Orthomolecular medicine
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2008-07-15T02:53:33Z
Levine2112
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actually, the link is already well noted in article; no need to repeat in "See also"
{{Articleissues|tone=December 2007|pov=March 2008}}
{{Biologically based therapy}}
'''Orthomolecular medicine''' is a form of [[complementary and alternative medicine]] with the goal to preventing and treating disease with [[nutrients]], often in the form of [[dietary supplements]].<ref>[http://findarticles.com/p/articles/mi_g2603/is_0000/ai_2603000096 Orthomolecular medicine] ''Encyclopedia of Alternative Medicine'' by Patricia Skinner</ref><ref name="orthomed"> [http://www.orthomed.org/ Definition of Orthomolecular medicine] at www.orthomed.org Accessed June 2006</ref> The term "orthomolecular" was first coined in a 1967 letter<ref name=pauling1967/> by Nobel Prize winner [[Linus Pauling]] and later elaborated on in a 1968 paper<ref name=pauling1968/> on [[micronutrient]]s and [[psychiatry]] to express the idea of "the right molecules in the right amounts" (''ortho'' is Greek for right<ref>ISOM. [http://www.isom.eu/tenets.php About OM]</ref>). In this paper, Pauling indicated that the right molecules are "substances that are normally present in the human body". Orthomolecular medicine began with a particular focus upon [[Mental disorder|mental illness]], and [[orthomolecular psychiatry]] remains a major subdiscipline.<ref>Syd Baumel (Aug 2000) "Chapter 5, [http://books.google.com/books?id=7QvKqNZrxocC&pg=PA84&lpg=PA84&dq=%22bill+w%22&source=web&ots=ITyDirbJHE&sig=b27plgzOn0P1ZRbR5tLwVqmjdIo&hl=en#PPA75,M1 The Orthomolecular Medical Approach to Depression]", "Chapter 6, [http://books.google.com/books?id=7QvKqNZrxocC&pg=PA84&lpg=PA84&dq=%22bill+w%22&source=web&ots=ITyDirbJHE&sig=b27plgzOn0P1ZRbR5tLwVqmjdIo&hl=en#PPA81,M1 Vitamin Power]", ''Dealing with Depression Naturally: Complementary and Alternative Therapies'', 2nd ed, McGraw-Hill; ISBN 0658002910 </ref> Proponents state that orthomolecular treatments are based on patients' personal biochemistries<ref>[[Roger J. Williams]] (1998) ''Biochemical Individuality: The Basis for the Genetotrophic Concept.'' 2nd ed. Keats Publishing. ISBN 0-87983-893-0 </ref> and employ [[natural product|naturally-occurring]] or [[Bioequivalence|bioequivalent]] [[biomolecule|biomolecules]], particularly nutrients such as [[vitamin]]s, [[dietary mineral]]s, [[protein]]s, [[antioxidant]]s,<ref>[http://orthomolecular.org/library/jom/1998/pdf/1998-v13n01-p044.pdf Alpha-Lipoic Acid (Thioctic Acid): My Experience]</ref> [[amino acid]]s, [[lipotropic|lipotropes]],<ref>[http://orthomolecular.org/library/jom/1996/pdf/1996-v11n03-p173.pdf Reduction of Cholesterol and Lp(A) in Regression of Coronary Artery Disease: A Case Study]</ref> prohormones, [[dietary fiber]], [[fatty acid]]s and other similar substances.<ref>[http://orthomolecular.org/library/jom/1997/articles/1997-v12n01-p004.shtml Coenzyme Q10: A Novel Cardiac Antioxidant (1997)]</ref>
Some [[Megavitamin therapy|megavitamin therapies]] can be classified as components of orthomolecular medicine. Orthomolecular practitioners often recommend levels beyond the [[Recommended Daily Allowance]], especially for [[Vitamin C megadosage|vitamin C]], and prescribe the removal of unhealthy foods from the diet. Megavitamin therapies have become relatively popular, with a survey in 2002 finding that approximately one in twenty-five US adults use high doses of vitamins as a form of therapy,<ref name=NCCAMsurvey/> with this being particularly common in people diagnosed with [[cancer]].<ref name=Velicer>{{cite journal |author=Velicer CM, Ulrich CM |title=Vitamin and mineral supplement use among US adults after cancer diagnosis: a systematic review |journal=J. Clin. Oncol. |volume=26 |issue=4 |pages=665–73 |year=2008 |pmid=18235127 |doi=10.1200/JCO.2007.13.5905 |url=http://www.jco.org/cgi/pmidlookup?view=long&pmid=18235127}}</ref>
Nutrients are useful in preventing and treating some illnesses<ref name=ACS/><ref>Lakhan SE, Vieira KF (2008) [http://www.nutritionj.com/content/7/1/2 Nutritional therapies for mental disorders]. Nutr J 7: 2. doi:10.1186/1475-2891-7-2 PMID 18208598</ref>, but the mainstream medical consensus is that the broad claims of disease treatment by advocates of orthomolecular medicine are unsubstantiated by the available evidence.<ref>Stuart Aaronson ''et. al.'' [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?highlight=orthomolecular&rid=cmed6.section.18479&WebEnv=0MnZPX94hO0XD2ugCELLkbhpkV5QLNBinRc8fAJ1IwDvCVoCzamY2zTpsFeeRiEdbTVTXzrZpQLqXt%40263F77C978AD3D40_0136SID&WebEnvRq=1#18482 "Cancer Medicine"], 2003, ''BC Decker Inc'' ISBN 1–55009–213–8, Section 20, p76</ref><ref name=References1990>{{cite journal | author = Nutrition Committee, Canadian Paediatric Society | year = 1990 | title = Megavitamin and megamineral therapy in childhood | journal = CMAJ | volume = 143 | issue = 10 | pages = 1009–1013 | url = http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1452516 | accessdate = 2008-04-04 | pmid = 1699646}}</ref><ref name=ACS/> The [[American Medical Association]] stated in 1997 that "much of the dietary intervention stressed by alternative healers is prudent and reasonable", but described as a "myth" the idea that "most diseases are caused by faulty diets and can be prevented by nutritional interventions".<ref name=AMA>[http://www.ama-assn.org/ama/pub/category/13638.html Report 12 of the Council on Scientific Affairs: Alternative medicine] ''American Medical Association'' June 1997, Accessed 21 March 2008</ref> Critics have described some aspects of orthomolecular medicine as [[food faddism]] or [[quackery]].<ref name=Jarvis>{{cite journal |author=Jarvis WT |title=Food faddism, cultism, and quackery |journal=Annu. Rev. Nutr. |volume=3 |pages=35–52 |year=1983 |pmid=6315036 |doi=10.1146/annurev.nu.03.070183.000343}}</ref><ref name=Jukes1990>{{cite journal | author = Jukes, T.H. | year = 1990 | title = Nutrition Science from Vitamins to Molecular Biology | journal = Annual Review of Nutrition | volume = 10 | issue = 1 | pages = 1–20 | doi = 10.1146/annurev.nu.10.070190.000245}} A short summary is in [http://arjournals.annualreviews.org/doi/full/10.1146/annurev.nu.10.072106.100001 the journal's preface].</ref><ref name=Braganza2005>{{cite journal | author = Braganza, S.F. | coauthors = Ozuah, P.O. | year = 2005 | title = Fad Therapies | journal = Pediatrics in Review | volume = 26 | issue = 10 | pages = 371–376 | doi = 10.1542/pir.26-10-371 | pmid = 16199591}}</ref> Research on nutrient supplementation in general suggests that some nutritional supplements might be beneficial, and that others might be harmful.<ref>{{cite journal |title=NIH State-of-the-Science Conference Statement on Multivitamin/Mineral Supplements and Chronic Disease Prevention |journal=NIH Consens State Sci Statements |volume=23 |issue=2 |pages=1–30 |year=2006 |pmid=17332802 |url=http://consensus.nih.gov/2006/2006MultivitaminMineralSOS028main.htm}}</ref><ref>{{cite journal |author=Huang HY, Caballero B, Chang S, ''et al'' |title=The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults: a systematic review for a National Institutes of Health state-of-the-science conference |journal=Ann. Intern. Med. |volume=145 |issue=5 |pages=372–85 |year=2006 |month=September |pmid=16880453 |url=http://www.annals.org/cgi/pmidlookup?view=reprint&pmid=16880453 |doi=10.1001/archinte.145.2.372}}</ref>
==History and development==
As a discipline focused upon using nutrients to treat illness, orthomolecular medicine practitioners trace the origin of the field back to the [[Vitamins#History|discovery of vitamins]] in the early 20th century.<ref name="OMHistory">[http://www.orthomolecular.org/history/index.shtml History of Orthomolecular Medicine]</ref> However, the word "orthomolecular" was coined by Linus Pauling in 1967. Thus orthomolecular practitioners lay claim to figures who preceded later controversies and labels, and perhaps would have rejected the controversial treatments which were later called orthomolecular medicine. Practitioners claim these figures were orthomolecular because of their emphasis on the role of nutrition in treating disease. In a paper on the history of orthomolecular medicine, Menolascino<ref name="Menolascino"/> notes that there were several eras in the use of nutrition to treat disease. After the discovery of nutrients at the dawn of the 20th century, some doctors began to think that vitamins could cure many things, and nutrition was incorporated into the medical curriculum. Supplements became ubiquitous. As spectacular results were not forthcoming, in the 1950s and 1960s medical science slowly became disillusioned with nutrition and cut it from the standard curriculum, just as orthomolecular medicine was heating up. Orthomolecular medicine highlights some figures from these early years as their founders.
