The War Against Vitamin Therapy

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The War Against Vitamin Therapy

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Abram Hoffer, M.D.

First published June 1996 in The Townsend Letter for Doctors and Patients.

Reprinted with permission.

" Dr. Klenner reported that patients given vitamin C would suffer no

residual defects from their polio. A controlled study in England on 70

children, half given vitamin C and half given placebo showed that none of

the treated cases developed any paralysis. "

The Vitamin Paradigm Wars

Abram Hoffer, M.D, Ph.D.

I have been involved in megavitamin controversies from 1955 when with

two colleagues we [1] published our paper showing that niacin lowered total

cholesterol levels. This was quickly confirmed because Dr. W. B. Parsons,

Jr[2] . It was easy to measure cholesterol levels. Dr Parsons is one of the

most knowledgeable and experienced internists in the use of niacin to lower

cholesterol levels. But after we[3] published a much more comprehensive

paper where we concluded: (1) that the addition of niacin or niacinamide in

large doses was therapeutic for acute and non deteriorated schizophrenics;

(2) was not therapeutic for chronic patients, our involvement in

controversy became massive, until today even though every study using the

same type of patients, the same methods and the same regimen, has

corroborated our findings.

The conclusions reached by Dr. E. Cameron and Linus ing[4] on the

beneficial effect of ascorbic acid on the outcome of terminal cancer was

just as forcefully rejected by the cancer establishment. The main reason

for the non acceptance of the Vale of Leven's conclusions and for the non

acceptance of our psychiatric findings is very simple. We are just now

beginning to emerge from the vitamins-as-prevention paradigm into the

vitamins-as-treatment paradigm. Psychiatry is simply ten or more years

behind the rest of the medical sciences.

The Five Stages of Vitamin Discovery and Use

Machlin[5] divided the history of the vitamins into five periods. The

first phase was present from 1500 B.C. to about 1900 A.D. when it was

empirically observed that certain foods prevented some diseases. Egyptians

used liver to prevent night blindness. Central American Indians used

specially treated and cooked corn to prevent pellagra for several thousand

years.

The second period started about 1890 and continued until about 1910.

During this period the relationship between the lack of certain foods and

disease became established. Thus polished rice was proven to cause beri

beri. Of course, if brown rice had remained the staple food of the Japanese

Navy there would have been no problem and no discovery of thiamin as a

vitamin. During the first period it became recognized that altering the

natural food supply would produce disease. This lesson is still imperfectly

understood by most modern societies.

The third phase from 1900 to 1948 was the golden age of vitamin

discovery, isolation and synthesis of vitamins. The fourth phase from 1933

began with the first commercial synthesis of vitamin C and continues today.

These four phases comprise the vitamin-as-prevention paradigm. This

paradigm became so firmly established that only now is it beginning to

weaken by the onslaught of new information.

The fifth phase is the recognition of health effects beyond

prevention and new biochemical functions. It is the vitamin-as-treatment

paradigm. It is beginning to enter the medical profession, has not yet been

accepted by the medical schools which remain many years behind in the

teaching of nutrition and is still tightly held by dietitians and many

nutritionists, especially those working for institutions.

The introduction of this last phase is credited by Machlin to our

paper in 1955 which showed that megadoses of nicotinic acid decreased total

cholesterol, the decrease being relatively greater the higher the initial

blood level. He wrote, " I somewhat arbitrarily started the fifth period

with the report in 1955 of the cholesterol-lowering effect of niacin, which

is a well-accepted response of the vitamin that has nothing to do with its

coenzyme role and is a clear health effect beyond preventing the deficiency

disease pellagra " . I had concluded many years ago that this early report

would be one of the most important findings which would take us into the

modern paradigm. It is the first vitamin to be approved for megadose use by

FDA, for lowering cholesterol, but it could also be used for any other

indication including the schizophrenias.

The Vitamin-as-Prevention Paradigm

This paradigm is described by the following rules or beliefs:

1) That vitamins are catalysts and therefore are needed in very small

doses since they can be recycled almost indefinitely.

