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This article may be reprinted free of charge provided 1) that there is clear attribution to the Orthomolecular Medicine News Service, and 2) that both the OMNS free subscription link http://orthomolecular.org/subscribe.html and also the OMNS archive link http://orthomolecular.org/resources/omns/index.shtml are included. FOR IMMEDIATE RELEASE
Holiday Greetings & Reflections from OMNSRichard Z. Cheng, M.D., Ph.D.
As we are in the holiday season, I would like to take this opportunity-on behalf of the Orthomolecular Medicine News Service (OMNS)-to express my sincere gratitude to our global community. OMNS exists because of you. First and foremost, I thank our readers, who come from around the world-clinicians, researchers, scientists, educators, and engaged members of the public-united by a shared commitment to orthomolecular, nutritional, and integrative approaches to health and healing. I also wish to express my deep appreciation to our authors and contributors, whose articles, commentaries, reviews, and letters form the intellectual backbone of OMNS. Your willingness to think independently, challenge assumptions, and share evidence-informed perspectives is what keeps OMNS vibrant and relevant. My sincere thanks as well to our Board of Editors (BOE) for their scholarly guidance and stewardship, and to our technical and editorial staff, whose behind-the-scenes efforts ensure that OMNS remains accessible and reliable. Finally, I would like to acknowledge and thank the Riordan Clinic, which graciously hosts the OMNS website and has long served as an institutional pillar of orthomolecular medicine. A Call for Contributions: OMNS as a Clinically Grounded Scholarly ForumOMNS remains an open platform for thoughtful exchange. We warmly invite submissions from clinicians, researchers, and informed professionals worldwide. Types of articles OMNS publishes include (but are not limited to):
We welcome both concise clinical observations and more in-depth scholarly discussions, provided they remain grounded in clinical relevance, real-world experience, and sound reasoning. The Clinician's Starting Point: The Patient, Not the MoleculeAs a practicing clinician, my primary responsibility has always been-and remains-the patient in front of me. Not a molecule.
Mechanisms matter. Biochemistry matters deeply. But in clinical medicine, mechanisms are means, not ends. Patients do not present with "pathway deficiencies" or "single-molecule failures"; they present with complex, overlapping, and evolving patterns of dysfunction, shaped by nutrition, metabolism, environment, hormones, immune function, lifestyle, stress, and medical history. This clinical reality is one of the central reasons OMNS has increasingly emphasized integrative and root-cause-oriented thinking. Root Drivers vs. Mechanisms: A Necessary Clinical DistinctionSome readers have commented that the "10 Root Drivers" framework [1] may appear complex. A brief clarification may therefore be helpful. The 10 root drivers are not intended to imply that every patient has all ten, nor are they meant to function as a rigid checklist. Rather, they represent distinct categories of upstream causal forces-conceptual groupings that help clinicians and researchers systematically look for potential root causes of chronic disease. In clinical practice, a given patient may have only a few dominant drivers, while others may be minimally relevant or absent altogether. The value of categorization lies not in labeling patients, but in preventing blind spots-ensuring that major domains of causation are not overlooked simply because they fall outside a single specialty, pathway, or laboratory marker. It is also not uncommon-for physicians, scientists, and lay readers alike-to confuse root drivers (causes) with biological mechanisms. This distinction is critical. For example, mitochondrial dysfunction in cancer or chronic disease is a mechanism, not a root cause. Likewise, intestinal dysbiosis or "leaky gut" is not a root cause; it is an intermediate pathophysiologic state (a mechanism) arising from upstream drivers such as antibiotic overuse, dietary toxins, chronic metabolic stress, or environmental exposures, and contributing downstream to inflammation, immune dysregulation, and disease progression, which may manifest clinically as conditions such as autoimmune disease. Mechanisms describe how disease unfolds. Root drivers explain why those mechanisms were set in motion in the first place. Confusing the two leads to interventions that manage downstream effects while leaving upstream causes untouched. Making this distinction-between causes and