Epigenetics and Chronic Illness: Why Symptoms May Be More Reversible Than We’ve Thought

This post introduces insights from links between adverse life events, epigenetics and chronic illness. It describes how this new science suggests that chronic physical diseases and other health conditions thought to be permanent may be instead be much more reversible than we’ve thought ⁽¹⁾“Metabolic features and regulation of the healing cycle—A new model for chronic disease pathogenesis and treatment.” Mitochondrion.

The field of epigenetics looks at the effects of molecules that attach to genes in order to direct, guide and otherwise alter their function. Our genes don’t change, but their behaviors do. The field of epigenetics looks at a natural process that directs and guides genes to turn on and off as a normal part of bodily function.

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The field of epigenetics started maybe 10-15 years ago, and is gaining momentum.

I had many questions about links between epigenetics and chronic illness when I heard about it over the years and cruised around the web with the following types of questions in mind:

• Do we know if epigenetics plays a role in specific chronic illnesses, such as chronic fatigue syndrome (ME/CFS)?
• Does trauma affect epigenetics (referred to as our epigenome)?
• Do events during pregnancy, birth and infancy influence epigenetics?
• Can epigenetic changes be passed on to future generations?
• Are epigenetic changes reversible?
• Can psychotherapy reduce or reverse epigenetic changes?

I was astounded when I discovered that the answers are Yes, Yes, and Yes. To ALL these questions.

Kind of awe-struck. Like a kid at Christmas with a new toy. I had more trouble sleeping than usual because the information was adrenaline-inducing and earth-shattering. Researchers seem to be feeling the same way.

Links between epigenetics and chronic illness offer clues that explain how life events affect risk for chronic illness. They also explain why such effects are not psychological.

The Difference between Genetics and Epigenetics

Chronic illnesses of all kinds, including autoimmune diseases such as type 1 diabetes, have increasingly been found to be the result of interactions between genetic and environmental factors. As I’ve described in my post summarizing the science linking chronic illness and trauma, environmental factors can include stressful and traumatic events: in prenatal life, in childhood, and even in the lives of our ancestors. Other nongenetic risk factors include insecure attachments and stressful relationships between parents and their children in early life. And risk for chronic illness can also be influenced by diet, infections, and toxins, among other factors.

Environmental factors are what intrigue me. These are factors that I have a chance of influencing. I keep thinking that there must be changes I can make in my life and in my own environment to reduce my symptoms. Or, better yet, to recover fully from chronic fatigue and the related symptoms. I’m beginning to think that epigenetics may help explain HOW this great desire might be reasonable. It suggests that working with factors that are within my control may actually be valid, and even effective. Even if they do seem to be (very) long-term endeavors. Approaches I’m working with include ongoing trauma therapy; working with the effects of prenatal, birth and early life events; looking at and working with my geneology; and changing my diet.

This field seems completely relevant and useful in the evolution, and possible reversal, of chronic illnesses of all kinds. So here’s my first stab at explaining what I’m learning about epigenetics and my initial understanding of how it works.

Genes affect Chronic Illness through Mutations

Genes are responsible for creating all of the proteins in our bodies, and these proteins have functions in every process that takes place within our cells (see an intro to genes on wiki and more about proteins on wiki). Genes are made up of DNA. The image below shows two strands of DNA connected through nucleotide bases, which are represented by the blue bars. (Does this image bring back any memories of biology class? or maybe it just looks like a fish).

Genetic factors that affect risk for chronic illness are the result of mutations within DNA, and can be passed down through the generations. A mutation occurs when one base is replaced by another or when multiple bases are replaced (see more info on genes on wikipedia). These changes occur within the DNA itself. When genes are copied, each new gene acquires this same mutation. Every new cell gets this mutation too.

Epigenetics alter Gene Behaviors

In contrast to genetic changes, epigenetic changes take place on or outside of the gene. The changes do not replace the actual components of DNA, as mutations do ⁽²⁾citing Francis; also see more about epigenetics on wikipedia .

The effect of epigenetics is to change how a gene behaves without changing the gene itself.

The most common way in which epigenetics affects gene behavior is through the addition of “methyl groups,” as demonstrated below. Methyl groups consist of one carbon and 3 hydrogen atoms and attach through chemical bonds. The DNA segment on the right is said to be “methylated” ⁽³⁾Francis, kindle version, location 198 .

The concept of the methyl group seems much less daunting to me now. And when I see it in research articles that I’m skimming, it has some meaning.

Methylation is just a process that changes a gene’s behavior according to experiences we have in life. Researchers are learning a great deal about these methyl groups and here’s a list of some of the qualities that seem applicable to chronic illness.

