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Genetic: Integrative and functional medicine came to the forefront for many medical practitioners and patients alike when they

1-genetic-testing-integrative-and-functional-medicine-32570

became dissatisfied with traditional medicine’s sole focus on what was considered “science-based” treatment approaches. Traditional medicine’s viewpoint of dealing with symptoms in isolation from the rest of a patient’s body, mind, and spirit can be too confining when it comes to certain conditions.

This evolution to a more function-centered approach as opposed to a disease-centered way of seeing the whole person has led to improved healthcare. It also looks at prevention, not simply illness and at living in a healthy state, not simply disease-free.

What Is Integrative & Functional Medicine?

Practitioners of integrative and functional medicine take into consideration genetic, environmental, and lifestyle issues when listening to their patients describe the symptoms plaguing them. Their inclusion of these issues makes the process more of a natural medicine approach.

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With the dramatic increase in chronic illness conditions and the lack of training traditional physicians have in dealing with these conditions, the move into integrative and functional medicine is needed.

Many of these chronic illness conditions have a genetic component that, along with environmental and lifestyle factors, lead to serious limitations on people’s lives. This shows the importance of the individual biochemical and genetic aspects of each person on his or her health.

This other approach in medicine realizes the necessity of considering nutrition, exercise, diet, and genetics in evaluating and remediating chronic illness conditions. The use of genetic testing in integrative and functional medicine is one way to take all of these factors into account.

SNPs & Integrative & Functional Medicine

Upon completion of the mapping of the human genome, we know there are 20-25,000 genes in each genome. With this knowledge came the information that there are over 80 million variants in the human genome.

These variants are comprised in part of single nucleotide polymorphisms (SNPs) and deletions or insertions in the genome. It is these SNPs that provide significant health information to providers of integrative and functional medicine to prevent or alleviate chronic illness conditions.

Knowing the presence of and placement of SNPs through genetic point mutation testing allows evaluation of the susceptibility to develop many of the chronic illness conditions that affect people today. In addition, this kind of testing helps pinpoint relevant SNPs and their corresponding metabolic markers in individuals.

Testing of this kind provides targeted interventions through the use of traditional medicine approaches as well as supplementation through integrative and functional medicine approaches. Monitoring of individuals’ progress is also made easier with genetic testing by measuring metabolic markers found in the original tests over a period of time.

Individual monitoring of this type is necessary when this kind of personalized intervention and supplementation is used. If there is an overload of either medications or supplementations, there can be an impact on the performance of metabolic processes that can lead to side effects. These side effects can influence functions and responses, such as the immune response.

Individual SNPs will determine how well medications and supplements are working.

Genetic Testing In Relation To Diet & Weight Loss

Integrative and functional medicine practitioners not only deal with illness, they also provide health and wellness evaluations. Current research has shown how important a role genetics plays in the prevention of many chronic health conditions.

Genetic testing can show vulnerabilities to conditions and suggest options for individuals. This kind of testing can also provide valuable information concerning how individuals can respond to different attempts to live more healthy lives.

Genetic testing has been shown to be effective in several areas: diet, eating behavior traits, nutritional needs, exercise, body and weight, and metabolic health. For each of these areas, there are certain genetic markers that can provide information regarding how genetics will affect each of these areas.

Diet

2-weight-obsession-integrative-and-functional-medicine-32570People are seemingly obsessed with weight. How to lose it and keep it off, how to re-distribute it to look more attractive. Professionals in integrative and functional medicine are approached regularly for help in this area.

Everyone knows it’s hard for some people to lose weight on any kind of diet, while others can lose weight any time they want. It’s not just due to lack of willpower that people don’t lose the weight they want. It may also be due to genetics.

Research has shown about 88 percent of people have bodies that resist burning fat through low-intensity exercise. Most people will gain weight if they eat almost any carbs (about 45 percent of people) or almost any fat (about 39 percent of people).

The reason for this is a diet and type of exercise matched to specific genotype lead to weight loss. These diets and exercise types are not the same for everyone.

For example, let’s look at adrenoceptor Beta 3 (ADRB3) with an SNP on rs4994. There are different variations of this gene. If you are either an AA or TT genotype, you have what is called a genetic privilege and just about any kind of exercise will work for you. On the other hand, if you don’t have either of these AA or TT genotypes, this is a genetic disprivilege and only a high-intensity type exercise will help you lose weight.

Further analysis of other genes and SNPs can tell you the type of diet, either low carb or low fat, that will work best for you. In fact, using a diet matched to your genetics can result in a loss of two and half times as much weight as a diet not matched to genetics.

In addition to choosing the right diet to lose weight, choosing the right diet may also help you avoid developing a chronic health condition. Research has shown diet to be implicated in many chronic illness conditions, so genetic testing to determine your specific vulnerability to illnesses and your response to particular foods may help prevent them.

Knowing your predisposition to illnesses can lead to targeted dietary and lifestyle changes that may modify any existing conditions and help prevent future developments. Future research may bring more information regarding bioavailable components in foods that can aid in alleviating health issues.

COMT & CYP19 Genes

3-dna-test-integrative-and-functional-medicine-32570Research has identified certain genes that work together and appear to show that some people retain fat regardless of, or in spite of, exercise.

In one study, researchers found two genes, COMT and CYP19 that appeared to be involved in patterns of fat loss and exercise. Having one CYP19 gene and variants of that gene did not affect fat, intra-abdominal fat, or total fat. However, having two of these genes seemed to be related to slightly more decrease in body mass index and significantly more decrease in total fat and percentage of body fat.

