Megavitamin therapy

Megavitamin therapy is the use of large doses of vitamins, often many times greater than the recommended dietary allowance (RDA) in the attempt to prevent or treat diseases. It is typically used in complementary and alternative medicine by practitioners who call their approach "orthomolecular medicine", but also used in mainstream medicine for "exceedingly rare" genetic conditions that respond to megadoses of vitamins.[1] In 2002, a review of these conditions identified about 50 that respond to "high-dose vitamin therapy".[2] Further understanding of these conditions is expected to play a part in the emerging field of nutrigenomics.[3]

Nutrients may be useful in preventing and treating some illnesses,[4] but the conclusions of medical research are that the broad claims of disease treatment by advocates of megavitamin therapy are unsubstantiated by the available evidence.[4][5][6] Critics have described some aspects of orthomolecular medicine as food faddism or even quackery.[7][8][9] Research on nutrient supplementation in general suggests that some nutritional supplements might be beneficial, and that others might be harmful;[10][11][12] several specific nutritional therapies are associated with an increased likelihood of the condition they are meant to prevent.[13]

Contents

Multivitamin vs megavitamin

Megavitamin therapy must be distinguished from the usual 'vitamin supplementation' approach of traditional multivitamin pills. Megavitamin doses are far higher than the levels of vitamins ordinarily available through western diets. Multivitamin supplementation has been demonstrated to have negligible effect in treating cancer. A study of 161,000 individuals (post-menopausal women) provided, in the words of the authors, "convincing evidence that multivitamin use has little or no influence on the risk of common cancers, cardiovascular disease, or total mortality in postmenopausal women".[14]

History

In the 1930s and 1940s, some scientific and clinical evidence suggested that there might be beneficial uses of vitamins C, E, and B3 in large doses. Beginning in the 1930s, the Shutes in Canada developed a megadose vitamin E therapy for cardiovascular and circulatory complaints, naming it the "Shute protocol".[15] Tentative experiments in the 1930s[16] with larger doses of vitamin C were superseded by Fred R. Klenner's development of megadose intravenous vitamin C treatments in the 1940s.[17] William Kaufman published articles in the 1940s that detailed his treatment of arthritis with frequent, high doses of niacinamide.[18]

In 1954, R. Altschul and Abram Hoffer applied large doses of the immediate release form of niacin (Vitamin B3) to treat hypercholesterolemia.[19] In a 1956 publication entitled Biochemical Individuality, Roger J. Williams introduced concepts for individualized megavitamins and nutrients.[20] Megavitamin therapies were also publicly advocated by Linus Pauling in the late 1960s.[21] In 1956, experimental results suggested niacin could be useful in the treatment of high cholesterol, results that were confirmed in 1986.[22]

Usage of therapy

An American cottage industry in the late 20th century, evolving megavitamin therapies are integrated with orthomolecular and naturopathic medicine. Although megavitamin therapies still largely remain outside of the structure of evidence-based medicine, they are increasingly used by patients, with or without the approval of their treating physicians.[23]

In 2008, researchers established that higher vitamin C intake reduces serum uric acid levels and may be useful in the prevention of gout.[24]

The proposed efficacy of various megavitamin therapies has been contradicted by results of one clinical trial.[25] A review of clinical trials in the treatment of colds with small and large doses of Vitamin C has established that there is no evidence for its efficacy.[26] After 33 years of research, it is still not established whether vitamin C can be used as a treatment for cancer.[27]

High doses of vitamin A[28] and D[28] are known to be toxic, whereas others have no recommended maximum dosage or tolerable upper intake level.

