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The Vitamin Paradigm Wars

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http://www.internetwks.com/pauling/hoffer.html

(links to some of the articles in the bibliography are there on the webpage)

© 1996

First published June 1996 in THE TOWNSEND LETTER FOR DOCTORS AND PATIENTS

Reprinted with permission by the Author and The Townsend Letter

The Vitamin Paradigm Wars

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:

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

doses since they can be recycled almost indefinitely.

)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 licence 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 pre-eminant 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.

[Return to Paper]

[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: Prelimary Observations. Proc. Mayo Clinic

31:377-390, 1956. [Return to Paper]

[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. [Return to Paper]

[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. [Return to Paper]

[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. [Return to Paper]

[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. [Return to Paper]

[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. [Return to Paper]

[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. [Return to Paper]

[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.

[Return to Paper]

[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. [Return to Paper]

[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. [Return to Paper]

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

New York, 1986. [Return to Paper]

[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. [Return to Paper]

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

thrombocytopenic purpura with ascorbate. Br. J Haematology

70:341-344, 1988. [Return to Paper]

[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.

[Return to Paper]

[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 [Return to Paper]

[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. [Return to Paper]

[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. [Return to Paper]

[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. [Return to Paper]

[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.

[Return to Paper]

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

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

[Return to Paper]

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