The researchers also found that having one genotype of the COMT gene and one copy of the CYP19 gene seemed related to significant loss of BMI, total fat, and percentage of body fat.

Why and how these genes and combinations work isn’t known yet. More research is needed to determine this. Other research suggests women with a specific CYP19 variant may also have increased levels of estradiol and estrone which may make it harder for them to lose fat through exercise.

Environmental Factors

Weight loss or gain is not solely at the mercy of your genetics however. A combination of genetics and environment is likely behind your success or failure regarding your weight loss attempts.

The thinking of professionals is divided on the subject of genetics versus environment/lifestyle choices. One set of these professionals regards environment to be the telling component. They point to the teaching over the years that food is a reward for good performance at anything. This, combined with constant reminders about food that are around us all the time, makes it hard for some people to lose weight and/or keep it off.

Others believe losing weight and keeping it off are more related to biological functions. They have found people to be metabolically different after losing up to ten percent of their body weight. Their brains also seem to respond to food differently. The emotional response to food is greater, but the brain regions that deal with food restraint are less active. This sets up the person to regain the weight lost.

Further research into why people lose weight and maintain that loss will be needed. Some of that research has to be on the genetic basis of weight loss.

Eating Behavior

4-diet-study-integrative-and-functional-medicine-32570Integrative and functional medicine practitioners view eating behavior as important for overall health. These behaviors include snacking behavior, feelings of satiety, craving for sweets, desire for food or certain foods, and the disinhibition of eating.

Nutrigenetics and nutrigenomics are two new fields of study related to how genes affect our diet and how our diet affects genes, respectively. Obesity, cancer, and heart disease are three of the health conditions most investigated in these two new fields.

One study involving these new fields showed the bitter taste gene receptor hTAS2R38 to be involved in tasting glucosinolates, found in some fruits and vegetables. Three genotypes in this gene receptor have been identified: PAV/PAV, PAV/AVI, and AVI/AVI.

Those individuals with PAV/PAV are said to be supertasters. They are very sensitive to bitter tastes in some foods and in some man-made compounds used in research. People with PAV/AVI are considered medium tasters. They can taste bitter in the research compounds, but not as much as the supertasters. Individuals with AVI/AVI are labeled non-tasters. They don’t taste bitter in the research compounds.

While it’s difficult to completely understand why these differences occur, it does appear they can make a difference in people’s diets. It could be that people who taste bitter greatly or somewhat will avoid certain vegetables that contain this bitter taste. Vegetables like kale and broccoli have this taste.

In this way, genetics have a significant influence on eating behavior.

5-kale-integrative-and-functional-medicine-32570Research indicates taste is only one of the ways genetics affects eating behavior. Caloric intake, meal size, and frequency of eating also appear to be affected. People’s desire for fats, carbohydrates, or proteins also may be influenced by genetics.

Research has found apolipoprotein A-II (APOA2) to be implicated in this kind of desire. Three variants in this gene, TT, TC, and CC, have been isolated as factors affecting the choice of fats, carbs, and proteins. One study showed both men and women who had the recessive CC chose more fat and protein and fewer carbs than either of the T alleles. The CC group ate about 200 more calories than the other group and tended to develop obesity more frequently.

It appears that APOA2 may affect not only food choices but also feelings of satiety.

Nontasters seem to prefer and seek out fats and flavors, so dieting may be more difficult for them to stick with and lose weight. Supertasters, on the other hand, enjoy a variety of foods, especially those that are spicy and robust. This may help them with diets.

Understanding the factors that appear to influence eating behaviors has gained importance with the tremendous increase in obesity in the U.S. and around the world, along with diabetes and cardiovascular disease. Eating behavior must be seen as a complex inter-relationship among psychological, cultural, physical, and genetic factors that influence the choice of foods, the amount of food intake, caloric intake, and timing of meals.

Regulating Eating Behavior

Clearly, taste affects food choices as seen in the discussion above. Another of the bitter receptors, TAS2R5, may also assist in regulating eating behavior. Alcohol dependence has been associated with an SNP in this receptor, along with another receptor, TAS2R16. These research findings seem to indicate variants in the TAS2R gene to be associated with ingestive behavior.

Genetic influence over meal amounts, how often people eat, and the timing of meals is a new area of study and may involve digestive neuroendocrine hormones such as CCK, leptin, and ghrelin. Studies are underway investigating the effects of these hormones on pathways that influence eating behavior.

A gene with a strong association with the risk of obesity, FTO, appears to contribute to obesity by downregulating leptin production in adipocytes. Adiposity and satiety appear to be associated with a fairly common variant, rs9939609. One study showed the A allele of rs9939609 to influence post-meal feelings of satiety and possibly to influence the excess caloric intake seen in men and women with high BMIs.

A gene involved in the detoxification of nutrients during digestion, AKR1B10, also appears to play a role in influencing human eating behavior.

Nutritional Needs & Genetic Testing

Another area in which integrative and functional medicine practitioners use genetic testing is in determining nutritional needs of their patients. As we have seen previously, genetic variants have an effect on taste and thus on nutrition. When people choose foods that “fit” their tastes but are short on nutrients, their health suffers. People also appear to have genetic responses to some supplements, such as some of the B vitamins and vitamin C.

