Last December we started publishing our State of Functional Medicine series which featured interviews with over 30 active practitioners and established thought leaders to learn more about why they chose the field of functional medicine, what excites them most about their work, the most common misconceptions they hear from patients, and most importantly — how they see the field evolving in the years ahead as healthcare shifts to be more personalized, proactive, and preventative.
You probably don’t have time to read every interview so we’ve gone through and pulled together some of our favorite answers to the various interview questions we asked practitioners. Here’s what we learned!
What has your experience been with genetic testing?
1. Dr. Adrienne Carmack, Medical Director at Integrative Health Matters
Genetic testing is something I use routinely. I’ve used the free genomics reports out there, as well as paid ones. Of the free ones, I’ve found Pure Encapsulations Pure Genomics the easiest to use, and there are many actionable items on the report. I first run the genome through 23andMe, both to get the raw data for Pure Genomics and to see the patient’s APOE4 and celiac risk gene status (on 23andMe’s Health Report). I’ve also used paid tests such as Genomind, which have allowed actionable insight but have proven cost-prohibitive in a cash practice and are somewhat limited in their scope compared to 23andMe. Given that we don’t prescribe many pharmaceuticals in our practice, Pure Genomics run off of 23andMe data has been the most reliable, though we are constantly evaluating other products and eager to offer even more. Overall, my primary goal with genetics is to help patients know what practices they will likely need to continue to stay well beyond those we implement to resolve current health challenges.
2. Dr. Rosa N Schnyer, Doctor of Acupuncture and Chinese Medicine, IFMCP, L.Ac.
I have some limited experience. Interesting, provides some guidance, but the science for individualized medicine based on genetics is not quite there (if you talk to the seriously genetically involved researchers and scientists). Genetics is a complex system. We know very little on how genes interact with each other and with the environment, and too many Fx Med providers offer quick solutions based on genetics. We are not quite there yet.
3. Fera K Butts, RN, BSN, MA, NE-BC, IFMCP, Functional Medicine Practitioner, BESANA
I have had a number of patients that are interested in learning more about their genetics. The most common genetic markers encountered so far have been MTHFR, HFE, and ApoE. The more patients become educated about their overall health, the more they are interested in learning all they can about their genetics.
4. Todd DiLeo, D.C, B.Sc., B.S., CSCS, CGP, CHHT, US Triathlon Coach, Intrinsic Wellness Clinic
Excellent! We use genetic testing as much as possible and I wish there was more. Functional medicine is personalized care and what better way to really personalize a program than genetic testing? Knowing the exact genetic make-up of a patient provides practitioners with an incredible insight on what that specific patient needs, how their cells process nutrients etc. This is where I expect to see more and more advancements.
5. Kike Oduba MBBS, MPH, Functional Health Practitioner, WellnessWits
I have found genetic testing to be quite illuminating, from seeing how much of our genetics can be turned on or off based on the environment we live in. It has helped me understand the way the human body can adapt itself or express disease when subject to different conditions. For many of my patients, it helps a lot to know the root causes of their health issues at the cellular level, coupled with the ability to prevent future ailments through proactive measures that can be taken if done early.
6. Anshul Gupta, Functional Medicine MD, Founder of AnshulGuptaMD
Genetic testing is a great tool in functional medicine testing, and has helped several of my patients in managing their diseases. There are so many different SNP’s that can help us to identify the underlying problem of my patients. The most common genetic tool I use to evaluate people is methylation problem. But there are several other ones that help me guide the proper treatment of my patients.
7. Heidi Iratcabal ND,IFMCP, founding partner Carpathia Collaborative, director of Science of Thriving
I think genetic testing has brought tremendous insight to health care and particularly functional medicine. Because each individual is unique the genetic testing helps provide insight to predispositions that could be manifesting or contributing to the cause of their ill health. The genetic testing for pharmaceutical compatibility is so important I feel everyone needs this on record before drugs are administered. This could reduce the 70,000 plus deaths a year from proper pharmaceutical prescriptions use. I believe we have scratched the surface of genetic testing potential.
8. Brandy Zachary DC, IFMCP, Body Love Cafe
It’s valuable and essential to personalized/individualized healthcare which is what functional medicine is all about. We still have much to learn, but there are so many SNPs that we know of now that provide helpful clinical information. I’ve used genetic testing to provide insight into methylation issues, broken detox pathways, increased cardiovascular risk and tendency to anxiety. The testing has allowed me to really customize protocols and fine tune my supplementation recommendations. I love it!
9. Lara Zakaria PharmD MS CNS CDN IFMC, Functional Pharmacist and Clinical Nutritionist, Dr KF Education Programs Programs coordinator
I love the prospects of genetic testing for personalized medicine – but I find most people get their results and assume their destiny is set in stone! The reality is, as Dr Bland reminds us, “our genes are not our destiny!” – It’s a powerful opportunity to use genetic information to inform lifestyle and nutrition interventions to help people thrive!
10. Martina Harms, PA-C, Functional Medicine Health Consultant
I’ve found genetic testing to be very useful in helping clients understand the underlying causes and particular variations that might be affecting their health. Unfortunately many have had testing without any practitioner guidance, and feel overwhelmed and don’t understand the complexity of epigenetics. I think genetic testing has incredible power and utility when properly interpreted and utilized. Your genes are not your destiny! You still have control over much of the outcome.
