Essentials of Complementary and Alternative Medicine (June 1999)

Intravenous Nutrient Therapy
Because nutrients almost always work in concert, many physicians practicing orthomolecular medicine feel that a therapeutic trial of nutrient loading is a useful 
approach to many patients with refractory conditions. Intravenous nutrient therapy is becoming increasingly popular among physicians practicing nutritional medicine. 
Although there are few controlled trials to support this treatment approach, the results are in many cases obvious and dramatic. A combination treatment consisting of 
magnesium, calcium, B vitamins, and vitamin C was described by John Myers, MD, in the 1970s and is currently being used by more than 1000 physicians in the 
United States. The author has administered more than 15,000 of these treatments, without observing any serious adverse reactions.
Because there is the potential for vasovagal, allergic reactions and drug interactions, treatment must be administered carefully and professionally and all patients 
monitored. The so- called Myers cocktail has aborted acute asthma attacks and migraines in a matter of minutes or even seconds. I have found it valuable in the 
treatment of some cases of chronic fatigue, depression, fibromyalgia, acute or chronic urticaria, allergic rhinitis, acute infection, congestive heart failure, occlusive 
peripheral vascular disease, and angina pectoris. Information on this intravenous protocol and its proper administration is available (
68
).
Recent studies have shown that intravenous administration of magnesium can rapidly relieve acute attacks of asthma (
69
) and migraine (
70
). Otherwise, most of the 
observations on intravenous nutrient therapy, though highly enthusiastic, are anecdotal. Unfortunately, blinded trials are difficult to perform because intravenously 
administered magnesium produces an unmistakable sensation of warmth.
Large intravenous doses of vitamin C (sometimes in combination with other nutrients) have been used to treat acute viral hepatitis, mononucleosis, and other 
infections. Although no controlled trials have been published, many physicians think that this treatment promotes unusually rapid resolution of these illnesses.
EDTA
Ethylenediamine tetraacetic acid (EDTA) is a synthetic amino acid used by some practitioners to treat atherosclerosis. Although EDTA is not an orthomolecular 
therapy, it is being mentioned here, because many physicians who use orthomolecular therapy also use EDTA.
In the 1950s, it was observed that some patients receiving EDTA for the treatment of lead poisoning experienced unexpected improvement in angina pectoris. Other 
reports of improvement in patients with atherosclerotic disease soon followed, and EDTA therapy eventually became a popular (though controversial) alternative to 
bypass surgery.
Although EDTA is known to chelate lead and other metals, its mechanism of action against atherosclerotic disease is not well understood. EDTA does influence lipid 
metabolism, free-radical production, platelet adhesion, blood coagulation, and prostaglandin synthesis (
71
). However, none of these actions can adequately explain 
the observation that the effects of EDTA persist long after the treatment is discontinued.
Physicians who use EDTA believe that it is safe and often dramatically effective in reversing cardiovascular diseases, particularly when administered according to a 
well-defined protocol and along with lifestyle modifications and various nutritional supplements (
72
). Chappell et al. presented a meta-analysis of 51 practice-outcome 