In the 1930s Dr. [[Max Gerson]] (1881 - 1959) developed [[Gerson therapy]], a strict diet which he claimed could treat many diseases. In 1933, Drs. Wilfred and Evan Shute began to use [[vitamin E]] to treat heart disease.<ref name="Shute">[http://orthomolecular.org/hof/ewshute.html Wilfred and Evan Shute]</ref> Some of the concepts frequently utilized in orthomolecular medicine, such as individual biochemical variation,<ref>[[Roger J. Williams]] (1998) ''Biochemical Individuality: The Basis for the Genetotrophic Concept.'' 2nd ed. Keats Publishing. ISBN 0-87983-893-0 </ref> [[inborn error of metabolism]],<ref>Stephen F. Mason. [http://oregonstate.edu/dept/spc/subpages/ahp/overview/overview5.htm THE SCIENCE AND HUMANISM OF LINUS PAULING (1901-1994).] ''Chemical Society Reviews'', 26, no. 1 (February 1997). Section 5, Molecular Medicine: “...Garrod in his book, Inborn Error of Metabolism (1909, 1923)” </ref><ref name="Menolascino">Menolascino FJ, et al. "Orthomolecular Therapy: Its History and Applicability to Psychiatric Disorders", ''Child Psychiatry and Human Development'', Vol.18(3), Spring 1988, pp 140-1 </ref><ref> Lois N. Magner ''[http://books.google.com/books?id=qtUzscI9_VIC&pg=PA238&lpg=PA238&dq=%22inborn+error+of+metabolism%22&source=web&ots=ha6R0iwZSt&sig=yM6OKedSh2HJkjsCK2bWXGz5-Vw&hl=en A History of Medicine]'', Informa Healthcare; 2nd edition (June 23, 2005) ISBN 0824740742</ref> and exogeneous supply of essential substances in therapy <ref>Beard J. The action of 'trypsin' upon living cells of the Jensen sarcoma. Brit Med J 1906;1:140-141 (Jan. 20, 1906). </ref> debuted in scientific and medical papers early in the 20 th century. Orthomolecular [[megavitamin therapy|megavitamin therapies]], such as with tocopherols and ascorbates,<ref>[http://www.seanet.com/~alexs/ascorbate/193x/index.htm AscorbateWeb: Timeline from 1935 to 1939]</ref> date back to the 1930s.
In 1948, Dr. William McCormick theorized that [[vitamin C]] deficiency played an important role in many diseases, and began to use large doses in patients.<ref name="McCormick">[http://www.doctoryourself.com/mccormick.html MEGADOSES OF VITAMIN C AND DR. WILLIAM J. McCORMICK], [http://orthomolecular.org/hof/wmccormick.html McCormick HoF]</ref> In the 1950s, American doctor [[Frederick Klenner]] also experimented with the use of [[vitamin C]] megadosage as a therapy for a wide range of illnesses, most notably [[polio]], and authored 28 research papers during his career.<ref>[http://www.doctoryourself.com/klennerbio.html Hidden in Plain Sight: The Pioneering Work of Frederick Robert Klenner, M.D.] Andrew W. Saul, online reprint from ''J Orthomolecular Med'', 2007. Vol 22, No 1, p 31-38, Accessed October 2007</ref><ref>[http://www.seanet.com/~alexs/ascorbate/198x/smith-lh-clinical_guide_1988.htm A posthumous summary of Frederick Klenner's 28 papers.] Lendon H. Smith, M.D., Clinical Guide to the Use of Vitamin C - The Clinical Experiences of Frederick R. Klenner, M.D. . Accessed October 2007.</ref>
McCormick and Klenner influenced biochemist Dr. [[Irwin Stone]], who extensively researched vitamin C and received the first patent for its commercial use. Stone found that all living beings have vitamin C. Further, nearly all vertebrates produce vitamin C, and produce much more when stressed. Some primates, including humans, do not produce vitamin C, and Stone claimed that this was due to a genetic defect which he called hypoascorbemia.<ref>[http://www.seanet.com/~alexs/ascorbate/197x/stone-i-orthomol_psych-1972-v1-n2-3-p82.htm ''The Natural History of Ascorbic Acid in the Evolution of Mammals and Primates'', Irwin Stone, 1972]</ref> Based on a rat's production of vitamin C, a 70 kg human would produce between 1.8 and 4 grams of vitamin C, and a stressed human up to 15.2 grams.<ref name="ascorbic">[http://orthomolecular.org/library/jom/1998/pdf/1998-v13n04-p198.pdf Observations On the Dose and Administration of Ascorbic Acid When Employed Beyond the Range of a Vitamin in Human Pathology]</ref> This contrasts with the current [[Dietary Reference Intake]], which maintains that 90 mg is adequate, and increases that to 120 mg if pregnant.<ref>Council for Responsible Nutrition. [http://www.crnusa.org/about_recs3.html Vitamin and Mineral Recommendations]</ref> Based on the levels of vitamin C in other vertebrates, Stone believed that ascorbate was not a trace vitamin but was required in humans in large daily amounts. He produced four papers between 1965 and 1967 to back up this assertion.<ref>STONE. I.: Studies of a Mammalian Enzyme System for Producing Evolutionary Evidence on Man. Amer. J. Phys. Anthrop. 15, 83-85, 1965.</ref><ref>STONE. I.: On the Genetic Etiology of Scurvy. Acts Genet. Med. Gemellol. 15, 345-350,1966.</ref><ref>STONE, I.: Hypoascorbemia, the Genetic Disease Causing the Human Requirement for Exogenous Ascorbic Acid, Perspectives Bio. Med. 10, 133-134, 1966.</ref><ref>STONE, I.: The Genetic Disease, Hyposacorbemia: A Fresh Approach to an Ancient Disease and Some of its Medical Implications, Acta Genet Med. Gemellol. 16, 52-62. 1967.</ref> In 1966 Stone met Linus Pauling and sparked Pauling's interest in vitamin C.<ref name="InMemoriam">[http://www.seanet.com/~alexs/ascorbate/198x/rimland-b-orthomol_psych-1984-v13-n4-p285.htm In Memoriam Irwin Stone]</ref>
Concurrent with vitamin C developments, [[orthomolecular psychiatry]] began to be developed in the early 1950s by a group of biochemists and [[psychiatrist]]s who believed that certain vitamin deficiencies were associated with mental illness.<ref>ISOM. [http://www.isom.eu/history.php#1968 ISOM History of OM]</ref> In particular, psychiatrists Drs. [[Humphry Osmond]] and [[Abram Hoffer]] began to treat [[schizophrenia]] with high doses of [[niacin]],<ref>[http://orthomolecular.org/hof/hosmond.html Humphry Osmond HoF]</ref> continuing work done by Dr. William Kaufman, who used [[niacinamide]].<ref name="Kaufman">[http://orthomolecular.org/hof/wkaufman.html Walter Kaufman HoF], [http://www.doctoryourself.com/biblio_kaufman.html Kaufman's bibliography]</ref> Incidental to this effort, Hoffer contributed to the discovery that niacin could treat [[dyslipidemia]] in 1954-5.<ref>{{cite journal |author=Guyton JR |title=Niacin in cardiovascular prevention: mechanisms, efficacy, and safety |journal=Curr. Opin. Lipidol. |volume=18 |issue=4 |pages=415–20 |year=2007 |pmid=17620858 |doi=10.1097/MOL.0b013e3282364add}}</ref>
In 1967, [[Linus Pauling]] introduced the expression orthomolecular medicine to describe one aspect of medicine,<ref name=pauling1967>Pauling L.
