ORTHOMOLECULAR MEDICINE

Orthomolecular medicine describes the practice of preventing and treating disease by providing the body with optimal amounts of substances which are natural to the body. The term "orthomolecular" was first used by Linus Pauling in a paper he wrote in the journal Science in 1968. This paper first described the theoretical foundations for what was later to become a specialty within complementary medicine. Many people use the term “nutritional therapy” synonymously with orthomolecular medicine, although the latter covers a much broader range of healthcare issues.

The key idea in orthomolecular medicine is that genetic factors are central not only to the physical characteristics of individuals, but also to their biochemical milieu. Biochemical pathways of the body have significant genetic variability in terms of transcriptional potential and individual enzyme concentrations, receptor-ligand affinities and protein transporter efficiency. Diseases such as atherosclerosis, cancer, schizophrenia or depression are associated with specific biochemical abnormalities, which are either causal or aggravating factors of the illness. In the orthomolecular view, it is possible that the provision of vitamins, amino acids, trace elements or fatty acids in amounts sufficient to correct biochemical abnormalities will be therapeutic in preventing or treating such diseases.

For the better part of the 20th Century, we've been taking vitamin and mineral supplements to eliminate deficiencies. Orthomolecular medicine takes this idea one step further, holding that larger than usual doses of certain nutrients can actually prevent or cure disease. Although there's still considerable debate over specific dosages and their therapeutic effects, the basic principle is now firmly established and widely accepted. Two of America's greatest scourges--heart disease and high blood pressure--can sometimes both be held at bay by high-dose nutrients, and advocates insist that many other chronic conditions, including diabetes and schizophrenia, can be helped as well.

With certain vitamins, it's possible to boost your intake to therapeutic levels simply by altering your diet. For instance, you can easily get 400 micrograms of heart-healthy folic acid by increasing your consumption of green leafy vegetables and fresh fruits.

However, the only way to get medicinal doses of many other nutrients is to take supplements. This is true of vitamin E. For most people, it's also true of vitamin B₆, even though it's plentiful in whole-grain cereals and breads, beans, and nuts. Likewise, therapeutic levels of calcium are hard to achieve without taking a supplement.

Heart Disease - Mainstream medical experts have long held that reducing the amount of animal fat in the diet can reduce your risk of heart disease. Now they are beginning to recognize that large doses of vitamin E have a similar protective effect. While the Recommended Dietary Allowance for the vitamin is only 30 international units (IU) daily, several large surveys have linked higher doses of vitamin E--at least 200 IU--with lower rates of cardiovascular disease. Even better, the Cambridge Heart Antioxidant Study (CHAOS for short) discovered that 400 to 800 IU of vitamin E slashed the number of non-fatal heart attacks among heart disease patients by 50 percent in the first year of treatment.

Another nutrient with strong links to heart health is folic acid, a member of the vitamin B family. Scientists first began to suspect its impact when they noticed high levels of homocysteine in children suffering from a severe form of hardening of the arteries that's usually found only in older adults. Homocysteine is suspected of damaging blood vessel walls, and further investigation revealed that the kids lacked adequate amounts of an enzyme needed to clear it from the blood. As it turns out, this enzyme requires folic acid to do its job.

Additional research found that many adults also have higher than normal levels of homocysteine in the blood, and that they too are at greater risk of heart disease. The investigators found that a daily dose of between 0.5 and 5 milligrams of folic acid could bring homocysteine levels under control. But would this alone protect them from heart disease?

The question remained unanswered until Dr. Eric Rimm and his associates at Harvard University conducted a study of over 80,000 nurses. Rimm discovered that, as the women increased their intake of folic acid and vitamin B₆ (another vitamin involved in homocysteine metabolism), their risk of heart attack declined. The risk was lowest in women who were getting more than 400 micrograms of folic acid and more than 3 milligrams of vitamin B₆ in their daily diet (more than twice the Recommended Dietary Allowances). The evidence was so compelling that, in an April, 1998 editorial, the prestigious New England Journal of Medicine concluded that all Americans should take 400 micrograms of folic acid a day.

The bottom line: To maximize your chances of escaping heart disease, many experts now recommend that you not only follow a low-fat diet, but also supplement it with 400 IU of vitamin E, 3 milligrams of vitamin B₆, and 400 micrograms of folic acid per day. 

High Blood Pressure - There is accumulating evidence that an increase in your mineral intake can be an effective remedy for mild hypertension. Clinical studies have found that, for people with a deficiency, extra calcium can lower high systolic blood pressure readings by as much as 13 points, and reduce diastolic readings to some extent as well. (Systolic blood pressure is the force against the artery walls during each beat of the heart. Diastolic readings give the pressure while the heart is at rest.) Calcium supplements have proven especially effective for people who are salt-sensitive--that is, those whose blood pressure goes up when they eat too much salt.

Similarly, a recent study entitled Dietary Approaches to Stop Hypertension (DASH) linked deficiencies in calcium, magnesium, and potassium with higher blood pressure readings, and found that merely boosting intake to recommended levels is sufficient to lower systolic and diastolic readings by 11.4 and 5.5 points respectively in people with high blood pressure. This modest increase in mineral intake produces the same results as a standard high blood pressure medication. Recommended Daily Allowances of the minerals are 1,000 milligrams of calcium, 400 milligrams of magnesium, and 3,500 milligrams of potassium.

