The Future of Personalized Medicine in El Paso

What is a disease? Over the years the definition of disease has evolved and changed as medicine became more advanced. Years ago, people used to think a disease was an actual entity or thing that had entered the body and was lying hidden causing disruptions. Now, we know that a disease is actually a disordered function. To properly treat the disease we need a treatment that is based upon the principle of restoring disordered functions to order.

Another discovery that has been brought to our attention along with disease is our genes. Similar to disease, our definition and understanding of our genes was not accurate. As the research has become more available, our original thinking of the genes you are born with are the genes you are stuck with has been proven wrong. We are taught that some people are born with good genes so they do not get diseases while others draw the short end of the stick and are born with bad genes, prone to illness and health care conditions. One main question that sparked the interest of scientists was, “If twins are born with the same set of genes, how come as they age one is diagnosed with diseases while the other is healthy?”.

Dr. Jeffrey Bland brings to light studies that have been done showing while we are not changing the genes we are born with, we can change the modifying factors of our lifestyle to modulate how these genes are expressed. The study below titled, “Epigenetic differences arise during the lifetime of monozygotic twins” shows this theory.

Monozygotic Twins Research Photo

Underlying Causes of Disease

The main environmental factors that trigger gene expression include toxins, allergens, microbes, nutrition, and stress. Gene expression is caused by genomics, proteomics, metabolomics, and epigenetics. When looking at a patient from a functional approach, we have specific targets we assemble symptoms into. From here, we classify which target needs to be worked on the most. These targets include:

  • Assimilation: mainly occurring in the gastrointestinal tract. We look at the break down of small nutrients and how the body uses them for energy. We also consider how they get absorbed, utilized, transported, and taken up from cells. Lastly, we consider how they are metabolized and excreted.
  • Defense & Repair: this is mainly in reference to the immune system and how our immune defense protects itself against inside and outside foreign invades. Additionally, the capability to repair our DNA.
  • Energy: bioenergetics, our mitochondria, and the factors that modulate mitochondrial energetics.
  • Biotransformation: exploring how the body gets rid of the toxins gathered, essentially how the body detoxes the byproducts of toxins we are exposed to. It should be noted that we have found nutritional and dietary elements have the ability to upregulate this activity.
  • Communication: taking a look at intracellular communication. We need to understand how when something happens in one area of the body, the signal is transported and notifies another body system.
  • Transport: exploring how things get from one side of the body to the other. An example being how does the glucose go from the gut to the cell, to be used as energy? We consider hormones and proteins as there are common dysfunctions in these transports that give rise and can later end up causing what we call a disease.
  • Structural: the skeletal system is a huge part of our body that is often overlooked. However, every single blood cell that you have in your body comes from bone marrow in the skeleton. Skeletal health is extremely important and we know that there is a connection between the bone marrow and glucose as well as other body compounds. Structure, exercise, and activity are all key components in maintaining a healthy system.
  • Psycho-spiritual: this aspect is non-quantifiable but has a superbly important role in modulating at every level.

Additionally, we are finding that many underlying reasons for disease is a lack of micronutrients. We all have biochemical individuality. This means that we all require a different amount of nutrients to accomplish the same task. The vitamin D levels a husband needs may vary greatly from the vitamin D his wife needs, which will also be different than the amount of vitamin D her brother needs. Considering this, it is not best to follow the RDA (recommended daily allowance) but rather to have a micronutrient test performed to evaluate what levels of micronutrients you need or are deficient in. The micronutrient test we use is from SpectraCell and a sample report is shown below:

Genes

Our genes help to produce proteins and when the genes are affected by an SNP (single nucleotide polymorphism) the specific need for enzymes will vary depending on the individual and SNP. There are variations that found certain SNPS require up to 50 times more levels of a specific vitamin co-factor to make an enzyme properly function over a person who has the wild genotype. A study conducted by Bruce N. Ames proving this theory can be read below.

