072: Understanding How Genetics Impact Health w/ Dr. Mary Louder

November 16, 2018 Dr. Anna Cabeca

I love bringing to you experts from all aspects, and today we have Dr. Mary Louder, a genetic medicine expert who specializes in understanding the genome and how we use that in medicine.

I first came across Dr. Mary Louder through a featured article on her and her practice, and I’m very excited to share with you her expertise on how genetics impact health — from breast cancer to lupus, Alzheimer’s and hyperthyroidism.

Transcript

In today’s couch talk, we’re going to look at how your genes can affect your health and well being. What do you really need to understand genetics? How can you enhance your overall life, health, longevity and life quality through your genes?

Coming to us from Colorado to shed light on these questions and more is Dr. Mary Louder. Born and raised in Grand Rapids, Michigan, Dr. Louder graduated from the University of Montana in athletic training and education and completed her Masters at the Michigan State University in sports medicine and spinal biomechanics.

She then became an osteopathic physician at MSU. Following that, she completed her post-doctoral training in family medicine and she is certified in family medicine and integrated holistic medicine.

She's practiced medicine for about 25 years and served as medical director for several facilities. Currently, she is an assisting clinical professor at MSU College of Osteopathic Medicine while running a private practice in Lafayette, Colorado.

It’s great to have you here, Dr. Louder. And it's certainly nice to have a fellow osteopathic physician on couch talk with us! Can you share with us a little more about your journey from an osteopathic physician into a holistic expert on this new genre of medicine involving the genome?

How Genetics Revealed the Missing Link in Healthcare

Yes, of course. Well, as an osteopathist, we always look at the structure of our body and how they function. This led me to look at things more holistically. I began expanding more into the integrative world by looking at mind, body, medicine, and supplements.

I quickly realized I had incomplete information. Although we would try supplements like chromium and Vitamin E, we wouldn’t see lasting results. What are we missing?

We began digging more into the pathways of functional medicine. That was great, but while it worked on some folks, others would get worse. I still didn’t have the complete picture.

Then, around 2002-2003, genomic information became available to us through various labs. It was very small sections of the genes that gave me insight into how medications like aspirin and Tylenol, as well as stimulants like caffeine, affect Phase 1 or Phase 2 of liver detoxification.

Then I also noticed an estrogen imbalance or estrogen-related illness. I felt there should be a connection somehow because Phase 1 of liver detoxification and estrogen go together. But I couldn’t find evidence of the connection.

I became frustrated with this incomplete picture and decided to put it aside and stop thinking about it. Thankfully, science marched on, and about 10-15 years later, a resurgence of genomics revealed new information on 200-400 more genes. Science had now identified variations in these genes called single nucleotide polymorphisms (SNPs) or snips.

Finally, I had the missing link. By applying this new understanding in genomes, I could see how things like differences in hormone metabolism would affect the liver.

Getting a Clearer Diagnosis According to Your Genetic Blueprint

How do these new understandings help you with specifically helping an individual optimize their health?

Well, when I combined the genome with the bigger picture of the body’s eight different systems, I realized we were literally looking at the blueprint of that individual.

My aha moment came when I was pouring over 150 pages of a patient’s medical data who had cancer. I realized I could apply the results of my patient’s biomarker tests right over their genome — right over her blueprint.

From that, I could see that not only does the patient need a particular type of Vitamin D, but she needed to receive it in liquid form or shots. Oral Vitamin D would not work for her. I also saw she didn’t have “brakes” on her stress response, so her stress levels would go way off trajectory.

One of the “brakes” governing stress is glutathione. Yet her glutathione level was normal. However, I also found that the gene responsible for producing the enzyme glutathione reductase, which recycles glutathione, was literally turned off in her DNA.

So although her glutathione levels were normal, it could not be reused. This showed me that adding more glutathione to her system won’t help. In other words, stress-reducing medications alone won’t help her.

From this insight, I could see that the pressure point for her illness was actually stress. I also saw, through looking at her blueprint and genomics, the difference between cancer she had as a young woman and cancer that she now has twenty years later.

Cancer she has now was based upon a gene variation resulting from stress upon her estrogen metabolism, which we know is triggered after menopause.

Now, we have a complete picture. And we can help her in a holistic way. Not just with medical treatment. We began asking ourselves: How can we bring in some psychological support? What areas does she need to change? What does her job look like? Where does she want her career to go? How are her relationships involving?

This holistic approach really had a bigger impact on her path to healing.

This experience made me aware that we can’t just guess our way through diagnosis. It’s best to be fully armed with as much science, and that includes understanding the information our genes hold to balance the structure and the function of that individual.

It’s beautiful to see how you’ve drawn out from this case with the client, that stress triggered by menopause, was the key stimulating event underlying her cancer. Can you go a little bit more into the chemistry behind this?

