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Section 1 - Introduction and Definitions

What is Nutrition?
Normal Nutrition
Supernutrition, Optimum Nutrition, Orthomolecular Nutrition and Malnutrition 

Section 2- Nutritional Quackery and Scientific Drug Dependence: the orthodox viewpoint 

Section 3 - The Orthomolecular Movement: pioneers ahead of their time

Section 4 - Beyond Deficiencies: mainstream medicine plays catch-up

Mainstream Medicine Plays the Catch-up Game
Genetic Nutrition: catch-up practice continues

Section 5 - The Future: more drugs or less malnutrition?

Section 1 - Introduction and Definitions

Introduction

The fundamental basis of any effective cause based healing system is the study of those substances which form an integral part of the condition of normality or optimum health. These substances are referred to as "nutrients". Without a thorough understanding of precisely what it is that constitutes the condition of normality or optimum health it is not possible to fully understand any deviation from this condition. Neither is it possible to deliberately restore or maintain normality or optimum functioning.

Since science teaches us that it is within the cells and mitochondria that the countless chemical reactions occur which determine our health and well being, it is here also that the nutrients are required in optimum amounts. To attempt to treat an illness with toxic foreign chemicals without first addressing any deviation in proper cellular nutrient levels represents not just a departure from science, it is also a total departure from basic common sense. In keeping with these facts we must also acknowledge the futility of attempting to assess nutritional status by measuring nutrient levels in the blood as if this is some kind of guarantee that nutrients will therefore be constantly delivered to all the billions of cells in the body in optimum amounts. We will not move forward until we accept the extreme crudity of such tests and the untested assumptions upon which interpretation of such test results are based.

I must also stress most emphatically that the "normality" to which I refer above cannot be defined, as is the want of modern science, in terms of a totally imaginary statistical average. I use the term normality, not in support of some make believe statistical world, but rather to denote that state of optimum functioning the biochemical individuality of which is the very antithesis of statistical averages. Normality is therefore an individual quality comprised of optimum nutritional status and absence of any abnormality or dysfunction and therefore should certainly not be statistically defined by reduction to the lowest common denominator. The normality I refer to is an individual and intrinsically holistic concept which is not conducive to analysis by reductionist methods.

The above fundamental facts form the basis of orthomolecular nutrition.

Although not generally accepted by mainstream medicine, the vital importance of nutrition has long been known. According to Boudreau in 1959 (1 ), "if all we know about nutrition were applied to modern society, the result would be an enormous improvement in public health, at least equal to that which resulted when the germ theory of infectious disease was made the basis of public health and medical work."

Yet, in spite of its importance, the subject of nutrition formed little part of medical training in those days, as today. According to Williams in this regard ( 4 ), "it is only fair to add that those physicians who do recognise the importance of nutrition in the medical scheme of things have done so as the result of individual research and not as the result of anything they were taught in the course of their formal medical education." Medicine, which should have its sights fixed "upon health, not upon ill health" ( 4 ), "has taken an extremely important and unfortunate wrong turn in its neglect of nutrition and this wrong turn is evident in connection with the thinking about all diseases, including cancer ( 2 ).

It is now more than half a century since various distinguished scientists and medical practitioners first began to realise that certain individuals possessed an excessive need for various nutrients which could only be satisfied by mega-doses which were well in excess of the standard RDA's ( see Nutrition is for the Birds, B vitamins ). How has medicine utilised and advanced the concepts introduced by these much esteemed pioneers of nutritional medicine? Given the importance of this matter it is timely to examine progress in the use of megavitamins and the use of optimum nutrition to maintain health and prevent disease. 

It is the vital topic of individuality in nutritional needs, or biochemical individuality, which is of fundamental importance for the future application of nutritional therapies. This topic, and the importance of genetics in determining nutritional requirements, or genetic nutrition, are discussed in Sections 3-5 of this article.

It is absolutely astonishing, as we enter the 21st century, that scientists have yet to discover that optimum health and nutrition cannot be achieved except by highly individualised and uniquely balanced combinations of nutrients which are specifically tailored to satisfy the needs of each individual. Until science becomes genuinely interested in individuality and balance, the true potential of nutrition will never be realised, except perhaps by those who are not restricted by fictitious scientific averages.

Beginning with a consideration of the definition of basic nutritional terms, let us examine what progress has been made since the brilliant work of Williams and colleagues 40-50 years ago.

Definitions

a) What is Nutrition? 
Nutrition is the act of nourishing the whole body and mind, the act of supplying the nutrients which are necessary for the maintenance of optimum health and vitality in every cell in the body. Correct nutrition has a normalising or optimising effect upon the body ( see Nutrition is for the Birds ). Nutrition provides the foundation for all the bodies metabolic reactions and restorative processes. All the bodies hormonal systems, the immune system, and the energy production system are dependent upon an adequate supply of nutrients. If the cells of the body are supplied with a less than optimum amount of any nutrient then the efficiency of the body will be impeded in some way.

I should emphasise at this point that it is the natural, nourishing, normalising and curative effects of nutrition which distinguishes nutritional therapy from drug therapy ( 4 ). Unlike nutrients, drugs conceal symptoms and intoxicate the body ( 4 ). Since drugs stress or overload the detoxification systems of the body they detract from optimum health rather than contributing to it. Nutrients on the other hand, are an absolutely fundamental part of normality and optimum health ( 3, 4 ).

The distinction between nutrients and drugs also underlies the frequently misunderstood distinction between herbs and drugs. While it is true that many herbs have a pharmacological or drug like effect, unlike synthetic drugs they also possess nutritional properties ( 6, 7, 21 ). They have an ability to nourish or restore the body which distinguishes them from synthetic drugs. In fact, many herbs which have a relatively weak pharmacological action depend almost exclusively upon their nutritional properties for their therapeutic effect. Such herbs are described as being "nutritive", "restorative", or "trophorestorative" because of this gentle nourishing action ( 6, 8, 21 ). Herbs classified as "Yin" herbs are also fundamentally restorative and nutritive ( 8, 9 ). Every ( whole) herb, even those which are not fundamentally nutritive, contains nutritional components such as vitamins, minerals, flavonoids, essential oils, amino acids and antioxidants ( 6, 7, 8, 9 ). Herbs in fact, are "foodlike" ( 21 ).The suggestion which is sometimes made that herbs are the same as synthetic drugs demonstrates a fundamental misunderstanding of the basic actions of nutrients and drugs. Drugs are never nourishing. They do not have any nutritive component whatsoever.

The current reductionist belief that herbal medicines should be purified or "standardised" is also associated with the belief that nutrition is unimportant and preference should be given to the use of isolated or "active" constituents such as are used in toxic symptom suppressing drugs. According to this belief the nutritive or "inactive" properties of herbs should be discarded and herbal medicines should be reduced to their "active" constituents. In other words, the nutritive components of herbs are regarded as being irrelevant. This of course is an inherently reductionist belief that flies in the face of thousands of years of holistic traditions of herbal medicine ( 6, 7, 8, 21 ). We have seen the consequence of this philosophy with the "purification" of foods and removal of their fibre and essential nutrients ( see Holistic Medicine: From Alternative to Mainstream? ).

I should also make the point here that the range of constituents contained in a "whole" herb serves to moderate the effect of the herb and reduce or eliminate any toxic reactions while whole herbs are also devoid of extraction solvents ( 23, 36 ). This should come as no surprise however since this same logic also applies to food, individual constituents of which may become quite toxic if taken in a highly concentrated and purified form.

Recently the claim has been made that the herb Kava Kava is toxic because of some cases of liver failure which have been attributed to it ( 29, 31, 32, 33, 34 ). However, it seems that it is only the highly purified or standardised form of the herb which has been blamed for these ill effects ( 30, 34, 62, 63, 64 ) especially the acetone extracted standardised extract ( 30, 34, 62, 63, 64 ). According to Walsh ( 62 ), in an article entitled "Kava's Source of Liver Damage Pinpointed", "Swiss researchers have linked the toxicity with an acetone-extraction manufacturing process widely used in the German and Swiss products." Kava Kava, as the whole herb, or as a drink, has been used safely by the Pacific islanders for generations and has not been associated with liver disease ( 31, 32, 33 ). In fact, it seems that Kava users have a significantly lower incidence of cancer ( 35 ). 

Science claims that herbs must be "purified", then science claims that the purified herb is toxic and should be restricted!! Sound familiar? This is scientific progress!! 

Such "mistakes" continue to occur for one reason; we ignore the big picture. We refuse to adopt an holistic approach in which all factors are considered. How many times must we be taught this same lesson?

b) Normal Nutrition 
During the early 20th century the nutritional basis of the "classical" vitamin deficiency diseases, such as scurvy, pellagra, and beriberi, was discovered ( see Science Today Quackery Tomorrow ). Although these diseases represented the extreme end of the spectrum of nutritional deficiencies the medical and scientific world nevertheless adopted the attitude that such diseases represented the only possible result of nutritional deficiencies. According to this line of thought, which still persists today, it is impossible for nutritional deficiencies to cause any other symptoms or diseases. Suggestions that nutritional deficiencies could be chronic or subclinical and could cause other chronic diseases were scientifically scoffed at and regarded as quackery by mainstream medicine and nutrition. It was left to the more open minded and progressive researchers to continue to advance the nutritional cause. Apparently the "scientific" world believed, even when it comes to the classical deficiency diseases, that a person either has the symptoms and signs of a full blown deficiency disease or else he/she has perfect nutrition. There was no in between. Another consequence of this attitude was the belief that deficiency diseases could not possibly result from malabsorption or idiosyncrasies in metabolism but could only be caused by extreme and prolonged dietary deprivation. Following on from this it was believed that it was virtually impossible to experience deficiencies of one or two isolated nutrients since impoverished diets would cause numerous deficiencies.

