In the Three Stooges 1937 short film, Dizzy Doctors, our heroes take jobs as medicine salesman based on the all-important qualification of…”needing a job.” They’re clueless as to their product’s purpose but that doesn’t stop them from opportunistically looking for an application that will make them money. Ten minutes into this romp, they graduate from selling medicine to practicing it. It’s a typical mind-numbing exploit from this trio but a perfect metaphor for the way our healthcare system works.
Cases in point, I don’t have to look too deeply into my Google news feed or my email inbox to find a report of some incremental discovery in the fields of genetics (study of genes and DNA), endocrinology (study of hormones and the glands that secrete them) or microbiotics (the study of the microorganisms that live on and in our body). From there, it’s just a hop, click and a jump to some article in the media that blows the finding out of proportion and yet another click or two to some unqualified charlatan selling snake oil that exploits the finding in a misleading way.
This is the first post in a three-part series about the three stooges of health genes, hormones and the microbiome. How much can you depend on your healthcare practitioner to know the score? What can you do to protect yourself? Who are the real stooges? Let’s find out. Starting with your genes.
Davey H and The Three Stooges
Okay, I know this is blasphemy, but I was never a fan of the Three Stooges. When most of my friends were happily tuning in Officer Joe Bolton on New York’s channel 11 (WPIX), I was searching the upper reaches of the UHF spectrum or aiming my aerial antenna (the wireless precursor to Comcast, may they rot in hell) towards Philadelphia in search of a Marx Brother’s movie. Discerning consumer of comedy that I was, I never appreciated the slapstick stylings of Larry, Curly and Moe when compared to the juvenile puns and pranks of Groucho, Chico, Harpo and Zeppo.
So if in my likening the current rage of conducting chromosome tests, hawking hormone adjustments and pitching probiotics to your favorite comedy troupe, I display ignorance, I apologize in advance. Just remember, the Karma Sense goal of this series is to educate you as a consumer of healthcare services. Because as my old boss Sy Syms used to say during commercial breaks of Joe Bolton’s Three Stooges Funhouse, “An educated consumer is our best customer.”
Genes Hormones Microbiome
To get started it may be helpful to reference that well-worn chart from The Karma Sense Eating Plan of the 6 Factors That Impact Health.
In this model, we link six different categories that work together to define your wellness. You have more control over some of these categories than others but at neither end of the spectrum is your control or lack thereof absolute. you have the least control over is your genes.
Of these categories, you have the least control over your genes.
Genes are the Moe of the Three Stooges metaphor. Moe is always trying to dominate his chums but things don’t always end up as he hopes.
Your genetic code exercises dominance over your health and happiness but in many cases, you can fight back. There are a ton of health conditions that your genes influence but that can be overcome with action on your part.
For example, there is a gene that goes by the short name of FTO (oddly, it stands for alpha-ketoglutarate-dependent dioxygenase Fat Mass and Obesity and not for F*ck the Opposition as I have always been led to believe). Geneticists now know that people with certain configurations of the FTO gene are prone to obesity. Their body and brains respond differently to food and this results in increased fat storage.
I have the most obesity-prone combination of the FTO gene. I’ve been called a lot of things (e.g., pompous, arrogant, rude, condescending). I mean a lot of things (e.g., boorish, supercilious, pontifical, poopy-head). But, it’s been a long time since I’ve been called overweight. And that’s because the way I interact with the world counteracts the coding in my genes.
The pace of advancement in genetics is mind boggling. But, science is still in a “we-don’t-know-what-we-don’t-know” mode. For example, our ability to predict the likelihood of breast cancer based on the state of the so-called BCRA1 and BCRA2 gene is a life saver. Many well-meaning physicians may use this knowledge to encourage expensive genetic testing and pre-emptive mastectomies. This is a tragedy.
