Epigenetics and Common Medications: Now What?

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Medications induce epigenetic changes
A recent article in The Guardian noted that, “Epigenetics is one of the hottest fields in the life sciences. It’s a phenomenon with wide-ranging, powerful effects on many aspects of biology, and enormous potential in human medicine.”  It is certainly true that epigenetics is a “hot” topic and that epigenetics research is paradigm shifting.  But because the field of epigenetics is so new, we currently have more questions about epigenetics than we have answers.

Questions about Epigenetics

What is epigenetics?  What positively affects epigenetics?  What negatively affects epigenetics?  Do some things have a greater influence on epigenetics than other things?  How do things that negatively affect epigenetics affect health?  How do things that positively affect epigenetics affect health?  How does epigenetics affect the health of our offspring?  At what point in time or development can epigenetic changes in a parent affect the health of a future child?  How likely is it that something that affects the epigenetic profile of a parent will be passed on to a child?  How will epigenetic traits passed from parents to children show up in the children?  What happens on a biochemical level to induce epigenetic changes?  How does the recent research on epigenetics change disease models?  What can I, personally, do to influence my epigenetics?  What should I do if I suspect that a toxic substance has negatively affected my epigenetics? Can negative or positive epigenetics lie dormant then show up in future offspring?

There are hundreds of questions around epigenetics that scientists are diligently working to answer.  Most of the answers to the questions listed above have partial answers that can be found in journal articles and text books. None of the answers are complete or comprehensive yet. There is much that is unknown and there is much to be learned in this relatively new field of research. Just touching on what is known about each of the questions listed would make this post long and convoluted, so I won’t go into details about each one.  However, it should be noted that the answers to these questions are meaningful for determining how people live their lives.

In this post, I will give a brief overview of what epigenetics is, I will point out that many popular pharmaceuticals have been shown to have a deleterious effect on epigenetics, and I will explore the question – What should you do if you have been exposed to a pharmaceutical that has been shown to cause persistent epigenetic changes?

What Does Epigenetics Mean?

The underlying DNA sequence that each individual has is static, but those genes can be turned on or off depending on conditions in the environment. The process of those genes turning on and off is epigenetics. The term “gene expression” is often used when describing epigenetics.

In “Epigenetic side-effects of common pharmaceuticals: A potential new field in medicine and pharmacology,” epigenetics is described as:

The term “Epigenetics” refers to DNA and chromatin modifications that persist from one cell division to the next, despite a lack of change in the underlying DNA sequence. The “epigenome” refers to the overall epigenetic state of a cell, and serves as an interface between the environment and the genome. The epigenome is dynamic and responsive to environmental signals not only during development, but also throughout life; and it is becoming increasingly apparent that chemicals can cause changes in gene expression that persist long after exposure has ceased.

This BBC Horizon documentary, The Ghost in your Genes, more thoroughly describes the mechanisms and the study of epigenetics:

In The Ghost in your Genes, both famine and stress are noted as things that not only change gene expression in the person who is experiencing famine and/or stress, but also change the gene expression / epigenetics of the children and grandchildren of those who experience stress or famine at critical times in their development.  In both a NOVA documentary on epigenetics and a study published in Nature Communications in 2014, it was noted that not only famine, but what a mother eats before and during her pregnancy can affect gene expression in her offspring.  Additionally, the authors of the article “Epigenetic side-effects of Common Pharmaceuticals” hypothesize that, “commonly-used pharmaceutical drugs can cause such persistent epigenetic changes.”

I took one of the drugs highlighted in “Epigenetic Side-effects of Common Pharmaceuticals” (Ciprofloxacin – a fluoroquinolone antibiotic) and had an adverse reaction to it.  According to the article, my adverse reaction may have been due to an epigenetic mechanism causing the adverse effects.  This leads me to the question of:

Now What?

Some of the drugs described in “Epigenetic side-effects of common pharmaceuticals: A potential new field in medicine and pharmacology” as having adverse effects through an epigenetic mechanism are: synthetic estrogens, combined oral contraceptive pills, fluoroquinolone antibiotics, beta-blockers, statins, cox-2 inhibitors, neuroleptics, SSRIs, Ritalin, Adderall, chemotherapeutics and general anesthetics. With 70% of Americans taking prescription drugs, and many of the drugs noted being popular, the question of what people are supposed to do after exposure to these drugs – in order to minimize and repair the epigenetic damage done – is not a trivial one.

I had an adverse reaction to Cipro/Ciprofloxacin, a fluoroquinolone (also called quinolone) antibiotic that has been shown to “inhibit eukaryotic DNA polymerase alpha and beta, and terminal deoxynucleotidyl transferase, affect cell cycle progression and function of lymphocytes in vitro, and cause other genotoxic effects.”  That sounds like pretty severe cellular genetic damage and it leads me to wonder – what am I supposed to do now that I have taken, and had an adverse reaction to, a drug that has been shown to cause, “extensive changes in gene expression….suggesting a potential epigenetic mechanism for the arthropathy caused by these agents?”

Should I change my diet so that I only eat things that are good for my liver and heart because, “It has also been documented that the incidence of hepatic and dysrhythmic cardiovascular events following use of fluoroquinolones is increased compared to controls, suggesting the possibility of persistent gene expression changes in the liver and heart?”  Will foods that are good for my heart, or a liver cleanse, trigger positive gene expression that can reverse the negative gene expression induced by the Cipro?  Are nutrient dense foods and liver cleanses powerful enough to combat the ill effects of a pharmaceutical that is specifically designed to disrupt the DNA replication process?  (Fluoroquinolones are supposed to disrupt the DNA replication process for bacteria while leaving eukaryotic cells intact. Unfortunately, fluoroquinolones also have deleterious effects on  mitochondrial DNA replication and chromosomes of eukaryotic/human cells.)  How do I know whether or not gene expression for liver and heart disease have been turned on in me?  If heart or liver disease genes have been turned on, can I turn them back off?

