Thursday, November 28, 2019

Is Orthomolecular Treatment a "Snake Oil"?

       In a Wikipedia entry about orthomolecular treatment a pediatrician and author named Julian Haber described the "orthomolecular" approach as "snake oil." I was confused how this statement could be so flippantly asserted. I pondered the substance of this assertion. The I investigated the author of the "snake oil quote" and the person who invented the term "orthomolecular treatment" to compare expertise and perspective.

Pondering the content of the Snake Oil Claim  
       "Snake Oil" alludes to the sale of tonic or organic oil peddled as cure for every ailment described to the gullible, naive  and desperate.  It brings up visions of salesman traveling through the rugged west of the United States stopping at small towns to sell bottles of the liquid to cure baldness, skin rashes, fever, headaches, fungus, swelling, headaches and whatever else might be ailing settlers desperate for any medical supplies.  After the pitch and sales the salesman would pack up his wagon and leave.  He would depart before data was gathered that might discount the claims. and move on to "new markets".  The salesman made money even as the "oil" failed to "cure".  Given the poor state of communication at the time there was little to fear in moving on to the next community.  There was no systematic evaluation of the outcomes available.  Ignorance, lack of data and mystery helped keep the markets available to the salesman here today who was then gone tomorrow.  The ruse was never exposed.
       The "snake oil" analogy appears at odds with orthomolecular approach.  Today orthomolecular approaches are being implemented world wide (though most popular in Australia).  Those using orthomolecular approaches use client interviews and analysis of blood, urine and hair.  This analysis leads to a nutritional program that may meet the needs of a particular individual.  There is no one size fits all vitamin, tonic, pill or powder as touted by the "snake oil salesman".   The Orthomolecular approach uses a variety of nutritional supplements from a variety of sources.  The snake oil salesman sought to avoid discussion of specific mechanisms, study, research or evaluation.  The Orthomolecular approach now has a rich research base with data gleaned from advanced techniques like resonance scanning, radioactive tracers, post facto studies and clinical trials among other techniques.  The data  are published in peer reviewed journals accessible to both the medical community and to the public.  In one example the The Journal of Orthomolecular Medicine has been publishing for over 3o years.  Significant studies in other similar journals are increasingly being cited in medical journals.  Orthomolecular practitioners like  Dr. Walsh, Dr. Mensah, Dr. Selig and many others collect data, publish and train doctors.  These leaders and leading journals do not change names and move on.
      So the suggested parallels between the "snake oil salesman" and the orthomolecular practitioners appears to be lacking substance.  "Name calling" fails to illuminate the differences for those who are ignorant.

  The birth of the orthomolecular medicine 
and the scientist that helped launch this approach.

How do the Authors Compare in Expertise?
      This quote might have one classify the leaders of the orthomolecular treatment movement as untrained and ignorant with little or no credentials selling "snake oil" to the gullible.  Dr. Haber who disparages the Orthomolecular approach is depicted as credentialed and "highly informed".   Dr. Haber had numerous articles and poems published in Good Housekeeping, American Veteran, Critique Magazine, Fort worth Star Telegram, Healthy Kids Magazine, American Family Physician, Di-Verse-City Anthology and Blood and Thunder.   Dr. Haber writes both fiction and non-fiction so he is very articulate (sort of like a snakle oil salesman?)  One wonders how would Dr. Haber compare with the person who coined the term "orthomolecular"?
     The person who coined the term "orthomolecular"  was Dr. Linus Pauling (1901-1994).  In 1954 Dr. Pauling was awarded an unshared Nobel Prize in Chemistry.  He is the undisputed founder of quantum chemistry , molecular biology and was considered a world renowned expert in biological molecules while he was alive.  He  published  over 850 peer reviewed scientific articles and books and 350 other articles and books (but none of them fiction).  Dr. Pauling obtained a B.S. from Oregon State University and his Ph.D. from the California Institute of Technology.   Dr. Pauling  was named one of the 20 greatest scientists of all time and was featured as a scientist "stubbornly ahead of his time" by those who endorsed him in the prominent publication "Scientific American" (1993).
      During the pinnacle of his professional career at age 40 Dr. Pauling was diagnosed with Bright's disease.   This was a serious kidney disease (now called glomerulonephritis) that was fatal with no treatment for renal failure available until  20 years later.  Linus Pauling worked with a nutritionist Thomas Addis, and Ava Helen Pauling as "nutritionist, cook, and eventually as deputy 'doctor'" to manage the disease with a low-protein salt-free diet and vitamin supplements.   Dr. Linus Pauling lived, worked, researched and published another 53 years.  His first success using the orthomolecular approach was very personal.  What one author calls "snake oil" had saved his life.   
     In 1965, Pauling read Niacin Therapy in Psychiatry by Abram Hoffer and theorized vitamins might have important biochemical effects unrelated to their prevention of associated deficiency diseases.  Pauling coined the term "orthomolecular" to refer to the practice of varying the concentration of substances normally present in the body to prevent and treat disease.  In 1968, Pauling published a brief paper in Science entitled "Orthomolecular psychiatry", giving a name to the popular but controversial therapy.  Dr. Pauling speculated that "orthomolecular therapy, the provision for the individual person of the optimum concentrations of important normal constituents of the brain, may be the preferred treatment for many mentally ill patients."   His ideas are not generally practiced by conventional medical professionals, has been strongly criticized BUT since 2005 this approach has spawned increasing numbers of new research in mainstream medical publications with many found in the US National Library of Medicine National Institutes of Health (with multiple peer reviewed journals).  
      So an author of numerous fiction and non-fiction works is quoted in a manner that depicts a Nobel Science Winner with 1200 non-fiction publications  as a snake oil salesman?

