ORTOMOLECULAR - Ask all your questions about
Excellent text by Dr. Frederico Lobo that answers all questions about ORTOMOLECULAR
1 - Where did orthomolecular medicine come from?
A: The prefix “Ortho” derives from Greek and means “correct”, so “Orthomolecular” means “correct molecule”. The term was coined in 1968 by Linus Pauling (1901-1994), an American professor of quantum chemistry and biochemistry. This scientist, who was awarded the Nobel Prize twice (Chemistry in 1954 and Peace Prize in 1962), initially based his work on randomized, double-blind studies by the Canadian psychiatrist Abraham Hoffer. Hoffer managed to reduce the length of stay of schizophrenic patients by using high doses of vitamin B3 (3g/day). Pauling proposed that mental disorders could be treated by correcting imbalances or deficiencies in brain constituents such as vitamins and other micronutrients, offering an alternative to the administration of synthetic psychoactive drugs. At the end of the 1960s, he began to develop the Biochemistry of Nutrition and, in the 1970s, expanded the Orthomolecular concept to medicine in general, defining it as the use of “the right molecules in the right concentrations”. This approach aims to prevent and treat diseases and promote health, based on the physiological and enzymatic actions of specific nutrients, such as vitamins, minerals and amino acids, present in the body. Linus Pauling is considered the father of molecular biology.
2 - What is the origin of orthomolecular medicine in Brazil?
A: In Brazil, there are two main pioneers in orthomolecular medicine. Both are renowned researchers and have contributed significantly to the popularization of orthomolecular medicine:
Prof. Dr. Hélion Póvoa is one of Brazil's leading experts in nutrition and biochemistry. A former student of Linus Pauling, he introduced orthomolecular medicine to the country. A full member of the National Academy of Medicine, a researcher at Fiocruz and a visiting professor of nutrition at Harvard, he has published more than 400 research papers in Brazil and abroad, as well as numerous books on orthomolecular medicine.
Prof. Dr. José de Felippe Jr is another pioneer of orthomolecular medicine (or, as he calls it, “Biomolecular Medicine”) in Brazil. A graduate of Santa Casa de São Paulo, with a doctorate in Physiology from the University of São Paulo and a PhD in Sciences, he is also a lecturer in Clinical Medicine and Intensive Care Medicine at the University of Rio de Janeiro. He is also the founder and first Secretary General of the Brazilian Association of Intensive Care Medicine (AMIB).
Currently, other professionals have made a significant contribution to orthomolecular/biomolecular medicine in Brazil, such as cardiologists Efrain Olszewer and Artur Lemos.
3 - Is orthomolecular medicine a medical specialty?
A: Firstly, it is important to clarify that the term “orthomolecular medicine” should not be used, as it is not recognized as a medical specialty or even as an area of practice. The Federal Council of Medicine recognizes it as a “medical practice”, as established by resolution no. 1,938, of January 14, 2010.
This resolution defines the limits and purposes of orthomolecular practice by doctors in Brazil, standardizing its application. The more appropriate term would be “orthomolecular/biomolecular strategy” or “orthomolecular/biomolecular practice”. It is worth noting that “orthomolecular” and “biomolecular” are considered synonyms.
4 - Is there scientific evidence of its effectiveness?
A: It is now unquestionable that oxidative phenomena, such as the formation of free radicals, play a crucial role in the origin of various pathologies. There are several studies demonstrating the benefits of antioxidant therapy, although there is also research indicating that, in certain situations, this therapy may be contraindicated. For example, the CARET Study revealed that smokers who consumed synthetic beta-carotene showed an increase in health problems, including lung cancer, showing that synthetic carotenoids are not recommended for smokers.
Therefore, it is essential that when looking for a doctor with an orthomolecular practice, this professional has a solid background in the area, such as a postgraduate degree, so that they can properly assess the advantages, limitations and risks of taking any substance that interferes with health.
The search for orthomolecular medicine should be aimed at prevention, well-being, promoting changes in lifestyle habits and health-related values. Preventive strategies are generally more effective than treating established problems. Of course, in cases of advanced pathologies, such as myocardial infarction or cancer, the possibilities of prevention have already been overcome, but even so, orthomolecular practice can offer a lot, such as guidance on healthy lifestyle habits, correction of nutritional deficiencies, targeted supplementation, among others.
