high doses of vitamins improved intelligence and educational performance in learning disabled children, including those with Down syndrome

"high doses of vitamins improved
intelligence and educational performance in
learning disabled children, including those with
Down syndrome"
The Pioneering Work of Ruth Flinn Harrel :
Champion of Children
(Reprinted with permission from the Journal of Orthomolecular Medicine, 2004. Vol
19, No 1, p. 21-26.)
The person who says it cannot be done should not interrupt the person doing it.
(Chinese proverb.)
Early in 1981, the medical and educational establishments were shaken to their
socks. Ruth F. Harrel and col eagues, in Proceedings of the National Academy of
Sciences (1), showed that high doses of vitamins improved intel igence and
educational performance in learning disabled children, including those with Down
syndrome. Though to many observers this seemingly came straight out of left field,
Dr. Harrel , who had been investigating vitamin effects on learning for forty years,
was not inventing the idea of megavitamin therapy in one paper. But she had at last
succeeded in focusing much-needed public attention on the role of nutrition in
learning disabilities, a problem that ink-wel -era US RDA's and pharmaceuticals by
the lunchbox-ful have failed to solve.
The start of the second World War was breaking news when Ruth Flinn Harrel
conducted her first investigations into what she cal ed "superfeeding." Her 1942
Columbia University PhD thesis, "Effect of Added Thiamine on Learning" (2), was
published by the university in 1943 and would be fol owed by "Further Effects of
Added Thiamine on Learning and Other Processes" in 1947 (3). Her research was not
about enriched or fortified foods; "added" meant "provided by supplement tablets."
World War II had just ended when Dr. Harrel stated in a 1946 Journal of Nutrition
article (4) that "a liberal thiamine intake improved a number of mental and physical
skil s of orphanage children." By 1956, Dr. Harrel had investigated "The Effect of
Mothers' Diets on the Intel igence of Offspring" (5), finding that "supplementation of
the pregnant and lactating mothers' diet by vitamins increased the intel igence
quotients of their offspring at three and four years of age."
THIAMINE (Vitamin B-1)
Most everyone has heard of beri-beri, and few are al that passionate about it
anymore. But beri-beri, which literal y means "I can't, I can't," may al too wel
describe the learning disabled child. Such children, recognized as truly disabled by
the Americans with Disabilities Act, are not unwil ing but rather unable to perform
wel in school. To see the physical incapacitation thiamine deficiency causes in
impoverished countries is al too easy. To see the mental incapacitation in American
classrooms is not difficult, either. Yet both may be caused by thiamine deficiency,
and both helped by thiamine supplementation. Harrel zeroed in on this topic sixty
years ago, demonstrating that supplemental thiamine improves learning. One
reporter wrote, "An experiment was conducted by Dr. Ruth Flinn Harrel which

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involved 104 children from nine to nineteen years of age. Half of the children were
given a vitamin B1 (thiamine) pil each day, and the other half received a placebo.
The test lasted 6 weeks. It was found by a series of tests that the group that was
given the vitamin gained one-fourth more in learning ability than did the other
group." (6)
Carbohydrates, including sugar, increase the body's need for thiamine. Children eat a
lot of sugar. An unmet increase is effectively the same as a deficiency. This may be
part of the mechanism of ADHD and other children's learning and behavior disorders,
as many so-cal ed "food faddists" or "health nuts" have proclaimed for decades.
Vitamin deficiency can become vitamin dependency. Chronic subclinical beri-beri may
result in thiamine dependency in the same way that chronic subclinical pel egra
results in niacin dependency.
B-COMPLEX
The B-vitamins as a group are absolutely vital to nerve function, and it would be
difficult to imagine the juvenile owner of malnourished nerves performing wel in
school. Specifical y, it is wel established that thiamine deficiency causes not only
loss of nerve function and ultimately paralysis, but also according to The Nutrition
Desk Reference (7), "memory loss, reduced attention span, irritability, confusion and
depression." (p 43) Riboflavin (B-2) deficiency causes "nerve tissue damage that
may manifest itself as depression and hysteria." (p 45) Niacin (B-3) deficiency
causes "loss of memory and emotional instability." (p 46) Pyridoxine (B-6) deficiency
results in "impaired production of neurotransmitters (and) mental confusion." (p 48)
Folic acid deficiency causes irritability, apathy, forgetfulness and hostility. (p 49).
Cobalamin (B-12) deficiency causes "degeneration of the spinal cord, fatigue,
disorientation, ataxia, moodiness, and confusion." (p 51)
Though these symptoms general y appear after prolonged deficiency, they are very
serious and, if untreated, the ultimate result in each case would be death. Practical y
speaking, a shortage of any one of the B-vitamins can be seen to lead to neurological
damage sufficient to contribute to learning and behavioral troubles.
Harrel recognized that thiamine and the rest of the vitamins work better as a team.
She used two clinical y effective but oft-criticized therapeutic nutrition techniques:
simultaneous supplementation with many nutrients (the "shotgun" approach), and
megadoses. Working on the reasonable assumption that learning disabled children,
because of functional deficiencies, might need higher than normal levels of nutrients,
she progressed from her initial emphasis on thiamine to later providing a wide
variety of supplemental nutrients.
DEFICIENCY DEBATE
The only escape from the inevitability of concluding that vitamin deficiency is a
serious factor in learning is the political one: declare a victory. Dodging the issue is
as easy as proclaiming that, thanks to food fortification (coupled with a generous
portion of wishful thinking), no child has such deficiencies. Though the processed
food industry and its apologists continue to assert exactly this, statistics fail to bear
this out.
An analysis of National Health and Nutrition Examination Survey (NHANES III) data
from 1988 to 1994 by Gladys Block, PhD, indicates that over 85 percent of American