Does Science Change?
     Changes in science disciplines rarely come easy or quickly.  In one example of change it took 70 years and numerous false sightings of a hypothetical planet "Vulcan" to confirm that the planet  did not exist and that General Relativity was more correct than Newtonian gravity.  In another more recent example the geologists who claimed tectonic plates moved entire continents were mocked and deemed incompetent for three decades by fellow professionals until "continental drift" became widely accepted.  In Psychiatry prior to the 1970's mothers of Autistic children were deemed "frigid" and expected to submit children for endless "therapy sessions" for what is now known to be a biological pathology.  In The Broken Brain by Nancy Andreason (MD, PhD, Psychiatric Chair and winner of numerous awards for professional courage) was met with similar skepticism almost 40 years ago and now mainstream psychiatry recognizes that biological pathologies underlie all mental illness.  Times are still changing.  In the same way it appears that Dr. Linus Pauling may be  proving to be "stubbornly ahead of his time"  when it comes to "orthomolecular treatment."
     Mainstream medical research is only recently beginning to recognize the impact of nutrients.  They are years behind but now beginning to see that statistical truth.  Listed below are just a limited sample of recent studies listed at  US National Library of Medicine National Institutes of Health:

          The impact of Vitamin D; omega fatty acids in studies on schizophrenia and other mental health/neural issues (2015):
           Links with vitamin B12, vitamin D and folic acid blood levels in patients with schizophrenia (May 2019):
          A 2018 study finding links with mental health links to Vitamin C:
     Linus Pauling forfeited incredible income as a spokesman for pharmaceuticals when he took up the orthomolecular cause.  The Wikipedia article may reflect the perspective of pharmaceuticals as sales and public relations persons in industry often edit the content of the articles in Wikipedia.   It is no secret that pharmaceutical  interests  seek to discourage orthomolecular approaches (as orthomolecular approaches offer cures rather than maintenance.)  There may pediatricians like Dr. Julian Haber who may prescribe medications than manage the illness.  The financial model for doctors and pharmaceuticals benefit greatly from long term dependence on medications.    Is it possible that curing a metabolic dysfunction with nutrients aimed at the a cure is not a sustainable economic model?
   

      Below are a sample of studies in the US National Institute of Health ; in other national peer reviewed journals appear to agree with Dr. Linus Pauling:

"with the B vitamin constituents. These conclusions received further support from a more recent study that also demonstrated improved mood following four weeks of supplementation with a multivitamin containing high levels of B vitamins."   
  
"[vitamin] B showed significant improvement on the mental health scale of the SF-36 compared to placebo. "

 "On the basis of current data, we suggest that oral doses of both folic acid (800 microg daily) and vitamin B12 (1 mg daily) should be tried to improve treatment outcome in depression."    

"evidence links low status of folate and the related B-vitamins (and/or elevated concentrations of homocysteine) with a higher risk of degenerative diseases including cardiovascular disease (CVD), cognitive dysfunction and osteoporosis." 

"Current research in psychoneuroimmunology and brain biochemistry indicates the possibility of communication pathways that can provide a clearer understanding of the association between nutritional intake, central nervous system, and immune function thereby influencing an individual's psychological health status. These findings may lead to greater acceptance of the therapeutic value of dietary intervention among health practitioners and health care providers addressing depression and other psychological disorders."

After examining a variety of studies that detail the impact of B and numerous other nutrients this review of studies states:  "As researchers continue to investigate the efficacy of nutritional healing, more and more information will be readily available to those wishing to take a more natural course of therapy. For the time being, we can rely on the already thousands of successful studies that “alternative therapies” need not be an alternative anymore."
  
"On the basis of current data, we suggest that oral doses of both folic acid (800 microg daily) and vitamin B12 (1 mg daily) should be tried to improve treatment outcome in depression."   

No comments:

Post a Comment