11. Zac Watkins, Functional Medicine Doctor, Founder of The Livewell Clinic and Platform Health LLC
Genetic testing gives me a way to show patients what chronic conditions they are more susceptible to. This is powerful as it helps patients know themselves in a way in which to be truly proactive in their life.
Genetic profiles also help guide my recommendations for those who need more support in certain physiological areas, like detox or hormone modulation.
12. Jennifer Kessmann MD, Functional Physician, Kessmann Clinics
I have used MTHFR, COMT, CBS and apo E quite a bit in practice. It is nice to see patterns that create issues and be able to correct them with the correct supplements and changes.
13. Sandra Scheinbaum, Ph.D, Founder and CEO, Functional Medicine Coaching Academy
Genetic testing is now widely available and affordable. It’s the foundation for a personalized approach as opposed to “one size fits all.” I’ve learned a lot about my own genetic profile and that’s led to making better, more informed diet and lifestyle choices.
14. Cambria DeMarco, ACNP-BC, IFM Practitioner/ Walsh & Bredesen Protocol Certified Practitioner, Functional Medicine Specialists
We are just scratching the surface with genetic testing. I am thankful for the work that has been done and the knowledge we are gaining. Many genes are important, but it is just as important to assess the biochemistry that is behind the genes. Is the gene expressing itself? We need to also assess the downstream biochemical effects of the gene in question because there may be other genes in play that we don’t even understand yet. Expression equals genes plus environment; and most genes do not express in isolation.
15. David M. Brady, Chief Medical Officer, Designs for Health, Inc. & Diagnostic Solutions Lab, LLC
My experience is that it has massive potential to help guide “personalized” interventions and lifestyle changes. However, I also see it misapplied and some practitioners becoming myopically obsessed and building entire practice paradigm’s and clinical approaches based on only several SNP’s. Clinicians need to realize that genomics are very valuable, but only when clinically contextualized and put into the proper perspective that genomic SNP analysis only reveals predilections and likelihoods of what may happen metabolically, not what “IS” actually happening. The epigenetics are the wild cards too seldom taken into account.
16. Christopher LeMay, D.O., CAQSM, IFMCP, Founder of Anywhere Total Health
I think my experience probably mirrors that of many of my colleagues. Genomics is an enormously expanding field that can help strategize lifestyle decision making. It gives some insight as to potential health risks and helps us partner to lower those risks. The key part of the discussion is that your genetics don’t dictate your diseases. Being at risk means that we need to piece together a customized plan that aims to lower those risks.
17. Ashlee Seek, Co-Founder and CEO of FGHC, LLC, Co-Executive Director of Faithfully Guided Foundation
I think we are just scratching the surface on genetic testing. While I do some basic testing, I focus more on lifestyle intervention so genes aren’t activated. My favorite quote is “genetics load the gun, lifestyle pulls the trigger.”
18. Betty Murray, CEO and Founder of Living Well Dallas Functional Medicine Center
Genetic testing is something we use routinely at Living Well Dallas. We currently use medical professional genetics testing and reporting. I have tried several free genomics reports as well as paid ones. Often, the free reports give conflicting and, in some cases, inaccurate reporting on some genes. Therefore, we recommend our patients conduct a practitioner focused genetic test or let us use the raw data from 23andme or Ancestry in our software to create a report that is actionable. On occasion, we will run specific genetics labs for specialized treatments. For instance, our psychiatrist uses Genomind frequently to assist with medication and nutritional supplementation choices because of its reporting of drug-gene interaction. We consider genomics part of the process in creating a personalized plan.
19. Jennifer Franklin, MD, FAAP, IFMCP, at CentreSpringMD
I use genetic testing in my patients in two main areas. The first is to detect any SNPs (single nucleotide polymorphisms) that may determine the nutritional and lifestyle recommendations best suited to help them thrive and bring healing. Understanding that genetics loads the gun, but the environment pulls the trigger helps patients take control over their own health destiny and know that they can be proactive to make changes that align with their genetic make-up. Secondly, I use pharmacogenetic testing to evaluate how an individual may metabolize a specific drug. This knowledge is invaluable for my patients that do require pharmaceuticals in their disease management in order to best select the medication that is right for them.
20. Marsha Nunley, MD, Heal Medical
Beneficial in general but I don’t see it as ready for prime time for all. Have had luck in looking for specific SNPs in various areas (autoimmune, autophagy, diet, cognitive risk) and managing those with supplements and lifestyle.
21. Elizabeth Board, MD, founder of Atlanta Functional Medicine.
It is improving and becoming more and more precise. Genetic testing provides valuable considerations in the development of a patient’s treatment plan but must be accompanied by the patient’s lifestyle, nutrition, environmental exposures and informative labs in order to reap its combined full potential. Because the research that supports the snp is growing, individual snps will become more powerful and relevant with time. Cost has been an issue, but understanding that genetic tests are a one time test with benefits that grow as research expands does help patients understand the value.
22. Elena Klimenko, MD, Integrative Medicine Specialist
My experience with genetic testing has been mostly a good one. I am witnessing this field evolve from interpreting a single SNP as an answer to all evil (ex. MTHFR) to a more sophisticated system of understanding genetic pathways.
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