2)That they are needed only to prevent deficiency disease i.e.

diseases caused by a deficiency of these vitamins. Thiamin is needed to

prevent beri beri, nicotinic acid is needed to prevent pellagra and vitamin

C is needed to prevent scurvy.

It therefore follows that any use of vitamins which disobeys these

rules is not indicated and has by many medical societies been considered

unethical practice or malpractice. If they are needed only in small doses

the use of large doses must be forbidden. If they are used only to prevent

disease, any use to treat other disease must be forbidden.

For these reasons regulatory daily requirement were developed as a

guide to society and to the professions. They are invariably small doses

based upon this paradigm and upon very little real hard evidence of their

practicality and usefulness. The prevention paradigm adherents presented a

hard and secure front against those who would break its rules by enforcing

the view that large doses were never needed, that they were potentially

dangerous (these dangers were never clearly defined and related to dose

level, and the height of sarcasm thrown against vitamins-as-treatment

physicians was that the only thing vitamins would do is to enrich the urine

and the waters into which that urine ran. Just a few months ago a physician

attacked some of my views in a popular medical journal by claiming that the

waters around must be rich in vitamin C. If I had retorted I would

have added that this is better than enriching them with antibiotics,

tranquilizers, antidepressants and the thousands of drugs which now enrich

the waters. A physician friend and colleague lost his medical license in

Saskatchewan. One of the charges against him was that he gave a patient

intravenous ascorbic acid. Another was that he diagnosed a patient

schizophrenic with the help of a test developed by Humphry Osmond and I

called the HOD[6] test. This is a very helpful perceptual test which yields

probability levels for the presence of schizophrenia.

Vitamin-as-Treatment Paradigm

This paradigm contains the following new rules, based upon a good

deal of evidence:

) That optimum doses should be used in both prevention and treatment

and that these doses vary from very small to very large, i.e. into the

megavitamin range. For example to prevent pellagra one needs about 10

milligrams of nicotinic acid daily, but to prevent the symptoms of chronic

pellagra from recurring one will need close to 1000 mg daily. There is no

optimum doses for the whole population. It depends upon age, sex, type of

illness, type of stress, i.e. upon the individual. We will have to

determine the optimum levels for schizophrenics, for depressions, for the

arthritides, for lupus, for cancer and so on. This is well described by

[7] in his classic works on biochemical individuality.

) That vitamins may have activity which appears to be unrelated to

their properties as vitamins. This was a very difficult concept to accept

but the introduction of the word antioxidants struck a responsive chord and

many physicians who were terribly fearful of using vitamins had no

compunction against using the same vitamins an antioxidants. This fits in

with the increasingly popular view that hyper oxidation, the formation of

free radicals, is basic in the pathology of a large number of conditions

including cancer, senility and so on.

The Assault on the Vitamin-as-Prevention Paradigm

This began about 55 years ago with the report by the American

pellagrologists that chronic pellagra could not be treated except by very

large doses of nicotinic acid; they used 600 mg daily. It was also shown

that dogs kept on the pellagra- producing diet for a long time no longer

responded to small doses of this vitamin. They had become dependent and

needed much larger doses.

The next assault on this paradigm arose from the classic studies of

Kaufman[8] who reported in two books before 1950 the marked

therapeutic benefit to arthritics by giving them multigram doses of vitamin

B-3 daily. But this important work was ignored and hardly any physicians

are aware it was ever done.

The next attack came from a different direction, from the work of

Drs. Wilfred and Evan Shute[9] of Ontario who showed that large doses of

vitamin E given for adequate periods of time were very helpful in treating

coronary disease, burns, and were useful in prevention. They were not

ignored. They were almost destroyed by a medical profession which was

completely unaware of the importance of their work, did not believe vitamin

E was a vitamin and knew with absolute certainty that their work was

useless. The Shute Clinic, still in existence, treated over 30,000 patients

from all over North America. The agenda of the few attempts to repeat their

work was to show how useless vitamin E was. Today the major studies[10]

which have confirmed this early work still consistently refuse to

acknowledge the prior work of these great pioneers, as if the idea had

sprung freshly minted from their own foreheads when they launched the

Harvard Vitamin E studies. Had the Shutes' findings been taken seriously in

1960, think of enormous saving of human health, the enormous decrease in

human misery and the enormous financial saving over the past 35 years.