The impact of nutrition is a lifetime factor, and practitioners of integrative and functional medicine evaluate nutritional needs closely. Any genetic variant that leads to abnormal nutritional requirements would likely be incompatible with survival. For example, miscarriage is more likely in a woman whose fetus has two alleles that negatively affect the use of any given nutrient than a woman whose fetus just has the common functional variants.

Several studies have isolated genes and alleles that affect nutrients and their utilization. For example, an SNP (Ala222Val) in the methylenetetrahydrofolate reductase (MTHFR) gene leads to a significant alteration in folate metabolism, increasing the risk of neural tube defects (NTDs) and cardiovascular disease, but lowering the risk of colon cancer. Increasing folate intake lowers the risks of developing serious health conditions.

Research has found other SNPs that alter homocysteine metabolism and folate uptake and transport. SNPs in enzymes that affect utilization and metabolism of vitamin B12 seem to be associated with NTDs and the possible development of Down syndrome and colon cancer.

SNPs in the vitamin D receptor may be associated with asthma in both children and adults. Lipid pathways, alcohol metabolism, and lactose metabolism appear to be affected by SNPs in other genes, also. A beneficial effect of these SNPs in the ancestors of certain ethnic groups or ancestral subpopulations may have been present, even though they tend to carry the risk of an adverse outcome today.

Environmental changes have been shown to bring a previously silent allele into a role as a disease allele. The aldolase B enzyme metabolizes fructose and was silent even with a high number of polymorphisms. In recent times, when fructose was added to foods as a sweetener, the polymorphisms began presenting as disease alleles.

Integrative and functional medicine professionals can use this information to guide their patients into more healthy lives.

Genetic Testing & Exercise

6-fitness-test-integrative-and-functional-medicine-32570Integrative and functional medicine also uses genetic testing to determine the best types of exercise for different people and to explore the likelihood of injuries of several kinds in athletes. This latter area of research and clinical practice can help reduce the number and severity of athletic injuries for adult and child athletes.

While there have been some gene variants associated with athletic ability, none have been shown to be predictive to any degree. Research in this area is promising for decreasing serious injury in young athletes. But to date, little scientific information regarding a genetic variation in young athletes is available.

Genetic testing as a way of choosing which athlete to select for a particular sport is increasing. However, little evidence has been found to show it is more accurate than traditional ways of selecting candidates. The ethics of this kind of testing for young athletes has been brought into question.

ACE Genes

Two genes and the SNPs associated with them have been examined in several population samples and thus have robust findings. The ACE I/D polymorphism was first found to be associated with human performance several years ago. This gene is part of the renin-angiotensin system that controls blood pressure through its effect on the regulation of body fluid levels.

The ACE I allele lowers ACE activity in serum and tissue. The D allele increases ACE activity in serum and tissue. The ACE I/I genotype has been shown over and over again to indicate performance endurance and greater efficiency in exercise. The ACE DD genotype has been shown to indicate strength and power performance levels.

This ACE I/D genotype does not appear to have predictive ability in Kenyan athletes, suggesting the confounding influence of ethnicity or geography.

ACTN3 Gene

7-endurance-athletes-integrative-and-functional-medicine-32570The ACTN3 is strongly associated with the protein alpha-actinin-3. This protein is involved exclusively in fast type II muscle fibers that are used in explosive activities. SNP R577X indicates a stop codon at position 577 rather than an arginine (R). An R allele puts athletes at an advantage in power sports. A study of the ACTN3 R577X variant in elite European athletes showed those in power event to be 50 percent less likely to have the XX variant and those involved in endurance events to be 1.88 times more likely to have the XX variant. For world-class endurance athletes, the odds of having the XX variant were 3.7 times larger when compared with lower-level athletes. It appears the ACTN3 gene is more important at the upper levels of sports.

While research shows the effects of the ACTN3 gene on athletic performance, especially in higher class athletes, the effects in the general population were negligible. It is unclear just what the association of this gene in the general population and choice of athletic activities in this population might be.

Resistance to injury and the ability to recover from injuries are also very important factors not only in professional sports but also for the general population. The emphasis on physical activity currently seen in the culture increases the risk of injury and the need for information regarding recovery.

Concussions and tendinopathies have been studied fairly extensively. Information on these two growing areas of injury among young athletes has been valuable for integrative and functional medicine specialists.

These two areas are important due to the long-lasting effects of both on young athletes. Research and clinical practice have shown the effects of concussion to linger into old age where they can increase the cognitive decline normally seen at that time of life.

APOE4 Gene

A better understanding of the genetic aspects of injury and recovery can help practitioners of integrative and functional medicine to both protect those young athletes at risk for injury and to better treat those who suffer injuries.

Regarding concussion, the gene most studied is APOE and its three alleles. The APOE e4 allele has been implicated in the development of Alzheimer’s Disease. This allele has been studied recently to determine its association, if any, with concussion risk and outcomes of traumatic brain injury. To date, the results are not clear.

Some findings have shown people with the e4 allele to have less favorable outcomes from traumatic brain injuries and boxers with this allele had higher chronic brain injury scores. These findings are consistent with e4 being a risk allele. However, one study of college athletes with the e4 allele did not find them to be more likely to suffer a concussion. Another study showed the e4 allele was not associated with poorer head trauma outcomes in children.

Another APOE variant, G-219T, has been linked with increased risk of concussion in athletes. Those athletes with the TT genotype compared to those with the GG genotype had a risk of concussion three times larger. A weak association was found in that same study between the tSer53Pro polymorphism in MAPT, the tau-protein encoding gene, and risk of concussion.