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elementary school-age children fail to eat the recommended five or more daily
servings of fruits and vegetables. "NHANES III, a federal y sponsored survey shows
that on any given day, 45 percent of children eat no fruit, and 20 percent eat less
than one serving of vegetables. The average 6 to 11 year-old eats only 3.5 servings
of fruits and vegetables each day, achieving only half the recommended 7 servings
per day for this age group." (8) Additional y, Dr. Block reports, 20% of children's
caloric intake comes from junk snacks, such as soda pop, cookies, and candy.
Though it is a stretch to say that al learning and behavioral disabilities are due to
inadequate vitamin intake, it is certain that some are. Behavioral deficiency tends to
show up before nutritional deficiency is recognized. Arthur Winter, MD, writes that
"In thiamine (vitamin B1) deficiency, symptoms such as lack of wel being, anxiety,
hysteria, depression, and loss of appetite preceded any clinical evidence of beriberi.
Other studies using the Minnesota Multiphasic Personal Index (MMPI) have also
demonstrated that adverse behavioral changes precede physical findings in thiamine
deficiency." (9)
DOSAGE DEBATE
Dr. Harrel anticipated that her use of megadoses would result in "controversy and
brickbats." (10) She was right. A number of wel -publicized studies (11-15)
conducted to "replicate" Dr. Harrel 's work seemingly could not do so. Would-be
"replications" fail the moment they start when they refuse to use adequate dosages.
Surely it is the most basic condition for any replication that one must exactly copy
the original experiment, or it is not a replication at al . When DNA replicates, it forms
an exact and indistinguishable copy of the original. Even the smal est of changes can
result in dysfunction, mutation, and death. Yet Harrel 's "replicators" failed to adhere
to her protocol, and consequently but not surprisingly, failed to get her results. (16)
Probably one of the closer replications was done by Smith et al (17) and even that
study total y omitted dessicated thyroid, a component of the Harrel protocol that her
coauthor Donald R. Davis, PhD, says was "emphasized to Smith (as) Harrel 's
subjects received thyroid continuously." (18)
F. Jack Warner, MD, a supporter the Harrel approach (19) writes: "Even today many
medical professionals scoff at the validity of Dr. Ruth Harrel 's study with nutritional
supplements and the important addition of thyroid medication. Dr. Harrel pleaded
with her replicators to use exactly the same chemical values of supplements and
medications. To date, this stil has not been accomplished." (20) In spite of obvious
bias, negative "replication" studies using incomplete or low doses are the ones that
have been accepted, and Harrel 's work shelved. This is saying that the results of
inaccurate replication are more valuable than the original successful research.
Imagine cloning a sheep, getting a hedgehog, and then claiming that it was the
sheep's fault. Incredible. But that is what politicized medical apologetics are capable
of.
The Harrel study was successful because her team gave learning-disabled kids much
larger doses of vitamins than other researchers are inclined to use: over 100 times
the adult (not child's) RDA for riboflavin; 37 times the RDA for niacin (given as
niacinamide); 40 times the RDA for vitamin E; and 150 times the RDA for thiamine.
Supplemental minerals were also given, as was natural dessicated thyroid. Harrel 's
team achieved results that were statistical y significant, some with confidence levels
so high that there was less than on chance in a thousand that the results were due

