The Science of Nutrigenetics for Optimizing Your Health with Rajka Galbraith, MD

Content By: Ari Whitten & Dr. Rajka Galbraith

In this episode, I am speaking with Rajka Galbraith, MD – who is an expert in helping women achieve optimal health and educating people on disease prevention, and overcoming many diseases of lifestyle. We will talk about optimizing nutrigenetics for detox, hormonal and executive function.

Table of Contents

In this podcast, Dr. Galbraith and I discuss:

  • Epigenetics vs Genetics (and how diet and lifestyle affects your gene expression)
  • The key detox genes 
  • STAINS – How to decrease oxidative stress
  • The best supplements for detoxing organophosphates
  • 10 action steps to boost glutathione production
  • How to optimize hormone metabolism

Listen or download on iTunes

Listen outside iTunes


Ari: Hey there. Welcome back to the Energy Blueprint Podcast. I am here with a new friend of mine, someone who I interviewed recently and now have, after interviewing, her enormous respect for knowledge. I’m super excited to be interviewing her again for this summit. She has her name is Doctor Rajka Galbraith. She’s been practicing medicine for over 22 years. She is certified by the Institute of Functional Medicine in functional medicine, the American Board of Family Medicine and the American Board of Integrative and Holistic Medicine. She’s passionate about empowering women to optimal health and in turn, having them become ambassadors to empower their families and others. It’s her personal mission to spread the word that disease prevention and cure are possible. She has a particular interest in nutrigenetics, although puts the focus on epigenetics first. She herself battled many avoidable symptoms. I was going to say unavoidable, but there are many avoidable symptoms and disease, and we’d like to put an end to this for our future generations. 

She’s an international speaker, wife, mother of two and avid yogi who loves the arts and travel. Her private practice, Simply Health Institute is located outside of Chicago, Illinois. And in this presentation, she’s going to be talking about optimizing nutrigenetics for detox, for hormonal optimization and executive function all with the central goal of superhuman energy. I’m super excited to get into this. She is a wealth of knowledge, so welcome. Such a pleasure to connect with you again. It’s really a pleasure.                  

Dr. Galbraith: Thank you, Ari. Thank you for that warm welcome. I’m super excited because I am passionate about the nutrigenetics. And like I said, the emphasis is on the genetics, but you’ll see, as we get through the talk, why it’s so important to know it backwards and forwards. So you can pretty much reverse engineer it if you don’t know it, but you’re always going to focus on the diet and lifestyle first and foremost. So I have an action-packed talk ready for you.

Ari: Wonderful. Let’s do it.

Dr. Galbraith: Like most functional medicine practitioners, I had my own healthcare journey. As a child, I had many dreams. I had a dream to become a doctor, a dream to get married and have children and a dream to not only cure just about everyone, but to have my own business and practice. And sadly throughout my journey, almost all of these were not ever materialized. So that’s why I devoted a substantial amount of time so that everyone can achieve their dreams and no one has to go through what I have. The picture ironically is of me attending my first delivery. And that was at my parents’ farm in Serbia, and it was a delivery of a calf. I went on to become a family doctor who did babies, but then soon found the limitations, not only for my own health, but for many of my patients.

So like any good academician, for the objectives today, I’m going to review epigenetics versus genetics, review some key concepts. And then we’ll dive into the three sections, the genetics of the key detox genes. And we could easily do 10 hours on detox alone, but we’ll do some of the ones that keep coming up time and time again for the patients I see. I’ll do a little case to highlight the interplay of these genes with what it means to be super human and or preventing disease. And then we’ll segue into genes responsible for hormonal metabolism as well as go over cases. Along the way, I’ll insert ways to support these genes as well as tests, laboratory studies that can test for the substrates that they’re responsible for producing. Then lastly, we’ll go on to the gene for executive function, which really will help to make us a super human. And if there’s time, I have a case at the end I’d love to highlight that will wrap it all together. 

Ari: Beautiful sounds great.

What are genetics and epigenetics?

Dr. Galbraith: Moving onwards, epigenetics and genetics, basically, what does that mean? Epigenetics is having your diet and lifestyle be able to modulate the expression of any gene. And the genetics is, what does that gene show? Genotype is what we see when we test and it can show us a mutation, but the phenotype tells us whether that mutation is actually expressing. The key study that really hallmarks this nicely is the agouti mouse model. And so they took two mice. One mouse was not predisposed to being obese. And that is noted in the picture here of having a lighter colored coat. And they set it a terrible diet and it became obese. And then they took another mouse who had obese parents and gave it a nutrient rich diet and a methylation support in that mouse did not become obese. So that’s the power of our diet and lifestyle and gentle supplementation support. 

