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Orthomolecular medicine

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Orthomolecular medicine and optimum nutrition are controversial[1] medical approaches that posit that many diseases and abnormalities result from various chemical imbalances or deficiencies and can be prevented, treated, or sometimes cured, by achieving optimal levels of naturally occurring chemical substances, such as vitamins, dietary minerals, enzymes, antioxidants, amino acids, essential fatty acids, prohormones, dietary fiber and intestinal short chain fatty acids.[2] [3] [4]

Orthomolecular medicine is a minority practice amongst a small proportion of medical practitioners.[5][6][7][8] Orthomolecular treatments are utilized in complementary and alternative medicine fields. The controversial field of orthomolecular psychiatry deals with the use of orthomolecular medicine to treat psychiatric problems.

The orthomolecular field, although viewed by its supporters as science-based, remains controversial among mainstream medical organizations, including the American Cancer Society, the American Psychiatric Association, the National Institute of Mental Health, the American Academy of Pediatrics, CHAMPUS, and the Canadian Paediatric Society, because of unsubstantiated claims, lack of proven benefits, and serious toxic effects.[7][6][5][9][10]

Orthomolecular proponents argue that recent mainstream nutritional studies provide support for their theories [11]. They also argue that it tends to be intrinsically safe as it only utilises molecules which are normally present in the body through healthy diet or normal metabolism. [3] [4] [12]

History and development

Orthomolecular megavitamin therapies, such as "megadose" usage of tocopherols[13] and ascorbates[14], date back to the 1930s.

The term "orthomolecular" was first used by Linus Pauling in 1968, to express the "idea of the right molecules in the right amounts within the context of psychiatry"[15] and subsequently defined "orthomolecular medicine" as "the treatment of disease by the provision of the optimum molecular environment, especially the optimum concentrations of substances normally present in the human body." or as "the preservation of good health and the treatment of disease by varying the concentrations in the human body of substances that are normally present in the body and are required for health." [16]

Since 1968 the orthomolecular field has developed further through the works of researchers. Despite this it is still often closely associated by the public with Pauling's advocacy of multi-gram doses of vitamin C for optimal health.

Method

Orthomolecular medicine posits that many typical diets are insufficient for long term health; thus, orthomolecular medical diagnoses and treatment often focus on use of natural substances found in a normal diet such as vitamins, dietary minerals, enzymes, antioxidants, amino acids, essential fatty acids, dietary fiber and intestinal short chain fatty acids.

Orthomolecular medicine argues that some diseases reflect biochemical anomalies and that it is advantageous to recognize and to correct these anomalies at an early stage, before they result in recognizable diseases.

The orthomolecular practitioner relies heavily on laboratory testing. In addition to standard clinical chemistries, orthomolecular practitioners now employ a wide range of laboratory analysis, including those for amino acids, organic acids, vitamins and minerals, functional vitamin status, hormones, immunology, microbiology, and gastrointestinal function. Many of these tests have not been accepted by mainstream medicine.

Orthomolecular therapy consists in attempting to provide optimal amounts of substances normal to the body, most commonly by oral administration. In the early days of orthomolecular medicine, this usually meant high-dose, single-agent nutrient therapy.[7] Thus, "optimal" is a matter of the "clinical judgment" of the orthomolecular practitioner. Most often, the orthomolecular practitioner uses many substances: amino acids, enzymes, non-essential nutrients, hormones, vitamins, minerals etc. in a therapeutic effort to restore those (or derivative substances) to optimum levels for healthy young persons.[17]

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

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

Popularity

A survey released in May 2004 by the National Center for Complementary and Alternative Medicine focused on who used complementary and alternative medicine (CAM), what was used, and why it was used in the United States by adults age 18 years and over during 2002. According to this recent survey, megavitamin therapy was the twelfth most commonly used CAM therapy (2.8%) in the United States during 2002, though the study did not distinguish between full-scale orthodox orthomolecular medicine and lay use of relatively publicized Vitamin C megadose supplements.[18] Poor adults were more likely to use megavitamin therapy than non-poor adults.[19]