Normal or adequate nutrition therefore came to be defined in the medical and scientific world as "the absence of symptoms and signs of the classical deficiency diseases." As has been so aptly noted by Williams however ( 3 ), "normal nutrition is some indefinite level of suboptimal nutrition." Conversely, malnutrition could only be evidenced by the presence of one or more of the classical deficiency diseases. The normal medical approach to nutrition has been summarised by Kenton and Kenton ( 22 ): 

According to modern medicine therefore, diseases such as heart disease, cancer, diabetes and birth defects were considered to occur in spite of perfect nutritional status. Whatever their cause, science claimed for many decades, merely on the basis of an assumption, that it had absolutely nothing to do with nutrition. These diseases however, have been linked by Williams ( 4, 22 ) to cellular malnutrition.

c) Supernutrition, Optimum Nutrition, Orthomolecular Nutrition and Malnutrition 
Even 40-50 years ago various scientists promoted the idea that proper nutrition goes far beyond absence of the classical nutritional deficiency diseases ( 3, 4,10,11 ). The suggestion that absence of such deficiency diseases constitutes absolute proof of perfect nutritional status was rejected by brilliant scientists who, in retrospect, were many years ahead of their colleagues ( 3, 4,11 ). These scientists sought to distinguish between the mainstream concept of "normal" nutrition, as defined as absence of the classical deficiency diseases, and a state of optimum nutrition which ensured optimum functioning and freedom from all nutritional deficiency conditions, both classical deficiencies and also the much more prevalent "subclinical" nutritional deficiencies and vitamin "dependencies". In order to underline this distinction the terms "optimum nutrition", "supernutrition" and "orthomolecular" medicine or nutrition, were utilised. According to Williams ( 3, 4 ), supernutrition involves eliminating deficiencies as well as avoiding imbalances and excesses. Hoffer ( 3 ) points out that "supernutrition is nutrition for the unique individual" rather than some imaginary statistically average "normal" person. Throughout this article the above terms are used interchangeably to refer to this state of optimum functioning and total absence of all nutritional deficiencies and dependencies.

The concept of optimum nutrition being a much higher ideal than normal nutrition, has always been much more appealing to those who strive for excellence in health and nutrition. Those who have traditionally been satisfied with the idea of "adequacy" have always resisted any suggestion that we should strive for a level of excellence in nutritional status.

It is important to realise that one of the main beliefs promoted by those who believed in normal (not optimum) nutrition was that everyone in the world of the same age and sex required exactly the same amount of each particular nutrient in order to avoid nutritional deficiencies ( see Nutrition is for the Birds, B vitamins, Science Today Quackery Tomorrow ). This belief resulted in the development of the RDA's and the idea that consumption of the RDA's of essential nutrients constitutes proof of nutritional adequacy. According to this belief everyone assimilates and metabolises nutrients with 100% efficiency and therefore it is impossible for nutritional deficiencies to result from individual peculiarities in metabolism. It was therefore assumed that every nutrient, once ingested, would automatically be delivered to the billions of cells in the body in optimum amounts. Under this belief system, human individuality is non-existent ( 3 ) and it is impossible to suffer from nutritional deficiencies if the diet contains the RDA's for all essential nutrients.

It must be emphasised most emphatically that these rather strange beliefs have never had any scientific basis. Rather, they merely represent unscientific assumptions which have been promoted for half a century throughout the scientific world.

Unlike the orthodox viewpoint, the concept of optimum nutrition deliberately sought to embrace the reality of individual peculiarities in metabolism and the existence therefore of chronic or subclinical nutritional deficiencies. These differing views were reflected in different definitions of malnutrition. For instance, malnutrition was commonly defined as (12 ) "failing health that results from a longstanding dietary intake that fails to meet nutritional needs" or a ( 13 ) "condition where diet omits some foods necessary for health". Alternatively, those who believed in the concept of optimum nutrition tended to use a more accurate definition of mal-nutrition ( 3 ): "an excess or deficiency of any nutrient", or ( 14 ), "poor nourishment resulting from improper diet or from some defect in metabolism that prevents the body from using its food properly." Throughout this discussion I will adopt the following definition: malnutrition is that condition, or metabolic disturbance that results, when any cell in the body receives more or less than optimum amounts of one or more nutrients.

Section 2- Nutritional Quackery and Scientific Drug Dependence: the orthodox viewpoint 

These comments of Davis, which underline the solid common sense basis of nutrition, have been reinforced by Williams ( 4 ):

While the fundamental importance of nutrition was clearly obvious to Williams, Davis, and others, science generally remained unconvinced. In fact, most scientists pursued a policy which would undermine the nutritional quality of the food supply and contribute to widespread nutritional deficiencies. This has been graphically illustrated by the scientific practice of food processing or adulteration, a practice which amazingly, only came to the fore since science discovered the vitally essential nature of essential nutrients. It seems that the more science found out about the essential nature of nutrients the more they proceeded to develop ways of removing these substances from our foods. When this scientific policy of nutritional impoverishment resulted in widespread nutritional deficiencies science then developed ways of manufacturing synthetic nutrients and adding these back to the foods from which other scientists had been responsible for removing them. Previously scientifically adulterated foods to which these synthetic nutrients were subsequently added were often described as "enriched" as if to somehow convey the impression that they were superior to natural unadulterated foods which had not been "improved" by science. In this rush to convince the public of the merits of science, truth was often the first victim.

The publicity campaign to support the use of "enriched" white flour and white bread for instance, was not just lacking in scientific facts, it set new standards for scientific misinformation and deception. Although there were significant losses of 22 or more nutrients during the processing of white flour and the production of white bread ( 261 ), the "enrichment" process involved replacing just 4 of these 22 nutrients ( 4, 10, 261 ). In spite of these facts, publicity campaigns made the following startling claims (10 ): "thanks to vitamin-enriched bread, white and whole wheat are now equally nutritious." While this public campaign of misinformation was continuing students being trained in nutrition were also targeted. According to Robinson, in a standard nutrition textbook ( 17 ), the suggestion that "white bread" was "nutritionally impoverished" was simply a "fallacy" (why then is it "enriched" at all? ). Robinson then continues ( 17 ): "most white bread is now enriched with iron, thiamine, riboflavin, and niacin and is approximately equal to whole-grain bread in nutritional value." So it seems that although 22 nutrients are almost totally removed or destroyed, white bread is not nutritionally "impoverished" at all, but by replacing 4 of these 22 nutrients in unimpoverished bread we can then produce "enriched" bread which is approximately nutritionally equal to whole grain bread!! Scientific progress is indeed a wonder to behold. When our nutrition experts are being trained in such a fashion it is no wonder that public health today is confronted with such enormous problems.

While many authorities sought to indoctrinate the public into believing that nutrients removed during food processing were unnecessary and therefore dispensable, there was considerable, though less popular, scientific evidence to the contrary. This was exemplified by scientific experiments such as were performed by Roger Williams ( 4, 15 ) involving two separate groups of rats, one which was fed commercially "enriched" bread, while the other group was fed this same bread plus additional vitamins and minerals. While two thirds of the rats fed the enriched bread alone died from malnutrition within 90 days most of the other group remained alive and healthy and gained weight seven times more rapidly than survivors of the former group ( 4, 15 ). It is hardly surprising that science continues to confirm the accuracy of common sense, but why do we need to wait for science to catch up? Perhaps we need more research into why common sense is becoming so uncommon!!

Even though the importance of natural foods and nutrition has such a solid common sense basis, the longstanding condemnation and negative attitude of medical science to nutrition ( see Medical Bias, Science Today Quackery Tomorrow, and Nutrition is for the Birds ) has had an extremely detrimental effect upon community attitudes to health and nutrition. Medicine of course, has always emphasised the importance of disease, not health ( 4, 10, 21 ). As has been noted by Davis ( 10 ), "our attitude toward health is so negative that persons interested in improvement are said to be on a 'health kick' or 'health binge' and are quickly labelled faddists or crackpots."

Even today toxic drugs are commonly regarded as being safe or even "recreational" whereas we are constantly warned about the toxic and dangerous nature of vitamins and other dietary supplements or natural treatments ( 19, 20, 21, 24, 25, 295, 296, 297, 299 ). Herbert ( 299 ) has recently likened those who promote the use of dietary supplements to "snake oil salesman", even going so far as to suggest that "the first snake oil nutrition salesman was the snake in the Garden of Eden....." It is a tragedy that so often in the nutrition debate the scientific facts are forgotten. 

These ideas continue to be supported, condoned or encouraged by the medical profession even in spite of the fact that the dangerous nature of medical "treatments" are responsible for more than 10,000 deaths annually in Australia alone ( see Holistic Medicine Sets the Standard for Safety ). We must be quite clear that these deaths, which have been confirmed by medical experts themselves, merely represent the tip of the iceberg since doctors are reluctant to report treatment failures and adverse drug reactions ( see Holistic Medicine Sets the Standard for Safety ).

Even in spite of the clearly established scientific facts regarding the dangers of toxic prescription drugs, some authorities still amazingly seek to warn the public about the allegedly dangerous nature of nutrients ( 296, 299 ). In a seemingly unscientific generalisation about supplements Herbert claims that ( 296 ) "supplements help some, harm others, and have no effect on most." If one were to apply this same type of generalisation to prescription drugs however, we would have to say that drugs help some, harm most, and kill many. What is particularly interesting is the way in which, according to Herbert ( 299 ), "snake oil salesman" may be recognised: "deception by omission of adverse facts, and the use of deceptive and misleading 'buzz words' has remained the hallmark of snake oil salesman down through the ages." However, if  "deception by omission of adverse facts" is the hallmark of the snake oil salesman, then clearly most modern health authorities, drug companies and doctors, are in fact snake oil salesman. Personally I think this assessment is a little harsh.

