Endocrinologists speak out about two 'Internet diseases': adrenal fatigue and Wilson's temperature syndrome

Everyone knows there is a lot of garbage on the Internet, particularly medical information that is distorted, misleading or flat-out wrong. The Hormone Foundation, the public-education affiliate of the Endocrine Society, on Wednesday issued fact sheets about two "Internet diseases": diseases that exist only in the minds of people who post about them on the Internet. The so-called diseases in question are adrenal fatigue and Wilson's temperature syndrome, diseases apparently conceived only in an effort to sell products promoted to treat them.

Adrenal fatigue, whose symptoms are said to include tiredness, trouble falling asleep at night or waking up in the morning, salt and sugar craving and needing stimulants such as coffee to get through the day, is said to be caused by overstimulation of the adrenal glands. Long-term life stresses, the theory goes, wear out the adrenal gland so that it can no longer keep up with the body's daily needs for stress hormones such as cortisol.

Those symptoms, the foundation said, may be produced by other diseases and can also occur as part of a normal, busy life.

Adrenal fatigue "is not a real medical condition," the foundation said. There are no scientific facts to support its existence, and it cannot be diagnosed through blood tests -- which would reveal a shortage of adrenal hormones.

Vitamins and supplements promoted to treat this "disease" often include extracts from human adrenal glands and hypothalamus that could be dangerous, and none of them have been tested for safety. Unfortunately, Congress has not given the Food and Drug Administration authority to regulate nutritional supplements such as those marketed for adrenal fatigue.

The foundation noted, however, that there is a very real disease called adrenal insufficiency. It is not caused by stress, but by physical damage to the adrenal glands or by tumors growing on them. Its symptoms include dehydration, confusion, weight loss, weakness, dizziness and low blood pressure. Other symptoms include stomach pain, nausea, vomiting and diarrhea. It can be diagnosed through blood tests and is treated with medications that replace the hormones the adrenal glands would normally make.

Wilson's temperature syndrome was supposedly identified in 1990 by "E. Denis Wilson M.D." of Longwood, Fla. He said that stress and illness result in a hormone imbalance that causes a lack of the thyroid hormone T3, resulting in low body temperature and slow metabolism. He promotes a product called WT3 that is supposedly a time-released version of the hormone T3, as well as special herbal and nutritional supplements. Such treatments are dangerous because too much T3 can stress the heart and damage bones.

Again, there is no medical evidence to support the existence of Wilson's temperature syndrome, no medical test can diagnose it, and there's no clinical evidence that the drugs and supplements promoted by Wilson offer any benefit.

"Doctors urge you not to accept an unproven diagnosis like Wilson's syndrome," the foundation said. "Your symptoms could be caused by a serious health problem. To take care of your health, it is important to get a correct diagnosis and proper medical treatment."

Wilson's temperature syndrome is also discussed at Quackwatch along with other "fad diagnoses."

Neither Medicare nor insurance companies will pay for treatments for either disease because they are not considered real conditions.

Infertile men 2.6 times as likely to have aggressive prostate cancer

Men who have difficulty conceiving children are 2.6 times as likely to have highly aggressive prostate cancer and 60% more likely to have slow-growing tumors, researchers reported Monday. Although the absolute risk of developing prostate cancer was still low in these men, the findings suggest that such men should be screened for prostate cancer at an earlier age, said Dr. Otis Brawley, chief medical officer of the American Cancer Society.

Previous studies have looked at the relationship between prostate cancer and the number of children a man has, but they have produced differing results. Some suggested that fatherhood was protective, while others suggested that it increased risk. Because the number of children a man has may not be an accurate reflector of his fertility, Dr. Thomas J. Walsh of the University of Washington School of Medicine and his colleagues decided to study men who had been evaluated for infertility.

The team studied 22,562 men who had been evaluated from 1967 to 1998 at 15 California infertility centers, comparing them with a similar group of healthy men from the general population. They reported in the journal Cancer that they identified 168 cases of prostate cancer among the men, about the same as the 185 cases that would be expected in a group that size. That suggests that simply being evaluated for infertility does not affect the incidence of prostate cancer.

Overall, 0.4% of the fertile men developed prostate cancer during the decade of follow-up, compared with 1.2% of those diagnosed as infertile. Taking age into account, that translated to a 160% increased risk of developing aggressive tumors and a 60% increased risk of developing slow-growing tumors, the team reported.

It is not clear why infertile men have a higher risk. Walsh speculated that the risk might result from exposure to environmental toxins in the womb that cause damage to the male chromosome, but argued that more research needs to be done, both to confirm their findings and to explore potential mechanisms.

