Linus Pauling
Medical research and vitamin C advocacy

In 1941, at age 40, Pauling was diagnosed with Bright's disease, a renal disease. Following the recommendations of Thomas Addis, who actively recruited Ava Helen Pauling as "nutritionist, cook, and eventually as deputy 'doctor'", Pauling believed he was able to control the disease with Addis's then-unusual low-protein salt-free diet and vitamin supplements. Thus Pauling's initial – and intensely personal – exposure to the idea of treating disease with vitamin supplements was positive.

In 1965, Pauling read Niacin Therapy in Psychiatry by Abram Hoffer and theorized vitamins might have important biochemical effects unrelated to their prevention of associated deficiency diseases. In 1968, Pauling published a brief paper in Science entitled "Orthomolecular psychiatry", giving a name to the popular but controversial megavitamin therapy movement of the 1970s, and advocating that "orthomolecular therapy, the provision for the individual person of the optimum concentrations of important normal constituents of the brain, may be the preferred treatment for many mentally ill patients." Pauling coined the term "orthomolecular" to refer to the practice of varying the concentration of substances normally present in the body to prevent and treat disease. His ideas formed the basis of orthomolecular medicine, which is not generally practiced by conventional medical professionals and has been strongly criticized.

In 1973, with Arthur B. Robinson and another colleague, Pauling founded the Institute of Orthomolecular Medicine in Menlo Park, California, which was soon renamed the Linus Pauling Institute of Science and Medicine. Pauling directed research on vitamin C, but also continued his theoretical work in chemistry and physics until his death. In his last years, he became especially interested in the possible role of vitamin C in preventing atherosclerosis and published three case reports on the use of lysine and vitamin C to relieve angina pectoris. During the 1990s, Pauling put forward a comprehensive plan for the treatment of heart disease using lysine and vitamin C. In 1996, a website was created expounding Pauling's treatment which it referred to as Pauling Therapy. Proponents of Pauling Therapy believe that heart disease can be treated and even cured using only lysine and Vitamin C and without drugs or heart operations.

Pauling's work on vitamin C in his later years generated much controversy. He was first introduced to the concept of high-dose vitamin C by biochemist Irwin Stone in 1966. After becoming convinced of its worth, Pauling took 3 grams of vitamin C every day to prevent colds. Excited by his own perceived results, he researched the clinical literature and published Vitamin C and the Common Cold in 1970. He began a long clinical collaboration with the British cancer surgeon Ewan Cameron in 1971 on the use of intravenous and oral vitamin C as cancer therapy for terminal patients. Cameron and Pauling wrote many technical papers and a popular book, Cancer and Vitamin C, that discussed their observations. Pauling made vitamin C popular with the public and eventually published two studies of a group of 100 allegedly terminal patients that claimed vitamin C increased survival by as much as four times compared to untreated patients.

A re-evaluation of the claims in 1982 found that the patient groups were not actually comparable, with the vitamin C group being less sick on entry to the study, and judged to be "terminal" much earlier than the comparison group. Later clinical trials conducted by the Mayo Clinic led by oncologist Dr. Edward T. Creagan also concluded that high-dose (10,000 mg) vitamin C was no better than placebo at treating cancer and that there was no benefit to high-dose vitamin C. The failure of the clinical trials to demonstrate any benefit resulted in the conclusion that vitamin C was not effective in treating cancer; the medical establishment concluded that his claims that vitamin C could prevent colds or treat cancer were quackery. Pauling denounced the conclusions of these studies and handling of the final study as "fraud and deliberate misrepresentation", and criticized the studies for using oral, rather than intravenous vitamin C (which was the dosing method used for the first ten days of Pauling's original study). Pauling also criticised the Mayo Clinic studies because the controls were taking vitamin C during the trial, and because the duration of the treatment with vitamin C was short; Pauling advocated continued high-dose vitamin C for the rest of the cancer patient's life whereas the Mayo Clinic patients in the second trial were treated with vitamin C for a median of 2.5 months.

Ultimately the negative findings of the Mayo Clinic studies ended general interest in vitamin C as a treatment for cancer. Despite this, Pauling continued to promote vitamin C for treating cancer and the common cold, working with The Institutes for the Achievement of Human Potential to use vitamin C in the treatment of brain-injured children. He later collaborated with the Canadian physician Abram Hoffer on a micronutrient regime, including high-dose vitamin C, as adjunctive cancer therapy. A 2009 review also noted differences between the studies, such as the Mayo Clinic not using intravenous Vitamin C, and suggested further studies into the role of vitamin C when given intravenously. Results from most clinical trials suggest that modest vitamin C supplementation alone or with other nutrients offers no benefit in the prevention of cancer.
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