It’s in the Genes

[Upbeat Guitar Music]

Mike: Welcome everybody. This is Avoiding Addiction Affliction, brought to you by Westwords Consulting, the Kenosha County Substance Use Disorder Coalition, and by a grant from the State of Wisconsin's Dose Reality Real Talks.

Mike: A little while ago, we had a great conversation about functional medicine with Lis Schmelzer.

Mike: We wanted to follow up that conversation today about the impact of genetics, supplements, a little thing called caffeine. If you recall Lis as a clinical nutritionist, nutrition sales executive and wellness advocate, and we had a great conversation last time.

Mike: Welcome back, Lis.

Lis: Thank you. Thanks for having me.

Mike: I got a lot of compliments on our last conversation and people who you think everybody knows things, but refresh us. For those who haven't heard it and maybe didn't hear us last time, what is functional medicine?

Lis: Sure. So it's an evidence-based model of individualized care and it focuses on the interconnectedness of everybodies system to uncover the true foundational root cause.

Lis: And it considers all the different complexities of what influences our health, like genetics, lifestyle, and nutrition.

Mike: That's great. I couldn't do that if you paid me. (laughs) That's terrific. Okay, so let's get into it then. I'm allergic to a few things. Strawberries, shellfish. I didn't ask for that. It just happened.

Mike: Turns out some members of my family are also allergic to some of the same things. Genetics play a role in our health.

Lis: Yes. Absolutely. So what was your journey with discovering that you were allergic to these things?

Mike: Well, that's really interesting you should say that because I wasn't always allergic to that.

Mike: And then one day I was eating shrimp when I was 40 and I got hives. And I went, well, that's kind of weird. And then the next time I ate it, I needed to go to the ER for a shot of whatever the Benadryl, whatever they give you. And then a doctor said to me, yeah, you can develop these allergies later in life.

Mike: You're not always born with them, but you may be genetically predisposed to them. So the trip was finding out was being exposed to them.

Lis: Right. So an allergy is an immune response and like what you just described with recalling your allergies. So your first exposure compared to your subsequent exposure was very different.

Lis: So the more you're exposed, the faster and more intense the response is, which is why you first experienced hives and then you had an anaphylactic response after that. And so that is definitely tied to our unique genetic makeup, but also the Nutrigenomics side of genetics. So we have our genetic makeup that influences our immune response, but then we also have Nutrigenomics, which is the individualized study of how food and nutrients will influence our gene expression.

Lis: So we actually can turn genes on and off and turn variants on and off depending on what we are exposed to through our diet and our environment.

Mike: So does that mean if I would've never had crab legs in my twenties or thirties, that I might not have ever experienced a shellfish allergy?

Lis: No. We still have inherited genes, but at some point throughout your health journey, something changed the way that your gene was expressing how your body reacted to those specific nutrients.

Mike: Do we understand those mechanisms about what happened?

Lis: Yes. So we have different biomarkers and testing that we can do, but really with a true allergic response. You have these reference indicators. So your pro-inflammatory cells, which we sort of touched on in the last interview. So our pro-inflammatory cells, and then we also have an increased production of our immunoglobulin E, so IgE.

Lis: And then that increases the release of histamine and other inflammatory, hormones. And so this is actually called mass cell degranulation. And again, going back to your exposure level over time, that's what influences the intensity of it.

Mike: Hmm. On my dad's side of the family, he died at 70. He came from a family of I believe seven kids. I had an uncle live to late nineties. An aunt lived to late nineties. The difference between the two of 'em was they took better care of themselves. My dad did not. So genetics play a role, but also what we put into our body plays a role as well.

Lis: Mm-hmm.

Lis: Yeah. So the interesting thing with Nutrigenomics is that our immune response can also give us signals or signs of nutrient excess or nutrient depletion. And it obviously it's more than that, but as a trained clinical nutritionist during a nutrition assessment, I know what to look for.

Lis: So, as an example, niacin or a vitamin B three. If we're above the threshold of 35 milligrams, that can cause a histamine release, which is why it presents as facial flushing, if that makes sense.

Mike: Yeah, it does. Are we also then genetically predisposed to things even like the sun from the different chemicals we have in our body?

Lis: There's a gene for everything. (laughs)

Mike: (laughs) I wish I would've had got the gene for talent. It would've been good.

Lis: Right.

Mike: You know it suggests though that if I take decent care of myself, my genetics are okay.

Lis: Yeah. I mean, again, it goes back to the whole self care. So diet, lifestyle, physical activity, environment.

Mike: And I know we wanna have a third conversation about addiction down the road. But I would imagine that it also works that way with that. For instance, when I go in for a medical procedure, I come out of anesthesia really quickly. It affects me not at all.

