RfArb

We would end up in edit warring here, so I posted the case to RfArb. ackoz 10:05, 23 June 2006 (UTC)

Guys

I am not here to spend two hours each day polemizing with your arguments. There must be plenty of them because you love the subject so much. I really don't care (don't take it hard .. there's really no personal hatred in this) about your ideas about Orthomed .. you are not important. Please dont whine at the RfArb page about my ignorance to your comments. I don't care about your arguments. I do care about the sources you use. Governmental public health agency= valid. Orthomed central website ~ well anyone can say I'm a god and put up a website and then write something on wikipedia, right? Why are there no "external" sources for your statements? And I don't "explode", 69. ackoz 02:42, 24 June 2006 (UTC)

Last time I was in Russia (90s), blind arguments for government agencies' insight and veracity did not seem to carry too authoritative weight w/o the authoritarian part. Also, some of BC CAC's assertions have been outright impeached or superceded by US Nat'l Academy of Sciences & NIH within the past 2 years (finally after 40-50 yrs of blinding bs!), provincial BC-CAC is behind the times, even in mainstream science. Every other conventional medical editor that I have corresponded with here has recognized and honored SPOV with relevant sources, sometimes a discussion. This orthomolecular article (talk) previously covered the issue that infinitely long specific argumentation in the article is counterproductive, and orthmed is not just anybody (Nobel laureates, separate MD+PhDs, large university department heads & founders, large pharma research heads, very conventionally successful lifelong researchers). InvictaHOG tacitly agreed, "...practice needs to be described as part of making an encyclopedia..." is a reasonable scope for the orthomed article as a knowledgeable description with pertinent references. In fact please reread 'HOG's answer[17], my interpretation was "take a deep breath, realize you won't agree with everything at Wikipedia, and carefully consider the optimum selection of articles for your time, expertise, contribution and enjoyment" If the orthomed article so as much as detectably, or even questionably, errs, I am sure there are at least six pairs of eyes ready, willing and eager to quickly set it straight again, HMS' InvictaHOG included (his watchlist admission & previous edit interests too).--69.178.41.55 04:55, 24 June 2006 (UTC)

• Double blind trials on Vitamin C Proc. Nat. Acad. Sci. USA Vol. 68, No. 11, p 2678-2681, November 1971. Lumos3 09:20, 24 June 2006 (UTC)

Thanks. ackoz 11:07, 24 June 2006 (UTC)

• Lumos3, I said two three randomized controlled trials, by different teams, different authors. Where are they? If you really understand the concepts of scientific debate, you know, that one study or a series of studies from one author or one author team does not prove anything. I can give you two three (at least) articles from various authors with studies that prove that Pauling was wrong. Plus I can give you the current valid guidelines for common cold (or better cancer) treatment, that would prove that megavitamin therapy is not accepted as a majority view. You want that here? ackoz 16:19, 25 June 2006 (UTC)

Basically, the conventional cancer crowd's "refutation" of Pauling is based on the frequently quoted, bogus Mayo-Moertel studies (they simply failed to even replicate a low end administration of the IV ascorbate of at least 10 gram per day of ascorbate, among many problems, much less try the 30-300 grams/day regimes if they were to legitimately try to repudiate vitamin in the general sense). NIH, NCI, ACS have the money, they have been abrogating their duties to run the proper trials for decades. The two papers below, simply acknowledge that as an "oversight" when in reality the conventional medical "expert" critics have been pummeled.

Ultimately, science is a process with varying degrees of evidence. Never mind the double blind RCT, conventional critcs have had nothing, zilch, nada to factually contest with on high dose intravenous vitamin C for years, and now they do. Guess what? - Pauling et al seem to be plausible again despite the smear campaign, can't dodge it any more, IV vitamin C needs more testing. Oh, dear!