Relation to mainstream medicine

Orthomolecular medicine claims an evolving nutritional pharmacology that overlaps between natural medicine and mainstream medicine. The International Society for Orthomolecular Medicine has some conventionally-trained doctors among its members and authors. However, the leading orthomolecular medicine website, Orthomolecular Medicine Online,[20] run by the Journal of Orthomolecular Medicine, discusses differences between orthomolecular medicine and current mainstream medicine,[17] which the website refers to as allopathic medicine.[8]

Amongst the differences, mainstream medicine attaches great importance to rigorous, double-blind pharmaceutical style studies, whereas orthomolecular medicine proponents believe that such studies overemphasize presupposed minimization of uncertainty in measurement and have instead led to false-negative results from otherwise poorly designed and executed studies that resulted in misrepresented "authoritative" disparagement of nutritional treatments.[21][22][23] Mainstream medicine avoids use of new, unproven xenobiotic molecules whose effects are unknown, instead favoring extensively tested, clinically proven drugs. Orthomolecular medicine holds that natural equivalent molecules, as non-toxic nutritional therapies, are often useful in the interim, before extremely expensive, time consuming authoritative tests are available.

Individual mainstream medical proponents are sometimes dismissive of orthomolecular medicine: "Scientific research has found no benefit from orthomolecular therapy for any disease" [5][6] despite strong counterexamples such as megadose niacin for dyslipidemias (1955)[24].

Supporters claim that some aspects of orthomolecular medicine, and in particular the optimal nutrition subset, have support in mainstream scientific research in a variety of areas:

  • Studies finding that greater than RDA of selenium[25][26][27] reduce the overall incidence of cancers
  • Studies finding that supplementation of long-chain omega-3 essential fatty acids reduced the incidence of cardiac mortality in secondary prevention trials[30][31][32]
  • The advocacy of daily multivitamins in cancer prevention by Bruce Ames[41][42] and by others in a JAMA review article for "chronic disease prevention in adults"[43][44]

Some of these studies' initial findings have not been supported by subsequent studies. For example, a subsequent meta-analysis found a lack of benefit to vitamin E supplementation.[45] Indeed, vitamin E supplementation may increase the risk for congestive heart failure.[46] Reconciling and confirming the conclusions of individual nutritional studies is a subject of ongoing research.

These studies all come from mainstream medical sources that do not claim to support orthomolecular doctrine, and in at least some cases, explicitly reject claims of orthomolecular proponents that nutritional supplements are desireable.[47] Ames supports daily USRDA multivitamin supplements as a public-policy solution to the lack of vegetables in United States diets, but has not endorsed global use of megavitamin therapy propounded by orthomolecular medicine.[41][42]

The skepticism regarding orthomolecular medicine comes in part from some of its proponents making claims more broad than those supported by double-blind controlled studies. [5][6][7][48][49] Based on investigational scientific studies, clinical experience, and anecdotal accounts, claims have been made that therapeutic nutrition can cure or treat "alcoholism, allergies, arthritis, autism, epilepsy, hypertension, hypoglycemia, migraine, clinical depression, learning disabilities, retardation, mental and metabolic disorders, skin problems, and hyperactivity."[50][7]

Criticism

Mainstream medical physicians regard most orthomolecular therapies as insufficiently proven for clinical use,[6] and criticize leading orthomolecular proponents such as Robert Cathcart who claim that vitamin C is a legitimate treatment for SARS.[51] Proponents contend that many mainstream doctors have little familiarity with the detailed concepts and clinical background of orthomolecular medicine. Mainstream medicine disputes the validity of most orthomolecular therapies based on the lack of authoritative studies and the poor results from the studies that have been done. Proponents dispute the results of mainstream studies, arguing that those studies are "strawmen" that used much lower doses, frequencies, duration or assimilable forms than they recommend or suffered from other special conditions, contamination, populations or statistical treatment often not clearly published in the documentation.

