View source for Chemistry:Megavitamin therapy

{{short description|Form of alternative medicine}}
{{Infobox pseudoscience
|image       =
|image_width =
|caption     =
|claims      = Health effects from very high doses of vitamins.
|topics      = [[Chemistry:Vitamin|vitamin]]s, dietary supplements
|origyear    = 1930s
|origprop    =
|currentprop =
|notableprop = Frederick Klenner, [[Biography:Linus Pauling|Linus Pauling]]
}}
{{Alternative medicine sidebar |fringe}}
'''Megavitamin therapy''' is the use of large doses of [[Chemistry:Vitamin|vitamin]]s, often many times greater than the recommended dietary allowance (RDA) in the attempt to prevent or treat [[Disease|disease]]s. Megavitamin therapy is typically used in [[Medicine:Alternative medicine|alternative medicine]] by practitioners who call their approach [[Medicine:Orthomolecular medicine|orthomolecular medicine]].<ref>{{cite journal |vauthors=Zell M, Grundmann O |title=An orthomolecular approach to the prevention and treatment of psychiatric disorders |journal=Adv Mind Body Med |volume=26 |issue=2 |pages=14–28 |date=2012 |pmid=23341413 }}</ref> Vitamins are useful in preventing and treating illnesses specifically associated with dietary vitamin shortfalls, but the conclusions of medical research are that the broad claims of disease treatment by advocates of megavitamin therapy are unsubstantiated by the available evidence.<ref name="isbn1-55009-213-8">{{cite book |vauthors=Aaronson S, etal |title=Cancer medicine 6 (Frei, Emil; Kufe, Donald W.; Holland, James F., eds) |publisher=BC Decker |location=Hamilton, Ont |year=2003 |pages=[https://archive.org/details/cancermedicine60002unse/page/76 76] |isbn=978-1-55009-213-4 |chapter=Cancer medicine |chapter-url=https://archive.org/details/cancermedicine60002unse/page/76 }}</ref><ref name=References1990>{{cite journal |author1=Nutrition Committee |author2=Canadian Paediatric Society | date=1990| title = Megavitamin and megamineral therapy in childhood. Nutrition Committee, Canadian Paediatric Society | journal = CMAJ | volume = 143 | issue = 10 | pages = 1009–1013 | pmid = 1699646 | pmc = 1452516 }}</ref> It is generally accepted that doses of any vitamin greatly in excess of nutritional requirements will result either in toxicity (vitamins A and D) or in the excess simply being metabolised; thus evidence in favour of vitamin supplementation supports only doses in the normal range.<ref>{{cite web | url=http://healthyeating.sfgate.com/body-excess-vitamin-b-c-might-consume-3056.html | title=What Does Your Body do to Excess Vitamin B or C That You Might Consume?| date=16 June 2012}}</ref><ref>{{cite web | url=http://www.webmd.com/vitamins-and-supplements/nutrition-vitamins-11/fat-water-nutrient | title=Vitamins & Supplements Center – Nutritional, Herbal, Dietary, and More - WebMD}}</ref><ref>Novella, S: ''Medical Myths, Lies, and Half-Truths: What We Think We Know May Be Hurting Us'', [[Company:The Great Courses|The Great Courses]]</ref> Critics have described some aspects of orthomolecular medicine as food faddism or even [[Philosophy:Quackery|quackery]].