The Walsh Research Institute has long studied the biochemical underpinnings of mood and behavior disorders, focusing on methylation imbalances, copper overload, pyroluria, and methylation subtypes such as over- and undermethylation. Methylation imbalances alone are estimated to account for upwards of 40% of mood and behavior disorders, per the Walsh Approach. In a recent interview for the Institute's advanced training course, Dr. David Epstein, a protégé of Dr. William Walsh, discussed a promising new approach to address high S-adenosylhomocysteine (SAH) levels by optimizing kidney function and supporting methylation through alkalinity and creatine supplementation.

The Challenge of Elevated SAH

SAH is a byproduct of methylation that, when elevated, impairs methyltransferase activity and disrupts critical biological processes, including neurotransmitter synthesis and DNA repair. Standard treatments typically focus on the methionine cycle; however, Dr. Epstein has been investigating a novel pathway: enhancing SAH disposal via kidney filtration.

Kidney Filtration and SAH Removal

Dr. Epstein referenced research showing that up to 40% of SAH is cleared through the kidneys. Poor kidney filtration, often exacerbated by chronic acidosis from conditions like stress, poor diet, and hypoxia, can hinder this clearance. Acidosis impairs enzyme function, including those involved in methylation, leading to SAH accumulation.

To counteract this, Epstein suggests alkalinizing the body using sodium and potassium bicarbonate. By raising pH levels to an optimal range (7.2-7.4), kidney function is enhanced, allowing for more efficient SAH clearance.

Key Insights:

• Chronic acidity impairs methylation-related enzyme activity.
• Kidney health plays a pivotal role in methylation by clearing SAH.
• Alkalizing agents like sodium bicarbonate can improve kidney efficiency.

Improving Methylation with Creatine Supplementation by Reducing Methylation Demand

Creatine synthesis consumes up to 40-50% of the body's methylation capacity. By supplementing with exogenous creatine (5-10 grams daily, and higher for specific cases), methylation demand decreases, freeing methyl groups for other critical processes like neurotransmitter regulation and DNA repair.

Why Creatine Helps:

• Reduces the body's reliance on methyl donors for creatine synthesis.
• Frees up methyl groups for neurotransmitter production.
• Supports muscle integrity and energy metabolism.

Practical Takeaways for Patients

Dr. Epstein's approach, now under study with funding from the Walsh Institute, involves:

1. Alkalinity Support: Sodium and potassium bicarbonate to support kidney filtration.
2. Creatine Supplementation: 5-10 grams daily to reduce methylation load.
3. Kidney Health Monitoring: Checking pH levels via simple urine or saliva tests to maintain optimal kidney function.

Conclusion

This innovative method offers new hope for patients with elevated SAH and methylation imbalances. By addressing systemic acidity, improving kidney function, and reducing methylation demands with creatine, practitioners can better support methylation-related brain and body functions. Dr. Epstein's ongoing research aims to further refine and validate this promising approach for clinical practice.