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All this is possible through the magic of epigenetics!

Every few years, it seems, a new concept emerges as the favorite go-to means of marketing unproven and highly implausible approaches to health care. Explanations of the proposed healing properties of homeopathic remedies incorporating quantum mechanics immediately comes to mind as an example of this phenomenon. Or how proponents of the most absurd treatments will just add “Nano” to anything and claim scientific miracles of healing.

From the Nano SRT website:

Q: What Is Stress Reduction Therapy?
A: SRT is a remarkable new procedure that combines the disciplines of Acupuncture, Biofeedback and Homeopathy with Laser Light technology. A computerized scan or test is done to see what your body is sensitive to, and how it is out of balance, then help it learn not to be.

Q: What does the Nano SRT do?

A: Substance specific frequencies converted to a digital format, and presented in the form of sound and light, are what allow for patient assessment and therapy down to the molecular level. The frequencies are what make it possible to assess thousands of substance sensitivities in mere minutes, then allow the brain and nervous system to record a new association that is positive or neutral instead of the inappropriate ones that were previously stored in memory. This breaks the link between the stimulus and response, makes symptoms unnecessary, creates balance and harmony, from dis-ease and disharmony, and allows the body to function better.


Notice the use of “frequencies,” “laser,” and “molecules” as bonus examples of pseudoscientific language. This new learning amazes me. Perhaps I will begin to make use of the concept at work: “I’m sorry Mrs. Johnson. Your child used to know how to not have pneumonia but he forgot, and his body needs to relearn it in order to not suffer from persistent pulmonary disharmony…because molecules.”

The current favorite in the world of irregular medicine appears to be epigenetics, which almost always amounts to magic or “The Secret” when they use the word. Of course, as Dr. Gorski discusses in a 2013 post on the subject, quacks aren’t the only people hyping epigenetics. They just imbue the concept with magical qualities, often claiming to be able to change the health of not only the patient but future generations as well.

According to some proponents of homeopathy, for example, as our scientific understanding of epigenetics improves we are beginning to realizing the many parallels with homeopathic principles.

From the website of Anke Zimmermann, a Canadian “Naturopathic Pediatrician”:

Not only physical problems may be caused by infections in previous generations, mental and emotional issues are also prominent. A family history of syphilis may be linked to obsessive compulsive disorders, deep phobic states and even violence in the offspring.

Worried that this sounds a little far-fetched? Well have no fear. According to “Dr.” Zimmermann, “All of this is well documented in the homeopathic literature.” She has seen it personally many times during her career and she can do something about it too:

A lifetime of anxiety may be relieved by a few doses of homeopathic syphilis, a disease which can totally destroy the nervous system…As the children are treated and their genetic expression normalized, the new, more balanced expression will also help to prevent disease in future generations. A most wonderful concept indeed.

That’s right, homeopathic syphilis. She also prescribes preparations that don’t contain tuberculosis as well. And she claims that these ridiculous concoctions alter the expression of our genes in a positive way. Epigenetics is magic!

Epigenetics is not magic!

What is epigenetics? It is most certainly not magic. Simply put, it is the alteration in the expression or function of a gene without a change in the sequence of DNA. Some experts may argue that this is not exactly right, that there are non-epigenetic mechanisms that do the same thing, but this definition is mostly accurate.

The key distinction, and there is some controversy regarding this, is that epigenetic changes must have the potential to be passed along to new generations of an individual cell line or even to persist in the offspring of an individual organism. Changes in the transcriptional output of genes that are not heritable are not epigenetic according to a 2008 consensus definition. But in 2013, the NIH used a more inclusive definition for their Roadmap Epigenetics Project which includes stable and long-term changes that are not necessarily heritable. Dr. Gorski goes into more detail on this in the post linked to above.

Epigenetics are extremely important throughout the lifespan, but particularly during prenatal development. When a new human embryo is formed, roughly 99% of the epigenetic changes acquired during the lifetime of the parents are “reprogrammed“. This allows the cells of the developing embryo to accrue their own epigenome and differentiate into all the different tissues found in the fully formed organism.

