Methylation and Autoimmune Disease: What Functional Medicine Gets Wrong
Just because someone has low methylation does not mean that this is the cause of their health problems or that it's helpful to boost methylation with supplements. Let me explain.
The other day, I received a newsletter from a well-respected immunology course highlighting a paper on the association between low methylation and autoimmunity.
The 2015 paper published in Immunology & Cell Biology, entitled Epigenomics of Autoimmune Diseases, reviews the strong association between low DNA methylation and a laundry list of autoimmune diseases, including lupus, rheumatoid arthritis, multiple sclerosis and type 1 diabetes.
The newsletter author excitedly highlighted excerpts from the paper indicating that under-methylation of DNA in various tissues may be a "critical element" in the development of various autoimmune diseases and argues that "hypomethylation plays a role in autoimmune disease expression."
For background, "methylation" means adding something called a "methyl group" to another molecule and we use this trick physiologically for all kinds of important functions, from detoxication of environmental toxins to making new blood cells.
We get methyl groups from our diet mainly in various B vitamins and some amino acids. Specifically, we get it from foods containing folate (folate comes from the same root as "foliage" meaning "leaf", so think leafy greens), foods containing B12, like meat, fish and eggs, and foods containing choline found in various animal and plant-based foods.
When it comes to adapting to our environment, we use methylation to change the expression of DNA on the fly, turning it up or down based on our need, which is pretty cool.
So where's the problem and why does this type of message make me a little grumpy? The implication here is that a key contributor to autoimmune disease is that a person doesn't have enough methyl groups in their body and so if we can boost this up, either through diet (preferred) or through boat-loads of high dose supplements (more common), we'll smack the autoimmune disease into submission.
And no doubt, like many misguided ideas, there is a kernel of truth to this. People can be low in methyl groups or have a higher than typical genetic requirement for them and this can be a contributing factor to not enough methylation happening. There are people who have become much healthier from rectifying this specific problem, especially if they are genetically predisposed to requiring more methyl groups than the average bear.
Although as a side-note, if people are consuming a generally crappy, processed diet, low in vegetables or meat or fish, etc we could equally say that it lacks sufficient methyl groups as any other nutrient. In other words, the problem isn't best characterized by low availability of methyl donors but of poor quality and poor nutrient availability in general.
But, and here's the but, that doesn't make this (low intake or low absorption of methyl groups) the only reason for low methylation or even necessarily the main one. See, when a cell gets stressed, like, for example, when it's invaded by a virus, it intentionally turns down methylation to prevent the virus from replicating itself.
Like, imagine if you became aware that someone was steeling your electricity, you might choose to not pay your bill until the squatter was evicted. This is exactly what our cells do, as part of a highly orchestrated series of steps to handle pathogens and stressors developed over 3.5 billions of years of evolution.
And we can see that the paper highlighted here supports this idea. That it's not necessarily that folks with autoimmune illnesses lack methyl groups in general. But rather that the specific tissues in question, which vary based on the autoimmune disease being studied, seem to have low methylation, indicating that either these tissues were stressed and decided to turn methylation down in order to contain a threat or even maybe that the body thought it would be advantageous for certain genes to be expressed more to help the body respond to pathogens, environmental toxins and stress.
Either way, the answer isn't B12 injections and buckets of methyl-folate, as thousands and thousands of folks turning to functional medicine have been learning the hard way over the past few years. There's even some evidence that doing so can increase the risk of certain cancers.
Rather, the solution involves taking a systems based approach and assessing, first, whether there are ongoing stressors that the body is dealing with by choosing to lower its rate of methylation. Rather than assuming that the under-methylation is a) unintentional and b) due to deficiency, which in many cases is simply not true.
If you have a complex chronic health issue, such as an autoimmune condition, then a process based on an understanding of complex systems is important for making steady progress, rather than bouncing around the supplement aisle.