[http://books.google.com/books?id=2QduA19d_X8C&pg=PA1371&lpg=PA1371&dq=%22orthomolecular+somatic+and+psychiatric+medicine%22+%22i+have+introduced+the+expression+orthomolecular+medicine%22+%22to+describe+one+aspect+of+molecular+medicine%22&source=web&ots=ISBoxbfXHj&sig=wMa8DO9wzls1AexkTGIz6STNIes&hl=en Orthomolecular Somatic and Psychiatric Medicine “], Communication: Luxembourg and Trier on 18-24 September 1967; Pauling L. 1968b: Orthomolecular Somatic and Psychiatric Medicine ''J Vital Substances and Diseases of Civilization’’, 14; 1-3. </ref> and the term "''orthomolecular therapy''", as published in ''[[Science (journal)| Science]]'' in 1968, to express the idea of ''the right molecules in the right amounts''.<ref name=pauling1968> ''Orthomolecular psychiatry. Varying the concentrations of substances normally present in the human body may control mental disease'',[[Science (journal)|''Science'']] 1968 Apr 19;160(825):265-71. (PMID 5641253) [http://www.roccomanzi.it/imp-vitaminerali/SCIENZIATI/scienziati-docu/pauling/orthomed-pauling2-mental-con_file/orthomed-pauling2-mental-con.htm]</ref> Pauling 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."<ref>[http://www.orthomed.org/ Definition of Orthomolecular medicine] at www.orthomed.org Accessed June 2006 and [http://lpi.oregonstate.edu/f-w99/orthomolecular.html What is Orthomolecular Medicine?, Linus Pauling Inst.]</ref>
Orthomolecular medicine has diversified since its beginnings in[[1968]], but the term orthomolecular is still associated with Pauling's advocacy of multi-gram doses of vitamin C for optimal health. Partly for this reason, detractors of orthomolecular medicine have described the practice entirely in terms of megadose nutrient therapy. Cassileth, a widely quoted critic of Pauling's ideas, asserts: "In 1968, the Nobel-prize-winning scientist Linus Pauling coined the term "orthomolecular" to describe the treatment of disease with large quantities of nutrients."<ref name="cassileth"/> In this way, criticism of orthomolecular medicine has, to a large extent, been confused with much older medical traditions of high-dose vitamin therapies, such as earlier "megadose" usages of [[retinol]] and [[ergocalciferol]] or synthetic pharmaceutical analogues, such as [[menadione]].<ref>Meyer TC, Angus J. "The effect of large doses of 'Synkavit' in the newborn". ''Arch Dis Child'' 1956; vol 31, p. 212-5.</ref>
<ref>Laurance B. "Danger of vitamin K analogues to newborn." ''Lancet'' 1955; vol 1, p 819.</ref><ref>Sutor AH. [http://www.thieme-connect.com/ejournals/abstract/sth/doi/10.1055/s-2003-42680 New Aspects of Vitamin K Prophylaxis.] ''Semin Thromb Hemost'' 2003; vol 29, p 373-376 "The problem was solved when synkavit [editor's note: no longer on the market] was replaced by low-dose (1 mg) [vitamin K<sub>1</sub> phytomenadion"</ref> However, such definitions of orthomolecular therapy are not synonymous with Pauling's definition. Interest in vitamin C has been renewed, beginning with the discovery that intravenous vitamin C can achieve plasma concentrations up to 70-fold higher than oral vitamin C.<ref>Annals of Internal Medicine. [Vitamin C Pharmacokinetics: Implications for Oral and Intravenous Use http://www.annals.org/cgi/content/full/140/7/533]</ref> A 2005 paper in the ''Proceedings for the National Academy of Sciences'' noted that vitamin C selectively killed cancer cells ''in vitro''. This paper noted that, although the original observational studies of vitamin C were based on intravenous administration, the subsequent double-blind placebo-controlled studies used oral ascorbate.<ref>PNAS. [http://www.pnas.org/cgi/content/full/102/38/13604 Pharmacologic ascorbic acid concentrations selectively kill cancer cells]</ref> In 2007, the researchers demonstrated how vitamin C ''in vivo'' could possibly kill cancer cells.<ref>[http://www.pnas.org/cgi/content/full/104/21/8749 Ascorbate in pharmacologic concentrations selectively generates ascorbate radical and hydrogen peroxide in extracellular fluid in vivo]</ref> A recent historical study of the past ten years has found three patients whose tumors shrank after receiving intravenous vitamin C along with other alternative and conventional treatments. The authors of the study claimed that the case studies "only signficant treatment" for these patients was vitamin C.<ref>{{cite journal |author=Padayatty SJ, Riordan HD, Hewitt SM, Katz A, Hoffer LJ, Levine M |title=Intravenously administered vitamin C as cancer therapy: three cases |journal=CMAJ |volume=174 |issue=7 |pages=937–42 |year=2006 |month=March |pmid=16567755 |doi=10.1503/cmaj.050346 |url=http://www.cmaj.ca/cgi/pmidlookup?view=long&pmid=16567755}}</ref><ref>{{cite journal |author=Assouline S, Miller WH |title=High-dose vitamin C therapy: renewed hope or false promise? |journal=CMAJ |volume=174 |issue=7 |pages=956–7 |year=2006 |month=March |pmid=16567756 |doi=10.1503/cmaj.060228 |url=http://www.cmaj.ca/cgi/pmidlookup?view=long&pmid=16567756}}</ref> However, this is far from conclusive, and studies are currently planned at the McGill University.<ref>[http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/research-backs-theory-that-vitamin-c-shrinks-tumours-471757.html Research backs theory that vitamin C shrinks tumours.] ''[[The Independent]]'', 28 March 2006</ref>
Research since the 1960s has branched out further into nutrients besides niacin and vitamin C. Dr. [[David Horrobin]] did important work with [[essential fatty acid]]s, which have played an increasingly important part in orthomolecular medicine.
==Scope==
Although orthomolecular medicine is based on the idea that nutritional imbalances should be corrected before illness occurs, and consequently is not easily integrated into any single branch of medicine, its claims are particularly associated with [[psychiatry]], in the field of [[orthomolecular psychiatry]], and [[oncology]], where Linus Pauling reported that Vitamin C could slow the progression of,<ref name=Pauling>{{cite journal | year = 1976| title = Supplemental ascorbate in the supportive treatment of cancer: prolongation of survival times in terminal human cancer | journal = Proceeding of the National Academy of Sciences | volume = 73 | pages = 3685–3689| url = http://yost.com/health/klenner/klenner-1971.pdf | accessdate = 2008-05-31 | format = pdf | author = Cameron E, Pauling L| doi = 10.1073/pnas.73.10.3685| pmid = 1068480}}</ref> and even reverse,<ref>{{cite book |author=Ewan Cameron, Linus Pauling |title= Cancer and vitamin C : a discussion of the nature, causes, prevention, and treatment of cancer with special reference to the value of vitamin C |publisher=Norton |location=New York |year=1979 |pages= |isbn= 0-393-50000-4 |oclc= |doi=}}</ref> cancer. As time went on Pauling came to believe that there was a deliberte and concerted effort to denigrate, distort and dissemble about his efforts, [[Ewan Cameron (physician)|Ewan Cameron]] the Scottish oncologist, who collaborated with Pauling, very reluctantly came to agree as he believed to perceive mounting evidence to support the Pauling's allegations of bad fath.<ref>{{cite book |author=Thomas Hager |title= Force of Nature: The Life of Linus Pauling |publisher=Simon & Schuster |location=New York |year=1995|pages= |isbn= 0684809095 |oclc= |doi=}}</ref>
Proponents of orthomolecular medicine claim that scientists associated with orthomolecular medicine had identified specific biochemical anomalies that account for many cases of [[bipolar disorder]], schizophrenia, and some similar manifestations, such as, in one case, an previously undescribed copper toxicity disorder.
Based on investigational scientific studies, single-blind and double-blind randomized controlled trials, clinical experience, and case histories, claims have been made that therapeutic nutrition can prevent<ref>[http://www.genengnews.com/news/bnitem.aspx?name=23587988 Clinical Data Shows Vitamin C May Reduce Risks of Cancer, Heart Disease and Variety of Other Health Disorders] Genetic Engineering & Biotechnology News , September 24 2007 reporting on Seminars in Preventive and Alternative Medicine (vol. 3, iss. 1, pp. 25-35) Mark A. Moyad, MD, MPH of University of Michigan. accessed October 2007</ref> treat, and sometimes cure [[acne]],<ref>Leung LH, [http://orthomolecular.org/library/jom/1997/articles/1997-v12n02-p099.shtml A Stone that Kills two Birds: How Pantothenic Acid Unveils the Mysteries of Acne Vulgaris and Obesity], J. Orthomolecular Med., Vol. 12, 2nd Qtr 1997, Accessed 9 July 2007 </ref> [[bee sting]]s, [[Burn (injury)|burns]], [[cancer]], the [[common cold]], [[drug addiction]], [[drug overdose]], [[heart diseases]], acute [[hepatitis]], [[herpes]], [[influenza]], [[mononucleosis]], [[mushroom poisoning]], [[neuropathy]] & [[polyneuritis]] (including [[multiple sclerosis]]), [[osteoporosis]],<ref>Plaza SW, Lamson DW. [http://www.thorne.com/pdf/journal/10-1/vit_k10-1.pdf Vitamin K2 in Bone Metabolism and Osteoporosis]. Alt Medicine Review, Vol 10, No 1.</ref> [[polio]], [[alcoholism]],<ref>Hoffer A, et al. [http://www.orthomolecular.org/resources/omns/v01n06.shtml Treatment Protocol for Alcoholism]. Orthomolecular Medicine News Service, 1 Jul 2005</ref> [[allergies]], [[arthritis]], [[autism]], [[epilepsy]], [[hypertension]], [[hypoglycemia]], [[migraine]], [[clinical depression]], [[learning disabilities]], [[retardation]], [[mental disorder|mental]] and [[metabolic disorders]], [[skin]] problems, and [[hyperactivity]],"<ref>Princeton Brain Bio Center. Brochure, distributed to patients. Skillman, N.J., 1983, The Center.</ref> [[Raynaud's disease]], [[heavy metal poisoning|heavy metal toxicity]], [[radiation sickness]], * [[Pyroluria]], [[schizophrenia]],<ref>Skinner P, "Orthomolecular Medicine", ''Gale Encyclopedia of Alternative Medicine: Holistic medicine'', Thomson Gale, 2004.</ref> [[Shock (medical)|shock]], [[snakebite]], [[spider bite]], [[tetanus toxin]] and [[viral pneumonia]].<ref name=Klenner1971>{{cite journal | author = Klenner, F.R. | year = 1971 | title = Observations on the dose and administration of ascorbic acid when employed beyond the range of a vitamin in human pathology | journal = J Appl Nutr | volume = 23 | pages = 61–88 | url = http://yost.com/health/klenner/klenner-1971.pdf | accessdate = 2008-03-21 | format = pdf}}</ref>
However, most orthomolecular practitioners do not claim to be able to treat all diseases. As Abram Hoffer wrote in 1989: "Nor is orthomolecular treatment a replacement for standard treatment. A proportion of patients will require orthodox treatment, a proportion will do much better on orthomolecular treatment, and the rest will need a skillful blend of both."<ref name="huemer"/> For example, Hoffer admits that in his experience, acute and not chronic schizophrenia responds to niacin.<ref>Hoffer, A. [http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1335278 Letter - Megavitamin and megamineral therapy in childhood]</ref>
==Principles==
Orthomolecular medicine is predicated on the premise that it is preferable to recognize and correct any possible anomalies in [[metabolism]] at an early stage, before they cause disease.<ref>Huemer RP. A theory of diagnosis for orthomolecular medicine. J Theor Biol 1977 67:625-635. Reprinted in Advances 1984 1(3):53-59.</ref> Orthomolecular medicine posits that many typical diets are insufficient for long term health; thus, orthomolecular medical diagnoses and treatment often focus on the use of nutrients such as [[vitamin]]s, [[dietary mineral]]s, [[protein]]s, [[antioxidant]]s, [[amino acid]]s, [[omega-3 fatty acid|ω-3 fatty acid]]s, [[omega-6 fatty acid|ω-6 fatty acid]]s, [[dietary fiber]], and short and long chain [[fatty acids]], although a wide range of other substances are used, such as [[lipotropic|lipotropes]] and prohormones. Abram Hoffer wrote a foreword to one edition of [[Weston Price]]'s 1930 description of his travels and observations of the health and diet among "primitive" peoples who did not consume processed foods, and were spared the ravages of "degenerative" diseases.<ref>Weston Price (2008) [Nutrition and Physical Degeneration ],Price Pottenger Nutrition; Eight Edition edition . ISBN-10: 0916764206</ref>
Orthomolecular nutrition and therapy attempts to provide optimal amounts of [[micronutrients]]. Most often, 'optimal' has been a matter of the clinical judgment of the orthomolecular practitioner, who gives these compounds in accord with the clinical symptoms of the patient and the practioner's judgment of what is appropriate, rather than the published [[Dietary Reference Intake|dietary reference intakes]] of these nutrients. Modern orthomolecular practitioners also use a wide range of laboratory analyses, including those for [[amino acids]], [[organic acids]], [[vitamins]] and [[minerals]], functional vitamin status, [[hormones]], [[immunology]], [[microbiology]], and [[gastrointestinal]] function. However, many of these tests are not employed by mainstream medicine for common diagnostic use.