Epigenetic changes allow an organism to respond to their environment in real time. In addition to aiding in prenatal development, epigenetic mechanisms respond to environmental exposures, significant stress and the availability of food, just to give a few examples. They also play a role in the development of many disease states, particularly obesity, certain genetic syndromes, and some cancers.

What are the mechanisms involved in epigenetic changes?

There are three primary mechanisms involved in epigenetic changes:

DNA methylation occurs when a methyl group is stuck onto a cytosine nucleotide that in humans is always sitting next to a guanine nucleotide. Methyl groups are acquired via a specific metabolic pathway that involves important vitamins like folate, B12, and riboflavin. Thus dietary factors and exposure to alcohol can interfere with the process and increase the risk of a variety of diseases. Fetal alcohol syndrome for example.

Proper methylation is vital in prenatal development after reprogramming has occurred, playing a key role in tissue differentiation. A completely blank state doesn’t actually result however, as a very small percentage of the established methylation is passed on to the new embryo. Identical twins share more of their global measures of methylation than dizygotic twins initially, but they drift apart over time. Epigenetics are partially to blame for why even identical twins can have different health outcomes as they age.

DNA methylation plays a large role in genomic imprinting, which in turn plays a large role in some classic genetic syndromes diagnosed by pediatricians. For unclear reasons, some genes are imprinted. This means that instead of acquiring two functional copies of a gene, one from mom and the other from dad, one of the genes is silenced primarily by DNA methylation.

When the process goes wrong, a child can acquire two functioning copies of the gene, no functioning copies of the gene, or an abnormally functioning single copy. One classic example is Beckwith-Wiedemann syndrome, which results in overgrowth and significant risk of intra-abdominal cancers early in life. BWS occurs when in addition to the father’s contributed gene, the normally epigenetically-silenced maternal copy of the insulin-like growth factor 2 gene continues to function because of a methylation error.

Another example is the dyad of Prader-Willi and Angelman syndromes. Both are caused by defects in the same region of chromosome 15, but the specific defects that can occur in the maternal and paternal copies of the genes differ. Because of imprinting, one parent’s gene is silenced. So which of the two clinically distinct syndromes the child develops depends entirely on which parent the abnormal but functioning gene is derived from.

Histone modification involves the alteration of basic structural units of genetic material in the nucleus of each cell, which can reduce the expression of genes. Rather than free floating strands of DNA, proteins called histones serve essentially as spools for coiled DNA to wrap itself around, with each unit being called a nucleosome. Strings of nucleosomes form chromatin, and a bunch of chromatin makes up a chromosome.

Each nucleosome can interact with its environment via portions of the histone proteins which jut out between the attached strands of DNA. If these epigenetic interactions affect enough nucleosomes, changing the chromatin in a region of the chromosome into a less active form, transcription of proteins can be repressed. Asthma is an example of the role histone modification can play in a disease process, but there are many more, including cancer.

Unlike methylation, histone modification has not been found to be heritable. So some experts would not consider it to be a form of epigenetics. I don’t have a horse in this race, and frankly I’m not sure why it matters. It is clearly a mechanism that explains why environmental changes, such as exposure to cigarette smoke, can impact human disease.

Non-coding RNAs make up the vast majority of the human genome, and play a regulatory role in the expression of our genes. The most well understood of these is microRNA. These roughly 22-nucleotide-long regions are believed to help regulate more than half of our protein-coding genes by reducing the transcription of proteins, thus holding a place of great importance in normal functioning of the cell and in disease.

Chiropractic and epigenetics?

I don’t think that the attempts by some in the chiropractic community to use the language of epigenetics will surprise very many people reading this post. Considering their track record of stealing ideas from science-based medical research, the abuse of our rapidly increasing scientific understanding by proponents of alternative medicine makes sense. It’s yet another in a long line of bright shiny objects dangled in front of patients to excite the believers and distract the skeptical.