Prostate cancer is the most common cancer in men after skin cancer, striking 192,000 American men each year and killing 27,000. Other risk factors include older age, a family history of the disease, obesity and being African American. Most national organizations now recommend that men be offered screening beginning at age 50, but there is a widespread controversy about this. Some critics argue that the screening leads to an unacceptably high rate of invasive procedures in men who do not have cancer, leading to impotence, urinary incontinence and other problems

Rise in male infertility linked to plastic food and drink cartons

Men with the highest levels of Bisphenol A (BPA) in their bodies had sperm counts which were 23 per cent lower on average than men with the least exposure, a study showed.
There was also a ten per cent increase in their sperm DNA damage.
BPA is used to harden plastics and is found in the linings of food and drink cans, reusable water bottles, CD cases, plastic cutlery and baby bottles.
Despite being banned in Canada, three US states and Denmark, British authorities insist the controversial compound is safe.
Damaged sperm are more likely to lead to infertility and a greater likelihood of miscarried foetuses and even birth defects.
BPA was found in 90 per cent of urine samples given by 190 men recruited at a fertility clinic for the Harvard University study.
They found a ten per cent rise in sperm DNA damage between those with the highest levels of BPA compared with those with the lowest.
Previous studies have shown adverse effects of the chemical on semen in rodents but none is thought to have reported a similar relationship in humans.
Dr Allan Pacey, a fertility expert at Sheffield University, said: ‘This survey needs to be followed up. The inference is it’s not good for fertility but it’s also not good for any foetus.
'In extreme cases it could lead to disabilities but it’s more likely the pregnancy will end in a miscarriage.’
The Food Standards Agency said human exposure to the chemical via plastics is ‘well below levels considered harmful’.

Gym fanatics risk fertility problems

Researchers found that exercising daily or to the point of exhaustion made fertility problems three times more likely.
While experts agree that a certain amount of physical exercise has obvious health benefits, it is believed that too much saps the body of the energy it needs for a successful pregnancy. The findings were made by Norwegian University of Science and Technology after a study of 3,000 women.
Although it is known that some elite female athletes have problems starting a family, other women who push themselves to the limit also appear to be affected.
In a survey, the women were questioned about the frequency, duration and intensity of their fitness regimes between 1984 and 1986. In a follow-up 10 years later, they were asked about their pregnancies.
Sigridur Lara Gudmundsdottir, who led the study, said: "Among all these women, we found two groups who experienced an increased risk of infertility. There were those who trained almost every day, and there were those who trained until they were completely exhausted. Those who did both had the highest risk of infertility."
Even after taking other factors such as age, weight, marital status and smoking into account, figures showed those who trained the hardest were three times more likely to have fertility problems than those who exercised moderately.
Younger women appeared to be more vulnerable to the risk. Among the under-30s who exercised the most, a quarter were unable to conceive during their first year of trying, compared to the national average of roughly seven per cent.
However, the negative effects of a punishing routine did not appear to be permanent. "The vast majority of women in the study had children in the end," Gudmundsdottir said.
"And those who trained the hardest in the middle of the 1980s were actually among those who had the most children in the 1990s," she added.
It was not known whether this was because the women had simply changed their activity levels or because their hormone profile improved with time. There was no evidence of impaired fertility through moderate amounts of exercise.
Gudmundsdottir advised that women who want babies should still maintain their fitness - but "ease off a bit" and avoid extremes. "We believe it is likely that physical activity at a very high or very low level has a negative effect on fertility, while moderate activity is beneficial," she said.

Decoding of DNA may unlock the hidden medical histories of Irish lives

The decoding of the first Irish genome represents a significant advance in the quest to understand the link between genetic variation and disease susceptibility on this island.

This places the Irish genetic code in the public domain for the first time and permits it to be compared with mappings of the codes of other population groups.

This is important as it is only by comparing the genome with other sequences that scientists can hope to isolate a specific “Irish genetic signature”, and to understand the genetic basis of our susceptibility to certain diseases.

A principal reason for sequencing Irish DNA was that it was not represented in any of the large genomic studies under way, explained the Irish project’s originator Prof Brendan Loftus of University College Dublin’s Conway Institute.

“Certain gene variants can become locked in a population due to factors like geography. Irish people’s genes mirror the island’s peripheral location in Europe, which makes it an interesting subgroup to sequence,” Prof Loftus said.

“Some 13 per cent of the variation we uncovered has not been seen before. It’s likely that some of that variation is specific to the individual and some is more diagnostic of him being Irish. We will only find out which is which over time.”

A Mayo-born graduate of Dublin City University, Prof Loftus spent the 1990s working in the US under the well-known Craig Venter, collaborator on the first human genome sequencing project completed in 2003 at a cost of €2.7 billion.

In contrast with the original human genome project, the Irish project was carried out with the resources of a small lab over about 13 months and at a cost of €30,000.

Prof Loftus said the project illustrated how rapidly the accumulation of genomic information on a population level can be generated.

But he acknowledged that while the capacity to generate the sequence data is proceeding at pace, the rate at which the data can be reliably interpreted has lagged behind.

One area where genetic sequencing is likely to play a major role is in patient response to medication.

“The majority of blockbuster drugs, from aspirin to cancer medication, don’t appear to work on significant sections of the population,” said Prof Loftus.