5 - How do you know if a doctor is qualified to practice the orthomolecular strategy, considering that orthomolecular medicine is not a common subject in medical courses in Brazil?
A: Although there are still few orthomolecular courses in Brazil, most are two-year postgraduate courses aimed exclusively at doctors. The main courses are recognized by the MEC and generally have extensive syllabuses.
In ASOMED's opinion, orthomolecular medicine is both a science and a medical practice and should be practiced exclusively by doctors. Nutritionists can employ some orthomolecular strategies, but the diagnosis should be carried out by doctors with postgraduate qualifications in the field. Therefore, before looking for a doctor working in this field, it is important to check that he or she has a specific postgraduate degree, participates in medical associations and keeps his or her training constantly up to date.
6 - What is the orthomolecular medical consultation like?
A: An initial orthomolecular consultation usually lasts at least an hour. It resembles a traditional medical consultation, including questioning about signs and symptoms (anamnesis), physical examination and, if necessary, requesting general and specific complementary tests, followed by a treatment prescription.
The difference with orthomolecular medicine lies in the time dedicated by the doctor and the more holistic approach to questions. While a specialist focuses primarily on their area (which is correct), the orthomolecular doctor seeks a more integrative perspective, considering the patient as a whole, which naturally requires more time. For this reason, it is rare for orthomolecular doctors to be covered by health insurance plans. Although they can provide care in other specialties using health plans and order tests through them, the orthomolecular consultation itself is generally not covered by the plan.
7 - Why do athletes and celebrities seek out orthomolecular medicine so much?
A: High-level athletes are constantly looking for methods to improve their performance and physical conditioning, in order to achieve the best possible performance within their physiological limits. In general, they are very attentive to concepts such as well-being and quality of life, positioning themselves as the vanguard of a health-oriented society.
The “famous” have popularized the so-called, albeit non-existent, “orthomolecular diet”. They also tend to be pioneers in adopting practices aimed at a healthier society, as they are often in contact with new ideas related to health. They seek more preventive medicine, which prioritizes healthy lifestyle habits, more natural therapies and fewer side effects.
Thus, athletes and celebrities alike share the need to mitigate the increased wear and tear on their bodies, whether from intense physical exercise or stress. They find in orthomolecular medicine an effective way of correcting this wear and tear and also of better preparing themselves for future overloads.
8 - Is orthomolecular treatment expensive?
A: There is a stigma that orthomolecular treatment is expensive. However, by analyzing everything that is carried out during an orthomolecular treatment and its effective benefits, one can see that the therapy, considering the cost-benefit ratio, can be considered “affordable”.
The cost of the consultation is justified by the time dedicated by the doctor to the patient, usually with an initial assessment lasting at least an hour (it is worth mentioning that the patient is followed up in return visits, which are also usually extensive).
Most of the tests requested are conventional and often covered by health insurance plans. As the treatment itself is personalized, it can vary in cost. This cost depends on the patient: the more they adopt healthy lifestyle habits and a balanced diet, the less they will have to spend.
So the concept of “expensive” is relative. If the patient has poor lifestyle habits and doesn't eat a balanced diet rich in vitamins, minerals and good fats, the cost of personalized formulation tends to be higher.
9 - What are free radicals and why does orthomolecular medicine aim to combat their formation?
A: Approximately 95% of the oxygen used in respiration is neutralized by the cell's respiratory chain and transformed into water at the end of its metabolic cycle. However, the remaining 5% is converted into free radicals. These, if not properly eliminated or if produced in excess, can be harmful to the human body, causing a pathological condition known as oxidative stress.
Oxidative stress can be triggered both by genetic abnormalities in the defense organs and by environmental factors such as smoking, radiation, excessive physical activity, metal poisoning, consumption of animal fats, fried foods, red meat, inflammation and infections, alcohol abuse, as well as physical and mental stress.
Today, medicine recognizes that several diseases are linked to the action of free radicals, including cancer, atherosclerosis, arthritis, cataracts and pulmonary emphysema. Other diseases, such as serious infections, diabetes, Parkinson's disease, Alzheimer's disease and demyelinating neurological diseases (such as amyotrophic lateral sclerosis), are aggravated by an excess of free radicals.
10 - What procedures should a doctor who calls himself an orthomolecular practitioner be able to perform?
