—
IN 1970, Linus Pauling published his first book, Vitamin C and the Common Cold, which urged Americans to take 3,000 milligrams of vitamin C every day—roughly 500 times the recommended daily allowance. The book became a national best seller. Within a few years, more than 50 million Americans—1 of every 4 people living in the United States—were following Pauling’s advice. Scientific studies, however, failed to support him.
In 1942, about 30 years before Pauling published his book on vitamin C, a group of researchers from the University of Minnesota published a study in the Journal of the American Medical Association of 980 people with colds, finding that vitamin C did nothing to lessen symptoms.
After Pauling published his book, and largely in response to its popularity, researchers at the University of Maryland and the University of Toronto and in the Netherlands performed several studies of volunteers who had been given 2,000, 3,000, or 3,500 milligrams of vitamin C a day for the prevention or treatment of colds. Again, large doses of vitamin C were found to be useless.
Because of these and other studies, not a single professional medical, scientific, or public health organization recommends vitamin C for the prevention or treatment of colds. Unfortunately, it’s been hard to unring the bell. Once Pandora’s box is opened, you cannot put anything back inside; once Americans had become convinced that vitamin C was a wonder drug, there was no going back.
Then Linus Pauling doubled down, claiming that vitamin C also cured cancer.
—
IN 1971, PAULING WROTE that megadoses of vitamin C (those greatly in excess of the recommended daily allowance) would cause a 10 percent decrease in the incidence of cancer in the United States; six years later, he upped his prediction to 75 percent. If we followed his advice, Pauling believed that vitamin C could make us practically immortal, living longer than ever before. He predicted that the average American life span would increase to a hundred years, then 150 years. Like Vitamin C and the Common Cold, his books Cancer and Vitamin C and How to Live Longer and Feel Better also became instant best sellers. Linus Pauling was so powerful, such a media darling, that cancer victims started to take his advice. Doctors, blindsided by Pauling’s influence, had no choice but to see if he was right.
In 1979, Charles Moertel and colleagues at the famed Mayo Clinic in Rochester, Minnesota, studied 150 cancer victims. Half were given 10,000 milligrams of vitamin C a day (roughly 1,500 times the recommended daily allowance) and half weren’t. They published their paper, titled “Failure of High-Dose Vitamin C Therapy to Benefit Patients with Advanced Cancer: A Controlled Trial,” in the New England Journal of Medicine. The title said it all; vitamin C hadn’t worked. Pauling was incensed. Surely Moertel hadn’t done the study correctly. Then Pauling found what he believed was the flaw in the experiment: Moertel had given vitamin C to patients who had already received chemotherapy, negating its wondrous healing properties. Pauling was now convinced that vitamin C worked only in patients who hadn’t received any chemotherapy.
Although he didn’t really see the point, Moertel was bullied into performing another study of vitamin C in cancer victims, this time in patients who had yet to receive chemotherapy. In 1985, he published his second study, again in the New England Journal of Medicine and again showing no difference. Now Pauling was really angry, accusing Moertel of “deliberate fraud and misrepresentation.” He considered suing Moertel, but his lawyers talked him out of it.
Linus Pauling had been so right for so long that he just couldn’t imagine that he could ever be wrong—even when he clearly was wrong. As described by biographers and colleagues, Pauling’s failures could have been predicted from his personality. “Linus Pauling is a classic example of a person who loves humanity but doesn’t care much for people,” wrote biographers Ted and Ben Goertzel. “He is generally without close friends. Politically, he is a crusader for his vision of truth with little tolerance for considering the viewpoints of others.” Like the Goertzels, Max Perutz—a colleague of Pauling’s who had also won a Nobel Prize in chemistry—praised Pauling for his breakthrough work, but also alluded to a darker side: “It seems tragic that [vitamin C] should have become one of Pauling’s major preoccupations during the last twenty-five years of his life and spoilt his great reputation as a chemist. Perhaps it was related to his greatest failing: his vanity. When anybody contradicted Einstein, he thought it over, and if he found he was wrong, he was delighted, because he felt he had escaped from an error. But Pauling would never admit that he might have been wrong. When, after reading Pauling and [Robert] Corey’s paper on the alpha helix, I discovered [a problem with their calculations], I thought he would be pleased. But no, he attacked me furiously, because he could not bear the idea that someone else had thought of a test for the alpha helix of which he had not thought himself.”