How Stress Can Turn “On” or “Off” the BRCA Gene

Well, we know that mutations on the BRCA gene can increase a woman’s risk of getting cancer. This patient had both the mutation in the BRCA gene and the snip that would “flip on” the BRCA gene.

For her, what triggers the snip to “flip on” the BRCA gene was stress. Stress ignites cortisol, which shifts other hormones, which leads to “flipping on” the BRCA gene. Given her body’s superstar stress response, this patient was then very, very susceptible to getting cancer.

And indeed, the first time she got cancer she was very young — only 32 years old. By knowing the “flipper” for her BRCA gene was stress, we knew that we had to treat her with surgery — not stressful chemotherapy or radiation. So, her genetic blueprint helped us get to a more accurate diagnosis, trigger, understanding, background and treatment options.

What Does a BRCA Positive or BRCA Negative Result Really Mean?

A lot of people then wonder, should I be tested for the BRCA gene? To see if they are at risk for hereditary breast cancers. But now, we also must consider how estrogen detoxification genes and snips also contribute to that picture.

Which means, getting a BRCA positive result doesn’t 100% mean a death sentence, right? Can you address how we can enhance the proper functioning of these genetic pathways?

First, let’s clear up the confusion between epigenetics and genomics. Epigenetics is where the snips commence. They are features that are "on top of" or "in addition to" the genome, and it doesn’t involve alteration to the gene itself.

A genetic change is a mutation in the genome, in the DNA itself, such as the mutations in the BRCA gene. This is a structural change.

So, the epigenetics can come in and say, “Okay BRCA, I'm going to turn you on or off”. Now, we can influence the snip based on our environment, stress levels, biochemical support, and other factors which will affect the inner functioning of that cell.

And that's what we see that makes the difference. It’s not just about whether you have a BRCA positive gene. It’s also about whether you have the snip, and the conditions, that will switch on the BRCA gene.

So how can we regulate the proper functioning of these genetic pathways? Well, it’s directly related to levels of cortisol, the primary stress hormone. So, if you have a super strong stress response, then that’s just flooding your system with a lot of messaging to tell the BRCA gene to turn on.

Managing Our Stress to Support Our Healing

Talking about the stress trigger, what are some of the things you implemented with this patient to manage her stress levels on her path to healing?

Sometimes our lives are so out of control, people have often said that a disease or diagnosis was a wakeup call. But before that, there were some red flags. So the first step is looking back without judgment, without shame, and without being hard on oneself and say, “Okay, here are some flags I probably missed”.

In this patient’s case, she was working in the health field within the military. It was a high powered job with lots of deadlines and requires intense interfacing and negotiation. It kept her stress level much higher throughout the day. She has a tendency to not unplug and didn’t have a personal practice to release stress from her system.

We know tissues store stress and trauma. We, humans, are multi-faceted beings, not just a physical but a spiritual being or emotional being having a human experience.

Each person has to try to figure out what their triggers are. Some of my patients have said, “You know what, I'm done with these types of clients and I’m dumping them”. One person said, “I really question the relationship I’m in”. Another said, “Well, I love my job but I can't handle the stress, so I need to figure this out”.

From my observation, a life-altering diagnosis is usually dramatic. The healing path requires a whole team: your surgeon, your radiology oncologist, your oncologist, supplementation, medication, detox. There aren't one-size fits all, so navigating that becomes amazingly difficult and within itself creates various stress responses.

So what we do to help them is to first find their base or their resiliency. We help them define what's true for them by asking questions like:

What do you want your life to look like?
What do you want your spiritual life to look like?
What emotional things are you enablers?
Do you tend to keep rescuing?
Or do you feel like you’re a victim?

Once you essentially know what you’re building, there are lots of tools you can use to build it.

Communicating with Our Cells to Connect with Healing

In some cases, I've seen where folks have high neuroplasticity in their cognitive portion of their genomic panel. What this means is that the mind-body approach becomes super important for them.

There was this one patient who had the BRCA gene, and her neurocognitive change was way off the chart. So she had the ability to have a strong influence on her genes. We know from science that at a quantum level, we can influence our genes by communication.

So for this patient, I said, “Start talking to your genes. Have a cell-to-cell talk. ‘Hello there detoxification’, or ‘Hello there liver, how are you?’” I know that sounds silly or hokey pokey, but what I observe is people then reconnect with their body.

There’s a branch in psychology called embodiments. The mind and body are not disconnected. It means you hear what your body says and you’re connected with your cells. Trauma drives us out of the body immediately. Trauma separates the mind and body — that’s disassociation.

