Talk:Orthomolecular medicine/Archive 1

message: My preliminary review of Orthomolecular medicine is totally unfavorable.
The primary problem seems to be that this article is nothing but a stub article hiding behind a lot of verbiage.  Major portions of the Orthomolecular medicine viewpoint are simply not documented in this article.  I got absolutely nothing out of this article other than a bunch of commonly held generalities..  
The article states: The substances may be administered by diet, dietary supplementation or intravenously,  for example.  What is that supposed to mean?  I have no idea.  As far as I know, diet has absolutely nothing to do with Orthomolecular medicine.  Intravenous treatments would seem to require professionalized care, while dietary supplementation says self-care.
This article totally fails SQG#3.  The proponent's viewpoint is largely missing.  No wonder that opponents have yet to attack this article.  There is nothing to prove or attack as it is presently written. -- John Gohde 23:35, 22 May 2004 (UTC)
thread_title:  Preliminary review of Orthomolecular medicine 

message: This article was  recently subjected to a compliance audit by the Wikiproject on Alternative Medicine. We have a master list of  20 Key Questions that are designed to measure the compliance of CAM articles to our Standards of Quality Guidelines. 
Overall, this article created a negative impression. The primary problem seems to be that this article is nothing but a stub article hiding behind a lot of verbiage. Major portions of the Orthomolecular medicine viewpoint are simply not documented in this article. I got absolutely nothing out of this article other than a bunch of commonly held generalities.
Orthomolecular medicine was the first article to be audited.  It was also the first to pass our audit. The answers to 4 questions indicated non-compliance to our standards of quality quidelines.  This resulted in a passing grade of 80%. 
#No footnote to support the health claim that RDA is inadequate. 
#No explanation of therapeutic effects. 
#No listing of effective medical conditions treated. 
#Did not recommend complementary treatment.
The Physical mode of action was determined to come from proper nutrition. -- John Gohde 05:45, 1 Jun 2004 (UTC)
thread_title:  Compliance Audit of 6/01/04 

message: In the section Relation to conventional medicine there's a phrase I find implies that diet isn't enough, but without citing any references etc:
:However most conventional doctors have little knowledge of the concepts of orthomolecular medicine and tell patients that a balanced diet will provide all the nutrition a person needs to be healthy.
It seems to me it wouldn't hurt with either some rephrasing, or an expansion as to why diet alone isn't sufficient (and perhaps also why OM non-followers find diet is enough).
:The problem here is that a basic tenet of Orthomolecular medicine is that a balanced diet does not provide enough vitamins. I would agree that the sentace is pov. It really neeeds to split into two parts one saying that many doctors have limited knowlage of orthomolecular medicine and another saying that the conventional medical view is that a blanaced diet is sufficientGeni 12:03, 15 Nov 2004 (UTC)
replies: text: Proponents point to an almost zero level of deaths caused by overdosing of vitamins compared to the significant numbers from pharmaceuticals.
What is "almost zero"? "Significant numbers"? It seems very vague.
11:42, 15 Nov 2004 (UTC)
replies: text: It has to be vague becuase exact numbers are hard to define. There have been a very small number of deaths from vitamin overdoesing but the total number probably isn't even into triple figures.Geni 12:03, 15 Nov 2004 (UTC)
thread_title:  Implying a "balanced diet" is not enough - POV? 

message: I have just conducted a (brief) literature review, looking for randomised placebo-controlled trials. Unfortunately, there are very few. Those that I did find, I have added to the article. (None of them supported megavitamin usage.) I didn't bother to add the numerous case reports, most of which showed harm arising from megavitamin use. Axl 20:00, 14 Dec 2004 (UTC)
thread_title:  Evidence 

message: I disagree with the merging of these two articles.  While megavitamin therapy is associated with orthomolecular medicine, it is a different concept and is not unique to ortho, and shares it own potential benefits and risks and should remain separate.  I am not an advocate of either therapy.  --Reflex Reaction (talk)• 16:56, 3 January 2006 (UTC)
thread_title:  Merging of megavitamin therapy 

