personalized medicine

Dr. Cates: Welcome to The Spa Dr. Podcast. I’m Dr Trevor Cates. On today’s podcast, we’re talking about how your genes play a role in your health and what you could do to change your genetic expression for optimal health. It’s really about personalizing medicine and there’s a great opportunity here. So I invited my guest, Dr Deedre Mason on to talk about this. She is a nature pathic physician emphasizing complimentary approaches to chronic disease. She’s a graduate of National University of Natural Medicine in Portland, Oregon. We went to school together. We were classmates and she is one of my best friends. I’m excited to have her on Dr. Mason lectures around the world on weight loss, healthy aging, and Nutrigenomics. She is a known for her passionate lectures, commitment to quality patient care, and the advancement of professional education. In today’s interview, we talk about how to personalize, how to individualize medicine around your genes. This information will help you understand why there isn’t a one size fits all when it comes to diet or wellness plans. Dr. Dee shares, how you can change the way your genes express themselves through your lifestyle choices and which ones are the most important places to start. So please enjoy this interview.
Dr. Cates: Dr Deedre it is so great to have you on my podcast. Welcome.
Dr. Mason: Thank you Dr Cates. I’m so in love with what you’re doing and I’m super honored that you invited me to come visit with you today.
Dr. Cates: Yeah. And I’m so for everybody watching and listening, Dee and I are really good friends. Do you went to medical school together and I’m so excited to have you on my podcast because um, you mean so much to me, sweetie. So it’s great to have you here and so everybody can get to know more about what a brilliant doctor you are. And so I want to talk about about how to personalize medicine because I feel like there’s so much information out there. People are looking up things, you know, Doctor Google, people are searching things, thinking they’re going to get all these answers online and people are saying, so why, why doesn’t this diet work for me? And I don’t understand. It’s confusing. And I think what people need to realize that there is a way to really personalize what they need for their medical care. And I know you do a lot with that. So, first of all, let’s talk about the importance of this and what do you think, what do you find in your practice and when you’re educating um, practitioners and others.
Dr. Mason: Right. And I think that’s important to note that, you know, I’m kind of spanning both sides of that because I am spending time educating practitioners on how to be a better detective. What are some quality of life questions that you need to ask? And this is really how I’m trying to move the needle in private practice and for other practitioners and their private practice because we no longer live in a world of paternal medicine where doctor knows best our patients, and you mentioned Doctor Google as far as the information you get from Doctor Google can be, or the thread that pulls for so many patients. But that is where medicine is at today. It is at a stage where we need to have more patient-centric practices where quality of life, longevity factors are coming into play and more patients are asking what is it that they can do to personalize their approach. And I’ll find, I’m sure that not just through your podcasts, but through our community and health care providers, you’re seeing the same things, is that our patients are far more educated than they used to be. They’re seeking out in sharing risk with us in establishing what they want their healthcare to look like. And there’s probably no better way for us to do that then to grab a bunch of extra data points that we didn’t have before as practitioners. And so looking at what the genome, um, has given us. So you’ll see more and more evidence behind the strength behind neutrogen gnomic analysis. We’re now seeing a pairing between your genome and of course the DNA of the microbiome. And we’re starting to see the interplay there. And that’s really, I think where we’re seeing this big bang of personalized medicine or knowing that your microbiome is dictating your moods, your cravings, your sleep, even your energy harvesting and your skin of course. Cause you know, as if you’ve educated me. It’s not just the oral biome or the microbiome, but that shared environment of the skin biome. And for that reason, I’m glad that you brought that up because now medicine isn’t just about my blood sugar level, my blood pressure levels, my total lipid levels. It’s now about how am I interacting with my environment, how is my environment interacting with my health for longevity factors? And again, this comes down to how is your microbiome performing and what does that mean to your genetic environment and how can you create a better genetic environment? Today in medicine, we know that we can change the way genes behave. We can turn bad genes down and we can turn optimized genes or genes that we want to optimize. We can do that as long as we create a better genomic environment for them. And so that’s kind of the target of that patient center practice is personalized nutrition because patients today, they want a program, a health care team that’s working in their interests, but they also want their treatment plan to match their lifestyle because nobody wants to do the hard stuff. Right. And nobody is served by trying to change everything all at once. And so that’s what we’re trying to create with practice with purpose.
