Bonus The Expert Panel

Transcription

1 Practical Clinical Application of Methylation and Epigenetics Bonus The Expert Panel CAM Genomic Conference April 11, 2015 London, UK 1

2 Disclaimer & Disclosures The information presented here is for informational and educational purposes only. Docere, Inc and Benjamin Lynch will not be liable for any direct, indirect, consequential, special, exemplary, or other damages arising from the use or misuse of any materials or information published. President and CEO of: Seeking Health Educational Institute ( Seeking Health ( MTHFR.Net ( 2

3 Why? 3

4 What 4

5 A Gene: MTHFR Substrat e Cofactor s End Product Promoter Enzyme Inhibitor The MTHFR gene produces the MTHFR enzyme 5

6 An Enzymatic Function: MTHFR Function: Lower Homocysteine Produce L-5-MTHF 6

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8 L-5-MTHF Function: Lower Homocysteine Regulate Methylation 8

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13 SNPs 13

14 SNPs A single nucleotide base change I. May or may not affect function I. No change II. Slower III. Faster II. May or may not be very common III. May or may not cause symptoms in healthy or sick individuals 14

15 MTHFR SNPs All about capacity to do work ie. Make L-5-MTHF I. 677CT: Heterozygous 40% reduction in function II. 677TT: Homozygous 70% reduction III. 1298AC: Heterozygous 20% reduction IV. 1298CC: Homozygous 40% reduction V. 677CT AC: Compound Heterozygous 70% reduction VI. 677TT AC: rare VII. 677CT CC: rare 15

16 MTHFR SNPs The More Work! The More L-5-MTHF is Needed vs 16

17 Where to start? 17

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19 Epigenetics Epigenetic changes are environmentally responsive mechanisms that can modify gene expression independently of the genetic code. and Epigenetics and the developmental origins of inflammatory bowel diseases. 19

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21 Epigenetics and Methylation 21

22 Support Pathways 1. Reduce 2. Remove 3. Restore 22

23 Step 1: Reduce 23

24 Folic Acid Must Go 24

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26 Should we use folic acid?! NTD Associated Genes: 1. MTHFR 2. MTR 3. MTRR 4. CBS 5. MTHFD1 6. RFC1 7. SLC19A1 8. DHFR 9. SHMT1 10. TCN2 11. TYMS 12. FOLH1 13. FOLR2 14. BHMT2 15. FOLR1 26

27 Folic Acid Slows Biopterin 27

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29 Insert Folic Acid Here 29

30 Insert Folate Here 30

31 Stress Must Go 31

32 Mental Stress 32

33 Mental Stress 33

34 Mental Stress Immune escape 34

35 Mental Stress 35

36 Identify and Reduce Stress 1. Family / Work / Friends / The Joneses / Financial 2. Sleep patterns 3. Dietary intake questionnaire 4. EMF / WiFi 5. Electronics / Games / TV 6. Exercise 7. Social Media 8. News 9. Commute 10. Caffeine 11. Personal Time 12. Meal Time Hygiene 13. Alcohol 36

37 Restore Nutrient Depletion Caused from Stress 1. Electrolytes 2. Basic Mitochondrial support (Ribose) 3. Taurine (caution) 4. Creatine 5. Choline (caution) 6. Adaptogens 7. Adrenal Cortex 8. Amino Acids (caution) methionine, cysteine, glycine 9. Minerals zinc, selenium, manganese (caution) 10. Vitamins A, B1, B2, B3, B5, B6, C, D, E, K 11. Specialty Glutathione (caution) 37

38 Optimize Diet 1. Balance blood sugar 2. Insulin resistance 3. Low histamine? 4. Low oxalate? 5. Low sulfur? 6. Low glutamate? 7. Identify food intolerances / allergies 8. 80% satiety 9. Chew 10. Hydration 11. Gluten, Soy and Dairy Free (2 weeks) 12. Caffeine alternatives (adrenal cortex, B5, NADH) 13. Alcohol alternatives (tea, mood support) 14. Whole foods 38

39 Stress Free! 39

40 Step 2: Remove 40

41 Remove Blocks 1. Reduce 2. Remove 3. Restore 41

42 Remove Blocks 42

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44 Identify Blockages 1. Yeast overgrowth 2. Viral infections 3. Bacterial infections 4. Exposures nitrous, heavy metals, BPA, phthalates 5. Oxidative stress NO, peroxynitrite (ONOO-) 6. Inflammation 44

45 Reduce Blockages 1. Filtered air 2. Filtered water 3. Glass, Stainless Steel 4. Organic, Free Range 5. Natural Cleaners 6. Dust Mite Covers 7. Air Flow / Humidity Control 45

46 Restore Nutrient Depletion Caused from Blocks 1. Probiotics 2. Anti-microbial 3. Anti-bacterial 4. Anti-viral 5. Anti-inflammatories - Boswelia, Curcumin 46

47 Unblocked! 47

48 Step 3: Restore 48

49 Restore Nutrients 1. Reduce 2. Remove 3. Restore 49

50 Restore Nutrients 50

51 Restore Nutrient Depletion 1. Pulse 2. Take when needed 3. Teach function of each product 4. Teach listening 5. Bell shape curve 6. Start low! increase slowly 7. Inquire about sensitivity / tolerance 8. Lozenges & Liquids > Powders > Capsules > Tablets > IV 51