High-dose vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity (increased Km): relevance to genetic disease and polymorphisms

We have epigenetic changes through the methylation process but the way our genes are expressed becomes different based on our lifestyle. An example mentioned before is toxins. Toxins cause the body to have inflammation. Inflammation is present in all health conditions and can be the real silent killer. Through exposure to toxins (chemicals in the food we eat, chemicals in laundry detergents, chemicals in household cleaning products like those that claim to “clean the air”, soaps, shampoos, plastic, the list goes on) cause molecular changes. These molecular changes then go on to influence changes at our cell-level. These cells are now causing tissue-level changes and causing individual health effects.

Environmental Toxico-Epigenomics

The absence of disease does not mean that there is a presence of health. Characteristics of inflammation may not be a diagnosis of a disease but it is a symptom and warning sign that there is an imbalance within the system.

Inflammation

Inflammation causes the body to have many health conditions, but one specifically is that it ages the body faster because the body is constantly in overdrive. This is deemed “inflamm-aging. Those who have inflamm-aging are those who tend to shuffle their feet around the grocery store and constantly feel sick and tired but yet, they do not have a disease. We call these the “walking wounded”. These symptoms are ones that people have come to manage but that does not mean they are healthy nor that they do not need help. Individuals who have serious inflammation have the highest risk for a cytokine storm.

Cytokine storm refers to an immune system gone awry and an inflammatory response flaring out of control. Those who have a cytokine store are more susceptible to disease and infection. This stems from not having a balanced immune system. The Immune system coming off balance has to do with the toxins we are exposed to and the health of your gut.

cytokine storm

Our immune system is housed in the gut. If you have poor gut health, chances are you have a poor immune system and high inflammation. Mucosal immunity in the gut is associated with immune surfaces and immune cells. Therefore, if you do not have strong mucosal immunity, you are already in a pre-inflammatory state, leaving yourself more vulnerable to disease and chronic health conditions.

The gastrointestinal system plays an important role in overall total body health. The gastrointestinal tract is a significant recipient of nutrients, toxins, and allergens. It is also home to several hundred different species of bacterias, yeasts, and microbes. The gastrointestinal tract possesses the power not only to digest the food ingested but to absorb nutrients and create an immunologic response. 

 When the mucosal layer of the gastrointestinal tract becomes compromised and inflamed, it allows undigested nutrients to break through and breach the barrier. Multiple agents can cause inflammation of the gastrointestinal tract that can result in autoimmunity conditions. 

Individuals with gastrointestinal inflammation can be seen with symptoms similar to but not limited to:

  • Chronic Fatigue 
  • Illness Related to Environmental Factors
  • Bloating
  • Gas 
  • Joint Pain 
  • Overall Inflammation 

In order to accurately assess an individual’s gastrointestinal health, there are several areas that need to be examined. A few of them being the intestinal permeability (the short-chain fatty acid-producing bacteria and the integrity of tight junctions), IBS and IBD related bacteria, metabolic health, and nutrition (vitamin production).

Personalized Health

Personalized health is now more customizable and beneficial than ever. By assessing the genes you possess we are directly able to see your predisposition and correlate them to your lifestyle. This allows us to make real advancements and a positive impact on health instead of shooting in the dark. One report we use to assess genotypes is the DNA Health test by DNA Life. A sample report is shown below.

 

 

On top of this report, we assess our patient’s diet, nutrition, and overall lifestyle. These are all key factors when it comes to modifying genetic expression. There is no greater medicine than what you put on the end of your fork. Teaching individuals that food is medicine and that food has the ability to heal is important when it comes to making substantial changes.

 

 

 

With the data available, we see that we have the ability to slow down widespread conditions and an individuals’ susceptibility to them. One being osteoporosis. Over 50% of individuals will have some form of osteoporosis or osteoporosis-related fracture in their lifetime. Not only is our bone health critical to maintaining structure, but our bones house bone marrow. As previously mentioned, bone marrow is where every single cell in the body is made. If you have any problem with an organ or tissue, or inflammation, you can guarantee that blood cells are involved. These blood cells being derived from bone marrow adds on another layer to personalized health that was not originally considered. The study below looks at the influences of lifestyle, body build, and vitamin D status in relation to the development of osteoporosis.

