orthomolecular medicine orthomolecular medicine orthomolecular medicine is a form of alternative medicine that aims to maintain human health through nutritional supplementation. the concept builds on the idea of an optimal nutritional environment in the body and suggests that diseases reflect deficiencies in this environment. treatment for disease, according to this view, involves attempts to correct "imbalances or deficiencies based on individual biochemistry" by use of substances such as vitamins, minerals, amino acids, trace elements and fatty acids. the notions behind orthomolecular medicine are not supported by sound medical evidence, and the therapy is not effective for chronic disease prevention; even the validity of calling the orthomolecular approach a form of medicine has been questioned since the 1970s. orthomolecular medicinealternative medicineclaimshealth effects of dietary supplements, particularly vitamin megadoses.related fieldsnaturopathyoriginal proponentslinus 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evolved out of, and in some cases still uses, doses of vitamins and minerals many times higher than the recommended dietary intake. orthomolecular practitioners may also incorporate a variety of other styles of treatment into their approaches, including dietary restriction, megadoses of non-vitamin nutrients and mainstream pharmaceutical drugs. proponents argue that non-optimal levels of certain substances can cause health issues beyond simple vitamin deficiency and see balancing these substances as an integral part of health. american chemist linus pauling coined the term "orthomolecular" in the 1960s to mean "the right molecules in the right amounts" (ortho- in greek implies "correct"). proponents of orthomolecular medicine hold that treatment must be based on each patient's individual biochemistry. the scientific and medical consensus holds that the broad claims of efficacy advanced by advocates of orthomolecular medicine are not adequately tested as drug therapies. it has been described as a form of food faddism and as quackery. proponents point to mainstream sources that have published research supporting the benefits of nutrient supplementation and to instances where conventional medicine uses vitamins as treatments for some diseases. some vitamins in large doses have been linked to increased risk of cardiovascular disease, cancer and death. the scientific consensus view is that for normal individuals, a balanced diet contains all necessary vitamins and minerals and that routine supplementation is not necessary outside of specific diagnosed deficiencies. history and development in the early 20th century, some doctors hypothesised that vitamins could cure disease, and supplements were prescribed in megadoses by the 1930s. their effects on health were disappointing, though, and in the 1950s and 1960s, nutrition was de-emphasised in standard medical curricula. riordon's organization cite figures from this period as founders of their movement, although the word "orthomolecular" was coined by linus pauling only in 1967. amongst the individuals described posthumously as orthomolecularists are max gerson, who developed a diet that he claimed could treat diseases, which the american medical association's 1949 council on pharmacy and chemistry found ineffective; and evan shute and his brother, who attempted to treat heart disease with vitamin e. several concepts now cited by orthomolecularists, including individual biochemical variation and inborn errors of metabolism, debuted in scientific papers early in the 20th century. in 1948, william mccormick theorized that vitamin c deficiency played an important role in many diseases and began to use large doses in patients. in the 1950s, fred r. klenner also tried vitamin c megadosage as a therapy for a wide range of illnesses, including polio. irwin stone stated that organisms that do not synthesise their own vitamin c due to a loss-of-function mutation have a disease he called "hypoascorbemia". this term is not used by the medical community, and the idea of an organism-wide lack of a biosynthetic pathway as a disease was not endorsed by stone's contemporaries. in the 1950s, some individuals believed that vitamin deficiencies caused mental illness. psychiatrists humphry osmond and abram hoffer gave people having acute schizophrenic episodes high doses of niacin, while william kaufman used niacinamide. while niacin has no known efficacy in psychiatric disease, the use of niacin in combination with statins and other medical therapies has become one of several medical treatments for cardiovascular disease. in the late 1960s, linus pauling introduced the expression "orthomolecular" to express the idea of the right molecules in the right amounts. since the first claims of medical breakthroughs with vitamin c by pauling and others, findings on the health effects of vitamin c have been controversial and contradictory. pauling's claims have been criticised as overbroad. later research branched out into nutrients besides niacin and vitamin c, including essential fatty acids. scope according to abram hoffer, orthomolecular medicine does not purport to treat all diseases, nor is it "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." nevertheless, advocates have said that the right nutrients at the optimum dose for the individual concerned can prevent, treat, and sometimes cure a wide range of medical conditions. conditions for which orthomolecular practitioners have claimed some efficacy are: acne, alcoholism, allergies, arthritis, autism, bee stings, bipolar disorder, burns, cancer, the common cold, depression, drug addiction, drug overdose, epilepsy, heart diseases, heavy metal toxicity, acute