As for the mainstream view, the primary statement is that mainstream medicine does not accept orthomolecular medicine (already stated at length in "Relationship to conventional medicine"). Perhaps minor elaboration, perhaps including the orthodoxy defenders' absolute dearth of relevant test data could extend a sentence. Your presupposed test data just are not there, the mainstream view happens to be truly baseless opinion or superstition. (show me *any* published conventional medical test using 50-100 grams of oral vitamin C much less closely titrated bowel tolerance or IV vitamin C) Orthomed's data may not always be multiple, fully bought and paid for dbRCT but there is real scientific evidence (often classed at a lower priority), more than you have. The article is a simple description of orthomolecular medicine, quit trying to hijack it and malign it with the fatuous, counterfactual dogma parts. That there are scientific disputes is long noted and described, laid out at length in talk for the morbidly curious but is totally non encyclopedic for ordinary readers.--69.178.41.55 21:40, 25 June 2006 (UTC)

• Pharmacologic ascorbic acid concentrations selectively kill cancer cells: Action as a pro-drug to deliver hydrogen peroxide to tissues, Proc. Nat. Acad. Sci. vol. 102, no. 38, p 13604-13609, September 20, 2005

• See the comment below. The same we-are-talking-nutrition-and-using-intravenous-usage-as-arguments. ackoz 15:58, 25 June 2006 (UTC)

• Intravenously administered vitamin C as cancer therapy: three cases CMAJ, 174 (7) March 28, 2006--69.178.41.55 09:47, 25 June 2006 (UTC)

• I think I heard about vit. C in this context, but what has IV Ascorbic acid to do with optimum nutrition aka orthomolecular medicine? Are you familiar with the meaning of IV'?? If the orthomolecular medicine is what the intro paragraph of the article says, this study has nothing to do with orthomolecular medicine. ackoz 15:55, 25 June 2006 (UTC)

Once again you are showing how little you know about the main subject, orthomolecular medicine. Please READ the bibliographic references, several are by the generally known authors that DEFINE this subject, not your opinion or desires. One of orthomolecular medicine's longest and greatest unresolved controversies IS intravenous vitamin C, simply because no conventional authority has deigned to repeat or test IV vit C for over 57 years[18]!!!!!--69.178.41.55 21:40, 25 June 2006 (UTC)

Plus, before you start beating me with "intravenous nutrition", you can have a nutritient and use him as a drug. Ascorbic acid is a simple chemical, and the articles you provided clearly state that in this case, the vitamin is used as a medicament, not a nutrition component. ackoz 16:48, 25 June 2006 (UTC)

Your point here is about the range of "optimum nutrition" as to whether to include therapeutic nutrition in life's time varying optima as synonymous with OM, *not* limiting orthomolecular medicine. Even if you were to restrict "optimum nutrition" to a "preventative nutrition" role, the sentence affected would be the first, "OM or optimum nutrition..." would become "OM and optimum...". Although the article doesn't emphasize it, rectal feeding and transdermal delivery are included...in conventional medicine, too.--69.178.41.55 21:40, 25 June 2006 (UTC)

69

Read WP:NPOV, please. Orthomolecular medicine is a minority viewpoint. There is no reason why the articles about vitamins should be filled with orthomolecular theories. If you want, you can surely add a small section to the article, describing the orthomed POV, but don't add pieces of this to every section of an article, pretty please, respect the NPOV policy. ackoz 16:45, 25 June 2006 (UTC)

We are only talking here about OM not all articles on vitamins. Please keep to the subject.Lumos3 21:51, 25 June 2006 (UTC)

Ackoz, you repeatedly twist WP:NPOV to badger me. I write conventional subjects too. Orthomolecular medicine has conventional and alternative (unsettled science, not moonbeams) components. When I write, I often use conventional literature (e.g. Goodman & Gilman's Pharmacological Basis of Therapeutics, Krause's on nutrition, or Harrison's Principles of Internal Medicine), just not all of it was in this week's pharma sales literature. I do write for conventional encyclopedic interest. Like at niacin, the conventional medicine, gold standard stuff that you cut out - ordinary prescription bounds & a maximum use amount warning - you are starting to border on physiologically dangerous, doctor. And so then you added in valuable text about ancient, small studies with unflinching praises for inositol hexanicotinate that have multiple questions about cholesterol treatment failures from *both* naturopathic & conventional doctors in the US, as well as your re-adding the less documented part about niacin for THC & bad LSD trips that Dr Wolffe previously criticized as "food for drugheads"[19]??? Puhleeeeezzze.