<ref name="autogenerated3">{{cite journal |author=Jarvis WT |title=Food faddism, cultism, and quackery |journal=Annu. Rev. Nutr. |volume=3 |pages=35–52 |year=1983 |pmid=6315036 |doi=10.1146/annurev.nu.03.070183.000343}}</ref><ref name=Jukes1990>{{cite journal |author = Jukes TH | year =1990 | title = Nutrition Science from Vitamins to Molecular Biology | journal = Annual Review of Nutrition | pmid = 2200458 | volume = 10 | issue = 1 | pages = 1–20 | doi = 10.1146/annurev.nu.10.070190.000245| doi-access = free }} A short summary is in [http://arjournals.annualreviews.org/doi/full/10.1146/annurev.nu.10.072106.100001 the journal's preface].</ref><ref name="autogenerated2">{{cite journal | author = Braganza, S.F. |author2=Ozuah, P.O. | year = 2005 | title = Fad Therapies | journal = Pediatrics in Review | volume = 26 | issue = 10 | pages = 371–376 | doi = 10.1542/pir.26-10-371 | pmid = 16199591}}</ref> Research on nutrient supplementation in general suggests that some nutritional supplements might be beneficial, and that others might be harmful;<ref>{{cite journal |title=NIH State-of-the-Science Conference Statement on Multivitamin/Mineral Supplements and Chronic Disease Prevention |journal=NIH Consens State Sci Statements |volume=23 |issue=2 |pages=1–30 |year=2006 |pmid=17332802 |url=http://consensus.nih.gov/2006/2006MultivitaminMineralSOS028main.htm}}</ref><ref>{{cite journal  |vauthors=Huang HY, Caballero B, Chang S, etal |title=The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults: a systematic review for a National Institutes of Health state-of-the-science conference |journal=Ann. Intern. Med. |volume=145 |issue=5 |pages=372–385 |date=2006 |pmid=16880453 |url=http://www.annals.org/cgi/pmidlookup?view=reprint&pmid=16880453 |doi=10.1001/archinte.145.2.372}}</ref><ref>{{cite journal |vauthors=Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C |title=Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases |journal=Cochrane Database Syst Rev |volume=2012 |issue= 3|pages=CD007176 |year=2012 |pmid=22419320 |doi=10.1002/14651858.CD007176.pub2|pmc=8407395 |hdl=10138/136201 |hdl-access=free }}</ref> several specific nutritional therapies are associated with an increased likelihood of the condition they are meant to prevent.<ref name="AmJEpidem2009">{{cite journal |vauthors=Satia JA, Littman A, Slatore CG, Galanko JA, White E |year = 2009 |title = Long-term Use of {beta}-Carotene, Retinol, Lycopene, and Lutein Supplements and Lung Cancer Risk: Results From the VITamins And Lifestyle (VITAL) Study | journal = American Journal of Epidemiology | volume = 169| issue = 7| pages = 815–828| doi = 10.1093/aje/kwn409 | pmid = 19208726 | pmc=2842198}}</ref>