To heal after trauma, we need to reconnect. It’s more than just the mind and body. We know that there’s a receptor in the heart that connects to the head. And then, there’s the gut. 70-80% of our immune system lies in the gut. But what about that gut feeling?

Do we drive through our gut feeling when somebody asks us to do something we don’t feel is right? Or do you say, “You know, I can't” or “I'm at my limit and I have to change things”.

So, it's making those decisions and getting back in touch with our core values that influence our response to our disease, to our distress, which is really an excessive response to stress. To reconnect and unwind — that's a detoxification, that's a change.

That's an energetic detoxification and I couldn’t agree more. I can see how that definitely affects your cell to cell communication. And I love that you said, we can influence our genes by cell-to-cell communication.

The more we know about epigenetics, SNPs, and these pathways, the more it will help us use natural things to promote turning off the “bad” genes. Things like turmeric, and I believe maca is one. You know I’m big on my maca greens. So, these are where we can influence our nature through a functional approach.

But nothing beats the spiritual approach you're talking about. Getting in touch with your core values, bringing your body and your mind back as one. And I definitely have firsthand experience with that; with my P.T.S.D. and the trauma, my family and I went through. And it’s just recognizing that I was ignoring what my body was telling me for quite a long time.

The Wisdom in Your Genome to Find the Best Diet for Your Body

Yeah, that's so true. And I think that's a really good point. We can look at any of the results we get back from our functional testing that overlays the genomics.

So, when I got my blueprint, I was also getting additional tests like intracellular levels, selenium, red blood cells or magnesium. And so I found I have a SNP for OCD. So now, I just say, “Don't worry, I have a snip, I'm just functioning within my snip, it’s alright”.

I just started to get so intrigued by the minutiae. But then I paused and stepped back. What influences more than the intercellular connectivity, spirituality, and communication? It was important to also see the bigger picture. Because I’ve observed folks who missed the red flags because they wanted to stay focused on the minutiae.

I'm hoping that as I get more proficient, I will have more of the art part of really helping patients go through this. That I can say, “Yeah here's the concrete details, but here's really the overall message of your genome. This is what your blueprint says to you”.

And I found that true too when people ask, “What am I supposed to eat? Paleo? Keto? Atkins?” Well, what does your genome say?

Some folks choose not to eat meat. But when their genome comes back, it says: “Must eat a wide variety of lean meats, fish, green leafy vegetables”. And they're like, “Well I used to do that, but it’s not in fashion now” or “I want to be vegetarian/vegan”. But really their genome does not support that.

So it becomes a really, really deep question. And a very personal question. And that's where the beauty and magic of a doctor-patient / provider-client relationship, can take shape. To take time with the patient, walk through those steps and say, “Well, this is the concrete part, but how does it feel? How do you want to go forward? What does that really mean?”

I’ve had some people actually reintroduce meats. One patient and this is really interesting, had breast cancer and lupus. She’s supposed to be gluten-free and dairy-free, but that’s not what her genome and snips said at all.

So, I say to this person, “Well, what if we shift your belief? Not challenge it, but shift it and open up to another possibility that maybe you don't need to have that.” She said, “I never thought of that”.

Two months later she circles back and says, “My doctor said I should stop taking my medicine from lupus and I think I’m ready to do that”. I said, “I think we should try it”. And she's been very stable for years.

Sometimes what underlines some choices for therapies or medications is the fear that if you don’t do something, then something will happen. But if you look at the genome, it says: “Yeah you’ve got some tendencies but if you're sure of all these other things, that tendency goes away”.

And so, the beauty of that is just amazing.

The Practice & Process of Shifting Your Tendencies with Nutrigenomics

So, if you know you have this tendency or this genetic profile for Lupus, what can you do to prevent that? Or with the APOE gene for Alzheimer’s? From what you’ve been saying, bottom line is, it's what your body resonates with. It’s getting in touch with what works for you and what doesn't.

It’s a practice and a process. Not just getting the genetic testing done. But understanding what we can do to shift that risk. And always following up with a physician who practices the art of medicine.

Yes, speaking of tendencies, let’s take an example of someone who lives in the Midwest, where they tend to take white bread, cheese, and a minimal amount of vegetables. They’re overweight, have low exercise tolerance, have difficulty losing weight, and they might be pre-diabetic, or have metabolic syndrome with elevated blood pressure, or be perimenopausal.

What we find is, when we look at their genomic overlay and snips, is that some people need more fish. But what if they don’t like fish?

So I turn to nutrigenomics, the study of how nutrition and genes interact, and the results could show that when an individual ate vegetables, it tasted more bitter for them than for the average person. Or that when they ate fish, it smelled and tasted more fishy for them than for others.

So we look into different preparations. For example, with tuna, you can add nutmeg, lemon, and certain herbs to change and enhance the flavor, so it drops out that fishiness.