In the early years of orthomolecular medicine, supplementation usually meant high-dose, single-agent [[nutrient]] therapy.<ref name="huemer">Richard P. Huemer MD, ''Orthomolecular Medicine'', Encyclopedia of Complementary Health Practice, Springer Publishing Company, September 18, 1997. [http://www.huemer.com/medi1.htm available online]</ref> Today, orthomolecular practitioners use many substances: [[amino acids]], [[enzymes]], [[hormones]], [[vitamins]], [[minerals]], or [[derivate]] substances in an effort to supply what they see as optimum dosages of these substances.<ref name="kunin">http://orthomed.org/kunin.html Principles That Identify Orthormolecular Medicine: A Unique Medical Specialty by Richard A. Kunin</ref>
Frequently supplementation with relatively large doses of vitamins is given, and the name [[megavitamin therapy]] is popularly associated with the area. Megavitamin therapy is the administration of large amounts of vitamins, often many times greater than the [[Dietary Reference Intake|recommended dietary allowance]] (RDA). The nominal ratio of dose to RDA to qualify for the term 'megavitamin therapy' has been a matter of minor semantic debate.
Administration of short-chain [[fatty acids]] in orthomolecular practice is usually done by increasing the level of [[dietary fiber]].<ref>Monica & Gene Spiller (2005) [http://books.google.com/books?id=SPeQLCwz9ncC&pg=PA34&lpg=PA34 What's with Fiber?], Ch 3, pp 22-29. Basic Health Publications. ISBN 159120111X</ref><ref>Gene A. Spiller (2001) CRC Handbook of Dietary Fiber in Human Nutrition, Third Edition. CRC Press. ISBN 0849323878</ref> The fatty acids are produced by [[fermentation (biochemistry)|fermentation]] of the fiber in the [[Colon (anatomy)|colon]], then absorbed into the body.<ref>{{cite journal |author=Escudero Alvarez E, González Sánchez P |title=Dietary fibre |journal=Nutr Hosp |volume=21 Suppl 2 |issue= |pages=60–71, 61–72 |year=2006 |pmid=16771074}}</ref> Attempts are also made to aid this process by a combination of [[prebiotics]] and [[Glycosaminoglycan| mucopolysaccharides]].<ref>Lester M Morrison, OA Schjeide (1974) ''[http://www.chestjournal.org/cgi/reprint/66/6/738-C.pdf Coronary heart disease and the mucopolysaccharides (glycosaminoglycans)]'', Charles C Thomas, Springfield,
IL,, ISBN 0398029032</ref> Long chain fatty acids, such as the omega-3 fatty acids [[alpha-linolenic acid]] (ALA), [[eicosapentaenoic acid]] (EPA), and [[docosahexaenoic acid]] (DHA), may also be given directly, in food or in capsules.
==Prevalence==
Orthomolecular medicine is practiced by few conventional medical practitioners.<ref name="cassileth"> Cassileth BR. Alternative medicine handbook: the complete reference guide to alternative and complementary therapies. New York: W.W.Norton & Co., 1998:67.</ref><ref name="wund">[http://www.orthomed.org/wund.html Orthomolecular Medicine Revisited], Wunderlich RC, Orthomolecular Medicine Online, accessed 6 Nov 2006 </ref> Orthomolecular treatments are instead more common in [[alternative medicine|complementary and alternative medicine]] fields, increasingly being integrated into [[Over-the-counter drug|over the counter]] retail products, [[Naturopathic medicine|naturopathic medical]] textbooks and mainstream pharmaceuticals.<ref name="omacorx">[http://www.omacorrx.com/ OMACOR<SUP>®<SUP>](omega-3-acid ethyl esters), Reliant Pharmaceuticals, Inc.</ref><ref>Mason M. [http://www.nytimes.com/2007/01/23/health/23consume.html?_r=1&oref=slogin "An Old Cholesterol Remedy [Niacin] Is New Again"]. ''NY Times,'' January 23, 2007</ref>
A survey released in May 2004 by the [[National Center for Complementary and Alternative Medicine]] focused on who used [[:category:alternative medicine|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. The survey reported uses in the previous twelve months that include orthomolecular related uses: Nonvitamin, nonmineral, natural products 18.9%, Diet-based therapies 3.5%, Megavitamin therapy 2.8%.<ref name=NCCAMsurvey>[http://nccam.nih.gov/news/report.pdf NCCAM.NIH] table 1 on page 8 </ref> The survey did not include other popular related categories such as juicing, supplemental antioxidants, essential fatty acids, amino acids, enzymes and others.
Another recent CAM survey reported that 12% of liver disease patients used the antioxidant [[silymarin]], more than 6% used megavitamins among others, and that "in all, 74% of patients reported using CAM in addition to the medications prescribed by their physician, but 26% did not inform their physician of their CAM use."<ref>Strader DB, Bacon BR, Lindsay KL, La Brecque DR, Morgan T, Wright EC, Allen J, Khokar MF, Hoofnagle JH, Seeff LB.
[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12358262&dopt=Abstract Use of complementary and alternative medicine in patients with liver disease.] Am J Gastroenterol. 2002 Sep;97(9):2391-7.</ref> The use of high doses of vitamins is also common in people who have been diagnosed with cancer, although usage depends of the type of cancer and ranges from 26% to 35% among [[prostate cancer]] survivors up to 75% to 87% in [[breast cancer]] survivors.<ref name=Velicer/>
==Criticism==
{{Infobox Pseudoscience
|topics = [[Medicine]], [[Nutrition]]
|claims = Proponents claim that doses of [[vitamin]]s and [[nutrient]]s, generally much larger than those recommended by [[nutritional science]], can cure or prevent most diseases.