In the early Fifties, Dr. Fred Klenner began his work on megadoses of

vitamin C. He used doses up to 100 grams per day orally or intravenously.

In clinical reports he recorded the excellent response he saw when it was

given in large doses. He reported, for example, that patients given vitamin

C would suffer no residual defects from their polio. A controlled study in

England on 70 children, half given vitamin C and half given placebo showed

that none of the treated cases developed any paralysis while up to 20

percent of the untreated group did[11] . This study was not published

because the Salk Vaccine had just been developed and no one was interested

in vitamins. Dr. Klenner's work was ignored.

However, only after Linus ing entered the field with his classic

report to Science in 1968 did the use of megadoses of vitamins receive

major world attention. The public and a few scientists were immediately

attracted to his conclusions world wide, while the medical profession as a

block dumped all over him. Their main objection apparently was that he did

not have an M.D. Dr. ing became interested in vitamins about the time

he had decided to retire. He had won his second unshared Nobel Prize and

was getting tired and frustrated by the opposition to his work for peace.

He had made a few powerful enemies including Senator McCarthy of anti

communist fame, and ph Stalin of communist fame who considered his

views on the atom directly opposed to communist theory. At a meeting in New

York in 1966, both Dr. Irwin Stone and I met Dr. ing for the first

time. Dr. Stone had assembled a large collection of vitamin C papers (he

hated the word vitamin C and preferred the more correct term ascorbic

acid). Dr. Stone first used the word megavitamin and the word

hypoascorbemia. He considered scurvy, not a deficiency disease, but a

metabolic error. I urged him to publish his review of ascorbic acid which

he did several years later[12] . Irwin heard Dr. ing state that he

wished he could live another 25 years because science was making so many

interesting discoveries. Dr. Stone wrote to him and told him he could

achieve his goal if he would take vitamin C in megadoses. Dr. ing tried

it out, was convinced because he felt so much better, and lived another 30

years.

The major impetus given by Linus ing to the megadose concept of

vitamin C stimulated by Irwin Stone has finally thrown this vitamin into

public and medical acceptance. Many years ago Linus ing concluded that

people taking ascorbic acid would live longer[13] . All the information we

have about ascorbic acid lead to this conclusion. It is therefore very

helpful to actually see what it can do in practice for the final test is

the practical one - does it work? In fact, it does. Dr. Enstrom[14] ,

School of Public Health, University of California at Los Angeles analyzed a

ten year study of 11,348 people, aged 25 to 74. Men who consumed at least

300 mg of ascorbic acid suffered 41 percent fewer deaths during that period

compared with men who took only 50 mg, in their food. They lived on the

average 6 years longer. For women the results were not as striking. This

amount of ascorbic acid can not be obtained from the diet alone and shows

that supplements are essential. Had they used gram doses daily, I think the

results would have been more striking.

Dr. A.G. Brox[15] and colleagues at McGill University found that two

grams of ascorbic acid daily, successfully treated 7 out of 11 patients

with idiopathic thrombocytopenic purpura (ITP). They had all been sick more

than two months and had not responded to adrenocorticosteroids. Three had

had splenectomies. Four had failed additional treatment including the

current usual treatments. Their report had been rejected by the New England

Journal of Medicine, I think, because they were then involved in a dispute

with Linus ing. They had refused to advise him whether a rebuttal

letter answering the Mayo cancer and ascorbic acid studies he had submitted

would be published until he threatened them with legal action. Then they

rejected it. I have one patient now with ITP on ascorbic acid who has been

well over five years, but only as long as she remains on her ascorbic acid.