Now, there are other key things to really understand and I’m not here to make you all an expert. But the gene is typically named for the enzymatic controls. And what happens is that usually it’s a conversion of substance A to substance B, which requires that enzyme and then cofactors. All I’m saying with cofactors, is any vitamins and minerals that might be necessary. And that’s where nutrigenetics comes in, where we can modulate by giving those vitamins and minerals that will support that conversion. And/or you can even give the n substrate, so giving substance B if it’s available. And again, to review, genotype tells us that gene is mutated. Phenotype tells us if that mutation is actually expressing. So a person can either have no mutations. Most genes have two copies, one from mom, one from dad. So no mutations is usually minus, minus. Some people in our field do not like that, but that’s called the wild type. It means there’s no mutations noted.

Now heterozygous means one of the two copies is mutated and the gene can function a little less well up to 20 to 30% less than it should. And homozygous means that both genes are mutated and you can see up to 60 to 70% less functioning of the enzyme. And like I said, typically there are two copies of a gene, but sometimes there can be less and we call that copy number variants. And why I bring this up is that, certain testing companies and not to poo poo 23andMe, they used to have a robust panel. I know they’ve paired it down a little bit because they do not pick up copy number variants and I saw that with myself as well. Again, we had already highlighted the epigenetics solely. We’ll go over that again, but basically saying, a healthy diet and lifestyle can turn off a mutated gene. And then conversely, an unhealthy diet and lifestyle can cause a normal gene to express as if it’s mutated. 

Another key concept is we typically don’t just treat gene mutations, but we really focus on the epigenetics. But conversely, what I’ve learned over time is, if someone’s chronically ill, there is a really strong chance that that gene mutation is actually expressing or that there’s phenotypic expression. So what I do in my practice as I look at combining the clinical history, what symptoms and disease processes are going on with the genetics and with any labs? How does that sound? Is that pretty clear?

Ari: Absolutely.

The detox genes

Dr. Galbraith: All right. We’re going to segue into those key detox genes. Like I said, there are so many and we could spend hours just talking about detoxification because there’s many different pathways, but I’m going to focus on just three pathways. The first is SOD or superoxide dismutase. We’ll get to each one of these more in depth as we go along. PON1 which is also known as serum paraoxinase arylesterase one, quite a mouthful. And then the three key glutathione genes, which I’ll go through in each section. So we’ll kick off the detox by talking about superoxide dismutase. So it’s involved in detoxifying free radicals. Those are also known as our reactive oxygen species. And one of the main free radicals is called superoxide. 

I’m going to show you a super cool pathway. It’s one of my nerdy pathways that I love to share. Think of it as when we cut open an apple and when that apple oxidizes with air that’s what oxidative stress is. So it’s the browning or destruction of the apple. So can you imagine if you have an excess of that going on in the body, you can have a browning or damage or destruction of the body. Think about osteoarthritis, any of the pain syndromes, any of the neurodegenerative diseases, dementia, MS, et cetera. So that’s where it’s really super important to kind of understand. And we’re going to go through ways to decrease this oxidative stress, but let’s talk about the pathway. I know this pathway looks very busy. So I’m going to have the listeners focus in on the green. Far left it says there’s a superoxide anion. Superoxide remember is our main free radical that gets neutralized by superoxide dismutase. That’s the SOD gene. And it turns it into hydrogen peroxide.

Well, we can’t just leave it there as hydrogen peroxide, because if you have an accumulation sometimes what you may see is reflux from an early young age or premature graying of the hair. So you want to convert that. You need to further neutralize that and that could be done one of two ways. So going on from hydrogen peroxide to the right of the pathway, there’s an enzyme called catalase, that’ll break it down into water and oxygen, so neutralizes it. Or going down below hydrogen peroxide in the green box, utilizing glutathione, it’ll break it down into water. So that’s pretty neutral. So what happens if there’s an over accumulation of free radicals or oxidative stress? And again, we’re going to talk about what causes that in a minute here, or if that gene doesn’t function like it should. 

