Episdoe 82: Dont Feel Well but Dont Know Why? Omics and Precision Medicine with Dr Anil Bajnath MD
Show Summary:
Dr. Bajnath is a Board-Certified Family Physician and author of The Longevity Equation: The Step-By-Step Blueprint to Hack Your Genes, Optimize Your Health, And Master the Art of Existence.
His approach to medicine incorporates precision personalized healthcare modalities such as individualized nutrition, genomic medicine, advanced biomarker testing, microbiome analysis, and biometric lifestyle monitoring.
In today’s conversation we'll be exploring what omics are and how Dr. Bajnath uses precision medicine to create personalized treatment plans for his patients. We'll also talk about how he integrates this approach into his medical practice and what you can do to bring this level of care into your wellness plan.
So, if you're curious about precision medicine and how it can improve your health, you definitely don't want to miss this episode.
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Full Transcript:
Dr. Anil Bajnath:
The biggest messages, we're all unique. We all have, you know, all sorts of different life experiences. And I also do believe that there is a transgenerational epigenetic programming. So, you know, I think that's been kind of clinically proven. And Mayo Clinic has really highlighted some of the research studies around three to seven generation hypothesis that, this goes back before us, it's beyond us. And that just because you’re going to your doctor and they’re just saying, hey your bloodwork looks normal and you don’t feel right and you’re not getting the right answers. There is hope.
Dr. Andrew Wong:
Welcome back to the Capitol Integrative Health podcast. I am your host, Dr. Andrew Wong. And I'm excited to bring you a conversation today with Dr. Anil Bajnath. Diving into the topics of omics and personalized medicine. Dr. Bajnath is a board certified family physician and author of the longevity equation, the step by step blueprint to hack your genes, optimize your health and master the art of existence. In today's conversation, we'll be exploring what omics are, and how Dr. Bajnath uses precision medicine to create personalized treatment plans for his patients. We'll also talk about how he integrates this approach into his medical practice, and what you can do to bring this level of care into your wellness plan. So if you're curious about precision medicine, and genomics, and how this can improve your health, you definitely don't want to miss this episode. Let's jump right in.
Dr. Andrew Wong:
Hey, Neil, welcome to the CH podcast, we're so glad that you're here.
Dr. Anil Bajnath:
Andy, it's always a pleasure getting to hang out with you. I'm looking forward to today's conversation, thank you so much for having me.
Dr. Andrew Wong:
Thank you for coming on. And definitely, this will be a lot of fun. You know, I know, we have talked over the years as colleagues and as friends. And really, we know that it is all about having fun, and we're talking about discussing health and wellness. Because fun makes, you know, kind of makes the merry go round and life, you know, a little bit more enjoyable.
Dr. Anil Bajnath:
It really does. You know, you got to enjoy what you do. And, you know, our conversations over the years for me have always been, you know, encouraging and inspiring on multiple levels, both clinically spiritually, professionally. And I thank you for those conversations.
Dr. Andrew Wong:
Same here. Same here. And I think let's segue into enjoyment and fun with our first question, which is a very broad question. But I think this is also very fascinating, because I think a lot of times people are wondering, or listeners are wondering, you know, how does it do you know, what makes Anil tick? What, how did how did you get into the functional medicine space, and I think this is very inspiring for people as well. So kind of just if you would tell us about what drew you to get into functional medicine, become a practitioner, and what you enjoy most about what you do when you're kind of having fun on a daily basis?
Dr. Anil Bajnath:
Well, thank you for that question. You know, actually, it's a labor of love, I got into the health sciences and the healing arts, you know, as a teenager, I started off working at a Whole Foods Market back when it was owned by John Mackey and the hippies, pre Amazon days and vitamins. And that was my first exposure to some of the nutraceuticals and at that time, we actually had tons of different doctors from around the world that would come in and tour a Whole Foods Markets around the US and provide educational seminars and series almost along the lines of what how pharmaceutical reps would, host these events and train you on the products and in the methods and mechanisms of action, and so forth.
So that was kind of my first, exposure to the world of Integrative Medicine at the age of 16. And it basically carried forward and did a senior project in high school around natural medicine and all the different vitamins, minerals, homeopathics and herbs. And, and then from there actually my, one of my high school wrestling coaches got me introduced to a technique using the microscope you see behind me there darkfield Phase contrast microscopy, and flew out and got certified in Chicago with this technique at the age of 19. Bought the microscope started analyzing everyone's blood. I thought I wanted to be a Humana pathologist until I did a kind of a rotation at MD Anderson Cancer Center in Orlando, Florida, where I was majoring in molecular Microbiology in Medical Laboratory Science. And after working there I realized I enjoy speaking to people and not just being a lab rat, you know, so to speak.
And so I've always been into, you know, the kind of the healing arts in the molecular sciences. And during undergrad, I essentially was sought out different trainings with, you know, different mentors and doctors, I completed a two year seminar series with the European biological medicine practice of Paracelsus. So the Paracelsus network with Dr. Thomas Rao, I also completed training with Peter Diadamo, with his course that he was hosting back then kind of in regards to nutrigenetics-nutrigenomics. And so that was, that was really exciting. So, it's always been something that I've been really interested in my first functional medicine course was like, in 2005, with the apex group, and to tease kharrazian, who's another blockbuster in the space. So it's really a labor of love, which kind of has directed me towards, you know, the field that I'm in now, you know, with functional medicine, anti-aging, regenerative medicine and teaching at the university. Yeah,
Dr. Andrew Wong:
Yeah. Well, and you know, just with that background, you've really gone to the greatest hits of all the different functional girls and, you know, integrative practitioners, you're really someone that's really gotten into the world of omics. And that's kind of our topic today is kind of how you bring genetic studies and you know, lab results and precision medicine and to your practice, kind of how you think about that. I think for listeners, just to start broadly, for those who may not be as familiar with it, what is omics? If you could just define that, and why is that so important for human health?