If she discontinues it, her platelet count begins to sink within a few weeks.

Linus ing[16] carried the orthomolecular concepts into the field

of cancer and again stirred up a hornets nest of hostility. For a good

discussion of his work see Hoffer[17] . But I am totally convinced he was

correct. His many scientific reports were very impressive. My studies with

ing[18] on 660 cancer patients beginning in 1978 are confirmatory.

The first major attention to megadoses of vitamins followed our

report of the effect of nicotinic acid on cholesterol, not because we had

reported it but because it was promptly confirmed by the Mayo Clinic. I had

been invited by the Mayo Foundation to give them a series of lectures on

schizophrenia. During a dinner I told their chief of psychiatry about the

effect of nicotinic acid on cholesterol. He passed it on to the chief of

medicine in the presence of his senior resident Dr. W. B. Parsons Jr[19] .

Dr Parsons is one of the preeminent experts in the use of megadoses of

nicotinic acid. The work was then taken up by Dr. E. Boyle, then with the

National Institute of Health, and later by the Coronary Drug Study which

eventually established nicotinic acid as the treatment of choice for

hypercholesterolemia. It is also by and large the cheapest and safest.

During that time Humphry Osmond and I published our second book, " How

To Live With Schizophrenia " [20] . A California patient[21] had recovered on

orthomolecular treatment having failed the best California could offer over

four years. Her father was so grateful he decided to educate every

physician in his community. He did so by handing out copies of our book.

One of them came into the hands of a psychiatrist. Dr. ing and Ava

visited her one afternoon, and Dr. ing saw the book on her coffee

table. He began to read it, borrowed it, and finished it by morning. He

went to bed still thinking of retiring and he arose the next day determined

that he would not and would enter this new field of megavitamin therapy. He

was intrigued by the large doses of vitamin B-3 we were using with safety.

This led to his Science report[22] and to his amazing contribution to the

theory of meganutrient therapy, in the use of vitamin C for viral and other

infections, for his very recent contribution to the cholesterol problem and

heart disease. Dr. ing made the greatest individual contribution toward

the overthrow of the old paradigm and its replacement by the newer, more

accurate, and useful one.

Megavitamin therapy was ignored by medicine at large and was vilified

by psychiatry. Only after Dr. ing entered the fray did the major

profession take notice, and then it too became very hostile and critical

especially after Dr. ing's first book on the common cold appeared. The

National Institute of Mental Health funded a study in New Jersey under the

direction of Dr. Wittenborn, a research psychologist. They had first

approached a psychiatrist in St. Louis, who agreed to do the study if I

would be a consultant. So the NIMH turned to New Jersey. The Wittenborn

study was double blind and was an attempt to repeat our original double

blind controlled studies started a decade before. Dr. Wittenborn in his

first report found that there was no difference between the placebo and the

treated group. We had claimed that it worked best for early or acute

patients and did not by itself help the very chronic ones. The

Wittenborn[23] study was primarily on these chronic cases. Later Dr.

Wittenborn re-analyzed his results by pulling out the early cases as we had

done, and in his second report he showed that he got the same results that

we had. His first report was greeted with shouts of enthusiasm from NIMH

and later by the American Psychiatric Association when they did their task

force report on Megavitamins and Orthomolecular Psychiatry. His second

report was greeted by a cold silence and may have cost him any further

support. His second paper was never referred to by the critics of

megavitamin therapy.

The American Psychiatric Association called Humphry Osmond and me

before their Committee on Ethics because I had published the California

paper. After a vigorous half-day debate over 20 years ago in Washington

they told us they would let us have their decision in a few weeks. We are

still waiting. However, they effectively killed interest in the use of

vitamins for treating schizophrenia when they issued their irresponsible

and flawed report[24] . The APA bears major responsibility for preventing

the introduction of a treatment which would have saved millions of patients

from the ravages of chronic schizophrenia. Just as the APA was once

captured by psychoanalysis, it is now captured by tranquilizers.

