These are my notes for a podcast interview with Andrew Rostenberg DC about how methylation plays into balancing hormones.
What does methylation mean?
Think of methylation as a verb, it's an action that occurs in your cells and is at the foundation of our biochemistry. We are carbon based organisms. Simply put, methylation is the movement of a carbon atom from point A to point B. You can think of it like a banking system, in which money flows to where it is need. Imagine though, if there were a crisis and the banks close, and you can't withdraw or deposit money when needed. If you imagine that carbon atoms are the money in this example, this is like poor methylation. Methylation ability is at it's foundation based in our genetics and in which SNPs (which stands for single nucleotide polymorphisms, which are common genetic variations) we carry. It also is affected by epigenetic changes as well as the process that regulates epigenetic changes. Epigenetics is about choice, not predetermined outcomes. We are born with the ability to heal, it's about giving our body back these abilities.
Hormone balancing and the methylation cycle....
In his practice, he sees mostly women with estrogen dominance, which presents as heavy periods, PMS, early menopause onset, irregular cycles, and having gallbladder disease and removal. He says the gallbladder is a "fatty trash can" that the body uses to get rid of toxic metals, xenobiotics, birth control pills, and hormones, among other things. When someone has had their gallbladder removed, it indicates that they have been a poor methylator for a significant amount of time, and they've been exposed to an elevated level of toxins. Taurine pathways have a big effect on gallbladder function. Also, where your body stores fat depends on hormone levels. Large hips and butt compared to upper body indicates estrogen dominance. There are two different forms of estrogens, the ones we make and the ones we are exposed to. Most petrochemicals that people have made act as estrogen in the body and are much stronger than our natural ones (these are called xenoestrogens). This is also not just a female problem, men can have high estrogen as well. Aromatase (sp?) is the process by which the body converts testosterone into estrogen. When insulin goes up, sex hormone binding goes down. Inflammation increases this as well.
What are the most important SNPs for hormone balance, and why?
COMT is the main enzyme that will break down estrogen. Estrogen has 3 different forms, 2 are carcinogenic and inflammatory. COMT helps the body minimize those forms. A SNP in this gene can slow down the clearance of estrogen and diverts it from the safer pathway through the liver into a more inflammatory pathway. Another major one is PENT which is responsible for making choline inside of the body. It makes phosphatidylcholine, which is one of the primary components of the cell membrane in white matter (so it support the nervous system). Choline is the body's main storage area for methyl groups and when the body needs more methyl groups it pulls the choline out of the cell membranes and breaks it down. This results in demyelination in diseases such as MS. In a recent research study, women on a low choline diet (no red meat, no egg yolks, no soy lecithin, maybe more?) developed signs of fatty liver syndrome and other signs of choline deficiency. A healthy body makes choline when there is not enough in the diet, but most of these women were found to have the PENT SNP. Other SNPS were found to have an even more profound affect on fatty liver disease.
What kind of health problems are you likely to see in a patient who has hormone imbalance issues due to poor methylation if it is not addressed?
We are sicker now, as an animal on earth, than we ever have been. We've had these SNPs in our genes for a long time, so what has changed? Our environment is polluted, especially with petrochemicals. High exposure to hormones from birth control pills, pesticides, other toxins rob your body of methyl "currency"- depletes the "bank account" to protect us. Low methyl groups means inflammation. The process by which the liver excretes toxins into the gallbladder, in order to get them out of the body, depends on the methylation cycle and the biochemicals taurine and glutathione (glutathione is itself a product if methylation so is already low in poor methylators). The liver is especially dependent on methylation. In low methylation status, the bile in the gallbladder becomes thick and "sludgy" and forms stones, bile production decreases, so when you eat you don't have enough bile to absorb the fat soluble nutrients that are so crucial to health such as vitamins A, B, E and K, omega 3s, choline, and other fats are just harder to absorb. Estrogen is very hard on the gallbladder. Estrogen is also deeply involved in autoimmune disease.