== Multivitamin vs megavitamin ==
Megavitamin therapy must be distinguished from the usual "vitamin supplementation" approach of traditional multivitamin pills. Megavitamin doses are far higher than the levels of vitamins ordinarily available through western diets. A study of 161,000 individuals (post-menopausal women) provided, in the words of the authors, "convincing evidence that multivitamin use has little or no influence on the risk of common cancers, cardiovascular disease, or total mortality in postmenopausal women".<ref name="WHI">{{cite journal  |vauthors=Neuhouser ML, Wassertheil-Smoller S, Thomson C, etal |title=Multivitamin use and risk of cancer and cardiovascular disease in the Women's Health Initiative cohorts |journal=Arch. Intern. Med. |volume=169 |issue=3 |pages=294–304 |date=2009 |pmid=19204221 |doi=10.1001/archinternmed.2008.540 |pmc=3868488 }}</ref>

==History==
In the 1930s and 1940s, some scientific and clinical evidence suggested that there might be beneficial uses of vitamins C, E, and niacin in large doses. Beginning in the 1930s in {{wipe|Canada}}, a megadose vitamin E therapy for cardiovascular and circulatory complaints was developed by [[Biography:Evan Shute|Evan Shute]] and colleagues, named the "Shute protocol".<ref name="pmid18911314">{{cite journal |vauthors=Vogelsang A, Shute E, Shute W |title=Some medical uses of vitamin E |journal=Med World (New York) |volume=161 |issue=2 |pages=83–89 |date=1948 |pmid=18911314 }}</ref> Tentative experiments in the 1930s by Claus W. Jungeblut<ref>{{cite journal |last=Jungeblut |first=CW |year=1937 |title=Vitamin C Therapy and Prophylaxis in Experimental Poliomyelitis |journal=The Journal of Experimental Medicine |volume=65 |pages=127–146 |doi=10.1084/jem.65.1.127 |pmid=19870585 |issue=1 |pmc=2133474}}</ref> with larger doses of vitamin C led to Frederick Klenner's development of [[Chemistry:Vitamin C megadosage|megadose]] intravenous vitamin C treatments for polio and other viruses in the 1940s.<ref name="pmid18147027">{{cite journal|author=Klenner, Fred R. |title=The treatment of poliomyelitis and other virus diseases with vitamin C |journal=Southern Medicine & Surgery |volume=111 |issue=7 |pages=209–214 |date=1949 |pmid=18147027 }}</ref> William Kaufman published articles in the 1940s that detailed his treatment of arthritis with frequent, high doses of niacinamide.<ref name="pmid13060032">{{cite journal |author=KAUFMAN W |title=Niacinamide therapy for joint mobility; therapeutic reversal of a common clinical manifestation of the normal aging process |journal=Conn State Med J |volume=17 |issue=7 |pages=584–9 |date=July 1953 |pmid=13060032}}</ref> Rudolf Altschul and [[Biography:Abram Hoffer|Abram Hoffer]] applied large doses of the immediate release form of [[Chemistry:Niacin (nutrient)|niacin]] (Vitamin B<sub>3</sub>) to treat hypercholesterolemia.<ref>{{cite journal |vauthors=Altschul R, Hoffer A, Stephen JD |title=Influence of nicotinic acid on serum cholesterol in man |journal=Arch. Biochem. Biophys. |volume=54 |issue=2 |pages=558–559 |date=1955 |pmid=14350806 |doi= 10.1016/0003-9861(55)90070-9}}</ref><ref name="pmid13792994">{{cite journal |vauthors=Altschul R, Hoffer A |title=The Effect of Nicotinic Acid on Hypercholesterolæmia |journal=Can Med Assoc J |volume=82 |issue= 15|pages=783–785 |date=1960 |pmid=13792994 |pmc=1938010}}</ref> In a 1956 publication entitled ''Biochemical Individuality'', Roger J. Williams introduced concepts for individualized megavitamins and nutrients.<ref name="isbn0-87983-893-0">{{cite book |author=Williams, Roger Lawrence |title=Biochemical Individuality |publisher=McGraw-Hill |location=New York |year=1998 |isbn=978-0-87983-893-5 }}</ref> Megavitamin therapies were also publicly advocated by [[Biography:Linus Pauling|Linus Pauling]] in the late 1960s.<ref name="isbn0-399-50764-7">{{cite book |author=Stone, Irwin |title=The healing factor: "vitamin C" against disease |publisher=Perigee Books |location=New York |year=1982 |isbn=978-0-399-50764-9}}</ref>

==Usage as therapy==
Although megavitamin therapies still largely remain outside of the structure of [[Medicine:Evidence-based medicine|evidence-based medicine]], they are increasingly used by patients, with or without the approval of their treating physicians, often after recommendations by practitioners of orthomolecular and naturopathic medicine.<ref name="pmid10893280">{{cite journal |vauthors=Richardson MA, Sanders T, [[Biography:J. Lynn Palmer|Palmer JL]], Greisinger A, Singletary SE |title=Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology |journal=J. Clin. Oncol. |volume=18 |issue=13 |pages=2505–2514 |date=2000 |pmid=10893280 |doi= 10.1200/JCO.2000.18.13.2505}}</ref> The proposed efficacy of various megavitamin therapies to reduce cancer risk has been contradicted by results of one clinical trial.<ref name="pmid19116389">{{cite journal  |vauthors=Lin J, Cook NR, Albert C, et al |title=Vitamins C and E and Beta Carotene Supplementation and Cancer Risk: A Randomized Controlled Trial |journal=J. Natl. Cancer Inst. |volume=101 |issue=1 |pages=14–23 |date=2009 |pmid=19116389 |doi=10.1093/jnci/djn438 |pmc=2615459}}</ref>