Folic acid is another safe water soluble vitamin. It has been used in

doses up to 15 mg daily. There has been a report that this dose caused

gastrointestinal disturbances but in another study with the same dose this

was not seen. Most patients do not need more than 5 mg. Recently it has

been proven that women will give birth to babies with spina bifida and

similar neural tube defects (NTD) much less frequently if they take

supplemental folic acid, 1 mg per day. I generally recommend 5 mg daily.

Dr. ells[25] in 1982 showed that giving pregnant women extra folic

acid decreased the incidence of NTD's. Before that he had measured the red

cell folate and white cell vitamin C levels of mothers who had babies with

NTD's and found they were lower in both. It was thus known since 1981 that

a multivitamin preparation containing folic acid would decrease the birth

of these damaged babies.

The immediate reaction to the original findings was one of strong

disbelief and hostility, and the establishment refused to advise women to

take folic acid until the requisite number of double blind experiments were

done. At last they are satisfied 11 years later, culminating with a report

in J. American Med Ass in 1989. Folic acid provided protection for most

causes of the defect. Even in women with a family history, the frequency of

babies with the defects was more than five times greater - 18 per 1000

against 3.5 per 1000, in women who did not take the vitamin in the first

six weeks of pregnancy. How many babies could have been saved by such a

simple solution? Even if the original findings had been wrong, what harm

would it have done to have advised them immediately about this very

important finding? I was astonished in 1981 at the vehemence of the

reaction by physicians and nutritionists, and I am still astonished. The

recent studies showed that folic acid decreased NTD's by 75 percent. If all

the other vitamins were used as well I am certain that figure would be

closer to 100 percent.

I can not recall in the past 40 years a single female patient of mine

on vitamins giving birth to any child with a congenital defect. I have been

able to advise them all that they not only would not harm their developing

baby by taking vitamins, but that their chances of giving birth to a

defective child would be greatly diminished. I was frequently asked this by

my patients who had been told by their doctors that they must stop all

their vitamins while pregnant. They looked upon vitamins as toxic drugs. I

am still asked the same question for the same reason today.

However, governments can learn and respond. It is now official that

pregnant women should take extra folic acid in order to prevent spina

bifida and other birth defects. The U.S. Public Health Service has issued

the following advisory: " In order to reduce the frequency of NTD's

(neural-tube defects) and their resulting disability, the United States

Public Health Service recommends that: All women of childbearing age

capable of becoming pregnant should consume 0.4 mg of folic acid per day

for the purpose of reducing their risk of having a pregnancy affected with

spina bifida or other NTD's " . This amount will not be provided by most

diets and requires supplementation. Apparently the US Public Health Service

is considering fortifying bread with folic acid. Folic acid is destroyed by

heat but some will survive.

In USA about 25,000 babies are born each year with spina bifida. In

Canada it has been estimated that each of these children will have cost

about $40,000 by the time they are 14 years of age. Giving women folic acid

early in their pregnancy would have avoided perhaps 3/4 of these births.

Over ten years, while the cautious scientists were discussing whether folic

acid was safe enough and was effective, 250,000 children were born at a

total cost of 10 billion dollars (over ten years). Folic acid for pennies

per day could have saved the United States public 7.5 billions dollars over

this ten year period. The saving in public health dollars will be enormous.

The waste in this long delay is inexcusable, since folic acid is totally

safe and could have been given to all pregnant women over ten years ago.

This is the costs of inactivity, of the conservative stance of the

profession when it comes to the super safe vitamins.

Conclusion

The vitamins-as-treatment paradigm is developing very rapidly and

will absorb the vitamin-as-prevention paradigm which is no longer needed.