—
AMONG PAULING’S MISANTHROPIC dealings with those who dared to oppose him—dared to believe that he could ever be wrong—no story was sadder or more telling than that of Arthur Robinson.
In 1973, Pauling founded the Institute of Orthomolecular Medicine in Menlo Park, California, later to become the Linus Pauling Institute. His biggest supporter was the pharmaceutical giant Hoffman-La Roche, one of the world’s largest manufacturers of vitamins and dietary supplements. Pauling decided that if other researchers were unable to show that megavitamins were wonder drugs, then he would do it himself.
When Pauling founded his institute, he brought Arthur Robinson along with him. Pauling was president, director, and chairman of the board. Robinson, a chemist and one of the brightest students to have ever graduated from the University of California in San Diego, was vice president, assistant director, and treasurer. Robinson’s job was to provide experimental evidence for Pauling’s theories about vitamin C. It didn’t work out that way.
In 1977, Arthur Robinson evaluated a special breed of mice that suffered from skin cancer. To some he gave the human equivalent of 10,000 milligrams of vitamin C a day; to others, he didn’t give any extra vitamins. The results were alarming. Robinson found that high doses of vitamin C actually increased their risk of cancer.
Robinson knew that Pauling and his wife were taking large doses of vitamin C. Concerned, he told Pauling of his results. “At that time [1970],” recalled Robinson, “he had put himself and his wife on at least 10,000 milligrams a day of vitamin C, and they were on it for the next decade. I pointed out that she was bathing her stomach with an enormous amount of mutagenic [cancer-causing] material for ten years.” (Ava Pauling would later suffer from stomach cancer.)
Pauling refused to believe it, threatening to have the mice killed and demanding Robinson’s resignation. “He claimed that his famous name gave him the right to absolute control over all ideas and research at the institute,” recalled Robinson. “Linus informed me that he would have me fired disgracefully from all of my positions, including that of tenured research professor, and that he would take several other actions ruinous to my professional career if I did not agree to his demands.”
Following Pauling’s orders, the board of trustees withheld Robinson’s salary, suspended him from the institute, and locked his files. Robinson didn’t go quietly, suing Pauling and the institute for $25 million. The lawsuit dragged on for five years, costing the institute $1 million in legal fees. The case was eventually settled for $500,000.
—
ARTHUR ROBINSON’S FINDINGS weren’t limited to mice. Soon other researchers found that megavitamins increased the risk of cancer in people, too.
In 1994, the National Cancer Institute, in collaboration with Finland’s National Public Health Institute, studied 29,000 Finnish men: All were smokers and all were at risk of lung cancer. The men were given large doses of vitamin E, beta-carotene (a vitamin A precursor), both, or neither. The results were the opposite of what had been expected. Those given megavitamins were actually more likely to die from lung cancer, not less.
In 1996, investigators from the Fred Hutchinson
Cancer Research Center in Seattle studied 18,000 people who, because they had been exposed to asbestos, were—like those who smoked cigarettes—also at greater risk of lung cancer. Participants were given large doses of vitamin A, beta-carotene, both, or neither. The study ended abruptly when the safety monitors realized that those taking megavitamins had a dramatically higher rate of lung cancer (28 percent greater than those not receiving vitamins) as well as heart disease (17 percent greater).
In 2004, researchers from the University of Copenhagen reviewed 14 randomized trials involving 170,000 people given large doses of vitamins A, C, E, and beta-carotene to see whether they had a lesser incidence of intestinal cancers. As had been true for lung cancer, vitamin recipients were more likely to have intestinal cancer than those who didn’t take supplemental vitamins.
In 2005, researchers from Johns Hopkins School of Medicine evaluated 19 studies involving more than 136,000 people who had taken megavitamins and found an increased risk of early death in vitamin recipients. In the same year, a study published in the Journal of the American Medical Association evaluated more than 9,000 people who took high doses of vitamin E to prevent cancer. Again, vitamin recipients were more likely to develop cancer and heart disease.