===Vitamin C===
{{Main|Chemistry:Vitamin C megadosage}}
The US Recommended Dietary Allowance for [[Biology:Vitamin C|vitamin C]] for adult women is 76&nbsp;mg/day and for adult men 90&nbsp;mg/day. Although [[Biography:Linus Pauling|Linus Pauling]] was known for highly respectable research in chemistry and biochemistry, he was also known for promoting the consumption of vitamin C in large doses.<ref>{{cite journal | vauthors = Cameron E, Pauling L | title = Supplemental ascorbate in the supportive treatment of cancer: Prolongation of survival times in terminal human cancer | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 73 | issue = 10 | pages = 3685–9 | date = October 1976 | pmid = 1068480 | pmc = 431183 | doi = 10.1073/pnas.73.10.3685| bibcode = 1976PNAS...73.3685C | doi-access = free }}</ref> Although he claimed and stood firm in his claim that consuming over 1,000&nbsp;mg is helpful for one’s immune system when fighting a head cold, the results of empirical research do not align with this view. A meta-analysis concluded that supplementary vitamin C significantly lowered serum [[Chemistry:Uric acid|uric acid]], considered a risk factor for [[Medicine:Gout|gout]].<ref>{{cite journal |vauthors=Juraschek SP, Miller ER, Gelber AC |title=Effect of oral vitamin C supplementation on serum uric acid: a meta-analysis of randomized controlled trials |journal=Arthritis Care & Research |volume=63 |issue=9 |pages=1295–306 |date=September 2011 |pmid=21671418 |pmc=3169708 |doi=10.1002/acr.20519 }}</ref> One population study reported an inverse correlation between dietary vitamin C and risk of gout.<ref>{{cite journal |last=Choi |first=Hyon K. |author2=Xiang Gao |author3=Gary Curhan |date=2009|title=Vitamin C Intake and the Risk of Gout in Men – A Prospective Study|journal=Archives of Internal Medicine |volume= 169 |issue= 5|pages=502–507|doi=10.1001/archinternmed.2008.606|pmid=19273781|pmc=2767211}}</ref> A review of clinical trials in the treatment of colds with small and large doses of Vitamin C has established that there is no evidence that it decreases the incidence of [[Medicine:Common cold|common cold]]s.<ref>{{cite journal|last1=Hemilä|first1=Harri|last2=Chalker|first2=Elizabeth|date=2013-01-31|title=Vitamin C for preventing and treating the common cold|journal=The Cochrane Database of Systematic Reviews|volume=2013|issue=1|pages=CD000980|doi=10.1002/14651858.CD000980.pub4|issn=1469-493X|pmid=23440782|pmc=1160577}}</ref>  After 33 years of research, it is still not established whether vitamin C can be used as a treatment for cancer.<ref>{{cite journal | last1 = Cabanillas | first1 = F | title = Vitamin C and cancer: what can we conclude--1,609 patients and 33 years later? | journal = Puerto Rico Health Sciences Journal |volume = 29 |issue = 3 |pages = 215–217 |year = 2010 |pmid = 20799507}}</ref>

===Vitamin E===
The US Recommended Dietary Allowance for [[Chemistry:Vitamin E|vitamin E]] for adult women and men is 15&nbsp;mg/day. The US Food and Nutrition Board set a tolerable upper intake level (UL) at 1,000&nbsp;mg (1,500 IU) per day derived from animal models that demonstrated bleeding at high doses.<ref name="DRItext">{{cite book | last1 = Institute of Medicine | title = Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids | chapter = Vitamin E | publisher = The National Academies Press | year = 2000 | location = Washington, DC | pages = 186–283 | doi = 10.17226/9810 | pmid = 25077263 | isbn = 978-0-309-06935-9 | chapter-url = https://www.nap.edu/read/9810/chapter/8| author1-link = Institute of Medicine }}</ref> In the US, the popularity for vitamin E as a dietary supplement peaked around 2000, with popular doses of 400, 800 and 1000 IU/day. Declines in usage were attributed to publications of studies that showed either no benefits or negative consequences from vitamin E supplements.<ref>{{cite journal |vauthors=Kim HJ, Giovannucci E, Rosner B, Willett WC, Cho E |title=Longitudinal and secular trends in dietary supplement use: Nurses' Health Study and Health Professionals Follow-Up Study, 1986-2006 |journal=J Acad Nutr Diet |volume=114 |issue=3 |pages=436–443 |date=2014 |pmid=24119503 |pmc=3944223 |doi=10.1016/j.jand.2013.07.039 }}</ref> One meta-analysis showed no association between vitamin E supplementation and cardiovascular events (nonfatal stroke or myocardial infarction) or cardiovascular mortality.<ref>{{cite journal|last1=Eidelman |first1=RS|last2=Hollar |first2=D|last3=Hebert|first3=PR|last4=Lamas|first4=GA| last5=Hennekens|first5=CH|title=Randomized trials of vitamin E in the treatment and prevention of cardiovascular disease|journal= Archives of Internal Medicine|date=2004|pmid=15277288| doi=10.1001/archinte.164.14.1552|volume=164|issue=14|pages=1552–1556|doi-access=}}</ref> Another meta-analysis concluded that high-dosage vitamin E increased all-cause mortality.<ref>{{cite journal |vauthors=Miller ER, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E |title=Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality |journal=Ann. Intern. Med. |volume=142 |issue=1 |pages=37–46 |date=2005 |pmid=15537682 |doi= 10.7326/0003-4819-142-1-200501040-00110|doi-access=free }}</ref>