message: *Hickey, Steve & Roberts Hilary; (May, 2004), Ascorbate: The Science of Vitamin C, Lulu Press, Inc.  (Note: Lulu (http://www.lulu.com/ascorbate) is a print on demand self-publishing house.)
*Levy, Thomas, MD JD; (September 2002), Vitamin C, Infectious Diseases, and Toxins, Xlibris Corporation (Paperback).   (Note: Xlibris is a print on demand self-publishing house.)
:I am not sure 2 self-published books really are notable enough in this context. There is also the commercial nature of these links to consider. While wikipedia guidelines are not completely clear, discussion is surely merited.--DocJohnny 19:09, 9 January 2006 (UTC)
thread_title: References

message: This entire section shows a strong pro-POV. Statements that doctors "have little knowledge", and attacking the studies done, especially when no rigorous pro studies exist. The fact is that conventional medicine regards this as pseudoscience, and that is not really in the article.--JohnDO|Speak your mind  20:43, 19 January 2006 (UTC)
replies: text: A look at Orthomolecular literature clears up things fairly quickly. This boils down to a tacit acknowledgment of the lack of scientific rigour in the field. An attitude of "If it's harmless and the patients report results, that means it works!" permeates the field. A brief overview of the Journal reveals attacks on double blind studies and worship of anecdote. And it is all so unnecessary. The nutrition industry is a huge industry. All it would take would be good outcome studies and this would all become mainstream. But we know that isn't likely to happen. --JohnDO|Speak your mind  11:41, 22 January 2006 (UTC)

text: Biochemical models are of limited relevance to actual practice. The difference between "medical orthodoxy" and orthomolecular views is that of science vs. pseudoscience. As clinicians, we "orthodox" types may sometimes try unproven treatments based on theory on a case by case basis if the situation is unusual enough that data does not exist. But we don't generalize from one patient to general effectiveness. The difference is a fundamental one very well illustrated by that link above. Medicine is about outcomes, and outcomes studies are necessary before effectiveness is proven. What it would take to "connect to my technical background" are outcome studies. Prove your claims. Again, all it will take are outcome studies proving the orthomolecular methodology. For example, look at the claims regarding redox therapy. If high intravenous doses of vitamin C really cure cancer, do a placebo controlled double blind trial. If proponents did provide trials that proved their claims, this entire discussion would be moot. High dose vitamin C would be orthodox. Instead of definitive data, we are provided with a variety of biochemical justifications of why "it should work" and case reports saying "it does work". Why do proponents find scientific methodology (i.e. double blind placebo controlled trials) so onerous? Using precise biochemical language instead of more patient accessible language does not make it more scientific. As it stands orthomolecular medicine looks like snake oil gussied up with biochemistry. --JohnDO|Speak your mind  20:36, 22 January 2006 (UTC)

text: There are people who use scientific sounding language to obfuscate matters. Science is more than using scientific terminology. Science is seeking truth through research. If good experiments are hard to design, it just means we have to work harder, not abandon experimentation altogether. Merely asserting "flawed design" with no proof is pointless.  The "small studies" that you mention are almost uniformly with no controls, subject to all of the problems above mentioned of dbRCTs and subject to observer bias, secondary gain, and placebo effect. In essence they aren't "small trials", they are anecdotes. There is also a difference between "real science" and engineering. Medicine is more akin to engineering and other applied sciences in that results have a real consequence. Engineers are also "parochial" in their obsession with their version of outcome studies. If anything they are even more conservative over innovation than physicians. As for dbRCT's, your claims are arguable, but no excuse for not doing them. "Captive pharma" and "tobacco science" are ad hominem and irrelevant and ignore the fact that the nutrition industry generates massive dollars as well. Again the objection seems to be "it might be corrupt so let's not do studies". Alternative medicine types seem to love pointing to Vioxx et al and ignore the fact it was these same studies that discovered their inadequacies. If "captive pharma" had approached these drugs with the same attitude as orthomolecular medicine, we would never have known about the dangers. After all, they were theoretically sound. "Big Med" is not a religion, it is a business, and that is enough for us to approach their work with some skepticism. But that does not invalidate research. It seems the essence of your argument is that research need not be done because it is too expensive or too difficult. My "pseudoscience 'tude" is not without reason. Act like scientists, and we will treat you as such. Glorify the anecdote and attack experimentation, and that 'tude is unlikely to change. Ok, end of diatribe on my part.--JohnDO|Speak your mind  04:41, 23 January 2006 (UTC)

