Dr. O’Bryan: Thank you, James. It’s a real pleasure to be ...

[Pages:21]Your Genetics and Autoimmune Diseases Guest: Tom O'Bryan, DC, CCN, DACBN

The contents of presentation are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. This presentation does not provide medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

James: All right, a warm welcome back to the Interpreting Your Genetics Summit. And I am so excited to welcome back a three-time guest on the Evolution of Medicine Summit. He's been on all of our summits. And he's got something very profound to offer you here today, as it relates to interpreting your genetic information. You may know him from his Betrayal documentary that I was a part of last year. He's been leading the conversation on autoimmune disease. And a warm welcome to the summit to Dr. Tom O'Bryan. Thanks for being with us, Tom!

Dr. O'Bryan: Thank you, James. It's a real pleasure to be with you and to support your projects, and especially this topic. This is a great topic to talk about.

James: Absolutely. So the purpose of this summit is really to give people who are getting their genetic information some responsible starting points on how to use that information. And from our last two conversations, I know that genetics is a big player in autoimmune disease, which autoimmune disease you get. So I think for many people out there, they may not be aware that autoimmune disease is a likely problem that they're going to come across in their lives. So let's just start with that because I know that there are some particular things about the naming conventions in autoimmune disease that make us maybe underestimate what a big impact it's having.

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Dr. O'Bryan: Yeah. So autoimmune means your immune system's attacking your own tissue. And what most, even physicians, don't know because they can't read all of the studies is that cardiovascular disease--heart attacks, strokes--the number one cause of getting sick and dying is autoimmune in its initiating phases and what fuels it to keep going. Cancer is autoimmune in its initiating phases. And then, we have the classic autoimmune diseases like multiple sclerosis, and rheumatoid arthritis, psoriasis. There's over 80 named autoimmune diseases.

But the mechanism, the autoimmune mechanism that starts this all off is actually a foundational mechanism for practically every degenerative disease. So when you understand that whatever disease you're going to get in your life most likely starts with your immune system being activated, it then opens up the conversation as to, "Well, why is my immune system activated?" And when you ask, "Why my immune system is activated," you're looking.

And what you will learn is that while your genes are getting turned on and the genes that you're vulnerable to having activated to produce disease are these particular genes, or these genes, or these genes. It doesn't matter what the genes are. The mechanism that's activating the genes is what's really the value to understand and to hold in the back of our minds when we're asking the questions about our genetics.

James: Absolutely. So cancer and heart disease get a lot of their like attention just because the numbers are so big when you stack them up. But obviously if you add in those as autoimmune in the initiating phases and then you add up all of the names. One of the things about autoimmune disease, which I think--and we've spoken about this before--is the naming convention where it's throat cancer. It's brain cancer. It's lung cancer. So cancer is after all of them; whereas in autoimmune, you just have a range of names that people don't put them together.

Dr. O'Bryan: Right, exactly right. That's exactly right. And everyone on this summit already knows, I'm sure. But the genes that you have doesn't mean you're going to get that disease. It means that you're vulnerable to a particular disease. "Mrs. Patient, if you pull at a chain, it always breaks at the weakest link. Always. It's going to be at one end, the middle, the other end. It's your heart, your brain, your liver, your kidneys. Wherever your genetic weak link is. And where's your weak link? Whatever your genes are. Whatever the deck of cards you've been dealt in life, that's the weak link in your chain."

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So when you have that basic understanding, the first thing that comes up is stop pulling on the chain so much, right. And then, the link won't break. And how do you stop pulling on the chain? Reduce the inflammation, reduce the activation of your immune system, which is what turns on the genes.

James: Absolutely.

Dr. O'Bryan: So as you get that big picture overview, you start asking the questions that all the speakers on this summit will give you specific information about. You'll listen to one speaker and say, "Oh, my gosh, I've got to do that." Or, "Oh, my gosh, I've got to do that." Or, "Oh, my gosh, I probably have that." But when you step back and understand, "Okay, where is the weak link in my chain?" And when you understand, "Okay, that's just the deck of cards I was dealt. Okay, how do I strengthen this link? How do I reduce the pull on this link?" It doesn't matter if it's the Alzheimer's gene or the heart attack gene or the cancer gene. It doesn't matter what the gene is. How do I reduce the pull on that link in my chain?

