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Dependency vs. Deficiency |
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Vitamin Need |
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by Andrew W. Saul "Man is a
food-dependent creature. If you don't feed him, he will die. If you feed him
improperly, part of him will die." ( Dependency is a fact of
life. The human body is dependent on food, water, sleep, and oxygen.
Additionally, its internal chemistry is absolutely dependent on vitamins.
Without adequate vitamin intake, the body will sicken; virtually any
prolonged vitamin deficiency is fatal. Surely this constitutes a dependency
in the generally accepted sense of the word. Nutrient deficiency of
long standing may create an exaggerated need for the missing nutrient, a need
not met by dietary intakes or even by low-dose supplementation. Recently (1),
Robert P. Heaney, M.D., used the term "long latency deficiency
diseases" to describe illnesses that fit this description. He writes: "(I)nadequate
intakes of many nutrients are now recognized as contributing to several of
the major chronic diseases that affect the populations of the industrialized
nations. Often taking many years to manifest themselves, these disease
outcomes should be thought of as long-latency deficiency diseases. . .
(I)nadequate intakes of specific nutrients may produce more than one disease,
may produce diseases by more than one mechanism, and may require several
years for the consequent morbidity to be sufficiently evident to be
clinically recognizable as "disease." Because the intakes required
to prevent many of the long-latency disorders are higher than those required
to prevent the respective index diseases, recommendations based solely on
preventing the index diseases are no longer biologically defensible." There are at least two
key concepts presented here: The first is,
"Inadequate intakes of specific nutrients may produce more than one
disease." This exactly supports Dr. William Kaufman's statements to this
effect 55 years ago, when he wrote that, in considering "different
clinical entities one cannot exclude the possibility that they may be caused
by the same etiologic agent, acting in different ways. For example, in
experimental animals, it has been shown that the lack of a single essential
nutrient can produce a variety of dissimilar clinical disorders in different
individuals of the same species. . . (O)ne might not suspect that the same
etiologic factor, lack of a specific essential nutrient, was responsible for
each of the various clinical syndromes of the same tissue deficiency disease
which is permitted to develop at different rates in different individuals of
the same species." (2) While amyotrophic lateral
sclerosis, progressive muscular atrophy, progressive bulbar palsy, and
primary lateral sclerosis are not all the same illness, they and the other
neuromuscular diseases may have a common basis: unacknowledged, untreated
long-term vitamin dependency. Therefore, each may respond to an
orthomolecular approach such as that successfully used by Dr. Frederick R.
Klenner (3) for multiple sclerosis and myasthenia gravis, half a century ago. The second key point Dr.
Heaney makes is that vitamin "intakes required to prevent many of the
long-latency disorders are higher than those required to prevent the
respective index diseases." This confirms Dr. Abram Hoffer's
observations to this effect some 40 years ago, when he treated prisoners of
war presenting severe, protracted nutrient deficiencies. Dr. Hoffer wrote (4) that
when released, after as much as 44 months of captivity, "only 75 percent
had survived. They had lost about one-third of their body weight. In camp
they suffered from classical scurvy, beriberi, pellagra, many infections, and
from protein and calorie deficiency. They were rehabilitated in hospitals and
were given doses of vitamins that were then considered high. Since then these
"About 35 years ago
(in the 1930s and 1940s) it was reported that some chronic pellagrins
required at least 600 milligrams per day of vitamin B3 to prevent the return
of pellagra symptoms. This was astonishing then and unexplainable since
pellagra as a nicotinic acid deficiency disease should have yielded to
vitamin (small) doses. Today the concept of vitamin-dependency disease has
developed. It is based upon the realization that there is a much wider range
of need for nutrients than was believed to be true then. "A person is said to
be vitamin dependent if his requirements for that vitamin are much greater
(perhaps 100-fold greater or more) than is the average need for any
population. The optimum need is that quantity which maintains the subject in
good health, not that quantity which barely keeps him free of pellagra. From
this point of view the Thirty years ago, in
another paper (5), Dr. Hoffer made this statement: "The newer concept
of vitamin-dependent disease changes the emphasis from simply dietary
manipulation to consideration of the endogenous needs of the organism. It
comes within the field of orthomolecular disease. . . The borderline between
vitamin deficiency and vitamin-dependency conditions is merely a quantitative
one when one considers prevention and cure." (p. 251) The differentiation
between deficiency and dependency is dose. Every patient that was ever helped
by high-dose nutrient therapy lends support to the concept of vitamin
dependency. By the same token, symptoms resulting from inappropriate and
abrupt termination of large doses of nutrients provide equally good evidence
for vitamin dependency. While deprivation of low doses of vitamin C causes
scurvy, abrupt termination of high maintenance doses may cause its own set of
problems. Called "rebound scurvy," this includes classical
scorbutic symptoms, as well as a predictable relapse of illness that had
already responded to high-dose therapy. Writes Robert F.
Cathcart, M.D.: "There is a certain
dependency on ascorbic acid that a patient acquires over a long period of
time when he takes large maintenance doses. Apparently, certain metabolic
reactions are facilitated by large amounts of ascorbate and if the substance
is suddenly withdrawn, certain problems result such as a cold, return of
allergy, fatigue, etc. Mostly, these problems are a return of problems the
patient had before taking the ascorbic acid. Patients have by this time
become so adjusted to feeling better that they refuse to go without ascorbic
acid. Patients do not seem to acquire this dependency in the short time they
take doses to bowel tolerance to treat an acute disease. Maintenance doses of
4 grams per day do not seem to create a noticeable dependency. The majority
of patients who take over 10-15 grams of ascorbic acid per day probably have
certain metabolic needs for ascorbate which exceed the universal human
species need. Patients with chronic allergies often take large maintenance
doses. "The major problem
feared by patients benefiting from these large maintenance doses of ascorbic
acid is that they may be forced into a position where their body is deprived
of ascorbate during a period of great stress such as emergency hospitalization.
