If you’ve recently come off a boat, plane or train (or even a car or elevator) and are still rocking long after your land legs should have emerged, you’ve probably done some researching online and discovered a condition known as MdDS.

If your persistent rocking and swaying are recent, please try to not to panic! I know this is hard, as I’ve suffered with MdDS myself, and I know what a horrible existence it can be. Most initial cases will resolve on their own within a few weeks, but some cases may require the use of medication, supplements, vestibular/eye exercises or other interventions to try to reach remission.  I use the term “initial” case because once your brain has discovered this path, it is possible that it can choose it again if it is re-triggered.  That is why I will personally never step foot on a boat again. No ferries, no canoes, no stand-up paddle boards, no pontoon boats, no floating watercraft ever again, period.

So why does this happen to some people?  No one has the answers as of now, but after working with many patients with MdDS I have noticed too many similarities to be coincidental.  Here are 4 similar traits I see amongst us:

• Type A Personality and High Cortisol Levels- most MdDS patients are go-getters and tend to be perfectionists. In other words, they are often high functioning and can handle a lot of things on their plate. Because of this, they usually have higher levels of cortisol in their system and suffer HPA axis dysfunction due to stress. (What is the HPA axis?)
• Propensity for Allergies and Auto-Immune Conditions- several patients who develop MdDS have suffered with chronic allergies, food sensitivities and chronic sinus problems. Many also have pre-existing autoimmune conditions such as Hashimoto’s or Lupus. I see more spontaneous onset (not triggered by a boat, plane or train) in patients with Lupus. All of these things could be related to potential methylation defects (see #4 below).
• COMT Neurotransmitter Genetic Variant/SNP -(single nucleotide polymorphisms- (homozygous +/+ or heterozygous +/-) (What are SNPs?)

The most common genetic variant that I see in my MdDS patients is the COMTv158m polymorphism. The COMT gene provides instructions for making an enzyme called catechol-O-methyltransferase which is necessary to breakdown and excrete catechols such as epinephrine, norepinephrine, dopamine and estrogens. If you have a COMTv158M variant, you will have an excess of these excitatory neurotransmitters as well as excess estrogen in your system, due to potential slow COMT activity. This can lead to higher levels of cortisol and cause HPA axis dysfunction, another common trait in MdDS patients. Things like alcohol and caffeine slow our body’s COMT mechanism even more.  Another interesting factor is that estrogen in balanced levels can be both neuro-protective and immuno-protective. However, excess estrogens, particularly 4-OH- E1 and 16-OH-E1 metabolites can be just the opposite and allow for less protection. This may be the reason MdDS is more prevalant in females.  To summarize, If COMT activity is slow and not working effectively in our body, it will inhibit detox pathways and therefore lead to potential estrogen dominance, excess stress and anxiety, and decreased neural protection.

• Methylation Gene SNPs -What is methylation? Methylation is a process in your body that is necessary for so many crucial things. It helps provide proper detoxification, keeps inflammation at bay, regulates cellular processes, increases energy, supports neural pathways and balances neurotransmitters, aids in immune function and much more. Some of the methylation variants that I see in MdDS patients include MTHFR, MTHFD1, PEMT, AND DAO. Each one of these SNPs in itself requires specific supplementation to optimize function. Often times, my MdDS patients have not just one of these SNPs but several. Being homozygous for any of these SNPs can cause more pronounced health problems.

In closing, I believe MdDS is highly tied to a genetic predisposition and associated neural inflammation.  As of now, we may not have the exact answers about how to effectively treat this condition, but what we CAN do is give care to the genetic SNPs with the specific nutrients/vitamins needed to offset the dysfunction. For example, magnesium is a great supplement to help with COMT function, however there are several others and guidance differs depending on each patient’s full gene picture. It is not a one-size-fits-all recommendation, so please do not self-treat! If you are suffering with MdDS and are interested in knowing if you have some of these genetic variants/SNP’s, we offer testing to determine this and would be honored to help you in your journey towards remission. We also offer free 15-minute Preliminary Consultations to patients across the globe which can be scheduled here.

Warmly,

Dr. Wolfe

Dr. Wolfe works as a health consultant. If you have any pertinent health information, files, lab results from any other doctors, she would like you to bring copies of those to your first visit. Because functional medicine services are not covered by most insurance companies, you do not need a referral to see Dr. Wolfe.