From The April 2001 Issue of Nutrition Science News
by Jack Challem
Many physicians, and likely many of your clients, use vitamin and mineral supplements to prevent and treat disease. For example, vitamin E reduces coronary artery disease risk, and it can benefit people with confirmed cardiovascular disease.  Similarly, selenium supplements reduce some cancer risks  and improve the health of AIDS patients.  But do large supplemental doses somehow turn nutrients into drugs? I would argue that once a nutrient, always a nutrient.
Three decades ago, Nobel laureate Linus Pauling, Ph.D., coined the term "orthomolecular" to describe a molecular rationale for using nutrients therapeutically. Pauling explained that a person could enhance his health by using "the optimum concentrations of substances normally present in the human body." In his landmark 1968 Science article, Pauling even described vitamin use in psychiatry. 
Vitamins, minerals and many vitaminlike substances such as Co-Q10 and alpha-lipoic acid are among the body's nutritional and biochemical building blocks. These nutrients take part in virtually every biochemical reaction. Many also have structural roles in DNA and tissues. They are essential for life, growth and health. However, many factors directly or indirectly interfere with normal nutrient metabolism, including aging, alcohol consumption, gastrointestinal disorders, genetic defects, infections, medications, surgery and tobacco use.
Low nutrient levels become rate-limiting factors for biochemical reactions, at first subtle and then manifesting myriad symptoms. Increasing the amount of the nutritional substratesprecursor therapy, so to speakcan normalize these reactions. For example, supplemental folic acid corrects a genetic defect that limits activity of 5,10-methylenetetrahydrofolate reductase, an enzyme needed to convert folic acid to its active form.  High doses of the nutrient do not become a drug. Rather, they provide a compensatory dose or an effective metabolic dose.
In contrast, drugs have no normal role in human metabolism. They mask symptoms rather than treat causesheadaches are not caused by an aspirin deficiency. Drugs can pose serious and frequent side effects, attesting to the fact that they are not part of the body's normal metabolic milieu. For example, nonsteroidal anti-inflammatory drugs relieve osteoarthritis pain, but they also degenerate joint tissue.
Just flip through the Physician's Desk Reference to grasp the fundamental "toximolecular" nature of drugs. Delete the side effects, warnings, and contraindications from this 3,000-page book, and you're left with only about 150 pages.
What's the take-home message in all this? Nutrients, even in the form of high-potency supplements, are still nutrients that play normal roles in health. Drugs may have a place in treating acute disease or injuries, but they are still biochemical outsiders. If Hippocrates were alive today, he might write, "First, try nutrients."
1. Stephens NG, et al. Randomized controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet 1996;347:781-6.
2. Clark LC, et al. Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. A randomized controlled trial. Nutritional Prevention of Cancer Study Group. JAMA 1996;276:1957-63.
3. Schrauzer GN, Sacher J. Selenium in the maintenance and therapy of HIV-infected patients. Chemico-Biological Interactions 1994;91:199-205
4. Pauling L. Orthomolecular psychiatry. Science 1968;160:265-71.
5. Whitehead AS, et al. A genetic defect in 5,10-methylenetetrahydrofolate reductase in neural tube defects. Quar J Med 1995;88:763-6.
6. Rashad S, et al. Effect of non-steroidal anti-inflammatory drugs on the course of osteoarthritis. Lancet 1989;2(8662):519-22
Jack Challem, known as The Nutrition Reporter, has been writing about vitamin research for 25 years and is the author of Syndrome X: The Complete Nutritional Program to Prevent and Reverse Insulin Resistance (Wiley, 2000).