Orthomolecular Medicine for Everyone. Abram Hoffer, M.D., Ph.D.
and nutrients sets orthomolecular physicians apart from other physicians, who seldom show any interest in the nutritional condition of their patients and are generally resistant and even hostile to the use of vitamins and minerals. These physicians depend almost entirely on drugs, surgery, and radiation. Nonmedical professionals such as psychologists and nutritionists can advise patients about nutrition. Even though they are not allowed to practice medicine (i.e., prescribe drugs), they are able to help many persons regain their health. But the majority of orthomolecular practitioners are physicians.
Few medical schools provide their students with a useful understanding of the importance of nutrition in generating disease and how to correct diet when they treat patients. Physicians have abdicated their responsibility in favor of nutritionists (who are usually biochemists) and dietitians. Very few clinical nutritionists practice in hospitals, so it is not surprising that hospitals are so naive about nutrition and that most of their patients suffer more from malnutrition on discharge than they do on admission. Medical students pay little attention to nonclinical nutritionists. It is clear to many of them that nutrition must be unimportant in the hierarchy of medical specialties and that it plays no role in medical practice. But orthomolecular physicians have adopted nutrition as a main component of any medical, surgical, or psychiatric treatment.
THE PRINCIPLE OF INDIVIDUALITY
Every division of medicine is bolstered by a set of principles based upon theoretical ideas and practical experience in dealing with patients. One of these principles in orthomolecular medicine is individuality—the fact that every person is unique and has different nutrient requirements and responds differently to treatment. Knowledge of individuality is ubiquitous from the time an infant first recognizes its mother as different from other women. The facts of physical and anatomical differences are not in dispute. We each have a particular shape, form, color, personality, and life history. The use of names recognizes that fact and the importance of individuality.
Physicians are equally aware of anatomical individuality but are less aware that there are wide ranges of need for drugs and even more variation in optimum vitamin requirements. Surgeons hope that an appendix that must be removed is where it is supposed to be, but good surgeons are not surprised when it is not. Physicians know a few patients are eased of their depression with 25 milligrams (mg) of a standard antidepressant, while some require 10 times as much. Nutritionists know nutrient requirements vary and that each person has a unique need for proteins, fats, carbohydrates, and micronutrients, but nearly every non-orthomolecular professional grossly underestimates the wide range of variation. Roger Williams was one of the pioneer researchers in this area, providing a persuasive summary of the vast data for the biochemical uniqueness of people in 1956.2
When any population is examined for any one attribute, such as height, weight, shape, or color, there is a range in the measurements. Height varies from under two feet in infants to over seven in a few adults. Most male adults range between four-and-a-half and six feet tall. When height is plotted against the number of people at that height, one has drawn a frequency distribution curve. Many more men will have a height of five-and-a-half feet than five or six feet. To give someone a simple estimate of the height of the population, we would estimate the average height and also the degree of deviation from it by the standard deviation. This statistic has been so arranged that the mean value plus or minus two standard deviations from this mean will account for about 95 percent of the population. About 5 percent of any group will vary beyond this range for biological variables in general.
Normally, the curve looks like a bell. The bell-shaped distribution curve applies to other measures, such as daily need for protein and for vitamins or minerals, but for each nutrient the curve will have a different shape. It may be short and broad or narrow, or it may not be bell-shaped. But for each one, at least 2.5 percent will require more than the rest of the population (the 97.5 percent). We can only surmise why this is the case, as there has been little interest in this phenomenon. In regard to nutrients, there may be a problem with absorption in the intestine. Thus, with pernicious anemia, specific areas in the gut that normally absorb vitamin B12 are lacking, or after the vitamin is absorbed it may not be combined efficiently into its coenzyme, or it may be wasted or held too tenaciously by some organ systems, thus depriving other parts of the body.
Orthomolecular physicians deal with patients whose needs for nutrients lie beyond the usual distribution. These patients require up to a thousand times as much of certain nutrients. For practicing with this principle, orthomolecular physicians are subjected to criticism by physicians who are not aware of these matters and who refuse to believe that a number of chronic diseases are present because these extraordinary nutrient needs are not met.
Because the concept of individuality is so basic to this entire work, it is necessary to enlarge our understanding of its enormous role in all human affairs. I assume that few will disagree with the fact that we differ in visible attributes such as height, weight, color, configuration, fingerprints, and so on. We also differ in physical capability, strength, dexterity, coordination, and skill, and in our interests. Discoverers want to be first, for only one can be so unique; scientists fight over priority, for only the first is remembered and honored. Artists strive to be different, to be known for the uniqueness of their creativity and talent. Uniqueness is often honored and rewarded, but of course it must be the type of uniqueness that society finds acceptable. Some forms of uniqueness lead to imprisonment or involuntary admission to mental hospitals. What few people recognize is that physical, physiological and even psychological factors that are measured as different arise from a metabolic apparatus, our bodies, which are unique. The total of these hidden biochemical factors that create our individuality is much greater than are the visible attributes. Identical twins, who are as alike genetically as it is possible to be, possess many biochemical and nutritional differences. When that one fertilized egg makes an error and divides in two, each of which creates a new individual, there is no perfect division of all the genes or other cellular particles that control life.
Biochemical Differences
Orthomolecular medicine is concerned mostly with biochemical and nutritional differences. They are as basic to the production of health and disease as normal biochemical reactions are for the final normal human being. The fact that some people require large doses of nutrients has been hard to accept because the vitamin concept has been accepted too well: early observations that vitamins were required in small amounts has become dogma and many believe that only small quantities are ever required. This dogma began to be called into question several decades ago when a few sick children were discovered who required very large quantities of pyridoxine (vitamin B6). They were said to be vitamin B6 dependent. The earlier concept only accepted the idea of a vitamin deficiency. The few classical deficiencies, such as pellagra, beriberi, scurvy, and rickets, are rare in industrialized nations, but when they do appear it is due to gross deficiencies and abnormalities of the diet. A child with a pyridoxine dependency would remain ill on a diet that contained enough pyridoxine for most people. Since these early findings, a large number of other dependency diseases have been found.
These findings were already foreseen by researchers over sixty years ago. They reported with surprise that some people with chronic pellagra (a niacin-deficiency disease characterized by dermatitis, gastrointestinal disorders, and mental disturbance) would not remain free of symptoms unless given at least 600 mg per day of vitamin B3 (niacin). This was considered an enormous dose at that time, when only 5 mg or so was considered necessary to prevent pellagra. Chronic pellagra produced an irreversible biochemical change so that small amounts of the vitamin could no longer maintain health. A vitamin deficiency, which we all would suffer from if deprived of small amounts of vitamin B3, had been converted into a vitamin B3 dependency, for which large amounts were necessary each day, forever.
I (A. H.) have seen a large number of patients who did not recover until they began to take 3 grams (g) per day of vitamin B3. In the past, they had suffered from severe prolonged stress and malnutrition. The best examples were those who had survived concentration camps in Europe or prisoner-of-war camps in