Collagen Genes, Integrative &Functional Medicine

Collagen is the primary component of tendons and ligaments, thus it is connected very closely with research into tendinopathies. It is no surprise that two variants in genes coding for collagen (COL1A1 and COL5A1) have been shown to suggest increased risk of injury to tendons. MMP3, a gene associated with connective tissue wound repair and the gene encoding TNC, an extracellular matrix protein, have also been implicated in increased risk of tendinopathies.

These are preliminary studies that need replication and further study to validate the findings.

Genetic Testing & Metabolic Health

8-cardiovascular-integrative-and-functional-medicine-32570Metabolic syndrome and metabolic health have been studied extensively due to metabolic syndrome being a major risk factor for the development of diabetes mellitus 1 and cardiovascular disease. Genetic and environmental factors interrelate in a complex fashion to bring about this condition. A cluster of metabolic abnormalities, including hypertension, dyslipidemia, abdominal obesity, insulin resistance, and impaired glucose tolerance make up metabolic syndrome.

All of the components of metabolic syndrome are highly heritable. Studies have shown links between metabolic syndrome and genes such as PPARg, adiponectin, CD36, and beta receptors.

There has been a considerable investigation into the heritability of metabolic syndrome. One study involved over 2,200 individuals in over 500 family groups. It was the first to identify major genes influencing metabolic syndrome.

Chromosome 3q27 was significantly linked to six factors involved in metabolic syndrome: weight, leptin, insulin, waist circumference, hip circumference, and insulin/glucose ratio. Chromosome 17p12 was strongly linked to plasma leptin levels.

Another study evaluated over 200 SNPs in 110 genes for their effects on coronary artery disease, highly implicated in metabolic syndrome. SNPs in eight of these genes showed association with metabolic syndrome: LDLR, GBE1, IL1R1, TGFB1, IL6, COL5A2, SELE and LIPC.

These genes are described below:

  • LDLR: Low Density Lipoprotein Receptor gene. It is strongly involved in the homeostasis of cholesterol. Hypercholesterolemia in families has been linked to mutations of this gene.
  • GBE1: Glycogen Branching Enzyme gene. It is involved in coding the glycogen branching enzyme which aids in glycogen synthesis. Branching of these chains allows a great number of glycosyl units to be stored in a molecule of glycogen.
  • IL1R1: Interleukin 1 Receptor, Type 1. Interleukin 1 is made up of two proteins, IL1-alpha and IL1-beta, and is a mediator of inflammation.
  • TGFB1: Transforming Growth Factor, Beta 1. This gene encodes the peptide involved in many functions in cells. Apoptosis may result due to dysregulation of the activation of this gene.
  • IL6: Interleukin 6 gene. It is a cytokine that regulates the immune response by activating a cell surface signaling assembly. Its production by neoplastic cells has been implicated in the growth of a number of cancers.
  • COL5A2: Collagen, Type V, Alpha 2. Mutations in the gene may bring on weakened connective tissue throughout the body.
    SELE: Selectin E gene. May be involved in the pathogenesis of atherosclerosis.

Some of the more common inherited metabolic conditions include:

  • Lysosomal storage disorders. These can result in the buildup of toxic substances inside lysosomes in the cells.
  • Glycogen storage conditions. Sugar storage problems can lead to weakness, low blood sugar, and muscle pain.
  • Mitochondrial disorders: Can lead to muscle damage.
  • Peroxisomal disorders: Can lead to a buildup of toxic products of metabolism.
  • Metal metabolism disorders: Special proteins control levels of trace metals in the blood. A malfunction in these proteins caused by genetic metabolism disorders can lead to toxic levels of metals in the body.

Symptoms of genetic metabolism disorders include:

  • Low energy levels
  • Decreased appetite
  • Abdominal pain
  • Weight loss
  • Jaundice
  • Seizures

From this list of symptoms, it’s easy to see the relationship of metabolic syndrome and adrenal fatigue. Practitioners of integrative and functional medicine will be faced with patients who present with adrenal fatigue and these similar symptoms. This makes it important for them to understand at least the basics behind Adrenal Fatigue Syndrome (AFS).

Adrenal Fatigue Syndrome

9-lethargy-integrative-and-functional-medicine-32570Feelings of fatigue and lethargy are presented more and more frequently in health care professionals’ offices. Combined with concentration difficulties, sleep problems, inability to lose weight, feeling your brain is in a fog, fatigue, and lethargy may point to AFS as the basic issue.

AFS is a constellation of many nonspecific symptoms that can become debilitating. The onset of the symptoms is slow and can be missed by traditionally trained professionals.

The symptoms of AFS result from the body’s normal response to stress from any source. The hypothalamic-pituitary-adrenal (HPA) axis is set into motion, releasing hormones and other chemicals that are designed to deal with stress. At the end of the axis are the adrenal glands that secrete cortisol, the stress fighting hormone. The purpose of this hormone is to limit the effects of stress on the body.

In normal circumstances, once the stress ceases, the cortisol levels decline and the adrenals get a chance to recover. However, in our stress-filled culture, the stresses continue. This puts the demand on the adrenals at an extreme level. At some point, the adrenals are no longer able to secrete cortisol, which results in damage to the body from the effects of stress.

Levels of inflammation and an increased immune response results. Inflammation has been implicated in many chronic illness conditions. It is at this point that the body begins breaking down from the accumulation of symptoms such as fatigue, brain fog, insulin resistance, and increasing inflammation.