So superoxide will be hanging around and there’s enough of it, it can combine with something called nitric oxide and then form something called peroxynitrite. And that’s what’s damaging to our tissues. And what you’ll see is lipid peroxidation, and that’s something we can actually measure or protein nitration. So to summarize, if you don’t neutralize your free radicals, the main one being superoxide, it can linger around and combine and form peroxynitrite, which is damaging to our tissue and even can be damaging to our DNA. So we need not only the SOD enzyme, but as I’ve highlighted in this pathway glutathione, which we’ll get to and catalase.

Ari: So basically for people listening, who don’t have the visual aid of this, basically there are specific molecules that are sources of oxidative stress at the cellular level. And I’m oversimplifying there, but superoxide dismutase and glutathione are incredibly important to neutralize or prevent the buildup of too many of those oxidative molecules.

Dr. Galbraith: That’s correct. So you do need them present, and then you also want to be able to regulate how much oxidative stress your body is undergoing. I’m going to list all the causes so people can be mindful and cognizant of that as well. And then people will ask, is there a way to actually measure oxidation? And there are several laboratories that will measure it. You can measure it in the urine or blood and urine. And one of the companies that does measure lipid peroxide. If they’re elevated, then your worry while there’s enough oxidative stress going on, that it can cause tissue destruction. So you want to look at where are the sources, remove the sources and then support that person’s genetics and support the nutrients that will help them detoxify.

Ari: Quick question. Do you know if there’s any research linking these markers of oxidative stress like lipid peroxides and the, I forget the full extension of this one, but it’s 8-OHdG? Just out of curiosity, what’s the full chemical name of that? I totally forgot.

Dr. Galbraith: 8-Hydroxydeoxyguanosine.

Ari: Nice. Do you know if there’s any actual data linking clinical end points, disease states or symptoms to those specific measurements? I know that there’s research saying that these are accurate measures of oxidative stress, but I’m just curious if higher levels have been linked to certain disease states.

Dr. Galbraith: No, you pull out a good question. I recently did research on bladder cancer and there’s a link. When there’s higher lipid peroxides, it is associated with bladder cancer, I only know that. In that instance, I’ve specifically researched myself because I have a patient who made it to 88 years old, just shy of 89 and had no issues except for bladder cancer. And so for him, we want to remove that oxidative stressor and for that particular individual, it was the exposure to the toxins in his city water supply. And so I’m going to measure that periodically to make sure that it’s controlled. So in that one study. I don’t have all the studies, but clinically what I see, so I always say a good clinician looks at the data and definitely practices evidencebase when you combine it with what you see clinically. Clinically as the numbers go down, people do have lessening of symptoms as well. So in bladder cancer, it’s definitely related and correlated. Great question. 

So how do I reduce oxidative stress in my patients? I eliminate inflammation and I have my patients remember that and I teach it by the word STAINS, S-TA-I-N-S. Just like stains in your laundry. And the first S is actually for sleep, stress, spirituality. So if you’re not sleeping, if you’re stressed out, not modulating stress, a lack of purpose is what I mean by spirituality, it can make you inflamed. The T is for toxins, and I’d referrer to that gentleman who had bladder cancer and he had high levels of toxins in his city water. And so it’s any toxins. So it’s found in the food we eat the air we breathe, the water we drink, the products we put on our skin and even our cleaning products in our home, kind of in a nutshell. And then in rare cases, not rare, but in other cases you could even have mycotoxins, which a toxicity from mold illness. 

Now we look at, the A stands for adverse foods. So those are inflammatory foods. And top two inflammatory foods still tend to be gluten and dairy, but there are many others that are inflammatory depending on what your genetic makeup is. And then I look at infections. So people who have an imbalance of good to bad bacteria in their bellies, people who have been exposed to even Epstein-Barr. It’s not so much the infection, it’s usually the immune system not allowing you to clear it, even Lyme disease. So if you can regulate that immune system, if you can create balance in our microbiome, which is all the bacteria in our large intestine, you can decrease inflammation. You can become inflamed strictly from having nutrient deficiencies and there are so many with vitamin D almost 100% precedent in the population. Or excess, excess being sugar, additives, preservatives, MSG, all the chemicals that shouldn’t be in our food. And then being sedentary or solitary. 

