Naturopaths and 23 and me

Genetic Testing Q from newbie
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dr.martyingram
Message 1 of 8 , Oct 21 12:42 PM
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I am just dipping my toes into the 23&Me world. Heard that they are going to start including carrier status, wellness, trait and ancestry reports. How is this different than the info that Sterling's app provides? I have also reviewed the Pure Genomics tool, but info seems limited (they say they only report on things that have been proven to be influenced by nutritional supplementation).


Anne Van Couvering
Message 2 of 8 , Oct 21 1:50 PM
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Hi Marty -

Interpreting and using 23&me is one of my specialties - I can't possibly answer this in an email - call me if you'd like to talk

917-653-7406

Anne Van Couvering, ND, CNS, LMT
Berkeley, CA


dr.martyingram
Message 3 of 8 , Oct 23 6:16 AM
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Thank you, Anne! So I'm gathering from what Chrissy wrote that there is a lot more information available from Sterlings app than the free information from Pure Genomics and what 23&Me is now allowed to offer by the FDA, but that this information would be about as useful to me as the raw data unless I took a course to learn to interpret it? I have never seen a report from Genetic Genie or mthfr so I do not really know what I would be getting into. Thanks!

Marty Ingram, ND
Brevard, NC


Anne Van Couvering
Message 4 of 8 , Oct 23 6:36 AM
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In a nutshell - yes.

23&me offers raw data - everything else is just silly - basically, it's the cheapest, most comprehensive way to check your SNPs, but there are drawbacks.

Genetic Genie pulls out information for about 20 SNPs. MTHFRsupport gives you a 42 page report, and has just started offering videos on different segments.

I've been studying this for 4 years now, and am just beginning to feel that I "get" it - with several weekend long seminars, multiple webinars, etc etc.  Unless you like to geek out in biochemistry, refer the interpretation out.  That said, I find it fascinating and am happy to discuss it with you.

Unfortunately, this is one of those fields where a little information is dangerous - all I can say is don't blindly throw methylB12 and methyl folate at people without knowing more of the story than just the MTHFR SNP.  I have spent a lot of months recovering people from that prescription.  (I'm sure many people also do well on it, but they don't come hunting a specialist).

Anne Van Couvering, ND, CNS, LMT
Berkeley, CA



yogi_doctor
Message 5 of 8 , Oct 23 7:15 AM
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For those of you new to nutrigenomics, you might be interested in checking out EpigeneticsRx (disclosure: I consult on research for them and do so b/c I think they have a ton of integrity).  They are a new player in the genetic testing and education arena and differentiate themselves by being research driven and NOT overstated (as compared to the many crowd-sourced, non-science based info online). It's a nice manageble 10 SNP panel. The education program is a 13-part webinar series - very rigorous and comprehensive.  www.epigeneticsrx.com

Also FYI here's our latest publication is peer-review original research of patient's experiences with MTHFR and methylfolate published just a few days ago:  http://www.esciencecentral.org/journals/epigenetics-in-clinical-practice-characterizing-patient-and-provider-experiences-with-mthfr-polymorphisms-and-methylfolate-2332-0672-1000124.php?aid=60490

See ya'll at AIHM in San Diego next week!

Erica Oberg, ND MPH
Pacific Pearl La Jolla
Guarneri Integrative Health
La Jolla CA


Joshua Goldenberg
Message 6 of 8 , Oct 23 7:36 AM
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I heartily recommend any of Dr. Oberg's qualitative research (and otherwise for that matter). In my experience it can be overwhelming and pathologizing for patients when they see their SNP profiles. On the flip side it can be empowering. I think this is an excellent area for qualitative research into the patient experience. I have been looking forward to this study of hers coming out.

For some reason less talked about in our profession it seems is the absolutely fascinating clinically actionable higher level evidence coming out on using genetic risk scores from a basket of SNPs as opposed to looking at each individually.

A great example is this Lancet paper: http://www.ncbi.nlm.nih.gov/pubmed/25748612

We have a short video summary on this evidence on www.DrJournalClub.com. If you are interested I can set you up with free access to check it out just email me privately (that goes for anyone on NatChat). COI: this is my website which is normally fee for access.

Also, be careful of genetic studies. They are extremely prone to false positives. Check out this series of 3 articles in JAMA on how to evaluate them critically:  http://www.ncbi.nlm.nih.gov/pubmed/19126812

Joshua Goldenberg, ND
Bothell WA


Anne Van Couvering
Message 7 of 8 , Oct 23 9:19 AM
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Agreed Joshua - I always look at the whole pathway and how it interacts with others before making recommendations - also, I need to hear the personal and family medical history - just because you have a SNP doesn't mean it's expressing - just like anything else, you don't treat lab values!

SNPs are just one more factor - for some people, not a big one - for others, the key to their health...

I don't find the smaller panels comprehensive enough to be able to really see the patterns, which is why I avoid them.

Anne Van Couvering, ND, CNS, LMT
Berkeley Ca


yogi_doctor
Message 8 of 8 , Oct 23 5:17 PM
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Joshua,
Thanks for the links to these references - excellent. And kudos to your DrJournalClub work; I love it as a resource and one-stop compendium of what my smarter patients are going to ask me about next week. So proud of you!
Erica