Table of Contents
Part of our mission is to take a central role to help change healthcare. Many patients are given lifelong medications with side effects only after they receive a diagnosis. However, many of these same patients have been in pain and symptomatic for years prior. We understand that healthcare should be personal and that you own your health. We are at the forefront of knowledge and see the importance of using gene-based evidence to create personalized health care plans for each individual.
Chromosomal structures are found in the nucleus of our cells. This where our genes are contained. We have 46 chromosomes, 23 from our mother and 23 from our father. A gene is a specific sequence in DNA or RNA located on a chromosome and is the functional unit of transcription. The transcription of the gene is what gives us our unique traits and controls the function of other genetic material. Genes do not control our destiny as we once believed. We see now that genes can be expressed differently depending on the environment we surround them in. Genes are like a lighthouse, they show us where to look.
In genes, we have mutations, variations, insertions, or deletions. Mutations can not be changed and deletions are fragments of genes or are completely missing. A nucleotide subunit is made of base pairs. These base pairs can be A, G, C, or T. Our body uses thousands of these nucleotides to create our DNA or RNA. A single nucleotide polymorphism or “SNP” is a gene variant caused by a change in a single nucleotide letter. These SNPs can affect the production of enzymes or how they work. With personalized medicine, we are not changing the genes. However, we are modifying how the gene is expressed.
To begin this process, we use a baseline test. This baseline test is called DNA Health by DNA Life. DNA Health tests for 36 genetic variants that are involved in important biological processes. These genes have the capability to alter their expression based on lifestyle changes we implement. Additionally, knowing this information and seeing the exact gene variant you possess allows us to modify your lifestyle and give us concrete information when it comes to your percentages and risk factors of diseases like cholesterol, bone health & your risk for osteoporosis, inflammation, oxidative stress, insulin sensitivity, and more. Remember that genes load the gun but our environment pulls the trigger. A sample DNA Health report is shown below for reference:
Lipid Metabolism is the first panel listed in the DNA Health report. This panel is highly important as cardiovascular disease is still the number one killer in America. Using this panel provides insight on how to be most preventative for our patients. More specifically, this panel looks at the genes that can influence LDL (Low-Density Lipoproteins aka bad cholesterol) and HDL (High-Density Lipoproteins aka good cholesterol) cholesterol levels. Those who have genes for a higher level of LDL and lower levels of HDL have been associated with a higher risk of heart disease. This panel tests for your genetic variation to 5 different genes.
The result of your genetic variation will be wild type, heterozygous, or homozygous. These variations will show us the genetic impact you have for diseases such as heart disease. Additionally, these results lead us in a better direction of what nutritional approaches to take as well as other labs to order for optimal patient success. It is important to realize that those who have poor cholesterol levels are commonly prescribed statin drugs. Musculoskeletal and exercise specialists such as physical therapists have said statin drugs have the common side effects of rapid muscle breakdown, muscle cramping, fatigue, and weakness. The study can be found here. In this case, a cardiometabolic profile may be run to take an additional look at important levels such as HDL, LDL, Insulin, HbA1C, and other markers associated with cardiovascular disease. The cardiovascular profile we use is from Dotors Data and a sample is shown below:
Our body is constantly killing off and making new cells. Vitamin B is essential to provide the building blocks we need for growing cells along with other important biochemical pathways. Continuing, vitamin B also plays supplies some of the necessary nutrients and chemicals we need to protect our DNA from external damage and daily wear and tear. Some specific vitamins that are involved in turning genes on and off while helping repair our body repair its DNA include folate, vitamin B6, and vitamin B12. The process of repairing our DNA is referred to as methylation. By donating methyl groups to a substrate, our bodies are able to repair and produce new DNA as needed. In this section, there are 6 gene variants being tested.