If you are curious about your health, fill out the diet, nutrition, and lifestyle journal above or this metabolic form below:

 

 

The thought of our genes not being set in stone, but instead influenced by our environment is not as new as we originally thought. However, with the research we have now, this thought is becoming more concrete as we are able to prove and show environmental impacts on genetic expression. We have the ability to test ones genes, test their environmental sensitivities, and create a personal healthcare plan designed specifically for them and to reduce their risk of disease. -Kenna Vaughn, Senior Health Coach 

 

References:

Beidelschies M, Alejandro-Rodriguez M, Ji X, Lapin B, Hanaway P, Rothberg MB. Association of the Functional Medicine Model of Care With Patient-Reported Health-Related Quality-of-Life Outcomes. JAMA Netw Open. 2019;2(10):e1914017. doi:10.1001/jamanetworkopen.2019.14017 

Hui Li, Liang Liu, Dingyu Zhang, Jiuyang Xu, Huaping Dai, Nan Tang, Xiao Su, Bin Cao,SARS-CoV-2 and viral sepsis: observations and hypotheses,The Lancet,Volume 395, Issue10235,2020,Pages 1517-1520,ISSN 0140-6736,https://doi.org/10.1016/S0140-6736(20)30920-X (http://www.sciencedirect.com/science/article/pii/S014067362030920X

Janelle S. Ayres,The Biology of PhysiologicalHealth,Cell,Volume 181, Issue 2,2020,Pages 250-269,ISSN 0092-8674,https://doi.org/10.1016/j.cell.2020.03.036.(http://www.sciencedirect.com/science/article/pii/S0092867420303299)

Epigenetic differences arise during the lifetime of monozygotic twins
Mario F. FragaEsteban BallestarMaria F. PazSantiago RoperoFernando SetienMaria L. BallestarDamia Heine-SuñerJuan C. CigudosaMiguel UriosteJavier BenitezManuel Boix-ChornetAbel Sanchez-AguileraCharlotte LingEmma CarlssonPernille PoulsenAllan VaagZarko StephanTim D. SpectorYue-Zhong WuChristoph PlassManel Esteller

Williams, R.J. (1950), Concept of Genetotrophic Disease. Nutrition Reviews, 8: 257-260. doi:10.1111/j.1753-4887.1950.tb02469.x https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1753-4887.1950.tb02469.x

John C Earls, MSc, Noa Rappaport, PhD, Laura Heath, PhD, Tomasz Wilmanski, PhD, Andrew T Magis, PhD, Nicholas J Schork, PhD, Gilbert S Omenn, MD, PhD, Jennifer Lovejoy, PhD, Leroy Hood, MD, PhD, Nathan D Price, PhD, Multi-Omic Biological Age Estimation and Its Correlation With Wellness and Disease Phenotypes: A Longitudinal Study of 3,558 Individuals, The Journals of Gerontology: Series A, Volume 74, Issue Supplement_1, December 2019, Pages S52–S60, https://doi.org/10.1093/gerona/glz220

Chung FF, Herceg Z. The Promises and Challenges of Toxico-Epigenomics: Environmental Chemicals and Their Impacts on the Epigenome. Environ Health Perspect. 2020;128(1):15001. doi:10.1289/EHP6104 https://pubmed.ncbi.nlm.nih.gov/31950866/ 

Ames BN, Elson-Schwab I, Silver EA. High-dose vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity (increased K(m)): relevance to genetic disease and polymorphisms. Am J Clin Nutr. 2002;75(4):616-658. doi:10.1093/ajcn/75.4.616 https://pubmed.ncbi.nlm.nih.gov/11916749/

 

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require additional explanation as how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900 <tel:9158500900>. The provider(s) Licensed in Texas*& New Mexico*

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