Dr. Anil Bajnath:
You know, it's really interesting, because when you really start, looking at the translational science process, meaning connecting those molecular dots, from genome to pathophenome, or from DNA to disease and dysfunction, right, we're able to, you know, build upon this architecture that gives rise to the human construct in our ability to kind of understand and navigate what's going on that molecular level. And, again, being, you know, molecular microbiologists by training, I always wanted to implement and infuse these different resources into clinical practice. And, you know, from the time that I graduated high school to the time where we're at now, there's been some tremendous advancements, with the completion of the Human Genome Project, and, and all sorts of other research in the field of precision medicine.
And so omics broadly refers to looking at those different respected sub sciences, for example, genomics, looking at DNA, transcript, omics looking at RNA, proteomics, looking at the proteins metabolomics, looking at metabolism, right, microbiome mix, looking at how the microbes, externally and internally are affecting us. And also even looking at the enviro biome, which is the external environment and how that influences and shapes our, you know, health expression. So it's, it's very interesting. So each one kind of connects that molecular dawn. And in somehow, I stumbled into the position of being the course director for the omics and medicine class at George Washington University, where I teach other, fellows undergoing the fellowship and the master's degree, this kind of an advanced translational science process. And to me, it's just one of those things that just very fascinating tool to look at. Because we all have our unique book of life, which was kind of genetically inherited 50%, co-authored by your biological mother, and then 50%, by your biological father. And that combination of inheritance patterns, coupled with, you know, just our life experience, gives rise to kind of who we are, what we are our disease, disposition and our resiliency.
So I really think that looking at, you know, individuals that through that lens, using omics and systems biology is one of the most precise ways of navigating individualized medicine and care. And then also a big part of that is looking at the epigenome and how that environment influences, you know, gene expression, right? Because we know that, you know, we're receiving all these different signals and inputs from the periphery, that's influencing our gene expression, and we have the ability to turn up different favorable genes and we have the ability to turn down you know, unfavorable genes based on various signals and inputs that we're feeding our ourselves you know, whether it's actual food, or environmental pathogens it's quite fascinating to see that on a precision level.
Dr. Andrew Wong:
So a couple of interesting thoughts that I had when you're talking is that it sounds like precision medicine will be kind of better suited towards someone really deeply understanding their physiology and how they can express or not express various genes in terms of epigenetics, almost like precision begets better prevention. Is that is that a sort of an accurate statement there?
Dr. Anil Bajnath:
I would definitely say yes, if you had access to your owner's manual, and you were able to kind of figure out, hey, why, when I eat these certain types of foods, I just feel lethargic and sluggish, and like bloat a little bit, might experience aches and pains, or hey, why is there this kind of prevalency, amongst, different generations of this specific disease or dysfunction, you know, that understanding and leveraging that information for empowerment, I think, is one of our greatest opportunities. But not to overstate it, because, again. I really feel as though that, the promise of genetics, what it was touted to be, clinically, you know, 1015 years ago, doesn't carry the same magnitude because of that epigenetic factor, that concept of genetic determinism, where if you have this gene, it's a doomsday diagnosis, or whatever it is, is no longer the prevailing kind of consensus is, as we better understand, the difference between genetics, genomics and epi genetics. And again, the difference, for the audience here, I think, would be important to define. Whereas genetics is kind of looking at things through the traditional lens of Mendelian genetics and inheritance patterns, looking at those inborn errors of metabolism, your PKUs and cystic fibrosis, those kinds of obscure issues, whereas genomics is referring to the entire book, where we're looking at all the different variations in genes, what's also known as single nucleotide polymorphisms, or snips, and how that influences our clinical expression, and how we can leverage that information for multiple clinical applications.
Additionally, I think that we're getting away from looking at snips now over the past couple of years, and we're looking at things called poly genetic risk scores, where we're aggregating clusters of genes and how that influences various molecular networks and pathways. And leveraging that information, I think, has a tremendous potential at for overall health optimization.
Dr. Andrew Wong:
So really, as these science advances, and some of this gets into clinical practice, it seems like the kind of going back to functional medicine lens, it's a bit more like, we can't totally discount the complexity, like we first tried to use the Human Genome Project to say, Oh, we're gonna figure out all these, you know, genes and just decode everything just from that, but it wasn't that simple. So then we went to snips. And now we're going to the poly genetic risk factors, right. So it's almost like the more we delve into it, the more that it's all connected still.