A: In the orthomolecular/biomolecular strategy, the doctor must be able to:
- Identify which essential nutrients are lacking or in excess in the patient's body;
- Diagnosing the presence of toxic metals in the body;
- Check that the endocrine, absorption, metabolization and excretion systems are functioning within normal parameters;
- Diagnosing food intolerances or allergies;
- Knowing and advising on healthy lifestyle habits for all their patients.
11 - What are the forms of action of orthomolecular treatment?
A: Orthomolecular treatment can work in three ways:
1. PREVENTIVE mode: Through increasingly early diagnosis, detecting subclinical metabolic alterations (before the onset of disease), orthomolecular treatment seeks to restore the individual's overall balance. This makes it possible to maintain health or obtain a more effective response to the specific therapies used in cases of disease. The tests used include imaging tests, laboratory tests and a capillary mineralogram. It is important to note that techniques such as Bioresonance (Vegatest), although used by some orthomolecular professionals, have no scientific validation before ANVISA, which is why some more skeptical orthomolecular practitioners choose not to use them.
2. SYSTEMIC mode: It works on the diagnostic assessment of all organs and systems, analyzing the interrelationship and interdependence between them. It includes cellular nutritional treatments, supplementing the body with essential nutrients or removing excess or toxic substances, such as heavy metals.
3. INTERACTIVE mode: It focuses on the interaction between human systems and environmental systems. This approach recognizes that we are part of a large network of interactions, such as man/nature, man/animals, man/climate change, man/pollution, among others.
12 - What are the substances used in orthomolecular medicine to treat patients and how do you know if they are lacking or in excess in the body?
A: In the process of producing energy and synthesizing substances to maintain cellular balance, the body synthesizes part of the necessary substrate. However, around 48 essential substances, which are also important for this process, cannot be synthesized by the body and must be obtained through food and respiration. These substances are called “Essential Nutrients” and are crucial for the proper functioning of cells and, consequently, the body.
The 48 essential nutrients that must be obtained externally include:
Amino acids: Histidine, Leucine, Isoleucine, Valine, Lysine, Methionine, Phenylalanine, Threonine, Tryptophan.
Essential fatty acid: Linoleic acid.
Vitamins: Thiamine (B1), Riboflavin (B2), Niacin (B3), Pyridoxine (B6), Folic acid (B9), Cobalamin (B12), Pantothenic acid (B5), Biotin, Para-amino-benzoic acid (PABA), Inositol, Choline, Ascorbic acid (C), Retinol (A), Calciferol (D), Alpha tocopherol (E), Menadione (K).
Mineral salts: Sodium, Potassium, Calcium, Phosphorus, Magnesium, Manganese, Iron, Copper, Zinc, Selenium, Chromium, Iodine, Sulphur, Lithium, Boron, Fluorine, Vanadium, Molybdenum, Lipoic acid, Bioflavonoids (rutin, hesperidin, quercetin).
Others: Water, Oxygen.
In orthomolecular therapy, several of these substances are used. The functions of vitamins, amino acids, fatty acids, enzymes and minerals have been re-evaluated thanks to clinical studies and basic research findings. To determine deficiencies in the body, a complete anamnesis (detailed clinical history), physical examination and specific tests are necessary. Examples include the Mineralogram (hair analysis), which shows the essential minerals used in the metabolism of various substances and detects toxic metals, as well as dosages of vitamin metabolites and fatty acids to diagnose the need to replace these substances.
13 - What are the main tests used in the orthomolecular strategy?
A: The tests used in orthomolecular medicine vary according to the doctor, but generally include:
- Clinical examination, including anamnesis and physical examination;
- Laboratory tests, such as blood tests (biochemical, hormonal, enzymatic), as well as stool and urine analysis;
- Imaging tests, including X-rays, ultrasounds, CT scans and MRI scans;
- Hair mineralogram.
There are also some unconventional tests used by some orthomolecular practitioners, although they are not exclusive to orthomolecular practice. The main ones are:
- EIS TECK;
- HLB (light and dark field microscopy, also known as fresh blood drop examination);
- Bioresonance (Vegatest);
- Nerve Express;
- Optical thermography.
14 - What is the Mineralogram?
