Abram Hoffer MD, PhD

Interviewed by Peter Barry Chowka

On Orthomolecular Medicine

©1997 by Peter Barry Chowka. All rights reserved.

"Pharmaceutical companies are very annoyed with niacin because their products have to compete with it. Some of their cholesterol-lowering drugs cost up to $150 a month while niacin costs about $10."

-Abram Hoffer, MD, PhD

During a career spanning more than four decades, Abram Hoffer, M.D., Ph.D., has not only made some of the most original contributions to the field of nutritional healing, but he's also pioneered the field of orthomolecular medicine (orthomolecular medicine achieves or preserves health by manipulating substances such as vitamins that are normally present in the body).

Hoffer is the author of more than 500 papers plus 15 books including his latest about cancer and nutrition--begun as a collaboration with the late Linus Pauling, Ph.D. Hoffer is president of the Canadian Schizophrenia Foundation and editor of the Journal of Orthomolecular Medicine. He runs a private clinical practice in Victoria, British Columbia, Canada.

PETER BARRY CHOWKA: Could you summarize your work in the field of nutritional medicine?

ABRAM HOFFER, MD, PhD: In 1952 my colleagues and I began developing a more effective treatment for schizophrenia that involved a biochemical hypothesis. We tried two nutrients: vitamin C and vitamin B3. We found that we could halve the two-year recovery rate of patients just by adding these vitamins to the program. This was the first major systematic attempt to use large dosages of vitamins therapeutically. In 1955 we also discovered that niacin lowered cholesterol levels.

Today, our paper in the Archives of Biochemistry and Biophysics is considered the introduction of the new paradigm of nutritional medicine. The old paradigm was that you needed vitamins only to protect yourself against vitamin-deficiency diseases like scurvy and pellagra, and that anyone who took more than the Required Dietary Amount (RDA) was wasting his money. The new paradigm is that vitamins have a much greater function than simply to prevent deficiencies--they are also valuable in treating diseases.

In the 1960s, Linus Pauling, Ph.D., became interested in our work. We established a relationship, and in 1968 he published "Orthomolecular Psychiatry," his very important paper that provided a scientific rationale for why certain people need a lot more vitamins than others. Pauling quickly captured worldwide attention with his books on nutritional medicine. And that's basically how the whole orthomolecular movement took off.

CHOWKA: How would you summarize the medical establishment's reaction to this new way of thinking about nutrition--that it has a major role in treating disease?

HOFFER: When our work on schizophrenia was first published in 1957, we ran up against a brick wall. Every psychiatrist "knew" that schizophrenia was not a biochemical disease. Rather, it was a psychosocial disease caused by "bad society" or "bad mothering practices." How could a simple vitamin help schizophrenic patients? Psychiatrists also "knew" that the American diet was perfect; therefore, no one had to take extra vitamins.

The Mayo Clinic in Rochester, Minn., where I worked as a research fellow, later confirmed our studies on niacin and cholesterol. As soon as the Mayo Clinic paper was published, [there was] acceptance on the one hand but still terrible rejection, because you couldn't take out a patent on niacin. And if you don't have a patent on something, you don't publicize it and you don't promote it. So niacin had to develop on its own. It's one of the few examples of a therapeutic compound that became established in spite of the efforts of various drug companies to thwart its use. Even today, pharmaceutical companies are very annoyed with niacin because their products have to compete with it. Some of their cholesterol-lowering drugs cost up to $150 a month while niacin costs about $10.

I made a prediction in 1957 that by 1997 our practices would be accepted. I assumed it would take 40 years, since in medicine it typically takes two generations before new ideas are accepted. We're more or less on schedule. In the past five years there's been a remarkable acceptance of the use of vitamins in general medicine. Many scientific meetings today represent a major step forward and show that there is a heavy interest among the [medical] profession in the use of vitamins.

Luckily, someone recently came up with the word "antioxidant." The term doesn't have the stigma nor does it generate the hostility that is associated with "vitamin." This allows the profession to positively lump together vitamin E, vitamin C, selenium and beta-carotene.

CHOWKA: Do you see organized medicine's resistance to innovation changing across the board?

HOFFER: I think it's changing primarily in terms of the orthomolecular or nutritional movement. I don't think there's been any major shift in the medical profession's general approach to new ideas. I don't think there ever will be that kind of wholesale change. Three hundred years ago, when the major disease was smallpox, Sir Thomas Sydenham [1624-89] developed a new treatment that reduced the death rate from about 50 percent to 1 percent or 2 percent. His reward was being challenged to a duel. The English medical association wanted to drive him out. He wrote: "A new idea is like a sapling in the middle of a road, and if it's not fenced in, it will be galloped over by the trampling hordes." That's a really great statement, and it's also my view of what happens to medical discovery.

