Dr. Sharon Hausman-Cohen: How to Address Dementia, Autism, and Other Chronic Diseases with Genomic Testing - Transcript

Dr. Mark Hyman: Coming up on this week's episode of the Doctor's Farmacy,

Dr. Sharon Hausman-Cohen: Diabetes, heart disease, cognitive decline, depression, anxiety, autism. They're not caused by any one gene variant. There is no diabetes gene. There are actually over a thousand genes that contribute to diabetes and many hundred that contribute to heart disease. But there's probably about 20 or 30 that are the main contributors, and those are the ones that my research has focused on.

Dr. Mark Hyman: Welcome to the Doctor's Farmacy. I'm Dr. Mark Hyman, and this is a place for conversations that matter. Now we're in an incredibly exciting time in medicine and our ability to look at our unique biology and genetic makeup is available in ways that we have never had before and allows us to personalize interventions and optimize our health, which is exactly what my conversation today with Dr. Sharon Hausman-Cohen is all about. How do we use your genome and your genetic variations and learning about them to optimize your biology, to prevent disease, and to optimize health? It's very cool stuff. Now, Dr. Sharon Hausman-Cohen is the Chief Medical Officer and co-founder of IntellxxDNA. Dr. Hausman-Cohen has been in the field of integrative medicine for over 25 years. She's a co-author of many publications and a textbook chapter relating to the use of genomics to improve outcomes and cognitive decline like dementia and autism.

Dr. Mark Hyman: She's proud that IntellxxDNA is being used in studies being done by Dr. Bredesen and his team in other groups studying complex illnesses as well as by well-respected functional medicine trained physicians across the country. She and her co-founder developed IntellxxDNA as an answer to an unmet need in the medical community, the need for accurate evidence-based genomics tools geared at helping physicians practice true root cause medicine. Whether the patient has cardiometabolic disease, brain concerns, or other medical mysteries, Dr. Hausman-Cohen received both her master's degree in medical degree from Harvard Medical School in addition to supervising the research for IntellxxDNA, she practices at Resilient Health in Austin. Now, there's a common misconception out there that many of the diseases we're experiencing are due to our genetics. I begin our conversation by explaining what genes actually do and explain why being predisposed to certain health issues is not the same thing as being predestined.

Dr. Mark Hyman: Dr. Hausman-Cohen then talks about the difference between genetics and genomics, a field that didn't even exist when I went to medical school, and we explore how advances in genomics can offer a greater personalized understanding of how to prevent and manage disease, dementia, and cognitive diseases. On the rise. Dr. Hausman-Cohen and I share patient cases that illustrate the potential for reversing cognitive decline. She explains why it's not always about what genes you have, but what genes you don't. We also discuss similar health profiles that we've observed in children with autism and adults with Alzheimer's disease. Think about that. The genetic profiles of those with autism and Alzheimer's are often very similar, and we talk about that in the podcast. Dr. Hausman-Cohen has light on how helpful the genomic revolution can be in addressing our mental health crisis as well. So we've got a whole mental health crisis.

Dr. Mark Hyman: How do we look at genetics and genomics to understand that better and treat in a more personalized way? Now, before our conversation, and out of my own curiosity, I did the IntellxxDNA ,j.u7kand a genomic testing, and then Dr. Hausman-Cohen talks about what my own test revealed and how I personally can apply it's finding to support my long-term health. Personalized information about our own biology is the future of medicine, which is why I'm so excited to share my conversation with Dr. Sharon Hausman-Cohen with you today. Now, let's dive in. Well, Sharon, welcome to the Doctor's Farmacy podcast. It's so great to have you here and to talk about something that most of us have no clue about. It doesn't make much sense, which is genetics, genomics, the omics revolution, our individual variations, what we can do about it. We're going to get all into the deep story of what we need to know in this new era of genomic medicine. So welcome.

Dr. Sharon Hausman-Cohen: Thank you. Thank you for having me.

Dr. Mark Hyman: So before we get started, I want to kind of just set the table because I think most people don't have a clue about DNA. I certainly didn't, and even after medical school, I don't think I really understood it despite having studied genetics in medical school and what's happened over the last 30 years is just nothing short of a revolution. I mean, I remember that the human genome wasn't even decoded until about 15 years or more after I was in medical school. So even when I was in medical school, and I guess I'm old now, not that old, I was completely clueless about this because there wasn't even the science about it. So lemme just set the table for everybody and help you understand what is DNA, what does it do? Why is it important? Why are we having this conversation with Sharon about the work she's doing to help us understand how to personalize and individualize our lifestyle, our diet, our habits, our exercise, how to optimize our genes?

Dr. Mark Hyman: How do we think about this? So what are genes? What are genes? Well, you've got chromosomes which are essentially inherited from your mom and your dad. You get 23 pairs from your mom, 23, I'm sorry, 20 chromosomes from your mom, 20 from your dad. That's 46 chromosomes, 23 pairs of chromosomes. And the chromosomes contain genes. You have about 20,000 genes or so. You can correct me if I'm wrong, and the number keeps changing, which is not that much different than an earthworm, but clearly we're different than an earthworm. What makes us so different is this incredible variety in our genetic code. So we may have variations in the code we call SNPs or single nucleotide polymorphism. So basically you're thinking about your genes as a software or maybe hardware depending how you think about it. But your genes are pretty fixed according to this code that is made up of four letters.

Dr. Mark Hyman: So your computer is a one and zero. It's a two letter code, a binary code. Your DA is a quaternary code. It's like letters that combine into different genes. And usually a gene is a three letter combination and it's like a CTG, and they stand for, they're different nucleotides. We're not getting into the names. It doesn't matter. But anyway, the point is that there are a lot of variations in these genes in humans. So while there may be 20,000 genes, there may be five to 7 million variations in these genes that affect the function of those genes. So what do genes do? Genes make proteins. They assemble amino acids into strings that form proteins. And those proteins can be structural proteins. They can be immune proteins, they can be regulatory proteins. They can basically do everything. The information is super highway is essentially proteins in your body.

Dr. Mark Hyman: They're controlling everything, and that's why your DNA is so important. And what we do is come into life with a certain set of fixed letters or code, but what we don't often realize is that we can influence the expression of that code. Just like let's say you have a software program on your computer like Microsoft Word. Well, you probably don't have a clue about most of the stuff it does. You can do spell check, you can do word count, you can do all that font colors, but there's a million functions that we don't even know most of us how to operate. Certainly don't. I've been using Microsoft Word for 20 years. So the influence of our lifestyle, our diet, exercise, stress, environmental, toxins, what we call the exposome, regulates our gene expression and turns on or off different genes or it turns 'em up or down and regulates what they do and affects our health.

Dr. Mark Hyman: And so while we may have predispositions, we're not predestined to most of the things we see. Oh, my family has diabetes or cancer or heart disease or dementia. You don't necessarily have to get them. The great example I use of this is the Pima Indians who a hundred years ago or hundred years ago had no diabetes, no obesity, no heart disease. They've lived their traditional lifestyle, but they were highly predisposed when given a high star sugar diet to get diabetes. So now they're the most obese population outside of Samoa in the world. 80% get diabetes by the time they're 30, their life expectancy is 46. So do they have the diabetes gene? Well, kind of, but not really. They have the predisposition gene. So we're going to talk about how today, how we can understand what our predispositions are, how we can understand our unique genetic code and how we can use that to optimize our health at every level.