Unfortunately, a lot of us have been solitary over the last little while. So all these things can cause inflammation. And if you eliminate them systematically, you could decrease that oxidative stress load on the body. One last thing I’ll highlight with free radicals is that, they’re not all bad. So we do produce free radicals when we make energy or ATP. So it’s a natural byproduct and a small amount of free radicals are necessary to combat those infections, to kill the pathogens, bacteria, viruses, yeast we may encounter. But it’s when that balance becomes excessive that it’s a problem. So that’s why SOD is important. The next one I see in patients who have illnesses in a way to keep us being super human, is that PON1. And what PON1 does, is it breaks down organophosphates. That fancy term is just insecticides and herbicides that are commonly seen in use in foods that are grown and sold to us, particularly the non-organic foods. And unfortunately, if you have a mutation in PON1, even if it’s not expressed, it does make you more susceptible to neurotoxic damage from these organophosphates. Ironically, there are labs that will measure organophosphates in patients. There is a company in Great Plains Lab and that measures them in patients. I hope I can say that on this.

Ari: Absolutely.

Dr. Galbraith: Okay, Great Plains Lab and it’s one I’ve been following when I had a patient whose symptoms were resistant. I say, we have to leave no stone unturned. So she wasn’t responding as quick as I like. And so I actually recently had mine measured and if our viewers could see my test results, what they would note is that of the four markers for organophosphates, I have two for incest, insecticides, and two for pesticides. Two of mine were nondetectable and two were in a very low range. And that’s because we eat organically and made a commitment to that because I want to be as super human as possible. 

Ari: Do they also test for glyphosate? 

Dr. Galbraith: They do. And unfortunately we had ours tested and our children are in the lower ranges, but by virtue of just being on this planet for a long time, my husband and I were kind of at that 75th percentile, although we [inaudible]. That as a bit shocking and so, we’re putting in place other measures to continue to eliminate that. 

Ari: I wonder if it’s just a geographic issue being in Chicago, Illinois, there’s probably a lot of non-organic farming around that whole area. 

Dr. Galbraith: Yes. That is a huge concern of mine is that the non-organic or inorganic farming is, you’re getting cross-contamination into your organic farms. So yeah, it’s unfortunate. So what could our listeners do if they didn’t want to test? Well, what they found is that seven days of eating organic will decrease your excretion of these organic phosphates by 90%. So you’re really going to decrease the level that are found. So it doesn’t take very long, but you want to sustain it at that level. And there are actually some supplements that you can utilize that are beneficial as well. So zinc and lycopene, and think of any of the antioxidants, vitamin E, vitamin C, particularly when they combined E with selenium and when they combined E with curcumin or turmeric. But in all reality, because these will excrete naturally on their own quite nicely when you reduce the exposure, you probably don’t have to supplement in this instance.

Now the last of the three detox genes is glutathione, and it’s considered the mother of antioxidants. Remember antioxidant inhibit oxidation or they inhibit the browning in the apple of the browning of our tissue, so to speak. There are three main genes. And I’ll say them kind of slowly. It’s not important to know them, but there is one distinct piece that is important to know. So one of the genes is GSTT1. So GS is glutathione synthase transferase. And there’s GSTM1 and GSTP1. So there’s just three main ones. You don’t have to remember the letters, but for the two that are not GSTP1s, so the T1 and M1, you can have zero copies of that gene. So that puts you at risk of being able to detoxify from things you’re exposed to. And for the M1, you can also have zero copies of the gene as well.

So if you have significant mutations throughout all three, then you really want to limit your exposure to toxins. You really want to support detoxification. You want to live as healthy as you can. And let’s summarize, what does this term detox even mean? And, my talking about one of those fad diets. Anytime you’re exposed to anything, so a medication, pollution, so some of the chemicals found in our cleaning products are in our skincare product, so things like phthalates and BPA, your body has to break it down. And it typically breaks it down in two phases. The first phase we call Phase 1 and you actually break it down and you put it into this intermediate phase. That toxin then becomes actually more active metabolites, so it could be even more damaging. So the most important part is Phase 2 where creating or adding a water molecule to that active metabolites, so you can then excrete it. What excrete it means is not very glamorous, pee, poop or sweat it out. In Phase 2, it’s heavily reliant on all three of those glutathione genes.

So could you imagine if you’re exposed to something and you break it down, you make it more toxic for your body, but then you don’t have adequate glutathione and you can’t excrete it. So it could be quite damaging to our tissue. And so it detoxifies a lot of things, biotics. So those are chemicals that act like estrogen, carcinogens, as I mentioned, drugs or medications, many of our free radicals. Remember it’s the step after SOD. SOD will neutralize the free radical, but then you have to take that hydrogen peroxide and further break it down to water, which is neutral. And one of the glutathione genes is particularly important for mercury detoxification and people who eat inorganic or farmed fish can have exposure to mercury and those who’ve had mercury fillings. And then one of the glutathione genes is really important for estrogen metabolism. 