James: Beautiful. So towards the end of the interview, I'd love to just get into how do we take pressure off the chain and talk about that. But maybe as a starting point, I know a really great analogy that you shared with me is this triangle of autoimmune initiation. And so maybe we can just start there because if I can help one person avoid an autoimmune disease that they would have got through not knowing this, then this summit is good. This was like a good use of our time on this planet, right. But obviously, there's tens of thousands of people listening. So if you can share what the recent literature says about what is initiating autoimmune, and what is under our control, and what is not?

Dr. O'Bryan: You bet, with pleasure. The study started coming out in 2004-- so about 13 years ago--that there is a trilogy in the development of autoimmune disease. Now, remember, autoimmune disease is the endpoint of the weak link in your chain getting looser, looser, looser. And it goes into an autoimmune disease. But there's a trilogy in the development of it.

First, you have to have the gene for that particular disease. Second, the environmental trigger that sets it off, pulling on the chain. The straw that broke the camel's back. And the third is called pathogenic intestinal permeability or the slang term is the leaky gut because it's the dysfunction in the intestines, the leaky gut, it activates the pull on the chain in your body. When you eat something that might not be good for you like wheat or dairy, if

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you have a sensitivity to wheat or dairy, when you eat it, it's in the tube, going down into the stomach.

"Mrs. Patient, your intestines are a tube that goes from the mouth to the other end. It's 20-25 feet long. It winds around there in your gut." Think of a doughnut. If you could stretch a doughnut out, just one big long doughnut. And you look down the center of the doughnut, that's your digestive tract. And when you swallow food, it's in the doughnut. It's not in the body yet. It's in the tube.

So food has to get through the walls of the tube to get into the bloodstream, and go to your brain, and your kidneys, and everywhere else. So it's that wall that gets damaged and allows all of these environmental triggers to get through into the bloodstream. You also can inhale stuff.

And it's the same type of wall in your lungs that lets stuff get through the tube. The concept is, it's that wall on the inside of the tube. That's where pathogenic intestinal permeability or the leaky gut occurs or the leaky lungs. It's the inside lining. So when you address that inside lining and you strengthen that inside lining, the result is you don't pull on the chain. And if you don't pull on the chain, you don't activate the gene.

James: Yeah, like I said in the old way of thinking, the gut and working with the gut was just something that would only affect the gut. Like, if you have an unhealthy gut, you're going to have maybe an autoimmune disease of the gut like Crohn's or colitis. But the new research, from my understanding, is that the gut is so connected to every part of the body that these kinds of issues in the gut could end up manifesting in the joints, or in the brain, or anywhere else in the body because of this dynamic connection system that is the human body, right.

Dr. O'Bryan: We just finished the Annual International Conference for the Institute of Functional Medicine. And it was the largest one we've ever had. Sold out, of course, like they all do. And this one the theme was Regeneration of Your Brain. How do you reverse some of the brain deterioration that's occurring, if that's the weak link in your chain? Almost every speaker talked about the importance of addressing the gut to heal your brain. They weren't talking about if you have gut symptoms. They were talking about you want to heal your brain, you want to turn around the degeneration that's going on, you have to also address the gut. You have to address the microbiome, the good bacteria in the intestines. You have to address the wall that I was talking about that leaks through, almost every speaker.

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And this is like the world's leading geneticist from Harvard on brain function talking. And the world's leading authority on reversing Alzheimer's, Dr. Dale Bredesen, who's published papers on actually reversing Alzheimer's in 9 out of 10 patients. That was in 2014. And now, it's over 100 patients that they've completely reversed it. It takes five years. It's a functional medicine approach.

