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ME Diagnosis and Genetic Testing and also, Gratitude

Valentijn

Senior Member
Messages
15,786
I'm homozygous for:
COMT V158M
COMT H62H
V158M means that gene function is at one-third of the "normal" rate. But it's also extremely common, and probably doesn't directly cause problems. Where it might cause problems is if production of those neurotransmitters isn't also slow. 20% of the general population is +/+ for that one, and it's certainly not causing widespread problems.

H62H doesn't result in any change in the coded protein. It also has an identical prevalence rate to V158M in some populations, and is very close in the other populations. Hence it's probably in strong linkage disequilibrium with V158M, so any association it has with gene function is probably actually due to V158M.
This one is a non-coding and mild down-regulation. All versions are pretty common. It shouldn't be doing much.
MAO A R297R
This one also shouldn't be doing much, and is again non-coding and extremely common to be +/+.
MTRR A66G
When homozygous, enzyme activity is reduced to 30% of optimal. So B12 and/or eating meat is probably a good idea.
CBS C699T
Congratulations, +/+ is the mildly faster, safer version :thumbsup: You're one of the lucky 10% who get it.
I know the heterozygous results are less important, but reading up on a few of them individually, some cause enough of a change in the gene expression to be significant:
MTHFR C667T
MTHFR A1298C
C677T +/- means that conversion of folic acid into methylfolate is at about 65% of the usual rate. A1298C can lower that to about 30%, but only if it's on the opposite strand (from a different parent) compared to the C677T. Either way, supplementing a low dose of an active folate, or eating a decent amount of veggies in your diet, should compensate for it completely.
MTRR A664A
No impact when heterozygous, and Yasko got it backwards. +/+ is the better version for methylation.
This one doesn't matter at all when heterozygous (and is another one which Yasko got backwards).
I also got 'no call' on CBS A360A. Not 'not genotyped' - 'no call'. :)
Just as well, since there's no risk factor associated with any version of A360A :p
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
@Valentijn - In case I don't say it enough, you are awesome. <3 Thanks!

What is your bg? Are you a geneticist? Mine is in chem and I find myself at loose ends with all the squishy stuff sometimes.

-J
 

Valentijn

Senior Member
Messages
15,786
@Valentijn - In case I don't say it enough, you are awesome. <3 Thanks!

What is your bg? Are you a geneticist? Mine is in chem and I find myself at loose ends with all the squishy stuff sometimes.
Nope, though I loved chemistry in high school ... took a 2nd class in it during high school instead of taking physics :p I'm a (non-practicing) lawyer.

But basically I've been immersing myself in biochemistry since I got sick when I started having a lot of frustration with doctors. And I have been delving into genetic aspects for the past year or two. I've taken several free Coursera courses on it, and picked up quite a bit via extensive reading, exploring various genetic sites, and sheer stubbornness.

The most important thing I've learned regarding SNPs is to Trust No One :cautious: Basically there's a zillion claims on the internet, most of which are unsupported by the research, and sometimes even contradicted outright by the research. The result is that people often think that a very common non-coding variant of a SNP is causing their symptoms, and they just need to "treat" it.

My current goal is to fight that misinformation by creating a report featuring methylation and related SNP data, with all of the actual sources listed at the end of that report. Of course, some of the for-profit report-generators will probably grab that data immediately and add it to their own paid reports, but at least it'll still be available for free as well from my program :p
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
Trust No One, lol. I understand.

At least Prom. has a number now to show you how much they 'trust' the information they're telling you - like how certain they are that having the SNP is detrimental. They also include frequency of the SNP so it's easy to say, "yes, they're certain there's an increased risk of high cholesterol with this SNP, but 21% of people have it, so I just have to eat healthily" because 21% of the people in the world aren't dropping dead of a heart attack at age 45. Finally, they also link you back to pubmed so you can examine the data yourself. :) It's helpful.

I dunno, you could put a paypal with a donation box there. At least then people who had the money to spare could drop some in there, but it would still be available to the people who didn't.

-J
 

Valentijn

Senior Member
Messages
15,786
They also include frequency of the SNP so it's easy to say, "yes, they're certain there's an increased risk of high cholesterol with this SNP, but 21% of people have it, so I just have to eat healthily" because 21% of the people in the world aren't dropping dead of a heart attack at age 45.
Yes, I find this useful at times - such as when someone gets hysterical about having a non-coding synonymous mutation which is present in 50% of the world's population. But conversely, people can get overly excited about rare genotypes which have no effect at all, or no research indicating anything one way or the other.

