Balance & Longevity: January 2024

Wednesday, January 3, 2024

Uterine Fibroids: New Approaches to an Underdiagnosed Health Issue

Written and produced by: Dr. Roberta Kline for the Women's Health Digest / Balance & Longevity educational seminar series.

FIBROIDS are the most common tumor of the female pelvis and are the number one reason for hysterectomy. While prevalence estimates vary widely, in part due to systemic underdiagnosis, they range worldwide from 4-70%. Globally, Black women have the highest rate, often 3x that of White women. In addition, Black women are more likely to have more severe symptoms and undergo hysterectomy at an earlier age, adding the burden of lost fertility for these women. The economic burden is also enormous. It is estimated that fibroids contribute to up to $34 billion in direct and indirect healthcare costs every year. [1]

NEED MORE ATTENTION TO THIS COMMON WOMEN'S DISORDER
For many decades, the understanding of causes and effective treatments has progressed slowly. With the acceleration of technology enabling molecular and genetic expression research and advanced non-invasive treatment, that is starting to change.

WHAT ARE FIBROIDS?

Fibroids are classified based on where they occur in the uterus.

Uterine fibroids, also known as uterine leiomyomas, are benign growths within the uterine wall that are made up of the same smooth muscle tissue as normal myometrium. But for reasons that are still not fully understood, they form into 3-dimensional spheres rather than the linear, elongated pattern of normal tissue.

Up to half of all women with fibroids are symptomatic. Although fibroids are typically benign, they can cause significant health effects. The most common symptoms are painful periods and heavy menstrual bleeding. Pelvic pressure and pain during intercourse are not uncommon. Depending on their size and location, fibroids can press on nerves and cause pain; obstruct nearby organs including ureters, bladder, and intestines. Fibroids can also cause reproductive problems including infertility, recurrent pregnancy loss, and other complications of pregnancy.

WHAT CAUSES FIBROIDS?
Fibroids occur after the onset of menses, and typically shrink after menopause, so clearly estrogen plays a role. Other standard risk factors for fibroids include ethnicity, age, family history, time since last birth, hypertension and diet. Vitamin D deficiency in particular, has been consistently linked with fibroids. [2]

Genetics clearly plays a role. Having a family member with fibroids increases the risk – and if it’s your mother, you are 3x more likely to develop them too. A hereditary mutation in the FH gene (fumarate hydratase) that causes renal cell carcinoma (HRCC) is now being linked to the development of fibroids, especially at younger ages. [3]

GENETIC EXPRESSION PROVIDES NEW CLUES
Emerging research is revealing the role of underlying molecular pathways and the genes and epigenetics that regulate them in fibroid development and growth. These include estrogen metabolism, inflammation, oxidative stress, insulin and glucose regulation, nutrient processing, telomere length and DNA repair. [4] Interestingly, but perhaps not surprisingly, there is significant overlap with other health conditions including endometriosis, as well as many chronic diseases of aging.

One of the surprising findings of gene expression research is that almost half of all fibroids have chromosomal abnormalities. [5] Despite this, progression to the cancerous form (leiomyosarcoma) is rare – less than 1%. As researchers look deeper, it appears that it is not the genetic changes within the fibroid that have the most influence on the development of fibroids and the progression to cancer. Rather, it is the microenvironment, or the cellular health around the fibroid, that has this role. [6]

Therefore, it may be that improving the microenvironment in which these fibroids develop could be effective early intervention strategies. Noninvasive therapies that can reduce inflammation and oxidative stress including diet, medication, PEMF, and photobiomodulation may be new opportunities for early intervention for fibroids as well. [7]

While genetic expression research on fibroids is shedding light on some of the genomic and genetic alterations that contribute to discrepancies between women of different ethnicities, it is clear that these aren’t the only drivers. [8] As with many other health conditions, where a woman lives and works plays an outsized role.

