The Philosophy
Orthomolecular medicine -- This field of medicine encompasses several different medical practices, including diet therapy. Orthomolecular diet therapy is based on the idea that the use of naturally occurring substances (such as vitamins, amino acids, trace elements, electrolytes, and fatty acids) can prevent and treat disease. See Linus Pauling below.
Nutraceutical Prescription -- A nutraceutical generally, is any nutritional, herbal or dietary supplement that would be used as by a practitioner of orthomolecular medicine. Nutraceutical can refer to custom designed combinations of nutrients intended for a specific purpose, i.e. anti-oxidant combination formulas, “brain” food formulas, reduced calorie meal replacements.
The Art
A practitioner of orthomolecular medicine will take a detailed history of the patient/clients health and perform a physical examination. Acute conditions requiring medical attention will be considered with their appropriate treatment or referrals will be made if indicated. In the absence of acute medical conditions the patient’s presenting symptoms will be evaluated based on the likelihood of nutrition deficiencies or imbalances. Additional testing such as blood studies or dietary diaries may be done to further identify opportunities for improvement.
Nutritional supplementation and/or dietary changes will be recommended if indicated and a trial period, typically two-six weeks, will be allowed to see if any changes in the patient’s conditions can be seen. The patient is then re-evaluated based on the response and modification will be made to the plan if indicated at follow up.
The Science
Research on dietary supplements spans the spectrum of basic to clinical research. However, the basic and preclinical research is better delineated for supplements composed of single chemical constituents (e.g., vitamins and minerals) than for the more complex products (e.g., botanical extracts). There is an abundance of clinical research for all types of dietary supplements. Most of this research involves small phase II studies.
The literature on functional foods is vast and growing; it includes clinical trials, animal studies, experimental in vitro laboratory studies, and epidemiological studies. Much of the current evidence for functional foods is preliminary or not based on well-designed trials. However, the foundational evidence gained through other types of investigations is significant for some functional foods and their "health-promoting" constituents. The strongest evidence for effectiveness is that developed in accordance with the NLEA guidelines for pre-approved health claims (e.g., oat bran or psyllium).
Over the past few decades, thousands of studies of various dietary supplements have been performed. To date, however, no single supplement has been proven effective in a compelling way. Nevertheless, there are several supplements for which early studies yielded positive, or at least encouraging, data. Good sources of information on some of them can be found at the www.naturalstandards.com, Natural Medicines Comprehensive Database and the National Institutes of Health (NIH) Web sites. The NIH Office of Dietary Supplements (ODS) annually publishes a bibliography of resources on significant advances in dietary supplement research. Finally, the ClinicalTrials.gov database lists all NIH-supported clinical studies of dietary supplements that are actively accruing patients.
The Natural Medicines Comprehensive Database is accessible at www.naturaldatabase.com. Related NIH Web sites include nccam.nih.gov/health, ods.od.nih.gov, and www3.cancer.gov/occam/information.html. The ODS annual bibliographies can be found at http://ods.od.nih.gov/Research/Annual_Bibliographies.aspx. ClinicalTrials.gov can be accessed at www.clinicaltrials.gov. Natural Standards can be accessed through intelihealth.com or naturalstandards.com .
Nobel Laureate, Linus Carl Pauling, 1901-1994, creates term Orthomolecular Medicine
He was a high school dropout, a maverick who jumped disciplinary fences, and an activist who was attacked for his political beliefs. Yet he won two Nobel prizes and published more than 500 papers and 11 books. He remains the only person in history to win two unshared Nobel Prizes.
His work focused on the antigen-antibody reaction, the structure of proteins, the molecular basis of sickle-cell anemia, the large-scale structures of many proteins, such as hemoglobin, a model for the structure of DNA. In 1954, Pauling's many achievements were crowned with the awarding of the Nobel Prize in Chemistry. (In 1963, Pauling was awarded the Nobel Peace Prize.)
Between 1973 and 1994, Pauling's research focused on a field he termed "orthomolecular medicine," the concept that optimal health could result from ensuring the right molecules were present in the right amount in the body. He viewed Vitamin C as one of the most important of these molecules, oversaw a number of investigations into its effects on diseases, and encouraged the ingestion of daily amounts many times greater than the accepted minimum daily requirement. He conducted research in this field until his death from cancer in 1994, at age 93
The Practitioner
Glen Aukerman, M.D. ABHM, ABFP, FACPM