text: You say there are other forms of testing, but do not suggest any, and unless you mean to question the fundamentals of experimental design, you can't away from the fact that without blinding and adequate controls, bias will eliminate any demonstration of causality. There is a reason dbRCT's are necessary. And more data is always better all other factors being equal. You also cannot compare apples to oranges, which is why meta-analyses are always less significant. And they are only significant if the individual experiments are statistically significant. This is why analyses of 500 case reports yields little. Your analogy is strained and we both should know that "a knowledgeable amateur" could never have produced a mirror of those specifications anyway. Knowledgeable amateurs have always been adept at poking holes and pointing blame, but producing the results is something else altogether. --JohnDO|Speak your mind  10:46, 23 January 2006 (UTC)

text: I will take you at your word concerning your criticisms of the pharmaceutical industry. Of course there are studies of dubious value. You aren't saying anything new. GIGO applies to dbRCT's as well. But that is a problem that applies to all experimentation. As to "rich man's game", it seems we are back to "it's too hard to do, so don't do it". Your statements thus far consist of unsupported allegations of "a better way" and unsupported allegations that "dbRCT's are oversold" sprinkled with warnings of corporate deception.--JohnDO|Speak your mind  10:46, 23 January 2006 (UTC)

text: As is readily apparent not nearly all data is controlled by the industry, unless you invoke the boogeyman of conspiracy. Calling me naive does not prove it. As for Moertel and Pauling, another unsupported allegation that would have been easily remedied by research by proponents. If the higher doses really work, that is easily demonstrated. --JohnDO|Speak your mind  10:46, 23 January 2006 (UTC)

text: The lack of corporate benevolence is hardly a surprise. As for the NIH, again a few good outcome studies would spur them to action. --JohnDO|Speak your mind  10:46, 23 January 2006 (UTC)

text: I am not so trusting that I will believe that statement without proof. I have little interest in territorialism. If you truly demonstrated vitamin C cured cancer, I would line up to applaud you. You mistake me, I have nothing against any treatment if it works. But your treatments are unproven and your field does not seem interested in changing that. --JohnDO|Speak your mind  10:46, 23 January 2006 (UTC)

text: I agree, see below for my suggestion. --JohnDO|Speak your mind  10:46, 23 January 2006 (UTC)
thread_title:  Relation to conventional medicine 

message: Here is a list of 15 principles that identify the spirit" of Orthormolecular Medicine:
1. Orthomolecules come first in medical diagnosis and treatment. Knowledge of the safe and effective use of nutrients, enzymes, hormones, antigens, antibodies and other naturally occurring molecules is essential to assure a reasonable standard of care in medical practice.
:Backed up with no outcome studies. Nutrition is important, yes. There is little evidence that all this supplementation does more than create expensive urine.--JohnDO|Speak your mind  01:28, 23 January 2006 (UTC)
replies: text: Several "orthomolecules" have been shown to be very toxic. The artificial distinction between "natural" and pharmacological is dubious. --JohnDO|Speak your mind  01:28, 23 January 2006 (UTC)

text: The first part is of dubious relevance since "nutrient" levels need to be associated with disease first. The second part is even more dubious and just asking for placebo effect.--JohnDO|Speak your mind  01:28, 23 January 2006 (UTC)

text: A good excuse to not do studies.--JohnDO|Speak your mind  01:28, 23 January 2006 (UTC)

