Orthomolecular medicine

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

Orthomolecular medicine is defined as the provision of the optimum molecular constitution, especially the optimum concentration of substances that are normally present in the body, for the purposes of treating disease and preserving health. Orthomolecular medicine is a minority view held by some qualified medical practitioners and is supported by scientific research. Orthomed.org Kunin Principles That Identify Orthormolecular Medicine: A Unique Medical Specialty - Richard A. Kunin, M.D. Accessed June 2006. Orthomed.org Wund Orthomolecular Medicine Revisited , Ray C. Wunderlich, Jr., M.D. Accessed June 2006. It forms part of a science based debate on the role of nutrition in health and has not yet gained acceptance as a therapy in established medicine.

Linus Pauling proposed the term "orthomolecular medicine" in 1968 in the journal Science. Definition of Orthomolecular medicine at www.orthomed.org Accessed June 2006. Linus Pauling defined orthomolecular medicine as "the treatment of disease by the provision of the optimum molecular environment, especially the optimum concentrations of substances normally present in the human body."

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

Method

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

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

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

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

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

Popularity

A nccam.nih.gov survey released in May 2004] by the National Center for Complementary and Alternative Medicine focused on who used alternative medicine (CAM), what was used, and why it was used in the United States by adults age 18 years and over during 2002. According to this recent survey, mega-vitamin therapy was the 9th most commonly used CAM therapy (2.8%) in the United States during 2002 nccam.nih table 1 on page 8 . Consistent with previous studies, this study found that the majority of individuals (54.9%) used CAM in conjunction with conventional medicine (page 6). "The fact that only 11.8% of adults sought care from a licensed or certified CAM practitioner suggests that most individuals who use CAM self-prescribe and/or self-medicate." (page 6).

Criticism and Relation to conventional medicine

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

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

The relationship of conventional medicine to Orthomolecular proponents has been sometimes technically adversarial. Some health professionals see orthomolecular medicine as an encouragement for individuals to dose themselves with large amounts of vitamins and other nutritients in an unsupervised way, which may be damaging to health. Rare or occasional risksemedicine - Toxicity statistics, 2003 of unsupervised misuse may include peripheral neuropathy, ataxia, congenital abnormalities, spontaneous abortion, gouty arthritis or jaundice. PMID: 3153129 PMID: 3737019 Many physicians express concern that megavitamin and orthomolecular therapies used solely as alternative treatments, if unsuccessful, may create dangerous delays in obtaining their conventional treatments, such as radiation and chemotherapy for cancer.Vitamin Therapy, Megadose / Orthomolecular Therapy, provincial BC Cancer Agency

Sometimes proponents claim partisan politics, pharmaceutical industry influence, and competitive considerations to be significant factors.The Truth About the Drug Companies by Marcia Angell Some other orthomolecular therapies have been long recognized and officially sanctioned within Europe and Japan. fibrinolytic activity of nattokinase, Miyazaki Medical College, Japan

Notable orthomolecular doctors

Orthomolecular scientists

Reference links

Bibliography

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