| eyes open
|
|
Abram
Hoffer, Md, PhD Part One http://naturalhealthline.com/newsletter/991215/hoffer.htm © text & photos by Peter Chowka
On December 7, 1999, the New York Times published a positive article about research involving new treatments for schizophrenia. The treatments involve giving people who have no symptoms, but who are reportedly at risk of possibly developing mental illness, drugs that might "prevent" it. My first thought was, What would Dr. Abram Hoffer think of this news? I first met Abram Hoffer, MD, PhD six years ago, and have interviewed him several times and stayed in touch with him since then. On December 7, I e-mailed Dr. Hoffer the Times article, and before the end of the day he replied with his usual well-informed and thoughtful analysis. This initial exchange inspired me to ask Hoffer if he would care to expand on the subject in a series of follow-up Q & A's, and he readily agreed. Over the course of the next several days, our electronic dialogue evolved and Hoffer went on to provide an expansive and provocative examination of his ideas about schizophrenia, mental illness, conventional diagnosis and treatment, and natural therapies. I am extremely pleased, and honored, that one of my last interviews of this decade is with Abram Hoffer. In the view of many observers, including this writer, Hoffer is one of the leading figures of twentieth century natural medicine. While other clinicians, because of their more self-aggrandizing nature, may be somewhat more famous in the public's mind, Hoffer is well respected and widely known in the medical and scientific world and has been extremely influential to his peers. He also has a significant following among the well-informed general public. During a career spanning more than five decades, Hoffer has not only made some of the most original contributions in the area of natural healing, particularly for mental illness, but he's also pioneered the entire field of orthomolecular medicine. (Orthomolecular medicine achieves or preserves health by manipulating substances such as vitamins that are normally present in the body). With MD and PhD degrees from respected universities, Hoffer's work has always been based on sound science and exceptional clinical work. He combines the best attributes of an innovative research scientist and a compassionate clinician. His work overall constitutes an absolutely vital contribution to natural medicine, particularly in view of the fact that he began his career decades ago when alternative therapies were not highly regarded by the mainstream and when a quest like his tended to be a lonely one. Hoffer is the author of more than 600 papers in the medical and psychiatric literature plus twenty books including his latest, Vitamin B-3 and Schizophrenia - Discovery, Recovery, Controversy. Another recent book, about cancer and nutrition, began as a collaboration with the late Linus Pauling, PhD. Hoffer has had extensive experience treating people for cancer and other diseases, in addition to mental illness. Hoffer is president of the Canadian Schizophrenia Foundation and editor of the Journal of Orthomolecular Medicine. He operates a private clinical practice in Victoria, British Columbia, Canada. Several years ago, I asked Hoffer how his work in the field of nutritional medicine started. He replied, "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, PhD, 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."
Peter Chowka: On December 7, 1999, the New York Times published a positive feature article about what the paper termed a new and "bold move against schizophrenia." The strategy involves research into "identifying young people at risk [of developing schizophrenia] and treating them with low doses of anti-psychotic drugs, even though they do not exhibit the full-blown symptoms of the illness." The studies are titled "prevention" trials. Among the concerns noted in the article are that "subjects in prevention studies will receive treatment unnecessarily, or be treated for what turns out to be the wrong problem. Behaviors used in the studies to determine risk. . .can also be signs of normal adolescent crisis, or of other psychiatric problems like depression that do not require anti-psychotic drugs." What do you think of this drug treatment strategy for "preventing" schizophrenia? Abram Hoffer, MD, PhD: I agree that we must diagnose schizophrenia early but I strongly disagree that we can use these powerful drugs to prevent its onset. The most that would happen is that the disease would be controlled and that the patients would have to take these drugs or similar ones forever. I suppose that is what the drug companies are after anyway. It certainly widens the field for sale of their drugs. My objection clinically is very simple. These