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The Link Between Adrenal Fatigue and DNA Methylation
Published: Townsend Letter for Doctors & Patients - May 2005
Editor:
Adrenal function is vital to life: without cortisol we die. This fact
has been known since the 1930s when it was described by Banting and
Best. Glucocorticords are essential for maintaining carbohydrate,
protein and fat metabolism. They also have a permissive effect
which allows for glucagon and catecholamines to work. Important
glucocorticoid effects include the normal functioning of the nervous
system, water metabolism, vascular reactivity, regulation of
circulating lymphocytes and the immune system and resistance to stress.
Complete lack ofadrenal function is a disease state known as Addison's
Disease. It is an autoimmune disease usually, caused by
antibodies that attack the adrenal gland. Conventional medicine
only recognizes two states: you either make cortisol or you
don't. Allopathic physicians are unaware of the decline in
adrenal function as illness becomes chronic.
The etiology is
adrenal fatigue begins with a stressor or in functional medicine terms
a trigger. Triggers fall into several categories: psychosocial
stress, environmental toxins (radon, mercury, mold), infectious
organisms (fungal, bacterial, parasitic), food allergies (wheat, corn,
sugar, milk), and other toxins (alcohol, drugs, prescription
medications) to name a few. In addition, stressful events such as
surgery or car accidents place a huge (usually unrecognized) load on
the adrenal glands. The initial response to each of the above
events is to elevate cortisol levels to help cope with the
stress. However, over time, the adrenals become weakened and lose
their circadian rhythm. This is due in large part to poor nutrition.
All stressful events require increased amounts of several nutrients:
vitamin C, pantothenic acid, B6 (pyridoxine), B12(methylcobalamin),
and folate. Interestingly, if the adrenal glands are
catheterized and a stressor is introduced, the first chemical to
leave the adrenals is not cortisol as one would suspect, but large
amounts of vitamin C. These nutrients are severely lacking in the
typical American diet or are not found in high enough amounts.
More often than not "orthomolecular" dosing is necessary to correct the
deficits.
The initial response to any stress is the
hypersecretion of cortisol, but over time (approximately one
year) there develops a negative feedback and a genuine "fatigue"
causing reduced levels of DHEA-S and cortisol . The end result is
an organism with reduced immunity, increased likelihood of autoimmune
disease, heart attacks, elevated cholesterol and triglycerides, skin
disorders, carbohydrate cravings, protein wasting, fatigue and
depression (to name but a few). Physicians normally view
these as separate events in a given organ and do not see that the
symptoms represent a disease process (inflammation) that may occur in
one or more organs simultaneously. Therefore everyone with any chronic
disease, not just cardiovascular disease, should be screened using
DHEA-S and a homocysteine level. As DHEA-S decreases, the level of
homocysteine rises, with a concomitant decrease in most B-vitamins, but
especially folate and B12. The currently accepted norms for these
parameters are too permissive, reminiscent of glucose control in years
gone by. All of our organs are linked and nothing that happens is
random. We are all the result of our genetic interaction with our
environment.
With the establishment of "disease" another
pivotal biochemical event happens: abnornal methyl groups nosedives as
well. These patients may then present with symptoms of depression
(inability to synthesize S-adenosylmethionine), joint pain (inability
to make methylsulfonylmethionine), to name a few. Not only does
teh abiltiy to convert to a methylated product is also
compromised. For example, in chronically ill individuals the sue
of B12 - as either the cyanocobalamin or the hydroxocobalamin form
seems to do little to improve fatigue or mental functioning. The
ideal compound to replenish B12 is methylcobalamin - the only active
form. In each case, oral supplementation with the missing
methyl-containing substrate ameliorates and symptoms. In each of
the scenarios listed, the severity of the illness correlates with the
level of the reduced or deficient DHEA-S and the concomitant elevated
homocysteine level. The elevated homocysteine leve is not only a
marker for inflammation, but it is a marker for deficient B vitamins as
well. The stage is now set for abnormal DNA methylation and the
induction of cancer.
Efforts to repair adrenal fatigure
include nutrients (in their most active form), glandular preparations,
DHEA (and in severe cases cortisol itself), and lifestyle modifications
with removal of triggers. Even with these measures, expect
adrenal recovery to take 3 to 5 years.
Susan Solomon, MD
Bibliography
Shealy, CN. Chronic Pain Managment.
TLfDP. 258:22-23, January 2005
Ganong, WF. Review of Physiology
McGrawh-Hill, 1999: pages 344-362
Poirer, LA. The effects of diet, genetics and chemicals on
toxicity and aberrant DNA methylation: an introduction.
J Nutr 2002 Aug: 132 (8 Suppi): 2336S-2339S
Shames, RL. Nutritional Management of Stress-Induced Dysfunction.
ANSR - Applied Nutritional Science Reports. 2002
www.DrLam.com: Adrenal Fatigue
Miller, AL. The methionine-Homocysteine Cycle and Its Effects on Cognitive Diseases
Alternative Medicine Review. vol 8, number 1, pages 7-13.
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