Linus Pauling has been criticized for making overbroad claims[52] for the efficacy of vitamin C but has received some support for modified claims in the last few years.[53][54]

The relationship of mainstream medicine to orthomolecular proponents has frequently been adversarial, with the former often confusing orthomolecular medicine with other, less science based modalities.[17] The American Academy of Pediatrics even labelled orthomolecular medicine as a "cult" in 1976.[55] Conventional health professionals see orthomolecular medicine as an encouragement for individuals to dose themselves with large amounts of vitamins and other nutritients without conventional supervision, which they worry may be damaging to health.[6] Rare risks[56] of megadose vitamins, which frequently involved pharmaceutical versions of vitamins such as synthetic menadione, unsupervised misuse, deliberate abuse and earlier medical treatments, may include increased risk of coronary heart disease[57], hypertension, thrombophlebitis, peripheral neuropathy, ataxia, neurological effects, liver toxicity, congenital abnormalities, spontaneous abortion, gouty arthritis, jaundice, kidney stones, and diarrhea.[6][58] [59][60][61][62] Megavitamin proponents point[63] to an almost zero level of deaths caused by overdosing with vitamins compared to the significant numbers from pharmaceuticals, including a number of over-the-counter items.[64]

The accumulated evidence of randomized clinical trials with chemically modified alpha tocopheryl esters, containing only one kind of natural "vitamin E" (of eight) in the stabilized (chemically inactivated) ester form (usually acetate) have been controverted. Initial hopes for alpha tocopheryl esters (usually acetate) were based on theoretical and epidemiological grounds that often involved the natural, full spectrum dietary forms of vitamin E (mixed R,R,R tocopherols - alpha- beta- gamma-, delta- isomers). Meta analysis of several randomized clinical trials of manufactured antioxidants, including alpha tocopheryl esters (acetate, succinate) not in an antioxidant form, have not shown any benefit to alpha tocopheryl ester supplementation for preventing coronary heart disease.[65] Indeed, alpha tocopheryl ester supplementation may increase the risk for congestive heart failure[66]. A subsequent meta analysis published in 2005 found that "high dose" alpha tocopheryl esters (>=400 units/day) was associated with an all cause mortality risk difference of 39 per 10,000 persons)[67]. Furthermore, a significant relationship was seen between dose and all-cause mortality, with increased risk with doses exceeding 150 I.U. per day. This meta analysis, however, was criticized on a number of grounds [68]. A criticism which the authors did not rebutt was that the mortality effect was a confounder resulting entirely from excess mortality in a few studies of combined alpha-tocopheryl ester and synthetic beta carotene in heavy smokers, a supplement and exposure combination that once had some academic support[69] but included synthetic "beta carotene, which was previously been shown to be harmful."[70] The preferred orthomolecular "vitamin E", mixed (natural) R,R,R tocopherols, available for two-thirds of a century, remain to be authoritatively evaluated in tests controlled for bile, pancreatic function, certain specific heart problems and risk factors, blood levels and cofactors (vitamins C, D3, K1, K2, selenium, co-enzyme Q10, etc.) in the common orthomolecular range, 600-3200 IU alpha tocopherol plus 25%-50% by weight of other R,R,R tocopherols.

Physicians express concern that megavitamin and orthomolecular therapies used solely as alternative treatments can create dangerous delays in obtaining their conventional treatments, such as radiation and chemotherapy for cancer.[6] For example, in a highly publicized Canadian case, the chemotherapy treatment of a 13-year-old cancer patient, Tyrell Dueck, was delayed, possibly fatally, because his parents were influenced by claims of orthomolecular cures for cancer.[71] Sustained megadoses of vitamin C may inhibit the immune system, a particular danger for AIDS and cancer patients resorting to orthomolecular medicine.[72]

Sometimes proponents claim partisan politics, pharmaceutical industry influence, and competitive considerations to be significant factors. However, some prominent orthomolecular proponents sell lines of orthomolecular products and tests questioned for their unvalidated benefit by conventional medical groups such as hair analysis.[73] The Linus Pauling Institute's funding comes mostly from National Institutes of Health[74]. Several orthomolecular therapies have been officially sanctioned within Japan[75] [76][77].