Dr. Cates: Yeah, I love that so much has unfolded on all of this Nutrigenomics and the impact of our lifestyle on our genetic expression. So much has unfolded since we graduated from naturopathic medical school in 2000 and it’s exciting to see what’s evolving, what has evolved and what’s continuing to evolve in this. So it’s really great to see. And I think that with patients, you know, with individuals, with all of us really, if we know if we look at our test results and we know that something is it specific to us and that we can look at it on a test result and we know it’s really going to impact us, it’s easier to make that change. Right? So I think that’s one of the things that I, that I love about some of these tasks. So what do you, when you, when you’re working with patients, when you’re making recommendations, what are some of the things that are really going to be important as far as looking at people’s genetic makeups and what, what are we really going to be able to impact when it comes nutrition?
Dr. Mason: I think it’s important that, that our patients understand that genomics and Nutrigenomics is still in its infancy. We’re still learning a lot about how to interact with gene environment, how to manipulate gene environment. But I also think it’s important for our patients to understand that Nutrigenomic or personalized medicine allows us to help the patient take a personal inventory because the individual that is overweight but doesn’t sleep well … for years has been targeting calories or targeting a balanced meal plan or has been targeting exercise. Right. And that that’s definitely been that 1970’s approach to obesity when today we know that stress factors, I mentioned the microbiome and sleep habits play a very large role in that. So when it comes to personalized nutrition in Nutrigenomic analysis, I now have that patient that presents with family history, uh, you know, obviously at their own individual personalized and presenting history. But now I get to take this genetic history and say some of these targets are over here, they’re in sleep. They are in going beyond the food or the quality of food that you consume. It’s a Nutrigenomic analysis that allows me to sit with the patient and take a personal inventory where I’m able to say if we were to look at eight pillars of health and I, I think there are eight pillars of health and they, they, they start with sleep is at being in pull position. Um, in regards to what we’re dealing with and the types of patients that we’re seeing today. And it ends with having that sexual or healthy sexual arousal. These are all quality of life factors that we need to pay attention to. And what I find is that Nutrigenomic analysis allows me to take diets, sleep, the microbiome, mental function or cognitive wellbeing, sexual arousal or age management, and take a personal inventory and say, how are we going to shuffle this deck for you so that we find that one thing that we’re going to do, that one thing that we’re going to target, as I said, nothing in nature acts in exclusion and no one is well-served by trying to change everything all at once. But I do find that if we can pick by looking at a personal inventory, that one thing that we’re going to work on right now that many other things fall into place and I would fade that sleep and diet and fitness, those are the trifecta. That’s what I’m trying to achieve with patients. Get them a little bit closer, helping them move that needle by understanding what fitness means to them and personalized genomics allows me to do that. You can put on weight if you pick up heavy things and put them back down again. Are you better with long distance running? Are you an individual that has to do high intensity interval type training to get the other genes to fall into place to change that gene environment? Diet definitely plays a role. Composition of diet, quality of diet, form of nutrients and this is often where supplementation may be one of those things that we look at to achieve a better genomic environment. No amount of diet is going to change that sluggish enzyme, but a constant concentrated amount of the right nutrient can do just that and can turn genes off that as I said are behaving abnormally and then turn genes up that we want to behave optimally. And then that comes down to sleep. And I’m sure I’m not the only one of your gas that it said if you can get sleep dialed in, we can help talk to people about the quality of sleep, whether that’s decreasing sleep latency, how easy it is to fall asleep, quality of sleep, so you’re not fragmented during the night or they wake up simply feeling restored. So many other things fall into place. thyroid falls into place, sexual arousal falls into place. You can whittle your middle if you get a good night’s sleep. And I think that it also opens up a dialogue with patients that they weren’t having with their practitioners before. They weren’t speaking to their primary about this concept of age management and longevity and what it meant to or what it means to them. And I think that’s something that personalized nutrition allows practitioners to do today as service that they’re able to give their patients. Again, pulling it back into that patient centric world or that patient centric practice with personalized nutrition. We’re now saying to our patient, I want you to ask me more questions and it doesn’t need to just be about lowering your blood pressure or improving your lipids. I want to know about the quality of your life, the quality of your mental wellbeing, your spiritual wellbeing, your physical wellbeing. You’re more than the data points on this lab work.