|origyear = 1967
|origprop = [[Linus Pauling]]
|currentprop = [[Abram Hoffer]], [[Archie Kalokerinos]], [[Matthias Rath]], [[Julian Whitaker]]
}}
===Methodology===
Orthomolecular medicine advocates claim that the methods of orthomolecular medicine overlap with those of both natural medicine and mainstream medicine. The International Society for Orthomolecular Medicine has conventionally-trained doctors among its members and authors, and the notable founders of orthomolecular medicine have all had professional degrees. The leading orthomolecular medicine website, Orthomolecular Medicine Online,<ref>[http://orthomed.org Orthomolecular Medicine Online]</ref> run by the [[Journal of Orthomolecular Medicine]], discusses differences between orthomolecular medicine and mainstream medicine,<ref name="kunin">[http://www.orthomed.org/kunin.html Principles That Identify Orthormolecular Medicine: A Unique Medical Specialty]</ref><ref name="wund">[http://orthomed.org/wund.html Wunderlich]</ref>
Amongst the differences, mainstream medicine attaches great importance to [[evidence-based medicine]],<ref>{{cite journal |author=Akobeng AK |title=Principles of evidence based medicine |journal=Arch. Dis. Child. |volume=90 |issue=8 |pages=837–40 |year=2005 |pmid=16040884 |url=http://adc.bmj.com/cgi/content/full/90/8/837 |doi=10.1136/adc.2005.071761}}</ref> particularly to rigorous [[double-blind]] [[randomized controlled trial]]s that test if a treatment is genuinely effective and exclude the [[placebo effect]].<ref>{{cite journal |author=Weihrauch TR, Gauler TC |title=Placebo--efficacy and adverse effects in controlled clinical trials |journal=Arzneimittelforschung |volume=49 |issue=5 |pages=385–93 |year=1999 |pmid=10367099}}</ref> Orthomolecular medicine proponents, on the other hand, believe that such studies overemphasize uniformity, under-emphasize variability between patients, and reduce choice and [[health freedom]].<REF>DJ Hess, [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1447283#top Complementary or Alternative? Stronger vs Weaker Integration Policies] Am J Public Health. 2002 October; 92(10): 1579–1581.</REF>
Mainstream medicine also avoids the use of new treatments whose effects are unknown, instead favoring 'clinically proven' drugs tested using mainstream medical standards. Even with this standard of caution, it has been estimated that up to 20% of drugs may subsequently have unrecognized, serious adverse reactions, requiring the later addition of the "[[black box warning]]", or withdrawal from market.<REF>Lasser KE, Allen PD, Woolhandler SJ, Himmelstein DU, Wolfe SM, Bor DH. [http://jama.ama-assn.org/cgi/content/abstract/287/17/2215 Timing of New Black Box Warnings and Withdrawals for Prescription Medications]. JAMA. 2002;287:2215-2220.</REF>
The skepticism about orthomolecular medicine comes in part because some of its proponents make claims more broad than those supported by scientific research, particularly claims that may contradict the results of clinical trials,<ref name="cassileth"/><ref>http://www.canstats.org/readdetail.asp?id=542</ref> and rely instead on less reliable observational studies, clinical and anecdotal experience, single blinded controlled tests, and case histories. Proponents of orthomolecular medicine argue that, despite the extensive testing of pharmaceuticals, some medications are withdrawn after approval, due to serious adverse events, and the FDA regulatory methodology and relationship with the pharmaceutical industry has been criticized.<ref>Marcia Angell, (August 24, 2004) ''The Truth About the Drug Companies: How They Deceive Us and What to Do About It'', Random House, 1st ed, ISBN 0-375-50846-5</ref>
===Views on safety and efficacy===
The conventional view among mainstream medical [[physician]]s is that most orthomolecular therapies are insufficiently proven for clinical use, that the scientific foundations are weak, and that the studies that have been performed are too few and too open to disputed interpretation. This form of alternative medicine has therefore been described as "[[food faddism]]" and even "[[quackery]]", with critics arguing that it is based upon an "exaggerated belief in the effects of nutrition upon health and disease".<ref name=Jarvis>{{cite journal |author=Jarvis WT |title=Food faddism, cultism, and quackery |journal=Annu. Rev. Nutr. |volume=3 |pages=35–52 |year=1983 |pmid=6315036 |doi=10.1146/annurev.nu.03.070183.000343}}</ref><ref name=Jukes1990>{{cite journal | author = Jukes, T.H. | year = 1990 | title = Nutrition Science from Vitamins to Molecular Biology | journal = Annual Review of Nutrition | volume = 10 | issue = 1 | pages = 1–20 | doi = 10.1146/annurev.nu.10.070190.000245}} A short summary is in [http://arjournals.annualreviews.org/doi/full/10.1146/annurev.nu.10.072106.100001 the journal's preface].</ref><ref name=Braganza2005>{{cite journal | author = Braganza, S.F. | coauthors = Ozuah, P.O. | year = 2005 | title = Fad Therapies | journal = Pediatrics in Review | volume = 26 | issue = 10 | pages = 371–376 | doi = 10.1542/pir.26-10-371 | pmid = 16199591}}</ref>
Many mainstream medical institutions dismiss orthomolecular medicine entirely. The [[American Medical Association]] describes as "myths" the ideas that vitamin and mineral deficiencies are widespread, that the causes of most diseases are poor diets, or that most diseases can be prevented by nutritional supplements.<ref name=AMA/> Similarly, the [[American Cancer Society]] comments that the current scientific evidence does not "support use of orthomolecular therapy for most of the conditions for which it is promoted". They stated some supplements have exhibited benefits for certain conditions, while a few have been confirmed to be harmful, and that the consumption of nutritious foods is the best recognized method to obtain vitamins, minerals, and nutrients crucial for good health.<ref name = ACS>{{cite web | url = http://www.cancer.org/docroot/ETO/content/ETO_5_3X_Orthomolecular_Medicine.asp?sitearea=ETO | title = ACS : Orthomolecular Medicine | accessdate = 2008-04-04 | format = | work = | publisher = [[American Cancer Society]] | date = 2007-06-19}}</ref> In another example, an adviser on alternative medicine to the [[National Institutes of Health]], stated that "Scientific research has found no benefit from orthomolecular therapy for any disease"<ref name="cassileth">{{cite book |author=Cassileth, Barrie R. |title=The alternative medicine handbook: the complete reference guide to alternative and complementary therapies |publisher=W.W. Norton |location=New York |year=1998 |pages=67 |isbn=0-393-04566-8 |oclc= |doi=}}</ref> and a recent medical textbook also states that there is "no evidence that megavitamin or orthomolecular therapy is effective in treating any disease."<ref>{{cite book |author=Frei, Emil; Kufe, Donald W.; Holland, James F. |title=Cancer medicine 6 |publisher=BC Decker |location=Hamilton, Ont |year=2003 |pages= |isbn=1550092138 |oclc= |doi=| url = http://www.ncbi.nlm.nih.gov/books/bv.fcgi?highlight=orthomolecular&rid=cmed6.section.18479&WebEnv=0MnZPX94hO0XD2ugCELLkbhpkV5QLNBinRc8fAJ1IwDvCVoCzamY2zTpsFeeRiEdbTVTXzrZpQLqXt%40263F77C978AD3D40_0136SID&WebEnvRq=1#18482 | pages = 76 | accessdate = 2008-04-04}}</ref> Proponents of orthomolecular medicine counter that vitamins and nutrients are now used in conventional medicine as treatments for disease, such as megadose [[niacin]] and fish oil for [[dyslipidemia]]s,<ref>Braverman ER, Weissberg E, [http://www.orthomolecular.org/library/jom/1988/pdf/1988-v03n01-p006.pdf "Fish Oil As One Therapy in Cardiovascular Risk Factor Reduction,"] ''J Orthomolecular Medicine'', 3(1), 1987</ref><ref>{{cite journal |author=Berra K |title=Clinical update on the use of niacin for the treatment of dyslipidemia |journal=J Am Acad Nurse Pract |volume=16 |issue=12 |pages=526–34 |year=2004 |pmid=15645997 |doi=}}</ref><ref>{{cite journal |author= |title=Don't overlook niacin for treating cholesterol problems. If you can conquer or cope with the "niacin flush," this B vitamin can do wonders for cholesterol |journal=Harv Heart Lett |volume=14 |issue=8 |pages=4–5 |year=2004 |pmid=15100082 |doi=}}</ref> 6000-25,000 iu vitamin E per day<ref>M Traber, Linus Pauling Institute, A Kamal-Eldin; "Oxidative stress and vitamin E in anemia", p. 164, Ch 11 in ''Nutritional Anemia '', 2007, SIGHT AND LIFE, Basel, Switzerland " " both hypobetalipoproteinemic or abetalipoproteinemic subjects become vitamin E deficient and develop a characteristic neurologic if they are not given large vitamin E supplements (approximately 10 g per day)"</ref><ref>Granot E, Kohen R. [http://www.ajcn.org/cgi/content/full/79/2/226 ''Oxidative stress in abetalipoproteinemia patients receiving long-term vitamin E and vitamin A supplementation''], ''AJCN'', Vol. 79, No. 2, 226-230, February 2004</ref> for the lipid disorder, [[abetalipoproteinemia]], and megavitamin therapies for over a dozen amino acid metabolism disorders.<ref name="Menolascino"/>
[[Dietary supplement]]s, such as those used in orthomolecular medicine, are less regulated than pharmaceuticals in the [[United States]]. Furthermore, a recent [[meta-analysis]] in [[JAMA]] suggested that supplementation with combinations of [[beta-carotene]], [[vitamin A]], and [[vitamin E]] may increase mortality, although with respect to beta-carotene this conclusion may be due to the known harmful effect in smokers.<ref>{{cite journal |author=Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C |title=Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis |journal=JAMA |volume=297 |issue=8 |pages=842–57 |year=2007 |pmid=17327526 |doi=10.1001/jama.297.8.842}} See also the [http://jama.ama-assn.org/cgi/content/extract/298/4/401-a letter] to [[Journal of the American Medical Association|JAMA]] by [[Philip Taylor]] and [[Sanford Dawsey]] and the [http://jama.ama-assn.org/cgi/content/extract/298/4/402 reply] by the authors of the original paper.
