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Introduction
Some years ago, as I sat at lunch with Dr. Abram Hoffer, I took some vitamin pills. Dr. Hoffer leaned over towards me and said, "You know, you're going to live a lot longer if you take those." As I looked at him, he added, "I guarantee it. If you don't, come back and tell me."

So said the founding father of orthomolecular medicine.

It was nearly 60 years ago when Abram Hoffer and his colleagues began curing schizophrenia with niacin. While some physicians are still waiting, those who have used niacin with patients and families know the immense practical value of what Dr. Hoffer discovered. Abram Hoffer's life has not merely changed the face of psychiatry. He has changed the course of medicine for all time. His 30 books, 600 scientific papers, and thousands of cured patients have yet to convince orthodox medicine. Dr. Hoffer has said that it takes about two generations before a truly new medical idea is accepted. Perhaps in the case of megavitamin therapy, maybe it is three generations. Great ideas in medicine, or anywhere else, are never self-evident. At least not until a brilliant mind like Dr. Hoffer's sees more than others have seen, and has the courage to speak out in the teeth of some often surprisingly bitter professional adversity. As a college lecturer, I learned some years ago that if you want to clear the department's lunchroom in a hurry, just say something positive about megavitamin therapy.The day after I first met Dr. Hoffer, I sat in as he taped a television production about his work. He did the entire 43-minute video in one take. Over the years, I was honored to ultimately write four books with Abram, and work closely with him in editing the Journal of Orthomolecular Medicine, which he founded in 1967.Abram taught me much, as he taught so many. Among the lessons I had was this: A speaker at a medical conference made two factual errors about niacin. I was sitting next to Abram, and he was, to all appearances, dozing off. He was not. He gave me a nod, and during the question session, got up to take the microphone. He complimented the speaker on his presentation, mentioned a few additional things about niacin, made another supportive remark, and sat down. The speaker was delighted. And, the speaker never knew he had just been contradicted and corrected. This was Abram Hoffer.

My final e-mail from Abram was a copy of his announcement to his colleagues the publication of one of our collaborative books, The Vitamin Cure for Alcoholism. It is based on Abram's experiences with one of his patients: Bill W., cofounder of Alcoholics Anonymous. We will begin there.

AWS: Dr. Hoffer, you cured AA founder Bill W. of his depression using niacin.

AH: His depression, yes, but I did not cure his alcoholism. He never did consider himself cured. He organized AA, and was able to establish fellowships that helped and millions stay sober. However, it was the niacin that made him comfortable in his sobriety. It takes the entire nutritional approach, plus AA.

AWS: Tell us more about Bill W.

AH: From the day he was freed of lifelong tension and insomnia by taking 3000 milligrams of niacin daily, Bill Wilson became a powerful runner with us. Bill helped me organize the first Schizophrenic's Anonymous group in Saskatoon, which was very successful. Bill introduced the orthomolecular concepts to a large number of AA members, especially in the United States. AA International did not approve of this. Bill made an immense contribution to orthomolecular medicine because he publicized the term "B3" to replace the chemical names niacinamide or nicotinic acid. Had Bill W. lived another ten years, orthomolecular medicine would have been much further advanced than it is today.

AWS: And how do things stand today?

AH: I have treated 5000 schizophrenic patients with niacin. The first was a 12-year-old boy in 1960. To get the boy to take it, his father crushed the niacin tablet and spread it into a jam sandwich. That boy is now a research psychiatrist. The treatment that worked in 1960 is still working today. That treatment is called orthomolecular medicine. Orthomolecular medicine restores natural metabolism with nutrients, such as vitamins and minerals, in optimum quantities. This means much more than the RDA or DRI. To overturn decades of error on the part of governments and the professions will take a good deal of effort and patience. Linus Pauling often spoke vigorously against the RDA in general and was ignored. These old, erroneous standards are part of the vitamins-as-prevention paradigm and will not yield until this old and stale paradigm is fully replaced by the vitamins-as-treatment paradigm. Pauling took 18 000 milligrams of ascorbic acid daily, which was 300 times the RDA. He loved to tell his audiences why he took so much.

AWS: That's what I personally take. When people ask why, I tell them that Dr. Pauling did, and he had two more Nobels than I have. Dr. Hoffer, where has high-dose nutritional therapy been most successful?

