How epigenetics fits into a gene-based practice approach
How Epigenetics Fits In Epigenetics is the science on how gene expression can be changed by therapies or environmental factors.
Often, I hear people ask "But Joe, what about the role of epigenetics? Isn't that more important than genetics?"
This is a good question - and the answer is it's extremely important!
The environment (including diet and lifestyle), plays a huge role in shaping gene expression, but what many people don’t realize is that gene variations actually have a significant impact in determining a person’s epigentic expression.
Genetics are important because they tell you what your epigenetic tendencies are which can allow you to focus on environmental levers or supplements that modify the genes and pathways that need to be epigenetically worked on.
Let's take the example of FOXO3, which is involved in tumor suppression, immune function, DNA repair, and resistance to oxidative stress. This protein is so important because it's a transcription factor, which means that it changes the expression of other genes. Higher levels of this protein leads to better health.
26% of the population has a version of this gene that makes it equivalent to smoking a pack of cigarettes a day for 25 years (according to one study) and results in a shorter lifespan.
If you have the risk variants of FOXO3, then it means that your genes are predisposing you to have lower levels of this protein. This can cause broad changes in gene expression regarding genes that combat oxidative stress.
However, FOXO3 can be impacted by the environment quite a bit. Exercise, saunas, fasting, and various plant compounds can increase FOXO3. We see all of these things as healthy, but they become even more important when you have the risk variants of this gene.
If you have this variation, then you can epigenetically change your gene expression to cancel out the negative impacts of these variants. Examples of When to Focus on a Gene As we discussed, there are many genetic and environmental factors that contribute to a condition.
It's certainly possible that you might have risk variants for a given gene, but not necessarily have negative impacts from it.
So how do you know when to treat a gene?
Generally, you don't want to treat a gene unless your client’s gene variant increases the risk for a condition or symptom they are experiencing.
However, there are some cases where you should treat a gene to prevent a future disease from happening.
In these cases, the treatments would involve generally healthy lifestyle choices that you'd usually encourage your patients to follow even if they didn't have the variants.
For example, APOE, BRCA, MTHFR and some other variants have a very large impact that should be treated even if an individual is completely healthy.
In these cases, you would make sure your client knows that they need to focus on these healthy choices even more because of these variants.
So how do you know when a gene is an exception to the rule? We have (or will have) reports dedicated to individual genes that we feel are exceptionally important. As a practitioner, we'd recommend you read these reports at least once or twice. And when you have clients, you can just download a report for each client, so that they can read it after your session.
Here are 3 examples where you would "treat" the gene with healthy behaviors:
APOE4: If your client has APOE4, you'd want to make sure they're getting enough DHA in their diet, and exercising enough. APOE helps bring DHA to the brain, and the APOE4 variant doesn't work as well.
You'd also want to keep a closer eye on their cholesterol levels, as the risk goes up substantially for people with higher cholesterol levels. This would be healthy advice whether your client has the variant or not, but it becomes even more important with the variant.
Some people consuming a carnivore or lectin avoidance diet, like I do, think high cholesterol is irrelevant for heart disease, but that's a mistake. And if you have an APOE4 variant, then you definitely want to be cautious.
My LDL cholesterol levels are about 140. This is the only marker in my blood that's not optimal. I am not very concerned about this because I don't have any APOE4 variants and all of my other markers are optimal, but I'd definitely focus on bringing this down if I did have APOE4 variants.
Consuming DHA, exercising and checking cholesterol is good general health advice, but it becomes more important if you have the APOE4 variants.
We have a report dedicated to APOE.
MTHFR: If your client has the bad MTHFR variants, but no health complaints, you want to make sure they're getting enough natural folates and avoiding the synthetic folates.
They can accomplish this by eating ample non-starchy vegetables and staying away from processed foods. In addition, you want to measure their homocysteine periodically and make sure it's below 8-9.
This is good advice regardless, but it becomes even more important if your client has the bad MTHFR variants (homozygous for C677T).
We also have a report dedicated to MTHFR.
BRCA1: If your client is a woman with bad BRCA1 variants, which increases the risk for breast cancer, then they need to be more intentional about staying away from VOCs and alcohol.
Formaldehyde (a type of VOC) and acetaldehyde (breakdown of alcohol) are common environmental sources of DNA damage that often require repairs by BRCA1, which is not working as well in women with risk variants.
VOCs and alcohol consumption are linked with cancer whether you have bad variants or not, but it becomes even more important if you're a woman with bad BRCA1 variants. Takeaway As you can see, epigenetics plays an important role in client treatment, but the emphasis you place on a therapy can be informed when you know your clients’ genes and specific variants.
While it may be easy to suggest healthy habits for all of your clients, the examples above show that there are certain situations in which general health recommendations become even more important.