I don't mind this so much in the rare SNP program ( http://sourceforge.net/projects/analyzemygenes/ ) because it's pretty obvious that no one has 50-150 SNPs which all mean they're about to drop dead, and because literally everyone has a bunch of rare SNPs. So it some ways it's a good way to ruthlessly expose people to the concept that having rare SNPs is completely normal, and maybe even makes the common-as-dirt SNPs a bit less scary in the process. Maybe :rolleyes: But showing just a few very rare SNPs in a non-rare report might just contribute to the over-excitiment.

My current approach for the report I'm creating is to use color coding and a brief indication of the impact of a mutation. For example, on the CBS gene there are a few SNPs where having the rare version is beneficial. I color those green, instead of the default white for the normal/common version of each SNP. Hence it's not telling 90% of the population with +/+ or +/- that they're somehow at a disadvantage when they're really just normal.

And I'm using red for outright disease-causing mutations, orange for mutations which have a large impact on gene function, and yellow for mild but statistically significant impairment in gene function. And then when there's studies showing the exact impact of a SNP on gene function, there's a little message like "82% reduction in gene function" in addition to the color coding. However, most of the "yellow" SNPs are based on weaker evidence, such as a possible correlation with increased risk of an associated disease.

Also, a homozygous mutation being pathogenic usually does not mean that the heterozygous is doing anything at all. But it does reflect that there could be a compound heterozygous missense mutation, so is still flagged yellow and labeled as a caution to look at that result and see if there's another one that could be teaming up with it to cause problems. Yet it should be clear that the heterozygous mutation is not a problem in its own right and does not require "treatment".
I dunno, you could put a paypal with a donation box there. At least then people who had the money to spare could drop some in there, but it would still be available to the people who didn't.
My fiance and I have discussed it in the past, and both agree that we don't want to ask for donations. People using this sort of utility are usually struggling enough, and those with serious illnesses have enough problems and guilt in their lives without suggesting that they should do the "right thing" and pay up.
 

Gondwanaland

Senior Member
Messages
5,095
Yes, I find this useful at times - such as when someone gets hysterical about having a non-coding synonymous mutation which is present in 50% of the world's population. But conversely, people can get overly excited about rare genotypes which have no effect at all, or no research indicating anything one way or the other.
Respectfully, I have been wondering a lot about the take away from your rationale. Are neither common or rare SNPs worthwile to be addressed in case of chronic or degenerative diseases? Don't they add to the burden of CFS/SEID? Unless you have a real mutation of some sorts like Down's Syndrome, your SNP set is irrelevant?
I don't mind this so much in the rare SNP program ( http://sourceforge.net/projects/analyzemygenes/ ) because it's pretty obvious that no one has 50-150 SNPs which all mean they're about to drop dead, and because literally everyone has a bunch of rare SNPs. So it some ways it's a good way to ruthlessly expose people to the concept that having rare SNPs is completely normal, and maybe even makes the common-as-dirt SNPs a bit less scary in the process. Maybe :rolleyes:
The health authorities in my country are alarmed by the escalating of chronic, autoimmune, cancer and degenerative diseases in the population as a whole. Much more than with diseases that may cause one to suddenly drop dead.

To me there is an obvious overwhelm from environmental toxicity and pointless medicine prescriptions increasing the burden on otherwise pretty harmless SNPs.
But showing just a few very rare SNPs in a non-rare report might just contribute to the over-excitiment.
Yes if the person looking into it is healthy, so I think there is no need to look into genes that haven't been expressed.
If the person is unhealthy, like the people here at PR, some of they will try to find what is broken, because good doctors can't be found easily, and then the sick people will start the research on they own, like us at PR.

I ask you to excuse me if I made a wrong interpretation, my cognitive issues have been getting worse lately.
 

Valentijn

Senior Member
Messages
15,786
Respectfully, I have been wondering a lot about the take away from your rationale. Are neither common or rare SNPs worthwile to be addressed in case of chronic or degenerative diseases? Don't they add to the burden of CFS/SEID? Unless you have a real mutation of some sorts like Down's Syndrome, your SNP set is irrelevant?
No, I'm just opposed to unsubstantiated claims, misinformation, and hysterical reactions. To use your own example, Yasko uses Downs' Syndrome as part of the basis for reasoning that mild and common SNPs on the CBS gene can have a huge impact. But the effects of having three copies of an entire gene is not even remotely comparable to having a non-coding, common, and harmless variation on a single SNP.
The health authorities in my country are alarmed by the escalating of chronic, autoimmune, cancer and degenerative diseases in the population as a whole. Much more than with diseases that may cause one to suddenly drop dead.

