Authors: Dr Paul Offit
I gotta tell you, right at the top of my list would be taking vitamins. I know that over the years doctors have said they're ridiculous and all that. But I started taking my vitamins at an early age. And I take them every day. Every bloody day! So I think that's number one. For whatever reason, I feel active and pretty good at my age.
âRegis Philbin
E
veryone loves vitamins. Derived from the Latin word
vita
, meaning “life,” vitamins are necessary for the conversion of food into energy. Millions of people believe that taking daily vitamins makes them feel better and live longer.
Thirteen vitamins have been identified. Nine are easily dissolved in water: vitamins B
1
(thiamine), B
2
(riboflavin), B
3
(niacin), B
5
(pantothenic acid), B
6
(pyridoxine), B
7
(biotin), B
9
(folic acid), B
12
(cobalamin), and C (ascorbic acid). Four aren't water-soluble: vitamins A (retinol), D (calciferol), E (tocopherol), and K (phylloquinone). When people don't get enough vitamins, they suffer diseases such as beriberi, pellagra, scurvy, and rickets (caused by deficiencies of vitamins B
1
, B
3
, C, and D, respectively).
The problem with most vitamins is that they aren't made inside the body; they're available only in foods or supplements. So the question isn't “Do people need vitamins?” They do. The real questions are “How much do they need?” and “Do they get enough in foods?” Nutrition experts and vitamin manufacturers are split on the answers to these questions. Nutrition experts argue that all people need is the recommended daily allowance (RDA), typically found in a routine diet. Industry representatives argue that foods don't contain enough vitamins and that larger quantities are needed. Fortunately, many excellent studies have now resolved the issue.
O
n October 10, 2011, researchers from the University of Minnesota found that women who took supplemental multivitamins died at rates higher than those who didn't. Two days later, researchers from the Cleveland Clinic found that men who took vitamin E had an increased risk of prostate cancer. “It's been a tough week for vitamins,” said Carrie Gann of ABC News.
These findings weren't new. Seven previous studies had already shown that vitamins increased the risk of cancer and heart disease and shortened lives. Still, in 2012, more than half of all Americans took some form of vitamin supplements. What few
people realize, however, is that their fascination with vitamins can be traced back to one man. A man who was so spectacularly right that he won two Nobel Prizes and so spectacularly wrong that he was arguably the world's greatest quack.
L
inus Pauling was born on February 28, 1901, in Portland, Oregon. He attended Oregon Agricultural College (now Oregon State University), in Corvallis, before entering the California Institute of Technology (Caltech), where he taught for more than forty years.
In 1931, Pauling published a paper in the
Journal of the American Chemical Society
titled “The Nature of the Chemical Bond.” Before publication, chemists knew of two types of chemical bonds: ionic, where one atom gives up an electron to another; and covalent, where atoms share electrons. Pauling argued that it wasn't that simpleâelectron sharing was somewhere between ionic and covalent. Pauling's idea revolutionized the field, marrying quantum physics with chemistry. His concept was so revolutionary that when the journal editor received the manuscript, he couldn't find anyone qualified to review it. When Albert Einstein was asked what he thought of Pauling's work, he shrugged his shoulders. “It was too complicated for me,” he said. For this single paper, Pauling received the Langmuir Prize as the most outstanding young chemist in the United States, became the youngest person elected to the National Academy of Sciences, was made a full professor at Caltech, and won the Nobel Prize in Chemistry. He was thirty years old.
In 1949, Pauling published a paper in
Science
titled “Sickle Cell Anemia, a Molecular Disease.” At the time, scientists
knew that hemoglobin (the protein in blood that transports oxygen) crystallized in the veins of people with sickle-cell anemia, causing joint pain, blood clots, and death. But they didn't know why. Pauling was the first to show that sickle hemoglobin had a slightly different electrical chargeâa quality that dramatically affected how the hemoglobin reacted with oxygen. His finding gave birth to the field of molecular biology.
In 1951, Pauling published a paper in the
Proceedings of the National Academy of Sciences
titled “The Structure of Proteins.” Scientists knew that proteins were composed of a series of amino acids. Pauling proposed that proteins also had a secondary structure determined by how they folded upon themselves. He called one configuration the alpha helixâlater used by James Watson and Francis Crick to explain the structure of DNA.