Based on the genetic results from the above panel, the combination of your genes may indicate a decreased/increased risk of methylation as well as homocysteine levels. Homocysteine is a key intermediate in the methylation process and can impact gene expression. Abnormal homocysteine has been shown to impair both the parasympathetic and sympathetic regulation of the blood vessels of skeletal muscle and affect long-term muscle function. For more information on defective homocysteine levels, click here. Additionally, to ensure our patients have an adequate amount of B Vitamins and methylation cofactor markers, we order an organix comprehensive test from Genova. A sample is shown below:
Additionally, organic acid testing helps provide us with critical information on how to best supplement your body from a nutritional standpoint. An interpretive guide of this test can be seen below for further information on how this test is beneficial to your health:
Detoxification is a natural body process that helps us in the excretion of excess nutrients and waste. The term “detoxification” has been thrown around in many different aspects, but in this instance, it is referring to a biochemical process that turns the end products of phase 1 metabolism, into a more water-soluble solution, allowing the body to easily remove the harmful substances through sweat and urine. In this panel, there are 5 genes being looked at:
By adding in more cruciferous and allium vegetables the body is better able to detoxify. Proper detoxification is crucial for all body systems but specifically helps the nervous system. The nervous system is held responsible for transmitting signals as well as all body movements and actions. When proper detoxification occurs, we see an increase in total body function, allowing the body to transmit electrical signals more efficiently. Doctors Data provides us with a specific Hepatic Detox profile to better assess our patients. A sample is shown below:
Inflammation is the underlying source of all chronic health conditions. We need inflammation, as it is a natural defense mechanism that helps our body heal. However, with chronic and prolonged inflammation we begin to see multiple health disorders such as obesity, heart disease, arthritis, and more. The actual release of inflammatory substances is controlled by specific genes. These genes govern inflammation. When these genes get left “on” the constant inflammatory response continues. In this section, we are looking at 3 specific genes.
Although these three genes may not seem like a lot, there are multiple types of genetic variations that are associated. Due to the importance of inflammation and its role in inflammatory disorders, this area is often a high priority. One of the first accommodations we make is diet. As mentioned above, genes load the gun, environment pulls the trigger. Inflammation is directly linked to dietary components and food sensitivities. Additionally, there are nutrient sources that have been proven to show a beneficial effect on inflammation, improving these inflammation markers. A food sensitivity test from Vibrant Wellness is shown below and is an example of what test we use to measure our patient’s food sensitivities. Additionally, we run a fatty acids test by The Great Plains Laboratory for the evaluation of the omega 3 to 6 ratio. This test provides specific markers for the evaluation of dietary balance.
Similar to inflammation, oxidative stress in the body is normal. It is a normal by-product of the body’s energy-generating biochemical processes. Oxidative stress molecules are highly reactive with other molecules and can harm DNA, cellular membranes, and proteins. To better calm these intense molecules, anti-oxidant molecules interact with the free radicals to ensure it is no longer a reactive molecule. The body should be balanced and when oxidative stress gets out of hand, we see health issues arise. There are 4 genes that play a role in oxidative stress. These genes are:
Our body naturally creates anti-oxidants just as it does free radicals. However, there are additional ways to obtain antioxidants through the diet. Once we see the results of your genetic factors, we will often order a DUTCH Comphrensive Urinary Hormone Test. This test measures 8-Hydroxy-2-deoxyguanosine which is a marker for oxidative damage on the DNA.
Depending on your body, your genes could reveal you have an increased risk for poor anti-oxidant status, relating to oxidative stress-driven disorders. With this, we significantly increase your uptake of vegetables and fruit daily to increase your phytonutrients. Additionally, we include an exercise routine. Oxidative stress is important to focus on consider it plays a role in the degeneration of neuromuscular junctions. For more information regarding oxidative stress and its role on neuromuscular junctions, please refer to the article linked here.
