Genetics: The New Frontier in Personalized Medicine
by Jeff Hogrefe, RPh, AFAARM
23andMe, Ancestory.com, AncestoryDNA.com… we are being bombarded with the opportunity to Genetically learn, where we came from, who we are, why we are as we are… ets.. This is both exciting and revolutionary new field of scientific discovery.
Genetic testing also has major implications in terms of how we approach medical care. With new discoveries regarding the unique and individual variations of cancer, we are finding that certain genetic traits can affect both outcome and treatment strategies in chemotherapy, immunotherapy, and adjunctive therapies. As the innumerable number of the James Cancer Billboards proclaim there is no Routine Cancer Our talented oncologists are quickly developing into expert geneticists.
Away from oncology, Genetic testing is being widespread in the arena of personalized individualized medicine Knowing certain gene variations can predict many things: How you will respond to certain medications and what dose of medication should you be given fall under the genetic subgroup called Pharmacogenomics. This area of genetics is somewhat black and white and has a relatively high level of predictivity and accuracy.
The other side of medical genetics is called Nutrigenomics. This area can be a little more subjective in terms of application. Nutrigenomics is looking at how certain genes can affect biochemical processes and how nutrition, diet, and lifestyle can affect genetic expression. Many companies offer testing that with their results is it possible to determine best strategies for diet, exercise, and overall health.
When implementing Nutrigenomics in predictive and preventative health, there are 3 main biochemical processes to focus on, Methylation, Detoxification, and Inflammation.
Methylation is the biochemical process of adding a Carbon and 3 hydrogens (methyl group) to various chemicals in our body. Methylation is used in over 250 biochemical processes in the body. The most notable functions include
- repairing DNA Damage
- improving immune function
- rebuilding cell walls (membranes)
- increasing energy production within our cells (mitochondrial function)
- clearing out dead cells and repairing damaged cells
- producing Neurotransmitters (serotonin, dopamine, norepinephrine, melatonin)
Nutrigenomic testing can determine how well the body methylates. Certain gene variations can decrease methylation by 75-80%. This can lead to such things as increased cancer risk, fatigue, inability to fight infections, increased risk for heart attack and stroke, and anxiety, depression and other mood disorders. Fortunately, it is possible to overcome genetic variations in methylation by identifying the variations and bypassing the biochemical processes with proper nutrition and supplements.
Poor methylation also decreases production of glutathione. Glutathione is the most important substance the body uses to detoxify and remove harmful substances from the body. Nutrigenomic testing can determine how well glutathione is conjugating and detoxifying harmful chemicals and carcinogens. Poor detoxification can increase risk of asthma, auto immune disease, cancer, and dementia. The goal is to determine overall detoxicification, and develop strategies to improve this process and decrease risk of disease (or slow onset of disease).
Nutrigenomic testing can predict levels of inflammation. Genetic variations can increase ability to express inflammatory chemicals that can increase risk of obesity, diabetes, stroke, heart attack, auto immune disease, and dementia. Current belief is that inflammation is tied to the initiation of most cancers as well.
Determining overall levels of inflammation and genetic variations that can affect the expression of inflammation is critical to predict overall health. Implementing strategies such as reduction in inflammatory foods (trans fats, sugar, omega 6 oils, animal fats, and processed foods) increasing low inflammatory foods (overall reduction is carbohydrates, omega 3s, fish, cruciferous vegetables, anti-oxidant fruits (berries) and olive oil) as well as proper supplementation: high dose omega 3s, standardized curcumin extract, quercetin and vitamin c, CBD oil, and resveratrol) is vital in prevention of disease.
Other important genetic variations Nutrigenomic testing examines include:
- mitochondrial function (energy production)
- ability to process and utilize vitamin d
- gluten sensitivity
- histamine response (allergies, eczema, and food intolerance)
- thyroid function
- blood clotting risk
- salt sensitivity and risk of high blood pressure
- lipid and triglyceride metabolism
- liver metabolism related to pesticides and estrogen-like substances
Nutrigenomic testing would most benefit individuals suffering with migraines, fibromyalgia and chronic fatigue, unresolved thyroid issues, ADD and ADHD, Autism, Metabolic syndrome, allergies, dementia, family history of cardiovascular disease and cancer, and anxiety, depression and mood disorders and women taking hormone replacement therapy.