CHOWKA: In your 1993 Journal of Orthomolecular Medicine paper published with Pauling, you describe treating people with cancer and report extraordinary improvement in those you treated with vitamin C and other nutritional substances.

HOFFER: To this day I have treated about 800 cancer patients. But I got into working with cancer patients by a fluke. I have a referral practice in Canada, and general practitioners decide which of their patients should be sent to a psychiatrist like me. In 1978, a woman with pancreatic cancer who started taking 10 g a day of vitamin C on her own was told by her family doctor, "Why don't you see Dr. Hoffer, he's an expert on vitamins." (By this time I had been so identified in Canada.) I simply modified her program and suggested she take as much vitamin C as she could. She went up to 40 g a day. Then I added some other nutrients. She came back a month later and said she was feeling fine. Six months later she phoned me with the good news that she had just had a CAT scan and it couldn't find the tumor. She said her doctors didn't believe it--they thought something had gone wrong with the machine, so they ran the test again. But the tumor was gone. It's one case. But single cases mean something. They indicate trends. By the way, the woman is still alive and well today, almost 20 years later.

The next case was a man with prostate cancer that had spread and was invading the pubic bone. The cancer clinic told him it was untreatable. He came to see me and I put him on a nutritional program including injectable vitamin C. Six months later I got a call from the man's doctor. He said, "Hey, the cancer is gone. On the X-ray, we can't see any tumor." I said, "Great. You can stop the injections and just carry on with the oral C." The patient died nine years later of a coronary when he was 80.

Two cases. What do two cases mean? That there's something significant going on even if you really can't establish it as a truth. The first woman I saw with pancreatic cancer decided that this "miracle" had to be divulged. So she began telling her relatives and friends. After awhile, one of them would go to his doctor and say, "I've got cancer and I want to see Dr. Hoffer." In 1989, I must have seen three or four patients this way. Then it gradually began to build. As a fair number began to recover, they talked to their friends, neighbors and doctors. Although at first most of the referrals were what I call "patient induced," toward the end they became doctor-generated. And so they're coming in at the rate of four or five a week now.

I kept plugging away. I simply told every patient I saw what I thought they ought to do. And after I treated about 45 people, I began to see a significant difference. The ones following the vitamin program were living a lot longer than the ones who were not. Dr. Pauling encouraged me to publish my results. I really went to work and carefully examined all the 134 patients I had seen between 1978 and 1988. I followed up to see what had happened to them. They had split into two groups--101 who stuck to the program and 33 who did not. I looked at the 33 as a pseudocontrol. The data was amazingly different. The survival of patients who didn't follow the vitamin program was something like five or six months. (All of my patients were very, very sick to begin with. I wasn't seeing early cases; I was seeing the cases that could not be treated, like pancreatic cancer, prostate cancer with invasion to the bone, or stage 3/stage 4 cancers of all types.) The survival rate of the 101 who did follow my protocol was 10 to 20 times as long as the patients who didn't.

Pauling took my data and analyzed it, then we published a paper. A few years later I wrote to Pauling and told him that the cases were piling up and the data were holding. He wanted more information, so I sent him another 170 cases. In the meantime, luckily, computers came along. We got a computer and I put all the data in it. I make it a point to follow up with every patient once a year--I contact them and talk to them just to see how they're getting along. I'm now examining their longevity--it's hard data that you can't argue with. And I'm also examining their quality of life. There's no question that patients who follow this program have a much better quality of life.

I'm convinced we've demonstrated that adding this nutritional-antioxidant approach is helpful in combination with standard treatment. My treatment is not an alternative. If there's a big lump, take it out. If radiation's going to help, do it. But when you also take the orthomolecular approach, it reduces the toxicity of radiation and chemotherapy, and improves the therapeutic results. We have taken a major step forward. Now it's up to the research establishment. It can spend several billion dollars a year to actually go back and sort out exactly what are the important variables.

I'm surprised--I expected the National Cancer Institute to come to Victoria and ask to see all of my records and talk to my patients. Pauling did that. He asked one of his associates from New York City, a psychiatrist, to fly out to Victoria. He spent three to five days with me. I said to him, here are 134 files, pick out any one you want. And he selected the long-term survivors, and he spoke to them and to their doctors. And then he went back to Pauling and said, "I have seen these people and these are the results Hoffer is getting."

CHOWKA: It's amazing to me, considering the billions of dollars that are poured into the cancer war, that work of this kind, no matter how promising, no matter how credibly presented for publication, faces the virtual impossibility of being published in a leading medical or scientific journal. Do you think that the public recognizes that medicine is seriously flawed and that publishing new and promising ideas is often impossible?