NeuroEndoMetabolic (NEM) Response

The traditional medical viewpoint of addressing individual symptoms and/or organs when working to alleviate illness conditions is simply too mechanistic. A more comprehensive viewpoint is needed in order to effectively deal with symptoms of AFS. The NEM model is such a viewpoint.

The model says it is important to consider organ systems operating in an interrelationship in which whatever affects one organ system affects others as well. In this regard, it is in line with the integrative and functional medicine viewpoint.

The NEM model is a functional approach that looks at interactions between the individual’s environment and the gastrointestinal, endocrine, and metabolic organ systems, among others. This allows a healthcare practitioner to find the root causes, triggers, immediate causes, and genetic factors involved in a person’s illness condition.

This is a much more comprehensive approach to alleviating people’s symptoms and illness conditions.

10-endocrine-integrative-and-functional-medicine-32570Increasing and unrelenting stress is a part of our culture that is detrimental to the health of every individual. The metabolic component of the NEM model added to the neuroendocrine aspect helps professionals to see how localized organ-specific responses and systemic responses are necessary for successfully dealing with stress.

The metabolic component of our stress response is very subtle in the early stages. But the derangements of our metabolism worsen as time goes on and stress doesn’t stop. By the time the stress response reaches stage 3 or 4, these derangements can become debilitating. At the severe stage, they can lead to hypersensitivity to supplements and to paradoxical reactions.

Very significant and debilitating symptoms begin arising. Often, these lead the person to be bed-ridden due to their severity.

AFS & Genetics

A question integrative and functional medicine experts and those who suffer from AFS all want to know is: Can you inherit AFS?

Before answering that question, you need to understand even if you have a gene or several genes that are involved in a health condition like AFS, it doesn’t mean you will automatically get that condition. Before genes can do anything, either positive or negative, to your health, they have to get the signal to “switch on.”

One good thing about that signal is you have quite a bit of control over it. Scientists and researchers have discovered environment, choices you can make, exert significant control over whether genes are turned on or off. This is called gene expression.

Can you choose to switch specific genes on or off? That’s beyond us at this point. What you can do is make good lifestyle choices, good exercise choices, good diet choices and either activate or de-activate genes in this way. Genetic testing as seen in integrative and functional medicine practices is a way to determine your choices in many areas. Which diet works best for you and what exercises will best benefit you can be answered through this kind of testing.

Answering the specific question posed above, ‘Can you inherit AFS?’, is a complicated process.

Two genes with significant involvement in this answer are MTHFR and COMT. Both are involved with methylfolate. People with mutations in MTHFR don’t have enough methylfolate leading to less adrenaline because of interference in the methylation process. Methylation aids in the production of adrenaline and other hormones.

The other gene, COMT, is involved in the production of hormones and chemicals in the body. Low levels of methylfolate with this gene leads to lower levels of epinephrine and higher levels of norepinephrine.

The lack of methylfolate with both of these genes, especially MTHFR, leads to feelings of fatigue.

When your body is stricken by stress, both your adrenals and MTHFR are affected. This leads to the fatigue felt by those of you who suffer from AFS. The enzyme that produces dopamine and serotonin is also dependent on methylation to work right. Low levels of methylfolate can lead to low levels of both of these neurochemicals which can then lead to low energy and fatigue.

What Can You Do To Improve Energy Levels?

There are some things you can do to aid in increasing energy and improving the work of the two genes mentioned, MTHFR and COMT.

Balance your blood sugar levels by eating three or four small meals per day. These meals should include good grains like quinoa or rice, good carbs, and vegetables. You can add protein from fish or free-range chicken.

Supplements can help support your adrenal glands and the methylation process also. Vitamin B1, B2, and B6 will help. There are usually no side effects from vitamin B1, but if you should begin feeling any itching, notice any rashes, or have trouble breathing, contact your healthcare professional immediately.

Side effects from B2 are also rare. Very yellow urine will be seen, but this is not serious. If you do have any rashes, breathing trouble, or itching, contact your physician at once.

Taken in large doses for a long time, B6 can cause side effects. Headache, nausea, and drowsiness are enough to contact your healthcare professional at once.

Some people try taking methylfolate (5-MTHF), but this is a labor-intensive effort and could bring on some serious side effects if your body is not ready for it. If your body gets overwhelmed by the 5-MTHF, you can feel headaches, irritability, anxiety, and heart palpitations. Get medical help right away for these side effects.

Despite advance testing, it is important to remember that tests are simply data points of alert. A clinical decision should be made after a detailed consideration of the history and state of the body. A shotgun approach to treating abnormal laboratory values is a common clinical mistake and can lead to negative clinical outcomes.

Conclusion

11-genome-mapping-integrative-and-functional-medicine-32570The mapping of the human genome has provided an opportunity for researchers and clinicians alike to consider the roles genes play in health and wellness. Discovering the presence and effects of single nucleotide polymorphisms (SNPs) has increased not only our knowledge of how genes affect health, but also has given us tools to use in preventing and remediating many chronic illness conditions.

Integrative and functional medicine practitioners have been among the professionals to use this information in a practical sense. Whether AFS can be inherited is yet to be seen. Clinically, we do see a strong correlation from one generation to the next.

Genetic testing to examine the working of MTHFR and COMT may be of some help. Diet and supplements can also increase your chances of these two genes working correctly and alleviating some of the symptoms of AFS.