A: A mineralogram is a method of measuring minerals in certain tissues of the body. Specifically, the Hair Mineralogram, also known as the “hair test”, analyzes the concentration of minerals in the hair. Used in the United States for over 30 years, this test is recognized by the Federal Council of Medicine in Brazil. It's a quick, efficient and painless procedure that provides valuable information about an individual's state of health, enabling safer medical advice. The hair contains all the minerals present in the body, and the Mineralogram assesses the presence of excesses or deficiencies of trace elements (minerals) and heavy minerals (toxic) in the body. This test is extremely useful for identifying the body's specific needs, indicating which supplements are necessary and which should be avoided.
The results of the Mineralogram provide detailed information about the body's internal condition. The report includes:
Mineral Nutrient Levels: Calcium, Chromium, Cobalt, Copper, Iron, Lithium, Magnesium, Manganese, Molybdenum, Phosphorus, Potassium, Selenium, Silicon, Sodium, Vanadium and Zinc.
Levels of Toxic Metals: Aluminum, Arsenic, Beryllium, Cadmium, Lead, Mercury, Nickel.
The scan is interpreted and presented in a personalized report, accompanied by graphs and detailed explanations about the patient's own body, providing answers that, in some cases, may have been sought for years.
These tests are available through specialized laboratories in Brazil or can be sent to American laboratories.
15 - How is the Mineralogram performed on the hair?
A: To carry out the Mineralogram, the patient must provide a sample of their hair. The ideal sample is taken from the nape of the neck or occipital region, covering the hair from the root to approximately 3 cm in length. The sample, weighing around 150 mg, must be free of dyes, perms, gels, conditioners and any other chemical treatments. The patient should be instructed to prepare for the collection, which can involve a period of weeks to months, especially if they use dyes or chemical products that could influence the test results.
16 - What symptoms of disease can the Mineralogram indicate?
A: The Mineralogram can help identify symptoms related to mineral imbalances in the body, such as mercury poisoning. Symptoms of mercury poisoning include depression, fatigue, tremors, panic syndrome, paresthesia, motor dyscontrol, gait changes, speech difficulties, memory loss, decline in sexual performance, stomatitis, loose teeth, headache, anorexia in children, hallucinations, vomiting, fever, chewing difficulties, sweating and loss of pain sense, among others.
17 - What other benefits can be obtained from the Mineralogram test?
A: There are countless benefits that an assessment using the Mineralogram can offer, including longevity, where it's not enough just to eat properly, but one way of slowing down ageing is to detoxify the body.
18 - What is the use of venous treatment (serums) in orthomolecular medicine?
A: This treatment is called detoxification. It basically eliminates heavy metals such as lead, aluminum and mercury, which can cause a number of clinical problems. In some cases, venous therapy is used to make up for nutritional deficiencies imposed by certain illnesses. It should be borne in mind that this type of treatment is selected for isolated cases where there is proof of intoxication and a clinical correlation with these heavy metals and is not something that is routinely done in orthomolecular practice; however, this varies from doctor to doctor. Patients who want faster results opt for intravenous vitamin and mineral replacement.
19 - How do you know if you are producing more or less free radicals and how do you control them?
A: There are several factors that increase free radicals, including smoking, air, soil and water pollution, pesticide use, electromagnetic pollution, sedentary lifestyles, pro-inflammatory diets, chronic stress and degenerative diseases. It can be measured in the body using various methods, the most common of which are:
- Measurement of free radicals in the blood by chemiluminescence;
- Measurement of MDA (Malonic Dialdehyde or Malondialdehyde) in urine: MDA is a substance that increases in the lipoperoxidation reaction caused by free radicals;
- Dosage of antioxidant enzymes such as Glutathione peroxidase, Superoxide dismutase and Catalase;
- Doses of antioxidant substances, such as vitamins (A, C, E, beta-carotene, folic acid, B12); in fact, their metabolites are measured and, when these are low, it is implied that there is a low intake or excessive use, possibly to neutralize free radicals;
- HLB, which is a test carried out by analyzing a drop of blood, taken from the patient at the consultation and evaluated with a high-resolution optical microscope.
If the levels of free radicals are outside physiological levels, depending on each case, the necessary antioxidants will be replenished. Often, this only starts with a change in lifestyle habits and dietary restructuring.
20 - So does this mean that if I take vitamins I'll be protected from diseases and premature ageing?
A: No, that's a misconception. Before any therapeutic intervention, it is crucial to assess patients' lifestyle habits, encouraging the adoption and maintenance of healthy habits and correcting harmful ones. A nutritional assessment is necessary to balance the diet, along with regular medical checks and lifestyle improvements, including measures to reduce factors that promote free radicals.