It is absolutely astonishing to see the extent to which medical science has created an almost universal community acceptance and dependence upon toxic drugs while simultaneously creating a huge degree of fear and paranoia about nutrition and natural health ( see Integrated Medicine, Medical Bias ). Doctors continue to justify the use of toxic drugs on the basis of their "risk /benefit" but yet, remarkably, when it comes to nutritional therapies the risk/benefit never seems to be mentioned. It is difficult to believe that such an incredible double standard continues to survive, let alone flourish. Paradoxically, medical science and the medical profession generally, continue to maintain a longstanding antagonism towards nutrition and the "health food" industry while simultaneously supporting the exceedingly hazardous pharmaceutical industry ( see Integrated Medicine ). Although studies of health food store customers revealed that they had higher intakes of essential nutrients they were nevertheless described as having a "high fad rating" ( 18 ). 

In spite of the fact that health food stores specialise in products which have been produced with more attention to quality, purity, and nutrient content, according to Robinson ( 17 ) health food stores sell products of the "nutrition quack". The health food industry has even been referred to by mainstream medicine as "a form of organised crime" ( 295 ) while the leaders of the health food movement have been referred to as "the quackery mafia" ( 295 ). That such authorities find the need to resort to such unscientific terms to describe more natural or healthful products is indeed curious. It is most notable that those authorities within mainstream medicine who seem most troubled by nutrition and natural health are not normally so vocal about medical bias and the spiralling increase in iatrogenic diseases. 

As nutrients were removed from our foods, drugs were added to our prescriptions. Doctors it seems, have become so obsessed with disease that they have rejected the importance of health. Common sense is in serious danger of becoming extinct.

The ridiculous nature of all this is further underlined by the fact that we often seem to care for our animals nutritionally better than we do our fellow humans. As has been noted by Williams ( 4 ), "people who would not think of feeding a dog bread, doughnuts, and coffee, or waffles and syrup eat such foods with abandon." According to Davis ( 10 ), nutritional supplements which are available for animals are "superior to any sold for humans." Although extensive nutritional supplements, including selenium for instance, have long been available for animals (16 ), for humans the use of selenium is a relatively recent "discovery" ( 26, 27, 28 ). Davis continues ( 10 ): "since no farmer would give his animals candy, prepared mixes, packaged cereals, gelatine desserts, soft drinks, or hundreds of other empty-calorie foods even if obtainable at bargain prices, without supplements his animals are far better off than humans. l see little hope for a nation which values the health of its livestock more than that of its people. " The wisdom of this assessment has of course, now been borne out as doctors struggle to explain the astonishing increases in cancer, heart disease, diabetes, mental disorders, asthma, etc. ( see Health Trends, But What About Efficacy? ).

It is difficult indeed to understand why the course of medical science has taken such an incorrect and illogical direction ( 4 ), a direction characterised by the determination with which medical authorities have sought to avoid any semblance of common sense. As I have discussed elsewhere ( see Medical Bias ), this anti-nutrition bias has been continuing for more than 200 years ( see Science Today Quackery Tomorrow, Nutrition is for the Birds ). This bias is consistently evidenced by the fact that nutritional discoveries, and the implementation and dissemination of nutritional information, have traditionally been left by the medical establishment to those outside of mainstream medicine ( 4 ). As has been noted by Williams ( 4 ), this has created "an intellectual vacuum regarding the subject of nutrition" and created a situation where "the layman's intuitions, uninformed as they may be, are more often justified than the physician's neglect."

While it is true that the lucrative profits of the drug industry and the influence of this industry upon medical training has tended to obliterate any serious interest in nutrition, the negative effects of intellectual elitism combined with reductionism and interventionism has had a much more longstanding and solid historical basis( see below ).

Tragically, with the continued flourishing of iatrogenic diseases, those who should be the primary beneficiaries of our "health care" system are frequently becoming victims, victims of a system which is fundamentally devoid of common sense. Victims however, still provide a lucrative income for those involved in "health" care. In no other field of human endeavour are professional persons or business persons so well rewarded for such dramatic negative results. Even three decades ago the American "health care" system was described as ( 210 ) "the fastest growing failing business in America."

b) When Nutrition became Quackery and Drug Dependence became Scientific: the nature of scientific evidence. 
Medical science it seems, has not only been determined to avoid common sense, but it has also been determined to avoid scientific evidence ( see Medical Evidence or Medical Ignorance? ). Scientists after all, even without the "benefits" of double blind trials, would not deny the fact that food is essential for health, so why would they deny the fact that the constituents of food are equally essential for health? Difficult though it may be to obtain a satisfactory and convincing answer to this question, there is a further question that is perhaps even more perplexing, namely, why would medical science choose inherently toxic and symptom concealing agents such as drugs rather than curative and harmless nutrients or natural treatments in their search for therapeutic agents? Why also is medicine so obsessed with disease and so unconcerned about health? Why is it that health authorities continue to be unconcerned about the consequences of concealing symptoms of chronic diseases with drugs while failing to address the underlying cause?

In the age of heroic medicine ( 7: see also Science Today Quackery Tomorrow ) the use of safe, non toxic plant based laxatives by alternative practitioners was regarded as quackery by mainstream scientific doctors who preferred instead to use highly toxic mercury based laxatives which frequently caused fatal mercury poisoning ( 7: see also Science Today Quackery Tomorrow ). According to the Australian government Committee of Inquiry into alternative therapies ( 294 ), medical treatments were "violent", "psychopathic patients were beaten, emetics and purging were common, and the success of bleeding and counter-irritation was measured by the pain the patient experienced." In spite of this the practices of bleeding and purgation with mercury based laxatives formed the fundamental basis of scientific medicine for around 300 years ( 7 ). Remarkably, such developments, from heroic medicine through to thalidomide and DDT, always seem to be justified by the alleged existence of supportive scientific evidence. Since it is the existence of supportive scientific evidence which is frequently claimed to validate medicine and distinguish it from nutrition and natural therapies, it is pertinent that we explore the nature of scientific evidence. To this end it is instructive to examine the changes in scientific thinking over the past few centuries that have led to our present predicament.

Prior to the 16th century, Western medicine was based primarily on the teachings of Galen and was fundamentally natural and holistic in nature ( 7, 8 ). Illness was thought of largely as an internal phenomena resulting from a condition of constitutional imbalance or a depletion of vital energy ( 7, 8, 21: see also Interventionism or Vitalism: who is the healer? ). Herbal medicines were used to balance the constitution and restore vital energy ( 7, 8, 21 ). Medicines were therefore essentially supportive and nourishing in nature. As has been noted by Chevallier ( 7 ): "up until the end of the 16th century, nearly all medical traditions had been based on the concept of working with nature, with the body's healing capacities, which could be supported and strengthened with appropriate medicinal herbs."

In the 17th century, Descartes, a French mathematician, was responsible for introducing a more reductionist philosophy which completely rejected holistic concepts such as vital energy ( 7, 21, 22 ). Descartes' philosophy was one of fragmentation, a belief that complex organisms could be best understood by reducing them to their constituent parts. In the words of Kenton and Kenton ( 22 ): "such thinking has also led to the notion that the human body is little more than a machine made up of a lot of different parts which can be analysed into a collection of cause-and-effect relationships. From this world view comes the notion of disease as an outside entity - a cruel act of fate caused by some external threat like a microbe something which we are neither responsible for nor able to heal ourselves." Patients therefore, were powerless and were led to believe that they must surrender responsibility for treatment to the practitioner.

According to Landis ( 21 ), Descartes' "analytical, materialistic, reductionist views" formed the basis of modern science and medicine. Landis continues ( 21 ): "in Descartes' view, even products of nature were not more than the sum of their parts; bodies were no more than machines governed by fixed mechanical laws, science was absolute and certain truth, and the mind and body were most certainly unrelated. When Louis Pasteur in the mid-1800s 'discovered' that pathogens outside the body are origins of disease, the mechanistic view of the body was further fuelled."

The Descartes or Cartesian view of reality however, had serious limitations ( 21 ): "disease came to be divorced from the organism as a whole", "the quelling of symptoms became equated with the cure of disease", and "organs, limbs or tissues came to be viewed as parts that could be treated separately from the rest of the body....... the patient became frequently superfluous to the healing process, nonessential to the repair of the broken part that happened to be attached to him or her."

Additionally, medicine became fundamentally interventionist in nature. Its main area of application was as a last resort patch up treatment for life threatening illness. According to Landis ( 21 ): 

While the strengths of reductionist medicine were largely confined to the treatment of trauma or serious life threatening illness, its weaknesses were also resoundingly clear. Reductionist medicine was woefully ineffective where the importance of vital energy was paramount such as in disease prevention, maintenance of optimum health, treatment of chronic degenerative diseases and nutrition. The principles of reductionist science were also ( 22 ) "practically useless if science is to discover ways of helping men and women to live at a state of high level health - not just free of overt symptoms of disease but feeling positively good and having a high resistance to the ageing process."

This was the beginning of the modern scientific approach to health care.

In considering the consequences of this philosophical approach to medicine it is important to consider two fundamental facts. Firstly, the whole concept upon which reductionism is based, that the sum of the individual parts is equal to the whole, is invalid. It denies the existence of synergism and systems theory ( see Holistic or Reductionist? ). Secondly, reductionism is fundamentally restrictive in nature. It is a tunnel vision approach which is rooted in artificial simplification, not truth. The rigidity of the boundaries established by reductionism are totally imaginary. In the real or functional world the individual constituents interact and overlap. The application of a restrictive reductionist philosophy to health care only serves to establish rigid artificial boundaries within which the study and practice of medicine must be eternally confined. Denying the existence of these limitations of reductionism has always been an exercise in convenience, not reality, and as such, has always been doomed to failure.

Notwithstanding my above comments I do of course acknowledge the gains made by reductionism, such as with advances in antibiotics and increased understanding of the functions of nutrients and hormones. Advances in interventionist treatments for trauma and serious diseases can also not be denied. However, a word of caution is necessary here. If these "advances" render the larger truth less visible then their eventual impact will be negative. Reduced understanding of healing, vital energy, optimum health and chronic diseases are the inevitable result of excessive dependence upon scientific reductionism.