Dr. Mark Hyman: And I learned a lot about this as a practicing physician. I've used this with my patients for decades. I keep learning more and more as we understand genetics more and more. So it used to be I was like, I think 3 billion for the first decoding of the human genome. Maybe one guy did it for million. A lot of money. Now you can get it done for under thousand dollars for entire genome. And we can also more specifically look at not just your whole genome sequence. A lot of stuff that just we didn't even know about it doesn't make sense is specific genes that we know are common in the population that we can influence by how we live and what we do that are relevant for different conditions and that are modifiable. And so that's what we're going to talk about today, and that's what Sharon has spent her life focusing on, which is this entire field of genomics and genetics and how we begin to unpack that in a way that is usable.

Dr. Mark Hyman: And by the way, everybody, we're just on the verge of a revolutionary medicine where the enormous amounts of data that we're going to be able to collect on us, I mean, think about it. When you go to the doctor, you don't get 7 million blood tests. But when you get your genes done, that's just forget about your microbiome. There's probably a hundred times as much DNA material in our microbiome as our own DNA, right? So there's a whole nother level of meta information that is regulating our biology. If we understand our own unique genetic variations, we're going to be able to actually map this out with machine learning and AI that's coming and have insights into what's going on about how to personalize our approach. And this whole area of personalized medicine, personalized nutrition, personalized supplements, personalized microbiome support, personalized everything. Medication is really here. And Sharon, you're at the forefront of this.

Dr. Mark Hyman: And just full of transparency, everybody, I have no relationship with business life with Sharon. I did the test that our company provides. It's SX DNAI was fascinated by it. It was far more in depth than most of the genetic tests that I've done before. And we had a chance to go through. We're not unpack some of my own problems, let's say, or predispositions and explain some my own health challenges that I've had and kind of go into all that. So I hope I set the stage right. Sharon, you can add in here or jump in if anything I didn't get right or if you want to amplify anything I said, please do. But I think I just wanted to kind of give people a level set up what's going on here with our genes.

Dr. Sharon Hausman-Cohen: Yeah, I think you gave a lot of great information. I do want to kind of flush out two things. One, genetics and genomics. When you and I were in medical school, because we're pretty much the same generation, there was no genomics, only genetics. And genetics is the study of inherited diseases. That's why you didn't get genomics is it wasn't invented yet. But genetics is things like sickle cell disease, cystic fibrosis, Huntington's. It's a disease that if your mom and dad each are either carriers or you get one copy or two copies of the affected gene, depending on the particular disease, you're going to get the disease. But that's not how chronic disease works. So you mentioned diabetes, things like diabetes, heart disease, cognitive decline, depression, anxiety, autism. They're not caused by any one gene variant. There is no diabetes gene. There are actually over a thousand genes that contribute to diabetes and many hundred that contribute to heart disease, but there's probably about 20 or 30 that are the main contributors that increase the risk or decrease the risk more than 20%. And those are the ones that my research has focused on. So you take that group of the Pima Indians and maybe they have a gene like FTO, which is a pretty well-known gene, that is kind of your metabolic switch. It turns on a hundred other genes that relate to your metabolism and exercise and fat have big interactions on that, particularly exercise. But maybe there's another population that has a gene that's called TCF seven L two, which codes for incretin. And not to get too technical, but incretin

Dr. Mark Hyman: Is what?

Dr. Sharon Hausman-Cohen: Yeah, but it's basically a hormone released from your gut that tells your pancreas there's incoming carbohydrates, release insulin. Well, if you can't make insulin, then your blood sugar's high because it can't get from the blood into the cells and you can't handle carbohydrates. And there's dozens and dozens of other gene variants that contribute to diabetes. So the same thing again, is true for heart disease cognition and what the study of genomics is, and what our research has been is figuring out what do those gene variants do and then how we can modulate 'em. And you talked about expression, sometimes you can up or down regulate expression with your diet, sometimes with supplements, and sometimes you might not be able to affect the expression of that gene, but you can address downstream pathways. So if you know that somebody's really bad at transporting B12 to their brain, we can flood the system with b12. So we really have had great success at precision medicine and improving outcomes in chronic disease by understanding what are the root causes.

Dr. Mark Hyman: I think it's so important what you just said, Sharon, that chronic disease and hair genetic diseases are quite different. I have deafness in my family. My grandmother was deaf and she had three other deaf siblings, so that was a recessive gene. So the mother and the father, my basically great grandmother and great grandfather had each had somewhere in their genetics copy of this. And they had nine kids and four of were deaf. That's an inherited genetic disorder. Thank God. I don't know any deaf kids, but things like diabetes or heart disease are different. And for reason, my grandfather was a great example of that. Everybody in his family had heart disease, all these nine brothers and sisters, and they all had bypasses and angioplasties in their fifties, heart attacks in their fifties. And he was great. And why? Because he was a laborer and he walked every night after dinner and he was deaf and he wasn't that educated.

Dr. Mark Hyman: So he didn't have a desk job. He had to use his body all the time, well, in his eighties before it really affected him. And then I was like, well, I'm pretty healthy. I'm just going to check my stuff. And I've been following my numbers. And actually I do have an inherited lipid disorder, and I do have a higher absorption of cholesterol from my gut after it's secreted by my bile. I have certain genes related to triglycerides that affect my risk for heart disease. I have certain genes that increase my risk of heart disease that I wasn't even aware of that I can see by looking at these. And what's really interesting is it's not just one gene. We're looking at it's patterns of genes, right? It's clusters of genes that put you at risk. And you might have three or four genes that put you at high risk, but you might have three or four others that actually really reduce your risk.

Dr. Mark Hyman: So it kind of levels out or you might not. So it's really interesting to see the whole pattern of your genes, and that's why your work is so important because a lot of people are in this space of genomics and genomic testing. But you've really done some really interesting things by creating a map with your company of a wide variety of genes, some of which are tested by other companies, but they actually have a much deeper look and also a much deeper look at what the things we know about what influence each of these genes. So these gene variants are called SNPs, right? They're single nucleotide polymorphisms. And what that means is one of the nucleotides, the A CTG is different. So think about it like a spelling kind of variation. If you're from Britain or I went to med school in Canada, color is spelled C-L-O-U-R. Here, it's spelled C-O-L-O-R. Sort of the same but a little different. And it's not a mutation, it's just a variation. But that snip can put you at particularly a risk. So can you explain this whole idea of polygenic risk and what that is and why we need to be thinking about not just one gene or one risk factor, but looking at these collectively?

Dr. Sharon Hausman-Cohen: Absolutely. So a polygenic risk is just another way of saying that chronic disease, there is no one gene. You get the risk from so many things. And there's a problem though with polygenic risk scores. So we'll talk about polygenic risk, but then we'll talk about the problem with the system when people get a polygenic risk score. So if you take the topic of cognition, for example, if you're going to look at a polygenic risk score for Alzheimer's, it's going to include a POE four. It's going to include some genes that affect amyloid processing and some other specific genes that affect mitochondria and on and on. And a polygenic risk score might actually include over a hundred different gene variants, but it's only gene variants associated with Alzheimer's, and it doesn't tell you what to do about it. So we don't include everything that's in the polygenic risk score.

Dr. Sharon Hausman-Cohen: We include the most important and the ones that the gene function is known and modifiable because to tell someone that you have this gene that's called LOC one seven, blah, blah, blah, and we don't know what it does, but we know it increases the risk of Alzheimer's, that's not useful information. So we take the genes that we know what they do or that in the literature it's been shown and we figure out how to modify 'em. But there's another really important factor. If you look at a polygenic risk score for Alzheimer's, it's not going to include the detox genes. It's not going to include the genes that affect brain ischemia that can contribute to stroke risk, either because they increase the risk of AFib or they make you have atrial fibrillation. It makes little clots go to the brain or that affect the clotting in your brain, which is a big factor after covid.