Lis: Okay.

Mike: Uh, I never am nauseous.

Mike: I'm hungry right afterwards. Other people, it makes violently ill. Well, is it surprising my, both my parents were addicted to alcohol and depressants. On the other hand, stimulants drive me nuts.

Lis: Okay. That's really interesting. And I'm gonna check into that after this conversation on what the gene is for metabolising anesthesia, because that's really interesting.

Lis: There's a correlation there.

Mike: You know, they always ask you, what is your weight? How do you tolerate? You know, and it's like, it seems it's not really a guess because those guys get paid and women get paid a ton of money, right. To be able to do it.

Lis: Mm-hmm.

Mike: Well, let's talk about the stimulants for a minute and, and a big one.

Mike: You're younger than me. I don't know if you remember this. Back in the day there was a commercial on tv. Do the Dew!

Lis: Mm-hmm.

Mike: And it showed people doing all sorts of elaborate things, and it was the, one of the first beverages with wide mouth cans, which encouraged young people to chug it.

Lis: Mm-hmm.

Mike: Because it allowed more of the fluid in, and, and therefore, Mountain Dew ended up with this reputation as being oh, just this wild, highly caffeinated beverage that parents should keep their kids away from.

Lis: Mm-hmm.

Mike: How does Mountain Dew stack up today?

Lis: Well, that's a, probably one of the biggest misconceptions with soda is the caffeine content. So a 12 ounce can of Mountain Dew only has 54 milligrams of caffeine. And if you compare that to an eight ounce cup of coffee, an eight ounce cup of coffee has 95 to 150 milligrams of caffeine depending on how you're brewing it.

Lis: And so. You know, the question is posed well, why is soda so energizing, or why does it seem so energizing? And it comes back to a different ingredient, which is sugar and refined sugar. And so one 12 ounce can of Mountain Dew has 46 grams of sugar in it, which is equal to 11 and a half teaspoons of sugar.

Lis: So imagine brewing your coffee in the morning and then adding 12 teaspoons of sugar to one cup of coffee. And that's really where soda gives the energy spike. But, going back to caffeine, the FDA considers caffeine as a food additive and a drug, and it classifies it as a central nervous system stimulant, as you mentioned.

Lis: And so tying this all into Nutrigenomics. Everyone has a gene called CYP or CYP one A two. And I know gene gene names are not attractive by any means, but it's named for the Cytochrome P 450 liver metabolic pathway. And so this gene is responsible for how we metabolize caffeine. And there are two gene variants that are very common with this particular gene.

Lis: And it causes fast caffeine metabolisers and slow caffeine metabolisers. So earlier you mentioned that stimulants really affect you.

Mike: Yes.

Lis: So I would bet you and I fall into the same category as being slow metabolisers of caffeine because I am also highly impacted by caffeine and i'll get the jitters and I definitely experience insomnia if I have caffeine after a certain time in the day.

Lis: But fast metabolisers like my father-in-law, he is completely unaffected by caffeine. So he can brew and after dinner cup of coffee and still be able to sleep just fine. And so he is a fast metaboliser who you still have the increased alertness without all the negative side effects. And so because of these two common gene variants, researchers examined how they affect the risk of other health concerns, and one of them was a heart attack or a myocardial infarction.

Lis: And so for the ultra slow metabolisers, like myself, drinking four or more cups of coffee per day was associated with a 30% higher risk of heart attack. Conversely, the fast metabolisers can drink one to three cups of coffee a day, and it'll act as a protectant against cardiovascular disease.

Mike: So, so wait, so that means that folks like me are at a higher risk if I drink caffeine to heart attacks than those who metabolize it quicker?

Lis: Correct. And so that's where Nutrigenomics is so critical in preventative healthcare because. If, I mean, like I said before, there are genes for everything including how we process sodium and other nutrients. But if you're a slow metaboliser, you should avoid consuming more than 200 milligrams of caffeine per day.

Mike: Okay. I know that anecdotally, right? How does one find that out? I mean, I'm due for an annual physical in a couple weeks. I've never heard some of these terms before, ever. And so my guess is she's not testing for that.

Lis: No, no. I would not guess that conventional providers would be offering or pursuing Nutrigenomic testing.

Lis: That's something that you would have to work with a functional healthcare provider to pursue that.

Mike: How do you, how do you get those numbers? Do you, is it a blood test? Is it, how does that come out?

Lis: It is a blood test. Mm-hmm.

Mike: And so it can break it down into, okay, you're a fast metaboliser, this slow of that, et cetera, et cetera,

Lis: Everything. Mm-hmm.