Our bones and skeletal system are constantly dissolving. We are continuously getting rid of the old bone and creating new bone tissue. However, after the age of 30, men and women start to lose bone mass. The percentage of bone mass loss jumps significantly for women after menopause. Nutrition and genetics both have an impact in determining bone health. The genes we look for in this section are:
Our peak bone mass is greatly genetically determined. VDR stands for Vitamin D Receptor and accounts for 70% of the entire genetic influence on bone density. Largely, a great percentage of the American population is Vitamin D deficient. This can lead to a low bone mineral density and put you at an increased risk for osteoporosis. We are able to assess your vitamin D levels with a micronutrient test from SpectraCell. A sample is shown below:
On top of a vitamin D supplement, we encourage getting out in the sun for a little each day as well as load-bearing exercises 3-5 times a week. Load-bearing exercises are needed to signal our bones and tissues to strengthen and repair.
Insulin sensitivity has been linked to many chronic health conditions such as type 2 diabetes, obesity, high blood pressure, and heart disease. Insulin is a hormone that is responsible for the uptake of glucose into a cell. The amount of glucose that circulates in the blood is based on the diet. If you have lower insulin sensitivity, you have a limited ability to respond to the action of the hormone. The specific genes looked for in this section are:
One of the most critical genes is FTO. This gene is present in several active tissues and is most expressed in the brain. This gene is connected to appetite, temperature, energy expenditure, energy intake, autonomic function, and endocrine systems. Based on your genotype, you could have an increased risk of insulin resistance and type 2 diabetes. Movement is more important and more powerful than insulin when it comes to managing blood glucose levels. We encourage patients to exercise regularly to improve their glucose levels as well as to improve bone strength. A test we use for patients who show an increased risk is the metabolic syndrome profile by Genova. Not only does this test show an individual’s HbA1C but it shows their fasting insulin levels as well. A sample is shown below:
As previously stated, vitamins play an important role in many biochemical pathways. We can not expect our bodies to produce adequate energy or function properly without these key micronutrients. Vitamin A is specifically essential for fetal development. It plays a role in eye and brain protection from oxidative stress while improving cognitive stress. The genes assessed in this panel are:
These genes that have to do with vitamin metabolism are highly important. Specifically, GSTT1. Using Vitamin C as a co-factor, this gene helps with hormonal regulation, metabolic energy, improving collagen, and connective tissue. Those who are deficient in Vitamin C have hindered tissue repair. Additionally, we use a micronutrient test from SpectraCell here as well to check essential micronutrients:
To help upregulate these genes, we encourage the increase of vegetable intake as it helps the pathways used in action. Vitamins have been proven to help with connective tissue disease and repair. For more, read the article, “Vitamin D Treatment for Connective Tissue Diseases”.
One of the last segments analyzed in the DNA Health report is food responsiveness. This section is important as food affects individuals in different ways. The new research is showing that specific genes can be tested to provide more insight on how an individual might respond to food components. Specifically lactose intolerance, caffeine sensitivity, salt sensitivity, bitter taste, alcohol metabolism, and more. The genes looked at are:
Additionally, these results can be paired with an Intestinal permeability test from Genova to reveal if a patient has “leaky gut” syndrome or other intestinal permeability health conditions.
Leaky gut has been associated with Alzheimer’s and other neurological health conditions. For more information on leaky gut and its deep interconnection to the nervous system, please read, “The Gut-Brain Axis, Including the Microbiome, Leaky Gut and Bacterial Translocation: Mechanisms and Pathophysiological Role in Alzheimer’s Disease”.
Our nutrition is the one thing we can have optimal control over. It just so happens that our nutrition is also the most important factor when it comes to fueling our body. 80% of health comes from what is on the end of your fork and what you put in your mouth. Nutrition ends up being the ultimate factor of how our genes are expressed. We provide our patients with dietary guidelines based on their genetics and their lifestyle for optimal results. However, some basic policies we include for all our patients is to think of it as a lifestyle change, not a diet. The word diet has many negative associations with it and those who “diet” are more doomed to fail. However, when we take the approach of making a lifestyle change and think about what we eat in the way of fueling our body and genes, we have far more success. Another important factor we like to implement is to eat when you are hungry and do not eat when you aren’t. There is a lot of mixed nutritional advice out there, some say its best to eat every 2 hours and others say to fast. The best results come from simply eating when you are hungry and not eating when you aren’t. Additionally, remember that you can never out-exercise a poor diet. Over-exercising to burn off unhealthy food will never show results as well as lead to access to inflammation. Chronic cortisol elevation can result in excess weight gain, energy depletion, sugar/carb dependence, sleep quality reduction, and lead to inflammation.
