Orthomolecular Medicine

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The Orthomolecular medicine or Orthomolecular Medicine ( Alt Gr. Ὀρθός ORTHOS right 'and molecularly ) is a decisive of Linus Pauling influenced alternative medical method. The focus is on the - sometimes high-dose - use of vitamins , minerals and trace elements to prevent and treat diseases. There is no proof of the effectiveness of this method.

From the perspective of orthomolecular medicine, a biochemical imbalance in the body leads to diseases. This imbalance can be balanced by adding dietary supplements. Minerals, trace elements, vitamins, essential fatty acids and amino acids as well as other " vital substances " are seen as more tolerable, risk-free and beneficial for the body than foreign substances such as plant extracts, medicinal herbs or synthetic drugs .

Conception

Linus Pauling, winner of the Nobel Prize for Chemistry and Peace , who first used the expression “orthomolecular” in 1968 in an essay on orthomolecular psychiatry, is considered to be the pioneer . In 1974 Pauling and his colleague Arthur B. Robinson stated: “We believe that a significant improvement in health and a reduction in age-specific morbidity and mortality in various diseases can be achieved by varying the concentrations of the molecules normally present in the body, of which many are vital. That field is called 'orthomolecular medicine'. "The Brockhaus Encyclopedia defined orthomolecular medicine in its 2002 edition as" maintaining good health and treating disease by changing the levels of substances in the human body that are normally present in the body and are necessary for health. "

The starting point of the orthomolecular theory is the controversially discussed thesis that nowadays it is hardly possible to adequately supply oneself with so-called vital substances through a balanced diet, because the food is only a fraction of what was originally available due to unnatural breeding, transport, storage and preparation Contained substances. This leads to chronic deficiency in the majority of the population. It is therefore necessary to supply these vital substances via dietary supplements.

Most vital substances in orthomolecular medicine are dosed considerably higher than recommended by the World Health Organization . According to proponents of orthomolecular nutrition, there have been successes in the treatment of numerous cancers and neurodermatitis, among other things .

Term megavitamin therapy

Megavitamin therapy is the use of vitamins in doses that are many times (often 100 to 1000 times) higher than the physiological requirement that forms the basis for the recommended daily dose .

The term originally comes from orthomolecular psychiatry, where such megadoses of B vitamins are propagated for the treatment of, for example, schizophrenia , depression , neuroses , autism and hyperkinesis . The use of megadoses was later extended to non-psychiatric clinical pictures and other vital substances.

criticism

Scientific and medical proof that such increased amounts of vital substances actually have a benefit has not been provided. For example, a systematic review by Jacobs and co-workers from 2015 examined the role of orally or intravenously administered vitamin C in the treatment of cancer patients. The authors concluded that there was no high-quality evidence of an increase in the anti-tumor effect of chemotherapy or a reduction in its toxicity. A meta-review of existing studies from 2019 also sees no clinically relevant effects of vitamin C supplementation in cancer. A high dose of vitamin C can neither protect against colds nor does it help to improve a cold that has already occurred.

The scientific and medical criticism focuses in particular on three arguments:

  • The alleged insufficient supply of the population does not correspond to the results of recognized scientific studies in nutritional science. For example, a study by the American Medical Association came to the conclusion that the assumption of widespread vitamin and mineral deficiencies in the population is incorrect, that the assumption that many diseases are due to an unhealthy diet is wrong and that the assumption that many diseases are caused by Supplementation could be cured, is wrong.
  • The effectiveness of the concept of orthomolecular medicine could not be proven with scientific and medical studies. One of the largest studies with over 12,000 patients could not find any effect of vitamin B12 on the onset of diseases in the cardiovascular system within 6 years . Vitamin B12 also had no effect on cancer. For the majority of the substances used, there are no recognized double-blind studies that document the benefits, side effects and dangers and make it possible to determine the actual need for each individual substance.
  • Overdosing the vital substances used, on the other hand, can even lead to damage to health. A number of studies have shown that long-term high-dose administration of vitamins , as practiced in orthomolecular medicine, can lead to serious health problems and shorten the average life expectancy.
    • Fat-soluble vitamins such as vitamin A , vitamin D, and vitamin K can build up in the body and are therefore potentially harmful. Water-soluble vitamins that are not required by the body are excreted through the kidneys, but they can also be overdosed, as the food chemist Udo Pollmer has shown on the basis of scientific studies. Vitamin E does not accumulate in adipose tissue, but three meta-analyzes found increased mortality for doses above 400 IU, even if other scientists contradicted the results.
    • With high doses of vitamin C (from one gram daily), diarrhea and sometimes colic occur . “Vitamin C changes a number of hormone levels in the blood, including those of estrogen , thyroid hormones and insulin . It destroys vitamin B12 (...). It increases the absorption of aluminum, which can damage the bones and the brain, it promotes the formation of kidney stones , osteoporosis (...) ”. In addition, vitamin C can transform the mineral iron into a radical generator and thereby favor cardiomyopathies . Pauling's claim that high doses of vitamin C protect against colds have not yet been confirmed by any scientific study. A review by the Cochrane Collaboration from 2013 found no influence of vitamin C supplementation of 200 mg or more daily on the common cold in the population average. The authors assess that vitamin C supplementation is not justified with this prevention goal, but at the same time see little justification for short-term, intense physical exertion (e.g. in polar researchers or marathon runners). According to Udo Pollmer , the vitamin C concentration in the blood plasma ( plasma level ) does not correlate with the vitamin intake. Studies have shown that there are great individual differences. "Some people have plasma levels of 75 micromoles per liter with a minimal intake of 5 milligrams a day, while others need 400 milligrams of ascorbic acid for this."
    • Orthomolecular medicine advocates recommend vitamin B6 and zinc to treat alleged "cryptopyrroluria" or " hemopyrrolactamuria ", syndromes for which there is no scientific evidence and whose existence has never been proven. In high doses, vitamin B6 can lead to sensory neuropathies up to and including symptoms of paralysis in the hands and feet. Overdosed niacin can cause allergy-like reactions with reddening of the skin, itching and the formation of wheals. In the case of long-term overdose, jaundice and liver damage can result.
    • Overdoses of vitamin B1 can lead to headaches and insomnia, and in extreme cases to pulmonary edema , bradycardia and gastrointestinal bleeding.

To the Skeptic's Dictionary , orthomolecular medicine is not a branch of medicine. Rather, it is "a set of beliefs about the role of diet and dietary supplements in human health and disease". These beliefs are generally not accepted by the majority of medical scientists.

The sometimes considerable costs of a treatment, which primarily promotes the business with dietary supplements and is supported by the manufacturers of supplement products, are also criticized .

Legal

In Germany, only a few vitamin preparations are approved as medicinal products . The others are sold as dietary supplements , for which the advertising must not contain any evidence of a supposed medicinal effect and high, possibly toxic, doses are not permitted. Food supplements are not subject to the Medicines Act , but rather the Food, Consumer Goods and Feed Code .

Many patients buy preparations from mail order companies that can be reached over the Internet . The statutory health insurance companies do not bear the costs.

literature

  • Hans Dietl, Gerhard Ohlenschläger: Handbook of orthomolecular medicine. Haug, Heidelberg 1994, ISBN 3-776-01405-9 .
  • Hans Konrad Biesalski (ed.): Nutritional medicine. Thieme, Stuttgart 1995, ISBN 3-131-00292-1 .
  • Uwe Gröber: Orthomolecular Medicine. A guide for pharmacists and doctors. 2nd Edition. Wissenschaftliche Verlagsgesellschaft, Stuttgart 2002, ISBN 3-8047-1927-9 .