This matter has been summarised by Chevallier ( 7 ): "in hindsight, it seems as if the new science of medicine could only be borne in separation from the traditional art of healing, with which it had always been intertwined. As a result, even though traditional medicine has generally lacked scientific explanation, it has frequently been far ahead of medical science in the way it has been applied therapeutically." As the reductionist approach of medicine became more consolidated the "causes" of disease were attributed to ( 8 ) "increasingly smaller and narrower factors." "Treatments" also became more refined and concentrated and although side effects became much more severe, they were of diminishing concern to medical practitioners.

As scientific medicine became more established in the 18th and 19th centuries natural treatments fell into disrepute only to be replaced by the deadly "cures" which were characteristic of heroic medicine ( 7, 8; see also Science Today Quackery Tomorrow ). In the words of Kaptchuk ( 8 ): "the university trained elites felt that traditional herbalism was 'tainted' by association with 'archaic' ideas. The revolution in science began to zealously attack any 'contamination' of the old order. An era of therapeutic chaos resulted which completely abandoned the old herbalism. Educated elite doctors infused with science would not be soiled with the past; herbalism was purged from the august halls of scientific universities. This nihilism reached its peak with the eighteenth and nineteenth centuries' madness of bleeding and calomel poisoning."

By the beginning of the 20th century herbal medicine was increasingly being politically outlawed as scientific medicine sought to override any tendency towards efficacy and safety based popularity of herbal therapies and establish a legal monopoly ( 7, 21 ). In spite of this trend, even in the 1930's 90% of medical treatments were derived from the herbal treatments which science had been seeking to outlaw ( 7 ). Unlike the much safer whole herbs that were used in the past however, herbs were increasingly being concentrated to form toxic drugs which, instead of being used in a supportive sense to increase vitality, were used merely to suppress isolated symptoms ( 7, 8, 21, 22 ).

Mainstream medicine, instead of acknowledging responsibility for past mistakes, often seeks to distance itself from the violence of heroic medicine on the basis of the new science and the current availability of "a range of drugs with scientifically proven efficacy" ( 294 ). Of course the reasoning here, although consistent with commercial interests, is totally invalid. The spiralling incidence of numerous diseases reveals that these drugs are grossly ineffective. Furthermore, scientific evidence reveals quite clearly that these drugs "with scientifically proven efficacy", are the primary cause of doctors becoming the third leading cause of death in developed countries, an "achievement" which may not have been beaten even in the days of heroic medicine. In the days of heroic medicine, as is still the case today, doctors generally seek to justify medicine on the basis of  "science" and refuse to acknowledge the hazardous nature of medical treatments. Nothing has changed. The determination to avoid responsibility is still a fundamental part of medicine.

Additionally, the fundamental yardstick by which "scientific" evidence is assessed is also invalid. Medical science evaluates the scientific efficacy of treatments by their ability to conceal the symptoms of an illness and thereby permit the underlying cause to deteriorate without inconveniencing the patient. Medical treatments are NOT assessed by their ability to CURE an illness, but rather by their ability to make the patient unaware of the disease from which he/she is suffering. In this era of so called "evidence based medicine" scientific evidence is therefore defined thus: scientific evidence of the efficacy of a medical treatment is the ability to demonstrate by double blind studies that the treatment can be relied upon to remove the patient's awareness of his/her illness while permitting the underlying cause to continue. Modern scientists argue that the most important aspect of scientific evidence is not that the treatment has a cause based effect, since this is irrelevant, but rather that the symptomatic nature of the treatment can be repeatedly demonstrated by double blind trials. According to this line of reasoning we should be more concerned about the proper construction of the trials than whether the treatment is cause based or merely symptomatic. Modern science seeks to ignore this distinction.

Today we are witnessing the end results of the established restrictive "scientific" basis of modern medicine. The 20th century, more than any other, has amply demonstrated the consequences of scientific reductionism. A century of unprecedented scientific developments, health care in the 20th century was characterised by a staggering and constantly increasing dependence upon drugs and surgery. The 20th century saw the discovery and isolation of all the vitamins and yet more was done in this century to remove these nutrients from our foods than ever before. The 20th century was characterised by endless medical "breakthroughs" and yet it also correlated with an unprecedented increase in the incidence of all manner of chronic diseases. While at the beginning of the 20th century heart disease was virtually non-existent, after 100 years of scientific advances heart disease had become the number one killer, killing an American every 60 seconds ( see Health Trends ). Continuing advances in scientific medicine also saw the emergence of a new group of diseases called "iatrogenic diseases" which are now responsible for more than 10,000 deaths every year in Australia alone ( see Holistic Medicine Sets the Standard for Safety ). In fact, the "cures" provided by modern medicine are so hazardous that a crisis in medical insurance has resulted. As all these changes have been occurring "scientific evidence" has also demonstrated the exceedingly dangerous nature of nutrition and natural therapies.

The above trends provide a very clear picture of the nature of "scientific evidence". First and foremost, scientific evidence is anything which justifies medicine's reductionist interventionist philosophy. This is clear from the "scientific" nature of heroic medicine, iatrogenic diseases, drug dependence, increasing heart disease and the adulteration of our foods, and conversely, the "unscientific" nature of nutrition and natural therapies. Scientific evidence is also infinitely flexible within the confines of its basic reductionist principles. This is necessary to allow endless inconsistencies and contradictions in medical treatments not to negatively impact upon the general direction of medicine and its underlying reductionist philosophy. Scientific evidence is also fundamentally commercial and mathematical in nature, being heavily dependent upon statistics and potential profits (see Health Trends, Medical Evidence or Medical Ignorance?, Medical Bias ).

The commercial profit oriented nature of modern scientific evidence ( see Medical Evidence or Medical Ignorance? ) is clearly illustrated by the recent changes to legislation concerning food and dietary supplements in America ( 311, 312, 313 ). While food labelling laws pertaining to health claims have been relaxed it seems that the laws pertaining to dietary supplements have been strengthened and will now be more rigidly enforced ( 311, 312, 313 ). While supplement manufacturers should of course be required to correctly label their products ( what is wrong with current false advertising laws? ) the two fundamentally important issues here relate to consistency and appropriateness of penalties.

If it is to be illegal to recommend echinacea for the treatment of herpes ( 311 ) and illegal to recommend taurine for the treatment of autism ( 314 ), then many of the claims made for pharmaceutical products should also be illegal since not only are these products often completely ineffective for their advertised purpose ( see But What About Efficacy? ), but frequently they are also positively harmful ( see Holistic Medicine Sets the Standard for Safety ). What is absolutely extraordinary about this matter is that this alleged mislabelling has been penalised by confiscation of the products even though there has been no evidence of ill effects ( 314 ). In contrast, manufacturers of medical drugs that have been scientifically proven to be responsible for hundreds or thousands of deaths incur no official penalty whatsoever let alone have their products confiscated( 227 ). Clearly the primary motivation here is NOT concern about public health and safety. This attitude is consistent with primary concern for commercial considerations, not public health.

Until doctors, scientists, and health authorities express proportionately greater concern about the current explosion in the incidence of iatrogenic diseases and the hundreds of thousands who die or are permanently maimed every year by prescription drugs then it is clear that their concerns are consistent with a preoccupation with commercial considerations, certainly not public health. The determination with which such authorities avoid publicising the increasing incidence of iatrogenic diseases and the scientifically proven dangers of prescription drugs is a measure of their disinterest in genuine science and public health. Interestingly, those "experts" who are most vocal about the alleged "dangers" of dietary supplements and natural treatments normally seem to be the most silent when it comes to iatrogenic diseases and the dangers of prescription drugs. 

Although 20th century medicine has won a few battles, unbiased consideration of the evidence leads to the inevitable conclusion that it has lost the war ( see Health Trends ). In spite of overwhelming scientific evidence of the failure of medicine however, there are still some who refuse to accept this evidence, perhaps even seeking to blame patients for the failings of medicine ( see Integrated Medicine). Interestingly, this attitude of denial appears most prominent amongst those who are most obsessed with a reductionist approach to health care.

The failure of modern medicine is hardly surprising in view of the fact that medicine was never structured to maintain optimum health and prevent or cure chronic disease. In fact, since medicine was deliberately based upon the study of disease rather than the study of health or normality, its entire basis has always depended upon an presumption of failure ( ie. inability to maintain optimum health and intervention only after significant disease has become established. ). This matter has been adequately summarised by Sigerist ( 38 ): "the ideal of medicine is the prevention of disease, and the necessity for curative treatment is a tacit admission of failure."

It is time to move on. This negative basis of medicine must be discarded and replaced with a positive system which seeks to maintain optimum health and reduce or eliminate the need for patch up interventionist treatments. If we are to address the spiralling increase in chronic diseases we must utilise safe and natural treatments similar to those that were used for most of human history. Health care should be fundamentally natural and supportive and should do no harm. Although traditionally scoffed at by reductionists and elitists, it is the practice of orthomolecular nutrition which promises to answer these needs and provide hope for the future.

Section 3 - The Orthomolecular Movement: pioneers ahead of their time

a) Pioneers of Orthomolecular Nutrition
Today, we owe so much of our knowledge of nutrition in general, and orthomolecular nutrition in particular, to the work of a relatively small number of dedicated scientists. At a time when the scientific world was mesmerised by the use of toxic symptom suppressing drugs, these pioneers of orthomolecular nutrition were clearly motivated by a commitment to truth which separated them from so many of their colleagues. Tragically, history shows that the rigidity, introversion and insecurity of modern science and scientists is such that there is an inability to cope with scientific discoveries which are perceived as departing excessively from the mainstream and threatening the status quo. There is a group mentality here which imparts to modern science a massive inertia the sole purpose of which is to establish limitations in current thinking and prevent significant change. It is only exceptional individuals who, frequently at great personal and professional cost, possess a sufficient commitment to truth to enable them to rise above the restrictive influences of mediocrity and conformity. Sadly, threats to the status quo are regarded with such seriousness in modern society that individuality, far from being encouraged, is usually penalised.