AH: It has been most successful for treating the walking wounded; that is, for those with arthritis, neurological conditions, and virtually all the psychiatric diseases. Orthomolecular medicine can be utilized within the whole field of medicine, even for patients whose primary treatment is surgery,

AWS: When were you convinced that orthomolecular medicine was the way to go?

AH: By 1960 I was convinced. My conviction was reinforced by the hostility generated by the profession. I assumed that this hostile reaction was stimulated by our success. The same thing happened to the Shute brothers with vitamin E. New research exposes the weakness of current medical doctrine. Such a challenge is often answered only by hostility, as there is no evidence to otherwise disprove it.

AWS: Please tell the story of how Linus Pauling first learned of nutritional medicine.

AH:  Linus became aware of our work from two families I treated who got well and stayed well. By then my book, co-written with Dr. Humphry Osmond, called How To Live With Schizophrenia had been published, and one night Linus saw it on a friend's coffee table. He stayed up all night reading it. That book convinced him that here was some merit to the idea of vitamin therapy. Later, he found no contrary evidence. Linus had the desirable personality characteristic that he tended to believe people if there was no logical reason for them to lie to him. For that reason he did not accept the stories put out by the drug companies and the FDA. Pauling knew for whom they were working, and it was not for you or me.

AWS: What about niacin and cholesterol?

AH: My colleagues and I demonstrated that niacin lowered total cholesterol in a 1954 study, and we should have been given an award. But, of course, niacin is not a drug and cannot be patented, and therefore our discovery remains mainly a major irritant to the drug companies who have not been able to discover anything as safe and as effective. It is remarkable that niacin is the best for blood lipid levels and also for the psychoses. Nature is not dumb.

AWS: What are the alleged "dangers" of niacin therapy?

AH:  Niacin is probably not quite as safe as water, but pretty close to it. Patients ask me, "How dangerous is niacin therapy?" I answer them, "You are going to live a lot longer. Is that a problem for you?"AWS: Data compiled by the American Association of Poison Control Centers (AAPCC) indicates that, over the past 25 years, there have been a total of one or two deaths attributed to niacin. When I looked for evidence to substantiate even this very low number of alleged fatalities, it was absent or assumed. AH: There have been no deaths ever from niacin. The LD 50 (the dosage that would kill half of those taking it) for dogs is 6000 milligrams per kilogram body weight. That is equivalent to half a pound of niacin per day for a human. No human takes 225 000 milligrams of niacin a day. They would be nauseous long before reaching a harmful dose. The top niacin dose ever was a 16-year-old schizophrenic girl who took 120 tablets (500 mg each) in one day. That is 60 000 mg of niacin. The "voices" she had been hearing were gone immediately. She then took 3000 mg a day to maintain wellness.

AWS: If I do not press this point, a reader will: Maintained high doses of niacin may raise liver function tests, and this is used as evidence of harm.

AH: Niacin is not liver toxic. Niacin therapy increases liver function tests. But this elevation means that the liver is active. It does not indicate an underlying liver pathology. Dr. Bill Parsons discussed this extremely well in his book on niacin and cholesterol (Cholesterol Control Without Diet; Lilac Press, 2000). I personally have been on 1500 to 6000 milligrams daily since 1955. The biggest danger of taking niacin is that you live longer. One of my patients is 112. She does cross-country skiing and has been on niacin for  42 years. The fear doctors have of niacin is not based on data or facts and, like any myth, is very had to eradicate. So many patients are on niacin that by chance some will also have liver damage from other conditions such as alcoholism, hepatitis and so on. Niacin does not make it any better nor worse.

AWS: What are the differences among the various forms of niacin?

AH: Niacin and niacinamide are equally effective for schizophrenia, but higher doses of niacin can be tolerated without nausea. Inositol hexaniacinate (a no-flush form of niacin) works, too, but not quite as well.  Only niacin or inositol hexaniacinate can lower cholesterol; niacinamide does not.

AWS: You have long been interested in nutrition as adjunctive therapy for cancer.

AH: I have treated over 1600 cancer patients, most of whom were given 12 000 milligrams per day or more of ascorbic acid, in combination with other nutrients. The results have been good, and at least 40% of the 1600 reached ten-year cure rates. A small number of patients who were on every attending physician's terminal and untreatable list were cured. Linus Pauling and I had examined the follow-up data and found that the significant prolongation of these patients' lives favors the use of the vitamins. We published this in our book Healing Cancer: Complementary Vitamin & Drug Treatments (CCNM Press, 2004).