Here are a few examples:

Chiropractor Serbinski wants you to know that you are not a victim of your genes (the emphasis is hers):

Bottom line: if you can change your environment, you can change your DNA. Thus, everything you do, eat and even think can change your DNA expression. Can chiropractic change your DNA? Yes! Epigenetics is just a fantastical way of explaining how you can control your gene expression (or health) by lifestyle choices you make. Health choices during pregnancy will also affect your newborn. Deleterious life choices can have a profound effect not only us, but also on the health of future generations

Here is a video on Chiropractic Miracles and Epigenetics:

When we adjust your spine, and we release that subluxation or that misaligned bone…that are disrupting the natural tone and energy state of your body. That’s the environmental factor that causes those genes to activate.

Not to be outdone, there is even at least one chiropractic Epigenetics Healing Center:

Dr. Goodbinder PSc. D specializes in Epigenetic science to help you not express disease and be able to function at your best with functional medicine therapies, Epigenetics, nutrient breathing treatments, and lifestyle counseling.

Finally, Chiropractor Kent writes about epigenetics and the potential for chiropractic:

For the chiropractor, correction of nerve interference takes on a deeper significance. Subluxation distorts our perception of the environment, and compromises our ability to respond to it. As every DC knows, following an adjustment, patients frequently report a heightened state of perceptual awareness and well-being. Quite simply, correcting interference may well affect not only the genetic expression of the patient, but also the bodies and brains of their progeny.

The theme running throughout these examples, and the many (Chapman Clinic for Spinal and Craniofacial Epigenetics), many (Anti-vaccine plus epigenetics!) more that can easily be found with a simple Google search, is that epigenetic forces trump the sequence of DNA in our genes. Hence you are not a “victim to your genes.” They simultaneously attack a straw man version of medical science for excessive focus on genes while trumpeting the advances of medical science in support of their claim to be able to harness the power of epigenetics.

As I mentioned earlier in the post, this adulterated version of epigenetics is nothing more than “The Secret” hidden behind talk of methylation and gene expression. You choose to do things, eat things, and even think things that make you sick. It’s your fault. And chiropractic adjustments of your attitude, in addition to your subluxations, can alter the expression of your genes and fix what ails you. This is, as per the routine, claimed without any meaningful evidence.

Conclusion

Epigenetics is a bit mysterious, but there is nothing magical about it. The processes involved, DNA methylation, imprinting, and histone modification, often occur for a good reason but almost certainly also play a role in many, perhaps even most, human ailments. And though not likely to lead to “miracle cures”, at least not anytime soon, our evolving understanding of epigenetic principles is one of the most exciting ongoing developments in modern medicine.

Despite what is claimed by some members of the alternative medical community, harnessing the power of epigenetics is not, and will never be, as simple as thinking your way to health, developing a specialized curative diet, or correcting subluxations that, despite not existing, somehow impair gene expression. We have a long way to go in figuring out all of the pathways involved in epigenetics, and in how to put this knowledge to use. But rest assured it will be science rather than pseudoscience and superstition that leads the way.

There are already some therapies in use based on epigenetic principles, and more are being developed. Researchers are investigating therapies for diabetic retinopathy, cardiac dysfunction and even anxiety disorders to give a few examples. Treatment of cancer has shown the most progress. The FDA has approved at least two drugs that work via demethylation or blocking histone deacetylase in an effort to correct cancer-inducing epigenetic changes. Stay tuned.

 

 

Posted by Clay Jones

Clay Jones, M.D. is a pediatrician practicing at Newton-Wellesley Hospital in Newton, MA, and a regular contributor to the Science-Based Medicine blog. He primarily cares for healthy newborns and hospitalized children, and devotes his full time to educating pediatric residents and medical students. Dr. Jones first became aware of and interested in the incursion of pseudoscience into his chosen profession while completing his pediatric residency at Vanderbilt Children’s Hospital a decade ago. He has since focused his efforts on teaching the application of critical thinking and scientific skepticism to the practice of pediatric medicine. Dr. Jones has no conflicts of interest to disclose and no ties to the pharmaceutical industry. He can be found on Twitter as @skepticpedi and is the co-host of The Prism Podcast with fellow SBM contributor Grant Ritchey.