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Epigenetics or how, by means of the physiology in and around cells certain molecules can by means of epigenetic mechanisms alter the gene expressions by turning it (that often happens in a certain degree) off or on and thus lead to physical complaints associated with (complex) PTSD which is in fact a stress disorder. It is often long-term stress initiating more diseases by means of epigenetics that explain these diseases. After all, Diabetes 2 and even more that we consider to be psychosomatic can be explained by epigenetics. When we discover these epigenetic mechanism we can create medicine to alter these set epigenetic influence.

What is epigenetics:

Many people and even scientists think exclusively in genetic traits, but the message or picture is not complete and creates the idea that genes has nothing to do with environment. It now appears that epigenetic mechanisms by means of nutrition and amino acids clearly have a function in the genetic expression - that is, on the functioning of the DNA - of properties and thus sensitivity, for example for psychiatric problems and thus resilience. But also the impact of environment and moreover stress. What exactly is epigenetics? It is, however, a mechanism that can partially or completely switch on or off certain genes and thus expressions. Thus, in particular, physiological conditions of cells - in and around the cells and therefore tissue - play a major role. Compare the genes with musical instruments of the orchestra and epigenetics with how the instruments of the orchestra are played.

Both Lamarck and Darwin are right it's how genes are the script that can be altered

The epigenetic influence

The gene expression and impact of mutations

Importance of neurological examination:

Although a meta-analysis of studies on the size of hypocampal structures clearly showed a significant reduction in client with PTSD, neurological examination is hardly a common practice or not done in mental health care. That is more surprising since many psychiatrists in particular claim that the brain is responsible for many diseases. The test methods for memory research are often no more than a 15-word list, based on implicit and explicit learning. So also the development of sub tests for, among other things, motor memory, short term memory (prefrontal cortex)  and also for other areas because our

brain has from a evolutionary point of view a adaptive learning ability. So we must have a better picture how these integrative memory processes work, according to other integrative processes like consciousness, ego or identity. We should therefor test how this integration progresses present themselves. People with PTSD can clinically suffer from under performance in clinical neurological tests due to experienced pressure. Finally, an IQ test is certainly important to determine to what extent a client can handle an insightful therapy and how communication can best take place between client and therapist.

Epigenetic mechanisms including DNA methylation and histone modifications are critically involved in immune responses. Antigenic stimulation together with a specific cytokine environment drives helper T cell differentiation into specific subsets with different functional capacities. This process takes place by induction of chromatin remodeling and changing transcriptional accessibility of important cytokine genes, such as IFN-γ, IL-4 and IL-17.

These epigenetic changes are by definition passed over the entire cell distribution to ensure selective survival of a cell line. Over the past decade, a growing piece of literature has unraveled the central role for epigenetic regulation in immunity mechanistically. In this review we focus on epigenetics in T-helper cell differentiation, regulatory T-cell function and IL-2 production.

Autoimmune system and diabetes:

Type 2 diabetes is likely to have its roots in an autoimmune reaction deep in the body, according to researchers at the Stanford University School of Medicine and the University of Toronto. The finding, in combination with a similar study by the same

group in 2009, sees the disease in an entirely new, unexpected category that opens the door to new potential therapies.
Edgar Engleman

Source: Stanford Medicine News center

Stress & diabetes:

As if a reduced immune system, shrunken brain and premature aging were not enough, a new study shows that stress (including PTSD) has another potential health effect: a higher risk of diabetes for men.
The study, conducted by researchers at the Sahlgrenska Academy at the University of Gothenburg, showed a correlation between reporting permanent stress - as opposed to reporting no stress or periodic stress - and an increased risk of diabetes.
The research, published in the journal Diabetic Medicine, included about 7,000 men without diabetes, heart disease or stroke history, who were born in Gothenburg, Sweden. Researchers tracked whether the men were developing diabetes, based on their hospital and death records.
At the beginning of the study, 15.5 percent of men reported  

that had 'permanent they stress' at home or work, based on their responses to a six-point scale. After 35 years, the researchers found that those who reported permanent stress are 45 percent more likely to have type 2 diabetes, compared with those who only report periodic stress or no stress.
And this is even after the researchers have taken into account other known diabetes risk factors, such as high blood pressure, age and physical activity level.
"Self-absorbed permanent stress is an important long-term predictor of diagnosed diabetes, independent of socio-economic status, BMI and other conventional risk factors of type 2 diabetes," the researchers wrote in the study.