In 1961, Pauling collected blood from gorillas, chimpanzees, and monkeys at the San Diego Zoo. He wanted to see whether mutations in hemoglobin could be used as a kind of evolutionary clock. Pauling showed that humans had diverged from gorillas about 11 million years ago, much earlier than scientists had suspected. A colleague later remarked, “At one stroke he united the fields of paleontology, evolutionary biology, and molecular biology.”
Pauling's accomplishments weren't limited to science. Beginning in the 1950sâand for the next forty yearsâhe was the world's most recognized peace activist. Pauling opposed the internment of Japanese Americans during World War II, declined Robert Oppenheimer's offer to work on the Manhattan Project, stood up to Senator Joseph McCarthy by refusing a loyalty oath, opposed nuclear proliferation, publicly debated
nuclear-arms hawks like Edward Teller, forced the government to admit that nuclear explosions could damage human genes, convinced other Nobel Prize winners to oppose the Vietnam War, and wrote the best-selling book
No More War!
Pauling's efforts led to the Nuclear Test Ban Treaty. In 1962, he won the Nobel Peace Prizeâthe first person ever to win two unshared Nobel Prizes.
In addition to his election to the National Academy of Sciences, two Nobel Prizes, the National Medal of Science, and the Medal for Merit (which was awarded by the president of the United States), Pauling received honorary degrees from Cambridge University, the University of London, and the University of Paris. In 1961, he appeared on the cover of
Time
magazine's Men of the Year issue, hailed as one of the greatest scientists who had ever lived.
T
hen all the rigor, hard work, and hard thinking that had made Linus Pauling a legend disappeared. In the words of a colleague, his “fall was as great as any classic tragedy.”
The turning point came in March 1966, when Pauling was sixty-five years old. He had just received the Carl Neuberg Medal. “During a talk in New York City,” recalled Pauling, “I mentioned how much pleasure I took in reading about the discoveries made by scientists in their various investigations of the nature of the world, and stated that I hoped I could live another twenty-five years in order to continue to have this pleasure. On my return to California I received a letter from a biochemist, Irwin Stone, who had been at the talk. He wrote that if I followed his recommendation of taking 3,000 milligrams of
vitamin C, I would live not only twenty-five years longer, but probably more.” Stone, who referred to himself as Dr. Stone, had spent two years studying chemistry in college. Later, he received an honorary degree from the Los Angeles College of Chiropractic and a “PhD” from Donsbach University, a non-accredited correspondence school in Southern California.
Pauling followed Stone's advice. “I began to feel livelier and healthier,” he said. “In particular, the severe colds I had suffered several times a year all my life no longer occurred. After a few years, I increased my intake of vitamin C to ten times, then twenty times, and then three hundred times the RDA: now 18,000 milligrams per day.”
From that day forward, people would remember Linus Pauling for one thing: vitamin C.
I
n 1970, Pauling published
Vitamin C and the Common Cold
, urging the public to take 3,000 milligrams of vitamin C every day (about fifty times the RDA). Pauling believed that the common cold would soon be a historical footnote. “It will take decades to eradicate the common cold completely,” he wrote, “but it can, I believe, be controlled entirely in the United States and some other countries within a few years. I look forward to witnessing this step toward a better world.” Pauling's book became an instant best seller. Paperback versions were printed in 1971 and 1973, and an expanded edition titled
Vitamin C, the Common Cold and the Flu
, published three years later, promised to ward off a predicted swine flu pandemic. Sales of vitamin C doubled, tripled, and quadrupled. Drugstores couldn't keep up with demand. By the mid-1970s, 50 million Americans were
following Pauling's advice. In the United Kingdom, where vitamin C was called “Pauling's Powder,” vitamin sales soon topped £550 million. Vitamin manufacturers called it “the Linus Pauling effect.”