Amongst those who pioneered the concept of orthomolecular nutrition are Roger Williams ( 51, 52 ), Professor of Chemistry, discoverer of pantothenic acid (vitamin B5 ), and founder and director of the Clayton Foundation Biochemical Institute at the University of Texas which, under the directorship of Dr Williams was responsible for more vitamin discoveries than any other laboratory in the world ( 52 ). Roger Williams, during his directorship, was also responsible for naming and concentrating folic acid from 30 tons of spinach to supply laboratories around the world ( 235 ). The Clayton Foundation was also responsible for the discovery of the active forms of vitamin B6 and the isolation and synthesis of lipoic acid ( 235 ). As a result of his view that there is "no place for orthodoxy in science" ( 235 ) Williams' directorship of the Clayton Foundation was characterised by the promotion of "independent thinking on the part of the members of the Institute" ( 235 ). Such was Williams devotion to science that he refused to publicise pantothenic acid until the patents had run out in order to avoid any impression that he was profiting financially from his discovery ( 236 ). According to Williams ( 236 ): "scientists must avoid even the appearance of being biased financially if their opinions are to carry much weight." Williams, unlike many, was true to his word.

Other pioneers of orthomolecular nutrition include Linus Pauling ( 53, 54, 73 ), Professor of Chemistry, dual Nobel Prize winner and originator of the term "orthomolecular"; Abram Hoffer ( 65, 66, 67, 68, 73 ), Associate Professor of Psychiatry, Professor of Biochemistry and Agricultural Chemistry, and co-discoverer of the megavitamin treatment of schizophrenia; Bernard Rimland ( 69, 73 ), founder of the American Autism Society and director of the Autism Research Institute; and Allan Cott ( 3, 73 ), orthomolecular psychiatrist and Founding Fellow of the Academy of Orthomolecular Psychiatry. In fact, Roger Williams, Abram Hoffer, Linus Pauling and Hans Selye are four of the "fabulous five" scientists of the 20th century ( 142 ).

In spite of the impeccable credentials of these pioneers and the voluminous evidence in support of orthomolecular nutrition (see History and Development, Nutrition is for the Birds, B vitamins) which has led to the establishment of various research organisations ( 69, 70, 71, 72) and a devoted medical journal ( 73 ), it is disappointing, although not surprising, to observe the negative campaign of opposition which still continues ( 74, 75, 295, 296, 299, 309, 310 ).

While the opposition of medicine to new ideas and its anti-nutrition bias are well known (see Nutrition is for the Birds, Medical Bias ), the lengths to which establishment medicine has gone in an attempt to suppress orthomolecular medicine are cause for major concern. Following the establishment of the Canadian Schizophrenic Foundation and the American Schizophrenic Association in 1967 for instance, Hoffer notes that it suddenly became impossible to publish nutritional research in establishment medical journals ( 11, 65, 73 ). This occurred in spite of the fact that prior to this Hoffer had succeeded in having around 150 articles published ( 73 ). Dr Hoffer and Dr Osmond were subsequently called before the Ethics committee of the American Psychiatric Association ( APA ) and asked why they were "publicising a treatment not acceptable to standard psychiatry" ( 73 ). One of the assistant editors of the APA journal even went so far as to announce that "he would never allow any article from our group to appear in his journal" ( 73 ). The peer review process, according to Hoffer ( 73 ), was used to prevent nutritional research from appearing in mainstream psychiatric journals. Hoffer points out that ( 73 ) "even today the Medical Index will not abstract our journals" and "not a single attempt was made to repeat our double blind controlled studies" ( 65 ).

Publication in medical journals and acceptance by mainstream medicine clearly has little to do with either evidence or efficacy. This however has always been the case since mainstream medicine found need to resort to legal and political methods to outlaw the much safer and more natural holistic therapies, a task greatly facilitated by university trained reductionists.

Hoffer, Pauling, Williams and colleagues are however in excellent company since history shows that scientists who comprise the more rigid thinking conservative majority usually reserve their most vehement condemnation for scientists who make the most important scientific discoveries. According to Hoffer for instance ( 67 ), when Sir Thomas Sydenham developed a dramatically more effective treatment for smallpox in the 17th century he was rewarded by being challenged to a "duel". Hoffer cites the comments of Sydenham ( 67 ): "a new idea is like a sapling in the middle of the road, and if it's not fenced in, it will be galloped over by the trampling hordes." Of course the degree to which new ideas are undeservedly condemned and rejected is directly proportional to the collective mental rigidity, bias, and insecurity of the critics themselves.

As has been pointed out by Hans Selye ( 76 ), who although himself once the victim of condemnation from his medical colleagues is now regarded as one of the greatest medical scientists of the 20th century, "great progress can be made only by ideas which are very different from those generally accepted at the time" but "the more someone sticks out his neck above the masses, the more likely he is to attract the eyes of snipers." According to Barzun ( 77 ), who is cited by Selye ( 76 ), "the new truth invariably sounds crazy, and crazier in proportion to its greatness." The theories of Sigmund Freud were considered so controversial in 1910 that Professor Wilhelm Weyandt, Chairman of a medical congress in Hamburg, exclaimed ( 78 ) "this is not a topic for discussion at a scientific meeting; it is a matter for the police." Other famous scientists who have been viciously criticised by their colleagues include W.B. Cannon, Louis Pasteur, Copernicus and Galileo ( 4, 76, 76a ) to name but a few. Clearly, it is the purpose of the conforming majority to ensure that any scientific changes which do occur remain insignificant.

Mob mentality, insecurity and inertia should determine neither the pace nor the direction of scientific change. In spite of overwhelming scientific and historical evidence however, scientific change continues to be determined predominantly by popularity and profits, not evidence. To those psychiatrists who oppose the nutritional treatment of mental disorders, the simple retort of Hoffer is apt ( 79 ): "how many of their patients are well?"

b) History and Development of Orthomolecular Nutrition 
Although the term 'orthomolecular' was not introduced until 1968 by Linus Pauling in his report into "Orthomolecular Psychiatry" ( 3, 39 ), megavitamin therapy began many years earlier. Wilfred Shute was one of the first doctors to use megavitamin therapy when he used large doses of vitamin E to treat heart disease in 1933 ( 3 ) while large doses of vitamin B3 were also used in the 1930's and 1940's to treat vitamin resistant pellagra cases ( 3,11, 40 ). This was followed by the use of megadoses of vitamin B3 to treat athritis ( 3, 41 ) and further reports of the use of large doses of vitamin E to treat heart disease ( 3, 42, 55 - 58 ).

Megadoses of vitamin B3 were first used to treat schizophrenia by Cleckley Sydenstricker and Geeslin ( 3, 43 ) in 1939, and by Sydenstricker and Geeslin in 1941 ( 3, 44 ) although it was not until a decade later that Osmond and Hoffer ( 3 ) reported the first double blind study of the use of B3 to treat this disorder. Four double blind studies ( 3, 45, 46, 47, 49 ) and additional studies ( 3, 48, 59, 80 ) confirmed the effectiveness of megadoses of vitamin B3 for the treatment of schizophrenia. Additionally, a further double blind study by Ananth and co-workers ( 50 ) found that when large doses of vitamin B6 ( 75rng ) were combined with the B3 the results were superior to B3 treatment alone. Schizophrenics were also found to have an increased need for vitamin C ( 80, 91 - 94 ). Subsequently, in 1969, many psychiatric patients were found to have an increased need for vitamin B6 ( 60 ).

Evidence also began to accumulate that children suffering from learning disorders, autism and hyperactivity also had an increased need for various B vitamins, particularly B3, B5 and B6 ( 3, 81, 82, 83, 121,122; see also B vitamins ). Additionally, adolescents with low levels of vitamin B1 who suffered from excessive anger, irritability and aggressiveness ( 84, 99 ) were found to respond positively to megadoses of this vitamin ( 84, 99 ). Patients suffering from agoraphobia, panic attacks and anxiety also responded positively to megavitamin B treatment with B1 and B6 ( 84, 100 ).

In spite of continuing evidence of the importance of an orthomolecular approach to schizophrenia ( 79, 95 ), Hoffer claiming a 90% recovery rate from his experience with 5000 patients ( 79 ), the medical opposition to such treatments has been intense ( 3,11, 65, 73, 84 ), unlike the enthusiasm with which medicine previously welcomed bloodletting and purgation with mercury based laxatives. There have been various trials organised which have reported negative results of megavitamin therapy ( 74, 75, 84 ) although such studies may have been characterised by bias or errors (11, 73 ). One negative study for instance, directed by Wittenborn ( 95 ) for the National Institute of Mental Health ( 11, 84) was used by the NIMH and the American Psychiatric Association to attack the credibility of orthomolecular treatment ( 11 ). However, when Wittenborn re-analysed his data a year later (11, 84, 96 ) he reported a sub-group of patients ( these were the more acute patients ) who demonstrated significant improvement following vitamin therapy, thus verifying the earlier claims made by Hoffer regarding acute patients. This second report however, was "never referred to by the critics of megavitamin therapy" ( 11 ) and was "greeted by a cold silence" ( 11 ).

At around the same time, in 1973, the American Psychiatric Association published the result of their inquiry into orthomolecular psychiatry entitled "Megavitamin and Orthomolecular Therapy in Psychiatry" ( 3, 84, 97, 98 ). Since the attitude of the APA to megavitamin therapy seems to have been well established before publication of this report it is hardly surprising that the report results were also consistent with this same attitude. It is also hardly surprising that the validity of the APA report was questioned by Pauling ( 3, 97 ). Since the minute details of this controversy have previously attracted more than adequate attention from those on both sides of this argument I prefer to emphasise the fact that it is the wider question, which is frequently ignored, which is of vital importance. That is, is modern psychiatric therapy safe and effective and does it have a solid biochemical basis? The answer to both questions is of course a resounding 'no' ( see Health Trends, But What about Efficacy? ).