AWS: Another of your close colleagues was Dr. Hugh Riordan (1932–2005), also an advocate of high-dose vitamin C therapy for cancer.

AH: Hugh was such a great healer, a marvelous physician, afraid of no one and willing to do what had to be done to help his patients get well. I am so sorry he went too soon. He needed another five years at least so that he could enjoy the fruits of his labors. I do hope that Hugh did have the final vision, the eventual result of the work that he did. I am reminded of Moses who angered God because he struck the stone instead of pointing his staff at it in order to bring water for the complaining Israelites. God said, "You will never see the Promised Land." But at the end God relented and he showed Moses in a far vision the Promised Land. This is a remarkable little tale, and I have learned a lot from it. I learned to be very patient. The lesson is that no one should ever expect to get into the Promised Land, because it will always recede from you. The noble objective is to strive to reach it knowing full well that it cannot be done.

AWS: I had just spoken with Hugh the very morning of the day he died. 

AH: The last time I felt bereft and hopeless was when my wife Rose died three and a half years previously. Death is so sudden and so unexpected, especially to be struck down when one is so close to achieving so many great things. I do believe that the good Hugh did will live forever.

AWS: There seems to be a lot of bad press about vitamins, claiming evidence that they are not effective against disease.

AH: The modern church of medicine does not relish alerting the press when the news is good about vitamins. There is no money in it, and potentially a loss if vitamins displace drugs, as they should. I sometimes harbor a silent wish for all our critics: that they should never under any circumstances ever take any supplemental nutrients, and be restricted to only eating modern high-tech food. Can you think of a more severe punishment?

AWS: Yet it turns out that most of the negative reports are based on research that used ineffectively low doses of vitamins.

AH: I agree. I could also spend millions to prove that the small amounts of these nutrients will not prevent car accidents. Who is funding all these silly studies? No orthomolecular physician ever claimed that giving 200 IU of vitamin E and 500 mg of C cured anything. Perhaps you should write a paper with tongue in cheek in which you announce, ANTIBIOTICS DO NOT CURE INFECTION. Then, report somewhere hidden in the paper that you only gave them 200 or even 20 000 IU of a drug that requires doses of 1 million or more. Such reporting is a superb example of the cynical, expensive, and sleazy research so loved by Big Pharma. This is because it delays the real introduction of good medicine, in the same way that tobacco companies denied smoking causes cancer and we supposedly needed more and more and more research to prove anything. All this allows the companies millions to their coffers. Their defense is delay, delay, and delay. The only objective of Big Pharma is to make money, lots and lots of it.  How dare we try to prevent them from doing so.

AWS: Vitamins have also been attacked with allegations that they are somehow actually dangerous.

AH: I am really impressed with the concern some scientists share over those "dangerous" vitamins. I wish they were as worried over those dangerous poisons called drugs. Each bottle of pills should have a poison label with skull and bones, and the word "poison" in large letters.

AWS: It seems that lately, while advised to take more vitamin D, the public has been specifically warned off of vitamins E and C.

AH: I am always amazed at the chicanery and slipperiness of vitamin critics. Perhaps they realize they are beginning to lose the public and they are flailing out in all directions. Almost all of my patients, whenever they read one of these screeds, laugh at it because they know firsthand how wrong it is. Half the population of Canada, and half the USA, is taking vitamins. And, if it will help dispel the nonsense about any supposed "dangers" of vitamin E, here is the program I personally follow. I started years ago. But I also take several other antioxidants. A combination is better than any one alone. Currently I daily take 1200 IU of vitamin E as succinate, the water soluble form. For my patients I have gone as high as 4000 IU as a treatment for Huntington's disease, and it has been very helpful. I can not recall any adverse reactions even though thousands of my patients are also taking vitamin E. I do take the B vitamins, vitamin C of course, vitamin A, vitamin D, and other nutrient factors. I think this has been helpful in keeping me active at my present age.

AWS: How do we best tailor nutrient doses for our own unique needs?

AH: Each person must take an individualized program which they can discover if they are lucky to have a competent orthomolecular doctor. If they do not, they can read the literature and work out for themselves what is best for them. I believe the public is hungry for information. As more and more drugs drop by the wayside, the professions are going to become more and more dependent on safe ways of helping people, and using drugs is not the way to do that. Using nutrients is.