Vitamins are important nutrients which will be used in optimum doses, small

or large, for conditions which are responsive whether or not they are

considered to be vitamin deficiency diseases. Only the fossilized

physicians who have been the most powerful antagonists of the newer

medicine still adhere to the old, totally inadequate paradigm. But there

are still physicians who question whether vitamin B-3 is the correct

treatment for pellagra. They will still promote their old ideas and will

bolster them by manufacturing toxicities. As a rule, when there are no

toxicities, it is simple to invent them, such as vitamin C causes kidney

stones, or damages the liver, or interferes with the treatment of diabetes

and so on. Every month I hear about new toxicities which totally surprise

and delight me because they indicate how imaginative my colleagues can be.

A. Hoffer, M.D, Ph.D.

Literature Cited

[1] Altschul R, Hoffer A & JD: Influence of Nicotinic Acid on

Serum Cholesterol in Man. Arch Biochem Biophys 54:558-559, 1955.

[2] Parsons WB Jr, Achor RWP, Berge KG, McKenzie BF & Barker NW:

Changes in Concentration of Blood Lipids Following Prolonged Administration

of Nicotinic Acid to Persons With Hypercholesterolemia: Preliminary

Observations. Proc. Mayo Clinic 31:377-390, 1956.

[3] Hoffer A, Osmond H, Callbeck MJ & Kahan I: Treatment of

Schizophrenia with Nicotinic Acid and Nicotinamide. J Clin Exper

Psychopathol 18:131-158, 1957.

[4] Cameron E & ing L: Cancer and Vitamin C. W. W. Norton & Co.

New York, 1979. Updated and Expanded Cancer and Vitamin C, E. Cameron and

L. ing, Camino Books, Inc., P.O. Box 59026, Phila., PA 19102, 1993.

[5] Machlin LJ: Introduction. Beyond Deficiency. New Views on the

Function and Health Effects of Vitamins. ls, New York Academy of

Sciences 669:1-6, 1992.

[6] Hoffer A, Kelm H & Osmond H: The Hoffer-Osmond Diagnostic Test.

RE Krieger Pub Co., Huntington, New York, 1975. Available from Behavior

Science Press, Institute for Social and Educational Research, 3710 Resource

Dr., Tuscaloosa, AL 35401-7059.

[7] RJ: Nutrition Against Disease, Pitman Publishing Co. New

York, 1971.

RJ: You Are Extraordinary. Random House, Inc. New York, 1967.

RJ: Physicians Handbook of Nutritional Science, C. C.

, Springfield, IL, 1975.

[8] Kaufman W: Common Forms of Niacinamide Deficiency Disease:

Aniacin Amidosis. Yale University Press, New Haven, CT 1943.

Kaufman W: The Common Form of Joint Dysfunction: Its Incidence and

Treatment. E.L. Hildreth and Co., Brattelboro, 1949.

[9] Shute EV: The Heart and Vitamin E. The Shute Foundation for

Medical Research, London, Canada, 1969.

Shute WE & Taub HJ: Vitamin E for Ailing and Healthy Hearts. Pyramid

House, New York, 1969.

Shute WE: Vitamin E Book. Keats Publishing, New Canaan, CT, 1978.

[10] Stampfer MJ, Hennekens CH, Manson J, Colditz GA, Rosner B &

Willett WC: Vitamin E consumption and the risk of coronary disease in

women. New England J. Med. 328:1444-1449, 1993.

Rimm EB, Stampfer MJ, Ascherio A, Giovannucci E, Colditz GA & Willett

WC: Vitamin E consumption and the risk of coronary heart disease in men.

New England J Med 28:1450-1456, 1993.

[11] Gould, : Private Communication to me in London, England,

in 1954. [Return to Paper]

[12] Stone I: The Healing Factor, Vitamin C Against Disease. Grosset

and Dunlap, New York, 1972.

[13] ing L: How To Live Longer and Feel Better. W. H. Freeman,

New York, 1986.

[14] Enstrom JE, Kanim LE & Klein MA: Vitamin C Intake and Mortality

among a Sample of the United States Population. Epidemiology 3:194-202, 1992.