Notable orthomolecular doctors

Orthomolecular scientists

  1. ^ The War Against Vitamin Therapy doctoryourself.com , Andrew Saul, PhD - Accessed, August 2006
  2. ^ The American Heritage Stedman's Medical Dictionary, 2nd Edition, 2004.
  3. ^ a b Definition of Orthomolecular medicine at www.orthomed.org Accessed June 2006
  4. ^ a b What is Orthomolecular Medicine?, Linus Pauling Inst. Oregon State University , Accessed August 2006
  5. ^ a b c d Cassileth BR. Alternative medicine handbook: the complete reference guide to alternative and complementary therapies. New York: W.W.Norton & Co., 1998:67.
  6. ^ a b c d e f g h "Vitamin Therapy, Megadose / Orthomolecular Therapy" British Columbia Provincial Health Services Authority 2000
  7. ^ a b c d e http://www.quackwatch.org/01QuackeryRelatedTopics/ortho.html
  8. ^ a b http://orthomed.org/wund.html
  9. ^ American Cancer Society 2006 "Orthomolecular Medicine has not been scientifically proven to help most of the conditions for which it is promoted. However, vitamins, minerals, and other supplements have been and continue to be studied to see if they can help or prevent many types of illness." [1]
  10. ^ Nutrition Committee, Canadian Paediatric Society. Megavitamin and megamineral therapy in childhood. Canadian Medical Association Journal 143:1009 1013, 1990, reaffirmed April 2000.
  11. ^ Orthomolecular Medicine News Service (OMNS) Listing or research and news items favourable to the Orthomolecular point of view
  12. ^ How safe are vitamins? Orthomolecular Medicine News Service, November 9, 2005 - Accessed August 2006
  13. ^ New/Old Findings on Unique Vitamin E
  14. ^ AscorbateWeb: Timeline from 1935 to 1939
  15. ^ Orthomolecular psychiatry. Varying the concentrations of substances normally present in the human body may control mental disease,Science 1968 Apr 19;160(825):265-71.(PMID 5641253) [2]
  16. ^ Definition of Orthomolecular medicine at www.orthomed.org Accessed June 2006 and What is Orthomolecular Medicine?, Linus Pauling Inst.
  17. ^ a b c http://orthomed.org/kunin.html Principles That Identify Orthormolecular Medicine: A Unique Medical Specialty by Richard A. Kunin Cite error: The named reference "kunin" was defined multiple times with different content (see the help page).
  18. ^ NCCAM.NIH table 1 on page 8
  19. ^ NCCAM.NIH page 4
  20. ^ http://orthomed.org Orthomolecular Medicine Online
  21. ^ The Acid Test For Schizophrenia, essay, 2005, accessed September 10, 2006
  22. ^ Hoffer's Home Page -The Schizophrenias, accessed September 10, 2006
  23. ^ P. Scott, E. Richards, B. Martin, Captives of Controversy: The Myth of the Neutral Social Researcher in Contemporary Scientific Controversies, Science, Technology, & Human Values, Vol. 15, No. 4, Fall 1990, pp. 474-494, accessed September 10, 2006
  24. ^ http://www.doctoryourself.com/hoffer_cardio.html
  25. ^ a b c Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. A randomized controlled trial. Nutritional Prevention of Cancer Study Group. Clark LC, Combs GF Jr, Turnbull BW, Slate EH, Chalker DK, Chow J, Davis LS, Glover RA, Graham GF, Gross EG, Krongrad A, Lesher JL Jr, Park HK, Sanders BB Jr, Smith CL, Taylor JR. JAMA 1996 ;276:1957-63 PMID 8971064 200ug/d of selenium for 4.5 years resulted in a 17% reduction of totality mortality by over 11 years (in total), due to a 50% reduction of (all) cancer mortality, 37% reduction in (all) cancer occurrence