Why don't you just stop harrassing me or is that part of your gratuitous, superquickie RfArb plan, too.--69.178.41.55 22:46, 25 June 2006 (UTC)

Ok, I see the withdrawal, thank you. Going forward, the BC-CAC line really has factual conflicts. It might be better to either find a better informed, more precise source to portray the conventional medical view or just write it yourselves. As an example of improved factual balance, I give this as an example: "BC Cancer Agency of Canada has said of orthomolecular treatments: Many/most "Megavitamin and orthomolecular therapies are not authoritately proven methods; some are considered dangerous by some/many mainstream scientists. "Scientific research has found no benefit from orthomolecular therapy for any disease." (Cassileth) [7] (that last sentence needs some kind of rewrite. Also suggest that we slow down a few days, or perhaps just concentrate on the "Criticism" part. I would like to get back toward a svelte article. Also this is a little duplicative on QW & part of the negative statements in "Relationship..." & "Criticsim"--69.178.41.55 00:09, 26 June 2006 (UTC)

Criticism: "scientific research..."

"Scientific research has found no benefit from orthomolecular therapy for any disease." Perhaps Cassileth meant something closer to "alternative medicine is no longer alternative when it is accepted conventionally". The statement, as is, is simply false. Since orthomolecular is a discipline that is not exclusive of conventional medicine, the same is not true for orthomolecular medicine. *Some* orthomolecular/megavitamin (and sometime conventional medicine) therapies with scientific research and clinical or epidemiologically demonstrated benefits:

B1 - neurological and alcohol related

B3 - anticholesterolemic

B9 - (folate) tissue issues

B6, B9, B12 - homocysteinuria

B12 - various neurological conditions and pernicious anemia

C - no official research (no find either) see previous above sections on developments at NIH, NAS

D - see vitamin D Council", immunity, SAD, cancer

K2 - Japanese research on osteoporosis and liver cancer with the menaquinone-4 vitamer

coQ10 - CHF

— Preceding unsigned comment added by 69.178.41.55 (talk • contribs)

RFC:Stop deleting the POV tag

This article is utterly biased, pushes the minority POV that this pseudoscience has any legitimacy, and fails to fully identify the severe criticisms of this terribly dangerous quackery. For examploe, the American Psychiatric Association called orthomolecular medicine a misnomer and "deplorable."[20] "The Research Advisory Committee of the National Institute of Mental Health reviewed pertinent scientific data through 1979 and agreed that megavitamin therapy was ineffective and could be harmful."[21] -- 70.232.110.230 19:04, 7 August 2006 (UTC)

Don't be absurd, the mainsteam POV is mentioned many times. --Michael C. Price ^talk 21:04, 7 August 2006 (UTC)

The article focuses on the minority viewpoint, and critical information about the degree to which mainstream science rejects OM has been repeatedly deleted. WP:LEAD and WP:NPOV are violated. -- Cri du canard 23:29, 7 August 2006 (UTC)

Since OM is the subject of the article and it is a minority viewpoint then of course it "focuses on the minority viewpoint". What is your problem with that?? And as I said earlier there are plenty of mentions of the mainstream view in the article as well. --Michael C. Price ^talk 23:55, 7 August 2006 (UTC)

My problem with that is that you're arguing that this article should be a POV-fork, which would violate WP:NPOV. Per WP:LEAD, the lead paragraph should emphasize the mainstream view that this is unsubstantiated pseudoscience, and then the minority viewpoint. Instead, the entire article is centered around the minority viewpoint. "Mentions" of the mainstream viewpoint are insufficient. There should be balance. Instead, all mainstream views are summarily deleted from the article. -- Cri du canard 01:33, 8 August 2006 (UTC)

