Dr. Amy Nett: That’s a great question. As we’ve sort of been saying in this Week One curriculum, genetics are very interesting. They certainly do have some influence on disease. I think in the curriculum this week we learned that about 10 percent of disease is associated with genetics, that, in general, it’s really our epigenetics, it’s our environment, it’s our diet and our lifestyle that are influencing our health and well-being. We do generally use the 23andMe genetic data primarily when we’re looking at methylation. Even then, I think we’re moving away from that somewhat. As far as I know, both Chris and I are still ordering 23andMe in correlation with the functional methylation profile. We use HDRI, Health Diagnostics Research Institute. We’re not really going to go into methylation in this course, but just so you know, there are genes that are associated with methylation. Of course, MTHFR everyone knows about, so we look at the MTHFR variants. We look at COMT. We look at MAOA, MTRR, CBS. We do look at all of those, and if we’re seeing certain symptoms, we may consider doing follow-up testing.
Let’s say you’re worried about a CBS mutation. You might consider ordering something like urine sulfate levels to see how much they’re manifesting that. In general, we haven’t been finding that too useful. We’ve probably only done that correlation on a handful of patients. So there can be value to ordering that genetic information, but I would say the greater value comes from ordering the functional tests, for example, the functional methylation. There’s a role for it, but by no means does the genetic data guide our treatment.