Environmental toxins including endocrine disruptors and air pollution, stress, and socioeconomic status all have been shown to be connected with higher rates of fibroids. These are likely related to bidirectional effects of epigenetic alterations, access to care and bias within the healthcare system, as well as other factors still to be identified. [9]

DIAGNOSIS
Ultrasound, and preferably transvaginal ultrasound, is the best initial diagnostic imaging procedure for detection of fibroids. 3D ultrasound can provide even more information than the standard 2D. With the addition of hysterosonography, or introduction of fluid into the uterine cavity under ultrasound guidance, impingement on the uterine cavity can be clearly demonstrated.

Image source: Freytag, D., Günther, V., Maass, N., & Alkatout, I. (2021). Uterine Fibroids and Infertility. Diagnostics, 11(8). https://doi.org/10.3390/diagnostics11081455 [OPEN ACCESS}

TREATMENT OPTIONS
Despite many women already having symptoms by age 25, most aren’t diagnosed until their 30’s or 40’s. By that time, the fibroids are typically larger and more problematic.

Current treatment options include medication to address symptoms – accounting for up to 70% of women at some point. Surgery to remove the fibroids (myomectomy) or the entire uterus along with the fibroids (hysterectomy) is the oldest and most invasive option. Newer techniques such as laparoscopy have improved these surgical approaches. Within the past couple of decades uterine artery embolization (UAE) has offered a less invasive option, and newer noninvasive approaches are now emerging that utilize radiofrequency ablation (RFA), and high intensity focused ultrasound (HIFU). [2]

Here, too, treatment options are impacted by ethnicity and socioeconomic factors. "Despite minimally invasive options, Black women continue to dominate the percentages of women having hysterectomies for benign disease," Marsh says. "We need to understand why." [1]

One of the main limitations for these newer techniques is that they are more effective on smaller fibroids. Since fibroids tend to grow over time, it would seem a benefit to have earlier diagnosis so that women have better treatment options. In fact, a recent study in Ghana showed that routine ultrasounds at yearly clinic visits increased the rate of diagnosis, and at younger ages. [10]

THE FUTURE OF FIBROIDS
While more definitive research specific to fibroids is needed, we already have noninvasive tools and strategies to address some of the most common underlying contributors. Let’s advance the science with research as we simultaneously give women more options to proactively improve their health.

REFERENCES

(1) Marsh, E. E., Al-Hendy, A., Kappus, D., et al. (2018). Burden, Prevalence, and Treatment of Uterine Fibroids: A Survey of U.S. Women. Journal of Women's Health, 27(11), 1359-1367. https://doi.org/10.1089/jwh.2018.7076 (2) Freytag, D., Günther, V., Maass, N., & Alkatout, I. (2021). Uterine Fibroids and Infertility. Diagnostics, 11(8). https://doi.org/10.3390/diagnostics11081455 (3) Lu, E., Hatchell, K. E., Nielsen, S. M., et al. (2022). Fumarate hydratase variant prevalence and manifestations among individuals receiving germline testing. Cancer, 128(4), 675-684. https://doi.org/10.1002/cncr.33997 (4) Välimäki N, Kuisma H, Oskari AP et al. (2018) Genetic predisposition to uterine leiomyoma is determined by loci for genitourinary development and genome stability eLife 7:e37110. (5) Kubínová K, Mára M, Horák P, et al. Genetic factors in etiology of uterine fibroids. Ceska Gynekol. 2012 Feb;77(1):58-60. Czech. PMID: 22536642. (6) Bharambe, B. M., Deshpande, K. A., Surase, S. G., & Ajmera, A. P. (2014). Malignant Transformation of Leiomyoma of Uterus to Leiomyosarcoma with Metastasis to Ovary. Journal of Obstetrics and Gynaecology of India, 64(1), 68-69. https://doi.org/10.1007/s13224-012-0202-4 (7) Tinelli, A., Vinciguerra, M., Malvasi, A., et al. (2021). Uterine Fibroids and Diet. International Journal of Environmental Research and Public Health, 18(3), 1066. https://doi.org/10.3390/ijerph18031066 (8) Edwards, T. L., Giri, A., Hellwege, J. N., et al. (2019). A Trans-Ethnic Genome-Wide Association Study of Uterine Fibroids. Frontiers in Genetics, 10. https://doi.org/10.3389/fgene.2019.00511 (9) Cheng, L., Li, H., Gong, Q., et al. (2022). Global, regional, and national burden of uterine fibroids in the last 30 years: Estimates from the 1990 to 2019 Global Burden of Disease Study. Frontiers in Medicine, 9, 1003605. https://doi.org/10.3389/fmed.2022.1003605 (10) Mesi Edzie, E. K., Dzefi-Tettey, K., Brakohiapa, E. K., et al. (2023). Age of first diagnosis and incidence rate of uterine fibroids in Ghana. A retrospective cohort study. PLOS ONE, 18(3), e0283201. https://doi.org/10.1371/journal.pone.0283201