I'm not suggesting a POV-fork, and if you'd stop listening to just the sound of your own voice you'd realise I'm not suggesting this either. Your use of the term "unsubstantiated pseudoscience" indicates that you are not capable of a NPOV. --Michael C. Price ^talk 12:37, 8 August 2006 (UTC)

"...unsubstantiated pseudoscience..." That "pseudoscience" bit is a naked pejorative and provocation. Several editors, gratifyingly new to me, have attempted to make several serious points with your misusage. Adequate substantiation has been an ongoing scientific debate for decades, prejudically contaminated by literally trillion dollar ( p.a.) conflicts of interest. The material that you are quoting is polemical, limited and dated. Scientific and clinical substantiation is being addressed molecule by specific molecule in orthomed circles despite literal persecution and very limited resources. More recently, even the "mainstream" is *starting* to reduce the competitve hijinks in testing and analyses but the anti-scientific attitude parading as "Science" only slowly disappears, mostly at the cemetery. You are proving your POV to us alright.--69.178.41.55 02:09, 8 August 2006 (UTC)

btw, even this very critical, conventionally oriented editor recognized the merit in orthomed's structure & presentation "...(like the approach at Orthomolecular medicine#Relation to conventional medicine)...Tearlach"[22] and I promise you, we are not special friends.--69.178.41.55 02:37, 8 August 2006 (UTC)

see also this discussion at Talk:Megavitamin therapy & List_of_ps...^{--69.178.41.55 03:40, 8 August 2006 (UTC)}

Sir: I have a POV, albeit one that corresponds to what major medical organizations say about OM. The problem here is that you have a POV, and won't let anyone implement NPOV policy by correcting the POV bias of the page as it currently exists. -- 70.232.110.230 11:58, 8 August 2006 (UTC) / User:Cri du canard

No, the problem here is that you do not understand what is meant by OM, as indicated by your dismissal of supportive dietary studies which indicate a near fivefold reduction of colon cancer at long term intakes above the RDA of folic acid. --Michael C. Price ^talk 12:37, 8 August 2006 (UTC)

BTW User:Cri du canard the refs for the above claim are here[23]. --Michael C. Price ^talk 20:12, 8 August 2006 (UTC)

Actually I am pretty easy when shown some hard facts to analyze. Perhaps 70.232... could link a few of those "major medical organization" quotes here for a quick review. Unfortunately I have to deal with various forms of hearsay from people who often confuse factually unfounded criticisms, various terms and practices like altmed, CAM, homeopathy, naturopathy, ad infinitum with orthomed, served with a large helping of various 'tudes and a total dearth of familiarity of the orthomed literature.--69.178.41.55 14:01, 8 August 2006 (UTC)

I left the references already. They keep getting deleted. -- Cri du canard 16:41, 9 August 2006 (UTC)

(1) You are billboarding a polemical position (QW) that is relatively lengthy to the OM summary, (2) this particular ref & debate actually belongs more at Orthomolecular psych where the mental measurement part is also part of the issue, (3) the particular study has similar problems of strong bias (e.g. specific defects conveniently ignored) that certainly fails the replication part - where the much higher profile and better documentable, higher stature Pauling situation with conventional medicine's multiple mishandling of vitamin C test has taken a generation to float to surface (the APA reference you have shown was noted as scientifically defective but "wins" on a "consenus" basis - a form of lynching but Orthomolecular continues to accrue favorable fundamental studies simlar to the way IV vitamin C for cancer has for 20+ yrs, but slower).