Web links

Individual evidence

  1. ↑ a b Irmgard Niestroj: Practice of Orthomolecular Medicine. 2nd Edition. Hippokrates, Stuttgart 2001, ISBN 3-7773-1470-6 .
  2. ^ Orthomolecular Medicine. In: American Cancer Society . November 28, 2008. Retrieved June 19, 2010 (English).
  3. ↑ a b c Goran Bjelakovic et al .: Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis. In: JAMA. 297, No. 9, 2007, pp. 842-857.
  4. ↑ Marion Kaden: Myth Antioxidants. In: World of Medicinal Plants. August 2009.
  5. ↑ Linus Pauling: Orthomolecular Psychiatry In: Science , April 19, 1968: Vol. 160, Issue 3825, pp. 265-271. doi : 10.1126 / science.160.3825.265 .
  6. ^ Arthur B. Robinson, Linus Pauling: Techniques of Orthomolecular Diagnosis In: Clinical Chemistry , August 1, 1974; 20 (8), pp. 961-965. PMID 4854609 . Full text (PDF) .
  7. ↑ orthomolecular medicine In: Brockhaus Enzyklopädie digital , Bibliographisches Institut & FA Brockhaus AG, 2002.
  8. ↑ Klaus Pietrzik, Ines Golly, Dieter Loew: Handbook of Vitamins. For prophylaxis, therapy and advice. Elsevier, Munich 2008, ISBN 3437553615 (chapter megavitamine therapy ), p. 409.
  9. ↑ Stephen Barrett: Orthomolecular Therapy. In: Quackwatch. June 12, 2000 (English).
  10. ↑ Carmel Jacobs et al .: Is there a role for oral or intravenous ascorbate (vitamin C) in treating patients with cancer? A systematic review . In: The Oncologist . tape 20 , no. 2 , February 2015, p. 210-223 , doi : 10.1634 / theoncologist.2014-0381 , PMID 25601965 , PMC 4319640 (free full text).
  11. ^ Gwendolyn NY van Gorkom et al .: The Effect of Vitamin C (Ascorbic Acid) in the Treatment of Patients with Cancer: A Systematic Review . In: Nutrients . tape 11 , no. 5 , April 28, 2019, doi : 10.3390 / nu11050977 , PMID 31035414 , PMC 6566697 (free full text).
  12. ↑ Does vitamin C help against colds? German Nutrition Society , December 22, 2015, accessed on January 20, 2020 .
  13. ↑ Bernd Kerschner: Vitamin C is useless for colds. In: Medicine transparent . September 15, 2017, accessed on January 20, 2020 (Austrian German).
  14. ^ Report 12 of the Council on Scientific Affairs: Alternative medicine. ( Memento of November 5, 2013 in the Internet Archive ) (PDF; 194 kB) In: American Medical Association. June 1997, accessed March 21, 2008.
  15. ↑ Jane M. Armitage et al .: Effects of homocysteine-lowering with folic acid plus vitamin B12 vs placebo on mortality and major morbidity in myocardial infarction survivors: a randomized trial . In: JAMA . tape 303 , no. 24 , 2010, p. 2486-2494 , doi : 10.1001 / jama.2010.840 .
  16. ↑ Prevention with antioxidants: damage predominates. In: Medicinal Telegram . 39 2008, pp. 123-124.
  17. ^ Edgar R. Miller et al .: Meta-Analysis: High-Dosage Vitamin E Supplementation May Increase All-Cause Mortality. In: Annals of Internal Medicine . 142, No. 1, 2004.
  18. ↑ Yedidia Dotan, Dov Lichtenberg, Ilya Pinchuk: No evidence supports vitamin E indiscriminate supplementation . In: BioFactors . tape 35 , no. 6 , 2009, p. 469-473 , doi : 10.1002 / biof.61 .
  19. ↑ Harri Hemilä: High-Dosage Vitamin E Supplementation and All-Cause Mortality. In: Annals of Internal Medicine. 143, No. 2, 2005, pp. 156-158 (commentary on the article by Miller et al.).
  20. ↑ Stacey J. Bell, Gregory T. Grochoski: How safe is vitamin E supplementation? In: Critical Reviews in Food Science and Nutrition. 48, No. 8, 2008, pp. 760-774, doi : 10.1080 / 10408390701719355 .
  21. ↑ a b Udo Pollmer, Susanne Warmuth: Lexicon of popular nutritional errors. Piper, Munich 2002, ISBN 3-492-23410-0 , p. 302.
  22. ↑ a b c Udo Pollmer, Susanne Warmuth: Lexicon of popular nutritional errors. Piper, Munich 2002, p. 303.
  23. ↑ Udo Pollmer, Susanne Warmuth: Lexicon of popular nutritional errors. Piper, Munich 2002, p. 313.
  24. ↑ Harri Hemilä, Elizabeth Chalker: Vitamin C for preventing and treating the common cold. In: The Cochrane Database of Systematic Reviews. , January 31, 2013. PMID 23440782 . doi : 10.1002 / 14651858.CD000980.pub4 .
  25. ↑ Udo Pollmer, Susanne Warmuth: Lexicon of popular nutritional errors. Piper, Munich 2002, p. 311.
  26. ↑ CRYPTOPYRROLURIA - WHAT TO THINK OF IT? Arznei-Telegram , October 12, 2012, accessed on January 20, 2020 .
  27. ↑ Udo Pollmer, Susanne Warmuth: Lexicon of popular nutritional errors. Piper, Munich 2002, p. 309.
  28. ↑ orthomolecular medicine or therapy In: Skeptic's Dictionary , December 8, 2015.
  29. ↑ Orthomolecular medicine: high costs for patients. Der Standard , July 27, 2012, accessed on January 20, 2020 (Austrian German).
  30. ↑ Criticism: Doctors make money from vitamin pills. Austria 1 , April 8, 2017, accessed January 20, 2020 .
  31. ↑ Healthier, fitter, live longer - really? Tagesspiegel , April 27, 2019, accessed on January 20, 2020 .
  32. ↑ Dietary Supplements: Big Promises, K (l) an Effect? , Cancer Information Service of the German Cancer Research Center (DKFZ), Heidelberg. September 3, 2008. Retrieved September 4, 2014.
  33. ↑ Federal Institute for Risk Assessment: Dietary Supplements. Retrieved February 25, 2010.