What is orthomolecular medicine?

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The prevention and treatment of disease by eliminating from the body those substances that contribute to malnutrition, such as sugar, salt, and animal fat, and by optimizing the amounts of such substances as vitamins and minerals.
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In 1968, Linus Pauling, a preeminent American chemist and two-time Nobel laureate, introduced the term “orthomolecular” to signify human health as “the right molecules in the right amount” in the body. He had earlier discovered the first disease described as “molecular” when he showed that sickle cell anemia is caused by a defect in the hemoglobin molecule. He later explored the role of molecular deficiencies in mental illness and, following the advice of biochemist Irwin Stone, began taking large amounts (megadoses) of vitamin C (ascorbic acid), which reduced the numbers and the severity of his bouts with the common cold.

Pauling then investigated the scientific literature and found studies that indicated that a high ingestion of vitamin C protected people against colds. Because medical and nutritional authorities had largely ignored these studies, Pauling compiled his findings and published the book Vitamin C and the Common Cold (1970) to alert consumers, doctors, and nutritionists about the results of his literature review.

Pauling’s book initiated the so-called vitamin C controversy, which pitted Pauling and a growing number of supporters against members of the medical and nutritional establishment, who generally criticized his claims. In the early 1970s, Pauling and others founded the Institute of Orthomolecular Medicine (later renamed the Linus Pauling Institute of Science and Medicine) near Stanford University. The institute was designed, among other things, to do research on how the deficiencies and surpluses of certain bodily substances affect human health. This research led to the publication of the book Cancer and Vitamin C (1979), which Pauling coauthored with the oncologist Ewan Cameron. Pauling then published How to Live Longer and Feel Better (1986), his final book. After Pauling’s death in 1994, his institute was moved to Oregon State University, where Pauling had obtained his undergraduate degree. The institute’s research mission remained orthomolecular medicine and nutrition, a goal shared with many orthomolecular doctors all over the world.

Mechanism of Action

Millions of years of evolution in Homo sapiens has led the human body to develop an armamentarium of substances that facilitate the health necessary for survival. According to orthomolecular physicians, however, modern diets often lack the proper amounts of essential vitamins, minerals, proteins, and other nutrients, and contain harmful amounts of such substances as sugar, salt, and animal fats. A person can maintain good health by eliminating substances that contribute to malnutrition and by optimizing the amounts of such substances as vitamins and minerals.

Uses and Applications

After interviewing a person seeking care and after analyzing that person’s blood, urine, and hair, the orthomolecular doctor attempts, through diet, supplements, and lifestyle modification, to restore a proper balance of chemical constituents in the body. The physician may prescribe megadoses of vitamin C, vitamin E, and niacin and restrict the ingestion of such processed foods as refined sugar, white flour, and animal fats.

Scientific Evidence

Because of the overwhelming data gathered by researchers in numerous double-blind studies of humans and nonhuman animals, general agreement exists among physicians and nutritionists that certain vitamins, minerals, proteins, carbohydrates, and fats are essential for good health. Controversies have developed, however, about what constitutes truly advantageous amounts of these substances. For example, Pauling believed that the Food and Nutrition Board of the U.S. Food and Drug Administration set the recommended dietary allowances of many of these substances much too low. As scientific evidence to bolster his claim, Pauling cited his own work, “Evolution and the Need for Ascorbic Acid,” in which he analyzes the diets of primates, showing that they ingested two to three grams of ascorbic acid per day. Furthermore, animals who manufacture their own vitamin C do so in mega- rather than micro-amounts.

In rebuttal of the claims of Pauling and orthomolecular doctors who support his views, other researchers performed laboratory and clinical studies that showed, for example, that megavitamin therapy had no value for people suffering from mental illness. Most famously, two Mayo Clinic studies (1979 and 1985) concluded that vitamin C was an ineffective treatment for persons with cancer. Scientific studies continued during the succeeding decades on the effectiveness of megadoses of vitamins and other nutrients for various illnesses, with some studies supporting the benefits but many indicating no or even negative consequences. Even as many people continue to use dietary supplements, many conventional health practitioners reject most of the doctrines of the orthomolecular proponents.

Choosing a Practitioner

Although orthomolecular medicine is widely considered an alternative medicine, it generally involves cooperation with conventional doctors and is thus more complementary than alternative in nature. For example, when Pauling and his wife were suffering from cancer, both used megavitamin therapy as a complement to surgery.

The International Society of Orthomolecular Medicine and many national societies provide lists of orthomolecular practitioners. Orthomolecular Health Medicine, founded in 1994, has a referral service.

Safety Issues

Proponents of orthomolecular medicine insist that megadoses of vitamins and other nutrients are perfectly safe, but critics insist that relying solely on nutritional rather than pharmacological treatment, when necessary, is dangerous. Researchers who support criticism of orthomolecular medicine have gathered evidence that confirms the hazards of megadoses of such fat-soluble vitamins as A and E. Megadoses of other vitamins have been associated with increased risk of heart disease, kidney stones, hypertension, and other diseases.


Bender, David A. Nutritional Biochemistry of the Vitamins. 2d ed. New York: Cambridge University Press, 2003. In this reference work intended for physicians, nutritionists, and clinicians, Bender has gathered an immense amount of information on the biochemical, medical, and physiological effects of vitamins. His data tend to support the traditional view of vitamins as micronutrients. Figures and tables, bibliography, and index.

Gratzer, Walter B. Terrors of the Table: The Curious History of Nutrition. New York: Oxford University Press, 2005. Gratzer treats mainstream scientists as the heroes and Pauling and his orthomolecular supporters as the villains. Further reading, references, and index.

Hoffer, Abram, and Andrew W. Saul. Orthomolecular Medicine for Everyone: Megavitamin Therapeutics for Families and Physicians. Laguna Beach, Calif.: National Health, 2008. Written by two orthomolecular practitioners, this book surveys the field, advocating megavitamin therapy as safe, effective, and inexpensive.

Linus Pauling Online, Oregon State University. http://pauling.library.oregonstate.edu.

Pauling, Linus. How to Live Longer and Feel Better. Corvallis: Oregon State University Press, 2006. This new edition of a book originally published in 1986 makes available again what has been called “the strongest presentation ever written on the need for supplemental vitamins.”

_______. Vitamin C and the Common Cold. San Francisco: Freeman, 1970. This best-selling and prize-winning book contains a chapter on orthomolecular medicine and helpful appendixes, references, and an index.

Williams, Roger J., and Dwight K. Kalita, eds. A Physician’s Handbook on Orthomolecular Medicine. New ed. New Canaan, Conn.: Keats, 1979. The editors have collected articles by orthomolecular doctors and researchers from around the world, though some reviewers, representing conventional medicine, found the claims of many contributors unsupported by scientific evidence.

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