To me there is an obvious overwhelm from environmental toxicity and pointless medicine prescriptions increasing the burden on otherwise pretty harmless SNPs.
Except that there's no established connection between those SNPs and any increased diseases. At the very least you'd expect to see a correlation in increased rate of a variant and a disease. But what are we to make of it when someone claims that a common SNP already shown to be beneficial is actually harmful? At the very least they should be publishing something, rather than increasing their focus on selling more products.

How do we decide which SNP to blame? It seems to be pretty random for many people. "Oh, I've got this SNP (and 960,000 other SNPs reported by 23andMe), let's arbitrarily match it up with these symptoms I have." The mere statistics of this approach are beyond absurd. Why not blame one of the other 960,000 SNPs? Or one of the 3 billion SNPs not tested by 23andMe?
If the person is unhealthy, like the people here at PR, some of they will try to find what is broken, because good doctors can't be found easily, and then the sick people will start the research on they own, like us at PR.
You are assuming a false dichotomy. It's not a matter of "broken" versus "healthy". It's often just a matter of something being less than optimal. And more often, it's a matter of completely inaccurate, illogical, and bizarre misinformation. Science helps to protect us from our biased perceptions and the fraudulent claims of others - it deserves more respect.
 

Gondwanaland

Senior Member
Messages
5,095
Except that there's no established connection between those SNPs and any increased diseases.
The absence of evidence is not evidence for absence
At the very least they should be publishing something, rather than increasing their focus on selling more products.
I don't buy her products, don't read her material, but benefit from her clinical evidence through experience exchange with fellow members here.
How do we decide which SNP to blame? It seems to be pretty random for many people. "Oh, I've got this SNP (and 960,000 other SNPs reported by 23andMe), let's arbitrarily match it up with these symptoms I have." The mere statistics of this approach are beyond absurd. Why not blame one of the other 960,000 SNPs? Or one of the 3 billion SNPs not tested by 23andMe?
This is exactly what science is about. Science is only a fraction of what is needed to be discovered.
And the SNPs explored in the methylation forum are the ones more probably involved in metabolism otimization.
When everything else fails, that is a sure fix!
It's often just a matter of something being less than optimal.
Thanks for rephrasing my statement in better English! (no irony)
Science helps to protect us from our biased perceptions and the fraudulent claims of others
There is endless malpractice based on fraudulent science funded by undercover interest conflicts. Take statins for instance, take anti-depressants and so on.

Science doesn't care for the ends of the Bell Curve. I seem to be in one of those ends.
 

Valentijn

Senior Member
Messages
15,786
The absence of evidence is not evidence for absence
In many cases, it isn't an absence of evidence. There's several research papers showing CBS C699T +/+ or +/- to mildly reduce homocysteine levels and the risk of disease associated with elevated homocysteine levels. And based on the biochemistry, faster CBS functioning could very well result in creating more glutathione - generally a good thing.

Additionally, an absence of evidence is not a license to create random connections between SNPs and symptoms. There are billions of SNPs and tons of symptoms, and there is no rational way to match most of those up. I'm not saying that no such connections exist, merely that is absurd to try to guess at this point, and that such guesses should certainly not be morphing into an indisputable dogma.
And the SNPs explored in the methylation forum are the ones more probably involved in metabolism otimization.
When everything else fails, that is a sure fix!
Which ME/SEID patients have been fixed by methylation? My general observation is that sometimes some symptoms are helped, and some even make some mild improvements in general functioning. But I've yet to see anyone cured of ME/SEID with methylation support. Even Rich Van Konynenburg saw that the patients in his study did not maintain the benefits of methylation support long-term. Instead of repeating a methylation mantra, he explored further to try to understand why that was happening and what else might be going wrong.
 

Gondwanaland

Senior Member
Messages
5,095

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
Whoa! A lot has happened since I was last here.

Also, a homozygous mutation being pathogenic usually does not mean that the heterozygous is doing anything at all. But it does reflect that there could be a compound heterozygous missense mutation

Being heterozygous can have an impact, even though it is less likely to. One of my earliest odd symptoms was a bleeding problem - i.e. I would not stop bleeding - though not to the degree of hemophilia. Unsurprisingly, my iron and B-vitamins were pretty shot as well. De Meirlier commented on the 'burst blood vessels' in my cheeks, which is a wee bit of an overstatement, but I do have a constant blush, and in my mom and one of my sisters it's more pronounced. After a recent massage, I was bruised all over. My gums bleed when I brush my teeth and I had constant nosebleeds as a child. Then I find that one of my rarer SNPs (0.41%) is related to Von Willebrand's Disorder, one of more common heritable bleeding disorders.