Dr. Anil Bajnath:
Exactly. And then one of the things that I love to use in clinical practice is actually transcript omics. So again, going back to the central dogma of biology, which is DNA into RNA and RNA into protein, right? I actually, you know, use transcriptomic data in the my clinical practice regularly, especially dealing with chronic complex illness, you know, to kind of unpack kind of the core factors that could be influencing somebody's gene expression. You know, we're not necessarily looking at what DNA you have using transcriptomics. But we're more so looking at the behavior of very specific gene patterns, right. So it's very interesting to look at and my mentor, Dr. Andrew Heyman likes to give the analogy if we're looking at the transcriptome, we're essentially looking at these various genes, right, if we were looking at if genes as maybe the instruments of your own personal Symphony Orchestra, we're measuring various, you know, sections of that orchestra, the strings and the brass and so forth. And maybe we're going to the flute and we're assessing is a flute appropriately tote tuned appropriately, or the piano? Is that piano? Like essentially tuned appropriately, and what's the harmony coming off of that piano? Is it upregulated as a downregulated in sound and structure? And that's kind of a, I think a really important opportunity clinically is, you know, looking at that transcriptome and how to apply it clinically.
Dr. Andrew Wong:
And let's talk about that's great. Let's talk about how we apply that clinically. So a patient walks into your clinic, maybe they have chronic fatigue, maybe they have more exposure or whatnot. How are you praying, bringing you know omics and personalize preventative health care modalities, you know, genomic medicine, all the different advanced biomarkers that you talk about, into your practice? Well,
Dr. Anil Bajnath:
you know, so generally, it's very interesting. So it depends on who's walking through the door, and what their goals are, what their symptoms are. Speaking with the Institute for Human optimization, I'm dealing with a subset of the population that's maybe a little bit more aware of, you know, some of the biohacking space and health optimization world. But I also work, you know, with Dr. Andrew Heyman and his practice as well, you know, a mentor of mine, and also, we work together and teach together at George Washington University, where, you know, we're advancing the science, the translational science of chronic inflammatory response syndrome. Now with serves Madison, you know, this, which you have kind of inferred with the mold exposure, you know, there's, there's kind of this algorithm and protocol for which you, you navigate, you know, these different cases, but essentially, we look to look to see, if individuals of the population have a very specific HLA haplotype, you know, and based on that genetic predisposition of your HLA s, and, you know, that could determine whether or not you're part of that kind of 25% of the population that carries with it, that haplotype that kind of predisposes them towards, you know, this, these environmentally acquired sensitivities and potential illnesses. And then once we kind of identify that and there's, you know, a series of other additional tests that we use like a VCs test, and, you know, which is a visual contrast sensitivity test to screen for Neuro inflammation, we then look to the system clusters and if you have eight out of 13 symptoms, you know, there's a high association that you know, 98% certainty that this could be service or chronic inflammatory response syndrome. And then you know, we test the environment with environment omics, we look at the proteomics in regards to you know, the various biomarkers like TGF beta one MMP nine c, three AC for a veg F, you know, and a whole host of others MSH low, a few others and that's a proteomic signature. And then we also use the transcript omics to look at the more like layer signature of kind of what's going on underneath the hood.
So we kind of connect those molecular dots in that sense to further identify what's going on and you brought up chronic fatigue myalgic encephalitis is a very common kind of issue. And one of the things that we see on a transcriptomic level with these individuals. And it's not only service it could also be associated with you know histamine dysregulation and things of that nature, but is something called molecular hypo metabolism. And that will like or hypo metabolism is essentially referring to how the mitochondria are triaging energy, right. And it ties back into what's known in the literature is cell danger response. And we we've all heard of cell data, most of us have heard of cell danger response, you know, in regards to cells, you know, kind of sense danger and they respond, and they respond by shifting and reallocating its resources and energy production, towards like a defensive posturing due to that threat, that environmental threat. So we see you know, the signs of molecular hypo metabolism on a mitochondrial level. And we see other signs of, you know, kind of how the, the body kind of reallocates its energy and, and triaging of energy and resources due to those environmental signals and threats.
Dr. Andrew Wong:
This is a transcriptomics test or for the molecular signals for hippo metabolism or what labs are these are these blood tests or what kind of labs
Dr. Anil Bajnath:
It’s a blood test is called Pro gene dx. Okay. There are a lab out of Massachusetts. And with Jimmy Ryan, Dr. Shoemaker and Andrew Heyman are kind of, you know, the major researchers and clinicians
Dr. Andrew Wong:
So these will be people with chronic fatigue or mold or different chronic illnesses. You wouldn't necessarily order a transcript trip. Transcript don't mix I should say, on a healthy patient walking walking in, they're looking to better their CrossFit game or something right?
Dr. Anil Bajnath:
Not on that that type of person. Yeah, no, actually, you know, it's interesting because when you look at, you know, especially aging as a biological process, I'm sure you're very familiar with the cell biology publication in 2013. With Lopez Atal, on, you know, the hallmarks of aging, you might have seen that it's been a kind of updated months ago in January of 2023. And essentially adding on three new hallmarks of aging, which include, you know, the dysregulated, or dysregulated, macro autophagy, chronic inflammation, and dysbiosis are microbiome and balance issues. And that kind of ties into this big issue that we see with biological aging as a whole, right, is that we have this chronic inflammation process that's taking place.
Now everybody's inflammation is different, right, and what's perpetuating that, and I think, you know, the transcriptomics could be a benefit to certain individuals, I reserve that test for kind of like the mystery illnesses with all sorts of like, kind of uncertainties of what's going on that molecular level. And not necessarily my jujitsu buddies that are coming in for, you know, other health optimization issues, you know, peptides, hormones and regenerative modalities. So again, I tried to be mindful with what I pulled the trigger on with individuals, but everybody, try, I try to get at least everybody get genotype to my practice. Additionally, I liked, you know, the biological age testing as well, to kind of, you know, really put into perspective from an aging, you know, you know, kind of baseline how we're aging, that pace of aging is really important.