HOFFER: I think the public is often totally surprised when they hear that. It's a function of the modern paradigm where you deal with cancer by attacking the cancer. It's also a function of the peer review system. "Peer review" simply means that if you want to publish a paper you send it to people who you think are going to say "yes," and if you don't want to publish it, you send it to reviewers who are going to say "no." Problems arise when we attack a paradigm that is held together by these common institutional threads. You're attacking the paradigm and the immediate reaction among the paradigm protectors is to defend it to the death. That's the way it's always been.

CHOWKA: Pauling once told me that progressive medical changes occur because the public is taking the lead or is at least helping to propel innovation--and that the public is often out in front of the medical authorities. How important is it for people to push for faster innovation?

HOFFER: The public must be involved. People have to know that conventional medicine involves a fantastic waste of time and money and unnecessary suffering. There are many examples of this, but I'll give you a recent one: Twelve years ago a Scottish physician reported a very important discovery--that pregnant women who are given folic acid won't bear children with spina bifida. But there was a tremendous amount of medical antagonism. Fortunately, there was enough interest generated that the British and American governments started some studies and concluded that the Scottish doctor was right. Yet every year in the United States, 25,000 children are born with spina bifida. The average annual cost of caring for each of these children, by the time they're 12, is $4,000. If the mothers were all given the recommended dose of 1 mg per day or less of folic acid, that cost could have been cut by at least two-thirds. Think of the millions of dollars saved. Think of the impact on these sick, unhappy children. It all could have been avoided.

Here's another example of delay. In the 1950s the Schute brothers in Ontario did some amazing work with vitamin E. Their claims were simple. They said vitamin E worked against heart disease and cerebrovascular disease. They were greeted with laughter. A couple of years ago, the Harvard School of Public Health published a huge study on vitamin E and showed that just 100 units of vitamin E per day decreased the death rate by 40 percent. Suppose they had done that in 1960? How many Americans would have been saved in the intervening 35 years had Harvard taken a responsible position and said, "We are skeptical of these claims but let's look at them"? But they wouldn't do that--it didn't fit their paradigm. So vitamin E was totally destroyed by the establishment. Think of the cost of those decisions.

Something will have to be done, and the public will have to do it. The public will have to do what people with AIDS did when they forced the FDA to change its regulations. People are going to have to overwhelm the medical journals and the medical schools and literally demand that medicine establish a technique for quickly examining bona fide claims made by reputable physicians. Every claim that's ever made doesn't have to be examined. But if a reputable research group or doctor makes a claim and has evidence for it, it should be taken seriously. It's too expensive not to.

CHOWKA: Are you optimistic about the future of health care, the promise of nutritional modalities, and the prospect of things improving in our lifetimes?

HOFFER: Oh, yes, I've always been optimistic that things are going to improve.

Five years ago no respectable scientist would ever admit that you should give anyone vitamin E. Today they don't mind talking about what they call "megadoses." Five years ago if you mentioned the word "megadose," they'd probably throw you out of a medical meeting. But there's really been a revolution, especially in the cancer field. I'm very optimistic.

I am convinced that within 10 to 20 years there will be some amazing changes. I think the United States is the leader in the field and much more prepared to look at alternatives. I don't like the word "alternatives," by the way. I think we are practicing standard medicine.

CHOWKA: Traditional medicine.

HOFFER: Traditional medicine is what we're doing. And this was lost beginning in the 1940s and '50s.

CHOWKA: One of the greatest misnomers is to refer to modern conventional medicine as "traditional." It's anything but traditional.

HOFFER: It's been a massive uncontrolled experiment. That's what modern medicine is. It does a good job in many areas. It's excellent for what we call horizontal medicine. It doesn't help at all for vertical medicine.

CHOWKA: "Horizontal" would be emergency medicine?

HOFFER: Yes. It's great for emergency medicine. If you're flat on your back, certainly go to a modern doctor. But if you're walking sick, they're not going to help you very much.

CHOWKA: What could we do to prevent or treat cancer better than we are now doing?

HOFFER: We could begin by immediately applying the complementary treatments that are already benefiting many cancer patients. The evidence is strong that diets including fruits, vegetables and grains in substantial amounts have anticancer properties. The more recent clinical evidence goes further--it shows that using the correct nutrients in optimum amounts will enhance the results of standard or orthodox therapy. END

Peter Barry Chowka is a journalist, medical-political analyst, lecturer and consultant who has documented traditional approaches to healing while working in a variety of media. He has been a consultant to the U.S. Congress and was appointed to the first advisory panels of the NIH Office of Alternative and Complementary Medicine in 1992-93.

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