  26. ^ a b Reduction of cancer mortality and incidence by selenium supplementation. Combs GF Jr, Clark LC, Turnbull BW in Med Klin 1997 ;92 Suppl 3:42-5. PMID 9342915
  27. ^ a b Reduction of cancer risk with an oral supplement of selenium. Combs GF Jr, Clark LC, Turnbull BW in Biomed Environ Sci 1997;10:227-34 PMID 9315315
  28. ^ J Urol. 1994 Jan;151(1):21-6. Megadose vitamins in bladder cancer: a double-blind clinical trial.Lamm DL, Riggs DR, Shriver JS, vanGilder PF, Rach JF, DeHaven JI. PMID 8254816 "The 5-year estimates of tumor recurrence are 91% in the RDA arm and 41% in the megadose arm"
  29. ^ Multivitamin use, folate, and colon cancer in women in the Nurses' Health Study. Giovannucci E, Stampfer MJ, Colditz GA, Hunter DJ, Fuchs C, Rosner BA, Speizer FE, Willett WC; Ann Intern Med" 1998 Oct 1;129(7):517-24 PMID 9758570 Long-term use (>15 years) of folate-containing multivitamin supplements produced an almost 5-fold reduction in the incidence of colon cancer.
  30. ^ http://www.ajcn.org/cgi/content/full/77/2/279?ijkey=9ab8b23f0bdf45f83af656d8623815f69608ad01&keytype2=tf_ipsecsha
  31. ^ GISSI-Prevenzione Investigators. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E in 11,324 patients with myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 1999;354:447–55.[PMID 10465168]
  32. ^ Orthomolecular Research
  33. ^ a b c d Vitamin E and vitamin C supplement use and risk of all-cause and coronary heart disease mortality in older persons: the Established Populations for Epidemiologic Studies of the Elderly. Losonczy KG, Harris TB, Havlik RJ in Am J Clin Nutr 1996 Aug;64(2):190-6 PMID: 8694019 over 9 years of vitamin E found a 34% reduction in total mortality along with a 47% reduction coronary disease mortality; over 9 years from vitamin C & E use found a 42% reduction in total mortality with a 53% reduction in coronary disease mortality
  34. ^ Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin. Canner PL, Berge KG, Wenger NK, Stamler J, Friedman L, Prineas RJ, Friedewald W in J Am Coll Cardiol 1986 Dec;8(6):1245-55 PMID: 3782631 "With a mean follow-up of 15 years, nearly 9 years after termination of the trial, mortality from all causes in each of the drug groups, except for niacin, was similar to that in the placebo group. Mortality in the niacin group was 11% lower than in the placebo group (52.0 versus 58.2%; p = 0.0004)." Dose used = 2g 3g/day for 6 years. The drop in mortality was only evident after 6-8 years.
  35. ^ Associations of Mortality With Ocular Disorders and an Intervention of High-Dose Antioxidants and Zinc in the Age-Related Eye Disease Study: AREDS Report No. 13. AREDS Research Group (Authors: Traci E. Clemons, PhD; Natalie Kurinij, PhD; Robert D. Sperduto, MD.) in Arch Ophthalmol. 2004 May;122(5):716-26. PMID: 15136320 "Participants randomly assigned to receive zinc [80mg/d] had lower mortality than those not taking zinc (RR, 0.73; 95% CI, 0.61-0.89)."
  36. ^ Vitamin C intake and mortality among a sample of the United States population. Enstrom JE, Kanim LE, Klein MA in Epidemiology 1992 May;3(3):194-202 (PMID 1591317) 35% reduction in mortality over 10 years from vitamin C use