In 2008, a review of all existing studies of more than 230,000 people who had taken megavitamins found an increased risk of cancer and heart disease.
In 2011, researchers from the Cleveland Clinic published a study of 36,000 men who took vitamin E, selenium (a mineral), both, or neither. Those who took megadoses of vitamin E had a 17 percent greater risk of prostate cancer.
—
LINUS PAULING WAS WRONG about megavitamins because he had made two fundamental errors. First, he had assumed that you cannot have too much of a good thing.
Vitamins are critical to life. If people don’t get enough vitamins, they suffer various deficiency states, like scurvy (not enough vitamin C) or rickets (not enough vitamin D). The reason that vitamins are so important is that they help convert food into energy. But there’s a catch. To convert food into energy, the body uses a process called oxidation. One outcome of oxidation is the generation of something called free radicals, which can be quite destructive. In search of electrons, free radicals damage cell membranes, DNA, and arteries, including the arteries that supply blood to the heart. As a consequence, free radicals cause cancer, aging, and heart disease. Indeed, free radicals are probably the single greatest reason that we aren’t immortal.
To counter the effects of free radicals, the body makes antioxidants. Vitamins—like vitamins A, C, E, and beta-carotene—as well as minerals like selenium and substances like omega-3 fatty acids all have antioxidant activity. For this reason, people who eat diets rich in fruits and vegetables, which are rich in antioxidants, tend to have less cancer, less heart disease, and live longer. Pauling’s logic to this point is clear; if antioxidants in food prevent cancer and heart disease, then eating large quantities of manufactured antioxidants should do the same thing. But Linus Pauling had ignored one important fact: Oxidation is also required to kill new cancer cells and clear clogged arteries. By asking people to ingest large quantities of vitamins and supplements, Pauling had shifted the oxidation-antioxidation balance too far in favor of antioxidation, therefore inadvertently increasing the risk of cancer and heart disease. As it turns out, Mae West aside, you actually can have too much of a good thing. (“Too much of a good thing can be wonderful,” said West, who was talking about sex, not vitamins.)
Second, Pauling had assumed that vitamins and supplements ingested in food were the same as those purified or synthesized in a laboratory. This, too, was incorrect. Vitamins are phytochemicals, which means that they are contained in plants (phyto- means “plant” in Greek). The 13 vitamins (A, B1, B2, B3, B5, B6, B7, B9, B12, C, D, E, and K) contained in food are surrounded by thousands of other phytochemicals that have long and complicated names like flavonoids, flavonols, flavanones, isoflavones, anthocyanins, anthocyanidins, proanthocyanidins, tannins, isothiocyanates, carotenoids, allyl sulfides, polyphenols, and phenolic acids. The difference between vitamins and these other phytochemicals is that deficiency states like scurvy have been defined for vitamins but not for the others. But make no mistake: These other phytochemicals are important, too. And Pauling’s recommendation to ingest massive quantities of vitamins apart from their natural surroundings was an unnatural act. For example, as described in Catherine Price’s book, Vitamania, half of an apple has the antioxidant activity of 1,500 milligrams of vitamin C, even though it contains only 5.7 milligrams of the vitamin. That’s because the phytochemicals that surround vitamin C in apples enhance its effect. Then there’s the plant goldenseal, which contains a powerful antibacterial substance called berberine. If you eat goldenseal, berberine isn’t toxic. But if you purify berberine away from the other phytochemicals in goldenseal, and eat the same amount of berberine that was in the plant, it is toxic. Other phytochemicals in goldenseal protect against berberine’s toxic effects. Another example would be the powerful antioxidant lycopene, which is present in tomatoes and used to hawk everything from ketchup to marinara sauce. Studies of rats with prostate cancer showed that tomato powder (which contains all of the phytochemicals found in tomatoes) could reduce the size of the tumors to a much greater extent than large quantities of purified lycopene. In short, Linus Pauling’s appeal to all things natural was anything but.