Dr. Cates: Yeah, yeah, absolutely. I mean, I think that, I think it’s so important to, to look at these things and how, um, how these specific gene snips can play a role too. So can you talk about some of the, when we, like for example, you mentioned weight loss, more talking about weight loss and customizing, personalizing people’s exercise and nutrition and their diet, what they should be eating. Can you explain to people what are the, what are the genes snips that you’re actually looking for.
Dr. Mason: So gene snip or SNP stands for single nucleotide polymorphisms and these are nothing more than variations in the way nucleotides come together. So your blue eyes versus my Hazel eyes, that’s a genetic polymorphism change in, in our genes. You know, I think something that surprises a lot of people is to identify that we’re 99.9% identical and only 0.1% different, a 0.01%, um, different than one another. And I always like to joke with people, I like to think of it as that I might get my 0.9% identical to an Olympic athlete and only 1% identical to a serial killer, right? I mean that’s how I like to look at that and look on the bright side. But the idea here is that there’s a disproportionate number of gene polymorphisms that dictate what I see in front of me. And it’s a very small percentage of these polymorphisms or these variations and our genetic code that dictate for lipids, elevated lipids and how you stored triglycerides and what that means, not just a heart disease, but obesity. It’s these variations that change transcription factors or change the way proteins work in the body. And that can mean all the difference in the world to how you manage or respond to stress, how you get a good night’s sleep. Whether or not you’re able to maintain mental focus. So when we look at obesity, um, polymorphisms, we look at things like FTO, which is a very popular gene and we feed that it is intimately linked to insulin sensitivity. So you can see that there’s, um, you know, a direct link to obesity and insulin sensitivity. But what is underlying the research in Nutrigenomic analysis is that sleep is actually one of the ways that you help that gene behave optimally. That this is a gene that leads to more snacking, decreased the tidy individuals just don’t feel sated. They don’t feel full, which means that they’re more likely to overeat, or not feel sated. And so when you look at Nutrigenomics analysis and you look at something called the Mc4r gene, and there’s a handful of these, these are melanocortin genes that are highly responsive to stress. And so my target and the reason why I bring these up is because my target isn’t the usual suspects. I do want my patients to eat quality foods, but when I’m able to look at Mc4r genes or FTO jeans, I did an intimate look into whether or not this patient has a higher risk for polycystic ovarian meaning that my target in her obesity as well as her quality of life because of fertility, is going to take a different route than simply calories in, calories out. When I look at that gene environment and how FTO and Mc4r relate to each other, I now know that my primary target is actually getting this woman a good night’s sleep and as a result of that, everything else is going to fall into place and I think that something that’s worth paying attention to. We have a lot of patients that will, they, they’ve got a singular focus, whether it’s weight loss or they want to know if they’re a good methylator. Our patients have a singular focus. They want to know if they’re lactose intolerant, gluten, gluten sensitive. And yet there’s so much more that looking at the genome, there’s so much more information that we get that goes way beyond methylation. As important as methylation is, it’s much bigger than the MTHFR gene. Right? And we think what we’ve learned from Doctor Ben Lynch and what we’ve learned from other thought leaders in Nutrigenomics today we know that it’s much bigger than this one gene and has a lot to do with gene environment. And I think that’s why I like looking at targets that patients want to see changed like obesity factors. Because we do see sometimes as singular focus or a target or a goal with our patients. And what personalized nutrition allows us to do is to look at the multitude of gene variants, how they interact with each other. And then when we’re doing that patient interview, Or, take that personal inventory. Now I know whether or not I need to hold methylation snips in higher regard drive a higher level of suspicion, not just because of family history, but because of some of the things that I’ve learned on interview. And now I’m going to look at blood pressure in a very different way. I’m going to look at the EDN1 snip for example, which is a vasoconstriction snip and it is not responsive in fact, to many of the antihypertensives that patients are being are light that are being prescribed but highly responsive to nitric oxide, highly responsive to magnesium. And so what I’m able to do when you look at gene environment specific snips, but then taking the totality of the patient presentation, I’m literally able to put one priority or one snip ahead of another and that gets patients to their goal faster because they now have a blueprint for what they’re going to do. They now know they’re going to focus on this. They thought they needed to focus on calories or exercise. I’m all those things are important. They end up taking a back seat to sleep or they know that they’re going to that so they can digest their treatment plan better. They know they’re going to focus on one thing first. And that’s ultimately what looking at these snips or these variations allow the practitioner and the patient together to discover.