Physicians should recognize the consequences of suddenly withdrawing
ascorbate under these circumstances and be prepared to meet these increased
metabolic needs for ascorbate in even an unconscious patient. These
consequences of ascorbate depletion which may include shock, heart attack,
phlebitis, pneumonia, allergic reactions, increased susceptibility to
infection, etc., may be averted only by ascorbate. Patients unable to take
large oral doses should be given intravenous ascorbate. All hospitals should
have supplies of large amounts of ascorbate for intravenous use to meet this
need." (6) This need is especially
serious for the cancer patient, whose exceptionally positive response to
mega-ascorbate therapy, and dramatically negative response to ascorbate
deprivation, is the very picture of vitamin dependency. Linus Pauling
colleague Ewan Cameron, M.D., wrote: "Ascorbate, however
administered, is rapidly excreted in the urine, so that administration should
be continuous or at very frequent intervals. Furthermore, exposure to high
circulating levels of ascorbate induces over-activity of certain hepatic
enzymes concerned with its degradation and metabolism. These enzymes persist
for some time after sudden cessation of high intakes, resulting in depletion
of circulating levels of ascorbate to well below normal unsupplemented
values. This is known as the rebound effect. It causes a sharp decrease in
immunocompetence and must be avoided in the cancer patient. Clinical
experience has shown that the best responses are observed when vitamin C is
administered intravenously, so insuring a high plasma level. However, because
long-term continuous intravenous administration is impractical, we recommend
an initial intravenous course of ten days duration, followed by continuous
maintenance oral regimen." (7) In short, the body only
misses what it needs. That is dependency. The destructive
consequences of alcohol and other negative drug dependencies are taught in
elementary schools. At the same time, the consequences of ignoring our
positive nutrient dependencies go largely undiscussed even in medical
journals. Vitamin dependencies induced by genetics, diet, drugs, or illness
are most often regarded as medical curiosities. The Hoffer-Osmond discovery
that schizophrenics, forming about one or two percent of the population, are
dependent on multi-gram doses of niacin, remains a psychiatric heresy. The
Irwin Stone-Linus Pauling idea of population-wide, genetically-based
hypoascorbemia has received negative attention, when it has received any
attention at all. Yet, writes Dr. Emanuel Cheraskin, "hypovitaminosis C
is a very real and common, probably epidemic, problem which clearly has not
been properly viewed and surely not adequately reported." (8) This is not a total
surprise. It took decades for medical acknowledgement that biotin and vitamin
E are actually essential to health. Simple cause-and-effect
micronutrient deficiency, a doctrine long enamored of by the dietetic
profession, is not always sufficient to explain persistent physician reports
of megavitamin cures of a number of diseases outside the classically accepted
few. Perhaps it is a law of orthomolecular therapy that the reason one
nutrient can cure so many different illnesses is because a deficiency of one
nutrient can cause many different illnesses. And if nutrient
deficiency is basically about inadequate intake, then dependency is
essentially about heightened need. As a dry sponge soaks up more milk, so a
sick body generally takes up higher vitamin doses. The quantity of a
nutritional supplement that cures an illness indicates the patient's degree
of deficiency. It is therefore not a megadose of the vitamin, but rather a
megadeficiency of the nutrient that we are dealing with. Orthomolecular
practitioners know that with therapeutic nutrition, you don't take the amount
that you believe ought to work; rather, you take the amount that gets
results. The first rule of building a brick wall is that you have got to have
enough bricks. A sick body has exaggeratedly high needs for many vitamins. We
can either meet that need, or else suffer unnecessarily. Until the medical
professions fully embrace orthomolecular treatment, "medicine"
might well be said to be "the experimental study of what happens when
poisonous chemicals are placed into malnourished human bodies." (Editorial published in
the Journal of Orthomolecular Medicine, 2004. Vol. 19 No. 2, p. 67-70.
Reprinted with permission.) This article is also available in German at http://www.doctoryourself.com/DeutschDependency.htm References: 1. Heaney RP:
Long-latency deficiency disease: insights from calcium and vitamin D. Am J
Clin Nutr. 2003; Nov; 78(5):912-9. 2. Kaufman W: The common
form of joint dysfunction: Its incidence and treatment. 3. Smith L: Vitamin C as
a Fundamental Medicine: Abstracts of Dr. Frederick R. Klenner, M.D.'s
Published and Unpublished Work. 4. Hoffer A: Editorial.
J. Orthomolecular Psychiatry. 1974; Vol 3, No 1, p. 34-36. 5. Hoffer A: Mechanism of
Action of Nicotinic Acid and Nicotinamide in the Treatment of Schizophrenia.
In: Hawkins D and Pauling L: Orthomolecular Psychiatry: Treatment of
Schizophrenia. 6. Cathcart RF: Vitamin C, titration to bowel tolerance, anascorbemia, and acute induced scurvy." Medical Hypothesis. 1981; 7:1359-1376. http://www.doctoryourself.com/titration.html 7. Cameron E: Protocol
for the use of vitamin C in the treatment of cancer. Medical Hypotheses.
1991; 36:190-194. Also: Cameron E: Protocol for the use of intravenous vitamin C in the treatment of cancer. 8. Cheraskin E: Vitamin C
and fatigue. J. Orthomolecular Medicine, 9:1, p 39-45, First Quarter, 1994. Andrew Saul is the author of the books FIRE
YOUR DOCTOR! How to be Independently Healthy (reader reviews at
http://www.doctoryourself.com/review.html
) and DOCTOR YOURSELF: Natural Healing that Works. (reviewed at http://www.doctoryourself.com/saulbooks.html
)
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