Perception, Behaviour, Thought & Vitamin B-3
review by Jule Motter

Dr. Hoffer's ABC of Natural Nutrition for Children
by Abram Hoffer, MD, PhD, FRCP(C)
Quarry Press, Inc., P.O. Box 1061, Kingston, Ontario K7L 4Y5 Canada;
613-548-8429; fax 613-548-1556;
www.quarrypress.com
Softbound, 316 pp., 1999, $19.95 Canada/ $14.95 USA

In 1938, the American Journal of Medical Science (Vol. 196) published an article by T.D. Spies and colleagues titled "The mental symptoms of pellagra: their relief with nicotinic acid." This article describes 'subclinical pellagra' in children. The symptoms include hyperactivity, perceptual difficulties, inappropriate social behavior, and, understandably, problems with school. Today, children with these same symptoms are labeled "hyperactive," "ADD," "emotionally disturbed," "dyslexic," or "minimally brain damaged," depending upon the focus of the diagnostician. Pellagra affects perception, thought processes, mood, and behavior. It results from an inadequate amount of vitamin B-3, also known as niacin (nicotinic acid), or its amide (niacinamide).

In his new book Dr. Hoffer's ABC of Natural Nutrition for Children, Abram Hoffer, a pioneer in orthomolecular psychiatry, refers to Spies' article to show that the connection between pellagra, caused by niacin deficiency, and behavior abnormalities is not new information. Hoffer began using large doses of vitamins (particularly B3) and minerals to treat schizophrenics successfully in the 1950's. His interest in treating children began when he entered private practice in 1967, and saw how quickly the few children who were referred to him responded to "optimal," usually megadoses, of vitamin B-3. He has come to the conclusion that many of the children now being treated with Ritalin are actually suffering from what he calls, "vitamin B-3 dependent or subclinical. pellagra." Dr. Hoffer's ABC of Natural Nutrition for Children introduces the reader to orthomolecular medicine, explains current diagnostic protocols (his own and conventional medicine's), tells how to treat and prevent learning and behavior disorders, and gives a substantial number of case studies from Dr. Hoffer's personal research.

Depression, which can affect hyperactive and hypoactive children, and perceptual disturbances are often the first indications of pellagra. Like people with schizophrenia, affected children may hear voices. Foods may taste different to them. Letters appear upside down, and words slip around the page. Children may see objects or creatures among the shadows in the semi-dark. Usually, children are unable to describe these changes in their perceptions without help. Dr. Hoffer's ABC of Natural Nutrition for Children includes a hundred-question Perceptual Dysfunction Test that can be completed by young children with the help of a parent. The PD Test was adapted by Dr. Glen Green from the HofferOsmond Diagnostic Test (HOD), which Dr. Hoffer and Dr.

Humphrey Osmond developed in 1960, to screen for schizophrenia. The HOD test can be used to evaluate mental health in children over 10 years old although Hoffer says that some children may have difficulty with some of the vocabulary. The HOD test is available as a computer program and at www. softtac@islandnet.com.

In addition to these questionnaires, a urine test can identify krytopyrroluria (IKP), a substance commonly found in the urine of schizophrenic patients. This substance causes a deficiency of B-6 (pyridoxine) and zinc by latching onto these nutrients and removing them from the body via urine. Hoffer has noticed that children with positive KP results also respond to B-3. While all of these tests and questionnaires may point to vitamin deficiency, the primary test is to give the child large doses of niacinamide or B-3 (often starting with 1 G tid). If the child's perceptual and behavioral problems are caused by a deficiency, Hoffer says that improvement will be noticed within months (or sooner).

Sugar craving and food allergies are other factors that Hoffer considers when treating perceptual and behavioral problems. Too much sugar in the diet can indicate nutrient deficiencies. A zinc deficiency can, in fact, cause sugar craving. Poorly nourished children are also more likely to absorb toxic metals, which are known to cause aberrant behavior and learning problems. Identifying food allergies is vital. Hoffer refers to numerous researchers and clinicians whose work over the past 75 years has shown that "...any food allergy can reproduce almost every known psychiatric syndrome from infantile autism and schirophrenia to mood and behavioral disorders."

"Perceptual, thought, and mood disorders make it very difficult for the child to grow and develop properly," writes Hoffer. "The difficulty of keeping up with their peers and with their parents' expectations for them creates so much stress on these children that they develop psychosocial techniques for dealing with the problem, for example, not going to school or running away." To Hoffer, these underlying disorders, which can be corrected with orthomolecular treatment, are like a hardware dysfunction in a computer. The psychosocial techniques that result as an adaptation to the biochemical problems are like computer software problems and must be corrected by "reprogramming ... by the application of behavioral or other forms of therapy." Behavioral therapies, however, will not resolve biochemical imbalances and vitamin deficiencies; nor, will drugs and tranquilizers. Until the orthomolecular or nutritional therapy causes improvement, however, Dr. Hoffer will prescribe drugs if needed. He prefers mellaril and imipramine to ritalin, which, he says, "has undesirable sideeffects ... such as interfering with growth due to loss of appetite and causing possible drug addiction."

The basis of Dr. Hoffer's treatment plan lies in a healthful diet, megavitamin therapy, and eliminating all refined sugars and junk processed foods. Vitamins B-3, B-6, and C and the mineral zinc are the nutrients most often required; but, Hoffer also uses optimal doses of other vitamins, minerals, fatty acids, and amino acids. In this book he gives symptoms and signs of specific nutrient deficiencies as well as side effects from megadoses. Niacin/vitamin B-3, for example, can cause flushing, nausea, and jaundice, which disappears when the therapy is stopped. Hoffer tells about one child who turned yellow within days of starting B-3 therapy, "even though his liver function tests remained normal. On inositol niacinate he did not turn yellow over a five year period of observation."

Compliance is the major problem with this treatment. Sometimes parents cannot or will not follow through. Sometimes children refuse to cooperate. Getting children, many of whom are addicted to sugar, to delete refined sugar from their diet can be a challenge. When children refuse to avoid sugar, Hoffer gives them permission to eat as much sugar as they want on Saturday if they agree to avoid it during the week. The headaches, nausea, and vomiting that results from the Saturday binge often convinces a child to avoid the sugary cause.

While writing this review, I heard of yet another child, a 7th grader, who shot 4 schoolmates and did not know whom he had shot. or why he had fired the gun. Psychologists talk about healing abandonment and disassociation. Gun control and calls for prayer and morality in the schools are also offered as solutions. But this rise in violence may well be caused by a "hardware" problem - a biochemical dysfunction due to nutritional deficiency.

We are seeing a growing interest in the effect of emotion and thought on biochemistry, but the other side of the holistic equation - biochemistry's effect on behavior and emotions has received less attention. Dr. Hoffer's ABC ofNatural Nutrition for Children offers vital information concerning the prevention and healing of mental disturbances and violence, demonstrated by too many of today's children.