Summary of clinical factors:
- “Methyls” are one-carbon methyl groups which play an important role in the function of the body’s biochemistry. They change the shape and behaviour of organic molecules through methylation processes or “pathways”.
- Expression of genes is regulated individually by epigenetic methylation markers on the DNA or in groups by the methylation of DNA histone bundles. Higher methylation levels at the individual genes or the histone groups reduces the expression of these genes.
- In the context of brain function and mental health, methylation status specifically affects expression of the genes for re-uptake proteins which regulate dopamine and serotonin levels at the neuronal synapse.
- People known as “overmethyators” (OMs) have methylation pathways with excess methyl groups in circulation, which increases epigenetic methylation. These people can have an excess of those neurotransmitters at the synapse.
- People known as “undermethylators” (UMs) can have the opposite predicament, with a lack of those neurotransmitters at the synapse.
- Either an excess or a lack (“imbalance”) of these neurotransmitters can affect brain function and lead to different clusters of mood disorder symptoms. These clusters of symptoms historically tend to be grouped together as either “Depression”, “Anxiety”, or “Schizophrenia” in the DSM diagnostic system.
- Folates reduce epigenetic methylation at the DNA and promote reuptake gene expression. OMs will do better, UMs will do worse. This is despite folates generally adding methyls to the methylation cycle hence the “folate paradox”.
- Methyl donor supplements like SAMe have the opposite effect, similar to SSRIs but in a different way. UMs will do better, OMs will do worse. This seems to be the reason for the severe worsening of symptoms when either is given to OMs.
- These clinical considerations are the reason why testing for methylation status is optimal to enhancing diagnosis and treatment.
Key technical points:
- Histones and genes on DNA have both acetyls (Ac) and methyls (Me) attached which make up the epigenetics that affect gene transcription.
- The balance of Ac and Me at any DNA area will determine gene expression. On DNA itself, more Me than Ac is an epigenetic “off” switch to transcription. The gene will not be expressed into a protein or enzyme, or to a lesser degree.
- The histones also have Ac and Me, and this regulates general chromatin open/closed configuration. Here, more Me than Ac creates a closed configuration. Closed means a bunch of genes together in the affected histones are less likely to be expressed.
- Therefore more Me than Ac generally tends to switch off genes, either individually on DNA or in bunches at the histones. These effects combine to make some genes more or less expressed than others depending on the overall sum of methylation and acetylation at each point.
- Nutrient therapy and nutrition in general can affect histone methylation more easily but slowly, and individual gene methylation is more permanent at the moment. Individual gene epigenetic methylation can be changed during early pregnancy in the fetus or later in life or through oxidative stress effects on DNA , but this latter is apparently a more random effect.
Images below from a powerpoint presentation By Dr Walsh
In the 1950s Dr Hoffer observed initially the success of niacins and folates treatments in people with the then current schizophrenia diagnosis, and deleterious effects of methionine. This was not satisfactorily explained and constituted a stumbling block in adoption of his treatment methods. Later came refinements from further clinical research which distinguished the two depression/psychosis groups of under/overmethylation (UM/OM) or histadelia/histapenia which are opposite in their treatments and contraindications.
Signs and symptoms of UM are those of the negative symptoms of schizophrenia (catatonia, etc) while those in OM are the positive ones (hallucinations, etc). These are consistent with the dopamine effects which are conventionally posited for these illnesses, which are seen as umbrella terms for diverse biochemical conditions according to the Walsh/Pfeiffer/Hoffer paradigm.
It’s really the methylation aspect which is key to the understanding of this it seems. There is a recently developing field devoted to nutrigenomics as they pertain to Single Nucleotide Polymorphysims (SNPs) on the DNA of methylation pathway enzymes which concords with this except in the key area of Mental Health/brain disorders which is the focus of the Walsh Research Institute (WRI).
Depressed or psychotic people with UM diagnoses respond well to SAMe or its precursor methionine whereas similar DSM labeled people with OM diagnoses react very badly, as in the unpredicatble SSRI response. SAMe is the major methyl donor to the methylation cycle and as such it was thought that this increased serotonin and dopamine levels, UM having too little and OMs having too much.
There was the puzzle of the folate paradox however, as folates are generally methyl donors and they tend to make UMs worse when the opposite effect is observed. With the advent of epigenetics came the answer: It really seems to be about DNA methylation marker effects on the reuptake proteins and histone configuration which are dominant in their effect.
The focus has shifted to the greater effect of reuptake over production, as folates are seen to remove methyl markers from individual gene markers and histone tails and therefore promote the expression of these reuptake proteins causing lower levels in the synapses. This is, of course, inference from observed clinical effects and current general research. Niacins, on the other hand, cause overall methyl levels to lower and are seen to have a similar effect on the histone tails.
This is why histadelia which is diagnosed from high levels of the indirect Whole Blood Histamine (WBH) marker is now known in Walsh terminology as undermethylation, and histapenia (low levels of WBH) is know as overmethylation or even more simply folate deficiency (folates are the main treatment). When dealing with the Lynch/Yasko paradigms the terminology can get tricky but this is resolved when one remembers this is in the separate domain of brain function and neurotransmitters.