drugs induce what I call the "tranquilizer psychosis." They convert schizophrenia into this new psychosis. It's characterized by a decrease in the intensity of the psychotic symptoms but induced in its place are apathy, disinterest, poor judgment, difficulty in thinking and concentration, and inability to work. These patients will never pay income tax. The drugs also cause tardive dyskinesia, impotence, and excessive weight gain. For the latter reason alone, young patients will simply refuse to take these drugs unless they are forced to do so by state sanction. But if people liable to become schizophrenic are treated using the orthomolecular approach, then schizophrenia really will be prevented and there will be no side effects. I have argued elsewhere that adding 100 milligrams of vitamin B3 per day to flour would almost eradicate schizophrenia in about ten years; at least no new cases would be formed. But the drug companies would make no money out of that. Chowka: A new direction for conventional medicine seems to involve giving more and more treatments to people prior to them showing any signs of active disease, for example, preventive mastectomies or giving women the drug tamoxifen before they get cancer. What do you think of this trend? Do you think it is expanding? Is it perhaps a sign of desperation? Hoffer: I think that one should define what is meant by "prevention." I consider prevention any change in lifestyle, in nutrition, or in medical procedures which really does prevent an illness from appearing. One of the best examples is the addition of vitamin B3 to flour which really does prevent millions of people from developing pellagra. This simple preventative procedure is free of side effects. Vaccination is preventive but not in every case and the price is often too high in terms of chronic illness generated by the vaccination. Double mastectomy will surely prevent breast cancer because there are no breasts left afterwards, but there is no evidence that these patients will remain free of other forms of cancer such as uterine cancer. But the human cost of such a procedure is high and it might be better to change one's lifestyle and nutrition in order to decrease the incidence of breast cancer -- and to detect it as early as possible when proper clinical nutrition and other treatments will surely yield very much better results than are possible today with orthodox treatment only. Preventive mastectomy reminds me of a surgeon, over fifty years ago in our hospital where I interned, who specialized in removing normal gall bladders. This procedure was soon stopped when pathologists looked at the tissue slides from these normal gall bladders and began to ask a few serious questions. Giving tamoxifen to prevent cancer has not been proved -- the statistical data has been interpreted in such a way that the results appear to be meaningful when in fact they are not. This is why the British studies using tamoxifen were negative while the US-Canadian studies were presented as positive. You have heard the statement "lies, damn lies and statistics." The women in these studies on placebo (an inactive substance used as a control in an experiment) had an incidence of two patients out of each one thousand who got breast cancer in the clinical trial each year. The women on tamoxifen had an incidence of one out of one thousand. When presented in this bland way it is obvious that to expose a thousand women to the hazards of a powerful hormonal suppressant drug, which even for patients who are sick is never given for more than five years and for good reason, in order to save one out a thousand, is ridiculous. There are better ways of doing this. In order to make the statistic look really good, the promoters of the treatment did not talk about actual numbers but about percentages. There was about a fifty percent decrease in the incidence, i.e., if one decreases the incidence from two to one, there is a fifty percent reduction. If the results were really clinically and practically significant they would not have had to use these shoddy statistical techniques. It is a sign of desperation in the cancer medical-industrial complex. Early detection and treatment -- however desirable -- is not "prevention." Real prevention is a way of preventing serious and chronic disease from developing in the first place. The use of tamoxifen represents a trend which is developing and which must be stopped until measures like this are shown to be totally safe and effective. The best prevention today is good nutrition which takes into account the individuality of people and which pays attention to families where certain nutritional disorders are more common. Chowka: Before we explore orthomolecular treatment, what is schizophrenia? How is it usually diagnosed?