ABOUT THE AUTHOR

ROBERTA KLINE, MD (Educational Dir. /Women's Diagnostic Group) is a board-certified ObGyn physician, Integrative Personalized Medicine expert, consultant, author, and educator whose mission is to change how we approach health and deliver healthcare. She helped to create the Integrative & Functional Medicine program for a family practice residency, has consulted with Sodexo to implement the first personalized nutrition menu for healthcare facilities, and serves as Education Director for several organizations including the Women’s Diagnostic Health Network, Mommies on a Mission. Learn more at https://robertaklinemd.com/

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Epigenetic Research Notes: Profiling the Dense Breast Paradigm (part 1) Coursework written by: Dr. Roberta Kline

LINKING DENSE BREAST WITH BREAST CANCER
We have known for a very long time that there is an increased risk of breast cancer for women who have dense breasts. Until recently, the research has been lagging in terms of what's the molecular mechanism, why do dense breasts present an increased risk of breast cancer? Without this knowledge, we can’t address the root causes, and are left with a lot of trial and error based on incomplete understanding. It's very encouraging to know that currently there are 124 clinical trials ongoing looking at dense breasts and the relationship with breast cancer, anywhere from improved diagnostics, to treatment, to prevention, and, what’s close to my heart, to understanding the molecular mechanisms - what's happening at the cell level, at the genetic level that is causing different women to have an elevated risk of breast cancer. (see feature)

Copyright Notice: The materials provided on this newsletter article is copyrighted and is the intellectual property of Dr. Roberta Kline as the writer/producer and or publisher. It is also under the protection of the (Integrative Cancer Resource Society and the AngioFoundation(201c3). This feature report is published strictly for informational purposes within non-commercial use and not for purposes of resale, distribution, public display or performance. Unless otherwise indicated on this web based page, sharing, re-posting, re-publishing of this work is strictly prohibited without due permission from the publishers. Also, certain content may be licensed from third-parties. The licenses for some of this Content may contain additional terms. When such Content licenses contain additional terms, we will make these terms available to you on those pages (which his incorporated herein by reference).The publishers/producers of this site (BALANCE & LONGEVITY) and its contents such as videos, graphics, text, and other materials published are not intended to be a substitute for professional medical advice, diagnosis, or treatment. For any questions you may have regarding a medical condition, please always seek the advice of your physician or a qualified health provider. Do not postpone or disregard any professional medical advice over something you may have seen or read on this website. If you think you may have a medical emergency, call your doctor or 9-1-1 immediately. This website does not support, endorse or recommend any specific products, tests, physicians, procedures, treatment opinions or other information that may be mentioned on this site. Referencing any content or information seen or published in this website or shared by other visitors of this website is solely at your own risk. The publishers/producers of this Internet web site reserves the right, at its sole discretion, to modify, disable access to, or discontinue, temporarily or permanently, all or any part of this Internet web site or any information contained thereon without liability or notice to you.

Tuesday, January 2, 2024

HEALING, STRESS AND THE PARASYMPATHETIC SYSTEM

Written by: Roberta Kline, MD

Analyzing STRESS & ANXIETY from a holistic point of view means identifying the body’s interconnected systems (ie. circulatory, cardiovascular, nervous, lymphatic, endocrine etc.) and its many touch points for stimulation. This analysis should also offer a comprehensive breakdown of the body's HEALING capacity- which includes our hormones, digestive system, immune system, brain, heart-- all the way down to our cells and mitochondria.

