© by Peter Chowka

The first part of this extensive new interview, conducted during the second week of December 1999, was published in Natural HealthLine on Dec. 15, 1999. Here is the second and final part.

Abram Hoffer, MD, PhD was born in Saskatchewan, Canada in 1917. He was awarded a PhD from the University of Minnesota in 1944 and an MD from the University of Toronto in 1949.

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). 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 represents an absolutely vital and original series of contributions to contemporary 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 clinical innovation was particularly disfavored. 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 with cancer and other diseases, in addition to mental illness.

In the midst of my extensive interview with Abram Hoffer, MD, PhD, a news story appeared and received major play in the nation's media:

"Few Seek to Treat Mental Disorders, U.S. Study Says"

Dec. 13, 1999

Robert Pear
New York Times Syndicate

WASHINGTON -- One in every five Americans experiences a mental disorder any given year, and half of all Americans have such disorders at some time in their lives, but most of them never seek treatment, the surgeon general of United States says in a comprehensive new report.

This story prompted several questions to Dr. Hoffer, after which we discussed orthomolecular medicine in some detail.

Peter Chowka: What do you think of this news? Do you agree with the U.S. Surgeon General that mental illness is so prevalent? Is it possible that many behaviors are now being medicalized? If so, why do you think that is? Is there a danger when experts claim that so much mental illness exists, that truly serious conditions like schizophrenia or psychosis may be marginalized or lumped in with quasi-mental illness?

Abram Hoffer, MD, PhD: I do agree that mental illness is very prevalent but the number of people who are ill depends on how one defines mental illness. Surveys over the past fifty years have shown that many people do have mental problems. I think one should divide the so called mentally ill into the major psychoses diagnosed as early as possible and the non-psychotic disorders such as anxiety states and depression. But the question cannot be easily resolved because diagnosis is driven by the American Psychiatric Association (APA) Manual on Diagnosis which becomes heavier, like the phone book, every time it is revised and adds new terms to the diagnostic list, each with its own number.

It has been argued that if this APA trend continues, then one day every person will be considered a psychiatric problem with his or her own diagnostic number. Sometimes, the APA backs down. For example, for many years homosexuality was considered to be a mental disease. Later, it was removed from the diagnostic list.

There is a major tendency to use diagnosis as a descriptive device that has no causal value nor any treatment value. Thus there are about fifty terms for children with learning or behavioral disorders. If a child has a problem with mathematics, that is given one term. If a child has a problem reading, it is given another term. In my opinion based on two thousand children under age fourteen whom I have treated since 1960, most of these children can be classified causally into two major groups: those with allergies and those needing orthomolecular doses of many of the B vitamins and some of the essential minerals and essential fatty acids.

All in all I think that about five percent of the population will have one or more major psychotic episodes during their lifetimes, that another five percent will suffer from one of the addictions including alcoholism, and another ten percent will have problems with depression and anxiety. I think about twenty percent of the population will have conditions that can be treated successfully by orthomolecular means. Pharmaceutical drugs should be used with caution and as support to the orthomolecular treatment only, not as the primary treatment.

Chowka: What are the conventional therapies for schizophrenia? How successful is conventional medicine in reversing it or controlling it?

Hoffer: Conventional treatment may be divided into two components: psychosocial and biochemical. Psychosocial therapy has never been very effective and no one has ever claimed that one could improve results over natural recovery rates. For this reason psychoanalysis quickly took hold especially in the United States and by 1955 it was in full swing to the detriment of thousands of patients and to the whole field of psychiatry as a science. While every other branch of medicine was advancing very rapidly, psychiatry was stuck in the same old mold until the first tranquilizer, chlorpromazine, a major anti-histamine, was shown to be active by a French surgeon, Dr. H. Laborit, in about 1950.

Since then, psychiatry has paid tremendous lip service to the need for psychotherapy even though in practice it is mostly ignored. What is in fact very essential is counseling, support, and understanding for chronic patients who have been damaged by the disease and by the way it was treated over the years, and rehabilitation and education for patients hit early and kept away from the mainstream of life for many years. But any psychosocial treatment used alone without biochemical treatment is a waste of human life and money.

The biochemical or medical treatment consists of the old and more recent tranquilizer medication. The main difference between the old and the new is that the new ones are much more expensive since they are still covered by insurance. Recent reports that discussed these treatments point out that there is little difference in efficacy, that both sets of compounds have side effects but that these side effects are different. In my opinion it does not make them better. The major side effect of the old treatments was tardive dyskinesia which is more rare with the new treatments but the new ones have major side effects such as excessive weight gain, and may still cause tardive dyskinesia.

Other drugs include the anti-depressants, which can be very useful and do not have the same degree and intensity of side effects. Lithium is used commonly but first these patients are diagnosed as bipolar even though they have pathological perceptual changes and thought disorders. Only later is it recognized that they were schizophrenic all along. The anti-anxiety drugs may also be used. These are the diazepines, which tend to be addictive and from which it may be very hard to wean patients.