Mike: Well, the effect of caffeine and you said your father-in-law just can fall right asleep then. Where you and I are up and I'm itching my arms and whatnot.

Lis: Yes.

Mike: And so there are other effects though, of consuming that on your long-term health, just besides the heart attack, I would think.

Lis: Absolutely. Obviously it disrupts our ability to fall asleep and stay asleep, but at a molecular level, it's because it is blocking the neurotransmitter adenosine, which is our sleep and relaxation chemical messenger. So if we're blocking that we won't be able to fall asleep and stay asleep.

Lis: And additionally, it also causes dependency issues because it is associated with enhancing the neurotransmitter dopamine, which we spoke about last session as well. Our pleasure and reward center is affected. And also it increases cortisol and adrenaline levels. And these are our stress hormones.

Lis: And unfortunately, our body is not intelligent enough to differentiate stress. And the best way to explain that is when our body experiences a physical or emotional threat like accidentally placing your hand on a hot burner. Or are you being chased through the woods by a bear? Our body only perceives that we are experiencing a threat, and so it activates the fight or flight response.

Lis: And so these two hormones specifically that caffeine increases cause increased blood pressure, increased heart rate, and so again, our body is just perceiving the stimulant caffeine as a stressor. And I'm sure you're familiar with individuals that have gerd, that have been advised to limit or avoid caffeine.

Lis: That's because it also exacerbates digestive discomfort because it stimulates acid production, and then it also interferes with multiple metabolic pathways, and that's our body's way of detoxifying and eliminating toxins and disrupting key nutrients being absorbed. So you can see there's you know, seven or eight other ways that it can negatively impact our short and long-term health.

Mike: Okay. So let me be a normal American for a minute. So can I counteract the effects of caffeine late at night by popping a couple of melatonin before I go to bed?

Lis: I wouldn't say counter effect the caffeine because it's still comes down to how is your body metabolising it? So metabolising means our body is taking a substance and it's breaking it down into a different molecule that we can excrete and eliminate.

Mike: So I'm just adding something else onto my daily regime instead of changing my regime.

Lis: Right. And melatonin is not a negative thing by any means. We need melatonin for sleep onset. But the great thing now with all of these different alternatives is that you can replace caffeine with other things like adaptogens or nootropics.

Lis: And actually one of my favorite things that I have started swapping out is mushroom coffee.

Mike: Go.

Lis: So it's just powdered mushrooms and it acts as an energizer without the stimulating side effects or negative impacts that you get from a true stimulant like caffeine.

Mike: Okay. Break that down just a little bit.

Mike: What does the mushroom do? What does it stimulate in order to give you that little boost that you feel.

Lis: So it just positively impacts your neurotransmitters and hormones in a way that isn't causing any dependency.

Mike: Hmm.

Lis: So it's increasing your alertness, increasing your focus, increasing your energy needs by modulating these hormones and neurotransmitters in a positive way.

Mike: Well where do you get it?

Lis: You can get it pretty much anywhere, but I like to, I actually order mine from a little apothecary in Milwaukee called the Tippy Canoe Apothecary. Which is a great, and I'm not doing a plug here for any specific brand, but that's one of my favorite mushroom coffees.

Mike: And is it expensive?

Lis: It can, I mean, it, it can be a little bit more expensive than a $5 bag of ground. Folgers.

Mike: Well, that's where I was going too, is that sometimes we're looking for quick, right? Fast, cheap. I have a friend of mine who's a physician. And she said you wouldn't believe how people are mad at her if they walk out of her office without a prescription.

Mike: We're looking for quick fixes.

Lis: Mm-hmm. Yeah. I think, you know, it goes back to the complexities of living a healthy lifestyle. But really it is having the full circle approach of sustainable, healthy choices with diet and exercise and lifestyle. And then it also ties into access and the socioeconomics of how we have these resources available to us.

Mike: Well, what's a healthy supplement look like, Lis?

Lis: Oh gosh. So the supplement industry, and I'm sure listeners can probably relate to this, can feel very overwhelming and noisy.

Mike: Oh, it's incredible!

Lis: Mm-hmm. I have had the pleasure of working at a practitioner grade supplement manufacturer. And that was where I really had deep, deep training on the quality of supplements.

Lis: So I think first and foremost, what is motivating a consumer to take a supplement? Is it low energy? Is it their immune health? Is it for performance? Stress management? But then it really comes down to the supplement manufacturer and there are a few different levels. So where are the raw materials coming from?

