Hi rich,
I was just wondering whether you have to have inherited a snp that interferes with recycling or making glutathione from both parents to cause problems or just one parent is suffice? Many thanks
Hi, anniekim.
I don't know, and wish I did. The SNPs in the glutathione system have not been studied in ME/CFS, as far as I know. I have encouraged some of the genomic researchers to look at this, but I don't think they have yet. Dr. Shoemaker may look into the gene expression of the enzymes in the glutathione system in his patients, and that may give clues about SNPs. Have to wait and see.
Best regards,
Rich
Rich, I wonder if this would be relevant to a subset of ME/CFS patients, like myself. This is a study that was just published last month:
Five polymorphisms were significantly associated with urine mercury levels (GSTT1 deletion), hair mercury levels (GSTP1-105, GSTP1-114, GSS 5'), or both (SEPP1 3'UTR). Overall, this study suggests that polymorphisms in selenoproteins and glutathione-related genes may influence elimination of mercury in the urine and hair or mercury retention following exposures to elemental mercury (via dental amalgams) and methylmercury (via fish consumption).
As you may recall stimulating the GST enzymes has been quite helpful for me...zinc, selenium, polyphenols. I realize these have multiple physiological activities, but there really haven't been too many things to help...so I thought this was significant.
Hi, anniekim.
I don't know, and wish I did. The SNPs in the glutathione system have not been studied in ME/CFS, as far as I know. I have encouraged some of the genomic researchers to look at this, but I don't think they have yet. Dr. Shoemaker may look into the gene expression of the enzymes in the glutathione system in his patients, and that may give clues about SNPs. Have to wait and see.
Hi Rich,
Best regards,
Rich
Thanks for your reply. I'm sorry I am getting a bit confused now. You have written that to get an isolated case of CFS/ME one has to have inherited some genetic polymorphisms from your parents. I'm taking from that you do know which snps indicate whether a person may have a problem with making gluthathione or recycling gluthathione? So it's just at this stage you don't know whether having two or one inherited snps makes a further difference?
Also I'm sure you have written it elsewhere but am fading so not up to trawling through the posts so can I ask what is the test that shows the relevant snps?
Many thanks
Hi, Anniekim.
I'm sorry if I have misled you into believing that all of this is understood and proven at this point. Unfortunately, it is not. There is still research to be done. What I have done is to develop a hypothesis to help point toward the types of research that are likely to be the most beneficial in improving our understanding of this disorder. There is quite a bit of evidence that supports the hypothesis, in my opinion, but there are still pieces that have not been tested. Nevertheless, we have used it to develop treatment, and the treatment has been significantly helpful to most who have tried it, but only a few have made what appear to be complete recoveries. There is still much to be learned.
I have inferred from published information on family studies, twin studies and the available polymorphism studies that there is a genetic component that makes people vulnerable to developing at least the sporadic cases of ME/CFS. I have inferred from the published risk factor studies, responses to my own questionnaires and the known biochemistry that glutathione depletion is what starts off the onset of ME/CFS, in response to a variety of stressors. I believe that in order for a polymorphism to be important in affecting the likelihood of onset, it must be near the beginning of the pathogenesis, in order to be accessed and to therefore make a difference. Putting all of these factors together, I have inferred that there must be relevant polymorphisms in the glutathione system that predispose a person to the development of ME/CFS. This is a hypothesis. It has not yet been tested, because the polymorphisms in the glutathione system in people who have ME/CFS have not yet been studied. I hope they will be, and have encouraged some of the genetic researchers to do so.
Best regards,
Rich
Hi, Anniekim.
I'm sorry if I have misled you into believing that all of this is understood and proven at this point. Unfortunately, it is not. There is still research to be done. What I have done is to develop a hypothesis to help point toward the types of research that are likely to be the most beneficial in improving our understanding of this disorder. There is quite a bit of evidence that supports the hypothesis, in my opinion, but there are still pieces that have not been tested. Nevertheless, we have used it to develop treatment, and the treatment has been significantly helpful to most who have tried it, but only a few have made what appear to be complete recoveries. There is still much to be learned.
I have inferred from published information on family studies, twin studies and the available polymorphism studies that there is a genetic component that makes people vulnerable to developing at least the sporadic cases of ME/CFS. I have inferred from the published risk factor studies, responses to my own questionnaires and the known biochemistry that glutathione depletion is what starts off the onset of ME/CFS, in response to a variety of stressors. I believe that in order for a polymorphism to be important in affecting the likelihood of onset, it must be near the beginning of the pathogenesis, in order to be accessed and to therefore make a difference. Putting all of these factors together, I have inferred that there must be relevant polymorphisms in the glutathione system that predispose a person to the development of ME/CFS. This is a hypothesis. It has not yet been tested, because the polymorphisms in the glutathione system in people who have ME/CFS have not yet been studied. I hope they will be, and have encouraged some of the genetic researchers to do so.