</ref> An essential regulatory difference is that pharmaceuticals must be proven safe and effective to the satisfaction of the [[Food and Drug Administration|FDA]] before they can be marketed, whereas supplements must be proven ''unsafe'' before regulatory action can be taken.<ref>{{cite web |url=http://www.fda.gov/opacom/laws/dshea.html |title=Dietary Supplement Health and Education Act of 1994 | publisher = [[Food and Drug Administration]] | date = 1994-10-25 |accessdate=2008-04-04 |format= |work=}}</ref> A number of orthomolecular US supplements are available in pharmaceutical versions that are sometimes quite similar in strength and general content, or in other countries are pharmaceuticals. The US regulations also have provisions to recognize a general level of safety for established nutrients that can forgo new drug safety tests. Proponents of nutritional supplement use have argued that the lower level of regulation results in cost savings for American consumers, pointing to higher supplement prices in Europe, where some supplements are more tightly regulated or even unavailable.<ref>{{cite web | last = Falloon | first = W | url = http://www.lef.org/magazine/mag2005/jul2005_awsi_01.htm | title = What Do "Regulated" Supplements Cost | publisher = Life Extension Magazine | date = 2005-07-01 | accessdate = 2008-04-04}}</ref>
==Relation to mainstream medicine==
Aspects of orthomolecular therapy remain controversial among mainstream medical organizations and physicians, who consider many aspects to be lacking sufficient [[Randomized controlled trial| RCT]]-based evidence. In contrast, orthomolecular proponents argue that many mainstream nutritional studies, both recent and historical, provide investigational and clinical support for their treatments and recommendations.<ref> [http://www.orthomolecular.org/resources/omns/index.shtml Orthomolecular Medicine News Service] (OMNS) Listing or research and news items favourable to the Orthomolecular point of view </ref> They also argue that orthomolecular therapies are intrinsically less likely to cause dangerous side-effects or harm, since they utilize only chemicals that are normally present in the body.<ref name="orthomed"/><ref>[http://lpi.oregonstate.edu/f-w99/orthomolecular.html What is Orthomolecular Medicine?], Linus Pauling Institute. Accessed online, 1 Nov 2007</ref><ref> [http://www.orthomolecular.org/resources/omns/v01n13.shtml How safe are vitamins?] Orthomolecular Medicine News Service, November 9, 2005 - Accessed August 2006 </ref> 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 that do not claim to support orthomolecular doctrine, and in at least some cases, explicitly reject claims of orthomolecular proponents that nutritional supplements are desirable.<ref>{{cite book |author=Jacobs, Joseph; Spencer, John A. D. |title=Complementary and alternative medicine: an evidence-based approach |publisher=Mosby |location=St. Louis |year=2003 |pages= |isbn=0323020283 |oclc= |doi=}}</ref>
Orthomolecular proponents, such as Robert Cathcart, who predicts that 120+ grams per day intravenous [[vitamin C]] should cure [[severe acute respiratory syndrome]]<ref>{{cite web | url = http://www.orthomed.com/auto.htm | title = The Ascorbate Effect in Infectious and Autoimmune Diseases | last = Cathcart | first = RF | accessdate = 2008-04-04 }}</ref> and has used up to 250 grams IV vitamin C per day, have been criticized for not having any conventional medical trials of such intravenous vitamin C treatments.<ref>{{cite web | last = Hasslberger | first = S | url = http://www.newmediaexplorer.org/sepp/2003/06/06/vitamin_c_could_be_effective_against_sars.htm | title = Vitamin C could be effective against SARS | publisher = New Media Explorer | date = 2003-06-06 | accessdate = 2008-04-04 }}</ref>
The orthomolecular field 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]]. A number of individuals and organizations contest the claims, benefits, degree of evidence and toxicity.<ref name="cassileth"/><ref name = ACS/> Based on testing with dosages well below orthomolecular recommendations, [[Linus Pauling]] has been criticized for making overbroad claims<ref>{{cite web | first = SJ | last = Barrett | authorlink = Stephen Barrett | title = The Dark Side of Linus Pauling's Legacy | publisher = [[Quackwatch]] | url = http://www.quackwatch.org/01QuackeryRelatedTopics/pauling.html | accessdate = 2008-04-04 | date = 2001-05-05}}</ref> for the efficacy of vitamin C but Paulings' claims have received some support from tests closer to the orthomolecular recommendations during the last few years.<ref name="pmid15068981">{{cite journal |author=Padayatty SJ, Sun H, Wang Y, ''et al'' |title=Vitamin C pharmacokinetics: implications for oral and intravenous use |journal=Ann. Intern. Med. |volume=140 |issue=7 |pages=533–7 |year=2004 |pmid=15068981 |doi= |url=http://www.annals.org/cgi/reprint/140/7/533.pdf | format = pdf}}</ref>
The relationship of mainstream medicine to orthomolecular proponents has often been adversarial; orthomolecular proponents, including Dr. [[Richard Kunin]], argue that mainstream medical claimants confuse orthomolecular medicine with other, less science based modalities.<ref name="kunin"/> The [[American Academy of Pediatrics]] labelled orthomolecular medicine a "[[cult]]" in 1976, in response to claims that orthomolecular medicine could cure childhood psychoses and learning disorders.<ref name="pmid995522">{{cite journal |author= |title=American Academy of Pediatrics Commitee on Nutrition: megavitamin therapy for childhood psychoses and learning disabilities |journal=Pediatrics |volume=58 |issue=6 |pages=910–2 |year=1976 |pmid=995522 |doi=}}</ref>
Conventional health professionals see orthomolecular medicine as encouraging individuals to dose themselves with large amounts of vitamins and other nutrients without conventional supervision, which they worry might be damaging to health. Rare risks<ref>{{cite web | url = http://www.emedicine.com/emerg/topic638.htm emedicine | title = Toxicity, vitamin | date = 2007-12-12 | accessdate = 2008-04-04 | last = Rosenbloom | first = M | publisher = [[eMedicine]] }}</ref> of non-orthomolecular "mega" dosages of vitamin relatives, which frequently involved pharmaceutical analogues such as synthetic [[menadione]], unsupervised misuse, [[suicide|deliberate]] [[attempted suicide|abuse]] and earlier medical treatments, may include increased risk of [[coronary heart disease]],<ref name="pmid9193380">{{cite journal |author=Rapola JM, Virtamo J, Ripatti S, ''et al'' |title=Randomised trial of alpha-tocopherol and beta-carotene supplements on incidence of major coronary events in men with previous myocardial infarction |journal=Lancet |volume=349 |issue=9067 |pages=1715–20 |year=1997 |pmid=9193380 |doi=10.1016/S0140-6736(97)01234-8}}</ref> [[hypertension]], [[thrombophlebitis]], [[peripheral neuropathy]], [[ataxia]], [[neurological]] effects, [[liver]] [[toxicity]], [[congenital abnormalities]], spontaneous [[abortion]], [[gouty arthritis]], [[jaundice]], [[kidney stones]], and [[diarrhea]].<ref name="pmid3153129">{{cite journal |author=Arroyave G |title=[Abuse of megadoses of vitamins] |language=Spanish; Castilian |journal=Arch Latinoam Nutr |volume=38 |issue=3 |pages=589–98 |year=1988 |pmid=3153129 |doi=}}</ref><ref>{{cite journal |author=Blair KA |title=Vitamin supplementation and megadoses |journal=Nurse Pract |volume=11 |issue=7 |pages=19–26, 31–6 |year=1986 |pmid=3737019 |doi=}}</ref><ref name="pmid7885163">{{cite journal |author=Roberts HJ |title=Vitamin E |journal=Lancet |volume=345 |issue=8951 |pages=737 |year=1995 |pmid=7885163 |doi=}}</ref><ref>{{cite journal |author=Bégin M, Kaegi E |title=Unconventional therapies and cancer |journal=CMAJ |volume=161 |issue=6 |pages=686–7 |year=1999 |pmid=10513271 |doi= | url = http://www.cmaj.ca/cgi/reprint/161/6/686 | format = pdf }}</ref> Megavitamin proponents point<ref>{{cite web |url=http://www.doctoryourself.com/testimony.htm |title=Testimony by Andrew W. Saul before the Government of Canada, House of Commons Standing Committee on Health, regarding natural health product safety | date = 2005-05-12 |accessdate=2008-04-04 |format= |work= | first = AW | last = Saul }}</ref> to an almost zero level of deaths caused by vitamins, even with large overdoses, compared to the significant numbers from pharmaceuticals, including a number of over-the-counter items.