text: Unsupported blanket statement showing a lack of understanding of fundamental biochemistry. Depending on the actual illness, a person may need more/less or the same of "nutrients". These things would require research.--JohnDO|Speak your mind  01:28, 23 January 2006 (UTC)

text: Environment pollution may be common. But causality has to be demonstrated. And the methods used to "determine toxicity" must be proven.--JohnDO|Speak your mind  01:28, 23 January 2006 (UTC)

text: Unsupported statement backed by little other than speculative data. Prove it first. Seems like an excuse for variable treatment methods.--JohnDO|Speak your mind  01:28, 23 January 2006 (UTC)

text: I would agree except that what is defined as "nutrient related disroders" are dubious and backed by little data.--JohnDO|Speak your mind  01:28, 23 January 2006 (UTC)

text: The first part can be used as justification for anything. The second is unfounded except by anecdote. Causality is again the issue.--JohnDO|Speak your mind  01:28, 23 January 2006 (UTC)

text: A tantamount admittance that orthomolecular medicine is not proven. Not all treatments are safe. And informed consent should be a priority in treatments of questionable benefit regardless of safety. Any misrepresentation is fraud.--JohnDO|Speak your mind  01:28, 23 January 2006 (UTC)

text: Ok. Except that the placebo effect has been amply demonstrated.--JohnDO|Speak your mind  01:28, 23 January 2006 (UTC)

text: The responsible clinician is not responsible for supplying information about dubious treatments. This has been well established.--JohnDO|Speak your mind  01:28, 23 January 2006 (UTC)

text: No argument there. But inundating the patient with technical jargon about molecular models and glossing over the lack of data supporting actual effectiveness is fraud.--JohnDO|Speak your mind  01:28, 23 January 2006 (UTC)

text: Ok.--JohnDO|Speak your mind  01:28, 23 January 2006 (UTC)

text: The first is arguable. I agree with the second.--JohnDO|Speak your mind  01:22, 23 January 2006 (UTC)
thread_title:  15 Principles 

message: obviously I didn't refresh recently.  working on it thanks—Preceding unsigned comment added by 69.178.31.177 (talk • contribs) 
The International Society for Orthomolecular Medicine has many conventional doctors among its members and authors.
:no dispute, but I am not sure they remain "conventional". Perhaps conventionally trained would be a better term.--JohnDO|Speak your mind  05:25, 23 January 2006 (UTC)
replies: text: This is POV and of little relevance. A better sentence would read However, conventional medicine disputes the concepts, research, and clinical efficacy of orthomolecular medicine.--JohnDO|Speak your mind  05:25, 23 January 2006 (UTC)

text: no dispute--JohnDO|Speak your mind  05:25, 23 January 2006 (UTC)

text: Not really. They do tests of questionable validity that purport to measure deficiencies. --JohnDO|Speak your mind  05:25, 23 January 2006 (UTC)

text: This is a straw man. The major complain against orthomed is not toxicity but lack of efficacy.--JohnDO|Speak your mind  05:25, 23 January 2006 (UTC)

text: A good response to the straw man--JohnDO|Speak your mind  05:25, 23 January 2006 (UTC)

text: Unproven statement, especially the evolving advanced claims. --JohnDO|Speak your mind  05:25, 23 January 2006 (UTC)

text: Critics deem orthomolecular therapies as unscientific based on the fact that they are without authoritative trials, and the trials that have been done are negative. The "nonrepresentative" is a hedge, since proponents can't point to any "representative" trials.--JohnDO|Speak your mind  05:25, 23 January 2006 (UTC)

text: A factual statement of the proponents POV, but completely one sided.--JohnDO|Speak your mind  05:25, 23 January 2006 (UTC)

text: Again without pointing to studies that show positive results that use so called "correct" doses, frequencies, durations, etcetera.--JohnDO|Speak your mind  05:25, 23 January 2006 (UTC)