So, it’s about learning how to cook it properly, to your taste, so you can still benefit from the food. It’s not taking fish sticks out of a box or a canned tuna that tastes horrible; it’s learning to prepare that same food and begin to adjust your palate.

For me, coconut is my friend. Coconut is anti-inflammatory and antifungal. It is good for your brain, your skin, and it's good for the planet. So, I try transitioning with coconut oil and use it in replacement of other oils.

So, you just kind of begin to shift things. And shift takes time and patience. Maybe three to six months, and you need a lot of reinforcement and education. But the biggest thing is to make it fun and make learning an adventure.

A friend of mine has taken a culinary genomics course while I'm steeped in the science course and medical course right now. And we're going to actually put things together because we want this to be fun for folks.

Food choices have to resonate with people. We want to support their healing instead of them reluctantly saying, “I have to eat kale again”.

However, once they see how these foods support their system, they can't get enough of them. And you’ll find they shift and start saying, “Where is the kale? Are we out? We need to go buy more”.

The Influence of Virus on the Thyroid

I also found the thyroid is not just influenced by cruciferous vegetables, but also from the heavy metals — you know the detoxification and liver side of things. And also with how Vitamin D affect thyroid metabolism rather than saying, “Oh, you're eating too much broccoli.”

Yeah, let's emphasize that because that is such a big thing. People on thyroid medicines and people with thyroid are fearing the cruciferous and you’re like that blows my mind. We know, inherently, when we think about it that does not make sense.

So, let's talk about these bigger influencers on the thyroid because that is an epidemic today. Especially in the perimenopause and menopause stage, where we have estrogen intoxication issues going along, right alongside thyroid detoxification issues.

That’s a perfect example. Science has now found viruses influencing the thyroid. I did not give thought to this until about 18 months when so many people came to me with thyroid issues. I thought, maybe this is just a Colorado thing.

Nothing we tried was working, so we then ran a genomic test and didn’t find any smoking guns regarding thyroid. I was not expecting that. Then I looked at their virus history, I saw they all had a history of infectious mononucleosis, or mono, that was relatively significant. Further lab tests show they had a reactivation.

Mono is caused by the Epstein-Barr virus, so I questioned if they had Epstein Barr types of symptoms like fatigue, being slow to recover after exercise, poor sleep, and night sweats. Every single one of them had these symptoms.

So we began treating the mono virus alongside homeopathy to support the body. As treatment progressed, their thyroids began responding. I was able to take two patients off thyroid medicine.

However, two patients overreacted to the treatment. They would get palpitations, sweat, and so on. We ran a genome test to see what their blueprint needs.

Although both their symptoms were the same, it turned out their genomes were different. So they needed two different recommendations, and then they started getting better.

Genes, Viruses And Vaccines: The Perfect Storm?

And that’s the art of medicine. Two patients with exactly the same complaints but leave with two completely different recommendations. So when you measure viruses, is there a compound effect from flu shots and vaccines?

I don't know. That’s a very good question. The vaccine issue is such a hot button. So I sit in the middle of that. I think there's things we know and things we don't know. The things we know is that we've saved a lot of lives with vaccines. But we don’t know what happens when we put all the vaccines together and administrate them at once.

If we go back to that genome of the individual, it may be that a person can't get rid of viruses very well. Maybe they have a problem detoxifying heavy metals. And if a vaccine gives them a stealth virus they’re not aware of, it creates a perfect storm. And so, flushing that out becomes a challenge. Overall, I think it’s fascinating. I don't have the answers in that, but my curiosity is very high.

My curiosity is high too. It’s always good to listen to that intuitive aspect of ourselves, right? To weigh the benefits versus the risk, what we know versus what we don't know. And then how we feel about that, like the Biology of Belief.

Getting in Touch

Well, it's beautiful how this area of science is advancing exponentially. There are very few physicians that are using it clinically and to see you incorporate this with your holistic approach is really a gem.

I want to thank you so much for being on the show today with us and encourage our listeners to share this podcast and comment below. As part of your discovery, here are some important questions to ponder over: What’s deeper inside? What can be influencing us?

Then, always go back to becoming present. To be our best self in a peaceful, internal way despite the craziness exists in our world. And in the way, Dr. Louder emphasizes this and ties it into the genome is simply powerful. Really, really powerful.

Thank you, Dr. Louder. Tell our listeners how they can get in touch with you today?

My website is www.drmarylouder.com. My office is 303-722-9000 and we're located in Lafayette Colorado. I can do long-term consultations or distance consultations, and I’m happy to help anybody who's interested.

Thank you again for sharing your time today. And thank you to our listeners for being here today.

You're welcome, have a great day everybody.

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