But at the top of the list, what you have to address is the gut because if you've got this pathway where there's tears in the gut--well, they're really tiny, tiny little tears called intestinal permeability--and all these environmental triggers that we're exposed to in our food or in our beverages, if they get into the bloodstream and start circulating, that's the gasoline on the fire that pulls on the chain that breaks at the weakest link. And that's your genes. So the gut, the gut is a critical component to address when you're wanting to address your genetic strengths and your genetic vulnerabilities.

James: Beautiful. So the purpose of this summit is really to have people take a responsible interpretation of their genetics. So what I hear you saying is that whatever your genetic test comes back, you want to be minimizing the pull on the chain. And you want to be minimizing and repairing the holes in your gut to make sure that you don't end up with a broken-chain situation, which would be an autoimmune disease, which could manifest anywhere depending on your genetic makeup.

Dr. O'Bryan: Let's use the example of Alzheimer's. What you said is exactly correct. Let's use the example of Alzheimer's. The main gene that's been talked about so many times, with regards to Alzheimer's, is APOE4. The APOE gene, there's three versions. There's a two. There's a three. And there's a four. You get one from your mother and one from your father. She can be a 2/2, a 2/3, a 2/4, a 3/3, a 3/4 or a 4/4. Those are the options. APOE4, if that's a gene that you have, you have a...

First, the average in our society today, without looking at genes, if you reach the age of 85, 50% of us will get Alzheimer's. That's the numbers today--50% of everybody. But if you have one of the APOE4 genes, so you're a 2/4 or a 3/4, it's 90% by the age of 85. If you have two APOE4 genes, one from your mother and one from your father, it's 90% by the age of 65 that are going to get Alzheimer's. But see, all of those studies, which are very accurate, all of those studies are based on people still eating Ding-Dongs, and Ho-Ho's, and drinking Coca-Cola, and pulling on their chain every day and not knowing that they're active. They're pulling, pulling, pulling.

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So all of my patients that have a family history of Alzheimer's, I recommend they get the gene test. And they say, "Well, I don't want to know." I say, "No, you do. You do because when you see this, that's the motivation for you to learn, "What do I do?" And so what you learn is, "Okay, how am I pulling on the chain in my life?" Whatever it is. "How am I pulling on the chain?" And then, you look at the biomarkers, the blood test or the urine test, that show you're pulling on the chain. You've got lots of inflammation going on. And there's a number of biomarkers.

But here's your starting point. And you want to see that there are problems here. And if there's problems with the biomarkers, the patient says, "Oh, my God." I say, "No, no this is good because all of these are correctable." So when you apply this lifestyle change, or this environmental change, or whatever it should be that your body needs, when you apply that, you recheck the biomarkers. And in six months, they're down to normal. And when they're down to normal, as with all the science we have today, you're not pulling on the chain anymore. And then, you just check those biomarkers every six months or every year.

I have many, many patients now, APOE4's, they were highly inflamed. They had symptoms that brought them to me. Now, their symptoms are gone. And they check those biomarkers every year. You don't mess around with this. I don't care how you feel because some people say, "I feel great. I don't need to do the test." No, you don't feel when you're killing off brain cells. You don't feel it until you've killed off enough brain cells that now it's obvious because you've got brain fog. And you're not thinking the way you used to.

So you want to check these markers. These are like temperature gauges on the dashboard of your car, as opposed to a hot light on the dashboard of your car. [Inaudible] The temperature gauges show that the problem is creeping up there before your engine's overheating. That's why you use these biomarkers.

James: What are some of your favorite biomarkers, Tom?

Dr. O'Bryan: 8-hydroxy-2'-deoxy-deoxyguanosine. That's a helluva Scrabble word. But just 8-hydroxy. It's a simple urine test. I think it's about 90 bucks. I'm not sure. But it's a measure of the DNA residue from damaged brain cells or damaged nerve cells, mostly in the brain. So you just do a simple urine test. And if your 8-hydroxy is up, you're killing off brain cells. And that makes you say, "Well, why?" And then, when you're with your doctor, you investigate to find out, "How are you pulling on the chain?" That's the first one.