mechanisms-is essential if our goal is not merely to describe disease, but to prevent it, reverse it when possible, and restore health at its roots. On Integration, Perspective, and EvolutionSome readers have observed that OMNS in recent years has placed greater emphasis on integration, systems thinking, and root-cause analysis. This is accurate, and it reflects my own evolving clinical perspective rather than a retrospective claim about the entire history of orthomolecular medicine. Orthomolecular medicine emerged from biochemical insight and nutrient-based intervention. Over time, however, sustained clinical practice has made one thing increasingly clear to me: nutrients never act in isolation, and neither do patients' problems. What appears, on paper, to be a "vitamin deficiency" or a "metabolic abnormality" is almost always embedded within a larger clinical context-one that cannot be adequately understood by examining a single molecule or mechanism alone. Thus, while OMNS continues to value rigorous biochemical and mechanistic work, it has increasingly emphasized integration across systems, because that is how patients actually heal. Mechanisms Matter-but They Do Not LeadConventional medicine has become extraordinarily adept at describing mechanisms, targets, and molecular steps, yet it often remains focused on downstream manifestations rather than upstream drivers. From a clinician's standpoint, the more useful questions are often broader:
Orthomolecular medicine, when practiced integratively, restores the proper hierarchy:
This does not diminish basic science or mechanistic research; rather, it places them within the framework of clinical science, where biological mechanisms are interpreted in context and applied in service of healing, rather than treated as abstractions detached from lived clinical reality. A Note on AI and the Writing ProcessSome readers have asked about the role of artificial intelligence (AI) in writing and content development at OMNS. I would like to address this openly. Yes, I use AI as a tool-for organization, refinement, and clarity-not only in writing OMNS editorials and articles, but also in the preparation of patient consultation reports. AI does not generate the ideas, clinical judgments, or integrative frameworks expressed in these materials. Over the past several years, I have deliberately trained and refined an AI model to assist my work-one aligned with the way I already think clinically: patient-centered, integrative, orthomolecular, and root-cause-based. In this sense, AI functions as an extension of the clinician's reasoning process, helping to organize complex information and communicate it more clearly, rather than a substitute for clinical thinking. Responsibility for all viewpoints, interpretations, clinical recommendations, and conclusions published in OMNS-and provided to patients-remains entirely human, professional, and mine. Looking AheadSome integrative and philosophical discussions naturally exceed the scope of short news pieces. OMNS will continue to serve as a platform for introducing and refining these ideas, while more detailed mechanistic and disease-specific analyses will follow in appropriate formats. In parallel, some of these broader integrative and philosophical discussions are also being developed as part of a longer-form, clinician-authored book project, 21st Century Medicine, focused on integrative orthomolecular medicine and intended to complement-rather than replace-the ongoing work of OMNS. Integration comes first not because mechanisms are unimportant, but because patients do not arrive in mechanistic fragments. Closing ThoughtsOrthomolecular medicine is not merely about nutrients and doses. It is a clinical discipline, grounded in biochemistry, informed by systems thinking, and guided-above all-by the needs of the patient. As we move into a new year, OMNS remains committed to:
Thank you for your continued trust, engagement, and support. I wish you and your families a healthy, peaceful, and reflective holiday season. Richard Z. Cheng, MD, PhD
References:1. Cheng, R. Z. From Mutation to Metabolism: Root Cause Analysis of Cancer's Initiating Drivers. Preprints 2025, 2025090903. https://doi.org/10.20944/preprints202509.0903.v1 Orthomolecular MedicineOrthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org Find a DoctorTo locate an orthomolecular physician near you: http://orthomolecular.org/resources/omns/v06n09.shtml The peer-reviewed Orthomolecular Medicine News Service is a non-profit and non-commercial informational resource. Editorial Review Board:
Jennifer L. Aliano, M.S., L.Ac., C.C.N. (USA)
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