  37. ^ Bruce N Ames, Ilan Elson-Schwab and Eli A Silver (2002). "High-dose vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity (increased Km): relevance to genetic disease and polymorphisms". American Society for Clinical Nutrition. 75: 616–658. Retrieved 2006-08-12.
  38. ^ Age-associated mitochondrial oxidative decay: improvement of carnitine acetyltransferase substrate-binding affinity and activity in brain by feeding old rats acetyl-L- carnitine and/or R-alpha -lipoic acid. Liu J, Killilea DW, Ames BN in Proc Natl Acad Sci U S A 2002 Feb 19;99(4):1876-81 (PMID 11854488)
  39. ^ Memory loss in old rats is associated with brain mitochondrial decay and RNA/DNA oxidation: partial reversal by feeding acetyl-L-carnitine and/or R-alpha -lipoic acid. Liu J, Head E, Gharib AM, Yuan W, Ingersoll RT, Hagen TM, Cotman CW, Ames BN in Proc Natl Acad Sci U S A. 2002 Feb 19;99(4):2356-61. (PMID 11854529)
  40. ^ Feeding acetyl-L-carnitine and lipoic acid to old rats significantly improves metabolic function while decreasing oxidative stress. Hagen TM, Liu J, Lykkesfeldt J, Wehr CM, Ingersoll RT, Vinarsky V, Bartholomew JC, Ames BN in Proc Natl Acad Sci U S A. 2002 Feb 19;99(4):1870-5. (PMID 11854487)
  41. ^ a b http://www.juvenon.com/pdfs/june05_ames-prescrip.pdf
  42. ^ a b http://reason.com/amesint.shtml
  43. ^ 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”
  44. ^ 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].”
  45. ^ Vivekananthan D, Penn M, Sapp S, Hsu A, Topol E (2003). "Use of antioxidant vitamins for the prevention of cardiovascular disease: meta-analysis of randomised trials". Lancet. 361 (9374): 2017–23. PMID 12814711.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  46. ^ Lonn E, Bosch J, Yusuf S, Sheridan P, Pogue J, Arnold J, Ross C, Arnold A, Sleight P, Probstfield J, Dagenais G (2005). "Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial". JAMA. 293 (11): 1338–47. PMID 15769967.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  47. ^ Spencer JW, Jacobs JJ. Complementary/alternative medicine: an evidence based approach. Toronto: Mosley, 1999:134,137; The selenium shocker. University of California at Berkeley Wellness Letter 1997;13:8-9; http://www.news.cornell.edu/releases/Jan97/selenium.ssl.html
  48. ^ http://www.tinussmits.nl/english/dynamic.htm?main=http://www.tinussmits.com/english/autism.htm
  49. ^ http://www.canstats.org/readdetail.asp?id=542
  50. ^ Princeton Brain Bio Center. Brochure, distributed to patients. Skillman, N.J., 1983, The Center.
  51. ^ http://www.canstats.org/readdetail.asp?id=542
  52. ^ The Dark Side of Linus Pauling's Legacy by Stephen Barrett
  53. ^ Padayatty SL et al, "Vitamin C Pharmacokinetics: Implications for Oral and Intravenous Use," Ann Intern Med. 2004 Apr 6;140(7):533-7.
  54. ^ Douglas RM, Hemila H (2005). "Vitamin C for preventing and treating the common cold". PLoS Med. 2 (6): e168, quiz e217. PMID 15971944.
  55. ^ Committee on Nutrition, American Academy of Pediatrics. Megavitamin therapy for childhood psychoses and learning disabilities. Pediatrics 58:910­912, 1976. PMID 995522
  56. ^ emedicine - Toxicity statistics, 2003
  57. ^ Rapola JM, et al. Randomized trial of alpha-tocopherol and beta-carotene supplements on incidence of major coronary events in men with previous myocardial infarction. Lancet 1997;349;1715-20.