As a general marker, ensure you are feeding your body anti-inflammatory foods to reduce the internal inflammation levels. These include organic, grass-fed, free-range, and wild-caught quality proteins, healthy fats/oils like olive oil, coconut oil, avocados, nuts and seeds, low glycemic fruits like berries, oranges, and apples, and organic non-starchy vegetables. It is important to note that anti-inflammatory diets are linked to be non-disease causing, provide continual healing, and improve fat utilization. For more information regarding health conditions, neuroprotection, and dietary factors, I highly recommend reading the following article:
Food, Nutrigenomics, and Neurodegeneration- Neuroprotection by What You Eat!
It is so exciting to have this knowledge and be able to truly help our patients with personalized medicine. So much stems from our genetics but the environmental factors and how our genes express is really up to us. That provides so much hope and I know personalized medicine will help to reduce the number of individuals diagnosed with many health conditions in the years to come. -Kenna Vaughn, Senior Health Coach
References
Di Stasi, S. L., MacLeod, T. D., Winters, J. D., & Binder-Macleod, S. A. (2010). Effects of statins on skeletal muscle: a perspective for physical therapists. Physical therapy, 90(10), 1530–1542. doi.org/10.2522/ptj.20090251
Köhler CA, Maes M, Slyepchenko A, et al. The Gut-Brain Axis, Including the Microbiome, Leaky Gut and Bacterial Translocation: Mechanisms and Pathophysiological Role in Alzheimer’s Disease. Curr Pharm Des. 2016;22(40):6152-6166. doi:10.2174/1381612822666160907093807
Pollari, E., Goldsteins, G., Bart, G., Koistinaho, J., & Giniatullin, R. (2014). The role of oxidative stress in degeneration of the neuromuscular junction in amyotrophic lateral sclerosis. Frontiers in cellular neuroscience, 8, 131. doi.org/10.3389/fncel.2014.00131
Reynolds JA, Bruce IN. Vitamin D treatment for connective tissue diseases: hope beyond the hype?. Rheumatology (Oxford). 2017;56(2):178-186. doi:10.1093/rheumatology/kew212
Veeranki, S., & Tyagi, S. C. (2013). Defective homocysteine metabolism: potential implications for skeletal muscle malfunction. International journal of molecular sciences, 14(7), 15074–15091. doi.org/10.3390/ijms140715074
Virmani A, Pinto L, Binienda Z, Ali S. Food, nutrigenomics, and neurodegeneration–neuroprotection by what you eat!. Mol Neurobiol. 2013;48(2):353-362. doi:10.1007/s12035-013-8498-3
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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The information herein on this entire blog site is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.
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Our information scope is limited to Chiropractic, musculoskeletal, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.
We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.
Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.*
Our office has reasonably attempted to provide supportive citations and has identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, please feel free to ask Dr. Alex Jimenez, DC, or contact us at 915-850-0900.
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Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*
email: coach@elpasofunctionalmedicine.com
Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico*
Texas DC License # TX5807, New Mexico DC License # NM-DC2182
Licensed as a Registered Nurse (RN*) in Florida
Florida License RN License # RN9617241 (Control No. 3558029)
Compact Status: Multi-State License: Authorized to Practice in 40 States*
Graduate with Honors: ICHS: MSN-FNP (Family Nurse Practitioner Program)
Degree Granted. Masters in Family Practice MSN Diploma (Cum Laude)
Dr. Alex Jimenez DC, MSACP, MSN-FNP, RN* CIFM*, IFMCP*, ATN*, CCST
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