hepatitis, herpes, hyperactivity, hypertension, hypoglycemia, influenza, learning disabilities, mental and metabolic disorders, migraine, mononucleosis, mushroom poisoning, neuropathy & polyneuritis (including multiple sclerosis), osteoporosis, polio, a hypothesised condition called "pyroluria", radiation sickness, raynaud's disease, mental retardation, schizophrenia, shock, skin problems, snakebite, spider bite, tetanus toxin and viral pneumonia. orthomolecular psychiatry main article: orthomolecular psychiatry hoffer believed that particular nutrients could cure mental illness. in the 1950s, he attempted to treat schizophrenia with niacin, although proponents of orthomolecular psychiatry say that the ideas behind their approach predate hoffer. according to hoffer and others who called themselves "orthomolecular psychiatrists", psychiatric syndromes result from biochemical deficiencies, allergies, toxicities or several hypothetical contributing conditions which they termed pyroluria, histadelia and histapenia. these purported causes were said to be found during an "individual biochemical workup" and treated with megavitamin therapy and dietary changes including fasting. these diagnoses and treatments are not accepted by evidence-based medicine. principles according to abram hoffer, "primitive" peoples do not consume processed foods and do not have "degenerative" diseases. in contrast, typical "western" diets are said to be insufficient for long-term health, necessitating the use of megadose supplements of vitamins, dietary minerals, proteins, antioxidants, amino acids, ω-3 fatty acids, ω-6 fatty acids, medium-chain triglycerides, dietary fiber, short and long chain fatty acids, lipotropes, systemic and digestive enzymes, other digestive factors, and prohormones to ward off hypothetical metabolism anomalies at an early stage, before they cause disease. orthomolecularists say that they provide prescriptions for optimal amounts of micronutrients after individual diagnoses based on blood tests and personal histories. lifestyle and diet changes may also be recommended. the battery of tests ordered includes many that are not considered useful by medicine. prevalence orthomolecular medicine is practiced by few medical practitioners. a survey released in may, 2004 by the national center for complementary and alternative medicine focused on who used alternative medicine, what was used, and why it was used in the united states by adults age 18 years and over during 2003. 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%. another recent cam survey reported that 12% of liver disease patients used the antioxidant silymarin, more than 6% used vitamins, 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." even though the health benefits are not established, the use of high doses of vitamins is also common in people who have been diagnosed with cancer. according to cancer research uk, cancer patients should always seek professional advice before taking such supplements, and using them as a substitute for conventional treatment "could be harmful to health and greatly reduce the chance of curing or controlling cancer". medical and scientific reception methodology orthomolecular therapies have been criticized as lacking a sufficient evidence base for clinical use: their scientific foundations are too weak, the studies that have been performed are too few and too open to interpretation, and reported positive findings in observational studies are contradicted by the results of more rigorous clinical trials. accordingly, "there is no evidence that orthomolecular medicine is effective". proponents of orthomolecular medicine strongly dispute this statement by citing studies demonstrating the effectiveness of treatments involving vitamins, though this ignores the belief that a normal diet will provide adequate nutrients to avoid deficiencies, and that orthomolecular treatments are not actually related to vitamin deficiency. the lack of scientifically rigorous testing of orthomolecular medicine has led to its practices being classed with other forms of alternative medicine and regarded as unscientific. it has been described as food faddism and quackery, with critics arguing that it is based upon an "exaggerated belief in the effects of nutrition upon health and disease." orthomolecular practitioners will often use dubious diagnostic methods to define what substances are "correct"; one example is hair analysis, which produces spurious results when used in this fashion. proponents of orthomolecular medicine contend that, unlike some other forms of alternative medicine such as homeopathy, their ideas are at least biologically based, do not involve magical thinking, and are capable of generating testable hypotheses. orthomolecular is not a standard medical term, and clinical use of specific nutrients is considered a form of chemoprevention (to prevent or delay development of disease) or chemotherapy (to treat an existing condition). despite a lack of evidence for its efficacy, interest in intravenous high dose vitamin c therapy has not been permanently extinguished, and some research groups continue to investigate whether it has an effect as a possible cancer treatment. views on safety and efficacy in general, the vitamin megadoses advocated by orthomolecular medicine are unsupported by scientific consensus. some vitamins are toxic in high doses, including niacin (b3), cholecalciferol (d) and tocopherol (e). the view of the medical community is that there is no evidence for the efficacy of orthomolecular medicine as a treatment for cancer, and that high vitamin doses may – on the contrary – increase overall mortality. nutritional treatments are not generally accepted as being helpful for psychological health. its claims have been criticized by most