PTSD and diabetes:

Studies show that people with PTSD are more likely to develop diabetes. The unhealthy behavior often associated with PTSD (eg smoking, substance use, poor eating habits) can be a risk factor for developing diabetes. In addition, in people with diabetes, the stress and unhealthy behavior of PTSD can have a negative effect on the course of diabetes. Specific health problems in people with PTSD and diabetes.
Researchers at the State University of New York Upstate Medical University and the VA Medical Center in Syracuse, New York, investigated the specific health problems among people with both PTSD and diabetes. They identified 14,795 military veterans with diabetes and looked at whether the veterans had PTSD, depression or other psychiatric diagnoses or not.
Participants were divided into four groups: people with depression and PTSD, people with
PTSD, but no depression, people with

depression but no PTSD, people with other psychiatric diagnoses in addition to PTSD and depression and people without psychiatric diagnoses. Over these different groups, they examined differences on a number of different health-related factors, such as glycemic control, cholesterol levels (total cholesterol, LDL and HDL), triglyglycerides, weight, body mass index (BMI).
The researchers found that compared to other groups, people with both PTSD and depression:
* Had a worse total cholesterol levels and LDL
* Had a higher triglyglyceride level
* Weighed more
* Had a higher BMI
With regard to glycemic control, however, people with depression had worse glycemic control than in people with PTSD or PTSD and depression.

Source: Verywell

Relation PTSD and fibromyalgia/ rheumatoid arthritus

After researching nearly 50,000 women, researchers have found a link between rheumatoid arthritis and PTSD. It is well known that posttraumatic stress disorder (PTSD) can lead to a number of physical, mental and emotional problems. Now researchers have found that PTSD can be linked to or even a number of chronic conditions. A study by Harvard Medical School and the National Institutes of Health (NIH) discovered a definite increase in PTSD symptoms in female RA patients.

The results, published in the medical journal Arthritis Care and Research, showed a connection between the two conditions. A significant number of patients diagnosed with PTSD later developed RA. Dr. Yvonne C. Lee and colleagues from Harvard Medical School in Boston studied 54,224 female nurses from 1989 to 2011. Participants completed a short trauma questionnaire and were screened for PTSD.

The participants were later classified according to both exposure to the trauma and their number of PTSD symptoms. At that time, 239 women in the study also had RA. The study found that women who had four or more symptoms of PTSD also had a higher risk of developing RA compared to those with little or no exposure to any form of trauma. What does it mean?

It is unclear why there is a relationship between RA and PTSD. According to the authors of the most recent study on PTSD

and RA, further studies are needed to investigate the role of other behaviors and clinical features, such as alcohol use and obesity, as potential contributors and / or mediators of the association between PTSD and Risk for RA . "
A study in 2015 aimed at veterans also showed a connection between PTSD and RA.

The presence of at least four PTSD symptoms was associated with a 76 percent increased risk of RA compared with people who had no history or symptoms of trauma. Lee, who was also involved in a research group in this study, said that inflammation can play a role, but nobody knows for sure.

"Years ago I noticed when working with [military] veterans that people with severe chronic PTSD also had inflammatory diseases," wrote Joseph A. Boscarino, Ph.D., of the Geisinger Clinic in Pennsylvania, in an online column.

"They have often had diseases such as rheumatoid arthritis and psoriasis and it was thought to be related to an increase in the immune response," noted Boscarino.

The physiology behind why PTSD is associated with a risk of developing diseases such as RA in nurses and veterans is not yet known. However, this discovery may be a potential part of the complex puzzle surrounding autoimmunity.

Source: Healthline