There are also numerous other uses of megavitamin therapy. I have already considered elsewhere the evidence concerning the use of vitamin B6 for the treatment or prevention of both asthma and heart disease ( see B vitamins ). Megavitamin therapy may also be used for the treatment or prevention of arthritis ( 4, 10, 101,102 ), allergies (10,102 ) and stress ( 4, 10, 61, 108, 109 ). While pantothenic acid may be useful in the treatment of both osteoarthritis and rheumatoid arthritis ( 10,102 ), vitamins B6, C, and E may also be useful in the treatment of the former condition ( 10,101, 102, 103 ). Pantothenic acid has also been found effective in the treatment of allergic conditions ( 10, 102, 104-106 ) and stress ( 4, 10, 108,109 ) while vitamin B6 has been found to reduce sensitivity to MSG ( 107 ). The effect of pantothenic acid on resistance to allergies and stress is hardly surprising in view of the importance of this vitamin for the maintenance of normal adrenal function ( 10,108,110, 111 ) and the fact that certain individuals may have a dramatically increased need for this vitamin (10, 61 ). High doses of vitamin B6 have also been found to be effective as a treatment for carpal tunnel syndrome ( 102, 103, 112-117 ) and may also be beneficial in diabetes ( 10, 118-120 ).

I have so far neglected to mention the use of megadoses of vitamin B3 to lower cholesterol levels, the first report of which by Hoffer ( 11 ) in 1955 has been regarded as the beginning of megavitamin therapy and the first medical use of megavitamins ( 11). This discussion is concerned with the use of vitamins as nutrients, to correct nutritional deficiencies, not their use as drugs for non-nutritional reasons ( 3, 123 ). A very clear distinction is needed in this regard. The use of massive doses of vitamin B3 to reduce cholesterol, or for that matter the use of massive doses of vitamin D for osteoporosis, have no established nutritional basis.

The same arguments may also be used in regard to the use of massive doses of vitamin C in the treatment of cancer or various immune conditions ( 3,11, 67 ). While such treatments may or may not be effective, without a nutritional basis such applications represent the use of nutrients as drugs and are therefore beyond the scope of the present discussion. While moderately increased doses of vitamin C ( ie 1000mg daily or 3g daily for short periods ) may perhaps be justifiable on a nutritional basis, doses in excess of this would appear to resemble the pharmacological use of vitamins B3 and D which I have already referred to. From a personal point of view I should also add that while I have never found vitamin C to be effective when I have experienced viral infections, in spite of evidence to the contrary ( 3 ), very occasionally on the other hand, I have experienced some benefits of this vitamin during bacterial infections.

Unlike in the previous instances, the use of vitamin B3 in mental disorders does have a much more established nutritional basis since it is well known that a deficiency of this vitamin may cause symptoms of depression or schizophrenia (see B vitamins ). Since the effectiveness of vitamins when used in a nutritional sense is clearly dependent upon the presence of a deficiency condition, perhaps a cellular deficiency, they will clearly have no positive effect in those persons whose symptoms are not due to a deficiency of the supplemented vitamin. This clearly is not the case when nutrients are used as drugs, the predictable consistency of effects in such applications readily distinguishing between nutritional and non-nutritional use of nutrients. The aim of genuine nutritional treatment is to restore cellular nutrients to an optimum, but not excessive, level. Clearly, since nutritional use of megavitamins can never be effective in the absence of the corresponding deficiency, lack of consistent effects of such therapies is a major problem for those who support a reductionist drug paradigm of disease treatment. Total consistency of the efficacy of nutritional therapies awaits the universal prevalence of nutritional deficiencies.

The evidence in support of orthomolecular nutrition is voluminous and it is clearly impossible for me to do anything other than merely uncover the tip of the iceberg in this brief review. I will however be considering additional more recent evidence in Section 4 of this article. Let us look now at the underlying scientific reasons for the effectiveness of orthomolecular nutrition. 

c) Biochemical and Scientific Basis of Orthomolecular Nutrition
While practitioners were reporting the efficacy and many diverse applications of megavitamin therapy, its underlying biochemical and scientific basis was being clearly established by Roger Williams ( 4, 5, 61 ). According to Williams ( 4 ), the following thesis formed the basis of this new approach to nutrition: "the nutritional microenvironment of our body cells is crucially important to our health and deficiencies in this environment constitute a major cause of disease." Williams et al ( 5 ) argue that the following four facts, "which have not entered the mainstream of medical thinking", are crucial to the general acceptance and understanding of the importance of optimum nutrition.

1. "Food is part of our environment" and forms our internal environment. Recognition of this fact raises the following question ( 5 ): "what happens to cells and tissues if this nutritional environment is not well adjusted?"

2. "Suboptimal nutrition prevails in nature." Williams et al ( 5 ) point out that nutrition is the limiting factor throughout the biological kingdom since growth and vitality can generally be dramatically improved by optimising nutrition. The result of this fact is that nutrition becomes ( 5 ) "something which is always subject to improvement" and "normal nutrition" becomes a "relatively meaningless expression."

3. "Individuality is a crucial factor in nutrition." The principles of biochemical individuality outlined by Williams ( 61 ) cannot be denied and go far beyond nutritional individuality. The importance of biochemical individuality is such that I will consider this matter below ( see Biochemical and Nutritional Individuality ).

4. "In nutrition, teamwork is essential." This fact, according to Williams et al ( 5 ), is not understood by mainstream medicine which regards nutrients as being totally worthless unless they can be used singly like drugs to treat specific symptoms or diseases.

Williams and co-workers ( 3, 5 ) stress the fundamental importance of these four facts in the study of medicine and nutrition:

The importance of these four facts is such that they require separate consideration commencing with the matter of suboptimal nutrition and our nutritional environment.

It is a grave error to assume, as modern medicine continues to do, that perfect nutrition is the general rule in modern society. The pathways traversed by nutrients from soil through to incorporation into human cells and tissues are indeed perilous and are rendered considerably more so by modern science. As has been pointed out by Williams ( 4 ), even within the human body the delivery of "about forty nutrients to billions of diverse cells all over the body is a huge logistic undertaking." Since the cells of the body rarely if ever receive optimum amounts of all nutrients there exists in the body a constant state of cellular malnutrition ( 4 ), a situation which is further aggravated by our depleted soils and modern processed adulterated foods. Nowhere is our nutritional environment more important than before we are born, during pregnancy ( 4 ). Williams emphasised three decades ago ( 4 ) that optimum nutrition during pregnancy has the potential to eliminate most "spontaneous abortions, stillbirths, premature births and the birth of deformed and mentally retarded babies." Tragically, in contemptuous disregard of the nutritional environment of the unborn, doctors in the past even advised pregnant women to practise semi-starvation during pregnancy to ensure that they had a smaller baby and easier delivery ( 17 ). The staggering importance of these matters warrants our most urgent attention.

The importance of the nutritional environment of the unborn has been graphically illustrated recently by the "discovery" of the effects of folic acid deficiency during pregnancy ( see Nutrition is for the Birds ). Doctors however were initially reluctant to accept this discovery and even greeted it with "hostility" (11 ). Even as late as 1996 suggestions were still being made that the "risks" and "safety concerns" of folic acid supplementation may outweigh any benefits ( 205 ). In spite of the fact that the validity of this discovery has only recently been accepted by modern medicine, Roger Williams had warned of the consequences of folic acid deficiency during pregnancy 30 years ago ( 4 ). The vitally important point here is not simply that folic acid deficiency during pregnancy may adversely effect the developing embryo, but rather it is the underlying nutritional mechanism of this effect which is of absolutely fundamental importance. That the developing embryo is affected adversely by suboptimal nutrition is hardly surprising, but unless we have a genuine understanding and appreciation of the underlying nutritional principles that are involved, this same lesson will need to be repeatedly relearned for each separate nutrient.

Evidence of the importance of nutrition during pregnancy is extensive ( 4 ), but it is hardly surprising to learn that more than one nutrient is involved ( 4 ). Apart from folic acid, Williams ( 4 ) also emphasises the importance of various other nutrients during pregnancy, including pantothenic acid, vitamin A, amino acids, zinc, manganese and various other B vitamins. Various studies have shown that the health of children, both physical and mental, is related to the nutritional quality of the diet of the mother during pregnancy ( 4 ). The importance of nutrition during pregnancy may be further underlined by the dramatic consequences of the drug thalidomide since it seems that the ill effects of this drug were due to its ability to interfere with the actions of vitamins B2, B3 and B5 ( 4 ).

But even in spite of all these facts doctors apparently remain disappointed that supplementing pregnant women with one vitamin alone, namely folic acid, only lowers the incidence of neural tube defects by 75% ( 11 ). Interestingly, according to a recent report combined supplements of folate and iron during pregnancy may significantly reduce the risk of childhood leukaemia ( 138 ). The essential nature of the various other vitamins which are necessary for proper reproduction will need to be discovered one by one until the the vital importance of the underlying nutritional mechanisms are finally understood and accepted. According to Williams (4 ): "those who doubt that faulty microenvironments often distort the early embryonic development of human beings have no logical or scientific way to turn to justify their doubt" Williams summarises: "if we cannot yet control nature, we do nevertheless have the means to control nurture."

Since the third fact mentioned by Williams relates to biochemical individuality which I will consider separately in the next subsection, let us examine the final factor, namely the teamwork nature of proper nutrition.

As far as optimum nutrition is concerned one of the major difficulties for mainstream medicine which has resulted from the restrictive nature of reductionist science is the inability to understand the interdependent nature of nutrients ( 3-5 ). Although all nutrients are part of a constructive team the overall strength of which is only as good as its weakest link ( 3-5 ), modern medical science prefers to use nutrients singly, as though they are drugs ( 3-5 ). Such a belief seems rather odd since most people, even scientists, do not consume ( 3,123 ) "tryptophan on Monday, ascorbic acid on Tuesday, calcium on Wednesday etc.," but rather consume balanced meals containing a broad range of nutrients. In fact, we are constantly reminded of the importance of balanced wholesome meals. In spite of this, science tells us that if we break the meal down into its constituent nutrients it is quite acceptable, and even scientific, to test these nutrients singly as though they are drugs. It is however, the fundamentally constructive nature of nutrients which distinguishes them from drugs. As is noted by Williams and co-workers ( 3, 5 ): "if a medicine were to act constructively, it would cease to be a medicine. It would be a nutrient."