Dr. Cates: Okay. Okay. And so just for clarification, I know I’ve had doctor Ben Lynch on my podcast and I know we’ve talked about methylation, but can you just give a little recap for people that are, you mentioned that word and they’re not quite sure what, what you’re referring to. Can you just give a long explanation on that?
Dr. Mason: Yeah, so in biochemistry or in physiology, the way biochemistry interact, these methylation pathways are literally what’s turning on and turning off neurologic switches, medicalomic or down stream switches in the body for detoxification, neurologic tone and repair. And so when we look at methylation pathways, um, we’re looking at the way enzymes function for the turning on and turning off of cellular activity at to cell to cell communication. And ultimately that is nutrient driven. It’s controlled in some fashion by end products of metabolism and inflammation. And I mean those are some of the simplified words that patients understand that they, they understand turning on and turning off inflammation and behind the scenes underneath it all. We’re doing that by influencing methylation pathways that are inside driven.
Dr. Cates: Okay, great. Thank you. And then you were talking about sleep and um, being particularly important for some people. And I just want to, I just want to reiterate it because I think there are, there are lot of people that have said, oh, I can get away with less sleep. Or some people are saying they need more sleep. And if you’re really paying attention to your body and you really are noticing how you perform best, I think that what’s happening is you’re getting a reflection of what’s actually happening with your genes. That your genes are actually are the type that, cause I think that it’s true. There are some people that need more sleep. There’s some people that can get away with less sleep, right? But for some people it is so important for your health because of your genes. And so this is what we’re talking about here because I get so many people saying, why is it that this person has smoked cigarettes their entire life? They’re living to 95 right? And this other person smoked and they got lung cancer. So there’s, there’s a lot in this about genetics and, and this combination of lifestyle factors and genetics. And I think that it’s so valuable to know this information so that you can make those choices and know where to place your focus. Right?
Dr. Mason: Right. And I guess that, that you’ve nailed it, right? Because what we need to be able to do is wear to identify where are we going to put our focus, not just what’s going to give me the most bang for my buck in energy throughout the day. But we’re really speaking about the long game. When I, when I talk to people about the importance of Nutrigenomics, I remind them we’re playing, we’re not playing checkers here. It’s not your next move or playing chess. We’re talking about what’s happening in the long run and what you do today to create a better gene environment is going to create a better brain environment, a cognitive function in the future. And so when someone, or weight or sexual arousal or better detoxification pathways, which ultimately is linked to better neurologic pathways and healthy brain aging, when it all comes down together, when we sift it all out. But one of the things I think that, you know, that you’ve hit on here is that there are people that seem to, you know, that seem to find weight loss easy. While some of us have sluggish weightloss genes and that’s gene environment. But the message there is not, I guess there’s nothing I do, it’s in my genes, right? The message here is that we can change gene environment. We can do it in a very short period of time, as long as we have the right combination of nutrients and often the rights form of nutrients. So I want people to see that Nutrigenomic analyses or precision nutrition type of solutions or personalized nutrition gives them the ability to do just that. Pick what they’re going to target through data points of your lab work, urine metabolites, all of the different things that we do, but also adding on that those Nutrigenomic biomarkers, we’re going to get a much better picture. Um, the thing I think is magical about many of these different types of testing or analysis is that there are thousands of ways to get sick and yet only a handful of ways that patients present, and nutrogenomix analysis or personalized nutrition allows us to take that higher, um, that aerial view, there’s so many different ways that we could have gotten here with this immune dysfunction. Right. And Nutrigenomic analysis paired with other biomarkers allows us to kind of focus in and say, I’m seeing a lot of clustering going on over here around these methylation pathways. I’ve seen a disproportionate number of genes or gene polymorphisms related to stress and they are expressing themselves in the cardio-metabolic nightmare patient with elevated lipids and they elevated blood sugar, the poor inflammatory control. And by looking at some of these snips, we can answer that question, why does this person get to smoke? And this person doesn’t cause they’ve better detox genes thing you do. Right? Why does this person seem to get away with four and a half hours of sleep? And I need to get somewhere closer to nine? Because they probably have genes that allow them to be more Leptin sensitive and push Gremlin down, meaning that their night’s sleep is less fragmented than yours. If less disrupted than yours. It may be about Serotonin and dopamine balance. Uh, and Nutrigenomic analysis gives us insight into that. So the answer, quite frankly, isn’t your genes,
Dr. Cates: Right? Well, and I want to make sure we’re clear that we’re not promoting smoking cigarettes.