Dr. Andrew Wong:
Are you using the DNA methylation to age and different things?
Dr. Anil Bajnath:
I like true age, you know, I'm, you know, actually for my birthday. A year ago, I went and toured the facility and everything else before I went and enjoy the Bourbon Trail out in Kentucky. I know they have a wonderful lab, and honestly, their bioinformatics is top notch. I know, there's some criticisms right now, in the space, whether or not you know, these clock genes are accurate representations of you know, of aging, you know, some would say, it's kind of misleading to the consumer to say, hey, we're going to reverse your biological age. But I think, you know, it's a great opportunity, if we have the resources to kind of peek under the hood to see, you know, what, that epigenetic expressions looking like, you know, what, you know, what is our aging process looking like, and the pace of aging, and we could do things to kind of identify that and if you've run that panel, you know, it's quite wonderful. It's, you know, you got your intrinsic and extrinsic and intrinsic and extrinsic age. Additionally, you have your Dane piece of aging, which is, you know, a major study, you know, as well, that that really identifies that now they've added on telomeres, right and stem cell activity,
Dr. Andrew Wong:
I have to recheck it. I did check mine a couple of years ago, but I haven't done the updated tests. So I'm really excited about the new additions, they have that test.
Dr. Anil Bajnath:
It's phenomenal. You know, I really like that. And that's kind of where I like to start, you know, from a health optimization standpoint, what's your biological age baseline? And do we have the ability to augment you know, that longevity trajectory, which kind of ties into my book that I'm finishing up the final edits in, you know, the longevity equation, you know, so within the longevity equation, you know, we kind of lay out all these different factors, we unpack the hallmarks of aging.
And then also, you know, I'm willing to share with your audience here now, you know, I've trademarked this concept of the biological 401 K, and the biological 401k is essentially our internal biological health savings accounts. Right. And essentially, we have the savings account, and we're making meaningful deposits and withdrawals and different forms of bioenergetic currency to this account, and meaningful bioenergetic epigenetic currency would include sleep nutrition, diet, exercise meaning and purpose relationships, you know, optimize environment stress reduction, decreasing that allostatic load all the fun things that we talk about in the field of integrative and functional medicine, but it also you know, looks at those are you know, the deposits and withdrawals so we know that hey man you know I've got a newborn my sleeps gone to crap my aura ring is yelling at me Hey, you know yeah to be optimal, optimal now it's like good you know, warning signs yet.
Dr. Andrew Wong:
They don’t have that baby curve. They don't curve it up for the baby, I guess. Yeah.
Dr. Anil Bajnath:
There's no confident, you know, factor to, you know, adjust for that that variable. But, you know, essentially it's just one of those things where we're looking at these different kind of biological deposits and withdrawals from our biological 401k. And ultimately what we have is this savings account that is essentially going to, you know, the ROI on the savings account is going to be essentially cultivating resiliency. And, you know, increasing your health span over your lifespan and compressing that time of disease and dysfunction, and hopefully growing old into our welder Lee as Dr. Eric Topol.
Dr. Andrew Wong:
Oh, I like that. I love that. Well, really well, just to request a sneak peek, and I would be the first in line for your book. So hopefully, I can get Lyme today. For your book. It sounds amazing. And Neil, I'm just curious about physiologically, how those 401k for one gate deposits happen is a kind of healthier DNA methylation? Is it kind of loss of zombie cells? You know, what's kind of going on under the hood? I guess it's something you're looking at your book, and I had to bring in zombie cells. I knew I wanted to talk about that today. Oh, I love thanks very much.
Dr. Anil Bajnath:
You know, so I think, you know, looking under the hood, there's so many different ways to assess your your resiliency, because it the big picture with this is is looking at, you know, loss of resiliency and adaptive capacity being kind of the benchmark of growing old, you know, some people are most more focused on their aesthetics or, you know, their, their, you know, their performance and so forth. But ultimately, once we lose those adaptive capacities, right, that's truly the benchmark of disease and dysfunction, right? Because you're to ask, what is health? You know, is health merely the absence of disease? I don't think so.
I think health is actually a homeodynamic process that's constantly in flux, right? It's not static, it's dynamic. And we're going to be putting in various signals and inputs that influences various allostatic loads, that's going to basically translate into, you know, how our body kind of balances out but health isn't, you know, merely an absence of disease. It's the adaptive capacity to have resiliency in my opinion. Right. And, you know, that's there's articles, and publications around resiliency and aging that we could unpack a little bit further. But to answer more specifically, yes, nutrition in regards to epi nutrients, as Kara Fitzgerald has mentioned, in her book, you know, looking at these different foods as providing information, communicating with so week four of the class that I teach, and I have some wonderful faculty, oh my gosh, I'm so blessed to be a part of George Washington University. You know, week four is the Nutrigenetics lecture that we have, and you know, we mentioned that, hey, food is information, communicating with your DNA and enhancing genes or influencing gene expression.