===Vitamin E controversy===<!-- This section is linked from [[Tocopherol]] -->
[[Vitamin E]] contains eight related chemicals, which are classed as either [[tocopherol]]s or [[tocotrienol]]s. These chemicals also exist as several [[stereoisomers]].<ref name=Kline>{{cite journal |author=Kline K, Lawson KA, Yu W, Sanders BG |title=Vitamin E and cancer |journal=Vitam. Horm. |volume=76 |pages=435–61 |year=2007 |pmid=17628185 |doi=10.1016/S0083-6729(07)76017-X}}</ref> In supplements these are usually present in stabilized [[ester]] forms, which are converted into the active form in the intestines.<ref>{{cite journal |author=Cheeseman KH, Holley AE, Kelly FJ, Wasil M, Hughes L, Burton G |title=Biokinetics in humans of RRR-alpha-tocopherol: the free phenol, acetate ester, and succinate ester forms of vitamin E |journal=Free Radic. Biol. Med. |volume=19 |issue=5 |pages=591–8 |year=1995 |month=November |pmid=8529918 |doi=10.1016/0891-5849(95)00083-A}}</ref> Research has focussed on alpha-tocopherol, since this is the form preferentially taken up by the body and the most abundant form in tissues.<ref>{{cite journal |author=Rigotti A |title=Absorption, transport, and tissue delivery of vitamin E |journal=Mol. Aspects Med. |volume=28 |issue=5-6 |pages=423–36 |year=2007 |pmid=17320165 |doi=10.1016/j.mam.2007.01.002}}</ref> Alpha-tocopherol is also regarded in orthomolecular medicine as the form with greatest nutritional significance.<ref name=LPI>[http://lpi.oregonstate.edu/infocenter/vitamins/vitaminE/index.html Vitamin E] Micronutrient Information Center, Linus Pauling Institute, Accessed31 May 2008</ref> In supplements this is either a mixture of stereoisomers (''all-rac''-alpha-tocopherol), or the biological stereoisomer ''RRR''-alpha-tocopherol.<ref name=Kline/>
Initial hopes for vitamin E were based on [[epidemiological]] studies. These suggested that people who consumed more vitamin E had lower risks of chronic disease, such as [[coronary heart disease]], and led to the idea that vitamin E supplementation could be beneficial.<ref>{{cite journal |author=Traber MG |title=How much vitamin E? ... Just enough! |journal=Am. J. Clin. Nutr. |volume=84 |issue=5 |pages=959–60 |year=2006 |month=November |pmid=17093143 |url=http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=17093143}}</ref> However, these [[observational study|observational studies]] could not distinguish between if the higher levels of vitamin E improved heath themselves, or if [[confounding variable]]s were responsible - such as if these people eat a more healthy diet or took more exercise.<ref>{{cite journal |author=Gaziano JM |title=Vitamin E and cardiovascular disease: observational studies |journal=Ann. N. Y. Acad. Sci. |volume=1031 |pages=280–91 |year=2004 |month=December |pmid=15753154 |doi=10.1196/annals.1331.028 |url=http://www.annalsnyas.org/cgi/pmidlookup?view=long&pmid=15753154}}</ref><ref>{{cite journal |author=Hemilä H, Miller ER |title=Evidence-based medicine and vitamin E supplementation |journal=Am. J. Clin. Nutr. |volume=86 |issue=1 |pages=261–2; author reply 262–4 |year=2007 |month=July |pmid=17616790 |url=http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=17616790}}</ref> To distinguish between these possibilities, many [[randomized controlled trial]]s were performed. [[Meta-analysis]] of these controlled clinical trials have not shown any clear benefit from any form of alpha-tocopherol supplementation for preventing chronic disease.<ref name="viv">{{cite journal |author=Vivekananthan DP, Penn MS, Sapp SK, Hsu A, Topol EJ |title=Use of antioxidant vitamins for the prevention of cardiovascular disease: meta-analysis of randomised trials |journal=Lancet |volume=361 |issue=9374 |pages=2017–23 |year=2003 |pmid=12814711 |doi=10.1016/S0140-6736(03)13637-9}}</ref><ref>{{cite journal |author=Stocker R |title=Vitamin E |journal=Novartis Found. Symp. |volume=282 |issue= |pages=77–87; discussion 87–92, 212–8 |year=2007 |pmid=17913225 |doi=10.1002/9780470319444.ch6}}</ref><ref>{{cite journal |author=Cherubini A, Vigna GB, Zuliani G, Ruggiero C, Senin U, Fellin R |title=Role of antioxidants in atherosclerosis: epidemiological and clinical update |journal=Curr. Pharm. Des. |volume=11 |issue=16 |pages=2017–32 |year=2005 |pmid=15974956 |doi=10.2174/1381612054065783}}</ref><ref name=Kline/>
A meta-analysis published in 2005 found that more than 400 units alpha tocopherol per day was associated with an increase in all-cause mortality.<ref name="miller">{{cite journal |author=Miller ER, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E |title=Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality |journal=Ann. Intern. Med. |volume=142 |issue=1 |pages=37–46 |year=2005 |pmid=15537682 |url=http://www.annals.org/cgi/reprint/142/1/37}}</ref> Furthermore, a significant relationship was seen between dose and all-cause mortality, with the risk of death increasing in line with the dose. This meta-analysis was criticized on a number of grounds, including that this increase in mortality could have been caused by alpha-tocopherol and beta carotene increasing the risk of [[lung cancer]] in heavy smokers.<ref>Carter, T. [http://www.annals.org/cgi/reprint/143/2/155-a.pdf Responses and Comments: High-Dosage Vitamin E Supplementation and All-Cause Mortality], Ann Intern Med. 2005 Jul 19;143(2):155; responses 150-160</ref> A similar increase in mortality was seen in a 2007 meta-analysis<ref name=Bjelakovic>{{cite journal |author=Bjelakovic G, Nikolova D, Gluud L, Simonetti R, Gluud C |title=Mortality in Randomized Trials of Antioxidant Supplements for Primary and Secondary Prevention: Systematic Review and Meta-analysis |url=http://jama.ama-assn.org/cgi/content/abstract/297/8/842 |journal=JAMA |volume=297 |issue=8 |pages=842–57 |year=2007 |pmid=17327526 |doi=10.1001/jama.297.8.842}}</ref> Here, no health risk was seen when all the randomized controlled studies were examined together, but an increase in mortality was detected when the high-quality and low-bias risk trials were examined separately. However, as the majority of these low-bias trials dealt with either elderly people, or people already suffering disease, so these results may not apply to the general population.<ref>[http://www.sciencedaily.com/releases/2007/02/070228172604.htm Study Citing Antioxidant Vitamin Risks Based On Flawed Methodology, Experts Argue] News release from Oregon State University published on ScienceDaily, Accessed 19 April 2007</ref> This meta-analysis was later repeated and extended by the same authors, with the new analysis published by the [[Cochrane Collaboration]]; this also concluded that some vitamin E supplements could be harmful.<ref>{{cite journal |author=Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C |title=Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases |journal=Cochrane Database of Systematic Reviews |issue=2 |pages=CD007176 |year=2008 |doi=10.1002/14651858.CD007176}}</ref>
Orthomolecular recommendations for vitamin E supplementation typically are based on a mixture of tocopheols and tocotrienols.<ref>M Walker, [http://www.enerex.ca/articles/new_old_findings_on_unique_vitamin_e.htm New/Old Findings on Unique Vitamin E], Townsend Letter for Doctors and Patients, No. 111, 1992, p. 826</ref> Forms of "vitamin E", which contain mixed R,R,R tocopherols and are also recommended by some orthomolecular practitioners.<ref>Hoffer, A. [http://orthomolecular.org/library/jom/1994/articles/1994-v09n02-p067.shtml The Finnish Antioxidant and Lung Cancer Study]</ref> These other forms of vitamin E have not been examined in as much detail as alpha-tocopherol and may have effects on health that are not produced by the alpha-tocopherol form.<ref name=Jiang>{{cite journal |author=Jiang Q, Christen S, Shigenaga MK, Ames BN |title=gamma-tocopherol, the major form of vitamin E in the US diet, deserves more attention |journal=Am. J. Clin. Nutr. |volume=74 |issue=6 |pages=714–22 |year=2001 |pmid=11722951 |url=http://www.ajcn.org/cgi/reprint/74/6/714}}</ref><ref name=LPI/>
===Time and therapeutic priority===
Conventional physicians express concern that megavitamin and orthomolecular therapies used solely as alternative treatments by other practitioners, if not successful, may create dangerous delays in obtaining conventional treatments, such as [[radiation]] and [[chemotherapy]] for [[cancer]]. For example, in a highly publicized [[Canadian]] controversy, the chemotherapy of a 13-year-old cancer patient, Tyrell Dueck, encountered a delay from legal actions, due to his parents' religious beliefs and interest in alternative treatments such as diet, herbs and vitamins.<ref>MA Somerville (2004) [http://books.google.com/books?id=RzPVfya_50MC&pg=PA175&lpg=PA175&source=web&ots=U16p2a63-h&sig=eLtYIUohGf6hRdegZVC_N5Yphdo&hl=en#PPA175,M1 The Ethical Canary: Science, Society and the Human Spirit], pp 175-179, McGill-Queen's University Press; 1 ed,
ISBN 0773527842</ref><ref>[http://www.cbc.ca/canada/story/1999/03/18/cancer990318.html Sask. court rules boy with cancer can't pick treatment] CBC, Friday, November 10, 2000, Accessed 07 April 2008</ref> Orthomolecular medical practitioners and orthomolecular oriented naturopaths have long expressed similar concerns about conventional medicine,<ref>Hoffer A, "[http://www.orthomolecular.org/library/jom/1993/pdf/1993-v08n01-p003.pdf The Politics of Medical Research]" ''J Orthomol Med'', vol 8, no 1, 1993</ref> particularly with gut related and chronic diseases as well as viral diseases.<ref>Klenner, FR. [http://www.orthomed.com/klenner.htm ''Observations On the Dose and Administration of Ascorbic Acid When Employed Beyond the Range Of A Vitamin.''] Human Pathology Journal of Applied Nutrition Vol. 23, No's 3 & 4, Winter 1971.</ref><ref>Klenner FR. [http://www.seanet.com/~alexs/ascorbate/194x/klenner-fr-southern_med_surg-1948-v110-n2-p36.htm ''Virus Pneumonia and Its Treatment With Vitamin C.''] Southern Med Surg, v110, no 2, p36, 1948.</ref><ref>Klenner FR. [http://www.seanet.com/~alexs/ascorbate/194x/klenner-fr-southern_med_surg-1949-v111-n7-p209.htm ''The Treatment of Poliomyelitis and Other Virus Diseases with Vitamin C''], Southern Med Surg, v111, no 7, p209, 1949.</ref><ref>Klenner FR. [http://www.seanet.com/~alexs/ascorbate/195x/klenner-fr-j_appl_nutr-1953-v6-p274.htm ''The Use of Vitamin C as an Antibiotic.''] J Appl Nutr, vol 6, p274, 1953</ref> It is usually possible, however, to combine orthomolecular and conventional treatments.