According to Williams (4 ) it is the inability of modern medical science to understand the teamwork nature of nutritional therapy which has resulted in the persistent misuse of clinical trials in attempts to demonstrate the clinical effectiveness of single nutrients. While drugs may be so tested because they do not rely on the presence of other drugs for their effectiveness, a nutrient on the other hand will only be maximally effective if it is the only missing link or limiting factor in the trial participants. Associated deficiencies will detract from the effectiveness of the trialled nutrient, a fact which seems to be little understood by medical scientists. As has aptly been pointed out by Williams (4 ), nutrients "work together, and no one of them can be tested as though it were an independent agent working by itself." Williams draws attention to the enormous amount of money and resources which have been wasted on nutritional research simply through failure to understand the teamwork nature of nutrition ( 4 ): "up to now much of this money and effort has been wasted simply because we have failed to appreciate adequately that nutrients are always involved in teamwork; we have allowed preconceived notions, gained from our centuries-old experience in testing drugs, to dominate our thinking."

To demonstrate the importance of the teamwork nature of nutrition Williams ( 4 ) cites the case of two trials of the effects of nutritional supplements upon tuberculosis patients ( 136, 137 ). The first trial ( 136 ), which used nutritional supplements which were lacking significant nutrients such as B5, B6, B12, folic acid and vitamin E, failed to reveal significant improvements in the supplemented patients. The second trial ( 137 ) ensured firstly that ALL participants were well nourished, while one group was additionally given a broad range of nutritional supplements. Williams describes the results in the supplemented group ( 4 ): "there was more improvement in chest X rays; more patients were discharged as cured; most patients had improved appetites; as a whole, they gained weight about twice as fast as the control group; and they showed .decreased restlessness and demand for attention." Although the control group in this study was "exceedingly well nourished" and the supplements used were "not up to modern standards" even at that time, the differences between the groups were nevertheless described as "impressive" (4 ).

Given these facts it is interesting to observe the current argument amongst scientists about the effects of nutrition upon heart disease. While most scientists acknowledge the positive effects of a balanced diet when it comes to heart disease and cancer, there is considerable consternation in scientific circles about which nutrients are involved. Endless clinical trials are organised as scientists desperately seek to discover the "magic" nutrient but with each negative trial result scientists seem to see their traditional contempt for nutrition as having been validated. According to Williams 30 years ago ( 4 ): "despite all the expensive experimentation done on heart disease, no one has tried, in a straightforward way, the prophylactic effect of a supplement that has been formulated in a sophisticated and comprehensive manner. We have presented evidence that the results should be strongly positive." Even today however, 30 years later, it seems that nothing has changed ( 315 ): "there are no completed large scale randomized trials of vitamin C or multivitamin supplementation in primary or secondary prevention of cardiovascular disease." 

This is an absolute disgrace which not only serves to draw attention yet again to medicine's complete neglect of nutrition, but it also underlines the need to continue to emphasise the basic rules of nutritional science ( 4 ); "all diseases need to be explored from the standpoint of what various nutrients can do when tested under conditions that allow the nutrients to function cooperatively."  The unreliable and inconsistent nature of modern nutrition research has recently been emphasised again by Shikany and White ( 325 ).

Although it is commonly believed that the classical deficiency diseases such as pellagra and beriberi maybe corrected by supplements of single nutrients this is only so if other cofactors are not also limiting ( 3-5 ). As Williams and co-workers point out ( 3-5 ), victims of these diseases frequently do not make a full recovery until all the required nutrients are provided. In spite of these facts however, normal nutrition "education" tends to favour the use of nutrients only if they are able to be used as "medicines"( 3, 5 ).

While science teaches us that coenzyme A and cortisol are produced from pantothenic acid ( 4, 124, 126, 131 ), we know that this vitamin cannot produce these compounds by itself. We know that thyroxine is produced from iodine, but numerous other cofactors are also necessary ( see Thyroid page ). We know that magnesium, zinc, riboflavin and phosphate are necessary in order to convert pyridoxine to its biologically active form ( 127, 128, 129, 130, 132, 133 ) and we know that vitamin E and selenium are synergistic ( 124, 134, 135 ) while the combination of different tocopherols and tocotrienols may also be more effective than alpha tocopherol alone ( 125, 203 ). In fact, it is increasingly being realised that cellular levels of gamma-tocopherol, the natural form of vitamin E in foods, may actually be reduced by supplements of alpha-tocopherol ( 203, 297, 299 ).

Although all these facts have been clearly established by science, clinical trials involving the use of nutrients are usually carried out with the nutrients being used singly in direct contravention of the fundamental principles of nutritional science as outlined by outstanding scientists. If we examine clinical trials of vitamin B6 such as I refer to elsewhere for instance ( see B vitamins ), it will be apparent that countless investigators fail to acknowledge the basic rules of nutrition. Additionally, clinical trials of vitamin E are usually confined to the use of alpha-tocopherol alone in spite of the fact that it is well known that this unnatural form of vitamin E is considerably less effective than gamma-tocopherol or mixed tocopherols and tocotrienols ( 125, 203, 297, 299 ). Current nutritional research is carried out on the basis of an assumption that there will be no other associated nutritional deficiencies present in trial participants that will interfere with the response to the trialled nutrient. Generally, no precautions whatsoever are taken to positively exclude the possibility of other limiting deficiencies.

Williams expressed his concern about this matter three decades ago and sought through his teachings and publications ( 4, 51 ) to address the shortcomings of nutritional research and the "billions" of dollars which were being wasted on poorly conducted nutritional research. Thirty years later however, nothing has changed. This is an absolute disgrace and underlines yet again the unscientific nature of "scientific" research.

Let us examine now the third fact mentioned by Williams and co-workers, namely the vitally important matter of individuality.

d) Biochemical and Nutritional Individuality 
Individuality, which has formed a fundamental part of holistic healing systems for thousands of years ( 7, 8, 9, 21 ), still retains its traditional significance in Ayurvedic medicine and traditional Chinese medicine ( 8, 9, 21 ). In the West also, individuality has been a central part of holistic healing systems from the time of Hippocrates and Galen ( 7, 8 ). However, the introduction of reductionist science in the West and the subsequent demise of holistic healing traditions has seen individuality become of diminishing importance over the past 300 years ( 7, 8, 9, 21 ). The persistence with which modern science has sought to homogenize the entire human race has displaced any serious interest in individuality from all mainstream Western health care systems. According to the Australian Government Committee of Inquiry into Chiropractic, Osteopathy, Homeopathy and Naturopathy ( 294 ), orthodox medicine practices "individual treatment" of the "disease", NOT the patient.

Reductionist medical science is about convenience, and there is after all, nothing more inconvenient than the individual who cannot be reduced to a series of make believe statistical averages ( 61 ). Another difficulty with the acceptance of biochemical individuality relates to the implications as far as human pride is concerned since the successful person seeks to take credit for his/her achievements and deny any significant contribution from genetics ( 61 ). In the words of Williams ( 61 ): "whatever must be charged to native endowment may be regarded as on the debit side of the ledger so far as his self-esteem is concerned." Even in spite of these difficulties the groundbreaking research of Roger Williams in the mid 20th century 61 ) has resulted in individuality beginning to regain its former importance, particularly in the area of medical research.

Williams points out that normality is commonly defined by orthodox medicine as those characteristics which are possessed by 95% of the population, those outside this figure being considered to be "deviates" ( 61 ). Williams argues however (61 ), "if 0.95 of the population is normal with respect to one measurable item, only 0.902 (0.95²) would be normal with respect to two measurable items and 0.60 ( 0.95¹⁰) and 0.0059 ( 0.95¹⁰⁰), respectively, would be normal with regard to 10 and 100 uncorrelated items." Williams therefore proposes the hypothesis that ( 61 ) "practically every human being is a deviate in some respects."

To test this hypothesis Williams and co-workers ( 61, 139 ) conducted a study of two groups of "normal" young men who were maintained under "basal" conditions. Each member of these two groups was repeatedly tested to determine their levels of various minerals and biochemical substances such as lactic acid, urea, amylase, phosphatase and blood sugar levels. The results of this study revealed not only wide ranging variations in many of the biochemical markers tested, but furthermore, most of these variations were consistent and unique to each individual during the entire duration of the trial. These results have been confirmed more recently by Robertson and colleagues ( 143 ).

These facts underline the serious shortcomings of modern pathology tests which are based upon the accuracy and reliability of "normal ranges". The determination of normal ranges is based upon surveys of people who have been clinically assessed as being "normal", the assumption being made that such persons are completely "normal" in every respect and therefore every one of their biochemical markers will also be exactly "normal" at all times ( 61 ). Such an assumption is clearly unwarranted since it not only denies the existence of the vast amount of evidence of biochemical individuality, but furthermore, it also assumes that the original clinical assessment of normality is infallible ( 61 ). If for instance, because of the existence of a disease susceptibility or subclinical disease, participants in such trials have blood values which lie outside the "normal range", then since such participants have been declared "normal", the normal range must be extended to include this data ( 61 ). There is an enormous potential problem here since any gradual community trends towards a certain disease susceptibility will remain unrecognised as "normal" ranges are altered to embrace such changes. Since the "normal" ranges have been derived initially from clinical examination, why not simply use clinical examination and dispense with more indirect tests?

It is abundantly clear that in the world of modern medical science normality has no "internal" definition determined by the status of the individual, rather, the state of "normality" is determined by the traits of others who are totally remote from the individual. The person with optimum health and well being for instance, would be decidedly abnormal if others lack such qualities. It is absolutely deplorable, as we enter the 21st century, that modern medical science is no more able to understand or define internal normality or optimum health than was the case 200 years ago. Absolutely no progress ( or even interest ) has been made in this regard. Medicine is only able to evaluate normality by applying external statistical data. This incredible failure of medicine is being further perpetuated as scientists increasingly resort to statistics to explore what is happening internally.