So that's one of our greatest opportunities with the foods that we're eating to change the way our cells are functioning, you know, these phytonutrients bind to G protein coupled receptors influenced second messenger secondary messengers within the cell, cyclic a&p And you know, IP three and all these other kind of, you know, pathways and turn on the molecular signatures signals to enhance those favorable gene expressions. So yes, epi nutrients, diets, a big part of it sleeps a big part of it, you know, you know, joy and happiness, heart rate variability, all of those different factors are, you know, within our locus of potential control, to enhance our in you know, or gene expression. But additionally, just to tie back into what you mentioned, a favorite topic of mine is the zombie cells, also known as cellular senescence in the literature, and one of the, you know, key 12 hallmarks of aging, you know, kind of is like this gatekeeper that gets into the terminal harm hallmarks, you know, and for the audience essentially, you know, senescence cells or zombie cells are refers to cells that kind of bio accumulate damage with time, right, they also might hit what is known as a Hayflick limit, which was originally discovered at, you know, Dr. Hayflick, and Moorhead in 19, I think 51 or 61, with their research with fibroblasts, and essentially, you know, what they found was that these fibroblast excels underwent X amount of mitotic divisions or their ability to divide, and they hit a, you know, the number around 50. What they found is, oh man, after 50 or so, cellular divisions, the cells stop dividing, okay? And it lost a lot of function, right? It wasn't dead, it wasn't alive, and it was actually metabolically active, and fast forward to what Our understanding of cellular senescence now, right, we know that, you know, it's basically arrested in the G one interphase of of cell, the cell cycle, rendering it metabolically active and producing what's called the SAS factors, the senescence associated secretory phenotype. And these SAS proteins actually accelerate the biological aging process. It's almost like poisoning the well. And there's some research that shows that one cell out of you know, five to 15,000 could accelerate the additional formation of senescence cells in our system. But what happens when the senescence cell outpaced the immunological clearance, this is where we start seeing that accumulation of those cells being associated with age related changes in the brain. It's now being associated with Alzheimer's and Parkinson's and there's clinical studies going on with that. There's been some really great human clinical trials in regards to kidney fibrosis, and idiopathic pulmonary fibrosis, you know, interventions to remove those cells using his drug therapies and modalities such as the SAP nib, quercetin, right, and there's a whole host of different studies that's going on right now at Mayo Clinic with Dr. Kirkland and his lab that's looking at, you know, these interventions to remove senescence cells, and to see how that influences the disease progression. But in my opinion, removing the zombie cells is great, but it's not addressing the latter hallmarks, right, which is altered cellular, altered cellular communication, right? And stem cell exhaustion.
And I believe that term, another terminal hallmark is, you know, the dysbiosis and chronic inflammation. So, you know, if you're looking at it from, you know, the aging perspective and the mechanisms behind it, just because you remove these senescence cells does not mean you're going to rejuvenate the stem cells, right. And, you know, it's stem cell rejuvenation, as you may have seen in the literature, you know, in regards to Yamanaka, factors, and you know, those different genes that regulate is stem cell rejuvenation is another key opportunity at kind of enhancing, you know, the biological age reversal. So that's a whole other conversation.
Dr. Andrew Wong:
Yeah, then we'll have to have you back and talk more about your book when it comes out. I'm so excited for that. Like I said, I'm first in line for that book, if you have a waiting line for that. I think the biggest thing is that you know what I learned from Kara when she was on. Number one, the most important thing is that her mother made her a rosemary salt shaker, that's one of those like, epigenetic hacks that she like sprinkles on her food. But I think you know, aging is one of those things that if we can age healthily, then we really are mitigating or even preventing potentially a lot of disease down the road, because we're really affecting the whole system, the whole biology there. So I think this is a really, really important topic. And I'm kind of wanting to tie it back into omics again. So I was wondering if you use in your practice, snip testing, you said, it's kind of we're getting into other things like poly genetic risk factors and transcript omics, etc. But are you still using snips that on? If so, how relevant is that?
Dr. Anil Bajnath:
Of course, you know, I think it's important to still keep snips on hand, you know, and be able to go back to that kind of blueprint to navigate. You know, why, why is this person's GGT levels gamma glutamyl, transferase. So high? You know, why did they do so? Well on glutathione? Well, maybe they have those, you know, polymorphisms and glutathione, recycling, you know, what's your Cytochrome P 450s. Looking at, and I also think one of our greatest clinical applications is looking at this through the lens of pharmacogenomics. Pharmacogenomics is critical, right?
For the future a personalized bumps and dialing in who's going to respond more favorably to what interventions because as we know, there is an ethnic kind of association here, where, you know, certain people respond to certain interventions differently. Okay. Right. And this is, you know, we could, you know, we could look at the, what I think is a great study that's coming out now is a mesa study, the multi ethnic study of atherosclerosis, you know, which is a modern day Framingham, you know, study. And, you know, as this study kind of starts unpacking all these different ethnic diversities, we're now finding that certain races respond to certain interventions differently and more favorably than others. And you know, the same ascvd risk score that we use for everybody is not going to be the same tool to further risk stratify individuals for these cardiometabolic and heart disease issues.