AWS: When does orthomolecular medicine not work?

AH: It usually does work. For schizophrenics, the natural recovery rate is 50%. With orthomolecular medicine, the recovery rate is 90%. With drugs, it is 10%. If you use just drugs, you won't get well. This is because mental illness is usually biochemical illness. Mental illness is a disorder of brain dysfunction. Schizophrenia is vitamin B3 (niacin) dependency. Not a deficiency; a dependency. If schizophrenia strikes someone at age 25, he's finished. That is, if he's only given drugs. Patients are given drugs and released. The new mental hospital today is the streets.

AWS: You have been a sharp critic of evidence-based medicine.

AH: One would be very polite to even describe EBM as pseudoscientific. The word science can not be used anywhere close to what is happening with EBM. It has become the main weapon to prevent innovation. It must be sent back to its archaic roots. Instead, we once more have to learn to think rather than calculate.

AWS: And double-blind, placebo controlled studies?

AH: Double-blinds are for the birds. I have been opposed to double-blinds for decades, even though my colleagues and I were the first psychiatrists to do them, starting in 1952. I consider them a license to kill. They are a dangerous fashion. There is no evidence that anecdotal information is any less accurate then clinical information. Devotees see everything filtered through their beliefs. If we abolish anecdotes, guess what will happen to medicine? It will die from sheer boredom.

AWS: You have actually described this as a paradigm war (Townsend Letter for Doctors and Patients, June 1996).

AH: Yes, and we are winning the paradigm war. Clinical research is continually a battle, pro and con. The reason is that probability theory is of no value whatever when dealing with people. This was pointed out very clearly by Lancelot Hogben (Statistical Theory: The Relationship of Probability, Credibility, and Error; Norton, 1957) over 50 years ago. Clinical tests were developed for plants and for animals, and the various factors were much more readily controlled.

AWS: Much medical knowledge has come from physician reports, which are neither double-blind nor placebo controlled. They are the valuable experiences of qualified observers. They are valid: just ask the patients that got better. Yet doctors' reports, as well as those of their patients, are typically marginalized as mere "anecdotes."

AH: Where are the good old days, when honest physicians honestly reported what they saw in language than any doctor could understand?

AWS: What is the primary problem with modern medical research?

AH: The problem is a monstrous cancer affecting all of us, and it is called Big Pharma. It needs a combination of surgery, radiation, and chemotherapy. The medical profession has been reduced to the state of well-paid salaries for the drug companies, and it is we who pay the bills. For example, Vioxx was promoted by one of the largest of advertising budgets and had characteristically high kill rates. Money, like water, will leak into every possible crevasse. We are literally inundated with this poisonous water coming from this industry. For too long has Big Pharma ruled the roost.

AWS: You are still a fighter, at nearly 92 years of age. 

AH: We have to continue our way without regard to the opposition. If not we will soon be working for them.

AWS: Tell us about your roots.

AH: I was born on a farm in southern Saskatchewan in 1917 in our first wooden house. My three older siblings were born in a sod shack. Public and high school education was completed in single-room schools. I had little to do with selecting my parents, selecting Canada, being raised on a farm, learning how to live with yourself, and having to work hard physically. I was educated by and during the Great Depression. The Depression was so enormous that any recent so-called recession is laughable. I remember when the president of the University of Saskatchewan in 1938 circulated a memo to staff and students that they must use toilet paper sparingly. Some tried to split the rolls. That was a real depression.

AWS: Where does your drive today come from?

AH: I have a secret which I cannot patent. I married Rose, had three marvelous children, made nutrition my career choice, and took niacin for the past 50 years. My parents provided me with the love and security and the same type of toughness they had shown in coming to the Saskatchewan prairies in 1904 and preparing me for this run. And my wife, Rose, who helped push me into medicine and supported me during every phase of our run. Her parents, Fannie and Frank Miller, helped us out so that I could become a medical student from 1945 to 1949. Rose believed in fate. She often told me that I would get the Nobel Prize. I did not bank on it, even though Linus Pauling had nominated me.

AWS: Many honors have come your way. You won the Dr. Rogers Prize, have been inducted into the Orthomolecular Medicine Hall of Fame, and have won the Linus Pauling Functional Medicine Award, among others. Still, there is one distinction that not everyone is already aware of: Abram Hoffer is an honorary Maori chief. 

