By Sarah A LoBisco, ND
One of the problems with modern day medicine is that treatment is tailored to a symptom and everyone with that symptom gets the same treatment protocol. The result is a health care system that spends the most in the world with some of the saddest statistics of efficacy. Although our life expectancy is lengthen by fancy machines that keep us breathing or pump our hearts, our quality of health is not one of vitality.
The problem with symptom, disease control is that everyone has a different biological makeup, including their ability to excrete and metabolize certain medications and chemicals. Bear in mind, that the body sees any foreign substance as a chemical; therefore, drugs and toxicants in the environment are removed in the same manner. As I wrote in a previous blog:
Genetic differences in enzyme detoxification pathways, including methylation and sulfation pathways, can cause some individuals to be more susceptible to environmental exposures than others. For example, someone who has a SNP, or single nucleotide polymorphism, in MTHFR (methylenetetrahydrofolate reductase), MS (methionine synthase), COMT (catechol-O-methyltransferase), Methyl-transferases, STM1, GSTP1 (glutathione transferases), Apo E 4 (apolipoprotein E 4), and/or Impaired Metallothionein function can create imbalances in clearance and a retention in toxins. These SNPs are actually quite common in the general population and their lucky owners are usually diagnosed with “psychosomatic illnesses.” The good news is that, with the new science of nutrigenomics, various nutrients in therapeutic doses can help to remedy the body’s slow detoxification capacity.
Conventional medicine has acknowledged this link between genetics and treatment for some time. It is known that various medications should be tested for individual genetic variations that cause the drug to be ineffective or toxic. The following exert from PLoS Genetics explains these SNPs and the drug, Warfarin:
We report the first genome-wide association study (GWAS) whose sample size (1,053 Swedish subjects) is sufficiently powered to detect genome-wide significance (p<1.5×10?7) for polymorphisms that modestly alter therapeutic warfarin dose. The anticoagulant drug warfarin is widely prescribed for reducing the risk of stroke, thrombosis, pulmonary embolism, and coronary malfunction. However, Caucasians vary widely (20-fold) in the dose needed for therapeutic anticoagulation, and hence prescribed doses may be too low (risking serious illness) or too high (risking severe bleeding). Prior work established that ~30% of the dose variance is explained by single nucleotide polymorphisms (SNPs) in the warfarin drug target VKORC1 and another ~12% by two non-synonymous SNPs (*2, *3) in the cytochrome P450 warfarin-metabolizing gene CYP2C9.
It doesn’t stop there with genetic differences. Another mode of excretion and biotransformation is in the gut microbiome. Most people today have heard of the importance of taking a probiotic, but is natural medicine becoming one-size-fits all approach too? Possibily?
See, everyone has a different makeup of bugs in their gut, hence the there is no one probiotic for everyone. According to an article in Nature, differences in genotypes of bugs (enterotypes) effect drug excretion and metabolism:
Our knowledge of species and functional composition of the human gut microbiome is rapidly increasing, but it is still based on very few cohorts and little is known about variation across the world. …
… This indicates further the existence of a limited number of well-balanced host-microbial symbiotic states that might respond differently to diet and drug intake… highlighting the importance of a functional analysis to understand microbial communities.
Here are some more fun facts on the GI tract from the Metametrix Institute Blog:
- The gut makes up approximately 75% of the entire body’s immune function. (If the GI tract is compromised, the immune system is, too.)
- The microbiota (bugs) in our gut number in the trillions and may include over 500 unique species. (Many of these species are yet to be identified. By a margin of 10:1, our human cells are outnumbered by bacteria…be kind to your bugs, we surely don’t want to encourage a revolt!)
- Each individual has his/her own microbial fingerprint. (Be on the lookout for more on gut enterotypes, which will help us customize individualized microbial treatment for patients in the near future.)
- The gut produces just as many neurotransmitters as the brain. (This is a big tie in to mental/emotional dysfunction. As an example, over 97% of chronic fatigue patients fit diagnostic criteria for major depressive disorder; interestingly enough, over 50% also meet diagnostic criteria for IBS. Coincidence, I think not!)
- Studies have linked increased anxiety levels to microbial infections in the gut. (Mouse studies have demonstrated that groups of mice with different microbial populations demonstrate very different motor activity and anxiety-like behavior. Ever overeaten some type of vittles and paid for it afterwards? Ever felt super sluggish and in dampened spirits afterwards? Here’s a study telling us why!)
- The presence of food allergies has been linked to neurological disorders including depression, bipolar disorder, and panic disorder. (In cases of schizophrenia, patients who are also diagnosed as having celiac disease have experienced a return to health with compliance to a gluten-free diet.)
I am a firm believer in the kind of medicine should suit the patient, not in making the patient suite the treatment or drug.
Check out my link at Saratoga.com for a continuation of this discussion and that highlights how functional medicine testing is important for various conditions, including Autism.
Takeuchi F, McGinnis R, Bourgeois S, Barnes C, Eriksson N, et al. (2009) A Genome-Wide Association Study Confirms VKORC1, CYP2C9, and CYP4F2 as Principal Genetic Determinants of Warfarin Dose. PLoS Genet 5(3): e1000433. doi:10.1371/journal.pgen.1000433
M. Arumugam, et al. Enterotypes of the Human Gut Microbiome. (abstract). Nature, May 12, 2011: 473(7346); 174-80.
Rachel Marynowski, ND. What’s Your Gut Mind. April 2, 2012. Metametrix Institute blogs. http://www.metametrixinstitute.org/post/2012/04/02/Whats-on-your-Guts-Mind.aspx?utm_source=April+2012%2C+Vol+7%2C+Issue++4+FINAL&utm_campaign=April+2012+e-nl&utm_medium=email