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to chance (P < 0.001) Simply stated, Ruth Harrel found IQ to be proportional to
nutrient dosage. This may simultaneously be the most elementary and also the most
controversial mathematical equation in medicine.
There is a tone to the controversy that does more than merely suggest that Harrel 's
research was careless or incompetent. This is unlikely in the extreme; Dr. Harrel ,
formerly the chairman of the psychology department at Old Dominion University, had
been studying children before many of her critics were even born. What is more
likely is that Harrel 's critics embrace the assumption that medicine must ultimately
prove to be the better approach, and if there are any megadoses to be given, they
shal be megadoses of pharmaceutical products. Vitamin therapy is unattractive to
pharmaceutical companies. There is no money in products that cannot be patented.
Children learn at an early age that mud pies don't sel . No investment is made, no
research is done where no money is to be recovered. Drug companies do not expect
to find, nor do they want to find, a cure that does not involve a drug. A tragic
example is modern medicine's approach to Down syndrome.
DOWN SYNDROME
If there is orthodox resistance to using vitamins to enhance student learning, there is
positively a fortified roadblock to the suggestion that vitamins can help children with
Down syndrome. Nutrition, critics say, can not undo trisomy 21. But nutritional
therapy is not a science-fiction attempt to rearrange chromosomes. Nutritional
intervention may help the body to biochemical y compensate for a genetic handicap.
Roger Wil iams, discoverer of the vitamin pantothenic acid, termed this the
"genetotrophic concept." Genetotrophic diseases are "diseases in which the genetic
pattern of the afflicted individual requires an augmented supply of one or more
nutrients such that when these nutrients are adequately supplied the disease is
ameliorated." (1) Ruth Harrel 's decades of research showed that it is plausible.
Conventional Down syndrome educational material holds that it is hogwash.
As of August 2003, the National Down Syndrome Society's "Position Statement on
Vitamin Related Therapies" states that "Despite the large sums of money which
concerned parents have spent for such treatments in the hope that the conditions of
their child with Down syndrome would be bettered, there is no evidence that any
such benefit has been produced." (21)
At the heart of the issue are the usual, and largely philosophical, front-line
disagreements of definition and interpretation. First, what precisely constitutes a
"deficiency" in a society that, as nutritional legend would have it, has eliminated
vitamin deficiency? Adherents of conventional dietetics presuppose that anyone who
claims that there are widespread vitamin deficiencies among children must proceed
from a false assumption. Those who advocate vitamin therapy would answer that
Down's creates a "functional deficiency" which must be met with appropriate
supplementation. The very idea that doses sufficiently high to effectively do so
should be 100 times the RDA is positively repel ent to most investigators. When
asked about whether she had received National Institutes of Health funding for her
study, Dr. Harrel replied, "Heavens, no! Nobody knows anything about the area of
dietary supplementation, but the National Institutes of Health knows for sure it's
impossible." (10)
Some reviews of Down nutrition studies actual y state that doses as low as 500 mg
of vitamin C are unsafe, and that other Harrel -sized dosages are harmful as wel . In

