Wednesday, September 19, 2012

Mito & VLCADD facts

Since this is Mitochondrial Disease Awareness week, I wanted to make a post about what Mito is as well as specifically VLCADD which is the thyme of Mito that Landon is effected with. I hope this helps educate those who weren't quite sure about Mito and/or VLCADD. I forget with everything we've learned along the way that not everyone has been through the journey with us and doesn't get all the information we do through our support groups and from the doctors and nutritionists. When I met with Landon's geneticists the first time, I literally went in with pages upon pages of questions. He said he had never had anyone 'grill' him in that way about the disease. It was information overload, but I just had to know everything I possibly could right then and there. We then had to wait 11 weeks to get the results from Landon's skin biopsy that was also taken that day when he was 3 weeks old. So, as you all know this a cause near and dear to my heart and my families as well.

Mito and VLCADD Facts:

What is Mitochondrial Disease?
  • Mitochondrial disease is a chronic, genetic disorder that occurs when the mitochondria of the cell fails to produce enough energy for cell or organ function.
  • The incidence about 1:3000-4000 individuals in the US. This is similar to the incidence of cystic fibrosis of caucasian births in the U.S.
  • There are many forms of mitochondrial disease.
  • Mitochondrial disease is inherited in a number of different ways
  • Mitochondrial disease presents very differently from individual to individual.
  • There may be one individual in a family or many individuals affected over a number of generations.

How common are mitochondrial diseases?
  • About one in 4,000 children in the United States will develop mitochondrial disease by the age of 10 years.
  • One thousand to 4,000 children per year in the United Sates are born with a type of mitochondrial disease.
  • In adults, many diseases of aging have been found to have defects of mitochondrial function.
  • These include, but are not limited to, type 2 diabetes, Parkinson's disease, atherosclerotic heart disease, stroke, Alzheimer's disease, and cancer. In addition, many medicines can injure the mitochondria.

What are the Challenges of living with Mitochondrial Disease?
  • Affects multiple organs, affects multiple family members, affects multiple generations.
  • Lack of awareness and understanding of the disease
  • Families are continuously forces to expend their very limited energy to explain their disease, advocate for themselves and fight for services.
  • Mitochondrial disease is often an " invisible disease."
    • Good day - patients look fine and healthy. They have more energy and appear rested.
    • Bad day - - patients appear tired to significantly ill. They are obviously fatigued and/or have significant illness. Repeated "bad days"often lead to decompensation and patients have difficulty returning to baseline.
  • Mitochondrial disease is unpredictable. Day to day, hour to hour patients can develop symptoms and their stability can be threatened.
  • Difficulties establishing a diagnosis interfere with a patient's ability to obtain adequate recognition, medical care, adequate insurance coverage, healthcare supports and disability services.
  • Lack of understanding of the disease and misinterpretation of symptoms can lead to misdiagnosis. Further progression of symptoms can occur if the symptoms are missed and opportunities for treatment and support are not recognized.
  • An individual can become symptomatic at any time in life despite the fact that it is inherited.
  • It is difficult to diagnose.

What is VLCAD deficiency?
Very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency is a condition that prevents the body from converting certain fats to energy, particularly during periods without food (fasting).

Signs and symptoms of VLCAD deficiency typically appear during infancy or early childhood and can include low blood sugar (hypoglycemia), lack of energy (lethargy), and muscle weakness. Affected individuals are also at risk for serious complications such as liver abnormalities and life-threatening heart problems. When symptoms begin in adolescence or adulthood, they tend to be milder and usually do not involve the heart.

Problems related to VLCAD deficiency can be triggered by periods of fasting, illness, and exercise. This disorder is sometimes mistaken for Reye syndrome, a severe disorder that may develop in children while they appear to be recovering from viral infections such as chicken pox or flu. Most cases of Reye syndrome are associated with the use of aspirin during these viral infections.

How common is VLCAD deficiency?
VLCAD deficiency is estimated to affect 1 in 40,000 to 120,000 people.

What genes are related to VLCAD deficiency?
Mutations in the ACADVL gene cause VLCAD deficiency. This gene provides instructions for making an enzyme called very long-chain acyl-CoA dehydrogenase, which is required to break down (metabolize) a group of fats called very long-chain fatty acids. These fatty acids are found in foods and the body's fat tissues. Fatty acids are a major source of energy for the heart and muscles. During periods of fasting, fatty acids are also an important energy source for the liver and other tissues.

Mutations in the ACADVL gene lead to a shortage (deficiency) of the VLCAD enzyme within cells. Without sufficient amounts of this enzyme, very long-chain fatty acids are not metabolized properly. As a result, these fats are not converted to energy, which can lead to the characteristic signs and symptoms of this disorder such as lethargy and hypoglycemia. Very long-chain fatty acids or partially metabolized fatty acids may also build up in tissues and damage the heart, liver, and muscles. This abnormal buildup causes the other signs and symptoms of VLCAD deficiency.

Read more about the ACADVL gene.

How do people inherit VLCAD deficiency?
This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.

sources: and http://ghr.nlm.nih.govpost signature


  1. My daughter has a undiagnosed metabolic condition, likely a form of mito. Her fasting study showed signs of VLCAD, but the genetic studies were we're still searching!

  2. My daughter was diagnosed as a carrier of VLCADD about 4 1/2 years ago. The geneticists at Mayo told us that sometimes carriers may have symptoms. Our daughter has had 3 fainting spells in her life. Two were due to being overheated (which she gets quickly) and one was due to feeling sick and over exerting herself. We notice she crashes easily when she's ill and when she hasn't had much to eat. She also is very sensitive to the cold--skin gets blue. Does your child, who is a carrier, suffer from symptoms or characteristics related to this disorder? I've been scouring the Internet for some confirmation of this happening. Everything I've found indicates they should not. But, why would the Mayo geneticists mention that?

  3. Hi Brigitte and Ben - My daughter is mostly asymptomatic. The only symptoms she shows is she has the same zinc deficiency that Landon has. No one can figure out why they have this deficiency, the numbers show they are perfectly fine, but if they don't have a multi vitamin (Landon took a liquid zinc for a few years), their bottoms will break out in a blistery rash and it's awful.

    We have a lot of friends that have symptomatic carriers, or are symptomatic carriers themselves and have always been told they're fine, and it's nothing.

    I, myself, am more of a symptomatic carrier. I have had bouts of hypoglycemia (how Landon presents), and have migraines which are a symptom of mitochondrial diseases.

    It will be interesting to see how E presents or doesn't present as she gets older.