HOW FUNCTIONAL MEDICINE USES GENETIC DATA
Functional medicine employs all available tools to help you heal quickly and naturally. In addition to diagnostic testing, nutrition, and pharmaceutical-grade supplementation another potential tool is your genetic data.
Especially for lowering disease risk, chronic conditions, or persistent symptoms - genetic data can provide a window into the inner workings of your body and illuminate pathways that may be blocked and preventing you from healing.
While genetic data is routinely used by online software programs to generate 'disease risk' and documentaries and news headlines frequently mention predictive genes - often this is only to stoke unnecessary fear.
The likelihood of developing most diseases is still highly influenced by our diet, lifestyle, and environmental factors.
Knowing and utilizing the science behind these risk factors enable competent practitioners to use these factors to enhance deficient pathways, improve overall physiological function and reduce disease risk.
GENETIC TESTING: GOING BEYOND 'DISEASE RISK'
Usually, how 'at risk' you are for certain diseases is based upon what your compromised genetic variants did in the first place. Adjusting your behavior and environment based on your genetics can help you heal more quickly and may reduce symptoms and disease risk - often very significantly.
A genetic mutation like MTHFR results in a reduction of your body's access to folate - a necessary vitamin for fetal development and methylation within the body.
Using this knowledge, we can supplement your diet with the necessary form of folate that is already 'broken down' in the form of 5-methyltetrahydrofolate (5-MTHF) thereby bypassing the compromised conversion process. [MTHFR1]
We would also make other changes to improve methylation function, thereby reducing your risk of folate deficiency-related diseases.
THE BIG PICTURE
Too often, doctors and patients focus on a few genes (like APO4 or MTHFR) while ignoring the rest. Our genes do not operate in a vacuum - not only can they activate or deactivate based on our environment and daily behavior, but they constantly interact with each other.
Focusing on one disease-predicting marker while ignoring others can cause you to miss genes that are even more relevant to your health and longevity.
An example of two less widely known variants that can materially alter your health and longevity are the detoxification-related variants listed below.
HOW GENETIC VARIANTS CAN AFFECT DETOXIFICATION
Genetic variations that modify Phase I or Phase II detoxification can cause problems in the body, from reactions to medication to the buildup of damaging toxins.
PHASE I DETOXIFICATION
This is the first step to neutralize toxins or break down medications. It involves the use of a certain enzyme (specific to what the body wants to break down) using oxygen to begin to change the compound.
EXAMPLE GENE: CYP1B1 - Two variants are checked for. Relating to estrogen and the processing of compounds in cigarette smoke, charred foods, and car exhaust. The consumption of cruciferous vegetables and fish oil could be used to utilize the function of pathways to minimize the risk associated with this variant.
PHASE II DETOXIFICATION
In this second step, water-soluble molecules are added to the already broken-down medicine (or compound or toxin) for it to be escorted out of the body through stool or urine.
EXAMPLE GENE: COMT - Inactivates types of estrogen and catechol drugs. Adrenaline levels are higher in these individuals, so meditation practices and stress avoidance are important. Adequate B-Vitamin consumption and Magnesium are also very important.
PHASE I AND PHASE II DETOXIFICATION
Many patients with long-term, complex, or chronic illnesses have a problem with the Phase I and Phase II detoxification process.
Many paradoxical reactions (having the opposite reaction, eg. anxiety medication makes you anxious) and intolerances to medications or supplements are the results of genetic variations (polymorphisms) involving either Phase I or Phase II of the detoxification process.
Phase I detoxification involves a variety of enzymes to modify toxins (or medications or other compounds) using oxygen. This initial phase creates a reactive site from which Phase II can take place.
Phase II detoxification involves the addition of water-soluble molecules to toxins (or medications or other compounds) so they can be excreted out of the body through stool or urine.
Polymorphisms that increase or decrease enzyme activity can be harmful and impair your ability to execute Phase I or Phase II detoxification processes. If you have increased output in Phase I without an appropriate increase in Phase II, this can produce compounds more toxic than what the body is trying to excrete.
Decreased Phase I activity will cause toxins to accumulate in the body.
Fortunately, a wide array of foods and nutritional medicines increase the efficiency of both Phase I and Phase II detoxification so that you can adapt to your detoxification capacity and fully resolve complex illnesses, chronic conditions, and long-term symptoms. [detox1]
LONGEVITY AND FUNCTIONAL MEDICINE
Conversations around genetic data often focus on frightening headlines, inevitable diseases, and unsustainable and expensive interventions.
Things like extreme fasting, extreme hot or cold therapies, expensive lasers, and sound baths are flashy - but usually do not stand up to research or are too far removed from their original cultural origins to be effective in the long term.
The answer lies in millennia-old applicable cultural practices as well as herbal and dietary medicine that are backed by decades of research.
Functional medicine merges the latest advancements in testing with high-quality supplementation informed by research. Natural modalities of healing are often utilized and dietary and lifestyle prescriptions are part of every treatment plan.
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Dr. Lum is a certified functional medicine practitioner whose practice has focused on the treatment of complex and chronic illnesses over the last ten years.
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Disclaimer: If you think that you may have a medical emergency, call your doctor or 911 immediately. No action or inaction should be taken based solely on the contents of this information. Nor should you ever delay seeking medical advice or treatment due to the information contained on this Website. The information on this Website is not intended to diagnose, treat, cure, or prevent any disease or medical condition. The information discussed is not intended to replace the advice of your healthcare provider. Reliance on the information provided by this Website, Dr. Brian Lum, or Functional Healthcare Institute is solely at your own risk.
References
[mthfr1] Ledowsky, Carolyn Jane, Janet Schloss, and Amie Steel. 2023. “Variations in Folate Prescriptions for Patients with the MTHFR Genetic Polymorphisms: A Case Series Study.” Exploratory Research in Clinical and Social Pharmacy 10: 100277. https://doi.org/10.1016/j.rcsop.2023.100277.
[detox 1] Cline, John C. 2015. “Nutritional Aspects of Detoxification in Clinical Practice.” Alternative Therapies in Health and Medicine 21 (3): 54–62. https://web-p-ebscohost-com.ezp-prod1.hul.harvard.edu/ehost/pdfviewer/pdfviewer?vid=1&sid=bd91955d-5ac5-47b4-b988-7d2c15bfab2d%40redis
[phase 2]
Zhai, Xiaohan, Musen Lin, Feng Zhang, Yan Hu, Xiaomei Xu, Yubing Li, Kexin Liu, Xiaochi Ma, Xiaofeng Tian, and Jihong Yao. 2013. “Dietary Flavonoid Genistein Induces Nrf2 and Phase II Detoxification Gene Expression via ERKs and PKC Pathways and Protects Against Oxidative Stress in Caco-2 Cells.” Molecular Nutrition & Food Research 57 (2): 249–59. https://doi.org/10.1002/mnfr.201200536.
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