===Use in AIDS===
Several orthomolecular related [[AIDS]] approaches such as multivitamins,<ref>[http://www.boston.com/news/local/massachusetts/articles/2004/07/01/multivitamin_found_to_slow_pace_of_hiv/ Multivitamin] found to slow pace of HIV, Study examined Tanzanian women,
''The Boston Globe'', July 1, 2004</ref> selenium and amino acids<ref>[http://www.doctoryourself.com/aids.html] HD Foster Treating AIDS with Nutrition.</ref> are used with reported improvements in patients. High dose vitamin C treatments have long been used clinically by some orthomolecular practitioners to treat AIDS patients.<ref> RF Cathcart, [http://www.doctoryourself.com/aids_cathcart.html Vitamin C in the Treatment of Acquired Immune Deficiency Syndrome (AIDS)], ''Medical Hypotheses'' 14:423-433, 1984 </ref><ref>Priestly JC. [http://www.orthomolecular.org/library/jom/1991/pdf/1991-v06n03&04-p174.pdf Highly Beneficial Results in the Treatment of AIDS], ''J Orthomolecular Med'', 1991, Vol. 6, No.3 & 4, p174</ref> However, a [[meta-analysis]] of fifteen clinical trials of vitamin therapy by the [[Cochrane Collaboration]] in 2005 found no conclusive evidence that such approaches either reduce symptoms or mortality in HIV-infected adults who are not malnourished, but found some evidence that giving vitamin A to infants with HIV is beneficial.<ref>{{cite journal |author=Irlam JH, Visser ME, Rollins N, Siegfried N |title=Micronutrient supplementation in children and adults with HIV infection |journal=Cochrane Database Syst Rev |issue=4 |pages=CD003650 |year=2005 |pmid=16235333 |doi=10.1002/14651858.CD003650.pub2}}</ref> In these situations, mainstream medical criticism arises when orthomolecular approaches are advocated as ''substitutes for'', rather than complements to, current medical treatments such as [[antiretroviral drug]]s.{{Fact|date=May 2008}}
===Economic interests and politics===
Some orthomolecular proponents claim partisan politics, [[pharmaceutical industry]] influence, and competitive considerations to be significant factors. The [[Linus Pauling Institute]]'s funding comes mostly from [[National Institutes of Health]].<ref name="Frei">Frei, Balz, ''LPI Research Newsletter - Spring 2006'', Linus Pauling Institute, June ,2006. [http://lpi.oregonstate.edu/ss06/director.html available online]</ref> Several orthomolecular therapies have been officially sanctioned within Europe<ref name="omacor">[http://www.hydro.com/en/press_room/news/archive/2001_12/omacor_en.html OMACOR] deal signed with new Euro partners, HYDRO, 11 Dec 2001</ref> and [[Japan]].<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2123064&dopt=Books fibrinolytic activity of nattokinase, Miyazaki Medical College, Japan]</ref>
<ref>[http://www.aafp.org/afp/20050915/1065.html Coenzyme Q10, prescribed for CHF in Japan since 1974, AAFP]</ref><ref>Kaitin, KI, Brown, J. 1995. A Drug Lag Update. ''Drug Information Journal'' 29:361–73</ref>
== Notable supporters of orthomolecular medicine==
<!--- INCLUSION REQUIREMENTS: If they aren't notable enough to have an article here at Wikipedia, they aren't likely eligible for inclusion here. Only include those with articles, so write the article first. Wikipedia is not to be used for promotion or advertising. If their notability can be established by very solid references, then that may suffice to justify inclusion. Note: Klenner and Cathcart AfD deletions remain problematic.-->
{{columns-start|num=3}} [[Abram Hoffer]]<br> [[David Horrobin]]<br>[[Archie Kalokerinos]]<br> [[Otto Heinrich Warburg|Otto Warburg]]<br>
{{column}} [[Linus Pauling]] <br> [[Carl Pfeiffer (pharmacologist)|Carl Pfeiffer]]<br> [[Matthias Rath]]<br>
{{column}} [[Irwin Stone]]<br> [[Albert Szent-Györgyi]]<br> [[Julian Whitaker]]<br> [[Roger J. Williams]]<br>
{{column}} {{columns-end}}
==Journal of Orthomolecular Medicine==
''[[The Journal of Orthomolecular Medicine]]'', founded in 1967 as the ''Journal of Schizophrenia'', is the main publication of those involved in Orthomolecular Medicine. [[Abram Hoffer]] has written that "''We had to create our own journals because it was impossible to obtain entry into the official journals of psychiatry and medicine. Before 1967 I had not found it difficult to publish reports in these journals, and by then I had about 150 articles and several books in the establishment press.''"<ref name="hoffer">Hoffer, Abram, ''History'', Journal of Orthomolecular Medicine. [http://www.orthomed.org/jom/jomhist.htm available online]</ref>
==See also==
* [[Alternative medicine]]
* [[Health freedom movement]]
* [[Life extension]]
* [[List of life extension related topics]]
* [[Metabolomics]]
* [[Megavitamin therapy]]
* [[Multivitamin]]
* [[Nutritional genomics]]
* [[Orthomolecular psychiatry]]
* [[Pyroluria]]
==Citations==
{{reflist|3}}
==Further reading==
'''Support'''<br>
* Roger J. Williams, Dwight K. Kalita (1979) Physician's Handbook on Orthomolecular Medicine, Keats Publishing, ISBN 0-87983-199-5
* Richard P. Huemer (ed.) (1986) The Roots of Molecular Medicine: A Tribute to Linus Pauling, W. H. Freeman and Company, ISBN 0-7167-1761-1 · 290pp
* Pauling, Linus (1986) How to Live Longer and Feel Better, W. H. Freeman and Company, ISBN 0-380-70289-4
* Abram Hoffer (1998) Putting It All Together: The New Orthomolecular Nutrition, McGraw-Hill, ISBN 0-87983-633-4
* Melvyn R. Werbach, Jeffrey Moss (1999) Textbook of Nutritional Medicine, Third Line Press, ISBN 0-9618550-9-6
* Abram Hoffer, M.D. with Linus Pauling (2004) Healing Cancer: Complementary Vitamin & Drug Treatments, CCNM Press, ISBN 1-897025-11-4
* David Moss (2000) Ph.D, Antioxidants Against Cancer, Equinox Press , ISBN 1881025284
* J. Alexander (2001) <small>LABORATORY EVALUATIONS IN MOLECULAR MEDICINE</small>: Nutrients, Toxicants and Cell Regulators. Inst. for Advances in Mol. Med., ISBN 0967394910
* Joseph E. Pizzorno, Jr., Michael T. Murray (November 2005) Textbook of Natural Medicine, 3rd edition, Churchill Livingstone, ISBN 0-443-07300-7 · 2368pp
'''Criticism'''<br>
* 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
==External links==
'''Support'''<br>
* [http://orthomolecular.org/library/jom/index.shtml Journal of Orthomolecular Medicine]
* [http://www.orthomolecular.org/ orthomolecular.org]
* [http://www.orthomed.org/ Orthomolecular Medicine Online]
* [http://www.isom.eu/index.php Official website for the International Society of Orthomolecular Medicine]
* [http://lpi.oregonstate.edu/f-w99/orthomolecular.html Linus Pauling Institute website]
* [http://www.orthomolecularvitamincentre.com/ Orthomolecular Vitamin Information Centre]
* [http://doctoryourself.com DoctorYourself.com] - Personal site of Andrew Saul PhD, Contributing Editor for the Journal of Orthomolecular Medicine.
* [http://www.soe.nl/resengin.htm Index orthomolecular research pages], Orthomolecular Education Foundation SOE (Netherlands)
'''Criticism'''<br>
* [http://nccam.nih.gov/health/backgrounds/biobasedprac.htm Biologically Based Practices: An Overview], [[National Institute of Health]] [[National Center for Complementary and Alternative Medicine]]
*[http://www.healthservices.gov.bc.ca/pho/pdf/phoannual2005.pdf Food, Health and Well-Being in British Columbia.] BC Provincial Health Officer’s Annual Report 2005.
* [http://wwv.acsh.org/healthissues/newsID.901/healthissue_detail.asp Should We "Thank God" for Julian Whitaker?], [[American Council on Science and Health]], 1999
* [http://www.ncahf.org/pp/supp.html Recommendations] of the [[NCAHF]] Task Force on Supplement Abuse (1987)
[[Category:Alternative medicine]]
[[Category:Orthomolecular medicine|*]]
[[Category:Biologically based therapies]]
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