Dr. Andrew Wong:
Yeah. So I think you were just saying as we should go towards personalized medicine and kind of continued move away from cookie cutter medicine, because cookie cutter doesn't really give you the results that you want. It sounds like,
Dr. Anil Bajnath:
you know, you know, it's interesting. I want to say that one size does not fit all, most definitely, because we're totally different. I'm bald, brown, and bearded, you know, you know, and you're, you're Asian. And, you know, I'm Southeast Asian. And, you know, we have just so much diversity here. And there's so many different factors that influence that. And I think where we need to evolve in, evolve to within the literature, is looking at how we could start doing N of one clinical trials, where every single individual is at the center of their own unique clinical trial, where we try to look at things, you know, most of them, the clinical models of study right now has been kind of geared towards this biopharmaceutical model, you know, post Framingham report for the standardization of medicine. And essentially, what we're doing is we're taking this large clinical, you know, trial of 1000s of people, and we're saying, Hey, you take this drug, or you get placebo, we're gonna random, right? And then all of a sudden, we get data. And then that data, as we saw during COVID, research can be very shifty, and then easily manipulated to enhance or discredit whatever the hell you want to look at. Right? I think, you know, it's important to have those large clinical studies, but the, you know, the research and the science of the masses needs to be further stratified to the individual, right, because my genetic blueprint is going to be totally different for and receptive to a drug intervention versus somebody else's. Based on my, you know, cytochrome 50s are other molecular targets comparatively?
Dr. Andrew Wong:
Yeah, that's great. And so on. I do have a funny thought about that, although we look different. We're brothers from another mother, right? That's thing. I think I can I can probably, you know, it's likely that we both, you know, like a lot of the same things. But you know, I guess, phenotypically but I'm curious about is the public health question, really, but let's say, you know, we have, you know, millions of people in the United States, billions of people around the world, whose kind of access to this type of care. How do you how do you stratify? Like, where to start with the fundamental lifestyle factors, you know, who needs omics testing? Who needs functional medicine testing? Where do you kind of where would you see, you know, kind of the whole access point for some of this type of more advanced personalized medicine?
Dr. Anil Bajnath:
Well, you know, it's interesting, that's a great question. And from a public health initiative, how do we increase access to care, and that was one of the main topics that, you know, Mayo Clinic recently just had their individualized medicine conference back in November of last year, and they have it every year. And I mean, they're really pushing this narrative forward with precision medicine and looking at how to overcome these different obstacles. And, you know, one of the biggest, you know, factors here is how do you overcome, you know, number one, increase access, but also overcome some of the hesitancy that the general public would have? If there's some sort of commercialization of genetic testing? You know, do we have to be fearful of genetic discrimination, even though there's the Dyna Act, a genetic information non-discrimination act? Or, you know, do we have to be concerned about, you know, how this is going to influence here for the individual as a whole? Right. So there's a lot of different factors here that, you know, I think, from a public health initiative we're grappling with, but one of the things that I think is more kind of creeping up into the realm of insurance based models in our kind of health care system here in the US, is that they're actually, you know, allowing in certain populations, coverage for genomic testing for pharmacogenomic applications, right.
So we're seeing that kind of infused into different health care models, more on the west coast on the East Coast, comparatively, we're also seeing reimbursement for pharmacogenomic testing in various subsets of the population. And we're seeing that infusion within the EMR system within the centralized database in the healthcare system. So I'm really excited to see a gradual adapt tation to, you know, some of these principles in various clinical settings to various capacities. So it's coming right now, how do you kind of determine who needs what based on what I mean? It's, it's really individualized, you know, I like to deal with like the biohackers and the people that are really curious about, you know, understanding their book of life and their, their, you know, what's going on in their health conundrum. And putting those pieces together and connecting those molecular dots.
And from a functional medicine perspective, you know, we're always looking, you know, at the root cause of what could be leading to this disease and function. You know, you got ATMs or antecedents, triggers and mediators, you know, so it really depends on the situation, is it simply, hey, you need to cut out the gluten because of whatever issues you're having? Or is it Hey, your thyroid is there, there's undiagnosed Hashimotos. And that's tied into the gluten. Is it an endocrine dysregulation? You know, and another big thing is looking at environmental component, the environmental components so critical, I'm sure you've done so much testing with, you know, these different environmental toxicants. And we see the same damn culprits every frickin time. You plastics, pesticides, and, you know, other Alpha toxins and heavy metals. Yeah, right. That's a real big thing, you know, that you need to address and remove that ongoing exposure, do an environmental audit and clean up the environment and, you know, do other interventions to help promote bio transformation? And elimination?
Dr. Andrew Wong:
Yeah, a lot of my patients, a lot of our patients ask like, Well, why are my heavy metal so higher? Why are my plastic levels so high? Is it because you're human on the earth? Yeah, it is polluted. And we got to find a way to clean that up. But, you know, I think this is a very common finding. Really,
Dr. Anil Bajnath:
Andy, why clean it up? When we could invent the bubble, my friend, we need to build a bubble. Right?
Dr. Andrew Wong:
Let's do that. We can do that. As long as there's tacos there. We got to have a taco stand there. Yeah, it's important tacos.
Dr. Anil Bajnath:
Without a doubt. I love some buffalo cauliflower tacos are amazing.
Dr. Andrew Wong:
So I guess my other question for that, Anil, is, so someone's kind of coming into your clinic, I'd love to give the listeners if you don't mind, like a taste of kind of how you practice medicine and how you would use genomics and a case if you have like a brief little case, vignette of someone that you felt was, you know, helped with this type of precision medicine, I think it would really illustrate you know, how, how we might use this and practice?