Dr. Mason: No, no.
Dr. Cates: But some people have gotten away with it longer. Right? And that was my point.
Dr. Mason: And that that’s in the cytochrome P450 genes. When we look at the site 1A genes, 1A2 genes in the 19 genes, that’s where we see this individual detox is better. And I’m saying while we would still counsel people to eat well, sleep well and absolutely do not smoke, it does give us the ability to prioritize certain things over others. They come in and say, I’m doing everything right. I eat right. And we’re able to say there’s this stress component that we really need to work on, right? We need to prioritize one of these personal inventory, um, markers above the other. And that’s why I think gene snip analysis allows us to do.
Dr. Cates: Yeah. Well, so let’s talk about age. Is there as there, when’s a good time to do this? Is there, is it, is there a point when it’s too late? Is it, um, timing wise for people there?
Dr. Mason: It’s never too late to do this. Um, and part of that has to do with the fact that we know that we can change gene environment in such a short period of time and if little as three months, we can turn genes down and turn genes up with the right nutrients, with the right gene environment. But you can right away swab a child, you can swab an infant and you can identify that child that, may be prone to obesity or may be prone to attention issues because we can feed those things in gene polymorphisms. And so now what we have is the parent rather, they’ve always been an advocate for their child’s well being, but now they have a better blueprint for what to target. Um, if they know that their child, um, you know, carries a handful of obesity polymorphisms, then they know that they’re going to focus more on not just dietary intake, but nutrient intake through supplementation exercise, especially if Nutrigenomic analysis gives them a target that this child is prone to extra weight or attention issues, neurologic progression or neurologic sensory issues. Um, if we can see it in their gene polymorphism testing, right? They just got a blueprint they didn’t have before.
Dr. Cates: Right. Because these are your genes. They don’t change over time. Right. You do it once. You can do it as a child, you can do it later. Right?
Dr. Mason: Right. And that’s an important fact that cause some people say, do I test again to get to find out if I’ve improved? And that’s what we take in other biomarkers lab testing to see that we’ve changed something that’s been influenced by the information that we received through personalized from Nutrigenomic analysis. Your genes are your genes for life. So there if you have, um, BDNF, which is a bay, a brain neuropeptide, and that it has some positive benefits for healthy brain aging, but, um, has a deleterious snip polymorphism that can be looked at as well, that’s always going to be there. That’s your, that’s your geno type. But it’s, um, that Ginotypic expression that we’re looking to change. And so when I look at the brain neuropeptides, or the BDNF snip, what we know is that VAT is influenced greatly by exercise, by chlorogenic acid, by caffeine. And so now what we’re able to do, speaking to that point about, is it ever too late now in that cognitive patient, in that brain aging patient, because we’ve looked at BDNF, we now know that we may specialize their exercise program. We’re definitely going to look at nutropics like chlorogenic acid. We’re definitely going to look to see what we can do to change brain aging. Even if we’re looking at more advanced, more mature years and an individual. Right?