text: How about something like this? Although the International Society of Orthomolecular medicine has many conventionally trained physicians among its members, the field enjoys a contentious relationship with conventional medicine. Conventional medicine deems orthomolecular practices to be unscientific due to the lack of authoritative trials demonstrating efficacy. They also refer to several trials with negative results. Proponents dismiss the negative trials as lacking validity due to differences in dosage, frequency, and other factors. Critics refer to the continued lack of positive trials at any dosage or frequency. Proponents also dismiss the need for authoritative trials pointing to their patients' perceived benefit, a position also deemed unscientific by critics. --JohnDO|Speak your mind  05:44, 23 January 2006 (UTC)
thread_title:  Section Dispute 

message: I think we are fairly close to consensus. I had five minor disputes with your last edit. 1) I think the first two sentences need to flow together, if you like them to be separate sentences, the word However is a good compromise. 2) The orthodox view does not dispute "many" OM therapies. It disputes OM.  3) I am not sure "refrains" is the best word to describe the attitude of conventional medicine towards OM. The attitude is considerably harsher, but "disputes the validity of" is fairly toned down but still descriptive of the sentiment. 4) The issue of positive studies. I think authoritative is fine, but the word sufficient implies that some authoritative studies exist and conventional medicine does not consider any orthomolecular studies to be authoritative. 5) Lastly, I don't think the "adoption by conventional medicine" sentence is really accurate. The rift is considerably wider than that. Mention of nutritionally based therapy is considered tantamount to quackery. I don't see any evidence that there is any "adoption" going on at all, since any adoption of OM is treated as defection. While there is now some preventive nutrition, therapeutic nutritional supplementation is not at all accepted. While this article should not be a conventional medicine polemic against OM, the relationship between the 2 should be accurately characterized. --JohnDO|Speak your mind 12:24, 24 January 2006 (UTC)
replies: text: I thought this was in previously, "most" twice,  although CM would like to generally disdain OM, can't avoid fact of overlaps and agreed authoritative support in some cases, as #2 above. --69.178.31.177 22:36, 24 January 2006 (UTC)
replies: text: I think OM means more than just nutritional therapies. There is a certain methodology that is rejected by CM. There is a slight amount of overlap in the substances used, but the way they are used is different. But I don't object to most or the international reference.--JohnDO|Speak your mind 23:21, 24 January 2006 (UTC)
thread_title:  Closer to consensus 

message: Assuming methodology is "next" on your list, current differential diagnostics would probably be started with the two nutritional / natural med textbooks,  Pizzorno & Murray (2 vol, 3rd ed; pp*density is a little less than Harrison's) or Werbach & Moss (lightweight, quick), they cover some of the testing. Orthomed usually relies on what is integrated into NMD and what floats in from CM with adds on, rather than distinct OM diagnostics (no schools).  OM psychiatry has more independent methodology but then you are another step or two out...how far are you going?
:I don't really have a list, I just browse and edit when I see something that I think needs editing. But we could probably clean up redox therapy sometime.--JohnDO|Speak your mind 03:56, 25 January 2006 (UTC)
thread_title: dark side

message: John - Searching for NPOV again. The sentiment that you state for CM is true, but the issue itself is debated and the language a little too prejudicial. Many of the tests used are either standard or similar, sometimes extended versions. 46+ blood panels, a number of the nutrients and many others are relatively the same. "Promiscuity of use" is a real difference. Some of the tests not validated with CM nevertheless have extensive science pedigrees, just not fully validated with CM.  Some tests you are thinking of may be outside of OM range, one of the other, farther out naturopathic areas. Also competition tends to remove some junk, one analytical lab will dissect the others to achieve a commercial advantage. Not saying its perfect. They are trying to build additional useful data for diagnosis, trending and / or general OM recommendations.—Preceding unsigned comment added by 69.178.31.177 (talk • contribs) 
:Ok, but let's simplify to just "Many of the tests are not accepted by conventional medicine". The preceding text is a bit excessive and unclear for a lay reader who may not be up on the process of research.  --JohnDO|Speak your mind 13:54, 26 January 2006 (UTC)
thread_title: OM tests

