Orthomolecular medicine

DEFINITION: The prevention and treatment of disease by eliminating from the body those substances that contribute to malnutrition, such as sugar, salt, and animal fat, and by optimizing the amounts of such substances as vitamins and minerals.

• PRINCIPAL PROPOSED USES: Cancer, common cold, heart disease, schizophrenia, wounds, and injuries
• OTHER PROPOSED USES: Alcoholism, asthma, chronic fatigue, digestive disorders, and osteoarthritis

Overview

In 1968, Linus Pauling, a preeminent American chemist and two-time Nobel laureate, introduced the term “orthomolecular” to signify human health as “the right molecules in the right amount” in the body. He had earlier discovered the first disease described as “molecular” when he showed that a defect in the hemoglobin molecule causes sickle cell anemia. He later explored the role of molecular deficiencies in mental illness and, following the advice of biochemist Irwin Stone, began taking large amounts (megadoses) of vitamin C (ascorbic acid), which reduced the numbers and the severity of his bouts with the common cold.

Pauling then investigated the scientific literature and found studies that indicated that high ingestion of vitamin C protected people against colds. Because medical and nutritional authorities had largely ignored these studies, Pauling compiled his findings and published the book Vitamin C and the Common Cold (1970) to alert consumers, doctors, and nutritionists about the results of his literature review.

Pauling’s book initiated the so-called vitamin C controversy, which pitted Pauling and a growing number of supporters against members of the medical and nutritional establishment, who generally criticized his claims. In the early 1970s, Pauling and others founded the Institute of Orthomolecular Medicine (later renamed the Linus Pauling Institute of Science and Medicine) near Stanford University. The institute was designed, among other things, to research how the deficiencies and surpluses of certain bodily substances affect human health. This research led to the publication of the book Cancer and Vitamin C (1979), which Pauling coauthored with the oncologist Ewan Cameron. Pauling then published How to Live Longer and Feel Better (1986), his final book. After Pauling’s death in 1994, his institute moved to Oregon State University, where Pauling had obtained his undergraduate degree. The institute’s research mission remained orthomolecular medicine and nutrition, a goal shared with many orthomolecular doctors worldwide.

Mechanism of Action

Millions of years of evolution in Homo sapiens has led the human body to develop an armamentarium of substances that facilitate the health necessary for survival. According to orthomolecular physicians, however, modern diets often lack the proper amounts of essential vitamins, minerals, proteins, and other nutrients, and contain harmful amounts of such substances as sugar, salt, and animal fats. A person can maintain good health by eliminating substances that contribute to malnutrition and optimizing the amounts of such substances as vitamins and minerals.

Uses and Applications

After interviewing a person seeking care and after analyzing that person’s blood, urine, and hair, the orthomolecular doctor attempts, through diet, supplements, and lifestyle modification, to restore a proper balance of chemical constituents in the body. The physician may prescribe megadoses of vitamin C, vitamin E, and niacin and restrict the ingestion of such processed foods as refined sugar, white flour, and animal fats.

Scientific Evidence

Because of the overwhelming data gathered by researchers in numerous double-blind studies of humans and nonhuman animals, general agreement exists among physicians and nutritionists that certain vitamins, minerals, proteins, carbohydrates, and fats are essential for good health. Controversies have developed, however, about what constitutes truly advantageous amounts of these substances. For example, Pauling believed that the Food and Nutrition Board of the US Food and Drug Administration set the recommended dietary allowances of many of these substances much too low. As scientific evidence to bolster his claim, Pauling cited his own work, “Evolution and the Need for Ascorbic Acid,” in which he analyzes the diets of primates, showing that they ingested two to three grams of ascorbic acid per day. Furthermore, animals who manufacture their own vitamin C do so in mega, rather than micro, amounts.

Rebutting the claims of Pauling and orthomolecular doctors who support his views, other researchers performed laboratory and clinical studies that showed, for example, that megavitamin therapy had no value for people suffering from mental illness. Most famously, two Mayo Clinic studies (1979 and 1985) concluded that vitamin C was an ineffective treatment for persons with cancer. Scientific studies continued during the succeeding decades on the effectiveness of megadoses of vitamins and other nutrients for various illnesses, with some studies supporting the benefits, but many indicating no or even negative consequences. Even as many people continue to use dietary supplements, many conventional health practitioners reject most of the doctrines of the orthomolecular proponents. Similarly, in the early twenty-first century, one meta-analysis found that micronutrient supplementation helped lower the impact of HIV in adults and prolonged life. In 2017, a follow-up study found contrasting results, with the micronutrients having little or no impact on HIV and failing to prevent death.

Choosing a Practitioner

Although orthomolecular medicine is widely considered an alternative medicine, it generally involves cooperation with conventional doctors and is, thus, more complementary than alternative in nature. For example, when Pauling and his wife were suffering from cancer, both used megavitamin therapy as a complement to surgery.

The International Society of Orthomolecular Medicine and many national societies provide lists of orthomolecular practitioners. Orthomolecular Health Medicine, founded in 1994, has a referral service.

Safety Issues

Proponents of orthomolecular medicine insist that megadoses of vitamins and other nutrients are perfectly safe, but critics insist that relying solely on nutritional rather than pharmacological treatment, when necessary, is dangerous. Researchers who support criticism of orthomolecular medicine have gathered evidence that confirms the hazards of megadoses of such fat-soluble vitamins as A and E. Megadoses of other vitamins have been associated with increased risk of heart disease, kidney stones, hypertension, and other diseases.

Bibliography

Bender, David A. Nutritional Biochemistry of the Vitamins. 2nd ed., Cambridge University Press, 2010.

Bland, Jeffrey S. “Glutathione, Orthomolecular Medicine, and Nutraceutical Therapy.” Integrative Medicine: A Clinician’s Journal, vol. 21, no. 4, Sept. 2022, pmc.ncbi.nlm.nih.gov/articles/PMC9542932/. Accessed 13 Dec. 2024.

Gratzer, Walter B. Terrors of the Table: The Curious History of Nutrition. Oxford University Press, 2005.

Hoffer, Abram, and Andrew W. Saul. Orthomolecular Medicine for Everyone: Megavitamin Therapeutics for Families and Physicians. National Health, 2008.

Pauling, Linus. How to Live Longer and Feel Better. 6th print, Oregon State University Press, 2015.

Visser, Marianne E., et al. “Micronutrient Supplementation in Adults with HIV Infection.” The Cochrane Database of Systematic Reviews, vol. 5, no. 5, May 2017, p. CD003650. doi:10.1002/14651858.CD003650.pub4. Accessed 13 Dec. 2024.

Williams, Roger J., and Dwight K. Kalita. A Physician’s Handbook on Orthomolecular Medicine. Elsevier, 2016.