Stress is part of life, and comes in many forms including physical, emotional, mental and environmental. Foods we eat, unhealthy relationships, difficulties at work, toxins in our environment, even poor posture or lack of sunshine can all create stress on our bodies. But when stress is catastrophic or becomes chronic, it creates imbalances in this functioning that are much more likely to promote disease while at the same time preventing healing from taking place. [1]

With people under record levels of chronic stress, it is no wonder we have an epidemic of people suffering from all sorts of health issues and chronic diseases. Heart disease, diabetes, obesity, pain, anxiety, depression, infertility, cancer, autoimmune diseases such as arthritis, neurodegenerative diseases such as Alzheimer’s …. These are just some of the many health conditions that have been linked to diet and lifestyle including chronic stress. [2, 3]

But how does this work? And is meditation the answer to reversing this trend? Science is revealing some interesting clues.

THE NERVOUS SYSTEM

One big connection is our nervous system. Our nervous system is our superconductor network of information exchange throughout our bodies, and consists of two main parts. The first is the central nervous system (CNS). As it sounds, it’s our command center where all data comes to be processed, and is made up of the brain, spinal cord, and nerves. The second is called the peripheral nervous system (PNS) and it connects every part of our body to our CNS through individual nerve cells called neurons and clusters of neurons known as ganglia.

The PNS is further divided into the Somatic Nervous System, also known as the voluntary nervous system, and the Autonomic Nervous System. The Autonomic Nervous System (ANS) manages all bodily functions that are not under conscious control. This includes heart rate, blood pressure, digestion, respiration, cellular activity, immune system, hormones, brain function, sexual function, and even body temperature.

The ANS is further divided into two parts: the Sympathetic Nervous System (SNS), which regulates our “fight or flight” response, and the Parasympathetic Nervous System (PNS), which controls our “rest and digest” response. They work closely together in a complex dance, maintaining our bodily functions and ensuring our survival every second of our lives.

Many health issues, including most chronic diseases such as heart disease, autoimmune disease, diabetes, depression and anxiety, and cancer, are related to an imbalance of our autonomic nervous system. Most typically, it is too much of the “fight or flight” and not enough of the “rest and digest” that leads us into this imbalance. [4]

FLIGHT OR FLIGHT

The Sympathetic Nervous System is located in the CNS, and in the spinal nerves from T1 (the thoracic region) down to L3 (the lumbar region) out to the neurons in the regions of the body supplied by these nerves. This sympathetic response is designed to keep us safe in the face of immediate danger. It signals the brain to turn up the volume on any physiological function crucial to staying to fight or running away from the source of the danger. Catecholamines such as epinephrine (adrenaline), norepinephrine (noradrenaline) and dopamine are released and a cascade of events happens rapidly – before we are even consciously aware that there is a threat. These include:

• Blood flow diverted to the heart, lungs and skeletal muscle

• Increased heart rate, blood pressure and respiratory rate

• Enlargement of bronchioles (in lungs)

• Dilation of pupils

• Rapid conversion of glycogen to glucose for fuel

• Activation of immune system

All other functions, including digestion, urination, higher level thinking, even sexual function and cellular repair, are temporarily turned off, so that all of our energy and resources go only toward ensuring our immediate survival. If the threat goes on for a longer period of time, a secondary system called the HPA (Hypothalamic – Pituitary – Adrenal) Axis takes over and relies on elevated cortisol and other hormonal changes to continue the high alert state.

But our bodies are not designed to be in this activated high-alert state for long periods of time. Once the immediate threat is gone, we are supposed to go back to our normal state of relaxation. This is the job of the Parasympathetic Nervous System.

REST AND DIGEST

The Parasympathetic Nervous System (PSNS) is located in the brain stem, includes nerves to the eyes and face, vagus and 10th cranial nerves, and sacral nerves (S2-S4). Regulated in large part by the vagus nerve (75%), it impacts a vast array of crucial bodily functions. When the parasympathetic response is triggered, it counteracts the fight or flight response primarily through release of acetylcholine.

Parasympathetic activation results in production of tears, saliva, and constriction of the pupils; lower and more variable heart rate, lower blood pressure and respiratory rate. It enables creative and critical thinking, normal kidney function and urination, improves immune function, enables sleep, sexual arousal and replenishment of fuel stores in organs; plus everything involved in digesting and utilizing our food including elimination and insulin production. Even mood and social bonding and connection are linked.