Scientists weren't as enthusiastic. On December 14, 1942, about thirty years before Pauling published his first book, Donald Cowan, Harold Diehl, and Abe Baker, from the University of Minnesota, published a paper in the
Journal of the American Medical Association
titled “Vitamins for the Prevention of Colds.” The authors concluded, “Under the conditions of this controlled study, in which 980 colds were treated ⦠there is no indication that vitamin C alone, an antihistamine alone, or vitamin C plus an antihistamine have any important effect on the duration or severity of infections of the upper respiratory tract.”
Other studies followed. After Pauling's pronouncement, researchers at the University of Maryland gave 3,000 milligrams of vitamin C every day for three weeks to eleven volunteers and a sugar pill (placebo) to ten others. Then they infected volunteers with a common cold virus. All developed cold symptoms of similar duration. At the University of Toronto, researchers administered vitamin C or placebo to 3,500 volunteers. Again, vitamin C didn't prevent colds, even in those receiving as much as 2,000 milligrams a day. In 2002, researchers in the Netherlands administered multivitamins or placebo to more than 600 volunteers. Again, no difference. At least fifteen studies have now shown that vitamin C doesn't treat the common cold. As a consequence, neither the FDA, the American Academy of Pediatrics, the American Medical Association, the American Dietetic Association, the Center for Human Nutrition at the Johns Hopkins Bloomberg School
of Public Health, nor the Department of Health and Human Services recommend supplemental vitamin C for the prevention or treatment of colds.
Although study after study showed that he was wrong, Pauling refused to believe it, continuing to promote vitamin C in speeches, popular articles, and books. When he occasionally appeared before the media with obvious cold symptoms, he said he was suffering from allergies.
T
hen Linus Pauling upped the ante. He claimed that vitamin C not only prevented colds; it cured cancer.
In 1971, Pauling received a letter from Ewan Cameron, a Scottish surgeon from a tiny hospital outside Glasgow. Cameron wrote that cancer patients who were treated with ten grams of vitamin C every day had fared better than those who weren't. Pauling was ecstatic. He decided to publish Cameron's findings in the
Proceedings of the National Academy of Sciences
(
PNAS
). Pauling assumed that as a member of the academy he could publish a paper in
PNAS
whenever he wanted; only three papers submitted by academy members had been rejected in more than half a century. Pauling's paper was rejected anyway, further tarnishing his reputation among scientists. Later, the paper was published in
Oncology
, a journal for cancer specialists. When researchers evaluated the data, the flaw became obvious: the cancer victims Cameron had treated with vitamin C were healthier at the start of therapy, so their outcomes were better. After that, scientists no longer took Pauling's claims about vitamins seriously.
But Linus Pauling still had clout with the media. In 1971,
he declared that vitamin C would cause a 10 percent decrease in deaths from cancer. In 1977, he went even further. “My present estimate is that a decrease of 75 percent can be achieved with vitamin C alone,” he wrote, “and a further decrease by use of other nutritional supplements.” With cancer in their rearview mirror, Pauling predicted, people would live longer, healthier lives. “Life expectancy will be 100 to 110 years,” he said, “and in the course of time, the maximum age might be 150 years.”
Cancer victims now had reason for hope. Wanting to participate in the Pauling miracle, they urged their doctors to give them massive doses of vitamin C. “For about seven or eight years, we were getting a lot of requests from our families to use high-dose vitamin C,” recalls John Maris, chief of oncology and director of the Center for Childhood Cancer Research at the Children's Hospital of Philadelphia. “We struggled with that. They would say, âDoctor, do you have a Nobel Prize?'”
Blindsided, cancer researchers decided to test Pauling's theory. Charles Moertel, of the Mayo Clinic, evaluated 150 cancer victims: half received ten grams of vitamin C a day and half didn't. The vitamin Câtreated group showed no difference in symptoms or mortality. Moertel concluded, “We were unable to show a therapeutic benefit of high-dose vitamin C.” Pauling was outraged. He wrote an angry letter to the
New England Journal of Medicine
, which had published the study, claiming that Moertel had missed the point. Of course vitamin C hadn't worked: Moertel had treated patients who had already received chemotherapy. Pauling claimed that vitamin C worked only if cancer victims had received no prior chemotherapy.