As health practitioners, we often encounter the temptation to prescribe supplements or jump to clinical conclusions immediately upon seeing a genetic result indicating a less favorable outcome. However, it is crucial to remember that genetic test results are not diagnostic. Instead, they help identify predispositions to certain traits when considered alongside other factors. This is particularly relevant for conditions like celiac disease, cancer, or vitamin deficiencies.
The fundamental concept of Nutrigenomics tests is that the predispositions they highlight are modifiable risks. These risks, which we are born with, can be influenced by our behaviors and actions. Thus, a predisposition does not necessarily result in a particular outcome.
Factors to Consider
Before making any conclusions based on genetic results, several factors need to be considered:
- Overall Genetic Predisposition: Don’t stop at a single gene result. Look at other genes that are linked to the same outcome or that may influence that outcome.
- Comprehensive Evaluation: Assess signs, symptoms, past and current lifestyle, family history, and environment.
With a clear understanding of these factors, you can provide personalized recommendations and evaluate the most appropriate course of action for each patient.
Practical Examples
Example 1: Increased Need for Choline
- Genetic Factors: Consider the PEMT gene predisposition and methylation genes.
- Diet: Evaluate if the patient is consuming enough choline-rich foods.
- Symptoms: Check for anxiety or sleep disruption.
If the patient shows symptoms and has a predisposition, you might consider supplementation and track their progress.
Example 2: Vitamin B12
- Genetic Factors: Look at the TCN2 gene and other relevant genes (FUT2, MTR, MTRR, MTHFR, 5-HT2A).
- Diet: Assess if the patient is eating enough B12-rich foods or if they are vegetarian.
- Symptoms: Consider energy levels and iron status.
Depending on the findings, you might recommend B12-rich foods or a B complex supplement, with or without folate.
Recommended Approach
- Awareness of Potential Predispositions: Understand the genetic risks.
- Evaluation of Past and Current Habits and Demands: Conduct a thorough assessment of the patient’s lifestyle.
- Dietary Recommendations: Suggest appropriate foods.
- Supplementation: Provide supplements if necessary.
- Phasing Out Supplements: After three months (or as needed), phase out supplements.
- Re-Evaluate Symptoms and Habits: Assess the patient’s progress.
- Repeat If Necessary: Restart the cycle if needed for another three months.
Explaining Results to Patients and the Role of Genetic Counseling
How you convey genetic test results to patients is crucial. Results indicating predispositions to conditions like lactose intolerance or celiac disease can significantly impact a patient’s life and should be communicated with care. It is important to emphasize that genetic tests do not provide diagnoses and should not be used to make clinical decisions such as eliminating dairy or gluten from the diet. Instead, these tests serve as screening tools to guide further investigations with more definitive tests, such as blood tests, endoscopy, or breath tests.
In cases involving serious genetic results, such as those related to Alzheimer’s disease or cancer, genetic counseling may be necessary. The goal of genetic counseling is to help patients use genetic information in a way that minimizes psychological distress and facilitates informed decision-making.