See also

References

  1. ^ Menolascino FJ, Donaldson JY, Gallagher TF, Golden CJ, Wilson JE (1988). "Orthomolecular therapy: its history and applicability to psychiatric disorders". Child Psychiatry Hum Dev 18 (3): 133–50. doi:10.1007/BF00709727. PMID 2898324. 
  2. ^ Ames BN, Elson-Schwab I, Silver EA (April 2002). "High-dose vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity (increased K(m)): relevance to genetic disease and polymorphisms". Am. J. Clin. Nutr. 75 (4): 616–58. PMID 11916749. http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=11916749. 
  3. ^ Kaput J, Rodriguez RL (January 2004). "Nutritional genomics: the next frontier in the postgenomic era". Physiol. Genomics 16 (2): 166–77. doi:10.1152/physiolgenomics.00107.2003. PMID 14726599. 
  4. ^ a b "ACS : Orthomolecular Medicine". American Cancer Society. 2007-06-19. http://www.cancer.org/docroot/ETO/content/ETO_5_3X_Orthomolecular_Medicine.asp?sitearea=ETO. Retrieved 2008-04-04. 
  5. ^ Aaronson S et al. (2003). "Cancer medicine". Cancer medicine 6 (Frei, Emil; Kufe, Donald W.; Holland, James F., eds). Hamilton, Ont: BC Decker. pp. 76. ISBN 1-55009-213-8. 
  6. ^ Nutrition Committee, Canadian Paediatric Society (1 January 1990). "Megavitamin and megamineral therapy in childhood. Nutrition Committee, Canadian Paediatric Society". CMAJ 143 (10): 1009–1013. PMC 1452516. PMID 1699646. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1452516. 
  7. ^ Jarvis WT (1983). "Food faddism, cultism, and quackery". Annu. Rev. Nutr. 3: 35–52. doi:10.1146/annurev.nu.03.070183.000343. PMID 6315036. 
  8. ^ Jukes, T.H. (1990). "Nutrition Science from Vitamins to Molecular Biology". Annual Review of Nutrition 10 (1): 1–20. doi:10.1146/annurev.nu.10.070190.000245. PMID 2200458.  A short summary is in the journal's preface.
  9. ^ Braganza, S.F.; Ozuah, P.O. (2005). "Fad Therapies". Pediatrics in Review 26 (10): 371–376. doi:10.1542/pir.26-10-371. PMID 16199591. 
  10. ^ "NIH State-of-the-Science Conference Statement on Multivitamin/Mineral Supplements and Chronic Disease Prevention". NIH Consens State Sci Statements 23 (2): 1–30. 2006. PMID 17332802. http://consensus.nih.gov/2006/2006MultivitaminMineralSOS028main.htm. 
  11. ^ Huang HY, Caballero B, Chang S, et al. (September 2006). "The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults: a systematic review for a National Institutes of Health state-of-the-science conference". Ann. Intern. Med. 145 (5): 372–85. doi:10.1001/archinte.145.2.372. PMID 16880453. http://www.annals.org/cgi/pmidlookup?view=reprint&pmid=16880453. 
  12. ^ Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C (2008). Bjelakovic, Goran. ed. "Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases". Cochrane Database of Systematic Reviews (2): CD007176. doi:10.1002/14651858.CD007176. PMID 18425980. 
  13. ^ Satia JA, Littman A, Slatore CG, Galanko JA, White E (2009). "Long-term Use of {beta}-Carotene, Retinol, Lycopene, and Lutein Supplements and Lung Cancer Risk: Results From the VITamins And Lifestyle (VITAL) Study". American Journal of Epidemiology 169 (7): 815–28. doi:10.1093/aje/kwn409. PMC 2842198. PMID 19208726. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2842198. 
  14. ^ Neuhouser ML, Wassertheil-Smoller S, Thomson C, et al. (February 2009). "Multivitamin use and risk of cancer and cardiovascular disease in the Women's Health Initiative cohorts". Arch. Intern. Med. 169 (3): 294–304. doi:10.1001/archinternmed.2008.540. PMID 19204221. 
  15. ^ VOGELSANG A, SHUTE E, SHUTE W (February 1948). "Some medical uses of vitamin E". Med World (New York) 161 (2): 83–9. PMID 18911314. 
  16. ^ Jungeblut, CW (1937). "VITAMIN C THERAPY AND PROPHYLAXIS IN EXPERIMENTAL POLIOMYELITIS". The Journal of Experimental Medicine 65 (1): 127–146. doi:10.1084/jem.65.1.127. PMC 2133474. PMID 19870585. http://jem.rupress.org/cgi/content/abstract/65/1/127. 
  17. ^ KLENNER FR (July 1949). "The treatment of poliomyelitis and other virus diseases with vitamin C". South Med Surg 111 (7): 209–14. PMID 18147027. 
  18. ^ KAUFMAN W (July 1953). "Niacinamide therapy for joint mobility; therapeutic reversal of a common clinical manifestation of the normal aging process". Conn State Med J 17 (7): 584–9. PMID 13060032. 
  19. ^ ALTSCHUL R, HOFFER A (April 1960). "The Effect of Nicotinic Acid on Hypercholesterolæmia". Can Med Assoc J 82 (15): 783–5. PMC 1938010. PMID 13792994. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1938010. 
  20. ^ Williams, Roger Lawrence (1998). Biochemical Individuality. New York: McGraw-Hill. ISBN 0-87983-893-0. 
  21. ^ Stone, Irwin (1982). The healing factor: "vitamin C" against disease. New York: Perigee Books. ISBN 0-399-50764-7. 
  22. ^ Sanford M, Curran MP (2008). "Niacin extended-release/simvastatin". Drugs 68 (16): 2373–86. doi:10.2165/0003495-200868160-00008. PMID 18973399. 
  23. ^ Richardson MA, Sanders T, Palmer JL, Greisinger A, Singletary SE (July 2000). "Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology". J. Clin. Oncol. 18 (13): 2505–14. PMID 10893280. http://jco.ascopubs.org/cgi/content/full/18/13/2505. 
  24. ^ Choi, MD, DrPH, Hyon K.; Xiang Gao, MD, PhD; Gary Curhan, MD, ScD (March 9, 2009). "Vitamin C Intake and the Risk of Gout in Men – A Prospective Study". Archives of Internal Medicine. 169 (5): 502–507. doi:10.1001/archinternmed.2008.606. PMC 2767211. PMID 19273781. http://archinte.ama-assn.org/cgi/content/abstract/169/5/502. 
  25. ^ Lin J, Cook NR, Albert C, et al. (January 2009). "Vitamins C and E and Beta Carotene Supplementation and Cancer Risk: A Randomized Controlled Trial". J. Natl. Cancer Inst. 101 (1): 14–23. doi:10.1093/jnci/djn438. PMC 2615459. PMID 19116389. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2615459. 
  26. ^ Douglas RM, Hemilä H, Chalker E, Treacy B (2007). Hemilä, Harri. ed. "Vitamin C for preventing and treating the common cold". Cochrane Database Syst Rev (3): CD000980. doi:10.1002/14651858.CD000980.pub3. PMID 17636648. 
  27. ^ Cabanillas, F (2010). "Vitamin C and cancer: what can we conclude--1,609 patients and 33 years later?". Puerto Rico health sciences journal 29 (3): 215–7. PMID 20799507.  edit
  28. ^ a b Snodgrass SR (1992). "Vitamin neurotoxicity". Mol. Neurobiol. 6 (1): 41–73. doi:10.1007/BF02935566. PMID 1463588. 

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