Dr. Cates: Okay. Anything that you can share about skin, like any specific tests that you look at, what genes, snips that um, give a good indication of how someone’s skin, maybe their skin aging is going to be
Dr. Mason: There is. Because when you look at things like foot 2, which is a B 12 polymorphism, or you look at what’s called the d h r 7 snip. These are vitamin D polymorphisms as well as a Beta carotene. Polymorphism. When we get a better look at nutrient metabolism, um, uh, Beta carotene in particular, not, not everybody is a good converter and Beta carotene and this is intimately linked to the health of skin. In general, it’s linked to the help that scan. And what we find is that we can influence that gene polymorphism these individuals have for Beta carotene, conversion with things like Astaxanthin and Astaxanthin has some very clear, Indications in sun screen in anti aging can very potent anti inflammatory. And so utilizing Astaxanthin and identifying this is going to need to be one of your pole position types of supplements for a healthy skin aging because you are a poor converter. You know, that’s one thing that I look at. But in general gene polymorphisms gives you, give you a lot of insight into gut health, which is intimately linked to healthy aging. In cell turnover, we’re able to look at many of the inflammatory snips or oxydative stress snips. And that gives us some insight into lypofusion that gives us some insight into age spots, um, hyperpigmentation. And so I think it’s important that, and I know you shared this message, whether it’s beauty from with and um, whether it’s when we change an environment on the inside, we’re going to start to see health on the outside. And that’s really where glowing skin comes from, is ultimately having a healthy gut, being able to control and manage inflammation both inside and outside. And so looking at antioxidant snips, inflammatory snips, gut health snips, they absolutely give us a look at your potential for healthy aging they give us. And you know when you mentioned how early can we snip somebody, it also gives us insight not just into how to eliminate concerns we have with metabolic disorders. But to answer that question that we talked about when we first started today, which is people’s longevity factors, patients are driven towards a better age management strategy and that should include a personalized Nutrigenomics.
Dr. Cates: Right, right. Great. And I think that you know, we’re looking at addressing the root causes behind skin issues. A lot of the things that you address with genetic, you know, with, with Nutrigenomics that you address for other health reasons are also going to help with the skin aging and skin issues. And I know that with gene snips or you can look at people that tend to be more sensitive to the sun and of course those people are going to be particular they can be and knowing that they can be more protective with their Some people, thet are some people that are genetically are more prone to college and breakdown and, and those sorts of men. Yeah. And so, so certainly there’s a lot that can be done with that. But like you’re mentioning, it’s really um, you know, it’s the whole approach. And so, so many of these genes, they have these crossovers. If you, if you change the genetic expression of it and one way it’s going to help your health in many different ways, right. So to the protective benefits of it.
Dr. Mason: And that comes down to that gene environment. You know, often we talk about gene expression and gene environment based on the nutrients that you’re getting or you’re not getting the sleep that you’re getting or you’re not getting the exercise you’re getting or you’re not getting, or how well you manage stress. But you bring up a great point, which is gene environment that has to do with the white genes with the way genes interact. And we do see that a great deal in genomic analyses is that we’ll see a handful of snips. As I often say, you have a disproportionate number of snips in this realm and that’s going to help us target it. But because this gene is also linked to this polymorphism over here, um, we need to influence that. And that’s where you get that full spectrum of health again, where a patient may desire a certain target, they want to know if they’re a good methylator cause it gives them insight into brain aging, detoxification pathways. And what I want to be able to do through personalized nutrition is then say that’s also linked to your gut. That’s also linked to how you manage insulin and that’s also relevant to your aging or your longevity factors. And so we kind of hold that web and we were able to show that web two patients of that.
Dr. Cates: I love that. Okay. So great. So Doctor Deidra, thank you so much for coming on today and sharing your information. Tell everybody where they can find you.
Dr. Mason: So you can find more information, not just about Nutrigenomics, but just what I like to refer to as your longevity factors. In short at the website, www.drdpracticewithpurpose.com.
Dr. Cates: Perfect. All right. Thank you Dee. See you soon.
Dr. Mason: Bye Now.
Dr. Cates: I hope you enjoyed this interview today with Dr Deedra] Mason and got some information on how personalized medicine can work and how genetic testing and Nutrigenomics plays a role in all of this. It’s exciting what’s coming up in medicine. So to learn more about Dr. Mason, you can go to the spa Dr Com, go to the podcast page with her interview and you’ll find all the information there. And while you’re there I invite you to join The Spa Doctor community so you don’t miss any upcoming shows. And if you haven’t already done so, I encourage you to get your customized skin report. Just go to theskinquiz.com it’s a free online quiz and find out what information your skin is trying to tell you about your health and what you can do about it. Just go to theskinquiz.com also, I invite you to join me on social media. The spa doctor is Facebook, Twitter, Instagram, Pinterest, Youtube. So you can join the conversation there and I’ll see you next time on The Spa Dr Podcast.