Because genetic testing is still in the very early phase of development, it is important to take all data points with the right perspective and refrain from treating abnormal laboratory numbers while the root cause of the problem can be masked.

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    Hello-Bienvenido's,
    My name is Dr. Alex Jimenez, I am Chiropractic Doctor specializing in advanced therapies focused on total joint health, strength training and complete fitness conditioning. We use patient Focused Diet Plans, Advanced Chiropractic Techniques, Agility Training, Cross-Fit and the PUSH System to treat patients suffering from various injuries and health problems. Our goal too is to help your body heal itself naturally. When your body is truly healthy, you will arrive at your fitness level and proper weight efforlessly. We want to help educate you on how to live a new and improved lifestyle. Our doctors have spent over 25+ years researching and testing methods with thousands of patients. We strive to create fitness and better the body through researched methods and total programs...

    My goal too is to help the body heal itself naturally. When your body is truly healthy and balanced, you will move pain free and ultimatly arrive at your optimal fitness levels and proper weight effortlessly. We want to help educate you on how to live a new and improved lifestyle. Our doctors have spent over 25 years researching and testing methods with thousands of patients. We strive to create fitness and better the body through researched methods and total programs. These programs are natural, and use the body's own ability to achieve goals of improvement, rather than introducing harmful chemicals, controversial hormone replacement, surgery, or addictive drugs. We want you to live a life that is fulfilled with more energy, positive attitude, better sleep, less pain, proper body weight and educated on how to maintain this way of life.

    The focus on spinal and skeletal adjustments is what makes doctors of chiropractic unique in their approach to treating patients with spinal complaints. This hallmark chiropractic adjustment, however, is not the only procedure a chiropractor may employ in managing a patient's care. I am very proud to bring my patients a variety of treatment options beyond the typical scope of care. With the advances in physical therapies and modalities we bring El Paso option that better aid in the rehabilitation process. Tissue healing is a wonderful process that begins the moment an injury occurs. How the injury is managed determine the final outcome in terms of healing. It is critical we implement immediate procedures as soon as we can in order to gain optimal recovery. The old day of let it rest until it gets better is not the only option.

    Letting it rest may even be an irresponsible approach considering what we now know. The implementation of active and movement based treatments have clearly shown increased and improved outcomes in many instances.

    As a doctors focused on the greater good for a patient, we must assess each patient individually and apply the appropriate protocols. It is also very important to denote, that El Paso has fine doctors in many specialties of healing and repair. The direct relationship we have with specialist of these disciplines is clearly what allows us to bring the highest quality of care to our patients.

    My promise to my patients is clear for all to read here. I, with Gods help, will do what ever it takes to assist you in your recovery. I too will draw upon all the specialist in this town to find you the collaborative care that is required with the disorders being tended to.

    With Great Regards to you.
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    Education:
    • Doctor
    Affiliations and Certifications:
    • Texas Chiropractic Association
    Services Provided:
    • Chiropractic Care
    • Physical Therapy
    • Rehabiliation
    • Strength Training
    • Crossfit Doctor
    • Return to Competition Rehabilitation
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  • Truide Torres
    Executive Director / Patient Liason
    Phone:   9152526149
    Email:     truidetorres@gmail.com

    Director: Patient Relations Advocate Dept.
    Truide has been working for the past 20 years in claims resolutions. She works hand in hand with patients and is availible to resolve dispute resolutions.

    Truide Torres (Bio)
    Driven by the passion of doing what is in the best interest of the patient, I wake up every morning with the drive to help those in need. The claims process for health care is full of pits, valleys and difficult obstacles designed to strike fear in those in need. My duty is to do what is within the confines of the law, "what ever it takes" to get those involved to pay attention to those who need help. That is what I am honored to do for our patients.

    Personally, I have seen great injustices transpire on those that do NOT have a voice. Whether, a language barrier or just not knowing the rules. My job is to find out how I can help. If I personally can not help, I will find the right sources to open the possibilities. I get the job done.

    As a wife and mother of 2 children, 3 dogs and 2 Cats. My passion is for God, Family and the mission of serving my fellow man.

    Let it be clearly stated... I am here to help. My phone 915-850-0900
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    Education:
    • Law Student (Matriculated)
    Affiliations and Certifications:
    • Legal Studies
    Services Provided:
    • Patient Advocate
    • Claims Managment
    • Case Management
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  • Daniel Alvarado
    Exercise Physiologist
    Phone:   9152038122
    Email:     daniel@push4fitness.com

    Daniel Alvarado is the owner and the top trainer at PUSHasRx® CrossFit Fitness Facility. Since becoming a Trainer Daniel has kept up to date on many continuing educational classes, ensuring that his clients receive the most comprehensive and advanced training. Working directly with the Doctors, he develops and collaborates on care plans that are patient specific. No patient ever gets the same clinical protocol. His expert clinical kinesiology experience spans over 2 decades. He has trained injured patients and NCAA National Champion Athletes. His technical ability to create programs that are clinically sound and second to none. He too has used his physical therapy and recovery experience to take broken top tier athletes into strict recovery protocols assisting them to achieve highly competitive national championships. He certainly will not admit it but, he is a top national champion trainer. Daniel, also develops youth programs that are sport specific to aid young athletes achieve great success. His mastery of clinical recovery is applied applied to all patients and top tier athletes alike. All patient programs are specifically designed with patient focused recovery priorities. He is happily married to beautiful Victoria Alvarado has one child. He enjoys strength training, movies, singing, conducting, writing poetry and being a CrossFit champion. Just a way cool dude. We think you will agree.
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    Education:
    • Exercise Physiology
    Affiliations and Certifications:
    • Crossfit Level I,II,III ; Pilates Instructor
    Services Provided:
    • Fitness Training
    • Strength & Power Fitness
    • Mental Strength
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  • Dennise Acosta
    Head Office Manager
    Phone:   915-850-0900
    Email:     dennis@elpasobackclinic.com