Dr. Sharon Hausman-Cohen: People who are more prone to micro clots are getting brain fog or it's not going to include all the inflammatory pathways. And you and I both know that inflammation is involved in everything in heart disease and diabetes and cognition and autism. And so we took a different approach. We do look at a multitude of different gene variants, but we look at the nutrients, we look at detox, we look at inflammation, we look at gut with every single patient, and then depending on what they and their doctor are working on, we look at the genes related to chronic disease or the genes related to autism or the genes related to brain health. And even with autism, you also have to look at the genes that are related to things like pandas and pans. And so we've had a really great success, especially combined with the functional and integrative knowledge that we have so many doctors now being trained on at not only untangling people who come in with cognitive decline and been told there's, there's nothing you can do about it, but also people who have mystery type illnesses, the person who's having pain that you can't understand.

Dr. Sharon Hausman-Cohen: And then what our research team has done is we have spent the time figuring out what can you do to modify that gene? So if it's a TNF alpha gene, there's a TNF alpha, which is a bad kind of inflammation that crosses the blood-brain barrier and also affects autoimmune. There's a gene that's in the promoter, which is the on-off switch makes you get four to five times more TNF alpha in your brain whenever it's triggered. Well, you can do things to turn off the promoter and turn off TNF alpha, but you can also do things that affect the master inflammatory switch. So you can look at genomics and epigenetics more broadly and look at co-factors. If you have a detox pathway that relies on selenium and it's not working well, well, you don't want to be short on selenium. So we let patient and physician know, make sure you optimize these co-factors. Make sure you optimize this. Make sure if you have high TNF alpha, you can use Lion's Maine, you can use allop poly manno. So we give specific from the literature what you can do for each gene variant. And I think that's what makes INTE DNA unique.

Dr. Mark Hyman: I think that's right. I think it's to sort of back up a little bit, the ability to kind of personalize it so important. But in the thinking about this, I want people to understand that your genes are fixed. You can't really change your genetic code. You might do gene editing in the future. There may be ways we can hack

Dr. Sharon Hausman-Cohen: Yet unless you have sickle cell, but we're getting there. Yeah.

Dr. Mark Hyman: Yeah. Sickle cell, right? That's almost right. I think was approved or just about be approved for

Dr. Sharon Hausman-Cohen: Cell. Yeah, they have some studies going on, and the F already had some people that have had their sickle cell genes edited out, which is amazing. A couple things from,

Dr. Mark Hyman: Yeah, which it's incredible. Imagine editing out the cystic fibrosis gene. I mean, this is really huge advances, but this affects, these are less than 1% of diseases, these inherited genetic, autosomal dominant recessive disorders. This is like Mendel's peas. This is not stuff that we're really digging into now, but what's important to understand is that while your code is fixed, it's like the keys on a piano, maybe 88 keys. But think about what that piano can do. It can play. Boats are, it can play jazz, it can play reggae, it can play rock, it can play classical, every kind of potential music just from a keys. So think about your life washing over your jeans as the piano player. Everything you do, everybody, the food you take, how you exercise, a lot of stress you have, or how you manage it, where you live, your social connections, your microbiome, environmental toxins, everything influences the expression of those genes like playing the score of your music.

Dr. Mark Hyman: That's the song of you and your life. And that is changeable. And that is called the Exposome. And essentially, Sharon, I think that's what Intes DNA is focused on is how can we modify the exposome to change the regulation expression of these genes to reduce their impact and a adverse impact or to optimize their function in ways that protect us. This is really an important concept, and I think we're going to get into the weeds a little bit, but I want to set the stage here because I think most people don't understand the power. We have to modify and regulate our expression and change our trajectory even if we have predispositions, even if you're a Pima Indian and you are at risk for type two diabetes at a rate far greater than most populations on the planet, you never have to get type two diabetes if you follow the right approach to regulating your gene expression, which they did naturally through their evolution in living in the desert in Arizona. So I think this is such a key point,

Dr. Sharon Hausman-Cohen: And I think that if I had access to a Pima Indians genomics, I would be able to say, okay, well, this is what's going on. Because it's not all about medicine. It's not all about diet. It's not all about supplements. It's not all about lifestyle. It's all of the above trying to avoid medicine if we get things early. So there's one gene that I had mentioned FTO, well, they've actually shown that the best thing to upregulate that when you have low expression of that is intense exercise. It does better than any supplement. And so that's one group of people, but then there are other genes that whey protein can upregulate. There are other genes that berberine can affect and that affect cold plunges can affect. And so again, the cool thing about genomics is everybody wants to get their diabetes under control if they're starting to pre-diabetes or get their heart risk down or get their cognition optimized. But we can say for this particular person, if you're only going to do six things or four things, here's the top for you. That would help.

Dr. Mark Hyman: So that cold plunge I did this morning, maybe it will help me prevent problems with my blood sugar. So I want to dive into the work you're doing around dementia. This is such a big issue, and I've personally seen some fascinating things about this. You're working with Del Bresson to look at the DNA of patients with complex illnesses and dementia. There's 7 million people in America who have dementia. They're probably going up to 15, 16 million, not too long. Future. There's 55 million people worldwide. It's the most expensive condition that we have, more than cancer, heart disease to deal with in America. And it's a terrifying disease. And I see it increasing. And I just want to share a story that I think I want to set the stage because I think this story, I did not really know about all these sort of relationships, but I was just sort of hunting for why my patient had dementia in functional medicine, it's always about the why.

Dr. Mark Hyman: And so we did deep dive into so many different aspects of his biology. We also measured a bunch of sns. Now, what's really interesting is that to me is that if you pay close attention when you look at people's genetic predispositions and then you follow it up with their life history, medical history, and biomarker testing, basically lab testing, you can see the expression of those genes and you can change the expression of those genes and see the changes in the lab results, which is quite interesting to me. Like the utmost obvious one is if you have a methylation problem, which is you can't regulate this particular gene, well, which are the set of genes that affects your methylation process, you need certain types or more B vitamins. You can actually have a high level of a marker called cysteine in your blood. You can take the vitamins, it reduces that, and you normalize the expression or you mitigate the risk from that gene.

Dr. Mark Hyman: Now, this patient was 70 years old and he had pretty significant dementia. So I would say not pre dementia, but sort of mild to moderate dementia and was sort of going downhill fast. And I'm like, listen, I dunno if I can help you. This is like 15, 16 maybe, I dunno, 17, 18 years ago. So it was quite a while ago, maybe longer. No, it was probably like 20 years ago actually. Now I think about it. And I was saying, let's check your genes. Let's check all the risk factors. And we found he had a collection of genes that I think were high risk. So one, he had APOE four four, which is an Alzheimer's risk gene. And that's one measure. Now test pretty easily. And it's important because it dramatically increases your risk. It doesn't mean you're going to get it, it just means you're much higher risk in the average population, maybe 10 times.

Dr. Mark Hyman: He also had methylation genes, which is a gene that infects methylation. He had two copies of this MTFR polymorphism. He had impaired glutathione genes, GSTM one, which is the gene that regulates glutathione in the main detoxifier in the body. And he also had gene, a CTP gene, which is cholesterol ster transfer protein, which affects your cholesterol, lipid metabolism. Now, I never saw this collection before in a dementia patient. I was seeing it for the first time. I was like, well, this makes sense. He's got the risk for genes. He's not methylating. We know homocysteine is high in dementia patients. We know that toxins can have an impact. He's not good at detoxifying. And we know that metabolic and lipid problems can also contribute to risk. And when we looked at his biomarkers, he had extremely high levels of mercury. He couldn't detoxify it, methylate and sulfate.