  58. ^ PMID 3153129
  59. ^ PMID 3737019
  60. ^ Roberts HJ. Vitamin E [letter]. Lancet 1995 Mar 18;345:737
  61. ^ Kaegi E, on behalf of the Task Force on Alternative Therapies of the Canadian Breast Cancer Research Initiative. Unconventional therapies to cancer: 5. Vitamins A, C, and E. Canadian Medical Association 1998; 158:1483-88.
  62. ^ http://www.quackwatch.org/01QuackeryRelatedTopics/DSH/colds.html
  63. ^ http://www.doctoryourself.com/testimony.htm TESTIMONY by Andrew W. Saul before the Government of Canada, House of Commons Standing Committee on Health, regarding natural health product safety (Ottawa, May 12, 2005).
  64. ^ http://www.emedicine.com/EMERG/topic638.htm
  65. ^ Vivekananthan D, Penn M, Sapp S, Hsu A, Topol E (2003). "Use of antioxidant vitamins for the prevention of cardiovascular disease: meta-analysis of randomised trials". Lancet. 361 (9374): 2017–23. PMID 12814711.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  66. ^ Lonn E, Bosch J, Yusuf S, Sheridan P, Pogue J, Arnold J, Ross C, Arnold A, Sleight P, Probstfield J, Dagenais G (2005). "Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial". JAMA. 293 (11): 1338–47. PMID 15769967.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  67. ^ Miller E, Pastor-Barriuso R, Dalal D, Riemersma R, Appel L, Guallar E (2005). "Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality". Ann Intern Med. 142 (1): 37–46. PMID 15537682.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  68. ^ High-Dosage Vitamin E Supplementation and All-Cause Mortality (pdf download)
  69. ^ PMID 16027469
  70. ^ PMID 12600900
  71. ^ http://www.healthwatcher.net/Quackerywatch/Cancer/Dueck/index.html
  72. ^ Eylar E, et al. Sustained levels of ascorbic acid are toxic and immunosuppressive for human T cells. Puerto Rico Health Sciences Journal 1996;15:21-6.
  73. ^ http://www.quackwatch.org/01QuackeryRelatedTopics/hair.html
  74. ^ [lpi.oregonstate.edu/ss06/director.html Director's newsletter, Spring 2006]
  75. ^ fibrinolytic activity of nattokinase, Miyazaki Medical College, Japan
  76. ^ Coenzyme Q10, prescribed for CHF in Japan since 1974, AAFP
  77. ^ Kaitin, K. I., and Jeffrey Brown. 1995. A Drug Lag Update. Drug Information Journal 29: 361–73.

Bibliography

Advocates

  • Abram Hoffer (1998) Putting It All Together: The New Orthomolecular Nutrition, McGraw-Hill, ISBN 0-87983-633-4
  • Abram Hoffer, M.D. with Linus Pauling (2004) Healing Cancer: Complementary Vitamin & Drug Treatments, CCNM Press, ISBN 1-897025-11-4
  • Pauling, Linus (1986) How to Live Longer and Feel Better, W. H. Freeman and Company, ISBN 0-380-70289-4
  • Roger J. Williams, Dwight K. Kalita (1979) Physician's Handbook on Orthomolecular Medicine, Keats Publishing, ISBN 0-87983-199-5
  • Melvyn R. Werbach, Jeffrey Moss (1999) Textbook of Nutritional Medicine, Third Line Press, ISBN 0-9618550-9-6
  • Joseph E. Pizzorno, Jr., Michael T. Murray (November 2005) Textbook of Natural Medicine, 3rd edition, Churchill Livingstone, ISBN 0-443-07300-7 · 2368pp

Critics

  • Barrie R. Cassileth (1998) Alternative medicine handbook: the complete reference guide to alternative and complementary therapies. New York: W.W.Norton & Co., ISBN 0-393-04566-8

See also

Support

Criticism
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