HOW THERAPISTS DIAGNOSE MENTAL HEALTH ISSUES

By: Jessica Connell, LCSW

HOW STRESS IMPACTS HEALTH AND HEALING

Healing requires coordination of a complex array of biological functional and systems. Research is rapidly expanding our understanding of the importance of the parasympathetic response, and how meditation helps to restore balance. While this impacts every biological system, here are some key areas:

Digestion
Nutrients must be properly digested to extract them from our food and into our cells, where they are critical to every function our bodies must carry out. From vitamins and minerals that are needed in every biochemical reaction, to energy production in our mitochondria, to building blocks of our proteins that form our enzymes, neurotransmitters, hormones, even our DNA - all of our cells need these basic materials to function. Stress shuts down our digestion, and if it goes on long enough our cells become depleted of the very nutrients needed to function and repair.

Immunity

Approximately 90% of our immune system resides in our gastrointestinal tract. While it is needed to defend us against invaders such as bacteria and viruses, it can also go awry if unchecked. This “runaway” inflammation is linked to most chronic diseases, and paradoxically also reduces the ability espond to infections. Our immune system has other functions, including being a cleaning crew. It removes debris left over from battling invaders. It also removes our own dead or badly damaged cells, and signals new and healthy ones to replace them. Stress results in an imbalanced immune system, making us vulnerable to infections as well as chronic disease.

Mitochondria
These tiny structures exist within every cell in the body, and as the “power plants” of the cell they are responsible for producing all of the energy needed for every single function. This energy is produced as ATP and to make it requires key nutrients from food to be digested and absorbed from the gut. But producing this energy also creates toxic molecules, which are neutralized by antioxidants which also come from our diet. If the demand for energy is too great for too long, the mitochondria – and its cell – become damaged. Without healthy mitochondria, cells become damaged, dysfunctional and even die.

Brain

The brain normally utilizes about 20% of our energy supplies, primarily in the form of glucose or ketones. This requires good digestion and healthy mitochondria to keep the brain supplied with fuel to function. Acetylcholine is a major neuro-transmitter in the brain and in nerve endings through the peripheral nervous system; it is also anti-inflammatory. It is made in the mitochondria using some of the same ingredients needed for ATP production.

Serotonin, a major neurotransmitter impacting mood, is mostly produced in the gut. When the stress response is prolonged, this depletes the brain’s capacity for creative and critical thinking and mood regulation, often further impairing the ability to deal with stress.

MEDITATION AND HEALTH

While meditation has been practiced in various forms for centuries, and has long been associated with many parameters of improved health and well-being, science is only recently starting to understand the mechanisms by which it works. Studies are demonstrating the positive impact of meditation practices on various disease conditions, and the potential power for it to change the trajectory of this epidemic of chronic disease. Research findings on HOW it works are not all consistent though, as ways of meditating can be quite varied and this seems to impact the results. However, some common threads are emerging; two main mechanisms are outlined below.

Default Mode Network:
One mechanism by which meditation works is by altering connectivity in the brain – the so-called Default Mode Network, or DMN. This is a network of brain regions that is active when the brain is restful but awake. Meditation seems to decrease this DMN activity, leading to increased cortical connectivity [5] - in other words, there is activity connecting areas of the brain that aren’t normally part of this network that enables us to take a different, more detached perspective on things in our life. When we aren’t so attached to events, the sympathetic response is less likely to be triggered, or if it is triggered it is to a lower extent that is easier to recover from.

Vagal Nerve:

Meditation also activates the parasympathetic response, in large part through the vagal nerve. This not only impacts heart rate and other vascular parameters, it also connects our gastrointestinal tract to our brain. There is now a growing body of evidence that this bidirectional communication through the “brain-gut axis” is a complex system that is key to our health, and when it is out of balance is linked to many health issues. [6]

Meditation has been shown to increase vagal nerve activity, or tone, and restore normal functioning of these many systems including digestion, immune response, and brain neuroplasticity/resilience. [6] It is thought that one way this occurs is through deep breathing, although there may be other mechanisms in play. As we learn more about how meditation works and how it influences our biology, we can develop more targeted and personalized approaches to maximize its potential – while making it easy and accessible for people to integrate into their daily lives.