Dr. Mark Hyman: He had really high levels of problems with, oh, sorry, what was I thinking? Blanked out. Yeah, he had really abnormal lipids. He had severe insulin resistance to lipidemia, so he had a terrible microbiome On top of that, he had, like I said, really low glutathione, high load of heavy metals. And so all these things I began to treat. So I didn't treat his dementia. All I did was help him get rid of heavy metals. I optimized his gut, I improved his methylation patterns. I helped regulate his metabolic health with prediabetes. And his cognitive function dramatically improved. He kind lost the diagnosis of dementia. You see cancer survivors, but you don't see dementia survivors, right? Well, we're started to see

Dr. Sharon Hausman-Cohen: A lot more of them. We've definitely seeing more.

Dr. Mark Hyman: What this taught me was that by understanding someone's genomics and their SNPs and their expression, that we can modify their biology in such a way to reverse the course of some really serious illnesses. And I want you to now dive into what you're learning with Dale Bresson and the work you're doing with his dementia patients, what you're seeing and what you're learning through the extensive testing you're doing.

Dr. Sharon Hausman-Cohen: So what we're learning is there's a lot of gene gene interactions and that people, initially when Dale came up with the different hypotheses of dementia, he talked about the sweet, he talked about the toxic, the different combinations. But really when you get it down to the gene level, it's more like 400 different combinations. And so the person that you were talking about that GSTT one gene is missing in 20% of the population, it's just completely gone. So that really affects their ability to get rid of a lot of the mercury and some of the other toxins. Half the population could be missing a GS TM one. And when you have that combined with a OE four, it can make the risk five times higher for dementia. When you have it combined with an A O four four, and even with an A four, it can triple their risk.

Dr. Sharon Hausman-Cohen: So being able to get rid of the TOXs is important. When you talk about M-T-H-F-R-M-T-H-F-R doesn't increase the risk of dementia that much, just about 14%. But when you combine it with problems with certain inflammatory pathways like IL six, it can more than triple the risk of vascular dementia. So this gentleman that you had talked about that had high cholesterol and M-T-H-F-R, he probably had a vascular dementia component. And by getting rid of his detox risk, his vascular risks, you get dramatic improvement. With the work with Dr. Brein we're the genomics that's being used in his current study, the Anthea trial, but he also in the publication that was in the Journal of Alzheimer's last year where they're taking patients, they're using a variety of modalities of testing, but using inx DNA genomics to help get a deeper understanding. And what they're finding is, again, if you optimize, there's certain things you can do for a E four individuals.

Dr. Sharon Hausman-Cohen: A E four individuals don't use sugar well in the absence of estrogen. And so that's really important to get them on a keto diet, or at least as close to it as you can, a very low low glycemic index diet. But when you also understand what else is going on with their detox, with their inflammation, with their different nutrients, you can then kind of prioritize. Rather than saying, take these 30 different supplements, you can say, oh, okay, you don't make choline well, so we need ccho for you because choline is really important for insulating the nerves so they fire well and you make too much of this particular kind of inflammation. And it's not that one supplement would work for inflammation, for cognition because some people make too much interleukin one and interleukin one alpha and beta inflammation, and that dramatically affects Alzheimer's risks. Other people make TNF alpha inflammation. Other people make this other type. And it's kind of like if I were to say to you as a physician, Hey, I want you to go treat my patient with an infection in room three. And you would say, well, what kind of infection do they? What infection? Yeah. And is it Lyme? Is it a virus? Is it bacteria? And if it's a bacteria, which kind? Well, we're getting that kind of granularity with inflammation because there's this inflammation that responds to poid that's in about 8% of the population. There's

Dr. Mark Hyman: Inflammation that's in chocolate, right? No. Is that in chocolate?

Dr. Sharon Hausman-Cohen: Well, endocannabinoids. So endocannabinoid inflammation, which, and you do get some anandamide. You get endocannabinoids. But yeah, it works on a couple of pathways. But you're right, it does work on the endocannabinoid pathways, which is where chocolate works. But there's also inflammation like interleukin one alpha and beta that's more sulforaphane and cetin and curcumin. And again, like I said, TNF alpha is different things, and I don't want to make it alphabet soup, but the idea is we can take it to a much more granular level. And there were people that were coming into the study, they had read Dr. Breen's book, started on the protocol of 2030 things, and then when their genomics were back, it was clear that their risk for dementia was more about hypercoagulability. So then you're going to use, which is a fancy word for your blood, getting thick and making clots too easily.

Dr. Sharon Hausman-Cohen: So they were switched to things like pycnogenol, which comes from pine bark and has been used in studies to help prevent D vts things like nattokinase or lumbo kinase. And their cognition got dramatically better because you were addressing the root cause. So the exciting thing about dementia is if you look at dementia publications, they've shown that even a very experienced neurologist is going to mislabel people as Alzheimer's more than 30% of the time. And the reason for that is because Alzheimer's is more of a after you die diagnosis based on what the brain looks like, and you can have more than one thing going on. So by knowing what's going on with inflammation, detox nutrients, cardiovascular risk clotting, you can really help a lot. We never would promise that we're going to get everyone with cognitive decline. Well, but when people come to us to a doctor using inx, DNA that have early memory loss, mild cognitive impairment, early dementia, we are having very significant percent of the people get dramatically better or anywhere from mildly better to dramatically better there. Of course, there's some people that don't get better. It depends on what's going on. But the fact that we're making progress is really exciting. And brain disease in general, because you were talked about being able to measure the blood and see what's going on, and that works pretty well for cardiometabolic, but because of the blood brain barrier, it doesn't really work as well for depression, for anxiety, for autism, for cognitive decline. So genomics can give you a window into what's going on with the brain with just a cheek swab. And that's a big plus.

Dr. Mark Hyman: It's kind of a miracle, right? You just take a little Q-tip, roll around your cheek and get all this information your gene.

Dr. Sharon Hausman-Cohen: It really is amazing.

Dr. Mark Hyman: It's pretty miraculous. We have come so far. I think what you're saying is just so critically important is that these conditions that we label in the medicine as Alzheimer's or diabetes or this or that autoimmune disease, whatever the date disease is, are very heterogeneous, meaning they're very different. There's no such thing as dementia or Alzheimer's, highly variable within any diagnostic group. And we label people in medicine according to their symptoms. That's how you get a diagnosis in medicine, not according to the causes or the unique genetics. And we're moving away from that. And this is whether you call it network medicine, systems medicine, root cause medicine, functional medicine, I don't care what you call it. This is where we're all going. And I think that the work that you're doing is sort of highlighting how we can't ignore this anymore. And what you're saying, I don't want to sort of skip over it because it's one thing to say, well, if you have diabetes and you don't need sugar and starch and you exercise, your diabetes is going to get better, go away.

Dr. Mark Hyman: Okay, I get that. You lose a hundred pounds, whatever, I'll get better. But you're talking about a condition where we've spent designation over $2 billion, probably more by now, over 400 plus studies with really zero, I would say zero benefit. There are a few drugs here and there that are approved, and essentially they either don't work like Aricept or they might slightly delay the admission to nursing home by a few months. That's considered a wildly successful drug that we're willing to spend tens of thousands of dollars a year on, which is just to me insane. And we're looking up the wrong tree or barking up the wrong tree or digging in the wrong hole or whatever we're doing to find the answers. And the answer is really lie to try in understanding the heterogeneity or the variations in these problems, partly informed by the genomics and the snip testing and metabolic testing and all the things like this guy I tested.

