There is little doubt that health care in the future will be patient centered, personalized and focused on improving function throughout the body and not just addressing symptoms. The days of “one size fits all” treatment plans are coming to an end. Health care is moving away from simply naming a disease and treating the symptoms, and now seeks to understand a disease’s origins, mechanisms and causes.
Some of the new key sciences involved in personalized health care include Nutrigenomics, Pharmagenomics and Toxicogenomics. These terms may sound a bit intimidating to comprehend but a basic understanding is very important for you and your family.
Nutrigenomics is defined as the study of the interaction between your genetic makeup and the nutrients you consume. It is the understanding of how your genetic variations influence nutrient absorption, metabolism, and biologic function. This form of genotyping can help determine which foods and food supplements you should consume to optimize your health and prevent or minimize your risk for metabolic diseases.
The most important factor influencing your gene expression throughout the day is your diet. Eating less, eating fewer animal products, more vegetables, and limiting your consumption of alcohol are a few simple changes that can positively influence your genes. Additionally, your unique genetic makeup may require that you consume a greater amount of folic acid, vitamin B12, calcium, or vitamin D than the average person to minimize your risk for certain disease processes. Nutrigenomics at the patient level requires individual study and observation.
Pharmacogenomics is commonly known amongst researchers in the pharmaceutical industry, and is generally defined as the study of how genetic differences can affect individual responses to a single drug or a group of drugs, in terms of their therapeutic effect and potential adverse effects. This is of particular interest when working to improve drug safety. Identifying one’s genetic variants can be used as predictors of drug toxicity and/or effectiveness, and is particularly useful in determining the effectiveness of certain anticancer drugs. Adverse drug reactions caused by the failure to predict toxicity in individuals, and toxic drug-drug interactions, now account for 100,000 patient deaths, 2 million hospitalizations, and $100 billion in health care costs to the United States every year. It has also been postulated that as many as 20% to 40% of people receiving pharmaceutical agents may be receiving the wrong drug based on their genetic profile and their ability to metabolize pharmaceuticals.
Toxicogenomics is a field of science that is often included with Pharmacogenomics. It is defined as the study of how genetic variations and weaknesses affect your ability to detoxify foreign chemicals from our environment. These toxic agents are sometimes referred to as Xenobiotics and can include, but are not limited to, pharmaceuticals. Environmental toxic agents such as PCB’s, organochlorine pesticides, PBDE fire retardants, furans, and dioxins, are just a few of the toxins known to be implicated in metabolic diseases.
Each person has a unique set of detoxifying enzymes in their body that are controlled by their genes. Variations in these enzymes can predispose an individual to illness and disease at much higher rates due to their inability to detoxify foreign chemicals. A natural way to increase detoxifying enzymes is through a patient’s diet. Diets high in cruciferous vegetables including broccoli, cabbage, and brussel sprouts contain a family of nutrient compounds called glucosinolates. These compounds support detoxification of foreign chemicals.
Experts estimate that the majority of medical evaluations in the future will be based (at least in part) on genetic testing. This is attributed to information gathered from the Human Genome Project. This research project was begun in 1990 and completed in 2004 by the National Institutes of Health to identify all of the approximately 20,000-30,000 genes in human DNA. There are several companies that use the information derived from this project to offer the public take-home genetic testing kits. Most of these companies have an internet presence while others are available through network marketing entities. Some experts have expressed caution regarding the use of these take home tests. They believe that nutrigenomic testing lacks scientific evidence to fully justify conclusions and recommendations based on test results. Nevertheless, that has not deterred the public demand for genetic testing or the companies that offer it.
Although genetic testing is a relatively new science, I believe it can be helpful and useful. The field of Toxiogenomics is also in its infancy, but several labs have begun to offer toxicogenomic assays to help in evaluating a patient’s genetic risk for toxin-mediated illness. In other words, if you work in proximity to toxic substances and suffer from chronic illness, you could be predisposed to becoming ill due to your genetic inability to break down toxins. If you decide to undergo genetic testing, be sure to share the results with your health care provider. Remember to be proactive and informed about your health.
Dr. John Dixon can be reached at the Natural Medicine Group 760.776.0022
Sources: 1) Laboratory Evaluations for integrative and functional medicine, lord et al; 2008; 2) Textbook of Functional Medicine, Jones et al; 2005 3) The integration of molecular diagnostics with therapeutics, Medscape.com