“There is a big thrust in the medical community towards personalising medicine and nutrition because people respond in different ways to the same product.

“And one of the most likely reasons for this is their genetic background. The drug companies are interested to see who these people are, and to find out if they will respond to variations of the existing drug compounds.”

Since the first human sequence was generated in the US in 2003, between 20 and 30 full human genome sequences have been published.

However, the rapid acceleration in DNA sequencing technology in recent years has seen a proliferation of projects, with more than 100 separate projects in progress.With the cost of sequencing dropping all the time, experts maintain it won’t be long before people will be carrying around parts of their genome on a USB key.

US company 23andMe, established by Anne Wojcicki – wife of Google founder Sergey Brin – already offers to sequence portions of the genome using a sample of saliva, for as little as $350.

Dr Gerard Cagney, principal investigator in functional genomics at the Conway Institute, said representative species from all branches of the tree of life – bacteria, fungi and plants, along with animals ranging from worms to insects and from fish to monkeys – are now being sequenced daily.

“Nevertheless, the technical difficulty associated with sequencing a small virus like HIV, containing some 9,000 units of DNA, pales in significance next to the challenge of sequencing a human genome, composed of more than three billion units.

“The problem is compounded by the fact that the entire sequence is assembled from short individual sequence fragments – typically less than 200 units – so the final product is similar to piecing together a huge jigsaw puzzle, and requires the work of computer scientists and statisticians,” Dr Cagney said.

“There are also large regions of repeated sequence in human genomes and their biological significance is still not fully understood.

“The sequencing process therefore relies partly on comparison with other known sequences, and it is for this reason that reading an Irish genome is significant.

“It can be used to place Irish genes in the context of worldwide human genome diversity.”

Genetic factors in breast cancer risk prediction

Breast cancer is now the most common cancer in the UK (see CRUK website). However, thanks to extensive research and improved management, survival rates for breast cancer have been improving for thirty years. Ongoing research is aiming to identify ways of reducing the incidence of breast cancer by improved prevention, as well as to understand the complex biological disease pathways in order to develop new treatments. Sporadic breast cancer is a complex disease associated with both genetic and environmental risk factors. There are now about 20 genetic variants known to be linked to disease susceptibility and more are being identified. Whilst the risk conferred by each is typically small, in combination there may be potential to use these markers to improve risk prediction.


A new study evaluates risk associated with 14 breast cancer risk variants (SNPs), alone or in combination, for half a dozen cancer subtypes [Reeves et al. (2010) JAMA 304(4):426-434], to look at how individual variants and polygenetic risk models correspond to breast cancer risk and subtype. This large prospective study used more than ten thousand women with breast cancer and about as many healthy controls without breast cancer. The scientists used meta-analysis of results from the study as well as of other studies. The analyses of the results suggested that SNPs in the FGFR1 and TNRC9 genes, as well as a third SNP on chromosome 2, were most closely tied to overall breast cancer risk, and that risk prediction was most reliable for oestrogen receptor (ER) positive cancers and lower grade tumours.

The researchers also developed polygenic risk models using combined data on four, seven, or 10 of the SNPs that were most strongly associated with breast cancer. They concluded that women under 70 years of age with the highest polygenic risk scores have an estimated breast cancer risk of 8.8% compared with a risk of 4.4% in women with the lowest polygenic scores. They also found that the polygenic risk score was substantially more predictive for ER-positive cancers (ranging from a high of 7.4% to a low of 3.4%) than ER-negative breast cancers (a range of just 1.4% to 1.0%).

This is an important study which evaluates the predictive value of selected genetic markers identified by different studies and finds that it varies for different tumour subtypes. However, the authors caution that whilst their findings are potentially useful for understanding disease mechanisms, they would not be useful for individual breast cancer risk prediction or population stratification as known risk factors for breast cancer such as family history are more predictive. Nevertheless, this is an interesting line of enquiry and it may be that ultimately the combination of established and novel environmental and genetic risk factors could refine risk prediction for targeted population screening.

Ancient iceman's gene map underway

Otzi, the 5,000-year-old frozen mummy, undergoes modern genetic mapping this year, an international team announced Tuesday.

Members of the team that recently completed gene maps of Egyptian pharaoh King Tutankhamun's family will join with gene sequencing expert Andreas Keller to create a biomedical gene map of the famous iceman, discovered by Alpine hikers in 1991, linking his lineage to diseases and cell biology.

"We are dealing here with old DNA which in addition is heavily fragmented", says Albert Zink of the EURAC Institute for Mummies, in a statement. "It was only by using the very latest technology with its low failure rate that we scientists were able to decode Ötzi's DNA in its entirety within this short space of time."

A look at Otzi's maternal DNA in a 2008 Current Biology report found no links between the iceman, killed by flint arrowhead fired into his back, and modern Europeans. The team hopes to find more about possible living relatives from the enhanced genetic map and look for signs of changes in human genes since Otzi's death.