Dr. Mark Hyman: There was one case, I don't think everybody I see with dementia has high mercury or has same gut issues. He has or say has the same levels of metabolic dysfunction that he had, but there are commonalities. And so we begin to see patterns and we begin to see these connections. And so what you're saying is you're taking people using this methodology and you're helping them not only slow, but even reverse and significantly reverse cognitive decline, which is something that we just don't see in medicine, right? It's like it just doesn't exist and yet it's happening. And I think it's happening on the margins. It's mostly dismissed by traditional medicine and neurology, but we're starting to kind of collect data and show the evidence. People like Richard Isaac from Cornell has done studies looking at multimodal interventions that are personalized to each person's cognitive decline and using just to show not only slow but improvement, there are finger trials, large scale lifestyle intervention trials and risk management trials where they optimize risk factors and they improve lifestyle.

Dr. Mark Hyman: And they see that just slowing, but actually reversal of cognitive decline. There's no drug that can do this. So we're not going to find the answer by finding the single pathway or the single drug or the single nutrient or the single intervention that works. It's going to be understanding the complexity and being able to work with that complexity. And that's what I think you're bringing to light, Sharon, is this incredible complexity that we now can see into and use to modify our own behavior, lifestyle and wellbeing and prevent things. For example, I was just watching the news. I don't watch the news, but I was reading something and it was about Chris Hemsworth and he has a OE oh four and he's a young guy, an actor super fit, but he's got the highest risk Alzheimer's gene, but that doesn't mean he's going to get it.

Dr. Mark Hyman: And so I wish someone would tell 'em, Hey, here's what you need to really look at. Here's all the other genes that play a role. Here's all the other factors that we need to look at with your health. We need to do a toxin screen. Look at your gut. We need to look at your metabolic health. You need to look at your nutrient steps. We need to look at all your steps, and then we need to modify what you're doing based on that to regulate and optimize your biology so that you don't end up with having a problem. So beautiful about this.

Dr. Sharon Hausman-Cohen: I agree. I mean, I have an A POE four four patient who is 81 years old who's in the 89th percentile for cognition for her age. That's amazing. And I have a couple of a APOE four fours that are doing really great, but again, in their seventies and eighties. And I also think we don't want to just focus on people who are seniors.

Dr. Mark Hyman: Yeah, sorry. Sorry to interrupt. It just reminded me of this patient. She was like 93 years old. She used to come see me at Canyon Ranch. She was a dentist, she was still working. She was a POE double four. She was sharp as a T. Now, I'm not sure I want her drilling in my mouth in 93, but she was going and she was focused on her health her whole life. She exercised, she ate well, she took her vitamins and she was fine.

Dr. Sharon Hausman-Cohen: It's also about what genes, so two things. One, it's also about what genes you don't have. It's not just the diet and lifestyle. There are some APOE four fours that are at a lot lower risk than others because of genes that they have that relate that are beneficial genes. So just like there's negative genes, there's some clue and some that relate to other pathways that help you clear amyloid more that are benefits. Sometimes if you have an a e four and you don't have certain other things with it, like certain mitochondrial genes with it or certain genes that relate to detox, that can have an effect. So I think it's both, but we've been talking a lot about cognition and brain science and people who are in fifties and sixties start to get very worried about memory seventies, eighties. But I think that the other area that genomics can be really helpful with is we're facing a mental health epidemic in the United States.

Dr. Sharon Hausman-Cohen: I mean it's like 20 some percent of children or more depending on the age group that are on medicines or have diagnoses of A DHD, of anxiety, of neurodivergence and those when you have any kind of a disease where it's kind of gone like this to this, which is what we've seen. We've had escalation and doubling and tripling and even more increased risk in autism. But also again in anxiety, depression, A DHD, that's not a gene that is a multitude. It's not one gene. It's a multitude of genes interacting with environment, diet, lifestyle. So we've had kids that they're diagnosed with A D, HD, but really it's that they need more magnesium, they need more vitamin C because they can't recycle vitamin C. And vitamin C is the co-factor for making the main brain chemical that you use for focus norepinephrine, which is for focus and motivation.

Dr. Sharon Hausman-Cohen: Or maybe they have a genetic pathway that relates to auditory processing that makes it harder for them to learn with auditory processing. Well, what do we do in our classrooms? We put them and make 'em listen all day. So for those kids, if they know they have problems with auditory processing, there are things that can help that. Gene, oxytocin helps, GABA helps, but you can also educate the child and say, okay, you need to take notes. I've had eight year olds instructed to take notes. Basically they're drawing pictures and writing words, listening to the teacher just so they can get other pathways involved. And with anxiety, we've had kids that the main missing piece was, for example, they didn't make their brain chemicals. Well, they didn't make something called tetra hydro terin, which you need for serotonin, you need for everything. So I feel like if we can switch to a precision medicine approach to each child, we can also overcome some of this label the kids and this sickness epidemic and let children be healthy.

Dr. Sharon Hausman-Cohen: You have talked, I've heard you speak because a number of times, but you've talked about how our nutrients in our soil have changed and in our food supply, and there's one of the genes that's highest risk for developmental disorders and autism that's in 5% of the population that the difference between you being a cardiologist or a PhD versus having intellectual disability and being floppy and not speaking well is how much zinc you got when you were younger. And we have, yeah, it's crazy. And we actually have a whole paper on that gene and how we figured out how to modulate it, but it's called shank three. But the way we figured out that it had to be modulated is we were doing the genomics and we had kids with two copies of this gene or one copy of this gene that had pretty significant autism.

Dr. Sharon Hausman-Cohen: It's in the literature with autism and supposedly intellectual disability, but it affects their ability to speak. So do we measure intellect? And yet the mother or the father was a professional with 20 some years of education and we're like, wait a second, they have the gene as well. There have to be things we can do about it. So my goal is that we start to not label kids, don't give them the label of A DHD, don't give 'em the label of anxiety or autism. Let's figure out what's going on and see if we can't improve their foundation with gut of course as well, detox and all the contributing factors and kind of help them live a healthy life. And again, I care about adults as well, obviously, but I think we need to

Dr. Mark Hyman: It's true, it's true. The kids, it's so important because they're setting the stage for their whole life. And I had the privilege of taking care of people from all ages, from autism to Alzheimer's. And what was often striking to me was that they were very similar. The profiles to genetic profiles of those with Alzheimer's and autism were actually very similar. They had a lot of the same methylation problems, glutathione problems, inflammatory genes. I was like, wow, this is really interesting. This is not something I saw in the literature 20 years ago. Just stuff that I started noticing. And I was like, well, this is something here. And I think now we're having much more data, much more science around what's going on and we're going to keep learning more and more and more. And there's stuff that we don't even know. We dunno yet. So I think we're going to just keep improving and expanding what we're doing.

Dr. Mark Hyman: I think the whole mental health issue is such a big factor. The biggest burden economically in society. It's the biggest source of disability, depression, anxiety, and the whole spectrum of mental health disorders and disease of despair. And partly it's related to our diet and the lifestyle, environmental toxins and how those influence our genes. But also there are interesting genes that you see pop up. For example, there's genes that look at dopamine receptors and appetite regulation that make it clear, well why does this person binge on this stuff? Or why does this person can't control their behavior? Why are they so addictive? And I'm like, well, I could never eat a whole sheet cake, but there's some people that can eat a whole sheet cake. I just wouldn't happen to me. And they have different genes and it's just fascinating to see this. And it actually maps out when I take their story as a doctor, I take their medical history and then I see their gene. I'm like, oh, this makes sense. It's so interesting. I had somebody actually yesterday that was just like that. I was like, wow, this so makes sense.

