dedicated to dr.abram hoffer

Dependencies

Irwin Stone first used the word megavitamin to describe the large doses of vitamin C that had been reported in the medical literature as effective. It is not an appropriate term because it has never been defined, and contrary to what many think there is no “megavitamin”. But it is clear that some individuals do need enormous amounts of some of the vitamins. The term vitamin dependency was coined. It was first used to describe the use of large doses of pyridoxine, vitamin B-6. I have extended the term to include all the vitamins which have been shown to be effective in larger than the usual vitamin doses. A vitamin deficiency classically is present when the amount normally present in food is much less than needed to prevent the deficiency disease for most people. For example, when Japanese sailors were fed polished rice they got beriberi. The polished rice did not contain enough thiamin to prevent beriberi. When people lived on subsistence diets high in corn and very low in animal foods they got pellagra. Just adding milk and meat to these diets cured their pellagra. Thus, a deficiency is present when normal needs for nutrients are not met by the diet. However, there are many reasons why individuals need more of some of the vitamins than they can get in their food. These are called dependencies, meaning that they have become dependent or need much larger amounts of these nutrients. Heaney1 considers these conditions a long-latency deficiency disease.

Using these vitamins in optimal or large doses was called orthomolecular medicine and orthomolecular psychiatry by Linus Pauling in his famous Science report in 1968. Orthomolecular theory and practise emphasizes the use of optimum doses of substances that are normally present and needed by the body including vitamins, minerals, amino acids, essential fatty acids and probably many other substances, but excludes herbs and their constituents.

1 RP Heaney: Long-latency deficiency disease: insights from calcium and vitamin D. Am J Clin Nutr. 2003;78:912-919

Individuality

Roger Williams showed that humans are not alike biochemically and that their nutritional needs are not identical. He showed scientists what we all knew: that we are all individual. We do not have the same fingerprints, the same blood types; we do not look alike, think alike or suffer alike. Why, then, would the early nutritionists think that we are alike in terms of the nutrients we need? The RDAs recognized that we are not alike and made a minor provision for this by recommending slightly higher doses than they actually thought we needed. But the range of doses they recommended were altogether too restricted as they were not based on large population studies but were arrived at from animal studies and by guess, using normal amounts in food as the basic guide. In reality, the range of need is much greater than was recognized, and is much greater than is recognized by the health professions today.

Essentially genes determine what our nutritional needs are. We cannot turn our genes into new ones and so have to be content with what we have, but we can feed them much more effectively. As I see it, there are no defective genes in individuals who are born normal and are normal for some time; if the genes really were defective they would have been eliminated long time ago by the process of evolution. If a person has been healthy and productive for 70 years and then develops Alzheimer’s disease, how can one blame the genes that had served so well for such a long time? But something has happened. Genes must have the correct internal biochemical environment, and if this is not provided they will not function properly. This suggests that any disease which develops later in life is caused by genes that are no longer being looked after properly; by this I mean they are not being fed properly. Diseases which are apparently genetic, like Huntington’s disease, are therefore not untreatable. We still have not looked for the factors in the gene’s environment that are lacking. The few patients I have treated with this disease recovered when given large doses of vitamin E and niacin. I have suggested that families with the gene ought to take these vitamins as a measure to prevent the development of the disease. One day we will have laboratory tests that will determine what the genetic needs are.

Bruce Ames in his wide ranging review of enzymes and the need for increased vitamin intakes concludes that as many as one-third of mutations in a gene result in the corresponding enzymes having a decrease in binding affinity of a coenzyme resulting in lower rates of reactions. These defects can be helped by high doses of the correct vitamins. He listed more than fifty genetic diseases successfully treated with high doses of vitamins. The high doses of the vitamins forces the reaction that is being catalyzed by too little coenzyme. He estimated that a very small proportion of all these genetic disorders have been discovered.

It is very unlikely that all single vitamin dependencies have been recognized. But as the modern foods become more and more deficient in overall nutrients, these will begin to show more and more. In1950 when I first started to practise psychiatry there were very few children recognized as being hyperactive or having a hyperactivity/learning disorder, one of the forty modern diseases described by psychiatry in DSM IV. Today up to 10 percent of the children of any classroom may carry this diagnosis. The main change has been the gradual deterioration of our national diets.

There is no reason why some individuals will not have multiple dependency conditions. Huntington’s disease is an example of a double dependency on niacin and on vitamin E. I thought that multiple dependencies (more than two) will be even rarer but I was wrong. There is one condition which is dependent on four nutrients. This is AIDS. HIV/AIDS is treatable by four important nutrients, the mineral selenium and the three amino acids tryptophan, cysteine and glutamine. These are components of glutathione peroxidase the essential compound that is lacking.