I would honestly suggest taking this part to orthomed psych in the body, the APA debacle doesn't do anything for traditionally "non mental" ailments more conceived by this article (and readers) even though theoretically orthomed psych is certainly part of OM, they cover topical ground fairly independently and the OM article is a brief *general* overview. Our approach since January is to largely cover detailed material in the specific relevant article. Your discussion would have more "room" there as well as a better fit to the body of the article. I think the APA report is a "good" (ahem, I disagree with its methodology as biased), notable reference there but not here. Other notable scientists have long noted their dissatifaction with conv'l psych, too. Hoffer's situation is really a protoscience flying into a political maelstorm, and is much earlier in the learning / demonstration curve whereas OM is actually getting a lot of scientific confirmation starting to overturn the conventional RDA "wisdom". Note that I am trying not to bludgeon you on these issues, you are new to the thought that OM is a serious science approach and I would prefer that you try to analyze it again with the information here at talk and the article links/refs given. So the part you consider factual I will recommend Orthomolecular psych, and I think you will find that has more space accomodation although fair warning it is not just a free shot, the nature on the contest could be better aired. So I will ask you to honor the sect POV sign in "controversy..." and remove the banner (disputed) sign. You are still treating us as lightweights, delusional or worse, - I hope that you will take time to study the prior discussions here at Talk to formulate questions that we might answer usefully. I am moving your insertion to the intro to "Orthomolecular Psychiatry" article. Hopefully you will find this a reasonable, more favorable approach. Thank you.--69.178.41.55 18:39, 9 August 2006 (UTC)

List of pseudoscientific theories

Some ignorant folks are trying to restore OM to the the List of pseudoscientific theories. Please help to prevent this. --Michael C. Price ^talk 19:13, 7 August 2006 (UTC)

It belongs there. It's Pauling's folly. -- Fyslee 19:19, 7 August 2006 (UTC)

Please see the above discussion[24] with a former Wikipedia editor. Notice the links to 2005-2006 articles by the National Inst of Health and Proc of the National Academy of Sciences. Or try this Hemilä H., "Do vitamins C and E affect respiratory infections?" Univ. of Helsinki, Dissertation, Faculty of Medicine, Dept. of Public Health. 2006.. "uuhhhh, gee Mr. Pauling, gosh, we honestly didn't notice..." comes to mind.--69.178.41.55 22:52, 7 August 2006 (UTC)

OM is more than Pauling's beliefs. Do you really think that no micronutrient (e.g. selenium, magnesium, etc) can be of benefit? --Michael C. Price ^talk 19:30, 7 August 2006 (UTC)

Of course not. There are situations where they can be necessary. There just isn't any good evidence for the more extravagant claims made by OM. It's fringe science at best, and usually quackery. It is nearly always accompanied by belief in and the pushing of weird and unscientific ideas and practices by the doctors who practice it. Being fringe doctors, they fall for weird ideas. -- Fyslee 20:35, 7 August 2006 (UTC)

Are these claims (from OM page) so extravagent or "fringe science at best":

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.

--Michael C. Price ^talk 20:46, 7 August 2006 (UTC)

No, not really. The use of the word "assertion" makes the quote accurate. It's an assertion, and properly understood ("typical" being junk food) it's also true. The solution is proper nutrition, not pandering to the pharmaceutical industry's nutritional supplements. While supplementation has its role in the treatment of severe cases, it's not the best solution for normal people or for fringe cases. A varied and balanced diet provides more than enough for good health. Pills and potions may have their role in rare cases, but they shouldn't be considered the source of health, as many orthomolecular physicians' method of practice gets people to believe. I'm always suspicious when a practitioner just "happens" to sell the remedy they diagnose as necessary. Fortunately MDs aren't normally allowed to do this, and they don't get a percentage of all prescriptions for the medicines they prescribe. -- Fyslee 20:54, 7 August 2006 (UTC)

Your assertion that "A varied and balanced diet provides more than enough for good health." is contradicted by many studies. --Michael C. Price ^talk 21:11, 7 August 2006 (UTC)

If that is all Orthomolecular medicine claims, then how is it different then normal nutritional science? Why does it need a seperate name? If that's all you believe, become a nutritionalist, certainly you won't find any opposition to your beliefs. Orthomolecular medicine makes itself distinct by making claims like "Nutrition should be the first step to finding a cure to any disease" or "1000% vitamin C intake can help cure cancer" Claims not based on any scientific studies. When a field claims to be science but isn't backed up by any scientific evidence, we call these fields "pseudo-scientific". Making SOME accurate claims is a typical technique of pseudoscience, cults, ect. CaptainManacles 20:58, 7 August 2006 (UTC)