Dr. Sharon Hausman-Cohen: It is. It's fascinating. I had a patient and she was struggling with her weight. She had gained like 40 pounds and her obesity panel, we divide things into panels. So there's cardiac disease, diabetes, obesity. Her obesity panel wasn't that bad. And so then we opened up more of her mental health report and she had tons of genes relating to addiction and high glutamate and high dopamine and that will create different behaviors. And I was like, do you by any chance think you might have a food addiction? And we found that she was at night watching a movie and eating a whole bag of whatever snack it was. And when we gave her knack and made her aware of the food addiction, she was able to lose weight again. So it's

Dr. Mark Hyman: Fun. Yeah, it's amazing.

Dr. Sharon Hausman-Cohen: Do you want to talk a little bit about some of the things we me learned from your genomic? Just nothing too revealing. Yeah, I was going

Dr. Mark Hyman: To get there. I was going to get there. So this is all set up and I think now hopefully you understand a little bit about our DNA, the idea of variations in our DNA, why it's important to measure them, how they can be modified, how your risks are not predetermined, but you might have a predisposition but you're not predestined to various problems that even in things like Alzheimer's or autism that can be modified. This is really exciting stuff. And I came into this field because it was always just a nutrition help and wellness, but I ended up getting chronic fatigue syndrome after living in China. And I lived in China and I lived there through the winter for over a year. And I dunno if you've ever been to China, but you could look out your window on a sunny, bright day and literally could not see the building across the street.

Dr. Mark Hyman: The air is thick with pollution and it's petrochemicals, it's mercury, it's lead. I literally had a patient yesterday who had really high blood levels just from being in China. I was like, I've never seen anything like it. You don't see high blood levels in adults unless they're eating paint chips or I dunno what they're doing. So she had extremely high levels and I actually learned about my own genetics back then. I learned some of my own variations, but we did a deeper panel and you helped me kind of understand some of the things that put me at risk and why I ended up with chronic fatigue and why I ended up with mitochondrial dysfunction and why I struggled so much and how, I mean the silver lining that is it made me figure out functional medicine and heal myself and help a lot of people. It was a painful process. I wish I'd kind of met you almost 30 years ago when all this happened. So can you talk about what you found in my tests and what my gene showed and kind of the things that were insights that you had that could help me optimize my own genetic expression and my risk of having more problems?

Dr. Sharon Hausman-Cohen: I think that two of the interesting topics were the detox and also the osteoporosis. And I think those would be fun to talk about. So the detox, you obviously have made it known that you got the chronic fatigue and felt horrible with China and thought that a lot of it was mercury and obviously there is a lot of mercury there. And of course I think mercury is a part of it. But then when we looked at your pathway that related to the glutathione related detox with the mercury related pathways, they really weren't so bad. You've got a few snips that, but when we opened up your pathway that related to more air pollution, it was horrible. You had where in the 7% of the population that really converts air pollution into a more toxic chemicals and can't eliminate it. And so that's going to change if you were my patient, how I would tell you to maintain yourself as you're traveling because that particular gene is actually an overactive gene, not an underactive.

Dr. Sharon Hausman-Cohen: People get an idea that if you have a snip, it must make it so the gene doesn't work. Yeah, no, but having overactive genes is a problem as well. And it's called CYP one B one and that it's a particular variant. You can't just look for a gene name, you have to know what location. And for CYP one B one, you can make it less active with resveratrol, with terrace still beans. So resveratrol is from red grapes, Tara, still beans from blueberries, hesper certain flavanoids. It also though makes it much harder for you to get rid of alcohol and smoke exposure. So India and China might not be the best places to vacation for

Dr. Mark Hyman: You. Yeah, I think I'm good with that. Yeah.

Dr. Sharon Hausman-Cohen: And then you also

Dr. Mark Hyman: Have, so you're, you're saying one B one basically sort of metabolizes these toxins, but then it kind of creates oxidative pathways, the radicals from them and it makes me more sick. Is that what you're saying?

Dr. Sharon Hausman-Cohen: Right. And so makes them so that you, people who have this are known to have increased sensitivity to the aromatic hydrocarbons, which is a fancy word for air pollution and smoke. And it's also more carcinogenic for them. And I think you and I talked a little bit about you have this and you also have a snip called PON one that affects the ability to clear pesticides. But because of some of the detox genes that you have, if you do kind of ignore it, it gives you a higher risk for lymphoma. So it's not just a, oh, I don't want to feel tired, my sister. Yeah, I wasn't going to say that. That would be

Dr. Mark Hyman: My sister had

Dr. Sharon Hausman-Cohen: Feels comfortable. But I remember we were going through it and I said, okay, this gene pattern that you have in the literature is associated with more than three times the risk, more than a 200% increased risk of lymphoma. And you said, well, what type? And I said, and that's when you said, yeah, that runs

Dr. Mark Hyman: Exactly what my sister had.

Dr. Sharon Hausman-Cohen: So again, for you resveratrol would be one of the things that I would say should be in your daily kind of pathway

Dr. Mark Hyman: Of, so drink a bottle of wine a day, is that what you're saying? You'd

Dr. Sharon Hausman-Cohen: Probably be better off using a long-acting resveratrol supplement because

Dr. Mark Hyman: Ones

Dr. Sharon Hausman-Cohen: Not so great for metabolizing. You're also not good at your anti-inflammatory pathway so that we have genes that make you have more inflammation and we have gene products that make you have less. And the main one that makes you have less is called IL 10. Well, 7% of the population don't make enough IL 10. And you are in that 7%. So I would also tell you you're going to get more sleep.

Dr. Mark Hyman: So IL 10 is one of the cytokines that's actually helps reduce inflammation, right? Correct. So it's not like a break on the inflammation. All cytokines aren't inflammatory. We learned that from covid about cytokines, but they're not all bad. They actually modulate your immune system. So this is a good one that helps reduce inflammation

Dr. Sharon Hausman-Cohen: And that checks balance. I

Dr. Mark Hyman: Can't do checks

Dr. Sharon Hausman-Cohen: Balance and that checks and balance is really important for everything from widespread pain. So what we call fibromyalgia, that is actually, if you look in our report under the key point, I'll actually read it to you. Individuals with this snip are prone to lower levels of the anti-inflammatory molecule. Interleukin 10 decrease IL 10 correlates with reduced ability to turn off inflammation and is associated with numerous conditions such as chronic widespread pain, rheumatoid arthritis, asthma and inflammatory bowel disease. And so it's kind of like you go, wow. And then if you were to look at the things that help you to have more IL 10 C, B, D, quercetin, they have been used in some of those same things. Arthritis pain, asthma, and even certain bacteria bifidobacteria and certain lactobacilli strains increase IL 10, sesame oil, garlic, cinnamon, they all increase IL 10

Dr. Mark Hyman: Exercise. All my favorite stuff. Yeah.

Dr. Sharon Hausman-Cohen: Well that's really common that people, I'll tell someone these are the foods that help and they go, you know what, I love those. And I think that we innately as humans, we do, we figure out some of that

Dr. Mark Hyman: It's animals do that. They actually graze these wild animals. They find not this the main food crops, but they find all these medicinal plants that they use to regulate their biology instead of intuitively. And I think, I wonder if we do the same thing and I actually, I did you mention the fibromyalgia? I did have, when I was really sick, I had severe fibromyalgia. My muscles were aching all the time. I was so sore. And I also developed after ciff infection, I developed inflammatory bowel disease, which I've cured, but it's like, wow, it kind of makes sense when you see what your potholes are.