When taking calcium supplements, it's important to boost your intake of vitamin D as well, since without enough of this vitamin, the calcium you take won't be absorbed into the bloodstream. For example, when older women take calcium supplements to forestall the brittle-bone disease osteoporosis, they are usually advised to take as much as 800 IUs of vitamin D daily--twice the standard recommendation.

Shizophrenia - This calamitous and still unexplained mental disorder sparked the first experiments with high-dose nutrient therapy. Indeed, when Linus Pauling, PhD coined the word "orthomolecular," he was referring to the schizophrenia treatments pioneered by Abram Hoffer, MD. Believing that large doses of niacin, vitamin C, and other nutrients might relieve the disease, Hoffer conducted controlled trials in which neither the patients nor the doctors knew who was getting real vitamins and who was taking fakes. Although patients with established cases of the disease were unaffected, those in its early stages showed dramatic improvement.

Although subsequent trials by other researchers failed to confirm Hoffer's results, his proponents charge that the later trials either were poorly planned or failed to include early-stage patients. At this point, the majority of mainstream physicians still regard the treatments as unproven, even though many patients swear by them.

Diabetes - Years ago, when doctors first learned how to feed seriously ill patients intravenously, the early IV formulas did not include trace amounts of chromium, an essential nutrient. Many of these patients mysteriously developed a diabetes-like disorder which, as it turned out, was a direct result of a chromium deficiency. Since then, researchers have found that daily intake of 200 micrograms of chromium picolinate can provide significant relief from diabetes, reducing the patient's need for insulin and oral diabetes drugs. A Chinese study found that between 200 and 1,000 micrograms a day improved blood sugar levels, serum cholesterol, and total metabolic control of the disease.

Although conclusive proof is still lacking, chromium picolinate may have other benefits as well. It has been prescribed for obesity, insomnia, depression, acne, and fatigue, and some advocates say it can even promote longevity.

High Cholesterol - A form of the B-complex vitamin niacin has long been an accepted remedy for high cholesterol levels. Dubbed nicotinic acid, and prescribed under the brand names Nicolar and Nicobid, it's taken in doses of 250 to 500 milligrams per day.

Almost everyone can increase their vitamin/mineral intake to therapeutic levels without fear of harmful consequences. However, if you are taking the blood thinning drug warfarin (Coumadin), you should avoid vitamin E supplements unless your doctor approves. Some reports suggest that the vitamin may cause bleeding under such circumstances. Another precaution: Vitamin E may interact with iron, so it's probably best not to take them at the same time of day.

Side effects are infrequent with orthomolecular treatments, but can occur. It is important to be evaluated and treated at a center, like CEIM, which is experienced in this type of therapy. Side effects are as follows:

Vitamin E -  Even large doses of vitamin E are relatively safe, and most adults can handle up to 1,000 IU with little or no harmful effects. There have been a few scattered reports of fatigue and weakness among persons taking 800 IU a day, but the symptoms cleared up as soon as the supplements were stopped.

Folic Acid -  While 400 micrograms of folic acid is considered safe for most people, larger doses can pose a problem for the elderly, who frequently suffer from a deficiency of vitamin B₁₂. Folic acid can hide the signs of this deficiency which, left unchecked, can progress to irreversible nerve damage. To eliminate the danger, simply take B₁₂ supplements along with the folic acid.

Folic acid can also pose a problem for people taking an anti-seizure medication such as Dilantin or phenobarbital. Each of these drugs causes a folic acid deficiency that needs to be remedied. However, a return to normal folic acid levels will increase the amount of drug needed to prevent seizures. To side-step this problem, doctors now prescribe the drugs and folic acid together.

Niacin - The high doses of niacin used in the treatment of schizophrenia (usually several grams a day) pose a slight risk of liver damage. It's best to take them under the supervision of a physician who will have regular liver function tests performed. If you have diabetes, you also face the possibility of an increase in blood sugar levels when taking niacin.

Unlike regular niacin, the nicotinic acid form has a variety of potential side effects, including darkening of the skin or urine, diarrhea, dry skin, eye disorders, flushing, gout, headache, indigestion, irregular heartbeat, itching, low blood pressure, low urine output, muscle pain, tingling, ulcers, vomiting, warts, and yellow skin and eyes.

Chromium - Doses of as much as 1,000 micrograms a day (5 times the maximum recommended allowance) have failed to produce side effects in major clinical trials. Nevertheless, there have been a few isolated reports that suggest some very minor degree of risk. Among the reported reactions were "disturbed thinking" and mental slowness. One woman taking 600 micrograms a day suffered chronic kidney failure. Another developed kidney and liver problems after taking 1,200 to 2,400 micrograms a day for 5 months.

Also, if you have diabetes, don't forget that chromium supplements can decrease the need for insulin or oral medication, and could lead to an unhealthy drop in blood sugar levels unless your medication dosage is reduced. All the more reason to check with your doctor when you begin taking chromium.

It's wise to continue seeing your regular doctor while undergoing orthomolecular therapy, especially if you are also receiving conventional treatments. A number of prescription drugs interact with vitamins and minerals, and the higher the doses, the more likely an interaction will be. To guard against problems, make sure the orthomolecular practitioner knows about your prescriptions, and that your doctor knows about the supplements you're taking.

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