In my opinion, one of the schizophrenic syndromes is a vitamin B3 dependency. But even amino acids may be required in large quantities—a few people sleep better when they take L-tryptophan, 1,000–2,000 mg per evening. Isoleucine may be required in large doses for some schizophrenic syndromes.
The question arises: Why should even a few individuals require these large quantities? What has allowed these conditions to remain as a small part of our population? What is the biological advantage that has overbalanced the serious disadvantages? Why has evolution not removed any person with these inherited factors, or is nature still proceeding with the very slow process of developing a variety of man much less dependent on certain nutrients? Is scurvy a way of weeding out those of us who cannot survive on tiny quantities of vitamin C? We have no definitive answers, but we do know it is possible for every person to become dependent on a large number of nutrients.
Linus Pauling showed how energy requirements of any cell created a species of animals unable to make vitamin C.3 Thousands of years ago, our animal ancestors foraged for food very rich in vitamin C. They may have consumed several grams per day in the green vegetation and fruit. With this type of diet, there would be less advantage in making vitamin C in our bodies, as most animals do today. A genetic mutation that removed the capability of making vitamin C from glucose would confer no disadvantage, as the vitamin C was available in the food. The energy saved or not required to make vitamin C would be used in other reactions. This energy saving conferred enough biological advantage for the genetic mutation to sweep across the entire population. Once established, there was no turning back. We are forever unable to make vitamin C and must depend on our food and supplements. Since the genetic condition hypoascorbemia became established, humanity has suffered fantastically from scurvy, one of the enduring great plagues.4
Dr. Pauling’s account of the development of hypoascorbemia may be expanded to account for all the nutrients we must receive in our food. They can be divided into two main classes: those that can be made in the body from other nutrients and those that must be preformed in our food. The first class is very large and includes every chemical in the body that is essential for health; there may be thousands of these. Ordinarily, we need not be concerned about them, but if one could not be made, it would become essential (that is, it must be obtained from food). Any diet that failed to provide it would allow a deficiency to appear. The second class is quite small, totaling around forty to forty-five nutrients. It includes the vitamins, eight or nine amino acids (if we include tyrosine, which is essential for some), a few fatty acids, and some minerals or trace elements. Of the twenty amino acids, eight cannot be made in the body and are thus considered essential amino acids. The remaining twelve can be made in the body from the essential amino acids. It is important, however, that we remember that all must be present in the body. The twelve nonessential amino acids are just as necessary to metabolism, and when supplied in adequate amounts they spare the body the need to make them. Biochemists have just begun to examine the relationship of deficiency of nutrients to disease.
At one time, single-celled creatures were neither animal nor vegetable, or perhaps they were entirely vegetable (i.e., dependent only upon inorganic salts, water, oxygen, and sunlight). Animal life must have developed for the first time when one cell engulfed another and survived, for by this simple step all the energy required by cells to make a host of organic chemicals could be used for other metabolic functions. That first cell that swallowed its neighbor became the parent of all animal life on earth. The energy saved became available for movement and cellular colonies, and for creation of the multicelled animal. If we still had to make everything in our bodies, we would probably be plants.
The earliest animal cells must have been able to live on salts, like plants, or by engulfing other cells. Gradually, the need to make everything would vanish, and these cells would become more and more dependent on eating other cells, and the machinery required to make organic molecules would be altered for other purposes. As soon as a nutrient like vitamin C could no longer be made, it would become an essential nutrient. Thus, the molecules that we call vitamins became essential, as did eight amino acids. It would be wrong to believe this process has stopped.
For example, niacin may be in a transitional phase—in the process of becoming a vitamin (a substance that cannot be made in the body). The body can convert about 1 to 2 percent of the amino acid tryptophan into vitamin B3. Perhaps, in a few people, a much greater fraction can be diverted into the vitamin. Are there a few who cannot divert any tryptophan into vitamin B3? We will never know until a search is made. Based on my experience, I believe this search will be most profitable in schizophrenic patients, especially in cases of childhood schizophrenia and infantile autism, for these individuals would be much more sensitive to the quantity of vitamin B3 present in food and would require much more. Any individual who could convert more tryptophan into vitamin B3 would be able to get by on a diet so low in vitamin B3 that it would cause pellagra in other individuals. There is a potential advantage in being less dependent on endogenous sources of vitamin B3, provided the diet contained enough: more tryptophan would be available for conversion into serotonin and other intermediate chemicals. Serotonin is important for activity of the central nervous system and probably for digestion. Perhaps schizophrenia is the price that society is now paying for the gradual spread of this phenomenon.
THE ORCHESTRA PRINCIPLE
Roger Williams emphasized another basic concept that he called the orchestra principle.5 Just as it is impossible to consider one instrument in an orchestra more important than another, so must all the nutrients required by the body be available. They all work together, and an excess of one cannot compensate for the deficiency of another. On a practical level, even the best use of nutrient supplements cannot compensate for the continued consumption of foods rich in added sugar and other cosmetic additives.
Let’s assume that during a great performance by a superb orchestra, directed by a great conductor, the principal violinist faints. The performance must stop. What to do? The conductor, believing the show must go on, may invite his principal drummer to replace the principal violinist. But the result will be cacophony, not symphony. The performance can resume only when the principal violinist recovers from her faint and can play again. Any single nutrient in the symphony of life is much like that principal violinist—it cannot be replaced by the wrong nutrient or by any drug.
ORTHOMOLECULAR PSYCHIATRY
Orthomolecular psychiatry has the same relationship to orthomolecular medicine as does orthodox psychiatry to orthodox medicine. Every patient with any disease has a psychological reaction or component that may be very minor and not require any psychiatric treatment, or it may be of such severity as to necessitate psychiatric treatment. For many patients, both specialties must work together.
Orthodox medicine tends to think in organic or psychological terms. If a thorough physical examination and tests do not reveal a sufficient explanation of the symptoms, then that patient’s illness is promptly dumped into the psychiatric area. Even the use of psychosomatic medicine has not altered this, for to most physicians psychosomatic medicine is looked upon as a disease with physical symptoms caused by psychological factors. In short, these physicians lump both psychiatry and psychosomatic medicine together.
Orthomolecular physicians recognize that a large fraction of the psychiatric patients are ill due to physical factors, not due to any organ dysfunction. The usual tests do not reveal pathology. These physical factors are changes in metabolism and/or nutrition. They might be looked upon as humoral factors or as a third category of illness. When treated successfully, the psychiatric symptoms clear. Very little psychotherapy is required, and that can be given by any competent physician.