EPILOGUE

In a recent MedTech Review of a meditation and brain optimizing device called BrainTap®, Dr. Kline and her colleagues took on the task of assessing its ‘active ingredients’- binaural beats, isochronic tones, holographic music and blue/red light. (see complete tech review) It is found that these neurosensory applications have had a long history in other devices also supporting the science and wellness communities for their reactive properties. Having collected the vast majority of user testimonials online, and clinical reports from fellow team mate, Dr. Leslie Valle (Santa Barbara, CA) who had already spent the better part of 3 years with the device on her patients, these reviews added greatly to our peace of mind about consumer safety.

Academically, the appeal in assessing this specific product is partly due to the diverse and multiple points of wellness that the device was designed to target. A wide range of brain and mental health-related specialists alike may truly enjoy conducting their own independent case study of this device, each using their specific level of science to assess its array of claimed benefits. Areas like the parasympathetic nervous system, brain optimizing and stress & anxiety are just some of the key points of interest worth exploring. If the device in fact aligns and supports Dr. Kline’s multi-layered physiological roadmap to wellness and the user’s reaction(s) in the meditation state, a fair and comprehensive tech review of this device should be best achieved under multiple streams of evaluators. Reporting on its assessed benefits would then be a matter of the collective team trading notes for all areas of common ground.

ROBERTA KLINE, MD (Educational Dir. /Women's Diagnostic Group) is a board-certified ObGyn physician, Integrative Personalized Medicine expert, consultant, author, and educator whose mission is to change how we approach health and deliver healthcare. She helped to create the Integrative & Functional Medicine program for a family practice residency, has consulted with Sodexo to implement the first personalized nutrition menu for healthcare facilities, and serves as Education Director for several organizations including the Women’s Diagnostic Health Network, Mommies on a Mission. Learn more at https://robertaklinemd.com/

References:

(1) Furman D et al. Chronic inflammation in the etiology of disease across the life span. Nat Med 25, 1822–1832 (2019).

(2) Cohen S et al. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. PNAS April 2, 2012: 109 (16) 5995-5999

(3) Vancampfort D et al. Perceived Stress and Its Relationship With Chronic Medical Conditions and Multimorbidity Among 229,293 Community-Dwelling Adults in 44 Low- and Middle-Income Countries. American Journal of Epidemiology, Volume 186, Issue 8, 15 October 2017, Pages 979–989

(4) Agnese Mariotti. The effects of chronic stress on health: new insights into the molecular mechanisms of brain–body communication. Future Sci OA. 2015 Nov; 1(3): FSO23.

(5) Jerath et al Dynamic change of awareness during meditation techniques: neural and physiological correlates. Front. Hum. Neurosci., 17 September 2012 Sec. Cognitive Neuroscience

(6) Breit et al Vagus Nerve as Modulator of the Brain–Gut Axis in Psychiatric and Inflammatory Disorders. Front. Psychiatry, 13 March 2018

Additional Resources:

Jacob Tindle; Prasanna Tadi. Neuroanatomy, Parasympathetic Nervous System. StatPearls Publishing Jan 2022

The Neuroscience of Meditation. Understanding Individual Differences. Academic Press 2020

GET TO KNOW YOUR ANXIETY AND STRESS

Video Extra: Dr Barbara Bartlik (NYC Psychiatrist) speaks about the use of non-invasive alternatives like PEMF- Pulsed Electromagnetic Therapy for many ailments including PTSD and Depression.

