Talk:Orthomolecular medicine

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Sept. 27, 2003 - June 14, 2006 June 14, 2006 - June 26, 2006 Aug. 7, 2006 - Aug. 31, 2006 Sept. 6, 2006 - Oct. 24, 2006

Contents 1 "vitamin" Accutane? 2 "cost" 3 " and safety" 4 Broken link 5 "Complementary and alternative medicine"

[edit] "vitamin" Accutane?

re: "pharmaceutical analogues such as...isotretinoin" It is the conventional medical crowd & campfollowers that have insisted upon the disinformational BCCA page here, as well as at other similar Wiki articles (I count at least 10 errors, misrepresentations, etc in BCCA, I stopped dissecting at 4 earlier because they incrementally do get so much more time consuming exploring the depths). Isotrentoin was mentioned because it was among the best to fit more BCCA descriptions & allegations than anything else that might be conventionally twisted to fit such a view of OM, although that might not be BCCA's intent. Your favorite, Whaleto, had more accurate material than BCCA, so why the preferential treatment?

from BCCA: "When vitamins are consumed in excess of the body's physiological needs, they function as drugs rather than vitamins because the human body has limited capacity to use vitamins in its metabolic activities." (Hafner), "High doses of some vitamins are toxic hence supplements are generally not recommended unless recommended by a physician. (Hislop)", "Because vitamins in large doses may have drug like effects, they could compromise the effectiveness of standard medical treatment in the same way that taking two different drugs might." (McDonald), "Pregnant women or those planning to become pregnant should not use megavitamin therapy. Congenital abnormalities and spontaneous abortions may occur." (Ontario) (Loescher), "Megadose vitamin therapy may cause injury that is confused with disease symptom. High vitamin intake is more hazardous to peripheral organs than to the nervous system, because the central nervous system vitamin entry is restricted." (Snodgrass).

^sarcasmWow! Isotretinoin must be it, nailed OM to a cross. Ha!^{end sarcasm}

Isotretinoin is an in vivo interconversion of a rare dietary form of vitamin A, used pharmaceutically in "megadose" quantities for disfiguring acne and is infamously pathological for inducing birth defects. Orthomed probably would better agree with naturopaths on environmental and dietary changes, and then, if you insist on something biochemical, look at 4%-5% niacinamide gel, oral pantethine, mixed tocopherols oil, lecithin, and maybe some vitamin A and zinc supplementation or even niacin or enzymes but haven't researched them deeply. Although my & wife's brothers suffered serious even disfiguring acne, son stopped his scarring with mixed tocopherols topically, hadn't heard of niacinamide gel or pantethine then. Of course this is an individual situation where there are many.

As far as I can tell from conversations here, Isotretinoin is as orthomolecular as conventional medicine can see, perhaps even best of that genre. If the shoe fits, wear it; even wallow in it.--TheNautilus 10:07, 4 November 2006 (UTC) Retry, clarify writing, sarcastic point, above.--TheNautilus 23:22, 5 November 2006 (UTC)

I'm a little confused here. Are there people in the orthomolecular community who recommend using Accutane for purposes other than acne? Andrew73 18:21, 5 November 2006 (UTC)

No, orthomed is not interested in isotretinoin. My complaint is that what BCCA charges & insinuates often traces back to previous (40s-50s) mainstream megadose uses or misbegotten pharmaceuticals and better describes current mainstream modalites of "megadose" retinoic acids (birth defects etc) while dumping utter trash on OM, including the retinol(old)/retinoid(new) therapies. Orthomed is like conventional medicine - if something turns out poorly in retrospect, it gets thrown out or, hopefully, improved.

Orthomed, with wider possible treatment ranges & individualization with non- or very low-toxicity nutrients, can automatically monitor for (rare) complications/side effects more tightly because it uses tighter, "subclinical" parameters in clinical tests; orthomed emphasizes safe/optimal forms (part of why I keep nailing specific molecules/formulas/uses rather than broad "vitamin" labels). The BCCA page is laughably inaccurate, a source of negative bilge that some previous editors have delighted in metastasizing (it is, by far, the most referenced footnote in the OM article as well as other articles-spamlinked), except that it might be a real killer for uninformed readers & maliciously perpetuate confusion. The BCCA page might be considered an exemplar of conventional medical sentiment, confusion & ignorance about orthomed, it is not WP:RS about orthomed itself, but I feel that I need conventional agreement on this point since my position is, ah, compromised. I thought "4 strikes and it's out" was more than fair as for WP:RS on factual references about orthomed itself.--TheNautilus 23:22, 5 November 2006 (UTC)