Drugs are very helpful in decreasing the intensity of the symptoms. Hallucinations are moderated and delusions greatly decreased in intensity. Agitated behavior is controlled and many patients will gain a degree of insight. Therefore, the drugs are very helpful and need to be used. They also work very quickly. However, very few patients ever recover to the point they can pay income tax. I challenge any psychiatrist not practicing orthomolecular medicine to describe any of their patients who are so well that they can go back to gainful employment, free of symptoms and signs. On the contrary, with orthomolecular psychiatry most of the patients sick for less than two years will recover. I see them every day in my office.

Tranquilizers induce what I call a "tranquilizer psychosis." In other words, the natural psychosis "schizophrenia" is replaced by iatrogenic [doctor-caused] psychosis. This condition was first suggested by Dr. Mayer Gross, a psychiatrist practicing in England over forty years ago, when he stated that these drugs converted one psychosis into another. The tranquilizer psychosis is marked by a decrease in the frequency and intensity of symptoms and signs, by a decrease in the intensity of the thought disorder, and by a calming effect on the patient. But it also causes concentration problems, memory problems, difficulty in thinking, apathy, inertia, and inability to function in normal activity.

In the short term, tranquilizers are helpful but they merely maintain a person in a chronic state of invalidism. This is the tranquilizer dilemma. And it is based on the following two conclusions with which no one will argue: The first is that these drugs do help patients initiate the process of recovery and the second is that they make normal people psychotic. In fact the original animal model for these drugs was the catatonic test. Animals were given drugs and those that made them catatonic became our tranquilizers.

So when drug treatment is started there is an improvement and as the condition gets better clinically, it is obvious that the disease process must also be getting better. As the process of recovery continues, the person becomes more normal in their biochemistry as well, and at a certain point the drugs begin to produce the tranquilizer psychosis. There is a change over from one psychosis to the other. Psychiatrists know this but will not talk about it. They deal with it by reducing or eliminating the drug but the unfortunate result is that the original condition recurs and the unhappy patient is left swinging between two extremes.

Modern treatment is helpful in controlling the disease and in keeping patients out of hospital but in terms of restoring these patients back to society, the treatments are singularly unhelpful.

Electro-convulsive treatment (ECT) has helped many patients but only when it is used in combination with orthomolecular treatment. It is used much more rarely now.

Chowka: Is it possible to diagnose schizophrenia or recognize it early on? Are there benefits to early diagnosis and treatment?

Hoffer: It is possible to diagnose early. In fact it is essential that this be done for the therapeutic results are so much better and quicker when an early diagnosis is made. Our book, How To Live With Schizophrenia, described very clearly what it is, what are the symptoms and signs, and how to make early diagnosis. Also our HOD test is very helpful in assisting early diagnosis. Ideally, the diagnosis should be made by the first physician who sees the patient. In Canada this is the family physician or general practitioner. When they are trained to recognize the disease and have simple tests like the HOD to help, they do diagnose early and treatment in their hands is very effective. I know several of these doctors who test their patients much more successfully than do any of the local psychiatrists because they do recognize them early and treat vigorously with orthomolecular methods. In many cases there may be no need for drugs. Late diagnosis condemns the patient to chronic invalidism and their family to a life full of stress and despair.

Chowka: In your experience, what is the optimum treatment? And please define "orthomolecular medicine."

Hoffer: The term "orthomolecular psychiatry" or "orthomolecular medicine" was developed by Linus Pauling, PhD in his famous report to Science magazine in 1968. He defined it as the use of substances that are normally present in the body using the optimum amount. He referred to nutrients such as vitamins, amino acids, essential minerals, and so on. The key words are naturally present and optimum. Because the optimum doses may vary enormously from very small - the usual RDA or vitamin doses - to very large - the megadoses.

In practice, orthomolecular medicine is combined with any other treatment that is effective. Thus, in treating many schizophrenic patients, I have found that they need rapid control and this is achieved by the drugs. But they also need to recover and this is obtained by the use of orthomolecular methods.

In brief, this is what the treatment consists of in my practice:

a) Nutrition - The diet is cleaned up by eliminating, as much as possible, all the junk in our food. "Junk" I define as any food that contains added simple sugars. It includes pastry, candy, soft drinks, and sugar in the drinks but does not include fruit to which sugar has not been added. One also looks for food allergies and eliminates them when they are found.

b) The right nutrients in optimum amounts - Thus with vitamin C one may need to use a range from 500 milligrams to thousands of milligrams daily. The sicker the patient is, the more vitamin C will be needed. In treating schizophrenia one may need 500 milligrams of B-3 with each meal up to 3000 milligrams after each meal. I can not give the details here. They are described in the orthomolecular literature and on my Web page. The nutrients include vitamins, minerals, amino acids, essential fatty acids, enzymes, and other natural substances .

c) The optimum amount of medication - This must be removed as soon as possible as the aim is to get and keep patients well without needing drugs, for the reasons described above.

d) Support, counseling, encouragement, hope, and above all, patience - Patients also have to be advised that they must be patient. Seldom are there quick cures.

One should expect the following results (my criteria for recovery are four):