Best regards,
Rich
Hi Rich,
Don't worry you haven't misled me, just me not understanding it all. Thank you for the clarification and your hard work. May I ask though which gene tests are people doing in relation to methylation as i read about people doing gene tests? I take it these gene tests are still in the infancy and just give an overview/indication of possible problems in the methylation cycle? Many thanks
Hi, anniekim.
Quite a few people have had the methylation SNPs (sincgle nucleotide polymorphisms) panel offered by Dr. Amy Yasko (http://www.doctoramyyasko.com or more specifically,
http://www.holisticheal.com/comprehensive-methylation-panel-with-methylation-pathway-analysis.html).
It has 30 SNPs on it that she has selected. The basis for her selection is that these SNPs are associated with the methylation cycle and related pathways, and that they assist in deciding about treatment for the individual. She uses this panel primarily for treating cases of autism, but it has also been used in ME/CFS and in several of the adult neurological disorders. I initially encouraged people to try the full Yasko treatment for ME/CFS, and some people have done so. However, it is very complex and fairly expensive, so that it was not feasible for many PWMEs to use. Therefore, in early 2007, I proposed a simplified version of it. I have also encouraged people to run the Health Diagnostics and Research Institute methylation pathways panel to determine whether there is a partial methylation cycle block and glutathione depletion, and to monitor the progress of treatment. Dr. Yasko does not use this panel, but I find it to be more direct than inferring the status of these parts of the metabolism from the set of tests that she uses, including the SNPs panel. I have no objection to using the tests she recommends, and in fact, if a person has the resources to do so, they can be very helpful. But for someone who is looking for a more streamlined approach at lower cost, I favor running the methylation pathways panel, and if it shows these problems, then to try the simplified treatment approach.
In addition to the simplified methylation protocol that I have proposed, there are now several other methylation-type treatments in use by various people. Freddd, on these forums, encourages the use of a somewhat different protocol that has helped him and several others. The simplified treatment will not work for him, and apparently not for some others, either. The reasons appear to be genetic, but we have not completely nailed them down yet. I think they involve the MTHFS and the MMACHC genes. There are also other methylation-type protocols in use by various physicians. All of them have in common that they include a fairly high dose of B12, either sublingual or injected, and a more normal dosage of folate, most of them using the active forms of folate, which are 5L-methyl tetrahydrofolate and folinic acid. Some people appear not to be able to tolerate folinic acid, and some do not tolerate folic acid or are not able to use it very well.
The SNPs panels give information about tendencies, and they can help to determine details of treatment that might be most effective for a given person, but they alone don't determine what is actually going on. A person has the same genes before they develop ME/CFS as they have after they have become ill. The genes may give them a vulnerability, but other factors are necessary to cause the onset of this disorder.
Lately, quite a few people have gotten the 23andme.com genotype panel. It includes about 1 million SNPs, and the price is lower than the Yasko panel. It does not include all the SNPs on the Yasko panel, even though the total is a million compared to 30. It is estimated that there is a total of 10 million possible SNPs in the human genome, so even though the 23andme panel is very large, it still characterizes only about one-tenth of all the SNPs that are possible to have. But for the vast majority of these SNPs, no one yet knows what their effects are. A lot more research will need to be done to determine this. I think it will need to be focused, based on hypotheses about which parts of the metabolism are most important. There is a trend these days to do research without specific hypotheses. They call this "data mining" or "data-driven research." They are hopeful that by doing a lot of number-crunching with computers, the understanding will somehow just drop out. I personally don't believe that this is a very efficient or productive way to do science. The genome is so complicated that this approach usually doesn't lead to much in the way of understanding what is going on. I prefer what is called "hypothesis-driven" research. Developing hypotheses is more of a right-brained (combined with left-brained) activity, while the data mining is pretty much just left-brained. Computer analysis can be very helpful, but I think you have to be able to tell the computer what to look for, and that's where a hypothesis comes in. Well, so much for my philosophical rant. I hope some of this is helpful.
Best regards,
Rich
Best regards,
Rich
I am interested in finding what SNP's I may have, as I seem to have some roadblocks working in my body, but am not sure what they are just by guesswork, of course.
@ Freddd,
SPEAKING UP HERE!
My physician is open-minded, and she and I just had an MTHFR conversation this week, in fact, in which I told her that I am going into this assuming that I am pretty much a "non-user" of folic acid. I am just letting her know that my treatment goals are to bypass that conversion altogether right now. Her clinical interest was definitely piqued. She wanted to check my blood folic acid levels (in addition to some other stuff related to chest pains) in about a month "just to see what might be going on when (I) am not strict with diet."
The fire in my feet was less this morning after I allowed myself an approximately 24 hour "washout" period for folic acid. Is this healing, low potassium, paradoxical folate deficiency, or perhaps folic acid overload? I just keep wondering what other genetics I may have going on that contribute to these problems, and those of my kids.
Happy to put this in a different thread if need be.