Personalised medicine is now a reality. There is a huge amount of information available to modern medical consumers to help us understand and overcome the individual genetic and biochemical glitches that nature handed out. Choosing to invest in your health beyond what’s available on the NHS allows you to understand and manage your health risks with more clarity and confidence, although I always recommend looking at more easily assessed and addressed lifestyle factors first.
Both functional and genetic testing can provide insights into key metabolic pathways that have the potential to determine your future wellbeing, allowing a highly personalised food and supplement regime. For example, the recommended daily amounts of nutrients established by public health committees are designed to keep 95% of the population free from deficiency diseases. Many people need higher quantities to function well, or they may need a specific molecular format to assimilate it properly.
There is an art to understanding which tests may be useful and that comes from experience and from building a comprehensive picture of your health history before deciding what to choose. Here are some examples of tests we can commission:
There are hundreds of functional tests available from a range or respected laboratories. Most of them involve providing blood, urine or stool samples. Functional tests can be used to assess:
- organ function e.g. adrenal, thyroid, liver
- digestive function and capacity
- microbial ecology and balance
- hormonal health e.g. breast cancer, PCOS, menopause, fertility
- nutrient status e.g. requirement for key nutrients and deficiencies
- inflammation and oxidative stress
- toxicity and detoxification capacity
- metabolic markers for chronic and critical illness
- difficulty gaining or losing weight
- cardiovascular health
- coeliac and gluten sensitivity
Functional tests vary in price from around £40 to £800. Generally the more information you get, the more expensive they will be. I will always try to optimise the balance between information and expense. The cost is not included in our consultation package.
It is cheap and easy to analyse the protein-coding part of your genetic material (the exome) in order to improve the outcomes of complementary therapy and medical intervention. Not only is genetic data used to help us identify risk for certain medical conditions, we can also use it to predict response to medications and to understand individual glitches in key biochemical pathways like neurotransmitter production, hormonal metabolism and liver detoxification.
Genetic testing is a relatively new ‘consumer product’ and our understanding of the role and interactions of genes is not complete. We must handle the ‘knowledge’ with care and not make bigger leaps than the evidence allows, which is why it is important to work with an experienced practitioner. I use genetic data as part of a wider clinical picture – and not as a standalone tool.
DNA testing is not for everyone; you may discover some difficult information. Your ability to handle genetic ‘bad news’ will depend both on your personality and your approach to health and wellbeing. We should discuss this before delving into DNA. Though I may suggest it, I will never pressure you to do this sort of test, and it is vital that you feel happy to say no if you’d rather not know.
If we decide to look at genetic influences as part of your consultation we will do so because you may have a strong family history of symptoms, or because you’re ‘tried everything’ and you still don’t feel well. We will focus on well-researched genes that have been shown to be modifiable with nutrition. Most likely we will focus on a set of genes that code for a particular function – for example oestrogen detoxification, neurotransmitter function, histamine breakdown – and use this information to build a more personalised protocol.
Genetic testing costs vary. If you already have your 23andme data they tend to cost between £40 and £200. Increasingly providers will analyse your DNA along with the test which can help to save costs. Again, the costs of DNA analysis and genetic reports are not included in our consultation package.
Testing is very useful to help us identify individual ‘glitches’ but it’s not essential. One of the main benefits of working with an experienced clinician is that I can often see patterns without the need for confirmatory testing, and tend to commission tests only when there is a conflicting pattern or highly complex case history.