Dear Friends,
Many readers of Orthomolecular Medicine News Service (OMNS) articles have written to us with thoughtful comments, questions, and reflections. OMNS does not currently have a Q&A or reader response section. Therefore, I will begin publishing selected letters and my replies here on my Substack.
This way, we can have a more open exchange of ideas, clarify important points, and explore together the many facets of health, nutrition, and integrative medicine.
Below are a few recent letters I’ve received, along with my replies.
1. On Vitamin D Guidelines
Reader:
With Vitamin D the US recommends 600 IU, yet when one gets a blood test it is fine to be between 20–100. Big difference. Which is right?
My Reply:
This is an excellent observation. The official “normal” range (20–100 ng/ml) is wide, but in clinical practice, optimal health is rarely seen at 20–30 ng/ml. Most orthomolecular physicians (myself included) recommend maintaining 50–100 ng/ml. To achieve this, daily intakes of 5,000 IU (or more, depending on individual response) are often needed. The 600 IU “recommendation” is outdated and insufficient for immune support, bone health, or chronic disease prevention.
2. On Autoimmune Disease & Vitamin D
Reader:
I have an autoimmune disease. My doctors warn me against taking more than 1,000 IU of Vitamin D per day. What do you think?
My Reply:
Autoimmune patients often need much more than 1,000 IU/day. In fact, in protocols such as the Coimbra Protocol, daily doses can reach 30,000 IU or more under close medical supervision, with regular monitoring of calcium, PTH, kidney, and liver function. This type of therapy must always be done under the care of an experienced physician. In my own practice, I routinely treat autoimmune patients with higher doses of Vitamin D, and with careful monitoring, I have seen excellent clinical results. For most patients, 1,000 IU/day is simply far too low.
3. On Vitamin C for the Common Cold
Reader:
Does vitamin C really work against colds? My doctor says it’s just expensive urine.
My Reply:
This is one of the oldest criticisms—but it ignores the science. Vitamin C has been shown repeatedly to reduce both the duration and severity of colds when taken in sufficient amounts (grams, not milligrams). The “expensive urine” argument misunderstands physiology: vitamin C is water-soluble, and the body excretes excess only after tissues are saturated. That’s how you know you’ve taken enough. My advice: don’t worry about the urine—focus on the benefits!
4. On Diet & Blood Sugar
Reader:
I’ve been told by my endocrinologist that diet doesn’t matter much for Type 2 diabetes, only medications. Do you agree?
My Reply:
I strongly disagree. Type 2 diabetes is fundamentally a disease of carbohydrate intolerance. Drugs can reduce blood sugar, but they do not reverse the underlying problem. A low-carbohydrate or ketogenic diet, combined with nutritional optimization, can often normalize blood sugar, reduce or eliminate the need for medication, and dramatically improve long-term outcomes.
However, diabetes is not just a “high sugar disease.” It is also a disease of micronutrient insufficiency and toxin overload. Addressing these factors—through targeted supplementation, detoxification strategies, and lifestyle changes—provides a much more complete and lasting solution. Medications manage numbers; diet, nutrients, and lifestyle address root causes.
5. On Cholesterol & Heart Disease
Reader:
Why do doctors still prescribe statins when dietary cholesterol is no longer restricted by the AHA?
My Reply:
This is one of the great contradictions of modern cardiology. The American Heart Association (AHA) quietly removed restrictions on dietary cholesterol in 2015, acknowledging that dietary cholesterol has little impact on blood cholesterol. Yet, the pharmaceutical focus on statins continues. Why? Largely because of entrenched guidelines, industry influence, and inertia.
A more rational approach emphasizes inflammation, oxidative stress, micronutrient deficiencies, and lifestyle—not just cholesterol levels. I have written about this extensively in the Orthomolecular Medicine News Service (OMNS), including:
These articles provide deeper context on how cholesterol has been misunderstood, why statins are over-prescribed, and how an orthomolecular and integrative approach can better address the true root causes of atherosclerotic cardiovascular disease.
