Abram Hoffer
Abram Hoffer (November 11, 1917 – May 27, 2009) was a Canadian biochemist, physician, and psychiatrist known for his "adrenochrome hypothesis" of schizoaffective disorders. According to Hoffer, megavitamin therapy and other nutritional interventions are potentially effective treatments for  schizophrenia and other diseases. Hoffer was also involved in studies of LSD as an experimental therapy for alcoholism and the discovery that high-dose niacin can be used to treat high cholesterol and other dyslipidemias.  Hoffer's ideas about megavitamin therapy to treat mental illness are not accepted by the medical community.

Biography
Hoffer was born in southern Saskatchewan, Canada, in 1917, the last of four children and the son of Israel Hoffer.  Originally interested in agriculture, Hoffer earned both a Bachelor of Science and a master's degree in agricultural chemistry from University of Saskatchewan in Saskatoon.  He then took up a scholarship for a year of post-graduate work with the University of Minnesota, followed by work developing assays for niacin levels at a wheat products laboratory in Winnipeg.  Hoffer earned a PhD in biochemistry in 1944, part of which involved the study of vitamins (particularly B vitamins and their effect on the body) and with an interest in nutrition went on to study medicine at the University of Manitoba in 1945.  After two years of clinical work at the University of Toronto,  Hoffer earned his MD in 1949.  Though originally intending to be a general practitioner, during his degree Hoffer developed an interest in psychiatry.  He married Rose Miller in 1942, and his son Bill Hoffer was born in 1944 followed by two more children, John and Miriam, in 1947 and 1949.

Hoffer was hired by the Saskatchewan Department of Public Health in 1950 to establish a provincial research program in psychiatry, and joined the Regina Psychiatric Services Branch, Department of Public Health in 1951.  He remained the Director of Psychiatric Research until entering private practice in 1967.  Critical of psychiatry for its emphasis on psychosomatic psychoanalysis and for what he considered a lack of adequate definition and measurement, Hoffer felt that biochemistry and human physiology may be used instead. He hypothesised that schizophrenics may lack the ability to remove the hallucinogenic catecholamine metabolite adrenochrome from their brains.  Hoffer thought niacin could be used as a methyl acceptor to prevent the conversion of noradrenaline into adrenaline and that Vitamin C could be used to prevent the oxidation of Adrenaline to Adrenochrome. Hoffer called his theory the "adrenochrome hypothesis".

In 1967, Hoffer resigned some of his academic and administrative positions, entered into private psychiatric practice in Saskatoon, Saskatchewan and created the Journal of Schizophrenia (renamed the Journal of Orthomolecular Medicine in 1986).  Hoffer used the journal to publish articles on what he called "nutritional psychiatry", later orthomolecular psychiatry, claiming his ideas were consistently rejected by mainstream journals because they were unacceptable to the medical establishment.  In 1976, Hoffer relocated to Victoria, British Columbia and continued with his private psychiatric practice until his retirement in 2005. In 1994 Hoffer founded the International Society for Orthomolecular Medicine, holding its inaugural in Vancouver in April of the same year.   Hoffer continued to provide nutritional consultations and served as editor of the Journal of Orthomolecular Medicine. He was also President of the Orthomolecular Vitamin Information Centre in Victoria, BC.

Hoffer died at the age of 91 on May 27, 2009 in Victoria, British Columbia, Canada. His remains were buried in the Jewish Cemetery of Victoria.

Research
Working in Saskatchewan with Humphry Osmond (who coined the term "psychedelic"), Hoffer and other scientists sought to find medicinal uses for hallucinogenic drugs.  Part of the research involved Hoffer, Osmond and their wives consuming LSD in an effort to become better acquainted with, and better understand its effects, later joined by other experimenters and their wives.  Their work began attracting notoriety within professional, provincial and federal and political circles, and they were courted by the emerging movement to restrict peyote as well as Native American groups that used the substance in religious ceremonies.  Hoffer, Osmond and others treated alcoholics with LSD.  Canadian scientists reported a fifty percent success rate in one study, although Hoffer speculated that it was more likely the psychedelic experience of LSD, rather than simulated delirium tremens, that convinced the alcoholics to stop drinking.

While working at the Regina General Hospital in the 1950s, Hoffer and James Stephen examined the effects of large doses of niacin on various diseases, including schizophrenia; Hoffer theorized that adrenalin, when oxidized to adrenochrome was an endogenous neurotoxin that could cause schizophrenia.  At the same time, another Canadian working in Saskatoon, pathologist Rudolf Altschul, was exploring the use of high doses of niacin to lower cholesterol in rabbits and patients with degenerative vascular disease.  The three combined their work, and in 1955 produced a paper entitled "Influence of nicotinic acid on serum cholesterol in man."  The paper summarized their research showing high-dose niacin significantly lowered cholesterol in both high cholesterol patients as well as low cholesterol control subjects.  The results were replicated by researchers at the Mayo Clinic and in Germany the following year.  High-dose niacin has since become a treatment option for individuals with high blood cholesterol and related blood lipid abnormalities.

At such high doses niacin acts like a drug rather than a vitamin and may have side effects of intense flushing of the face and torso and, rarely, liver toxicity.  Hoffer continued to promote niacin as a treatment for schizophrenia, though this approach was not accepted by mainstream medicine.  Subsequent research suggested that Hoffer's adrenochrome theory had merit as people with schizophrenia have defects in the genes that produce glutathione S-transferase, which eliminates the byproducts of catecholamines from the brain.  Though Hoffer and Osmond reported nicotinic acid could help with the treatment of schizophrenia, these results could not be replicated by others.  Despite the apparent face validity of Hoffer's "transmethylation hypothesis" (in which it was thought that the production of catecholamines could sometimes go awry and produce a hallucinogenic neurotoxin),  it was ultimately rejected for two reasons: the alleged neurotoxins were never identified and the cause of schizophrenia became attributed to dysfunctions in neurotransmitters.

Controversy
Hoffer's claims regarding schizophrenia and his theories of orthomolecular medicine have been criticized. In 1973, the American Psychiatric Association reported methodological flaws in Hoffer's work on niacin as a schizophrenia treatment and referred to follow-up studies that did not confirm any benefits of the treatment,
prompting at least two responses.
Multiple additional studies in the United States, Canada, and Australia similarly failed to find benefits of megavitamin therapy to treat schizophrenia. The term "orthomolecular medicine" was labeled a misnomer as early as 1973. Psychiatrist and critic of psychiatry Thomas Szasz,  author of The Myth of Mental Illness (1961), called Hoffer's ideas about schizophrenia "pure quackery" and his claims "arrogant" for attributing the condition of mental illness to an unsubstantiated nutrient deficiency.

Publications

Footnotes