Tuesday, July 19, 2016

Genes vs Belief Epigenetics and Exosomes by Kelly Brogan MD

Think diseases run in the family? Think again.
Have you ever worried about “getting” breast cancer because your mom and aunt both had it? What about Bipolar Disorder (yes, psychiatry capitalizes it’s diagnoses for extra emphasis!) or Lupus? It has probably felt like you have a ticking time bomb inside you and you just want to know when it’s going to go off. When that diagnosis is going to be delivered. Women like Angelina Jolie have engaged willful mutilation in the name of the persistent belief that genes are destiny.
This is simply not true.
“It runs in my family” no longer means what we once believed it to.
You may not know this yet, but the whole game has changed and we are several decades into the most powerful shift in scientific thinking in the past 300 years. Science, when handled with care, is a process, not a destination.
Science fundamentally reflects our native curiosity, our creative impulse, and our sense of wonder. Along the line, however, it began to take on a different flavor. With men like Newton, Darwin, and Descarte at the microphone, a culture of reductionism, force-based perceptions around the nature of reality, and separation of spirit and matter all predicated the culture of ruthless medicine we are steeped in today. We war against nature, our bodies, and each other. There’s good and bad. There’s the illusion of the objective. We pray at the altar of facts and data.
I used to believe that science meant answers and solutions. And now I don’t. Here’s why.
Anyone who has plumbed the depths of science, either through study, primary research, or experimentation, will reach the limitations of belief in science as the be all end all. Beyond this glass ceiling is the sense of wonder that is stripped from the soulless realm of modern biology. The amazing thing is that, the past several decades have furnished a new kind of science. It’s a science of inquiry rather than utility. The conclusions of today’s abstracts seem to read, “isn’t this amazing?” rather than “here is confirmation that this drug is necessary to manage our wayward biology”. In essence, it reflects a new story about our role in the holobiont, or the more purposeful station we occupy in the web of nature.
In this new story, we are not the result of several billion years of random mutations and survival of the fittest. Instead, we are adapting, as Lamarck once suggested (and even Darwin acquiesced), purposefully. This purposeful adaptation means that we are interacting with our environment in a co-creative dance with balances and micro/macro feedback loops to keep a certain meta-order intact.  
How a focus on genes made lifestyle irrelevant
When I was in training, I had one hour of nutrition education that essentially positioned food as caloric currency. Why would it matter if we were born with the diseases we would ultimately struggle with? In gene-based science, toxicant exposure, rest, nutrition, and relationships are clearly window dressing considerations. (Jonathan Latham’s work on identifying the historical influence of the Tobacco industry on the push towards the hume genome project and gene-centricism in medical science is amazing. https://www.independentsciencenews.org/science-media/science-and-social-control-political-paralysis-and-the-genetics-agenda/)
With the completion of the human genome, however, we learned that we have fewer protein-coding genes than an earthworm. This means that the genes we thought made us who we are, don’t.
We had to go back to the drawing board. Where on earth does our seemingly infinite uniqueness come from? How are diseases manifesting if not genetically?
And a new science was born. It was named epigenetics.
Epigenetics encompasses all that is beyond the genes (it actually means “above”) and includes modulators, modifiers, and any influence on the expression of genes and even the possibility that nonhuman genes may play an expressive role in human physiology. It also refers to the the almost 99% of our genome that was once pejoratively called “junk DNA” and now is more mystically referred to as Dark Matter, as Dr. Jeff Bland describes here.
One of the most powerful examples of the relevance of epigenetics is the lore of the ‘breast cancer gene’. Jolie, and many other women have succumbed to the hex or the belief that they are cursed by their genes, doomed to develop diseased breasts, ovaries, and uteruses if they just go on living with them in their bodies.
The literature, itself claims that gene mutations such as the “breast cancer gene” or BRCA seems to be doing different things over time. Doesn’t that mean, by definition, that we are talking about epigenetics? Because the risk of a gene itself should not change over time. An oft-cited study concludes:
Risks appear to be increasing with time: Breast cancer risk by age 50 among mutation carriers born before 1940 was 24%, but among those born after 1940 it was 67%.