===Niacin===
The US Recommended Dietary Allowance for [[Chemistry:Niacin (nutrient)|niacin]] for adult women is 14&nbsp;mg/day and for adult men 16&nbsp;mg/day. Niacin is available as a prescription product, either immediate release (500&nbsp;mg tablets; prescribed up to 3,000&nbsp;mg/day) or extended release (500 and 1,000&nbsp;mg tablets; prescribed up to 2,000&nbsp;mg/day). In the US, niacin is also available as a dietary supplement at 500 to 1,000&nbsp;mg/tablet. Niacin has sometimes been used in combination with other lipid-lowering medications.<ref name=TabletLabel>[https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ce739d68-d89c-437c-90fb-3c0c45140f22 Niacin tablet label] Updated March 14, 2013. Page accessed Feb 11, 2016</ref> Systematic reviews found no effect of niacin on [[Medicine:Cardiovascular disease|cardiovascular disease]] or death, in spite of raising [[Medicine:High-density lipoprotein|high-density lipoprotein]] (HDL) cholesterol. Reported side effects include an increased risk of [[Medicine:Diabetes|diabetes]].<ref name=Kee2014>{{cite journal | vauthors = Keene D, Price C, Shun-Shin MJ, Francis DP | title = Effect on cardiovascular risk of high density lipoprotein targeted drug treatments niacin, fibrates, and CETP inhibitors: meta-analysis of randomised controlled trials including 117,411 patients | journal = BMJ | volume = 349 | pages = g4379 | date = July 2014 | pmid = 25038074 | pmc = 4103514 | doi = 10.1136/bmj.g4379 }}</ref><ref>{{cite journal | vauthors = Schandelmaier S, Briel M, Saccilotto R, Olu KK, Arpagaus A, Hemkens LG, Nordmann AJ | title = Niacin for primary and secondary prevention of cardiovascular events | journal = The Cochrane Database of Systematic Reviews | volume = 2017 | pages = CD009744 | date = June 2017 | issue = 6 | pmid = 28616955 | doi = 10.1002/14651858.CD009744.pub2 | pmc = 6481694 }}</ref><ref>{{cite journal | vauthors = Garg A, Sharma A, Krishnamoorthy P, Garg J, Virmani D, Sharma T, Stefanini G, Kostis JB, Mukherjee D, Sikorskaya E | title = Role of Niacin in Current Clinical Practice: A Systematic Review | journal = The American Journal of Medicine | volume = 130 | issue = 2 | pages = 173–187 | date =2017 | pmid = 27793642 | doi = 10.1016/j.amjmed.2016.07.038 | doi-access = free }}</ref>

==See also==

Related topics
* ''[[Finance:Codex Alimentarius|Codex Alimentarius]]''
* Essential nutrient
* [[Unsolved:Health freedom movement|Health freedom movement]]
* [[Philosophy:Life extension|Life extension]]
* List of ineffective cancer treatments

Vitamin topics
* [[Chemistry:Multivitamin|Multivitamin]]
* Naturopathic medicine
* [[Medicine:Orthomolecular medicine|Orthomolecular medicine]]
* [[Medicine:Hypervitaminosis|Hypervitaminosis]] (toxic vitamin intake)
** [[Medicine:Hypervitaminosis A|Hypervitaminosis A]]
** [[Medicine:Hypervitaminosis D|Hypervitaminosis D]]
** [[Chemistry:Vitamin B3#Toxicity|Vitamin B<sub>3</sub> § Toxicity]]
** [[Medicine:Megavitamin-B6 syndrome|Megavitamin-B<sub>6</sub> syndrome]]

==References==
{{Reflist|2}}

==External links==
* [https://quackwatch.org/related/ortho/ Orthomolecular Therapy] at [[Organization:Quackwatch|Quackwatch]]

{{Vitamin}}
{{Food chemistry}}
{{Nutritional pathology}}
{{Dietary supplement}}
{{alternative medicine}}
{{pseudoscience}}

{{DEFAULTSORT:Megavitamin Therapy}}
[[Category:Vitamins]]
[[Category:Medical treatments]]
[[Category:Therapy]]

{{Sourceattribution|Megavitamin therapy}}