Problems you see in estrogen dominant women also include anemia from the
heavy bleeding, estrogen thickens the blood and makes it more prone to
clotting, which can even cause stroke (birth control pills can also do
this). Estrogen sensitive cancers (including uterine, breast, ovarian,
and also prostate) also demonstrate estrogen dominance. The prostate is
the analog of the uterus and prostate cancer is the result of too much
estrogen in a man. A study published in the BMJ showed that in parts of
the world, as women began to use the birth control pill (BCP), the rates of prostate cancer in
men went up concomitantly. The more women on the BCP meant more
estrogen being excreted in urine, which went into the water supply.
There are also risks from having not enough estrogen. There is an
optimal amount to have in the body. Women who are deficient in estrogen
have a higher risk of stroke, heart attack and other cardiovascular
disease. The adrenal glands are supposed to kick in at menopause and
compensate for the reduction in estrogen, but many women develop adrenal
fatigue during their menstruating years and so the adrenals aren't able
to step up the way they need to.
Connections with mito dysfunction...
The cells in the stomach that produce stomach acid are some of the most energy-hungry cells in the body. Toxin buildup in the body, which results from low methylation, damages the mitochondria so cells are not able to make as much energy to do their jobs. This creates a vicious cycle in which toxicity creates a situation in which the body can't absorb the nutrients that it needs to heal itself, from impaired bile function and reduced stomach acid. Stomach acid levels are critical to break down proteins, and especially to absorb minerals from our diets (which is one of the reasons that chronic antacid use depletes the body of minerals such as calcium). This is also a significant cause of anemia as adequate stomach acid is necessary for proper iron absorption.
How does methylation of hormones affect the brain, and is there a relationship with neurotransmitters?
Estrogen has a huge impact on neurotransmitters. He says drinking coffee can cause estrogen dominance because it is detoxed through the same pathway (but possibly only in people with certain SNPs?). He mentions that people under stress can use starches to try to increase dopamine levels. This topic was mostly glossed over and I will find another podcast to fill in this area.
How is stress related to methylation hormone imbalance?
While adrenal stress isn't technically under the methylation umbrella, the constant stress that people tend to contribute to issues that relate to methylation, such as blood sugar imbalance and digestive trouble. Adrenal stress pushes blood from our organs into our muscles. Things like digestion, detoxification, tissue repair, get put on hold chronically. It also reduces brain function and memory formation.
Miscellaneous tidbits that came up during the questions include...
Common causes of anemia include malabsorption problems such as celiac disease, chronic infections including viruses and especially bacteria (who take the iron for themselves), low levels of stomach acid, untreated hypothyroidism, because a thyroid component is needed to uptake iron from the gut into ferritin. Also vitamin C is crucial for iron absorption.
For patients with vertigo and dizziness, aldosterone and anti-diuretic hormone are important to consider, especially the aldosterone and renin cycle. Low aldosterone can relate to other adrenal issues, including POTS. Adaptogens help the brain communicate with the adrenals rather than helping the adrenals function directly. caution should be exercised with licorice and yucca however, as both can be very estrogenic.
Taurine is a membrane stabilizer. Seizures come from destabilization. Regular seizures are very stressful to the body so really tax the adrenals. Heart arrhythmia is the same mechanism- an unstable membrane of heart muscle.
11 beta hydroxy steroid deficiency or mutation is related to PCOS. It is what inactivates or activates cortisol. Excessive cortisol can cause POTS. Fat cells promote cortisol levels WAY more than non fat cells.
PCOS is an anovulatory cycle, which means no progesterone is made in the second half of the cycle, which puts a lot of strain on the adrenals.
Estrogen can break down into certain metabolites, one is protective and 2 are destructive. Iodine helps the body convert the dangerous forms back into estrogen. Estrogen dominance can cause thyroid problems.
Saliva hormone testing should be collected on day 19-21 from the beginning of the cycle.
Stress pushes cholesterol to be made into cortisol instead of other hormones. Stress causes us to "burn the furniture", meaning break down tissues in the body for protein for the liver to then turn into blood sugar, rather than burning fat, which breaks down muscle, builds fat, which then further increases the cortisol level in a vicious cycle.
Estrogen dominance is the ratio between estrogen and progesterone, which can be very high estrogen and normal progesterone or low estrogen but much lower progesterone.