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one such article posted at the Down Syndrome Information Network, the authors
conclude that "If it is necessary for additional vitamins to be given to someone with
Down syndrome, al that is usual y needed is a multivitamin tablet, not more than
once a day, at a cost of about one penny per tablet. Meanwhile, the best nutritional
advice anyone can honestly offer is to consume a varied and balanced diet - whether
you have Down syndrome or not." (22)
Another popular argument is that, even al owing that children eat poorly, there is
insufficient evidence that Downs is aggravated by poor nutrition, or helped by good
nutrition. After al , Downs is a genetical y-determined disease. But surely the genes
do not operate in a nutrient vacuum. For example, vitamin E has recently been
demonstrated to preferential y protect genetic material in Down patients' cel s.
"Vitamin E treatment decreased the basal and G2 chromosomal aberrations both in
control and Down Syndrome (DS) lymphocytes. In DS cel s, this protective effect,
expressed as a decrease in the chromosomal damage, was greater (50%) than in
controls (30%). These results suggest that the increment in basal and G2
aberrations yield in DS lymphocytes may be related to the increase in oxidative
damage reported in these patients." The results would also suggest that antioxidant
vitamin supplements would be an especial y good idea for Down's individuals. (23)
Although the greater question may be, can optimum nutrition help compensate for a
genetic defect, the essential question must be this: can nutrition help a given Downs
child? Dianne Craft, a special education teacher, comments on Harrel 's 1981
research:
"Dr. Harrel noted that one of the observations that they made during this study was
that when there was a ten point rise in IQ, the family noticed it. When there was a
fifteen point rise in IQ, the teachers noticed it. When there was a twenty point rise in
IQ, the neighborhood noticed it.
"The story of one child is particularly poignant. This seven year old child was stil
wearing diapers, didn't recognize his parents, and had no speech. His motor skil s
were relatively unimpaired and he could walk and run fairly wel . In forty days, after
some of the supplements were increased, his mother telephoned. . . saying, "He's
turned on, just like an electric light. He's asking the name of everything. He points
and says, 'What zis?' Final y he pointed to his father and said, 'zis?' I said, 'That's
your father and you cal him daddy, and he looked at him and said 'daddy.' I'm your
mother; can you cal me mommy?" She went on to say, "I think he saw us for the
first time." This little boy went on to do very wel in his learning, and eventual y
tested with an IQ of ninety, which an average IQ." (24) I have seen a beautiful photo
in Medical Tribune (9) of Dr. Harrel being hugged by one of the study group
children. The kids noticed their own improvement.
Perhaps Harrel 's dramatic IQ gains were merely due to the placebo effect. If so, I
want every school district on earth to lay in a stock of sugar pil s, for gains like this,
in only eight months, are astounding. Perhaps success was due to Dr. Harrel 's
group's expectations or to her bedside manner. But, as Abram Hoffer has said, "I am
nice to al my patients. Only the ones on vitamins improve." Harrel col eague Donald
Davis writes, "No amount of matching or variable control with Harrel 's subjects could
change their large IQ gains which are the crucial and so far unexplained difference
between the Harrel group and others." (25)
When Dr. Harrel died in 1991, she was far from being alone in reporting success

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with high-dose nutrition therapy. Dianne Craft writes, "For over forty years, Dr.
Henry Turkel (26, 27) treated Down's children successful y using orthomolecular
methods. He used a combination of vitamins, minerals, and thyroid hormone
replacement. His patients improved mental y and they lost the typical Down's
syndrome facial appearance. With over 600 children treated, he found an eighty to
ninety percent improvement rate." (24)
To date, the orthodox Down authorities' position may be summed up as, there is no
evidence that it helps, so do not try it. Dr. Harrel 's view would be, there is reason to
believe that nutrition might help, so let's see if it does. The first view prevents
physician reports. The second generates them.
Theorization can only go so far. The proof is in the pudding, and Ruth Flinn Harrel 's
approach yielded smarter, happier children. Her results are sufficiently compel ing
justification for a therapeutic trial of orthomolecular supplementation for every
learning-impaired child.
References:
1. Harrel RF, Capp RH, Davis DR, Peerless J, and Ravitz LR. Can nutritional
supplements help mental y retarded children? An exploratory study. Proc Natl Acad
Sci USA, 1981. 78: 574–8.
2. Harrel RF. Effect of added thiamine on learning. NY: Bureau of Publications,
Teachers Col ege, Columbia University, 1943. Issued in the series: Contributions to
education, no. 877. Reprinted: New York, AMS Press, 1972. ISBN: 0404558771.
3. Harrel RF. Further effects of added thiamine on learning and other processes. NY:
Bureau of Publications, Teachers Col ege, Columbia University, 1947. Issued in the
series: Contributions to education, no. 928. Reprinted: New York, AMS Press, 1972.
ISBN: 040455928X.
4. Harrel RF. Mental response to added thiamine. J Nutrition, 1946. 31:283.
5. Harrel RF, Woodyard E and Gates AI. The effect of mothers' diets on the
intel igence of offspring. Also known as: Relation of maternal prenatal diet to
intel igence of the offspring. NY: Bureau of Publications, Teachers Col ege, Columbia
University, 1956.
6. Dr. Ruth Flinn Harrel : Effect of added thiamine on learning." The Health Seeker, p
18-19. http://www.geocities.com/HotSprings/2194/vitamin.html
7. Garrison RH and Somer E. The Nutrition Desk Reference. New Canaan, CT: Keats,
1990.
8. http://www.eurekalert.org/pub_releases/2002-05/pn-akp051602.php 16 May,
2002. Accessed August, 2003.
9. Winter A. Differential diagnosis of memory dysfunction: Finding the cause when
your patient can't remember. http://www.afpafitness.com/articles/Memory.htm
Accessed August, 2003.
10. Horwitz N. Vitamins, minerals boost IQ in retarded. Medical Tribune. Vol 22, No