8 Characteristics of Epigenetics

1. Environment. The level of activity of our genes, and the degree of methylation that occurs through epigenetics, is determined by environmental factors ⁽⁴⁾citing Francis; and epigenetics on wikipedia . These include:
   • emotions
   • stress
   • adversity & trauma, including adverse childhood experiences or “ACEs” ⁽⁵⁾Papale, L. A., et al. (2018). “Differentially Methylated Genes in Saliva are linked to Childhood Stress.” Scientific Reports 8(1): 10785 , ⁽⁶⁾Romens, S. E., et al. (2015). “Associations between early life stress and gene methylation in children.” Child Development 86(1): 303-309 , ⁽⁷⁾Francis, kindle location 524
     
   • infections
   • toxins
   • drugs and medications
   • diet
   • exercise
2. Level of Activity. Methyl groups affect whether a gene is highly active, slightly active, or turned off completely. The activity of genes affects our bodies and physiologies, as well as our behaviors and emotions. Methylation is one way that epigenetics influences our nervous systems and how we respond to stress ⁽⁸⁾Francis, kindle location 180; also learn more about methylation on wikipedia .
3. Quantity. Having more methyl groups generally makes a gene less active ⁽⁹⁾citing Francis, kindle location 198 . This characteristic is consistent with the cumulative effects of trauma, where greater exposure affects the intensity and severity of symptoms, as well as the rate of onset of a chronic illness (described in The Chronic Illness Model under Trauma #2: compounding).
4. Location. The effects of methyl groups can influence genes at locations quite distant from where they are attached ⁽¹⁰⁾Francis, kindle location 383 . This is how gene regulation affects hormones and receptors in the brain, for example, which in turn affects the regulation of distant organs, such as the adrenals in the belly.
5. Development. All of our cells carry the same genes, but different genes are active in different cells. As we grow a body from the starting point of a single-celled egg, methyl groups are what guide development. They determine which cells become heart tissue, liver cells, brain cells and other tissues. This is relevant to the impact of life events during the prenatal period and in early life, when organ systems are going through critical periods of development and influenced by a mother and fetus’ life experiences (described in The Chronic Illness Model under Development and Relationship #1: critical periods).
6. Measurement Tool. The measurement of methyl groups is being used by researchers to evaluate effectiveness of treatment. A 2013 study, for example, treated combat veterans for PTSD with short-term psychotherapy ⁽¹¹⁾Yehuda, R., et al., Epigenetic Biomarkers as Predictors and Correlates of Symptom Improvement Following Psychotherapy in Combat Veterans with PTSD. Front Psychiatry, 2013. 4: p. 118. . The veterans who no longer had PTSD after treatment showed a decrease in methyl attachments on specific genes compared to levels before treatment. The veterans who improved also had fewer methyl group attachments than the veterans who did not.
7. Reversibility. As noted in Yehudas’s ⁽¹²⁾Yehuda, R., et al., Epigenetic Biomarkers as Predictors and Correlates of Symptom Improvement Following Psychotherapy in Combat Veterans with PTSD. Front Psychiatry, 2013. 4: p. 118. study above, epigenetic modifications are potentially reversible ⁽¹³⁾Francis, kindle location 80 .
8. Transgenerational. The effects of environmental factors can be transmitted to the egg and sperm, and can affect multiple future generations. These effects can decrease as well as increase risk of chronic illness in these future generations. One study found protective effects of diets high in methyl groups (called methyl donors) in a study of mice prone to cancer and diabetes. These studies are described, along with some of the other characteristics described above, in a great introductory article in Discover Magazine, “DNA is not Destiny” ⁽¹⁴⁾Watters, E., DNA is not your Destiny: the new science of epigenetics, in Discover. 2006 from 2006. The diet isn’t very detailed in the article other than to mention beets, onions, and garilc as being methyl-rich, so I’ll write more in a future post when I learn more.

Epigenetics and Chronic Illness

The role of trauma in the shaping of disease is much more powerful – and unrecognized – than we have acknowledged.

The study of epigenetics is showing important mechanism by which life experiences affect how our genes behave and why it’s not psychological.

Epigenetic changes have been found to be reversible, at least some of the time, even with a seemingly indirect treatment such as psychotherapy.

So the question becomes, if epigenetic changes are reversible, might chronic illnesses be reversible as well?

In future posts I’ll look at some of the other questions I have about the role of epigenetics in chronic illness, including:

• the role of prenatal, birth, and early life events
• the effects of trauma in childhood
• transmission to future generations
• how stress and trauma in the first, second, and third trimesters of pregnancy affects risk for different diseases
• as well as some findings about ME/CFS and other chronic illnesses, and more.

Are there any  particular life experiences that affected your risk for chronic illness? Have you tried anything that has helped with your symptoms or disease?

Resources

Free ebooks for more on trauma and chronic illness

Books and Therapies for Healing Nervous System Perceptions of Threat

Brain Plasticity and Chronic Illness

Chronic Illness and Trauma: Summary of the Science

References

“Epigenetics: How Environment Shapes our Genes ⁽¹⁵⁾Francis, R.C., Epigenetics: how environment shapes our genes [kindle edition]. 2012, W. W. Norton & Company: New York. p. 256 ,” by Richard C. Francis. Much of the information in this post comes from this book.

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