    Dennise has been at Injury Medical & Chiropractic Clinic for four years. Known as the master multi-tasker. Dennise, handles patient care from the moment you walk in the door. She is akin to the air traffic controller. She will assist you in matter requiring clinical preparation and effective inter-office communication. She unifies all department and clinical providers making sure all important information reaches all clinicians in a timely manner. She also loves to work out, stay in shape, watch movies and help people.
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  • Sandra Martinez
    Head Clinical Therapist
    Phone:   915-850-0900
    Email:     sandra@elpasobackclinic.com

    Sandra has been working at Injury Medical & Chiropractic Clinic for over 5 years. As the head Licensed Massage Therapist, she manages and directs critical aspect of clinical care. The patients love her ability to make you laugh while removing those pesky trigger points causing pain. She is able to relax and bring comfort to all she touches. There just simply is no patient that escapes her talented touch. Trained in advance myofascial techniques, she is an integral part of patient recovery. You will never see anything but a kind smile and resolute persona ready to correct your condition and aid in your recovery. She definitely enjoys helping people, has 1 dog and loves movies. She loves flowers too.
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    Education:
    • LMT: Licensed Massage Therapist
    Affiliations and Certifications:
    • LMT, MMT, ART
    Services Provided:
    • Massage Therapy
    • Muscle Release Techniques
    • Neuromuscular Re-education
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  • Alejandra
    Billing Agent
    Phone:   915-850-0900
    Email:     billing@elpasobackclinic.com

    Alejandra works in accounts & billing. She is the radar of the bunch. Nothing appears to escape her mind. Highly intelligent and appears not to need a computer for recall of facts. She provides information retrieval for patients and clinical staff. She has been at Injury Medical & Chiropractic Clinic for three years and ready for any task at hand. She performs interoffice communications with attorneys and medical director of ancillary offices. She loves her family and places know how to prioritize well.
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    Education:
    • Nursing Student (Matriculated)
    Services Provided:
    • Billing
    • Medical Records
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  • Mike Contreras
    Personal Trainer
    Phone:   915-203-8122

    Big Mike was born and raised in El Paso and is an excellent personal trainer and CrossFit coach. Mike works hand in hand with each patient’s clinical care plan in order to achieve optimal outcomes. A trusted clinical representative of the PUSHasRx System along with his advance protocols. Mike not only trains the injured and recovering. Mike is a sincere human that has great talent of brining out the best in every individual he works with. He will never admit it, but we will share with you a secret. He with his God given talents trains the greatest athletes and champions in El Paso. Many champions in our community know of his commitment. As a youth, he also played football (wide receiver), basketball, and track at Bel Air High School. Educated in Clinical Human Kinesiology at UTEP and loves playing football and basketball with his little nephews in his free time. Mike has three sisters and one brother, most of which live nearby in El Paso. When he’s not watching the Cowboys or Spurs play, he’s usually lifting, sleeping or watching movies. We are blessed to have this soul on our team.
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    Education:
    • Exercise Physiologist
    Affiliations and Certifications:
    • Crossfit Level 3
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  • Alexander Isaiah Jimenez
    Collegiate Athletic Consultant & NCAA Wrestling Champion
    Phone:   915-820-9443
    Email:     alexanderijimenez@outlook.com

    Alexander Isaiah Jimenez leads the power and agility education programs for the high school athletes. While still studying for his medical degree he provides physical performance testing in order to collaborate with clinicians. He is gifted in creating physical performance programs no matter what the clinical presentation is. As national fitness champion and collegiate wrestler, he too understands what performing at high levels entails. He too has had to recover from debilitating injuries only to return better then before an win national titles. He understand how the recovery process is different for clients, patients and extreme athletes. We are blessed to have his counsel.
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    Education:
    • Bio-Medical Science (Pre-Medical) - Matriculated
    Services Provided:
    • Strength Coach
    • Agility Coach
    • Mentor
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  • Ethan Padilla
    Personal Trainer & Strength Coach
    Phone:   915-203-8122

    Ethan was born and raised in El Paso and is one of our most outgoing and friendly coaches. Ethan earned his nickname “rampage Ethan” from his years at El Dorado High School, where he played inside linebacker. He has placed twice in the Strongman Competition and also recently competed in the Desert Games with his fellow PUSH Athletes as a team and placed 4th overall! Ethan is currently pursuing his Bachelor’s Degree in Kinesiology at UTEP. His focus on clients is obvious to all. Ethan is able to manage very large groups of individuals like no other. His awareness of the dangers while exercising is his greatest concern. When he’s not coaching or studying for class, he likes to spend time with his family (who are here in El Paso) or with his weimaraner puppy. Fun fact: Ethan loves any food with sprinkles (especially donuts with sprinkles) and is a diehard Seattle Seahawks fan.
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    Education:
    • Physical Therapy Student (Matriculated)
    Services Provided:
    • Strength Coach
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  • Andres
    Recovery & Nutrition