[edit] "cost"

"Nutritional supplements often cost less than pharmaceuticals." has a number of issues. (1) My original point is that regulation can bring vast cost increases (retail prices as well as manufacturing, support, & mktg costs) with it. (2) The stmt's veracity at retail may be geographically conditional i.e. high drug costs, low cost supplements in the US may be true, but prescription priced supplements in Europe, Canada or Australia, at higher costs than US, vs lower drug costs outside the US, this statement is often false. (3) At actual manufacturing costs, this statement is probably often false. ie. 0.8 mg Baycol vs even 3 - 6 grams of cheap niacin ($0.05-$0.10 Costco retail), Baycol could have probably "won" with a lower manufacturing cost ("you", of course, would lose ;-> ).--TheNautilus 01:18, 10 November 2006 (UTC)

Valid points... I've rephrased a little, to be more clear about sourcing, but carried through the point that less regulation usually equals lower prices (U.S. compared to Europe). MastCell 02:49, 10 November 2006 (UTC)

[edit] " and safety"

The current presentation about FDA regulated "safety" misleads a normal reader to imply that drugs (new or old) are safer than orthomolecular supplements (pls careful about what is considered OM), the historical record does not support that proposition by a long shot. Drugs certainly are not "proven safer" at the point of introduction than exisiting vitamins and supplements, merely that most dangerous drugs were not recognized as immediate threats to life and health beyond small "acceptable" percentages in a given category (mgmt game: max the number of slices) that can be balanced in net efficacy approaching zero within p=0.05 and all the test features one can walk through. Again the recent historical record is pretty strong here. I realize my edit and sentence construction may need polishing but I am serious about the point.--TheNautilus 05:03, 13 November 2006 (UTC)

It doesn't say pharmaceuticals are "safer" than vitamins/OM. That would depend on the specific drug/vitamin/dose in question and cannot be generalized. It says that pharmaceuticals are held to a higher standard of proof than vitamins/nutraceuticals in the U.S., which is a fact. MastCell 05:16, 13 November 2006 (UTC)

"It says" I have left the efficacy part of statement, while fussing with the "proof" wording because, well, it isn't in most general senses, it is a p=0.05 significant (or better) statistical result, a good demonstration, that can be massaged in many ways, that should not fail on use so often (20% w/d, blk boxed or downgraded?)... I don't dispute that more formal testing is required for new drugs. I am concerned about the communicated impression left with less saavy readers who haven't any ideas of what is going on here, a possible supposition that GMP nutritional supplements are, on balance, less safe than the incoming new pharmaceuticals, a proposition which the mortality figures don't support by at least orders of magnitude, even without OM grade medical advice. Hence I wish to treat safety in a separate sentence about this and carefully reflect the relative safety story (two conditions here - meets GMP and orthomed protocol based, not just "big ones" "Hecho en Timbuktoo" or old Pharmaloo willy nilly carpet bombing with something ugly and then saying its OM-MV.)--TheNautilus 12:00, 13 November 2006 (UTC)

Quite simply, pharmaceuticals must be proven safe and effective to the FDA's satisfaction before being marketed. Vitamins and "nutraceuticals", on the other hand, can be marketed freely and must be proven unsafe by the government before any regulatory action can be taken (ephedra, anyone?). This says nothing about the safety of specific meds; it speaks directly to where the burden of regulatory proof lies. This is an important point for the "relationship to mainstream medicine" section. The fact is that the standards are different, and this deserves mention. You've already hammered away at the relative safety records of prescription drugs vs vitamins quite a bit elsewhere in the article. Our job is to provide accurate and at least somewhat balanced information; protecting "less sophisticated" readers from themselves is a paternalistic justification which doesn't fly for removing a clearly worded and accurate sentence. MastCell 20:52, 13 November 2006 (UTC)

proven safe and effective - I am picking at this oft bandied construction as a self congratulatory (FDA, pharmas etc) slogan and advertising phrase because there *are* a lot of upset people who are, and have been, pretty unhappy with it & the FDA. As I indicated, there seems to be a large disparity between promise and performance that doesn't sound like a hard science version of "proof" either, "demonstrated" would be about right. You referenced CFR on DSHEA - although I haven't run the dumpster dive on CFR and US Statutes, I have to say that phrase doesn't quite sound like direct language either (INAL). Standards are different is a fact, as are the results, and other relevant information/experience. I am all game for a brief, cogent statement about a clearly worded and accurate sentence. We are collaborating from somewhat different perspectives and need to carefully work out what that means.