Actually I have one more point to make on glutathione. You can actually measure it. So you can go through a conventional lab, conventional labs are going to measure it in the red blood cells, so you get a couple of week average.

But you can even go to specialty labs like SpectraCell or Vibrant or even Genova and give a level of glutathione and see is it in the optimal range, average or suboptimal. And then you know there would be ways that you can support that, that we’re going to review. Great Plains lab does a urine test that looks at an indirect marker for glutathione. So the ones I mentioned before were red blood cell through a conventional lab, like Quest or LabCorp. Or directly measuring it through one of these specialty companies like Genova or SpectraCell. Great Plains Lab, just as an inverse marker for some reason and it looks at a measure for something called pyroglutamic acid. And if that number is elevated, it usually signifies a deficiency in glutathione. 

So ways to increase it are your sulfur rich foods, garlic and onion, your cruciferous vegetables, taking in whey protein. I put a little thing that some people of course have dairy intolerances and N-acetyl cysteine is a huge supporting methylation. And that’s your active B vitamins like B12 and folate and even other antioxidants, selenium, vitamin E and C, exercise. And sometimes you’d have to actually supplement and we’ll go through that. So let’s put this together in a case. So I had a woman who came to me, 40 years old and she thought she was coming to me for a genetics consultation about MTHFR. She was having recurrent miscarriages and undergoing IVF, and she wanted to optimize MTHFR. And as you know, Ari, it’s more than just MTHFR. I mean, that got a lot of buzz in the media, but it’s so much more.

Ari: Yeah, it was a time there where everybody was saying, I have this symptom and that symptom and all these different problems and it’s because I’m MTHFR. Yeah, there was a lot of very myopic reductionist thinking around that specific variant.

Dr. Galbraith: Yeah. And so she came in and unfortunately there’s about a month delay between the booking and appointment. She saw me and she got diagnosed with acute rheumatoid arthritis, boom, out of the blue. So we took her through our program and we optimize all those levels of inflammation. I have a six step process and it does focus on eliminating all those things that I talked about in STAIN, sleep and stress and foods and infections and nutrients and exercise. And even the spirituality, there were some things that came up. She was seen and given a protocol to follow for three months. So she was kind of a usual case. So she was an international patient that flew in and we gave her multiple steps and I lost her at follow up. And I thought, boy, maybe she didn’t get better or what happened? I wondered if she ended up on meds. And then 18 months later to the date, she came back to me for another consultation. And this time she really wanted to look at not just MTHFR, but her whole genetics.

I said, “Boy, I was really worried about you. What happened?” She goes, “Oh, I feel like I’ve never had rheumatoid arthritis.” So that’s how astounding. So remember I took her from significant symptoms to complete resolution, not knowing her genetics, just MTHFR, which I didn’t even focus on that. And then we looked at her genetic mutations retrospectively and besides MTHFR, she had a homozygous. That means two of her SOD genes were mutated. And it explained why when I gave her SOD, it actually did help alleviate her pain as we brought her back into balance. And then she had PON1 that was also doubly mutator homozygous and it explains why one of the final steps was, we had her go undergo a detox. And this led to after all the multiple steps, it was not one thing, to complete resolution of her pain. So in her instance, we know that it’s super important for her to eat organic and it’s super important for her to control inflammation. So isn’t that amazing? And I think people don’t know that. They don’t know.

Ari: Absolutely. I want to go back real quick to the slide action steps to increase glutathione, you mentioned a number of things. Sulfur-rich foods, cruciferous vegetables, alpha-lipoic acid, vitamin C, milk thistle, exercise, things like that. On liposomal glutathione, I’m wondering if you think there’s any issue of like negative feedback loops, if you take the end product as opposed to precursor. Some of the things you mentioned like sulfur-rich foods, selenium, vitamin C, these are cofactors and precursors that allow your body to make the amount of glutathione that it wants to make. But then to take the end product is a little bit different. I’m not saying it’s inherently bad, but I’m wondering if you perceive there to be more of a potential for side effects when we do something like that or down-regulating the body’s own production of glutathione or anything along those lines.