Epigenetics across Generations

Should I not have kids?  A chemotherapeutic agent, Topotecan, with the same mechanism of action as fluoroquinolone antibiotics – the disruption of DNA replication through interrupting topoisomerases – was found to “profoundly affect the expression of long ASD (autism spectrum disorder) candidate genes” according to the study, “Topoisomerases Facilitate Transcription of Long Genes Linked to Autism” published in Nature in September, 2013.  Autistic kids are just as much of a blessing as non-autistic kids, but the question remains; did Cipro negatively affect my epigenetic profile in a way that will cause negative gene expression in my children, should I choose to have them?  I wasn’t pregnant when I took Cipro though. Does that matter? Does the timing of exposure to the pharmaceutical that negatively influences gene expression make a difference?

A friend’s son was given a drug to keep him from wetting the bed.  Shortly thereafter he developed Tourette’s-like symptoms.  Several drugs used to prevent bed-wetting fall into the category of “Neuroleptics, SSRIs, Ritalin, Adderall.”  Per Epigenetic Side-effects of Common Pharmaceuticals, “The long-term use of these drugs causes an iatrogenic disease termed ‘‘Tardive Dyskinesia” (TD), which refers to a variety of involuntary, repetitive movements such as grimacing, tongue protrusion, lip smacking, puckering and pursing of the lips, and rapid eye blinking.”  Those symptoms are awfully similar to my friend’s son’s symptoms and it made us wonder, should he talk to his son about the possibility that he carries epigenetic errors that can be transcribed to his future children?  Should his son take that into consideration when he is of an age to have children?  Could my friend’s future grandchildren be adversely affected by a drug that was given to his son to stop bed wetting?  If so, how might they be affected?

Lessons Learned and Forgotten from Thalidomide and DES

How does pharmaceutical induced epigenetic damage affect a person’s children or grandchildren?  Some drugs, such as thalidomide and DES, have demonstrably shown that intergenerational adverse epigenetic effects of pharmaceuticals are possible, and can be severe.  “Diethylstilbestrol (DES), which was used to prevent miscarriages and other pregnancy complications between 1938 and 1971, is known to cause cancer in the male and female reproductive tracts later in life. Many other adverse associations have been identified in DES-exposed women and their offspring, and animal studies have shown effects in the next generation (grandchildren), a clear demonstration of transgenerational epigenetic effects.”  You can read about some of the effects of DES on children and grandchildren of exposed women HERE, HERE, and through doing a search for “DES” on Hormones Matter.  The transgenerational adverse effects of DES and thalidomide are frightening, and you’d think that lessons would have been learned from those experiences, but did we actually learn any lessons?  The effects of DES and thalidomide on the children of the women given those drugs were rooted in epigenetics, yet some of our most popular pharmaceuticals today also have deleterious effects on epigenetics. Is it possible that we learned nothing and that the harm brought on by drugs given to millions of people today (drugs like fluoroquinolone antibiotics, SSRIs, statins, and others are prescribed to millions of people annually) are going to show up as amplified harm in our children and grandchildren?

It is not yet known what the intergenerational effects of fluoroquinolone antibiotics, most chemotherapeutics, statins, beta-blockers, SSRIs, etc. are. But it is a question that is worth asking and it is certainly a question that is worth exploring and answering in a scientific way.  With millions of people taking pharmaceuticals daily, and many of those people having children, we should all demand answers to the questions of how pharmaceuticals are affecting not just our individual gene expression, but also how the genes of our children and grandchildren are going to be expressed.

Until those studies come out, what are we, collectively, supposed to do with the information that pharmaceuticals are adversely affecting gene expression?

What I’m Going to Do

I know what I’m going to do. I’m learning as much as possible to empower myself; I’m not having kids; I’ll try to live a healthy lifestyle. I feel okay about these things. I grieve a bit for the loss of my trust in the medical system, and for the decision not to have biological children, but on an individual level, these decisions aren’t tragic. However, if many people follow my lead, there would be quite a bit of trouble in the world. It’s not realistic for everyone who has taken a SSRI, beta-blocker, fluoroquinolone, statin, etc. to forego having kids. It’s not going to happen. Honestly, I don’t even know that it should happen. There are too many questions that are still unanswered about how pharmaceuticals affect epigenetics and what those epigenetic effects look like, for anyone to make an informed decision.

But we still should ask the difficult questions.  And we should still demand answers to the difficult questions.  We deserve to know – what should we do if our gene expression has been negatively affected by a pharmaceutical?  There won’t be easy answers, but the hard questions, and the hard answers, are valuable.

Note:  Unless otherwise specified, quotes are taken from “Epigenetic side-effects of common pharmaceuticals: A potential new field in medicine and pharmacology

Information about Fluoroquinolone Toxicity

Information about the author, and adverse reactions to fluoroquinolone antibiotics (Cipro/ciprofloxacin, Levaquin/levofloxacin, Avelox/moxifloxacin and Floxin/ofloxacin) can be found on Lisa Bloomquist’s site, www.floxiehope.com.

 

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