I doubt ephedra was ever on the OM list, that's the commercial herbals department. You might check with the naturopaths for their perspective. OM type recommendations rarely cite herbal extracts w/o vitamin, mineral, antioxidant, etc/OM list content or such use (pls reread Pauling's definition). Artificial stimulation like this would be less OM than ordinary overusage of sugar and coffee, perhaps a "farmaceutical" in sheeps clothing. Neither am I clear that the FDA acted wisely & regulated maturely rather than playing political games feeding rope to some manufacturers and then declaring a disaster, (self servingly) crying they didn't have enough power. Horsefeathers, they will *never* "have enough power".--TheNautilus 23:09, 13 November 2006 (UTC)

Why don't we say something along the lines of "pharmaceuticals must be proven safe and effective to the satisfaction of the FDA before they can be marketed." That way, readers can draw their own conclusions, based on their level of distrust of the FDA, but the statement is still accurate. The fact that vitamins/supplements are unregulated has a number of implications for their relationship to mainstream medicine - perhaps the most direct is that it's really hard to do a well-conducted, meaningful trial (witness all the flack Miller and others have gotten) when formulations are anything but standardized and may vary from lot to lot or manufacturer to manufacturer. I realize ephedra's not OM, but that (and other cases like the PC-SPES debacle [PMID 12208892]) point up the danger of unregulated supplements in the hands of an unscrupulous manufacturer/marketer, and may make mainstream docs a little wary of recommending them - hence relevant to the "relationship to mainstream medicine" section. MastCell 01:08, 14 November 2006 (UTC)

[edit] Broken link

I commented out the sentence about Robert Cathcart and how he's "not allowed" to test his theories. (the text is still there, but I enclosed it in comment tags so it doesn't show in the article). The main issue is that the citation appears to be broken. The other thing is that it's not clear what it means to say testing has not been "allowed". No one prevents Cathcart, or anyone else, from testing their theories. Perhaps the source had some information on this, but it appears to be a broken link. MastCell 17:25, 16 November 2006 (UTC)

Testing not allowed occurs at several levels. Reasonable research or clinical trials of IV vitamin C have been unsupported since Jungeblut in the late 1930s (derailed, perhaps sabotaged, by Sabin), Klenner, ca late 1940s-70s, his articles commented repeatedly about lack of interest in IV "C" studies (as close to a slap in the authoritative faces or throwing the glove down as you'll see keeping license. ignored); Pauling came and went 70s-90s (applicants with less than 3 Nobels need not apply - laughed at, he was finally attacked); conventional medical trials have had a terrible record achieving amounts more than 1000 mg/d even though FR Klenner, Riordan, T Levy have mapped out IV administration that many college grads should be able to follow to 100+grams C/day and even 1000 mg/d IV "C" has been demonstrated to be important. Cathcart publicly broadcast about SARS & West Nile, with no response for something that is pretty much all upside if one suspects that multiple mature physicians with multiple credentials across multiple decades and languages aren't all delusional.

SARS patients (rare - how many in the US?) and access to patients can be pretty difficult, remember I previously mentioned "exile".--TheNautilus 21:31, 16 November 2006 (UTC)

OK... so if you'd like to say that OM proponents allege that there's a conspiracy to sabotage their research, that would be fine (provided it is sourced). This is Wikipedia, after all. MastCell 22:26, 16 November 2006 (UTC)

No, I am not for replaying Jungeblut & Sabin in the article, I mention it FYI so if *you* want to look up the available Jungblut & Sabin papers(ca 1935, 1937, 1939) you could consider your own opinion. (Andrew Saul will not be your favorite author but for possible convenience, I've linked it here. ) The fact is that promising IVC results have never been adequately *or equivalently* followed up, by a long shot, when made by nominally qualified physicians with outstanding claims. 1935-1937, in relation to FRK's later clinical data, Jungeblut is on the threshold of a pronounced measurable effect on polio, Sabin comes in with 1/4 dose IVC and a more severe innoculation method, announces *his* failure as C's failure; Klenner at even higher doses (in terms of mg/kg & over 30 gm/day IVC preferred) and starkly claimed successes never gets tested in almost 60 yrs. Pauling's 10 grams/d IVC, lowish (vs 30-100+g/day Klennerian regimes), gets conveniently overlooked for 20-30 yrs (the Moertel fiasco oral only "oversight" was finally wimpishly acknowledged at NIH by someone), when to an outsider, IVC's absence is one of the first discrepancies likely to be noticed. And that BCCA reference as the primary ref as a source for doctors' opinions reflects poorly on the profession as well as fatally misrepresenting a number of items. Adjudging conspiracy vs bias vs slop - I am not going there in the article. Failure to perform similar tests (ie. oral vs IV, X grams vs XX grams, wrong molecule, or absent cofactor *for decades*) and funky (mis)representations are historical facts and should be mentioned/described as these items *greatly* affect the ground (mis)assumptions & thinking of most people, including physicians, about OM topics.--TheNautilus 00:21, 17 November 2006 (UTC)