HEALING, STRESS AND THE PARASYMPATHETIC SYSTEM (part 1)

Written by: Roberta Kline, MD

THE NERVOUS SYSTEM

See complete feature by Dr. Roberta Kline

HOW THERAPISTS DIAGNOSE MENTAL HEALTH ISSUES

By: Jessica Connell, LCSW

ROBERTA KLINE, MD (Educational Dir. /Women's Diagnostic Group)

Dr. Kline is a board-certified ObGyn physician, Integrative Personalized Medicine expert, consultant, author, and educator whose mission is to change how we approach health and deliver healthcare. She helped to create the Integrative & Functional Medicine program for a family practice residency, has consulted with Sodexo to implement the first personalized nutrition menu for healthcare facilities, and serves as Education Director for several organizations including the Women’s Diagnostic Health Network, Mommies on a Mission. Learn more at https://robertaklinemd.com/

MITOCHONDRIA EXPLAINED VIA CHRONIC FATIGUE

MedScienceNews

Review on CFS/ME (Chronic Fatigue Syndrome and Myalgic Encephalomyelitis

By: Dr. Roberta Kline

One of the key underlying findings in conditions causing chronic mental or physical fatigue is dysfunction of the mitochondria. Mitochondria are small structures located in the nucleus of every cell, and every cell contains thousands of them. These powerhouses produce the energy our bodies need to carry out every function in the form of ATP (adenosine triphosphate). When mitochondria don’t function at their best, or too many of them are destroyed, our energy levels suffer. While this can be due to inherited genetic disorders, most often it is seen as the result of chronic damage over time.

Many of the biochemical reactions in our bodies produce toxic versions of oxygen, hydrogen and nitrogen, including how we make ATP. These toxic molecules, which we call free radicals, have to be neutralized so they don’t damage the mitochondria. Our bodies have powerful antioxidant defenses to keep these in check. But when these protective systems become overwhelmed by too many free radicals, oxidative stress results and mitochondria are damaged.

Each person’s ability to handle these toxins and oxidative stress is different and depends on the interaction between their genes and their environment. Our genes commonly have small errors, called SNPs (single nucleotide polymorphisms) that affect how each protein in our body works. [see: genetics vs genomics article] Since proteins run all of our biochemistry, these small DNA changes can affect how we deal with emotional stress, energetic stress, and physical stress; how we process the toxins; what we need nutritionally. When we get a mismatch of our genes and our diet and environment, that can set us on a collision course for disease if it persists over time.

Some of the most common causes of oxidative include deficiencies of key nutrients and antioxidants (such as CoQ10, Alpha-lipoic acid, B vitamins, and Vitamin C), and overload of toxic substances in our environment (including air pollution, heavy metals like mercury and arsenic, herbicides and pesticides). Emotional stress is also often a key factor. Viral and other infections that trigger an immune response that then gets out of hand is also a common contributor. Chronic inflammation goes hand -in-hand with the oxidative stress, and this is why so many chronic diseases related to inflammation are also linked to mitochondrial dysfunction – either as a cause or as a result. Once this cascade of oxidative stress and inflammation gets going, it feeds itself and can be hard to reverse unless all contributing factors are addressed.

Because mitochondria are found in every cell of the body, often multiple systems are affected. This can result in a wide range of symptoms that are often hard to diagnose, especially in conventional medicine. Fortunately, we have ways to understand what each person needs through personalized approaches. By integrating functional medicine, genomics, and a wide range of healing modalities, we have the knowledge and the tools to unlock what each person needs to restore health – and then keep them healthy.

Dr. Roberta Kline combines her decades of experience as an ObGyn physician, energetic healer, functional and genomic medicine practitioner, along with Human Design and Astrology to help women get to the root of the health of mind, body, and spirit. She is dedicated to serving her fellow clinicians in addition to her patients, she has created and taught courses in functional, genomic, energetic medicine within a holistic model through faculty positions with the University of New England College of Osteopathic Medicine and The Graduate Institute. Currently, as founder of bobbiklinemd.com, she shares the wisdom gained from her own health journey to empower women in successfully navigating life and health challenges for themselves and their children.

SPOTLIGHT SERIES:

Climbing Out of CFS with Alternative Therapy

SHOT DOWN BY CFS
In 2017, Suzanne Wheeler was diagnosed with Myalgic Encephalitis or Chronic Fatigue Syndrome. She was home bound for about two years and bed bound about 50% of the time. Suffering from significant chronic pain throughout her body with a health report reading equivalent to that of about a 95 year old, Suzanne spent the better part of 15 years being mis-prescribed therapeutic drugs and dangerous opioids that gave little or no positive results. Read Suzanne's exploratory journey to wellness, her extensive research and her ultimate solution to getting back on her feet again with PEMF.

