Epigenetics
What is epigenetics and why is this an important concept in functional medicine?
Epigenetics refers to changes in the expression of genes (how genes are turned on or off) that can occur without changing the underlying DNA sequence. This means that the DNA itself doesn't change, but how the genes are read and used by the body can be altered. Epigenetic changes can be influenced by a variety of factors, including environmental and lifestyle factors, (e.g., diet, stress, exposure to toxins), and can occur throughout an individual's life. These changes can have a significant impact on health and disease risk, and can even be passed down through generations. Understanding epigenetic changes can help identify new targets for disease prevention and treatment, as well as inform strategies for promoting healthy aging and development.
Functional medicine doctors view epigenetics as a key factor in the development and progression of many chronic diseases. We recognize that epigenetic changes can occur as a result of environmental and lifestyle factors, and that these changes can contribute to the development of chronic diseases such as diabetes, cardiovascular disease, and cancer. From a functional medicine perspective, understanding an individual's unique epigenetic profile can help guide personalized treatment strategies that address the underlying causes of their health issues. This may include identifying environmental and lifestyle factors that may be contributing to epigenetic changes and implementing targeted interventions to promote healthy gene expression.
Functional medicine also recognizes that epigenetic changes can be reversible, which means that targeted interventions may be able to reverse or mitigate the effects of these changes and promote optimal health and disease prevention. This approach emphasizes the importance of personalized care that considers an individual's unique genetic and epigenetic profile, as well as their environmental and lifestyle factors, to promote optimal health and wellbeing. I see this as the positive flip side to discovering that you are for example, an APOE 4 allele carrier or a carrier of a BRCA gene mutation. We can take this information and make the best choices for ourselves and our bodies.
I remember a powerful story told by Dr. Jeffery Bland, a renowned MD and pioneer of functional medicine. Dr. Bland talked about how his view of genetics shifted and expanded after hearing a researcher speak about first generation Japanese immigrants who were part of the Women’s Health study. In that study, the researcher analyzed a cohort of Japanese immigrants to the United States whose parents, grandparents and other relatives in Japan had lived into their 90s. The immigrants, however, did not live as long, and became sick and died much earlier in their 70s.
It was a big a-ha moment for Dr. Bland—because the genetic inheritance over the generations did not dramatically change but the life-span outcome did, there had to be an explanation related to the fact that the immigrants were in a different environment. This triggered explorations into the variables that might influence the aging process by converting genes into expression or phenotype. This search inspired much of the functional medicine revolution going on today. Dr. Bland summarized: “we now would say, that certainly 25% - 30% of our life expectancy, is tightly controlled by our genes, and some of those genes can be obviously very dramatic in their control of our aging process and life expectancy. And so that gives 25 to 30% of things that are variable, which is a big playing ground for us to be involved in.” Functional medicine is in the forefront of exploring that playing ground. Integrative approaches such as lifestyle interventions, precision nutrition, supplements based on unique genetics and lab testing have all come to be part of the functional medicine toolkit. Make a functional medicine telehealth or in person (Denver, Colorado) appointment to start the journey of controlling your environment as much as possible to affect positive changes not to your genes specifically but to how your genes are turned on or off.