6. On Prayer, Peace & Healing
Reader (Rev. Dr. Stephen A. Lawrence):
I would love to see a revival of prayer, joy, peace, forgiveness, faith, hope, and love in the solutions to our health problems. Blessings to you and the whole organization.
My Reply:
Thank you, Rev. Dr. Lawrence. I couldn’t agree more. Health is not only biochemical but also emotional, spiritual, and relational. Prayer, joy, forgiveness, and love have profound physiological effects—lowering stress hormones, improving immune function, and promoting healing. Integrative medicine must embrace the whole person, not just lab results. Blessings to you as well.
7. On Cancer Therapies (Re: Rasnick’s Book)
Reader (Samuel in NL):
Very interesting, thanks. Unfortunately, the book is too expensive. Since my spouse has dealt with cancer twice in her 72 years, as well as three of my close neighbors, the cause and practical treatment/cure is of great interest to me.
In NL, the mutation-based theory seems to be accepted; however, the individual -nibs/-nabs appear to be too expensive for the state-supported health care system. So most folks always get 5FU/Oxiplatin/Gemcitabine/etc. as 1st line, and the specific tumor mutations—if ever identified—are not referenced until 2nd/3rd line therapy.
Take care, dear Dr. And best regards.
My Reply:
Thank you, Samuel. Your observations highlight a global problem: the dominance of the mutation-based, targeted-drug paradigm, which is both expensive and often limited in effectiveness. Meanwhile, safe, cost-effective strategies—like metabolic and nutritional therapies—are sidelined or ignored.
In fact, this is exactly the theme of my upcoming cancer debate with Dr. Dave Rasnick, hosted by Children’s Health Defense tomorrow. While he emphasizes chromosomal changes, and others focus on genetic mutations, my view is that these are downstream effects—the “wreckage” rather than the “wrecking ball.”
From an Integrative Orthomolecular Medicine (IOM) perspective, cancer is best understood as a disease of mitochondrial dysfunction, oxidative stress, toxin overload, and micronutrient deficiencies. These upstream drivers damage the body’s terrain, eventually producing mutations and chromosomal instability. If we focus only on mutations, we miss the initiating causes that are actually modifiable.
This root-cause approach does not reject conventional care but expands it:
Metabolic support (restricted ketogenic diet, fasting strategies).
High-dose nutrient therapies (Vitamin C, D, niacin, magnesium, etc.).
Detoxification and infection control.
Hormonal and immune balance.
By repairing the terrain, we not only reduce cancer risk but can also improve outcomes even during conventional treatment. This broader view offers patients real hope, especially in settings where mutation-targeted drugs are unaffordable or inaccessible.
The presentation of both Dr. Rasnick and myself will be made public shortly, so readers will be able to see our perspectives side by side.
Closing Thoughts
Thank you to all who wrote to me. Your questions and reflections help keep this conversation alive and grounded in real-world experiences.
As I continue publishing with OMNS, I’ll use Substack as the platform for dialogue and Q&A. Please keep your letters coming—I’ll feature as many as possible in future posts.
Together, we can advance the conversation on health, nutrition, and integrative medicine beyond narrow guidelines and toward true patient-centered care.
— Richard Z. Cheng, M.D., Ph.D.
About the Author
Richard Z. Cheng, M.D., Ph.D. – Editor-in-Chief, Orthomolecular Medicine News Service
Dr. Cheng is a U.S.-based, NIH-trained, board-certified physician specializing in integrative cancer therapy, orthomolecular medicine, functional, and anti-aging medicine. He maintains active practices in both the United States and China.
A Fellow of the American Academy of Anti-Aging Medicine and a Hall of Fame inductee of the International Society for Orthomolecular Medicine, Dr. Cheng is a leading advocate for nutrition-based, root-cause health strategies. He also serves as an expert reviewer for the South Carolina Board of Medical Examiners, and is the co-founder of both the China Low Carb Medicine Alliance and the Society of International Metabolic Oncology.
Dr. Cheng also offers online Integrative Orthomolecular Medicine consultations.
📰 Follow his latest insights on Substack: https://substack.com/@rzchengmd