Dr. Sharon Hausman-Cohen: Yeah. You have these genes that you have a few other inflammatory genes that increased your risk for getting that inflammatory bowel disease. But when you treated it instead of using anti TNF alpha because it wasn't TNF alpha for you, that increased the risk. When you used all those great plant substances, the polyphenols and decrease the inflammation fixed your gut bacteria, you were able to fix your risk. And even from a brain standpoint, so you're an A OE two, which is great. That gives you more longevity and it gives you better cognitive, better memory. I call that

Dr. Mark Hyman: The jackpot gene. Yeah,

Dr. Sharon Hausman-Cohen: That's a great gene. I get mad at my friends that are AE twos because they remember things. Remember 10 years ago when you said such and such? It actually can increase the risk of PTSD though because they have such good memories. But so for you, when you get older, if you were feeling like your brain was having any brain fog, I would look at your genomics and I would go, you know what? You have more issues with interleukin one alpha and interleukin one beta for you. The inflammation was just like, I call it bright red because that's kind of the big flame for you. So you have, again, I think have figured that out and that probably if I were to ask you what things work for you, a lot of the things, curcumin, sulforaphane, kaz claw resveratrol that work on your genes, you probably have already figured out you feel better on because it lacks that inflammation keeps your brain feeling clear.

Dr. Mark Hyman: Yeah. So I'm a mess, right?

Dr. Sharon Hausman-Cohen: No, no. Let's say you've got some really great genes. You just have, and again, and your mercury detox, your glutathione detox pathways, which are important for a lot of things. They were very good. You just had some things where magnesium, you need more magnesium, you don't absorb it well, you need to keep your inflammation at check. And then those environmental toxins and then osteoporosis.

Dr. Mark Hyman: That's so helpful. That's so helpful. So this isn't just to slow it down for a minute and what you're saying is so important. So by knowing my genes, I know I'm not good at detoxifying environmental toxins, so I need to make sure I reduce my exposure and upregulate all the pathways that help me clean them out. I know I have a preposition inflammation, so I've got to be clear about avoiding things that are triggering inflammation and there's certain compounds and phytochemicals and help me regulate that. And also have on the positive side, like a OE two, what we call the jackpot genes like longevity gene. That's good. So I have a mixture. It's not all good and bad. It's really about how to personalize what I'm doing. So I'm already taking a lot of things you mentioned just intuitively I think I know my body needs that I know based on my biomarkers that I can measure. So your genes are your genes, but then what you can measure in your blood as a result of those genes is how those genes are expressed. So I might have a risk for high IL one beta, which is an inflammatory cytokine, but I might not be behind my blood if I do all the right things.

Dr. Sharon Hausman-Cohen: Right? And some of them you can measure in blood, but again, the benefit of genomics is some things are only expressed in the heart or in the bones or in the kidneys. So when we were starting to open your genomics, I said, well, we can just skip the top gene a guy, and it's probably not of concern to you right now, but you have much higher risk than typical of osteoporosis. And you said, wait, stop. And you said that you actually did not have a good bone density and so would've never been able to,

Dr. Mark Hyman: I think in my late early fifties or I was like, I checked my bone density and body was like, I'll just check it. And I was like, wow, it's kind of on the lowish side. And it didn't make sense because I've been a runner my whole life biker. I mean, I didn't lift weights by yoga. I mean I really shouldn't have had low levels. Right?

Dr. Sharon Hausman-Cohen: And that's one of the differences between what my area of research and what in inte XDNA does and a lot of the neu nutrigenomic products is we also look at the genes that contribute to chronic diseases and osteoporosis runs in my family. So of course in INTE XDNA report, I included a pathway of osteoporosis because I wanted to learn more about that. And you are in the 1.1% of the population that has the number one gene that contributes to osteoporosis called a LDH seven A one. And dehydrogenase doesn't really matter exactly, but this gene regulates your bone building when you're younger. So people who have this, they don't have enough of these cells called osteoblasts growing up, so they never get as much bone. So if you had known this when you were younger, and you can still as a man because you keep your testosterone good, you can still have benefits. Things like alpha lipoic acid, things like ashwagandha, things like sulforaphane, those will

Dr. Mark Hyman: Actually all stimulate.

Dr. Sharon Hausman-Cohen: Yeah, it's amazing that you figured that. So again, and even NAD and NNM, so I think thing

Dr. Mark Hyman: Is

Dr. Sharon Hausman-Cohen: Genomics just gives us this map. And so now you're at higher risk, so you're going to keep your testosterone under control. You're going to do things. And if you ever were to kind of be really at high risk, you could then know, okay, not that I want to use a medication, but a bone building medication like teper with forte or TIMOs would really help you stimulate those osteoblasts. So I think that the difference in medicine in the year 20 25, 20 26, 20 30, 20 35 is we're going to have the ability to take somebody of any age and give them their instruction manual because that's really what our genome is. It's our book of ourselves. And having a doctor that's trained in integrative and functional medicine right now is really where people are going to get this kind of work because we're being trained with the institute that you helped to create to think about what are the root causes. But I'm hopeful that within the next decade, every cardiologist, every endocrinologist, every family physician will be thinking this way about why does this child have a DHD? Why does this person have cognitive decline or osteoporosis or why did they get sick when they went to China and get chronic fatigue?

Dr. Mark Hyman: I mean, listen, I think what you're doing is so remarkable, and I think people are aware of genetic testing. There's now over the counter genetic testing like 23 and me, I've had that done. And it's kind of fun. It's like, oh yeah, well, my urine's going to smell funny if I asparagus, great thanks. Or it's kind of not really news to use. Most of the time it's sort of more entertainment value. And actually, I talked to who co-founded it and when she was doing that, I said, you really have an opportunity here to actually help people understand how to modify these gene expression patterns and not just tell them what they have or find out that they have 25 siblings from their firm, donor dad or something. They half siblings. And we just got interesting. I have a friend who has seven siblings she didn't know she had that are half siblings.

Dr. Mark Hyman: That's all cool, but it's really not a useful tool in medicine. And since I've been doing this, I've been doing genetic testing for over 20 plus years through snip testing. Initially there's just a few steps we checked and now where there's a whole suite of SNPs that we have now learned about that are things that we understand their role in different diseases, we also understand how to modify those SNPs so that we can change the trajectory just like you did. Well, if I take alpha lipoic acid or resveratrol, I'm going to modify this or that pathway so it will work better. It won't be as much inflamed or my bones will be better or my detox pathways will be better. And that's all really incredibly helpful information for me as an individual who wants to optimize my health. And it's also important for me as a physician to be able to use that information to guide my therapy with my patients.

Dr. Mark Hyman: So there's a lot of over the counter tests for nutrigene genetics and nutrigenomics and pharmacogenomics, and they're all interesting. And there are some doctors who are using genetic testing and snip testing to look at, we call pharmacogenomics, which is how we respond to different drugs. Should I take a statin? Should I take this blood thinner this, or should I take the aspirin or not? And there's really the increasing use of this in traditional medicine, but it's still limited and it doesn't include all the things we're talking about today. It doesn't include the wealth of science that's sitting in a kind of national library medicine database that is sort of almost impenetrable to most people. And even most physicians, I don't have a clue to be honest with you about this, but you're making this for the first time accessible and you're making this really usable by practitioners.

Dr. Mark Hyman: Now, this is not a consumer facing company that you have. It's really for practitioners to learn how to understand S snip testing, how to learn what the data is behind each snip, how to learn the data that informs what to do with each snip. So what's the evidence base for this? Is it good? Is it not? And you can start to customize it. So you're telling me to take alpha lipoic acid, there's really no downside, right? And there's a lot of upside if you're saying, well take this drug. Well, maybe I'll think twice or I'll be more careful, but it's really an incredible moment in medicine where the future is going to look very, very different. And I think inte DNA is looking at many, many things. So why don't you take us through what this panel of tests you have are and what's being measured and just sort of how people can access it and what to do with it.