—
PAULING’S ADVOCACY GAVE BIRTH TO a vitamin and supplement industry built on sand. Evidence for this can be found by walking into a GNC center—a wonderland of false hope. Rows and rows of megavitamins and dietary supplements promise healthier hearts, smaller prostates, lower cholesterol, improved memory, instant weight loss, lower stress, thicker hair, and better skin. All in a bottle. No one seems to be paying attention to the fact that vitamins and supplements are an unregulated industry. As a consequence, companies aren’t required to support their claims of safety or effectiveness. Worse, the ingredients listed on the label might not reflect what’s in the bottle. And we seem to be perfectly willing to ignore the fact that every week at least one of these supplements is pulled off the shelves after it was found to cause harm. Like the L-tryptophan disaster, an amino acid sold over the counter and found to cause a disease that affected 5,000 people and killed 28. Or the OxyElite Pro disaster, a weight-loss product that caused 50 people to suffer severe liver disease; one person died and three others needed lifesaving liver transplants. Or the Purity First disaster, a Connecticut company’s vitamin preparations that were found to contain two powerful anabolic steroids, causing masculinizing symptoms in dozens of women in the Northeast.
—
LINUS PAULING’S LEGACY IS MIXED. He was the first to marry quantum physics with chemistry, the first to link the fields of molecular and evolutionary biology, and one of the few who stood up to McCarthyism and nuclear proliferation. But later in his life Linus Pauling was indistinguishable from the country fair hucksters and snake-oil salesmen of a century before—the father of a $32-billion-a-year vitamin and supplement industry. “Linus Pauling paid for his extraordinary gifts with his failure to appreciate where they rightfully ended,” wrote historian Algis Valiunas. “One cannot but think what a marvelous legacy would have been his if he had just known when to quit.”
How could a man who was so devoted to the rigor, hard work, and hard thinking required to achieve what he had achieved be at the same time unwilling to look critically at studies that consistently showed he was wrong, including those performed in his own institute? Sadly, Pauling’s not the only one. Other brilliant, award-winning, internationally recognized scientists have also succumbed to hubris—with disastrous results.
Two of those scientists were associated with the AIDS epidemic.
On June 5, 1981, the Centers for Disease Control and Prevention (CDC) published a report of an unusual outbreak: Five previously healthy gay men in Los Angeles had developed a rare form of fungal pneumonia (Pneumocystis carinii) typ
ically seen only in cancer victims or in people with severe immune deficiencies. These men, however, had all been previously healthy. The report also included the story of another seemingly unrelated cluster of gay men in New York and California who had developed a highly aggressive form of cancer called Kaposi’s sarcoma.
One month later, the New York Times reported 41 more cases of Kaposi’s sarcoma, again all in gay men. By the end of the year, another 270 similar cases in gay men were reported; 120 of these men had died. The press called it “the gay plague.”
On September 24, 1982, CDC officials gave the disease a name: AIDS, for acquired immunodeficiency syndrome. Then, they set up a task force to find out what was causing it. Clues started to accumulate. On December 10, 1982, the CDC reported the first case of AIDS in an infant who had received a blood transfusion. The following week, the CDC reported another 22 cases of unusual infections in infants.
On January 7, 1983, the CDC reported the first cases of AIDS in women who had had sex with men who had AIDS. The following month, Robert Gallo, a researcher at the National Institutes of Health (NIH), predicted that an unusual virus called a retrovirus was causing AIDS. Gallo’s prediction was surprising; up to this point, retroviruses had been considered to be benign viruses that didn’t cause diseases in people. The CDC agreed with Gallo, believing that the disease was likely caused by a virus that was transmitted sexually or by exposure to blood. On May 20, 1983, Luc Montagnier found the cause: a virus he called LAV for lymphadenopathy-associated virus.
On April 23, 1984, Margaret Heckler, secretary of the U.S. Department of Health and Human Services, announced that Robert Gallo and his colleagues at NIH had also discovered the cause of AIDS: a virus they called HTLV-III for human T-cell lymphotropic virus. Heckler predicted that a vaccine to prevent AIDS would be available in the next two years. (That was more than 30 years ago.) Researchers soon realized that LAV and HTLV-III were the same virus, and settled on a third name: HIV for human immunodeficiency virus.
Pandora's Lab Page 18