message: disease has "multiple non-specific causes"...
DOes that mean that the theory referenced here rejects teh germ theory of diseases?
Or is it just referring to non-infectious diseases?   Clarification needed in article.  (I can't tell if it is harmless otherwise) Midgley 21:07, 28 January 2006 (UTC)
thread_title:  Germ Theory 

message: I have concerns about this Purification Rundown link. (1) it seems more like advertising or extraneous POV; (2) it is not a general orthomolecular medicine reference - it is a specific subject ref where the context of this article's development was for general refs to avoid endless is too-is not arguments that were trashing the page, see "References" above, early Jan 2006, between DocJohnny & 69...177;  (3) I think that there are source and verifiability issues,  (4) without that much knowledge of Scientology, much less its detox treatment ritual, following the P-R link and also google, I see two items that raise flags about the "orthomolecular purity" of this treatment.  Just because a treatment might claim some orthomolecular roots, self described personnel or is described as such, does NOT make it a principled orthomolecular treatment.  I think that an encyclopedia article would best focus on clear examples.
For an exaggerated example of this concern: There is a conventional medicine oncology treatment that uses injected vitamin C.  The idea is that a  daily shot of IM vitamin C roughly triples the cumulative body tolerance to Trisenox (arsenic trioxide) chemotherapy.  There is no way you can call that whole treatment "orthomolecular medicine" even though it uses a long described (in orthomed) property of vitamin C.  Perhaps a more accurate orthomed connection would be a comment in the Pur'n Rundown article that explores whether Pur'n Rundown was partly developed with material "borrowed" from orthomed or perhaps "Niacin" uses. Google ("Purification Rundown" + "abram hoffer") or + "orthomolecular" shows almost no hits (Abram Hoffer largely defines niacin and orthomed). I can think of dozens of specific treatments/links that might more clearly illustrate orthomed than this link. --69.178.31.177 12:22, 18 February 2006 (UTC)
thread_title: Purification Rundown 

message: "...is practiced by a few hundred physicians.  It..."
The source of "hundreds of physicians" appears to be an old Barrett figure, at least over a dozen yrs old possibly several decades, by a notorious and sometimes scurrilous orthomed opponent, whom even some of his supporters here at Wikipedia have acknowledged a strong bias as simply pleasing to certain professional factions.  I think that an objective # of practitioners statement would best be stated in perhaps the 2nd, 3rd paragraphs, or even a separate 4th paragraph with some sources.  IMHO, the first paragraph is best oriented toward summarizng the description of the area. 
Several points should be constructively considered here:  
(1) When is a conventionally trained doctor (in the US, DO or MD) being orthomolecular or an orthomlecular dr - 1 type of treatment, 2 types of treatments or everything - how do parts count? Especially when a previously recognized generic treatment is displaced by a less able (but highly  advertised) pharmaceutical. There is no "ortho" school.  And yes, success may mean mainstream absorption.
(2)  Naturopaths, 4 & 5 yr NMD/ND, duly licensed in a number of US states and a few DC essentially practice some degree of orthomolecular medicine in a number of cases (optimum nutrition) as probably do some psychology PhDs and other allied health professions. 
(3) What geographic area are we talking? I know of 3rd world MDs, educated in or influenced by NoAM, that apparently picked up on some Hoffer / Klenner results in the 50s/60s before Hoffer and Pauling really defined the field.
(4) reference quality sourcing of an accurate, current estimate may be an interesting exercise.  Actually the correspondence claims of Klenner, Shutes, et al might support "hundreds" as of the 1950s.
(5) stmt placement can be distracting to the introduction of an article
"...and asserts that a normal diet is insufficient for health..."  modified, "normal" certainly begs the question of whose normal.--69.178.41.55 10:00, 29 May 2006 (UTC)
thread_title: # of orthomed practitioners, "normal" diets