Williams dealt with the topic of the fictitious average or "abstract" man more than half a century ago during an address to the Philosophical Society of Texas ( 237 ): "real people are of very great concern to me and I think to all of us, but abstract man is only an idea. He doesn't have any particular job, he doesn't marry anyone in particular, he doesn't have any particular trouble or any particular aspirations." Williams concludes: ".......I am willing to let someone else worry about him."

Since a detailed examination of Williams' comprehensive study of biochemical individuality, which embraces variations in genetics, anatomy, biochemistry, and endocrine glands ( 61 ), is beyond the scope of the present discussion, this discussion will be restricted predominantly to the matter of individuality in nutritional needs. As is noted by Williams in regard to the discovery of promising new medical treatments ( 61 ), an "open door" "presents itself when every individual is considered to be a potential deviate with respect to his nutritional needs." Since I have considered various other aspects of individuality elsewhere, the interested reader is referred to these articles ( see Body Types, Traditional Medicine, Chronic Fatigue Syndrome, B vitamins, Nutrition is for the Birds ).

Nutritional individuality, according to the orthodox viewpoint, simply does not exist since everyone in the world of the same age and sex is believed to require precisely the same amount of each particular nutrient in order to maintain health. The only exceptions to this are people suffering from specific diseases such as alcoholism or various gastrointestinal disorders. In fact, from the perspective of orthodox medicine we are all so nutritionally identical, nutritional clones if you like, that our nutritional needs are calculated for us before we are even born!! According to Williams ( 4 ): "the orthodox position advanced in medical education today appears to be this; 'the blood routinely carries full nourishment to all the cells and tissues.' This is preposterous biologically; it overlooks the crucial, undeniable fact that whether the blood carries adequate nutrition or not depends upon what we eat."

As has been pointed out by Williams ( 4 ), the orthodox viewpoint, which denies the existence of human individuality, is based upon the assumption that we each possess perfect digestion and absorption of all nutrients and an internal delivery and utilisation system which always completes its numerous tasks with total perfection. These beliefs have formed the basis of the orthodox approach to nutrition for the past half century.

In sharp conflict with the orthodox viewpoint, Williams used extensive evidence to demonstrate that in fact most human beings have an increased need for one or more nutrients (3-5, 61 ). According to The Heinz Handbook of Nutrition (144 ):

As is noted by Williams ( 4 ): "if we gear all our thinking and our investigations to the concept of the 'normal man' who is approximately average in every respect, we are probably leaving out of our thoughts and investigations the very individuals who are vulnerable to heart attacks. This is an indefensible modus operandi." Williams and colleagues ( 3, 5 ) emphasise that "those who neglect this principle may concern themselves unwittingly with the nutrition of a miniscule part of the whole population - those whose needs are about average in each of dozens of respects."

This increased need, which evidence indicates applies to a broad range of vitamins, minerals and other nutrients ( 61 ), is caused either by various inefficiencies in digestion, absorption, metabolism and excretion of the affected nutrients ( 4, 61, 158, 192 ) or by more transient environmental factors such as stress, drugs, pollutants, and infections ( 4, 10, 61, 158, 192 ). Williams points out that by and large, inefficiencies in nutrient metabolism have a genetic basis ( 61 ). Differences in absorption and assimilation, and also kidney excretion patterns, are likely to follow a genetic pattern. Challem ( 192 ) argues that a new "vitamin paradigm" needs to be established which accepts the fact that "individual nutritional requirements are partly fixed by genetics but also dynamically influenced by variations in the body's biochemical milieu and external stresses."

If in fact various diseases of modern society are due to nutritional deficiencies caused by genetic defects in nutrient metabolism, then, since symptoms per se are not inherited, variations in the clinical expression of these deficiencies in succeeding generations would not be too surprising. In my own case for instance, although asthma has a strong genetic component, my family has never had any history of this disorder ( see B vitamins).

I have considered evidence elsewhere ( see B vitamins, Nutrition is for the Birds ) that certain persons require levels of specific B vitamins which are perhaps 100 times the normal requirement. Although, in the case of vitamin B12, people who lack the intrinsic factor may require more than 1000 times the normal amount of this vitamin if it is taken orally, this must be regarded as exceptional. When it comes to the other B vitamins it would seem reasonable to conclude that those persons whose needs are 100 fold above normal for one or more of these vitamins would represent the extreme end of the spectrum since this represents around 1% utilisation of the affected vitamins.

According to Williams ( 4, 61 ), the existence of extreme genetic disturbances in nutrient utilisation could not occur without other persons suffering from less severe forms of the same genetic weakness. In other words, if one person requires 100 times more of a specific vitamin than normal then there must also be others who require 10 or 20 times the normal amount. Williams describes this as the (4, 61 ) "principle of genetic gradients." It is odd that although orthodox medicine readily accepts the existence of various severe vitamin dependency conditions where there is an extremely high need for certain vitamins ( B vitamins ), they nevertheless seem to believe that virtually everyone else has perfect vitamin assimilation. In fact, most people probably have only moderately increased needs.

There is in some circles, as has been noted by Williams ( 61 ), considerable reluctance to accept the validity of genetic weaknesses because of the belief that such weaknesses are untreatable and irreversible. This of course is not necessarily so since various genetic disorders are effectively treated by modern medicine ( 61 ). Furthermore, as Williams points out ( 61 ), the potential of nutritional therapy in regard to genetic nutritional diseases, referred to by Williams as the "genetotrophic" approach ( 3-5, 61,140 ), is enormous. The genetotrophic approach is described by Williams thus ( 61 ): "every individual organism that has a distinctive genetic background has distinctive nutritional needs which must be met for optimal well being." This gave rise to the concept of "genetotrophic diseases" ( 238 ): "a genetotrophic disease is one which occurs if a diet fails to provide a sufficient supply of one or more nutrients required at high levels because of the characteristic genetic pattern of the individual concerned."

Williams further points out that if human variations in nutrient needs are significant then the genetotrophic approach is of paramount importance and becomes more so the greater the extent of this variation ( 61 ). Since the available evidence demonstrates a very considerable degree of variation there may be an opportunity here to completely abolish various genetic diseases by optimising nutrient intakes and this is the remarkable significance of the genetotrophic approach ( 3-5, 61 ). The possible scope of this type of therapy is almost limitless since ( 61 ) "almost any deformity, weakness, or disease could be created or accentuated by a lack of a crucial nutrient from a crucial tissue at a crucial time." The first step in the successful application of such therapies is a thorough understanding of the principles of biochemical individuality.

The groundbreaking work of Williams, although still largely neglected by practitioners of mainstream medicine, nevertheless continues to heavily influence the world of medical research. Williams' research into biochemical individuality or "genetic polymorphism" ( 141 ) has been credited with the abandonment of the previous medical belief involving the "rigidity" of genes ( 141 ). Williams also recognised, through his development of the genetotrophic concept, that "nutritional status can influence the expression of genetic characteristics" (141 ) and ultimately that "our genotype gets transformed into our phenotype as a consequence of nutritional, lifestyle and environmental factors which are important in determining our health patterns." Davis and Williams ( 141,147 ) subsequently demonstrated that various genetic characteristics such as sleeping time after anaesthesia, healing time and weight gain after surgery, could be influenced by nutritional status.

Up to this point we have confined our discussion of nutritional individuality to an increased physiological need for essential nutrients only. There are however, many other substances, which although normally non-essential because they are synthesized by the body, may become essential in the individual person if the body cannot produce them in sufficient amounts. In this connection Williams mentions substances like coenzyme Q10, lipoic acid, lecithin, glutamine, and other amino acids (2, 3, 4, 61 ) but with our current knowledge we could add various others such as carnitine, phosphatidylserine, taurine, creatine, probiotics, enzymes, and a whole host of antioxidants ( 145,146 ). Some of these, such as coenzyme Q10 and carnitine, have already demonstrated significant health benefits ( 84, 145, 146 ), a fact which seems to contradict the "non-essential" status of these substances ( 192 ). In fact, when the reality of biochemical individuality is acknowledged, the description of some nutrients as "non-essential" becomes spurious, unscientific and misleading. Potentially, virtually any nutrient may be considered to be essential in someone at some time.

It is abundantly clear that the potential benefits of biochemical individuality and the genetotrophic approach are absolutely enormous. With its solid scientific and common sense basis, its safety and freedom from toxicity, its inherently curative nature and its ability to reverse genetic diseases, the genetotrophic approach has the ability to revolutionise the entire practice of medicine. It is absolutely shameful that modern medicine, even 50 years after the introduction of the concept of biochemical individuality, continues to deny the nutritional individuality of patients and continues to promote increased dependence upon toxic symptom concealing iatrogenic disease causing drugs.

In concluding this section I should perhaps note the concern expressed by Williams that the principles of biochemical individuality should not be seen as completely contradicting and displacing the use of general principles and statistical averages which are used so widely in modern science ( 61 ), the suggestion perhaps being made that "it isn't scientific to study individual men" ( 237 ). The two approaches should be used together in a complementary fashion. Williams claims that the principles of biochemical individuality are essential when it comes to the practical application of medical science whereas general principles and averages may be more useful in a theoretical or research setting.

Let us move on now to examine more recent medical developments as mainstream medicine slowly begins to discover the remarkable potential of nutritional individuality and attempts to catch up to the research carried out by Williams and colleagues 40-50 years ago.

Click here to access Part 2 of this article comprising the following sections:

Section 4 - Beyond Deficiencies: mainstream medicine plays catch-up

Mainstream Medicine Plays the Catch-up Game
Genetic Nutrition: catch-up practice continues

Section 5 - The Future: more drugs or less malnutrition?

Science or Progress - a return to common sense?
The Current Medical Paradigm - the use of drugs to conceal malnutrition
The New Paradigm - the use of nutrients to cure malnutrition

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This page was last updated on 18/05/09
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