Lis: Number one, where are these ingredients coming from? How is the manufacturer testing these ingredients? Are they using an in-house lab? Are they using a third party lab? Is the lab certified? And then I think one of the biggest misconceptions is that the FDA doesn't have any control over this industry or this division of healthcare, but they really do.

Lis: So there are supplement manufacturers that have the FDA come in and audit their entire manufacturing facility annually. And so those are the manufacturers that you want to look for. Another certification is a CGMP, so it's good manufacturing practices. And then are they testing every batch or are they doing skip testing, which is every other lot?

Lis: And the biggest thing with safety is adulteration. So whether it's intentional or unintentional, we need to know is there truth in the labeling? So how does the supplement manufacturer guarantee or prove that what they say is in the supplement is truly what is in the supplement for purity and potency.

Lis: And so identification of the ingredients, but then also testing for contaminants like microbes, mycotoxins, heavy metals, pesticides and if the supplement manufacturer cannot substantiate their claims or prove their claims, that's a huge red flag. And being able as a consumer to pick up a supplement bottle and read the label and understand the dosing, recognizing if the ingredients are first and foremost safe, but are they also effective?

Lis: And then being able to understand the purity and potency side of it. And so the third piece to all of this is are there any drug nutrient interactions or dietary interactions or toxicology risks? And so my recommendation is that if you cannot confidently check off most of those boxes, you would need to be working with an individual who is professionally trained, like a clinical nutritionist or an integrative pharmacist to ensure that your dosing in your supplements is safe and effective.

Mike: That's a lot, but that's really good because I don't know where to go. You know, right outside my pharmacy, there's a wall of vitamins and supplements from different manufacturers, and the assumption I think is, hey, if they're in the store, they must all be good.

Lis: Right.

Mike: And then the store today is, you know, Amazon or online, and you don't know if you're ordering something if it's decent or not.

Mike: Sometimes.

Lis: Yeah, if you can find a provider or a clinician to work with that can guide you not necessarily sell you something, but just to guide you so that you know that what you're getting is safe and effective. That is really important with supplement use.

Mike: Different cultures view this in different ways, right?

Mike: And we live here. So the quick fix again, some things are developed for one thing and then they're used for something else. Like, isn't ozempic or wasn't it developed for, was it diabetes or right? Diabetes?

Lis: Mm-hmm.

Mike: And Wegovy and now it's weight loss and all of these people are, and that just feeds into the psychology that, yeah, there is a quick fix out there.

Lis: Yeah, I think cardiometabolic illness is really tricky because if you look at the foundation of what is associated with cardiometabolic illness, it's obesity. And so if we peel back the layers of obesity, it can be very misunderstood because it's not as simple as calories in equals calories out. And again, going back to the socioeconomic factors with fresh food access and living a sedentary lifestyle, and the genetics and the health of our microbiome and our sleep hygiene and stress management.

Lis: That all plays a role in our hormone regulation and then the added layer of behavioral psychology, because we do all experience an emotional response with eating. And so I think the researchers and developers of those prescriptions hopefully had good intentions in mind with, okay, well what is causing cardiometabolic illness?

Lis: Is obesity, and if we can help support obesity or treat obesity, that'll in turn have positive impacts on cardiometabolic illness.

Mike: This is so new though. We don't have the long-term effects of all this dramatic weight loss over a quick period of time, though yet.

Lis: Right.

Mike: I want to ask you as a get outta here question about lifestyle.

Mike: Long ago I used to run every day. I know I wasn't supposed to. Not in the way I was doing it 'cause I'm a bigger guy or whatever, and then I couldn't anymore and it took me a while. Now I bike every day. I can't imagine a day where I don't do it. It's just a part of the day. How do you convince somebody to make the hard choices of taking care of yourself rather than looking for the quick fix?

Lis: That's a great question. And you know, every nutritionist has their own philosophy. For me, it's education. It's providing the scientifically researched information to individuals or clients that I'm working with so that they feel empowered and they make their own decisions and they really have autonomy when it comes to their health and their preferences.

Lis: And everyone is at a different place in their health journey. And so it's really important to me that I meet everybody where they are at and to encourage and motivate them, and then to build that collaborative partnership so that I'm not convincing them, because when I hear the word convince it makes me think of something that's forceful or maybe not sustainable.

Lis: So I would say the biggest thing for me is education, providing the right resources.

Mike: That's great and that's what we're hoping to do here obviously. Lis I really appreciate you being with us a second time. I'm looking forward to the third time.

Mike: For all of you who are listening, I hope you're finding this as educational as I am.

Mike: Thanks for your thoughts, your expertise Lis. And for those of you listening, we hope you find health wellness wherever you are. Thanks for listening. Be safe and take care of your whole self.