Dr. Anil Bajnath:
Sure, I'm trying to think of a great case, there's so many too many data. Like where do we begin the traditional service case where it's like, you're genetically predisposed, transcriptomic Lee demonstrating activity of you know, upregulation in the genes associated with sirs, and then you have the entire bio omics connection in the proteomic connection. That's, that's kind of a slam dunk in regards to that, that chronic inflammatory response syndrome, but, you know, for the other 75% of the population, how could they leverage this information? For further, you know, enhancement? I think, you know, a couple of opportunities here. I think, number one, you know, one of the things that I see mostly is looking at diet, right? How do we leverage this information for diet, what's the appropriate macro nutrients that I should be using number one, based on genetics, number two, based on your actual metabolism, and VO two Max, that's going to shift your ratios on, you know, protein, fat carbs, and, you know, and set up some of the neutral genetic kind of associations. And, you know, I could tell you stories about, you know, people having, you know, I have a young lady, who is a nurse practitioner, who has been suffering with all sorts of issues, neuro psychiatric, cognitive issues, skin issues her entire life.
And sure enough, when you start peeling back some of the genetics, we're finding that she has some defects in her collagen synthesis, that's leading to some truncated proteins and dysregulated, keratin production, and leading to, you know, those eggs and mattes kind of, you know, skin formations and things of that nature. And then, you know, it's also tied into some of the truncated proteins on the adaptive side of the immune response. And, you know, that's leading to her why am I only sick question, you know, well, this is a, you know, we're lacking this part of the sophisticated part of the immune system to achieve a normal, adaptive kind of regulatory kind of process to deal with these different threats, whatever it is, and then, you know, what do you do with this information in regards to well, if you start seeing that from the genetic level, and then the proteomic level, that there is a clinical manifestation of that you treat the you treat that issue, whether that's looking at a chronic neutropenia with a low CD 57 Count and looking into transfer factors, or if it's looking at, you know, elevations in GGT, with defects associated with glutathione recycling, it's macro cytosis and MTHFR and homocysteine we all know that one You know, so there's, you know, looking at some of the detox pathways as we start unpacking and hormonal metabolites, there's so many different clinical applications, you know, that that you could use to kind of refine and enhance the clinical process? I hope that answered your question.
Dr. Andrew Wong:
It does. I think it just kind of teaches us that there's just so many rich and varied applications of this kind of science. And really, the whole point of, you know, medicine, in my opinion, is really just to, you know, better our lives, you know, so that we can be of service for others, and for hopefully, the world, you know, I think that, you know, everyone wants to live their best life. And this is a real way to a pathway, you know, forward to to help people a system, and kind of becoming the CEO of their own health with with more data, right, instead of blindfold on. So I liked that. So much, and I think we often close with and I thank you, Neil, for coming on today, we definitely have to do many more podcasts, talk about some of the rabbit holes that we need to kind of dive into more, definitely want to talk more about various kinds of biohacking or resilience topics will be amazing. Just in general terms, it's like take home points, what is like the one thing or maybe one or two things you wish kind of everyone knew about kind of omics, and that genetics, genomics, omics, etc, space, that that would benefit them?
Dr. Anil Bajnath:
You know, I think that, you know, we the biggest message is, we're all unique. We all have, you know, all sorts of different life experiences. And I also do believe that there is a transgenerational epigenetic programming. So, you know, I think that's been kind of clinically proven. And Mayo Clinic, you know, is really highlighted some of the research studies around the three generation three to seven generation hypothesis that, you know, this goes back, you know, before us, it's beyond us. And that just because, you know, you're going to your doctor, and they're just saying, Hey, your blood work looks normal, and you don't feel right. And, you know, you're not getting the right answers, there is hope. Right. And, you know, to me, again, being a molecular biologist, I like to start off with, you know, deconstructing things. And some people don't like that, you know, some people are more like, really, you know, bioenergetic, and they want to, you know, feel things a little bit more and do less sciency things and more like pale, energetic things. And I totally respect that everybody's different. My mind is just programmed towards that as, again, a molecular biologist, to connect those molecular dots. And I think, you know, leveraging this, in fact, information for empowerment is going to be critical, as Dr. Jeffrey bland says, you know, this information should not be, you know, for, you know, to be should not be used to kind of strike fear into people, but to be used for better understanding and empowerment. So that's, that's kind of like the big take home message.
Dr. Andrew Wong:
Absolutely. Beautiful. Do you have any? Thank you? Do you have any resources for anyone who might want to learn more about omics? And certainly, we want to also have our listeners, you know, have some resources, to where to learn where, you know, where, where to go to learn more about you and work with you, etc?
Dr. Anil Bajnath:
Yeah, so I am, I have my private practice with the Institute for Human optimization, I fho.org. And I have, you know, information there as well. And you know, I'm going to be releasing more content, especially with the book, once it's kind of delivered, I'm going to be starting the longevity equation podcast, and I'm building out this biological 401k Kind of an immersive program as we speak. So I'm working on a lot of projects here. So that we could kind of like, educate ourselves for empowerment, you know, that's the goal. Becoming the CEO of your own health is actually the tagline of the biological 401k. So I love that you said that. And, yeah, so essentially, that's what we're gonna do, you know, if they want to learn more about omics they could either, you know, the NIH has a lot of great resources, the National Institutes of Health. Additionally, they could take the class at George Washington University that kind of is a teaser of what we're doing here in clinical practice. So you know, there's there's so many different ways to do that. But you know, I encourage anybody that wants to kind of go through the process to schedule Little discovery call on my website ifho.org. And, you know, because I'm kind of, you know, selective with who I work with, in regards to certain things, you know, I just want to make sure it's a good fit for both of us, you know, and I can best serve people to my fullest capacity.