Dr. Galbraith: Absolutely, you should never be cavalier when you’re replacing. So if you give a substrate, you can sometimes get that negative inhibition. So there is that worry. And I would say, I would utilize that when someone has significant mutations and significant disease. And so if you’ve got modest mutations and modest symptoms, and maybe they’re doing a dose periodically, and/or they’re doing a single dose rather than a double dose, so gentle support. But if they’ve got significant mutations, like most people in those instances alone. I wouldn’t be cavalier and you’d want to be following and tracking them. I tell people, and even if I pulse dose in some methylfolate, I’m like, you can’t be on this forever. Definitely you need to be followed continually, whether that’s once a year or twice a year, three or four times a year, depending on what their clinical kind of predisposition is. So you bring up a good point. Yeah, absolutely.

Ari: Thank you for answering that. I’ve always been curious, because some people are very cavalier about it and say, the more glutathione, the better. Just keep pumping in glutathione in your body even if you’re already healthy, more is better. Just knowing what I know about human physiology, that seems to rarely be the case with anything.

Dr. Galbraith: Exactly. You have to be very careful. And that’s why in the beginning, I said, focus on those epigenetics, but be cognizant that if someone’s chronically ill, that mutated gene is likely expressing and then support it in a sensible fashion. So let’s put it that way. So we kind of reviewed detox and unfortunately we’re all going to be exposed. You can avoid, but there’s going to be something, that’s importance of it. The main thing about us being superhuman is that unfortunately all these toxins more readily take out our mitochondria because our mitochondrial DNA is not protected in histones and that’s what can lead to fatigue and that’s what can lead to the disease processes. So that’s why I focused on this because optimize that and you certainly will have much higher levels of energy than those who aren’t focused on eliminating oxidative stress by limiting inflammation and removing those triggers.

How hormone metabolism affects health

So the second part to this is hormone metabolism. I’m going to do this in a general sort of way. And just to let our listeners know that, our hormones come from cholesterol and you can actually have too low of cholesterol from cholesterol channels over and through multiple steps. Testosterone is produced in all of us. And testosterone can go one of two ways. It can convert over to DHT. And DHT is a super testosterone or it’s the testosterone on steroids. So think of muscly men like The Rock. But unfortunately DHT makes you bald or too much of it. And so think of the rock he’s bald and muscular. So that’s someone who’s taking the testosterone, converting it over very quickly. And then testosterone can also be forwarded to estradiol. That testosterone to estradiol, I think about if we give someone testosterone and they do that quickly, and it’s a man, you can feminize them and give them boobs or man boobs. So you have to be really mindful of knowing which way that goes. 

And once estradiol is formed, there’s a few things that can happen. The estradiol can be can be converted. Actually, it can form into four different byproducts and they’re hydroxyestrogens. 2 is considered the good estrogen. 4 is the bad and can potentially have deleterious effects on us. And 16 is intermediate. It was thought to be bad and it’s not really certain. So again, to highlight. Cholesterol is needed to make all your sex hormones. We’re predominantly going to focus on testosterone and its conversion either to DHT or estradiol. And then we’ll also talk about taking that that estradiol and converting it to hydroxyestrogen, and then to excrete it out of the body as well. So there’s lots of key genes and there’s lots of numbers that may be difficult to relay. So we’ll start with the testosterone to DHT, is actually converted by, the gene is SRD5A2. Not important to know it’s also known as 5 alpha-reductase. And remember if a man is converting quickly and I give them testosterone, I can make, I can make them balder, so I have to be careful. Same with a woman. So some women have male pattern baldness and they convert quickly. So what can help person out? What can we do naturally to decrease that conversion? 

Things that are high in lycopene? And so lycopene, many of you may know is high end tomatoes, but it’s the brightly red color foods. So tomatoes, watermelons, even carrots and papaya and mangoes and that’ll block that conversion. Sometimes I say, I would never prescribe hormones without knowing the genetics, but you want to just be cautious because you can actually measure testosterone and DHT. There are medications. So we all know about ROGAINE or Minoxidil, it’s called the generic name Finasteride. So I’m not suggesting that the listeners utilize that, but just to know. And then the other important gene for hormone metabolism-

Ari: I just want to comment really quick. I had never heard that about natural methods to decrease conversion of testosterone to DHT. That’s a great tip.

Dr. Galbraith: Yeah, so that was something I found specifically while I was researching for our talk today. So I didn’t know that either.