Dr. Sharon Hausman-Cohen: Absolutely. So as you mentioned, we cannot, it's not that we don't want to be able to help consumers directly. If we were to be having a consumer product, we couldn't give as much information. We're called a clinical decision support tool, which under the FDA, you can only sell to licensed healthcare clinicians. And so by doing that, we're able to give, we're a tool that helps doctors, whether they're naturopaths dos, MDs, PAs, we can sell to anyone who's a licensed healthcare clinician, help them kind of take that genomic science that's in the literature and make it applicable. As you mentioned, I have strong, I started out doing a PhD in medicine. I quit after my master's, but so I have my research background, my genetics background, my molecular biology background and my functional integrative medicine and family practice background. So with my background, I was able to lead a team of researchers to develop this, but it would take an individual physician many hundreds of hours to just hand start to look through someone's genome.

Dr. Sharon Hausman-Cohen: So what we did is we went through the literature figured out for all these really important clinically significant genes, we don't want ones that aren't important because again, we would be looking, there are over a million SNPs in the human genome, and that's a lot of data to go through. So let's start with the most important things. And then we figured out based on the literature, how does the little change that one letter change affect the gene? And then based on the literature, what can we do to help address it if somebody has that with diet and lifestyle? So the way the process works is a patient who wants this can, if they already have an integrative or functional medicine doctor, they can ask them if they have been trained on inx DNA. If they haven't, we are happy to train doctors for free. My goal is in my lifetime is to improve the field of medicine.

Dr. Sharon Hausman-Cohen: You had your way of doing it by establishing IFM, and this is my way of doing it is let's help get more precision to the foundation that you and so many have built. So they can ask their doctor, not only do we train them when they order their first report at no charge, but we mentor them so they will get great success even on their first report. We have a mentoring program, we have all kinds of things, but then if they don't have a doctor, they can also go to our website and find out who is trained on anx DNA in their state. It's a simple buccal swab, which just means inside of your cheek takes about three weeks to come back. We have three different basic reports. Some people get all of them, but we have one that's on chronic illness, kind of the heart disease, diabetes, thyroid, statin response, osteoporosis, macular degeneration, all those kind of chronic things.

Dr. Sharon Hausman-Cohen: We have one that's focused on the brain, and it's not just about, as we said, genes associated with Alzheimer's risk or classic dementia, but also low oxygen to the brain. Hormone receptors can affect the brain. We didn't talk about that coagulation. And then we have one that's more focused on mental health, which is also used as our pediatric backbone. But then we add on autism and some other things. All of them are going to have what I call the foundations, which is things that relate to gut, things that relate to inflammation, nutrition, detox. Really, the brain ones have much more extensive of that, but they all have a certain amount of that. And so then they just order the report and it takes about three weeks to come back. We again, help the physicians learn, how do you take that data and make it so you can kind of go, what is the most important thing we kind of call it?

Dr. Sharon Hausman-Cohen: How do you find the hotspots? So we help, it comes up with a little hotspot report, and we do have a patient version, but the physician needs to get access to it first and then release it because you really, we never want to arm and harm. And the companies, when you find out that somebody's an A OE four, and if that's all they know, that's harmful because if they don't know what they can do, what other genes interact? There's a OE fours that have only 1.7 times the risk, and there's a OE fours that have 12 times the risk of cognitive decline, but all of these genes are modifiable. And then there's people who are a OE three three, and they're not off the hook. They can have high risk for things that create vascular dementia and growth factors and inflammation and homocysteine. So there's about 20 different kind of panels in each report. So the typical report will look to 400 to 600 SNPs, but it's all organized. So it sounds a little like drinking from a fire hose, but we organized it. You saw when we went through it, it's like we get this hotspot of here for this person. Pay attention to these 15 or 20 genes first.

Dr. Mark Hyman: Yeah. So it's a lot of information. And I think as someone who's been doing this for 20 plus years, 25 years, it's still, I feel like a newborn babe, just kind of figuring it all out. So I think while I do have a pretty deep understanding and use this clinically for a long time, it just provides a whole nother layer of depth. And I think we've talked about the future, what's coming, and even for you who's deeply steeped in this, who understand so many of these pathways deeply, who understands all the signs behind it, it's still hard to kind of put all that together. And I think using the power of machine learning and artificial intelligence, which sounds scary to some people, but medicine I think is one of the use cases where this is going to be best applied to help create a predictive model of the hierarchy of priorities of what you should be doing, what you should be looking at, and what are the most important potholes. Maybe there's a few little tiny divots here in the road, but then there's this giant pothole in front of you, so you want to make sure you pay attention to that one. So I think we're going to be able to sift through that in a much more robust way. And I think your work's going to just be the foundation for so much of that.

Dr. Sharon Hausman-Cohen: Yeah, the machine learning we can't use yet. Not because we couldn't, but the FDA doesn't let us use artificial intelligence machine learning. The doctor is going to have to make the final decisions right now. Really,

Dr. Mark Hyman: Why does the FDA not let you do that?

Dr. Sharon Hausman-Cohen: Because if people want to join with us in studies, we will get there. But that would make it so that you become a medical device and there is a brand new category of the FDA for these kinds of low risk medical devices. But we are in the process of doing studies, but we will need more studies before we can layer that on. And again, if any of your listeners, if your friend that you interviewed that was the head of 23 and me, people want to collaborate on doing a big study where we do this reach out, and eventually, I absolutely do think that being able to do those kinds of decision trees and machine learnings, of course that makes sense. But we're not, again, right now, that's the other reason it takes a physician is or a trained healthcare licensed clinician is because you do have to use a lot of your own medical knowledge. We can give you the references. Everything is referenced. We can give you information on the supplements. So if you've never used a particular one, you can learn about dosing and what it was done in the studies, but it still takes the human brain, which gives us job security for a little while.

Dr. Mark Hyman: Okay. Well, this is exciting. Thanks so much for what you've done as an open up the field and provide help for so many people through their practitioners. And I hope more and more doctors will start to use this in their practice. It's been game changer for me as I guide my patients on how to best optimize their health or treat complex chronic conditions. And I think this will just become part of medicine. So thanks for what you do. And Sharon, lastly, where can people go to learn more about the test?

Dr. Sharon Hausman-Cohen: So they can go to inte d.com. It's a little bit of a tricky spelling, but if I tell you where the name came from, you'll remember it. It's from an intelligent approach to DNA. So it's I-N-T-E-L-L. And then the two Xs are, because myself and our co-founder are both women, and then DNA

Dr. Mark Hyman: Xd. I wonder what the XX was. I mean like xx. Okay. It should be capital X though. Yeah,

Dr. Sharon Hausman-Cohen: You can capitalize. It'll still work. And there's a lot of some publications and podcasts, but there's also a find a practitioner link so that you can find someone in your area.

Dr. Mark Hyman: Oh, Sharon, thanks so much for what you do. And we're just going to keep learning more when we head back on to talk more about things than I learned so much from doing the test myself. And appreciate all your support and help.

Dr. Sharon Hausman-Cohen: Thank you for having me. And we'll have to circle back in a year or two because we have more things coming down the pipe.

Dr. Mark Hyman: Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health, and subscribe wherever you get your podcasts. And follow me on all social media channels at Dr. Mark Hyman, and we'll see you next time on The Doctor's Farmacy. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic and Function Health, where I'm the Chief Medical Officer. This podcast represents my opinions and my guest opinions. Neither myself nor the podcast endorse with the views or statements of my guests. This podcast is for educational purposes only. It's not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. Now, if you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who is trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.