AH: Many years ago, Rose and I were on a speaking tour. In New Zealand we were staying in a hotel where there were many guests. One afternoon, I was asked whether I would like to be made an honorary Maori chief. When I discovered that all I had to do was to be there, I agreed. Later in the afternoon, in the large lobby with Rose and a swarm of hotel guests, the doorman, who was a Maori, started the solemn ceremony. I stood in front of him very respectfully. He began to talk to someone, silently, using his facial expressions and contortions. I was then told that he was cleansing me of any evil spirits. He did not tell me that he had seen any, and I was too cowardly to ask, but this was an important precaution as no one with evil spirits was going to be given that honor. After he had cleansed me, he stepped forward and threw a rather large and, I hope, dull sword which fell in front of me. He must have had ample practice with this. Then he came forward and did something with it, and lo and behold, I was a chief. I have always taken this honor seriously, especially since I am free of all evil. Someone should tell the American Psychiatric Association.

AWS: You and the APA have not exactly seen eye to eye. Why?

AH: In 1950, I became director of psychiatric research for Saskatchewan's Department of Public Health. I was a founder of the Canadian Schizophrenia Foundation, now the International Schizophrenia Foundation. My main objective was to research the cause of this disease and to find a better treatment. This is now called "orthomolecular medicine," after Dr. Pauling published his seminal paper in Science in 1968. After the American Psychiatric Association called my good friend and colleague Humphry Osmond and me before their Committee on Ethics because of what I had published, they effectively killed interest in the use of vitamins for treating mental illness. The APA bears major responsibility for preventing the introduction of a treatment which would have saved millions of patients from the ravages of chronic schizophrenia. Just as the APA was once captured by psychoanalysis, it is now captured by pharmaceuticals. They are biased. No amount of evidence will persuade someone who is not listening.

AWS: And for those who are, you and I have two new books in the works.

AH: Our publisher is a great gambler. At age 91, I cannot guarantee that I will be around by the fall of 2010. But let's go ahead anyway, and you youngsters can complete it if I move on to other fields of existence.

And he did. Abram Hoffer died May 27, 2009. Thanks to Dr. Hoffer, medicine will never be the same. That may be the best of legacies.

Further Reading
Hoffer A, Saul AW. The Vitamin Cure for Alcoholism. Laguna Beach, CA: Basic Health Publications; 2009. ISBN: 978-1-59120-254-7. Reviews at: http://www.doctoryourself.com/alcoholcure.html.
Hoffer A, Saul AW. Orthomolecular Medicine for Everyone: Megavitamin Therapeutics for Families and Physicians. Laguna Beach, CA: Basic Health Publications; 2008. ISBN: 978-1-59120-226-4. Reviews at: http://www.doctoryourself.com/orthomolecular.html.
Hoffer A, Osmond H. Megavitamin therapy: in reply to the American Psychiatric Association Task Force Report on Megavitamin and Orthomolecular Therapy in Psychiatry. Canadian Schizophrenia Foundation. August 1976. Available at: http://www.iahf.com/orthomolecular/reply_to_apa_tfr_7.pdf.
A bibliography of Abram Hoffer's books and papers is posted at: http://www.doctoryourself.com/biblio_hoffer.html.

Andrew W. Saul has 33 years' experience in natural health education. He taught nutrition, health science, and cell biology for the State University of New York, and is the winner of three New York State teacher fellowships. He is assistant editor of the Journal of Orthomolecular Medicine, the author of the popular books Doctor Yourself and Fire Your Doctor! and coauthor of Vitamin C: The Real Story. He is coauthor with Abram Hoffer of The Vitamin Cure for Alcoholism and Orthomolecular Medicine for Everyone. 

Dr. Saul has been awarded the Citizens for Health Outstanding Health Freedom Activist Award, was named one of seven natural health pioneers by Psychology Today, and is featured in the movie Food Matters. His peer-reviewed, noncommercial natural healing website, DoctorYourself.com, receives over 40,000 hits per day.This interview is posted with the permission of the Journal of Orthomolecular Medicine 2009, Vol. 24, No 3. All issues of the Journal of Orthomolecular Medicine from 1967 through 2006 are now online for public access, free of charge, at http://orthomolecular.org/library/jom. For more information or to subscribe, go to  http://www.orthomed.org/jom/jom.html, e-mail centre@orthomed.org, or telephone 416-733-2117.