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Antibodies. Antibodies to your brain. You want to look at antibodies to the blood-brain barrier in your gut. The lining, that tube for intestinal permeability. You have a simple type of lining on your brain that stops molecules from getting in the brain that shouldn't be here. So you want to look for antibodies to amylase, antibodies to S100B. These are the technical stuff. But there's a panel of antibodies that you could look for to see, "Is my brain on fire right now," because if you have elevated antibodies, your brain's on fire. You're killing off brain cells. I don't care how you feel. "Here's the test results. You want to do it again? All right, we'll do it again." But these tests are extremely accurate. The technology now is 99% sensitivity and 100% specificity, which means they're right on the money every time.

But if a patient goes, well, maybe the test is wrong. "Well, maybe, you want to do it again? We'll do it again. That's fine." I've never seen it come back different now. So you look at antibodies to your brain. You look at 8-hydroxy. You look at urine lipid peroxides. You look at--and this last one is not so much a measure of brain deterioration, but--hs-CRP. High-sensitivity CRP is a measure of inflammation in your body. So you look for the inflammatory markers, in this example APOE4. You look at 8-hydroxy, antibodies to your brain, urine lipid peroxides. Those are the three that I use. And there may be others, also. But the concept is you look for the biomarkers to tell you that your engine's overheating before you've killed off so much tissue, it's now obvious.

James: Yeah, this is the beauty of combining, I think, the genetic tests and the biomarkers because obviously that seems like the most relevant way to take a responsible attitude to it to see what the blueprint of the house looks like, and then also to get an idea of like how the house is actually being built, and to be able to see that. So--

Dr. O'Bryan: I'd like to give you an example.

James: Sure.

Dr. O'Bryan: I was with a good friend of mine--one of my mentors--yesterday. And he's just been diagnosed with an autoimmune disease that's a nasty autoimmune disease. And they tell him, it's a type of cancer. So he went to an oncologist who put him on steroids to keep it down. And I said, "What happened?" And he said, "I don't know. Six months ago, my blood test was completely normal. But now, this came up." And I said, "Well, that's great! That means it's fresh. You know, that means it hasn't gone..." So his hot light or the temperature gauge was on for a long time. It was on for a long time. It

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had to be killing off cells, killing off cells. Now, this autoimmune disease is causing symptoms. And so he went back to the doctor. And boom, they found it. But it wasn't there six months ago. Well, yes, it was. But it just wasn't bad enough yet to be diagnosable, right.

So the oncologist has him on these drugs to calm down the symptoms. Great. Perfect protocol to begin with in the short term. But I said to him, "So, Len, the question is why is this happening? What's the trigger that's pulling on the chain to cause this? Obviously, you've got the genes for this." And it turns out his grandfather had similar symptoms and died from it. They didn't diagnose it back then. But he had the exact same symptoms that Len's developed. And so it's genetic.

So what is the trigger pulling on the chain for him? He said, "Well, they didn't talk to me about that. They didn't think about that, you know. They gave me these drugs. And I know the side effects of the drugs. But I need to take the drugs." I said, "Yes, you do. But let's ask the question, where is this coming from? And maybe, in three months, six months, a year, you'll be able to get off the meds." And he's a brilliant guy. So he said, "Well, that makes perfect sense." So now, he's diving in to get the tests done to find out what's pulling on his chain.

James: So what are the things that are classically pulling on people's chain the most? What are these environmental insults that are modifiable for most people? Because what I see is like some people need the tests to get fired up, right, generally men, especially the genetic tests. And that's one of the things I'd like to reach more men in this summit because I think women intuitively get it. They realize the process that happens from wellness to illness. And it's not just something that happens overnight. And that's why 75% of functional medicine doctors and 75% of functional medicine patients are women.

So one of the things I've seen is that I've heard Jeff Bland talk about his own engagement into his health to a deeper level when he had the genetic testing. I did it for myself. For this summit, I did the metabolomic testing, the genetic testing, and went through all the results online in real time just to be able to show that this is not something that's scary. This is something that is ultimately empowering.

So what are the major things that are under our control? Because some people will want to do the test. But ultimately, whatever test you get, you're pretty much going to want to start to take some action. For those people who

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