My reply yesterday, above, was hot under the coller because I only read the OM article's dif on an old screen and read it as *commenting out* the entire second paragraph that you had formed instead of just the one sentence that you commented out. So my apologies in this hot zone where small communications errors could cause wider misunderstandings.--TheNautilus 19:15, 17 November 2006 (UTC)

No worries... thanks for the note. MastCell 21:38, 17 November 2006 (UTC)

[edit] "Complementary and alternative medicine"

Hello, TheNautilus. Could you explain why you feel that describing OM as part of "complementary and alternative medicine" is unacceptable? Most of the article is taken up with explaining the ways in which OM differs from/rejects conventional medicine, so it seems logical to state upfront that it's a complementary/alternative field. These terms are not pejorative, to the best of my knowledge; they are descriptive. MastCell 00:44, 30 November 2006 (UTC)

Orthomed's *relation* to CAM should identified and summarized, but the CAM article is not a good, literally, first line reference for several reasons. 1. Orthomed claims both mainstream and alt med aspects as Steve Harris earlier explored at length in orthomed Talk: Orthomolecular medicine is not the same as alternative medicine; Definitions; Can a study or treatment be "orthomolecular" without anyone admitting it; Overlap between nutritional science and OM. 2. CAM as defined & described in the "Alternative medicine" article is not even well agreed, and introduces complexity, confusion, & distraction too soon, 3. CAM as a subject is quite *broad* including many things unrelated to OM or science and risks more confusion where people are already quite confused about OM to begin with(see Talk:OM 2005-2006), 4. the CAM article introduces negatives that apply to other areas, again confusion or guilt by association. 5. the "Alternative medicine" article is still POVish by title, discussion and overconsolidated structure.

I have attempted to edit the Introduction to appropriately work in the CAM point & link in a reasonable and informative way.--TheNautilus 18:53, 30 November 2006 (UTC)

But OM is clearly used primarily as an alternative to, or complement to, mainstream medical treatments. Look at the laundry list of diseases that OM is supposed to treat/cure - no mainstream medical practitioner would treat those diseases with OM as a primary method (although nutrition in general - but not megavitamin therapy - is an important complementary method in the treatment of many diseases). A belief that SARS can be cured with megadoses of Vitamin C is "alternative". Again, I don't think it's a smear to say that OM is complementary/alternative (if anything, the pejoratives in this article are the references to "conventional" doctors) - it's an accurate, neutral description of the field's position with respect to mainstream medicine. Of course, OM is a subset of CAM; CAM includes many things that don't pertain directly to OM. And the state of the alt-med article isn't a reason not to link to it; in fact, it might be worth your efforts to improve its deficiencies. MastCell 20:55, 30 November 2006 (UTC)

I think focusing on definitional items in the first paragraph is correct, nutrition is definitional to OM, CAM is not. Clearly much of OM is not considered mainstream medical therapeutics (yet or again) but still do have a scientific or clinical basis, even if not FDA blessed. "Alternative medicine" carries the stigmata of other less science or measurement based subjects and the reader absolutely has their hands full trying to build up to grasp the nature of orthomed even in close focus w/o secondary & extraneous comments (witness that the article struggles to credibly communicate the OM points to MD/PhD/Ivies who are considered superior readers). At the risk of already being redundant, the next two introductory paragraphs each link the altmed article in slightly different contexts. This is more than adequately informative (or warning) for an uninformed reader, presented in an orderly fashion.

Edit Altmed? Thanks for the invitation but my interest in much of alt med is not that high, the CAM/altmed article(s) has made less progress with many times the effort (archive length), the OM article already stretches my ability to add or detract where I have a much stronger grasp of the issues.--TheNautilus 00:19, 1 December 2006 (UTC)

Some forms of CAM do have a scientific basis... I don't think it automatically implies that something's totally unfounded. I think the "struggle" in convincing allopaths has less to do with the prose/organization of the article and more to do with differing opinions about validity of medical evidence, etc. That said, I don't feel strongly enough to make a federal case out of it. You're right that CAM is linked in the second paragraph; that will be fine. MastCell 01:25, 1 December 2006 (UTC)