I find your claim that "become a nutritionalist, certainly you won't find any opposition to your beliefs." detached from reality. --Michael C. Price ^talk 21:11, 7 August 2006 (UTC)

OK, that's enough. I don't see any evidence whatsoever presented that this topic is pseudoscience. It was intitated by a two-time Nobel prize-winner, and is subscribed by by a variety of MD's and nutritionists. There's a long track-record of publications in premier journals such as Science and Nature. None of this is the hallmark of pseudoscience, which are usually wacky theories advanced by individuals who have no formal education or training in science, theoreies that lack published articles in mainstream peer-reviewed journals, much less the leading journals. linas 22:36, 7 August 2006 (UTC)

Many pseudo-sciences are practiced by a variety of otherwise profesional people. Tellington touch is a prime example. Many many hospitals have a variety of alternative care options, as long as they do no harm, they figure it couldn't hurt. Regardless, these still remain pseudo-science, as they have not been scientifically shown to work, and many have been shown to quite clearly not work. Make me eat my hat, show me replicated scientific double-blind studies. Right now, the "references" provided to prove Orthomolecular medicine is a science is two links to a commercial Orthomolecular page that doesn't cite any studies. CaptainManacles 06:52, 8 August 2006 (UTC)

A few notes: (1) the orthomed & megavitamin articles are brief overviews constructed to describe, to provide quality orthomed sources, and *to try* to make comprehensible what the subject is generally about because so few even know what orthomed is basically about, not to "prove" the individual therapies; (2) if you drill into to the reference links you can find thousands of scientific references ( e.g.RJ Williams, U Tx Biochemical Institute founder, L Pauling, of course) and hundreds of peer reviewed orthomed articles JOM. Except for his two books, the Saul site is studiously noncommercial, and almost all of what is in the books is on the site, so no commercial pressure. (3) The decision back in back in January was to dump endless argumentation about specific therapies as a hopeless article approach (~100 items???) and leave such detail to more specific, individual articles as they occur in Wikipedia. (4) the situation about dbRCT is laid out earlier in the OM talk page, way above in several places.--69.178.41.55 09:53, 8 August 2006 (UTC)

See relevant talk onTalk:List_of_pseudoscientific_theories#Orthomolecular_Medicine which I reproduce below:

Even the JAMA has come round on this:

Vitamins for chronic disease prevention in adults: clinical applications. Fletcher RH, Fairfield KM in JAMA 2002 Jun 19;287(23):3127-9 PMID: 12069676 “Most people do not consume an optimal amount of all vitamins by diet alone. Pending strong evidence of effectiveness from randomized trials, it appears prudent for all adults to take vitamin supplements..... We recommend that all adults take one multivitamin daily..... It is reasonable to consider a dose of 2 ordinary [i.e. RDA levels] multivitamins daily in the elderly”

Vitamins for chronic disease prevention in adults: scientific review. Fairfield KM, Fletcher RH in JAMA 2002 Jun 19;287(23):3116-26 PMID: 12069675 “Although the clinical syndromes of vitamin deficiencies are unusual in Western societies, suboptimal vitamin status is not [unusual].”

--Michael C. Price ^talk 19:49, 7 August 2006 (UTC)

Here're three studies on folic acid and colon cancer:

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 in 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. Other cancers not analysed. The protective effect (relative to age-matched controls) increased with the duration of supplementation. The relative risk of colon cancer over the period 1980-1994 (against folate intake in 1980, without adjusting for other vitamins) was: 1.0 (<= 200 ug/d), 0.92 (201-300 ug/d), 0.79 (301-400 ug/d) & 0.69 (>400 ug/d). This risk declined with time: comparing the >400 with the <=200 folate ug/d group the risk declined from 0.85 (1980-mid1988) to 0.56 (mid1988-1994). Amongst multivitamin users (pooling all folate categories) the risk declined with duration of use: 1.02 (4 years use), 0.83 (5-9yrs), 0.80 (10-14 yrs) & 0.25 (15+ yrs). Women who had 15+ years of multivitamin use and >300 ug/d energy-adjusted folate (in 1980) had a RR of only 0.22[CI: 0.05-0.88] compared with users with <15 years multivitamin use and 201-300 ug/d (>RDA) of energy-adjusted folate. FDA regulations forbad the use of 400ug of folate in multivitamin supplements prior to 1973, which limited the ability for a longer -term follow-up. The study abstract concludes: “Long-term use of multivitamins may substantially reduce risk for colon cancer. This effect may be related to the folic acid contained in multivitamins.”

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 “We did not observe strong independent associations between folate, vitamin B6, vitamin B12, methionine, or alcohol and risk of colon cancer after adjusting for body size, physical activity, cigarette smoking patterns, energy intake, and dietary intake of fiber and calcium. However, when assessing the associations between colon cancer and a composite dietary profile based on alcohol intake, methionine, folate, vitamin B12, and vitamin B6, we observed a trend of increasing risk as one moved from a low- to a high-risk group”

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 “Folate is crucial for normal DNA methylation, synthesis and repair, and deficiency of this nutrient is hypothesized to lead to cancer through disruption of these processes. There is some evidence to suggest that relatively high dietary folate intake might be associated with reduced colorectal cancer risk, especially among individuals with low methionine intake. […] Folate intake was inversely associated with colorectal cancer risk (IRR = 0.6, 95% CI = 0.4-1.1, p for trend = 0.25). The inverse association was essentially similar among individuals with low and high methionine intake, and was similar for colon and rectal cancers when those endpoints were analyzed separately. Among individuals with low methionine intake, folate intake did not appear to lower the risk of rectal cancer, a finding that may be due, in part, to the low number of cases in the subgroup analysis. Overall, our data lend some support to the hypothesis that high folate intake is associated with a reduced risk of colorectal cancer. Copyright 2001 Wiley-Liss, Inc.” --Michael C. Price ^talk 19:54, 7 August 2006 (UTC)

"It's good to take the USRDA of vitamins" (which I agree with) is not ortho's claim that "Vitamins can cure almost every disease." I don't agree with your attempt to bait and switch legitimate medicine with the claims of orthomolecular medicine.

Hardly bait and switch. BTW the nurses were getting more than the RDA. OM does not claim that "Vitamins can cure almost every disease." It is about prevention much more than cure. Reread the opening of OM:

Optimum nutrition and, most broadly, orthomolecular medicine emphasize the 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.

Sadly, I'm not surpised that being presented with evidence doesn't change your POV. --Michael C. Price ^talk 20:35, 7 August 2006 (UTC)

This isn't just "my" POV. It's the POV of the NIMH, the APA, the AAP, the AMA, etc., etc. Citing mainstream articles on vitamin research doesn't move the quackery that orthomolecular medicine espouses out of the pseudoscience category. Fletcher and Fairfield are not orthomolecular scientists. The people who are identified as orthomolecular scientists on the orthomolecular science page are known for pushing unsubstantiated claims. You haven't refuted a single sentence from a single one of the multiple sources I identified. Instead, you're burying the talk page in irrelevancies that have nothing to do with why orthomolecular medicine is considered pseudoscience. -- Cri du canard 23:26, 7 August 2006 (UTC)

Your approach is twisted. If I cite orthomolecular sources they are derided as self-serving. If I quote mainstream sources I'm told they "doesn't move the quackery that orthomolecular medicine espouses". So what sort of "evidence" are you after? Sounds like the stuff that you agree with and nothing else. As for "burying the talk page in irrelevancies" the OM article starts by stating that optimum nutrition is a subset of OM, therefore any nutritional studies are relevant by definition. --Michael C. Price ^talk 23:38, 7 August 2006 (UTC)