Our review shows that, in contrast to currently held beliefs of many oncologists and despite 66 published studies, it is not yet possible to draw evidence-based conclusions about the association between BRCA1 and/or BRCA2 mutation carriership and breast cancer prognosis. We only found sufficient evidence for a 10% worse unadjusted recurrence-free survival for BRCA1 mutation carriers. For all the other outcomes the evidence was judged to be indecisive.
This reflects a more modern understanding that only about 1% of diseases are truly genetic in nature (i.e. due to a congenitally inherited and irreversible gene defect), and that we may very well have misunderstood our interpretation of these gene’s functions. The rest is lifestyle. In other words, we create our experience and determine our destiny.
As we embrace our agency in our own bodily experience, we must embrace complexity and take off the blinders of our one gene – one ill – one pill model of thinking. As you open your mind to this shift underfoot, a shift into a more ecological type of medicine, a more collaborative, communal, and connected type of medicine, revel in what the more beautiful science is showing us about our need to let go of what we once believed. It served us, but it’s time has passed.
Here are the 3 most powerful game changers in recent literature:
Gamechanger # 1: The Microbiome
An extension of the one cause – one problem dialectical thinking, is the rush to characterize microbes as pathogens, as bad guys. We have done so for as long as we have been seeking to control and dominate nature. Pestilence and contagion have fit neatly into the lighthouse beam of fear that we sweep across our psychic terrain. But even Pasteur, arguably the father of germ theory, on his deathbed, was reported to say: ” I was wrong. The microbe (germ) is nothing. The terrain (milieu) is everything.”
What is the terrain though? The implication is that we are, in fact, an ecosystem, positioned within an ecosystem. There is no linearity, so that when we pull one thread of the spider web, the entire thing moves.
With the dawning of our awareness that microbes including fungi, bacteria, viruses, and others, live in and around us, we ceased to be human in the ways we had come to believe. We are not, in fact, humans trying to uphold and protect our humanity in a sea of invaders. We are a meta-organism, a holobiont, interfacing with a greater whole, like a fractal repetition of a pattern.
With the emergence of science seeking to study the microbiome, primarily in the gut, we have learned that these bacteria have the capacity to perform some of our most vital human functions, and some that seem to be eerily custodial. Take for example, the fact that there are bacteria in our guts that have evolved to detoxify the chemicals in an average dry cleaner. How could they possibly have foreseen the need for this function? Then there’s the digestion, barrier protection, immune signaling, hormone balancing, and brain controlling functions of the microbiome.
Through this lens, our tonsils and appendix are no longer vestigial, and the special role of a woman’s physiology is recentered as the conduit through which this microbiome passes from mother to fetus, and even through the inheritance of our primary cellular energy production sites – the mitochondria – themselves, ancient bacteria that were assimilated into the human organism over a billion years ago.
Because we know this now, we cannot war against nature any longer. Vaccines and antibiotics, hand sanitizers and bleach are necessarily brought under scrutiny. We will never win this battle because it’s not a battle meant to be won. Nature will continue to remind us of this with the emergence of superbugs, pharmaceutical damage, and disturbed immunity.
The term dysbiosis, used by holistic and integrative practitioners to refer to gut imbalance, of course, actually means “wrong living”. No doubt, our struggles today, stem from a lack of connection to the natural world. It is, in this way, poetic justice that we would only be able to heal our guts, right our relationship to the microbial world through food – nature’s gift, bounty, and language.
Gamechanger #2: Exosomes
The nail in the coffin of protein-coding-gene-determined-health is a group of tiny bubble-like blobs that influence gene expression. Amazingly similar to viruses in nature, structure, and possibly even function, exosomes are created and received by our bodily cells in order to direct, determine, and react to states of being.
40-100nm in diameter, exosomes typically carry something called micro RNA or miRNA which are key regulators of gene expression, naturally impacted by environmental factors, from toxicants, nutrition, and lifestyle patterns.