For healthy aging and disease prevention, several factors must be considered, including genetics. The idea that taking vitamins is the “elixir of youth” is a fallacy, and no doctor should promise results to patients. A doctor who promises results is acting against the medical code of ethics, as medicine is a contract of means, not results (ends).
21 - Which people can benefit from orthomolecular treatment?
A: Anyone can benefit from the orthomolecular approach, from those seeking prevention to those with a pathology to be treated.
22 - At what age should you go to an orthomolecular doctor?
A: There is no ideal age for seeking out a doctor specializing in preventive medicine or orthomolecular strategy. The earlier you start this follow-up, the better the results will be, since the main focus of this type of treatment is to prevent diseases, not just to treat them once they have appeared.
23 - How does the orthomolecular diet work?
A: There is no such thing as an orthomolecular diet, and it's a misconception that taking vitamins alone can lead to weight loss. The doctor will certainly emphasize the importance of dietary reeducation, adequate water intake and regular physical activity. The orthomolecular approach can be beneficial in situations involving laboratory alterations, such as hypothyroidism, hyperinsulinism, increased insulin, insulin resistance, compulsion for certain food groups due to alterations in neurotransmitters, difficulties in exercising due to chronic fatigue, among others.
24 - What aesthetic results can be expected with the use of the orthomolecular strategy?
A: Naturally, a healthier person, as well as being less vulnerable to illness, is physically more energetic and energetic, which shows in their features. It's that “something” that comes from the inside out and usually makes all the difference.
25 - What about physical activities? Are they essential in the orthomolecular strategy?
A: They are indispensable in any medical treatment that requires or allows them. The beneficial effects of exercise go far beyond weight reduction: they include cardiovascular protection, muscle mass gain, a sense of well-being, improved quality of life, lower blood pressure and heart rate, the release of endorphins, improved mood quality, among others. Remember that the change must be in lifestyle!
For sedentary people, these exercises should be started gradually, after a proper assessment, in order to avoid unnecessary risks.
26 - Aren't foods able to provide us with the vitamins we need?
A: No, according to some experts. They argue that theoretically a balanced diet could provide the minimum amounts of nutrients needed. However, in practice, this is unlikely.
Reasons for supplementation:
- Eating a well-balanced diet is challenging these days. Consider the recommendations: up to five fruits a day, eight portions of vegetables, frequent consumption of fish, legumes, whole grains, different types of olive oil, avoiding overcooking food, chewing well and slowly... sounds difficult, doesn't it?
- Today's soil is not as rich as it used to be, directly affecting the nutritional value of food. This is mainly due to monoculture and the lack of soil rotation.
- The excess of pesticides, especially in fruit and vegetables, reduces the nutritional value of food and is harmful to our bodies. There are many studies showing the damage caused by consuming products containing pesticides.
- The use of antibiotics and growth promoters in animals alters their protein composition and is associated with a higher amount of fat in beef due to confinement.
- Stress, pollution and a fast-paced lifestyle affect our bodies, impairing digestion and the absorption of vitamins and minerals. In addition, the increased production of free radicals requires more antioxidants, which must be combined as they act synergistically.
These factors, coupled with excessive consumption of industrialized foods, can lead to subclinical malnutrition and a weakening of the body, which doesn't become evident until the onset of disease. Therefore, many doctors who work with the orthomolecular strategy consider personalized supplementation to be necessary. However, this must be carried out by a qualified professional and the doses must respect safety limits, such as the Noael (No Observed Adverse Effect Level).
27 - Do vitamins make you fat?
A: No, vitamins don't produce calories. What can happen is that some of them restore appetite, but in these cases, it's the inadequate intake of other foods that leads to fat mass gain.
28 - Will I have to take the same amount of vitamins for the rest of my life?
A: No. Initially, after a careful assessment, it is common to use a larger quantity of vitamins to meet the body's needs. Then, as a certain balance is reached, the maintenance phase begins, in which the amount of supplements is reduced. In some cases, many of these nutrients can only be obtained through food, such as Selenium, which can be acquired by eating four Brazil nuts a day.
29 - If we stop the treatment, will the problems return?
A: Treatment can be discontinued, but the results obtained can be progressively lost, especially if lifestyle habits are unhealthy. In some situations, the problems can return, especially when the treatment is not carried out completely and as directed.
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