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3. Wednesday, 21 January, 1981. Pages 1 and 19.
11. Bennett FC, McClel and S, Kriegsmann EA, Andrus LB, Sel s CJ. Vitamin and
mineral supplementation in Down's syndrome. Pediatrics. 1983 Nov; 72(5):707-13.)
12. Bidder RT, Gray P, Newcombe RG, Evans BK, Hughes M. The effects of
multivitamins and minerals on children with Down syndrome. Dev Med Child Neurol.
1989 Aug;31(4):532-7.)
13. Menolascino FJ, Donaldson JY, Gal agher TF, Golden CJ, Wilson JE, Huth JA,
Ludvigsen CW, Gil ette DW.) Vitamin supplements and purported learning
enhancement in mental y retarded children. J Nutr Sci Vitaminol (Tokyo). 1989
Jun;35(3):181-92.
14. Smith GF, Spiker D, Peterson CP, Cicchetti D, Justine P. Failure of
vitamin/mineral supplementation in Down syndrome. Lancet, 1983. 2:41.
15. Weathers C. Effects of nutritional supplementation on IQ and certain other
variables associated with Down syndrome. Am J Ment Defic. 1983 Sep;88(2):214-7.
16. Pruess JB, Fewel RR, Bennett FC. Vitamin therapy and children with Down
syndrome: a review of research. Except Child. 1989 Jan;55(4):336-41.
17. Smith GF, Spiker D, Peterson CP, Cicchetti D, Justine P. Use of megadoses of
vitamins with minerals in Down syndrome. J Pediatr. 1984 Aug;105(2):228-34.
18. Davis DR and Capp RH. Vitamins and minerals in Down Syndrome. J Pediatr.
1985 March;106(3):531.
19. Thiel R.J. Facial effects of the Warner protocol for children with Down syndrome.
Journal of Orthomolecular Medicine, 2002;17(2):111-116
20. Warner FJ. Metabolic supplement for correction of raging free radicals in Trisomy
21: A noncomparative open case study. http://www.warnerhouse.com/radicals.htm .
Accessed August, 2003.
21. http://www.ndss.org/content.cfm?fuseaction=SearchLink&article=45 . Accessed
August, 2003.
22. Sacks B and Buckley F. Multi-nutrient formulas and other substances as
therapies for Down syndrome: An overview. Down Syndrome News and Update,
1998. 1(2), 70-83.
http://www.down-syndrome.info/library/periodicals/dsnu/01/2/070/DSNU-01-2-070-
EN-GB.htm
23. Pincheira J, Navarrete MH, de la Torre C, Tapia G, Santos MJ. Effect of vitamin E
on chromosomal aberrations in lymphocytes from patients with Down syndrome. Clin
Genet. 1999 Mar;55(3):192-7.
24. Craft D. Can nutritional supplements help mental y retarded children? 1998.
http://www.diannecraft.com/nut-sup1.html Accessed August, 2003.

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25. Davis DR. The Harrel study and seven fol ow-up studies: A brief review. J
Orthomolecular Medicine, 1987. 2:2, 111-115.
26. Turkel H. Medical amelioration of Down's syndrome incorporating the
orthomolecular approach. Journal of Orthomolecular Psychiatry, 1975. 4:102-115.
27. Turkel H. The medical treatment for Down's syndrome. Southfield, MI: Ubiotica.
1985.
Andrew Saul, Number 8 Van Buren Street, Hol ey, New York 14470 USA Telephone
(585) 638-5357

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