Methylation. Epigenetics. Have you heard these terms? If not, you will, and they are important because they’re the future of Psychiatry, if not all of medicine.
Regarding depression, maybe you’ve heard of the methylation cycle, SAMe, and the role of the MTHFR mutation in causing an imbalance in this cycle, and how folates can correct this imbalance. But it turns out it’s not that simple, because of the role of epigenetics.
What’s epigenetics you ask? Epigenetics is the process by which genes are expressed, and these epigenetic processes are effected by our environment, beginning in utero and later by our nutrition and environment. Dr. William Walsh is responsible for discovering that the ratio of methyl to folate has a great impact on epigenetics, i.e. gene expression.
When it comes to depression and anxiety, we’ve all heard the role serotonin plays. But what determines the level of serotonin in the synapses where it counts? It’s not the amount of serotonin manufactured by the body. It is the amount of serotonin reuptake transporter found in the synsapse, the same enzyme targeted by SSRI antidepressants such as Prozac and Zoloft. These anti-depressant medications inhibit the removal (reuptake) of serotonin from the synapse, thus increasing the amount of serotonin in the synapse.
Alternatively, instead of inhibiting this enzyme from functioning and removing serotonin from the synapse, if you simply produce less of this enzyme, you would have the same effect- more serotonin in the synapse.
And the amount of this enzyme produced by the body is determined by- can you guess? The methyl/folate ratio in a person. As defined by Dr. William Walsh, a higher ratio is referred to as overmethylation and a lower ratio is undermethylation. Methyl and folate tend to have opposite effects epigenetically- methyl turns off genes and folates turn them on. So people who are undermethylated produce more serotonin reuptake transporter, which results in a lower level of serotonin in the synapse. If you give them folate, this will lead to even more serotonin reuptake transporter being produced by it’s gene, which then leads to more reuptake and removal of serotonin from the synapse, the opposite of what they need! Approaches other than that developed by William Walsh often look no further than the MTHFR mutation and recommend high doses of folate. But in a person who is undermethylated according to Dr. Walsh’s definition, i.e. has a low methyl/folate ratio, giving folates will make him or her worse!
Before starting an SSRI, or if you want to treat your depression naturally with the right supplements, get your methylation status checked first with some simple blood tests, particularly whole blood histamine. While most functional doctors will check homocysteine for methylation status, this doesn’t take into consideration the epigenetic roles that methyl and folate play. Whole blood histamine gives a more complete picture, because it’s level depends on the relative activities of methyl versus folate in the body.
If you find yourself or someone you love suffering from anxiety, depression, ADD, Bipolar Disorder or schizophrenia, reside in New York State, and want to try a nutrient-based non-pharmacological approach, contact our office for a consultation. We offer both in person and telepsychiatry confidential appointments.