It is a syndrome and should properly be called "The Schizophrenias." Syndromes are constellations of symptoms which may arise from a variety of causal factors. Thus, pneumonia is a syndrome but it may be caused by different infections such as tuberculosis, pneumococcus, cancer, viruses, and more. Although the syndrome is the same, the treatment is different and depends on the exact cause. The syndrome of schizophrenia consists of changes in perception such as voices and vision (hallucinations) and thought disorder. Thought disorder is present when the patients believe that their voices and visions are real and most often they will act upon that belief. In rural Saskatchewan many years ago, a young man who was recently discharged from the local mental hospital shot seven members of a family, sparing only the baby who he left crawling on the floor. The previous night the shooter had seen and heard the devil, a very tall, dark man with the head of a pig -- a devil who ordered him to drive one hour and, when and where he arrived, to kill. When I asked him why he did not kill the little boy, he replied that by then he was tired of killing. His visions and voices were perceptual changes, his belief that the devil was real was evidence of his thought disorder. Both conditions in the same patient made him schizophrenic. There are many causes of schizophrenia including vitamin B3 deficiency (pellagra), vitamin B3 dependency, food allergies, hallucinogen intoxications, head injuries, chronic infection, fevers, and more. Modern psychiatry prefers not to diagnose schizophrenia early because if they do, there is not much they can do for the patients. So they use euphemisms such as "bipolar" or "borderline personality disorder." If the patient has any depression, they call him "bipolar" and can then give him lithium which does not help. If patients behave badly, they call them "borderline personality disorder." Psychiatrists are reluctant to diagnose early and accurately. There are no laboratory tests for schizophrenia but there is a helpful card-sort test called the HOD test (Hoffer Osmond Diagnostic). It consists of cards that the patient sorts into true and false boxes. From the number of cards in the true box, one derives a score that is very high in schizophrenic patients and very low in people who are not sick or who have other psychiatric diseases. Chowka: Is conventional medicine successful in correctly diagnosing or identifying schizophrenia? Hoffer: It depends on whether one is diagnosing the syndromes or the causes. Diagnosing the syndrome is not very difficult and in most cases the diagnosis of insanity is made by relatives and friends long before it is made by physicians. The family recognizes that there is something seriously wrong and may call the patient crazy or strange or queer. But since only physicians are legally allowed to make diagnoses, the final determination - whether it's schizophrenia or something else -- is made by physicians. In my opinion, and this is based on the large number of cases I have seen after they have been treated by other psychiatrists, they are too reluctant to diagnose it, preferring other terms, usually "bipolar" or "depression" or more recently "borderline personality disorder." Diagnosis is always fashionable and changes as do men's and women's fashions. The current manual of diagnosis developed by the American Psychiatric Association is noted for its unreliability and its ability to create more and more diagnostic disease entities with new numbers. It has been argued that eventually every single individual in the United States will have a psychiatric diagnostic label and number. About forty years ago, Dr. Nolan D.C. Lewis, the eminent Professor of Psychiatry from Columbia University in New York, and his research psychologist examined seventy manic depressive patients by following their careers in and out of hospitals for many years. They found that, of the seventy originally diagnosed manic depressives (now bipolar), thirty-five were clearly schizophrenic in their final re-admission. They showed that if the first psychiatrist who diagnosed them had taken into account perceptual disturbances, these patients who later were called schizophrenic would have been diagnosed accurately in the first instance. In other words, the disease did not change its character but it was missed by sloppy diagnostic work ups. I am in complete agreement with these findings and have seen exactly the same thing in patients who I saw treated by other psychiatrists throughout their various re-admissions. If psychiatrists would adopt the presence of perceptual changes and thought disorder as the main criteria there would be little difficulty in diagnosing the syndrome. Diagnosing the causes of the syndrome is much more important -- because the syndrome is merely descriptive and does not tell us how to treat while the causal diagnosis immediately points to the correct treatment. If the syndrome is caused by a chronic wheat allergy, it will be treated successfully be removing wheat from the diet. If it is caused by a deficiency of vitamins, putting them back will cure the disease, and so on. Causal diagnosis is very simple but one has to know what these causes are and how to determine if they are present. Chowka: How is schizophrenia related or how does it compare to other forms of mental illness? Hoffer: Schizophrenia is a unique illness since it strikes early and lasts forever. In its early stages it can mimic every known psychiatric disorder from chronic anxiety, to chronic depression, to any of the personality disorders. That is why it is so important to diagnose accurately and early. A major difference is that patients with schizophrenia when they are not sick are physically and mentally superior to non-schizophrenic patients. Another difference is that schizophrenic patients can tolerate enormous doses of strong drugs which would wipe anyone out who is not schizophrenic. Schizophrenia is also much more costly to the patients, families, and the community since it strikes early, is devastating to everyone involved, and lasts such a long time. The other serious diseases such as depression and anxiety disorder in most cases have a very high