Not all breast cancers are caused by the BCRA mutation and not all BCRA mutations are guarantees of eventual breast cancer. There are many other less expensive and annoying diagnostics available to predict one’s odds for breast cancer. A detailed survey of family history of breast cancer should come first. This survey ought to include such detail as the relationship and age of the inflicted. Breast cancer by a second cousin or by a relative in her eighties would not be a cause for immediate concern.
For some, the peace of mind of a genetic test may be worth the expense. For others, it may lead to unnecessary suffering. This article from Wired relates this point well.
There are over three billion base pairs of genes to research. All humans have most of these base pairs in common. Even with the remainder, that leaves an infinite number of combinations. Needless to say, but apparently I feel the need to say it anyway, there’s a lot to learn and few people have the intellect, knowledge and resources to become experts in even a small part of our genetic structure.
Even the experts are subject to error. Sometimes that human error is compounded by the usual culprit, Microsoft. For example, three Australian researchers recently did a study of over 3,000 research papers about genetics. They found that twenty percent of them had errors instigated by the use of Microsoft Excel. Do you see those funny acronyms I’m using to indicate specific genes (e.g. FTO, MTHFR)? Sometimes they end up being close enough to other terms so Excel, in its infinite wisdom, autocorrects them. An example is the SEPT2 gene which Excel converts to the date September 2 (no doubt in deference to National Blueberry Popsicle Day).
As complex as genetics is, there are plenty of amateurs willing to step up and claim they are more than they are. They try and convince you that any collection of nondescript symptoms you may have are the cause of some genetic defect. I cover one of these in depth in the classic Karma Sense Wellness post, Karma Sense Can Be a MTHFR.
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To summarize that post, MTHFR is the symbol used for a specific gene that provides the instructions for making methylene tetrahydrofolate reductase (or “stuff in your body,” for short). Certain physicians and other self-proclaimed health professionals direct their patients to behave in very specific ways due to the distinct configuration of the patient’s MTHFR gene. They start off by hawking expensive genetic testing the results of which they use to pressure you to buy costly supplements and procedures. This is a scam. One way to tell it’s a scam is
This is a scam. One way to tell it’s a scam is when the leading “experts” seem more interested in convincing other people that they can make money by also becoming “experts.” Such is the case with Dr. Ben Lynch and his MTHFR.NET traveling snake oil road show.
Superhero Genes (Because What Karma Sense Post is Complete Without a Superhero Reference)
As a final demonstration of how little we know about the human genome, this study in Nature Biotechnology, looked for people who seem perfectly healthy despite carrying DNA mutations linked to severe childhood disorders such as cystic fibrosis. In a pool of 589,306 people (N=589,306), the study authors found thirteen people with genetic mutations that scientists know cause the disease yet these people don’t have it. Obviously, there’s more to learn.
Perhaps less obvious is the new superhero ensemble I think we all deserve with the name The Lucky 13. (NOTE TO SELF: Copyright this comic book franchise ASAP).
What Can You Do to Avoid The Gene Stooge?
Unfortunately, surfing above channel 14 and adjusting the rabbit ears won’t work.
To fight the tide of over-confidence and under-handedness in the world of genetics, you’ll want to look towards the conclusion of this series. Since there’s a great deal of overlap with each of the stooges, it’s best to tell the whole story before dispensing advice.
For now, since I’m not a genetic expert either, I’ll defer to someone who is. Dr. Mary Beth Weber is a professor at the Global Diabetes Research Center at Emory University in Atlanta, Georgia. Dr. Weber said in a recent Medscape article, “Although a lot of people are arguing for genetic testing and personalized medicine, I would tend to agree that we are not [yet] at that point clinically.”
Meanwhile, one thing I am an expert on is delivering useful health and happiness content in a reliable and entertaining way. If you’re interested in joining the fun, consider subscribing to the Karma Sense Wellness newsletter. If keeps you up to date on the latest blog posts, podcast topics, events and exclusives available only to subscribers.
We’ll pick up with the next stooge, Larry/Hormones here.