The SNP is rs61750615, and I'm heterozygous; but next to the SNP is the annotation:

Unfortunately, the link leads to the wrong location, so I can't further explore this without some research.

This does not, despite evidence, mean I have Von Willebrand's. It does, however, imply that maybe I should get a genetic test for VW's. The evidence piled up like that plus the SNP is beginning to look about as shady as a guy in a trenchcoat and dark glasses hanging around my valuables. ;) Sometimes, you even bleed intramuscularly when you have Von Willebrand's. Could that be part of why my muscles hurt all the time? Could this be why my blood volume is so low?

IOW, TL;DR...

Use the SNPs as potential directions of research rather than final conclusions. Or as things to try out, as in the case of methylation. I mean, people are trying to feel better, not necessarily even find the root of their problem anymore. If detox and extra B-Vitamins helps you feel better, why does it matter if methylation is The Answer to Life, the Universe, and Everything?

-J
 

Valentijn

Senior Member
Messages
15,786
Being heterozygous can have an impact, even though it is less likely to.
Yes it can - but as in your example, it's pretty well known when it can and when it can't. The problematic homozygous MTHFR missense mutations can still have a large impact when heterozygous, albeit a milder impact than when homozygous. But MTRR missense mutations don't have any significant impact when heterozygous, unless someone is compound heterozygous.

And the homozygous (recessive) requirement seems to be the norm, whereas pathogenic heterozygous (dominant) mutations are a lot rarer. Hence my dislike of every heterozygous result being treated as equal - some are serious, but most are completely benign. Coloring them all yellow and treating them as universally moderately problematic misses out on the actual nuances.
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
@Valentijn - I understand. Your issue is with people's tendency to behave as though everything on planet earth, including Biology, behaves by the same rules. When I was teaching, I remember how frustrated I would get when my Chem students just wanted to memorize a series of steps and use that to solve every problem... and how some literally refused to believe me when I told them that wouldn't work. ;)

@Sidereal - I grew up in a town by the ocean, so I'm sure I was exposed to mold on a day-to-day basis. I never lived in a house with a mold problem or spent a great deal of time in... moldy situations? Old abandoned shacks? (Or pricey NY flats that have been flooded with seawater - let's not discriminate.)

Speaking of maintaining a spirit of scientific inquiry, I do wonder about the mold stuff and some of the viral stuff too. I think the issue is that I don't know enough about blood tests' sensitivity levels, and I really, really feel like I want some control-group data. If you tested a bunch of people who feel fine for as many different pathogens as I have been tested for, what's the likelihood that they're going to come back 'infected', too, with something? Haven't we all been exposed to this stuff, and don't we have it in our bloodstreams too?

Come to think of it, in the context of my conversation about Von Willebrand's and @Gondwanaland's comment, maybe the simple reason why we ALL seem to have exaggerated reactions to medications is that many of us have low blood volume. This makes the medication more concentrated than it would otherwise be: more drug in the bloodstream per liter. Is this ridiculous and simplistic? It seems too simple to be right biologically, but it is true from the perspective of a chemistry person:

500-mg drug / 3 L vs 500-mg drug / 4 L

167-mg/L concentration vs 125-mg/L concentration.

Crowds the receptors - metabolites that may need to be recycled in the liver produced too quickly...

Might be part of the picture.

-J
 

halcyon

Senior Member
Messages
2,482
If you tested a bunch of people who feel fine for as many different pathogens as I have been tested for, what's the likelihood that they're going to come back 'infected', too, with something? Haven't we all been exposed to this stuff, and don't we have it in our bloodstreams too?
The thing that comes to mind when you go down this line of reasoning is poliovirus. Many were exposed to it, most who caught it had asymptomatic infections, others became crippled with poliomyelitis. We can't assume that just because the majority of the population doesn't have a problem with these infections that they don't case massive problems in a small percentage.
 

Sidereal

Senior Member
Messages
4,856
Speaking of maintaining a spirit of scientific inquiry

Well, I know how implausible this sounds and I'm by no means a "believer" so I'll post this in a take it or leave it spirit and then leave you be, but I'm under the impression of Dr Shoemaker's book I've just finished reading.

In it he discusses in great detail bleeding problems and acquired von Willebrand disease in his mold patients. He says his own problem has become so severe he has almost bled to death on occasions. He says he has seen thousands of patients with CFS (what he calls chronic inflammatory response syndrome - CIRS) whose illness was allegedly triggered by mold exposure and the vast majority of them have a couple of rare HLA genes that apparently make them susceptible to something other people don't have a problem with.

As @halcyon pointed out, one person gets no symptoms from polio infection, another ends up in an iron lung for the rest of his life.