Dr. Andrew Wong:
Yeah, yeah, that makes sense. And then, and then finally, just another question about kind of access and just kind of for the listener, part of our mission at CH, as you know, is making integrative health care more accessible and focusing on the small steps that we can take to improve our health. So we'd love to hear from you in the oil, what is one thing under $20 That you feel has transformed your health? Before you answer, I will say that some of our previous guests during this time of inflation, I said that $20 is too cheap, we needed to be $100. So I'm having given people a little bit of a choice there. But let's try to start with under $20. If we, if we can if we can go from there.
Dr. Anil Bajnath:
You know, I gotta be honest, and I tell this to all my friends, family and patients. I have not taken an antibiotic. And I don't know, over 20 something years, maybe 30 years since I was a kid. I don't know how or why I've been so lucky and blessed. Maybe it's because I got into supplementation and everything else, you know, at a young age, and I've always been supplementing, but I have been sleeping next to my bed on the nightstand with Colloidal Silver since a teenager. And I really I know there's mixed opinions about Colloidal Silver this than the other, but I'll tell you what, anytime I noticed a sniffle a tickle or a scratch edge. Yeah, yeah, I just I just started, you know, and for me, it's, it's worked very nicely. You know, so I usually use that as like a kind of superficial topical kind of antimicrobial agent, whatever it might be. And then I move into other immune modulating supplements, you know, depending on the the presentation to to address, whatever issue to get ahead of it.
Dr. Andrew Wong:
The best spray or liquid, something like that.
Dr. Anil Bajnath:
Yeah, the sublingual, the throat spray the nasal spray, you know, our gentlemen. When, but so is, you know, the consumer version of it that's available at Whole Foods, which is sovereign silver. Okay, so, you know, for me, that's what's, you know, helped me over the years, you know, greater than 23 years now, since I've been taking it and I love it, I have not really been ill, because I that's next to the nightstand. And even if I feel a little worn down, and I feel as though Oh, no, you know, just too much and too much exposure, I just do a little dose, you know, there's a maintenance dose that you theoretically could take on the regular and then there's, you know, acute dosing that you could do if battling an illness. And I don't do the maintenance, I just take it every now and then. And then if I need to load up, I load up,
Dr. Andrew Wong:
Right. And then without taking antibiotics, right, that's actually protecting an iOS microbiome for the last 20 years by not having to take antibiotics. That's nice.
Dr. Anil Bajnath:
That that has always been at the forefront of the rationalisation is that I'm trying to preserve my amazing bowel health. I'm telling you.
Dr. Andrew Wong:
Yeah, yeah. And I think that's the thing we we can kind of touch on here at the end is that, you know, it's about genomics and epigenetics, but of course, the microbiome is, is a big part a huge part of our kind of a even, you know, genetic material on how that gets expressed.
Dr. Anil Bajnath:
Oh, yeah. And as part of my testing is looking at everybody's microbiome, you know, because, you know, that's where, you know, Apocrypha T said that all disease begins in the gut. Yeah. And I think even Sir William Oastler, one of the four horsemen of Johns Hopkins echoed that as well with his quotes. And essentially, I really think that it's one of our greatest opportunities, and, you know, with a recent, you know, kind of evolution of the Human Microbiome Project. It's one of our greatest potentials of harnessing the power of this. And so I guard my microbiome at all costs. You know, obviously, the Gamble's that I take are sketchy taco spots when traveling
Dr. Andrew Wong
With some bourbon with some bourbon,
Dr. Anil Bajnath:
Yeah, with the bourbon. Yeah, I'm actually uh, you know, I don't I don't have bourbon all the time. But I believe that bourbon is America's first one of America's first medicines especially as exhibited during the time of prohibition and I have a pretty expansive bourbon collection. Okay, okay. If you saw it, you would think I would have a problem. I also carry at my house here of, you know, kind of medical knickknacks and you know, I have this prescription for medicine, medicinal bourbon. Okay at the time of prohibition,
Dr. Andrew Wong:
That’s interesting. Yeah. All sorts of stuff. But funny. That's, that's awesome. Yeah. So thank you so much for coming on today. love to have you back to chat more about biohacking resilience. There's so many that topics we could talk about. We could also talk about tacos more. I think that's always a good topic. But um, yeah, thank you so much for coming on. I think this is so informative and very helpful for people, I think just, you know, give people hope. And that, you know, we can take charge of our own, you know, quote, unquote, genetic destiny or, you know, healthy aging and really trying to live our best lives to be of service to everyone in the world here.
Dr. Anil Bajnath:
I love it. And thank you so much for everything that you're doing. You know, and being a friend and mentor to me over the years, it means a lot. And it's truly an honor and pleasure to be speaking with you today.
Dr. Andrew Wong:
Yeah, thank you. Thank you for taking the time to listen to us today. If you enjoyed this conversation, please take a moment to leave us a review. It helps our podcasts to reach more listeners. Don't forget to subscribe so you don't miss our next episodes of conversations. And thank you so much again for being with us.