natural recovery rate. Chowka: Is the incidence of schizophrenia increasing? How much of a problem does it present (how many people are affected)? Hoffer: I think that the incidence is increasing. The two main factors in causing the syndrome are food allergies and nutrient deficiency. The foods may be any food but are usually staples, such as milk, sugar, and the cereal grains. One of my very intelligent patients, both alcoholic and schizophrenic studying for his PhD, was allergic to tomato juice. When this was removed from his diet, he recovered. The nutrient deficiencies are usually some of the B vitamins, especially pyridoxine and niacin or niacinamide, and the chief mineral deficiency is zinc. Mineral excesses are more rarely factors. Our modern diets are generally too rich in certain staples, such as cereal grains and wheat that are still new to humanity since they have been around only for the past 10,000 years. Wheat and modern diets are nutrient poor due to our present commercial production processes and because of the general ignorance of society with respect of what constitutes optimum nutrition. During World War II in England when sugar consumption was cut in half, when only a very dark brown flour was available for bread, and when the English were forced to depend more on their own home grown products, the incidence of schizophrenia went down in spite of the stress of the war and the bombing of London and other cities. The second factor is genetic morphism. This concept was developed by Sir Julian Huxley, Professor Ernst Mayer of Harvard, Humphry Osmond my friend and colleague, and myself in a paper we published many years ago. A genetic morphism is any genetic condition which is still present today. If the genes that are causally related to schizophrenia were all evil they would have long ago been deleted by evolution. The fact that we still have them in our gene pool proves that they have value in the fight for survival. That is not to say that it is valuable to be sick. But the possessor of these genes who are not sick have characteristics which have survival value. These are the first order relatives of patients such as parents, siblings, and children. It was found that these relatives were superior in both psychological and physical attributes. Thus, on the psychological side they are more creative and more intelligent and many of our well known great contributors had these genes. But they were not sick. On the physical side they are physically better formed, more youthful, do not gray as fast, can withstand shock and pain better, do not get many common diseases as often, and do not get cancer nearly as often. Since 1955, I have seen over 5000 schizophrenic patients. Only six ever developed cancer and of these, only only one died from it. The rest are cured. I examined over 200 families with one schizophrenic patient, the index case. The incident of schizophrenia was very high but the incidence of cancer was very low. Conversely, patients who get cancer hardly ever become schizophrenic. I have seen 1100 cases of cancer since 1977 and of them, only six became schizophrenic. Similarly, in two-hundred families with cancer the incidence of cancer is very high but hardly anyone ever developed schizophrenia. My hypothesis is that this is understandable by knowing the properties of adrenochrome, the first oxidation product of adrenalin in the body. Adrenochrome is an hallucinogen and in excess will cause schizophrenia to appear. But it is also a mitotic poison, i.e., it inhibits raid cell division. I hypothesize that the body uses the adrenochrome as another way of controlling excessive cell division -- cancer. If a person becomes schizophrenic it means that he or she has too much adrenochrome and therefore will probably not get cancer. If a person develops cancer it means that he does not have enough adrenochrome and therefore is unlikely to become schizophrenic. Because of the morphism factor, the schizophrenic genes are increasing in our gene pool. An additional factor is that patients are no longer incarcerated in mental hospitals and prevented from reproducing. I predict that when an accurate count is made of the people in our community who have schizophrenia, when it is accurately diagnosed, we will find a slow, subtle increase. The easiest way to prevent the disease but not the genes from recurring is to make sure that every person with these genes is treated properly. For then only the positive values of these genes will be expressed and the negative value (the production of the disease) will be avoided. It is my hypothesis that schizophrenia is an evolutionary advance in which the body is giving up the synthesis of vitamin B3 from the amino acid tryptophan and is becoming more dependent on food sources. This will increase the production of serotonin which may have survival value but only in the presence of natural diets where there is ample vitamin B3. I use the same argument here that Linus Pauling used in explaining people lost the ability to synthesize vitamin C many years ago while consuming adequate amounts of vitamin C. If we survive the millions of years required for genetic drift, I suspect we will all the have the gene but no one will be sick. We will all be taking adequate amounts of the essential vitamins and minerals.
For more information, A. Hoffer, MD, PhD, FRCP(C) |
Following
is part one of my new interview with Abram Hoffer, conducted
during the second week of December 1999. The second part will
appear in the next issue of Natural HealthLine. 
Hoffer:
Schizophrenia is a common disease affecting about one to two percent
of people in modern society. These patients will have one or more
episodes of disease during their lifetimes. Most of them will
not recover. It strikes early in life -- between age fifteen and
thirty-five is the peak incidence -- but it may strike at any
time, men and women equally. It was rarely described before 1800
AD. It occurs in all peoples but tends to be more frequent among
the poor in any society. The response to treatment depends on
the nation. Wealthy nations have more severe forms while less
developed nations, while having the same incidence, have more
benign forms with a better response.