    Andres has been at PUSHasRx for two years. He brought his company Recovery and became the official juicer. Andy will fix you right up. Andres, will make sure that your nutritional recovery programs fits within your standards. Also, there is great care in making sure the nutritional requirement are clinically met. Patients and high performance athletes depend on high performance nutritions. Upon your completion of the physical medicine portion of therapy you will be offered specialized organic recovery drinks and supplementation to help aid in your recovery. You will be confident that from your pushing to recovery, you will be taken care of.
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    Education:
    • Recovery Inc.
    Services Provided:
    • Nutrition
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  • Iylene Avalos
    PUSHasRx Trainer
    Phone:   915-203-8122

    ylene has been working with us for over 4 years. In her spare time she enjoys working out and running. She has 2 dogs and loves movies. Iylene is extremely aware of body mechanics and mindfully watches rehabilitation movements. She is always standing ready to assist and respond to client needs. Her commanding voice is always clear to all, no matter what floor you are on. Iylene is always ready and willing to answer any question you may have regarding fitness and recovery.
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    Education:
    • Personal Trainer
    Services Provided:
    • Personal Trainer Level I,II,III,IV
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  • Rick Cano
    Personal Trainier Level V
    Phone:   915-203-8122

    Most early-rising PUSHasRx members know Rick well as a fantastic coach who focuses strongly on form and will always make you laugh. He was born and raised in El Paso and loves to train his athletes and coach CrossFit. Rick is a very diligent, kind and considerate trainer. He is always mindful of client techniques and aware of client goals. When he’s not coaching, Rick loves to work on cars, especially his ’69 Chevelle (his next car will hopefully be a ’69 Charger). He not only became a certified Automotive Mechanic at 17, but while working on his certification at EPCC, he won 1st place in a bench competition when he was 16 (approx. 56 reps at 155#). His favorite movements are clean & jerks and snatches. He loves oreos (eats them every night), loves watching the CrossFit games, and loves his three bulldogs. He spent one year full-time personal training before he started coaching CrossFit two years ago. He is CrossFit Level 1 Certified and hopes to get his Level 2 Certification soon. Rick has competed in several competitions, including WOD for Toys in 2014, where his team placed 1st.
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    Education:
    • Physical Fitness Trainer
    Affiliations and Certifications:
    • Crossfit Lever I,II,III
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  • Astrid Ornelas
    Blogger/Research/Curator
    Phone:   915-850-0900

    Astrid has been at Injury Medical & Chiropractic Clinic for about three years. Astrid has taken her love for writing to an new level. She is a gifted and talented copywriter able to create amazing storylines. She creates content for patient consumption. She is able to bring words to life in a way that perplexes even the elite authors of the day. She loves nutrition and the healing power of clean eating. A naturalist at heart you will never see her eating processed foods that would be contra to clean living. She enjoys movies and creating storylines for Anime.
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    Education:
    • Literature Graduate
    Services Provided:
    • Insight Analyst
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  • Adam
    Videographer & Graphics Specialist
    Phone:   915-850-0900

    Adam has been at Injury Medical & Chiropractic Clinic for about a year. He enjoys designing and various forms of art. A story teller by trade he can see things people don’t see until his masterpieces are revealed. Adam is a director of many medias using the top graphics, audio and video medias to tell the story of our patient. Modest to the core, you would never know what he is about to create. We are blessed to have his talents telling the world about Chiropractic using any and all medias available.
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    Education:
    • Graphics Artist
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Treatment Methods
Dr. Jimenez uses the following methods to treat patients.
  • Our Passions
    Email:     doctorback@gmail.com

    We Welcome You 👊🏻.
    Purpose & Passions: I am a Doctor of Chiropractic specializing in progressive cutting-edge therapies and functional rehabilitation procedures focused on clinical physiology, total health, functional strength training and complete conditioning. We focus on restoring normal body functions after neck, back, spinal and soft tissue injuries.

    We use Specialized Chiropractic Techniques, Balanced Diet Plans, Agility Training programs, Cross-Fit techniques, the PUSH-Rx Rehabilitation System and a highly specialized program for our Veterans.

    We've been blessed to use our methods with thousand of El Pasoans over the last 27 years. This has allowed us to improve health and restore true fitness through researched non-surgical methods and wellness programs. These programs are natural and use the body's own ability to achieve goals of improvement, rather than introducing harmful chemicals, controversial hormone replacement, surgery, or addictive drugs. We want you to live a life that is fulfilled with more energy, positive attitude, better sleep, less pain, proper body weight and informed on how to maintain this way of life.

    As an extension to dynamic rehabilitation, we too offer our patients, disabled veterans, athletes, young and elder a diverse portfolio of strength equipment, high performance exercises and advanced agility options. We are very proud to have teamed up with the cities premier therapist and trainers in order to provide high level competitive athletes the option to push themselves to their highest abilities within our facility.

    Come learn how to improve your health for yourself and your loved ones.

    With a bit of work, we can achieve optimal health together, no matter the age or disability.

    Its all about: LIVING, LOVING & MATTERING! 🍎

    God Bless

    2 CONVENIENT LOCATIONS:

    (LOCATION#1) CENTRAL ELPASO:
    6440 Gateway East, Suite B

    (LOCATION#2) EAST SIDE ELPASO:
    11860 Vista Del Sol, Suite 128

    PHONE: 915-850-0900 ✔️
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