[15] Brox AG, Howson-Jan KJ & Fauser AA: Treatment of idiopathic

thrombocytopenic purpura with ascorbate. Br. J Haematology 70:341-344, 1988.

[16] Cameron E: Protocol for the use of vitamin C in the treatment of

cancer. Medical Hypothesis 36:190-194, 1991.

Cameron E & A: The orthomolecular treatment of cancer II.

Clinical trial of high-dose ascorbic supplements in advanced human cancer.

Chemical- Biological Interactions 9:285-315, 1974.

Cameron E & A: Innovation vs quality control: an

" unpublishable " clinical trial of supplemental ascorbate in incurable

cancer. Medical Hypothesis 36:185-189, 1991.

A, Jack T & Cameron E: Reticulum cell sarcoma: two complete

" spontanous " ; regressions, in response to high-dose ascorbic acid therapy.

A report on subsequent progress. Oncology 48:495-497, 1991.

[17] Hoffer J: Nutrients as Biologic Response Modifiers. Adjuvant

Nutrition in Cancer Treatment. Ed. P. Quillin & R. M. . 1992

Symposium Proceedings, Cancer Treatment Research Foundation and American

College of Nutrition, Cancer Treatment Research Foundation, 3455 Salt Creek

Lane, Suite 200, Arlington Heights, IL

60005-1090, 1993

[18] Hoffer A & ing L: Hardin Biostatistical Analysis of

Mortality Data for Cohorts of Cancer Patients with a Large Fraction

Surviving at the Termination of the Study and a Comparison of Survival

Times of Cancer Patients Receiving Large Regular Oral Doses of Vitamin C

and Other Nutrients with Similar Patients not Receiving those Doses. J

Orthomolecular Medicine 5:143-154, 1990.

Hoffer A & ing L: Hardin Biostatistical Analysis of

Mortality Data for a Second Set of Cohorts of Cancer Patients with a Large

Fraction Surviving at the Termination of the Study and a Comparison of

Survival Times of Cancer Patients Receiving Large Regular Oral Doses of

Vitamin C and Other Nutrients with Similar Patients Not Receiving These

Doses. Journal of Orthomolecular Medicine 8:1547-167, 1993.

Hoffer A: Orthomolecular Oncology. In, Adjuvant Nutrition in Cancer

Treatment. Ed. P. Quillin & R. , Cancer Treatment Research

Foundation, 3455 Salt Creek Lane, Suite 200, Arlington Heights, IL

60005-1090, 1994.

[19] Parsons WB Jr: Clinical Alternatives Chap 8. In, Coronary Heart

Disease. The Dietary Sense and Nonsense. An Evaluation by Scientists. Ed.

G.V. Mann, Janus Publishing Company, London, England, pages 119-135, 1993.

[20] Hoffer A & Osmond H: How To Live With Schizophrenia. University

Books, New York, NY, 1966. Also published by , London, 1966. Written

by Fannie Kahan. New and Revised Edition, Citadel Press, New York, NY, 1992.

[21] Hoffer A: Five California Schizophrenics. J Schizophrenia

1:209-220, 1967. [Return to Paper]

[22] ing L: Orthomolecular Psychiatry. Science 160:265- 271,

1968. [Return to Paper]

[23] Wittenborn JR, Weber ESP & Brown M: Niacin in the long term

treatment of schizophrenia. Arch Gen Psychiatry 28:308-15, 1973. Wittenborn

JR: A Search for Responders to Niacin Supplementation. Arch Gen Psych

31:547-552, 1974. [Return to Paper]

[24] Hoffer A & Osmond H: In Reply to The American Psychiatric

Association Task Force Report on Megavitamin and Orthomolecular Therapy in

Psychiatry. Canadian Schizophrenia Foundation, Regina, SK, now at 16

Florence Ave., Toronto, ON, Canada M2N 1E9. August 1976.

[25] ells RW: Prevention of Neural Tube Defects by Vitamin

Supplements. Ed. Dobbing, Academic Press, New York, 53-84, 1983.

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