reports (
73
, 
74
). Of a total of 24,000 patients treated, 88% showed objective evidence of improvement.
However, in three small randomized trials in patients with peripheral vascular disease who received various lifestyle and nutritional recommendations, EDTA was not 
significantly more effective than placebo (
75
, 
76
 and 
77
). Each of these studies has been severely criticized, and one is under investigation by the Dutch courts. To 
date, there have been no controlled trials of EDTA therapy in patients with coronary artery disease, the condition for which it is most frequently used (
78
, 
79
 and 
80
).
Thus, a discrepancy exists between the often dramatic effects that practitioners have reported and documented and the results from controlled trials. Large, 
well-designed clinical trials are therefore urgently needed. If EDTA therapy is, indeed, effective, then it would represent a safer and less expensive alternative to 
bypass surgery. A complete chapter on EDTA, including its pharmacology and clinical use, and a review of the published research will appear in  Textbook of CAM, to 
be published next year.
Other Uses of Orthomolecular Medicine
Published research suggests that many other medical conditions may respond to orthomolecular treatments. These conditions include hypertension, diabetes mellitus, 
diabetic neuropathy and retinopathy, infertility, rheumatoid arthritis, carpal tunnel syndrome, acne vulgaris, herpes simplex, seborrheic dermatitis, premenstrual 
syndrome, menorrhagia, cervical dysplasia, fibrocystic breast disease, attention deficit hyperactivity disorder, peptic ulcer, alcoholism, sickle cell disease, Parkinson's 
disease, anxiety, and tardive dyskinesia. There is also evidence that nutritional treatments might delay the progression of multiple sclerosis, amyotrophic lateral 
sclerosis, and AIDS (
20
).
Toxicity
Although nutrients and related compounds are generally quite safe, orthomolecular medicine is not without risk. Large doses of vitamin A, niacin, niacinamide, vitamin 
B
6
, zinc, selenium, and certain amino acids have been reported to cause toxic effects. Recently, beta-carotene supplementation was found to increase the risk of lung 
cancer in cigarette smokers. (For details on the safety and adverse effects of specific nutrients, see 
Chapter 7
 in this book.)
Physicians practicing orthomolecular medicine must be familiar with the adverse effects of nutrients, as well as the dosage ranges at which these effects can develop. 
In addition, a working knowledge of drug-nutrient and nutrient-nutrient interactions is essential. However, when nutrients are administered with appropriate 
precautions, the incidence of severe toxicity resulting from nutritional therapy is extremely low.
ORGANIZATION
Training
Currently there are no accredited training programs that certify physicians in the practice of orthomolecular medicine. Practitioners typically become self-trained in this 
field by reading the medical literature and attending seminars on the subject. A four-day professional workshop, “Nutritional Therapy in Medical Practice,” is presented 
annually by Alan R. Gaby, MD, and Jonathan V. Wright, MD (
20
). The American Holistic Medical Association and the American College for Advancement in Medicine 
hold annual and semiannual conventions, respectively, which include various topics related to nutritional therapy and orthomolecular medicine. Naturopathic medical 
schools require extensive training in nutrition, which includes many aspects of orthomolecular medicine.
Reimbursement Status
Reimbursement for orthomolecular treatments is variable. Evaluation-and-management services are generally reimbursed the same as in conventional medicine. In 
most cases, nutrients and intravenous therapies are not considered “usual and customary” and are therefore not covered. However, some third-party payers do pay 
for such treatments or evaluate them on a case-by-case basis. A few medical insurance companies are now offering plans that reimburse for many types of alternative 
medicine, including nutrients and intravenous therapies.
Relations with Conventional Medicine
There is no official relationship between orthomolecular medicine and conventional medicine. However, a growing number of medical schools are offering courses 
and continuing education seminars that include various aspects of this discipline.
PROSPECTS FOR THE FUTURE
Practitioners are gradually incorporating more nutritional and orthomolecular treatments into their practices. Hundreds of such practitioners have conscientiously tried 
these treatments and have been impressed with their effectiveness.
Published research and the clinical experience of many physicians suggest that more widespread application of orthomolecular medicine could improve the safety and 
effectiveness of medical care while simultaneously reducing costs. Although many of the treatments that show promise have not been subjected to controlled clinical 
trials, they could easily be tested if research funding were available. By testing the most promising orthomolecular treatments, the practice of medicine might be 
changed dramatically, with enormous implications for the public health.
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A workshop titled “Nutritional Therapy in Medical Practice” is presented annually by Alan R. Gaby, MD, and Jonathan V. Wright, MD, and is available on audiocassette tape (with reference 
materials). For information, contact Wright-Gaby Seminars, 515 W. Harrison St., Suite 200, Kent, WA, 98032; 253-854-4900, ext. 166
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To request a copy of the intravenous nutrient protocol, send a self-addressed stamped envelope to the Wright/Gaby Nutrition Institute, P.O. Box 21535, Baltimore, MD 21282
69.
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CHAPTER 28. H
OMEOPATHY
Essentials of Complementary and Alternative Medicine
CHAPTER 28. H
OMEOPATHY
Edward H. Chapman
Background
 
History and Development
 
Principal Concepts
The Homeopathic Pharmacy
 
Preparation of a Homeopathic Medicine
Homeopathic Provings
 
Materia Medica
Provider-Patient Interactions
 
Homeopathic Approaches: Complex and Classical Homeopathy
Therapy and Outcomes
 
Treatment Options
 
Description of Treatments
Treatment Evaluation
Use of the System for Treatment
Organization
 
Training
 
Licensure
 
Certification
 
Legal Status
 
Reimbursement Status
Prospects for the Future
Chapter References
BACKGROUND
Homeopathy is a unique approach to healing that uses extremely dilute medicines to trigger a person's innate capacity to heal. Homeopathy is based on  the law of 
similars, the observation that medicines can produce in healthy people the same symptoms they cure in the sick. Homeopathy approaches the whole patient in a 
systematic manner, using naturally occurring substances to restore health on physical, emotional, and mental levels. The homeopathic approach is dramatic by nature 
of the small amount of medicine used—often beyond the concentration that scientists can measure in molecules. However, an effect of those minimal doses can be 
demonstrated. The controversy about homeopathy centers around this apparent action of microdoses. The advantage of low doses is that the side effects and costs 
are minimal.