In fact, seminal research has demonstrated that stable miRNAs are transferred from plants including rice and ginger, into mammalian physiology where they then serve to regulate gene expression. Once again, food is reframes as so much more than calories and nutrients…it is information.
Researchers are suggesting that infant assessments of miRNA patterns may help to identify fetal brain injury from toxic exposures including mercury, aluminum, and medications, at birth, so that healing protocols can be prioritized and initiated. Powerfully, however, in order to understand the “signatures” of different disease states, we would have to study them in their natural unfoldment, without pharmaceutical interventions, before we could ascertain what is evidence of illness and what is evidence of medication effect. The authors state clearly:
“In addition, one must control for the influence of psychotropic drugs on miRNA expression since several studies showed that lithium, haloperidol, or valproate induced changes of the miRNA profiles in brain.”
This, of course, is why preventive medicine involves interfacing with the environment in a language that the body understands based on millions of years of co-evolution.
Gamechanger #3: Belief
When I was in training, the placebo effect was framed as a nuisance factor that needed to be controlled for. I now understand that the placebo effect doesn’t mean that you were fooled or tricked. It doesn’t mean you’re making it up or that you’re gullible. It means that a complex physiologic cascade of events was kicked off by your experience of taking a pill with the promise of relief.
It is rapidly being characterized as the most important driver of outcomes in everything from psychiatry to surgery.
My research on the placebo effect has helped me to understand that psychiatric medications, and specifically antidepressants, are more risk than benefit, and that I cannot achieve meaningful outcomes with patients who do not fundamentally believe that their bodies can heal.
How could it be that belief is this important?
Dr. Candace Pert, the pioneering researcher credited with the discovery of the opiate receptor, has debunked the Cartesian dualism that for hundreds of years has put the mind out of the realm of the body. She also challenged the notion that the mind is something that merely relates to the body. The mind, per her conclusions, is the body.
In fact, she used the language of the bodymind and elucidated how neuropeptides travel around the body encoding emotion in different tissues and organs. The shape of these peptides, or their conformation, further transmitted information to receipient cells.  All of the sudden, informational transfer takes on another dimension – vibration.
Another pioneer of the role of belief in cellular physiology, Dr. Bruce Lipton was several decades ahead of his time in establishing the role of environment and belief in the body’s physiology. His work has decentralized the nucleus (where the genes are housed), and focused on the cell membrane as an information-processing interface with the environment.
Taken together, this research all seems to suggest that we are a product of our energetic experience in the context of a greater whole. Even physics is mirroring this with the emergence of theories like Rupert Sheldrake’s morphic resonance, which suggests that collective experiences set a potential template for individual experiences in a type of memory transfer that has little to do with genes.
We are not random genes driving a purposeless life until we die.
It appears that human experience is not as it has been previously framed and echoed by philosopher Alan Watts – flesh robots on a dead rock in the middle of nowhere. When the human experience is reduced in this way, it’s most essential elements are denied – beauty, spirit, meaning.
In fact, human experience is the universe manifested at one point. It is the emergent properties of many, infinitely complex and interfacing systems. It is fundamentally sacred, larger than our will, and gently demanding of our humility.
This is the teleologic perspective – one in which the purpose rather than the cause is the explanation of phenomena. I reflect on this when I consider how adaptable our bodies are – in real time, within hours – and how we have not adapted fully to the lifestyles we have felt entitled to over the past 100 years. We live from our egos with total disregard for nature, each other, and our own bodily vessels. And we are sicker than we have ever been, from cradle to grave.  It seems that we are not “meant” to adapt to this way of living and we are reminded of this through the signals of illness. We are called back to the Continuum through our anxiety, depression, and illness. We are reminded that we haven’t figured it out, that science is not and cannot be used merely as a tool for control, and that consciousness as an emergent property of our physiologic web, is a gift.

The fairest thing we can experience is the mysterious. It is the fundamental emotion which stands at the cradle of true art and true science…the mystery of the eternity of life, and the inkling of the marvellous structure of reality, together with the single-hearted endeavor to comprehend a portion, be it ever so tiny, of the reason that manifests itself in nature. – Einstein

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