CLICK TO SEE SUZANNE'S COMPLETE SUCCESS STORY

Epigenetic Research Notes: Profiling the Dense Breast Paradigm

Written by: Dr. Roberta Kline.

As an Ob-Gyn physician and genomics specialist, I have spent the better part of 10 years translating research in the genomic and gene expression areas into clinically usable information for healthcare professionals. One of the biggest challenges we face when connecting research with patient care is the long delay in the translation process and dissemination of the information. It often takes 10 to 20 years for information (validated findings) that comes out of research to be applied in clinical practice. These delays result in many lost opportunities to provide better care for our patients. This is one of the reasons why I'm really passionate about accelerating this process and making it easier for clinicians and their patients to take advantage of cutting-edge information and new technologies.

It's very encouraging to know that currently there are 124 clinical trials ongoing looking at dense breasts and the relationship with breast cancer, anywhere from improved diagnostics, to treatment, to prevention, and, what’s close to my heart, to understanding the molecular mechanisms - what's happening at the cell level, at the genetic level that is causing different women to have an elevated risk of breast cancer.

One of the striking features that we're learning about dense breasts and what is creating that density is the microenvironment, which means the environment in the supporting tissue surrounding the glands. This includes fibroblasts and collagen. It seems that rather than estrogen being the dominant factor, it is inflammation that is creating the increased density of breast tissue.

ESTROGEN VS INFLAMMATION
What's fascinating to me is that even though we associate estrogen with the primary means by which women develop breast cancer, it may be a different process for breast cancers linked to breast density. Some of the research that has just come out in the last few years is showing us that rather than being hormonally driven, we think what's happening is there is an increase in these inflammatory markers in the tissue that is denser, and this is what can also lead to cancer.

There is clearly a genetic, or hereditary component, because having dense breasts is noted to run in families. But while having dense breasts increases a woman’s risk of breast cancer by up to 4-6x, not all of these women actually get cancer. That means there are other factors that can potentially increase as well as reduce a woman’s risk. This is where genomic research has been a gamechanger in identifying these other factors including for women with inherited genetic mutations, such as BRCA.

We now know that there are multiple genes in multiple other pathways that can modify a woman’s risk of breast cancer even if she carries a BRCA mutation. [1]. Researchers have identified smaller changes in genes called SNPs (single nucleotide polymorphisms) that have a much lower individual impact than genetic mutations, but together can be additive.[2] In fact, women with specific patterns of SNPs had their risk of breast cancer significantly reduced. This can help explain why not all women with BRCA mutations get cancer, and provides insight into potential protective biological mechanisms.

This is a really powerful paradigm shift, because now it opens the door for truly individualizing each woman’s risk – and potentially being able to change it through diet, lifestyle, or other modalities.

We now are also learning that gene SNPs can also play a role in a woman’s risk for dense breasts and breast cancer. While there's much research that needs to be done, from my experience, there's a lot we can do already to potentially intervene and help women with dense breasts. As we wait for more definitive research, we can learn from the nutritional genomics and functional medicine realms.

We have long known that pro-inflammatory conditions are underlying drivers for so many of the chronic diseases we see today, from cancer to heart disease, diabetes, autoimmune disease, depression and more. The flip side of inflammation is oxidative stress. They go hand in hand. Some of the genes that drive these processes are now also being linked to dense breasts and potentially the increased breast cancer risk that women with dense breasts have.

My question is, why can't we use some of these dietary lifestyle and nutritional supplement interventions that we already know decrease many of these pro-inflammatory pathways? Why can't we start using those in clinical practice as we wait for research and clinical trials to better refine our knowledge? The fact is, we can! But it takes education, awareness and advocacy to implement these strategies more widely and make a difference now.

Reference:

1) link to polygenic model – breast cancer, Lynch syndrome etc https://healthresourcedigest.blogspot.com/2022/03/the-future-in-personalized-medicine.html

2) Link to genetics/genomics https://modernhealing1.blogspot.com/2020/11/what-is-lynch-syndrome.html