52 Restore Nutrient Depletion 1. Amino Acids methionine, cysteine, glycine 2. Minerals zinc, selenium, manganese and others 3. Vitamins A, B1, B2, B3, B5, B6, B9, B12, C, D, E, K and others 4. Specialty Glutathione, SOD, Choline, EFA s, Taurine, Liver 52

53 Restored! 53

54 Cautions 54

55 Caution with These (need patient preparation) 1. Amino Acids methionine, cysteine 2. Molybdenum 3. Glutathione 4. SOD 5. Sulfur containing 6. Copper & Iron 7. B12 8. Folate 9. Choline 10. SAMe 55

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58 Patient Evaluation 58

59 Methylation Dysfunction Conditions/History (some) Meds Bile stagnation IBD, Constipation Diabetes Obesity Fatty Liver (NASH) Allergies / Asthma / Atopy Mental dysfunction Cancer Hispanic, Chinese, Italian descent Reflux Dental issues / Amalgams / Root Canals Lyme, H pylori, Candida, EBV, Hep, Strep Autoimmune Eating disorders Neurological disorders Cardiovascular disorders Lifestyle Type A Vegan Vegetarian Addictions Hobbies Commuter Couch Potato Premier Athlete Occupational Exposures 59

60 At-Risk Populations for Methylation Dysfunction Environment Zipcode ( New construction Remodeling Office/Employment Mold Gas/Propane/Exhaust Cleaning supplies Gardening supplies Food Water Bedroom location House orientation Proximity to freeway / street / powerlines 60

61 Labs 61

62 Labs 1. Pathogens CDSA Total IgA, IgE, IgG 2. CBC w/ chem panel 3. Serum Ferritin 4. CRP / TNF alpha 5. Urinary Organic Acids 6. Urinary Hormones 7. RBC Fatty Acids 8. RBC Essential and Toxic Elements 9. Fasting Insulin 10. Methylation Profile (after basics are done or get a baseline if interested) 62

63 Oxidative Stress & Mitochondrial Screening Glutathione Levels Enzyme Upregulation Ammonia Levels Vitamin Levels 63

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67 Steps of Treatment No Protocol Think Step by Step and Systems Do NOT Treat the SNP 1. Remove causes and exposures 2. Reduce stressors 3. Identify all areas of dysfunction and restore 4. Pathogens 5. Labs CBC w chem panel Urinary hormones, (Precision Analytical) Serum ferritin, TNFa Methylation Profile RBC Fatty acids RBC Essential and Toxic Elements Fasting insulin DHEA-S 24 hr Iodine and Spot 67

68 Support Pathways 1. Remove 2. Reduce 3. Restore 68

69 Immediate Support (commonly) 1. Diet 2. Lifestyle 3. Environment Reduces Catabolism & Burden 4. Adaptogens Supports many Pathways 5. Adrenal 6. Electrolytes 7. Liver (castor oil, milk thistle, enema) 8. Thyroid (indirect ideally adrenal, mitochondria, iodine) 9. B vitamins (no folate/b12 initially) 10. Trace Minerals (watch Fe, Cu) 11. Liposomal Glutathione (start low dose) DependentEnzymes.pdf and 69

70 Interventions Implement on most patients Breathing Sleep schedule Filtered water Caffeine free or greatly reduce Whole food meals: healthy fat, grass-fed meats, protein, veggies, few good carbs Gluten and dairy free three week trial then challenge one at a time Chewing Read: The Metabolic Makeover CoQ10 Liposomal Glutathione Choline Prenatal Probiotic D3 Adaptogens Adrenal cortex Exercise rebounder, weights, resistance, yoga, Zumba Sauna Potassium Magnesium 70

71 Key Points to Take to the Clinic 1. Identify Obstacles and Remove 2. Foundation / Basics 3. Inform 4. Prepare 5. Team care 6. Test RBC Fatty Acids, Methylation Profile, 23andMe, MTHFR Support, ION Panel 7. Adrenals / Adapt 8. Glutathione 9. GI 10. Pathogens 11. Inflammation 12. Mitochondrial support 13. Sulfur tolerance (SUOX blocked?) 14. Pathways and Systems NOT Protocols or SNPs 71

72 Three Points to Take to the Clinic 1. Balance Methylation Remove blockages Reduce workload Restore nutritionally 2. Screen for SNPs 3. Test Methylation and restore balance after Foundation 72

73 Key Supplements to Use at the Clinic 1. Adaptogens 2. Liposomal Glutathione (start low) 3. Phosphatidylcholine 4. Electrolytes (w/ Ribose/Creatine/Taurine) 5. Fatty acids 6. Multivitamin/mineral (to start - no folate, B12, Cu, Ca, Fe) 7. Methylfolate w/ methyl/adenosylcobalamin (after foundation) Throw away Folic Acid 73

74 Enzymes and SNPs All about capacity to do work 74

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78 Thank you Great ways to stay informed: Newsletter Available at Facebook: October 2013 Nutrigenomics Conference March 2014 Nutrigenomics Conference Pathway Planner Poster and Set Physician s Forum for Collaboration 78