Ari: That makes me feel a little bit better about not knowing anything.

Dr. Galbraith: I didn’t know it either. And I suspect though it’s going to be a mild decrease in conversion, not as strong as the full out medication. The next gene that converts testosterone to estradiol. Again, the numbers and letters are not important, but for a thoroughness sake, CYP19A1 is the name of the gene and it governs aromatase. So people have heard of aromatase, so testosterone to estradiol. So again, the importance of this is, what if I give a man testosterone and he converts rather quickly as a mutation that upregulates that? The last thing you want to do is give him moods or man boobs. In women, if it’s converting quickly and they can’t clear it, you’re potentially increasing estrogen levels to the point of they can put them on save. And you worry about am I putting them in a situation that makes them so estrogen dominant and you think about cancers, of course. 

How about natural things that increase that conversion to estrogen? So think about an unhealthy person. So someone who has excess adipose or fat tissues, someone who’s stressed out, someone who has prediabetes or insulin resistance, someone who’s completely inflamed and then ironically zinc deficiency. That increases it. A natural way to increase testosterone, you want to make sure people are zinc replete, so it slows that conversion. And there are some others as well, but the main ones being that, focusing on an uninflamed, healthy lifestyle that is nutrient replete. So anything you want to add to that?

Ari: No, I think it’s great. I was looking at your next slide here on decreasing conversion of testosterone to estradiol. And I love how on the list smoking is listed. And then in parentheses it says not recommended. Maybe also put, not recommended next to dioxin too.

Dr. Galbraith: Yeah definitely. I hope to change that up. So dioxin is a terrible toxin. I think agent orange, right? So we don’t recommend that.

Ari: Just to be clear, we’re not saying start smoking cigarettes in order to improve your hormones.

Dr. Galbraith: So I had kind of highlighted the ones that I thought were more important. So flax seeds. So a lot of people when they make smoothies, will add flax seed and it does help decrease that conversion and flavonoids, green tea. Anastrazole, so if you’re treating men and they have that fast conversion, say you don’t know their genetics, you’re going to very quickly measure. And if they have that fast conversion and the estradiol levels go up, you can block that conversion by giving a gentle pulse dosing of Anastrazole, which blocks that, if needed. You’re not going to use it and everyone you’re going to want to follow up. So either you know their genetics or their labs or both, so you which way it’s going. You want to follow everyone closely. You don’t want people on hormone replacement where they’re cavalierly not being followed. So that’s dangerous.

That leads me to a case. I have funny story I’ll do it in a minute or so here. I was ironically attending a hormone conference in February when we last could travel. And I waited at the car rental place for almost two hours without a ride. I arrived, they had zero cars in the shop. So I was renting in Beverly Hills and happened to be there, what a nice location. And I happened to be able to talk to everyone who came in there. I’m pretty extroverted and enjoy it. And this guy came in and I feel like I’m sometimes a hairdresser or a bartender, even though I’m not acting as their doctors, I always get the story. You’ll see why I have a picture of a Maserati up here in a minute. So this gentleman came in and his long minute story of how he’s trying to get in shape for like his 30th reunion for high school. And that he was put on hormone replacement and he developed man boobs and he gained weight around the middle.

And so that is that, someone wasn’t following. So he was definitely converting that testosterone quickly to estrogen. Thank goodness he wasn’t doing it to DHT because he didn’t lose his hair. And the outcome of that two-hour wait was that I had an ordinary small fund convertible rented just to enjoy the California sun. It was out in California. And they ended up upgrading me to a Maserati Levante and it was super fun. So just tying it back in of why I have that picture. But it’s a very much real car, so lots of speed. So it’s great to open up. But that’s why you should be careful. And now onto the estrogen metabolism. Again, I want to kind of just focus on a couple of things is that, estrogens remember, can be broken down to 2, 4 or 16-Hydroxy. Estrogen 2 being good, 4 being considered bad or potentially harmful.

And then when we look at what increases the conversion of estrogen to 2Hydroxy, it’s some of the same things that help with stopping the testosterone to estrogen. So your flax seed, but it’s also your cruciferous vegetables. And then they’ve taken the active compounds out of cruciferous vegetables, and those are I3C and DIM, and you can give them in supplemental form. So if someone is not able to do this on their own, probably besides the diet lifestyle, that’s probably one of the most important supplements that will support someone if they don’t detoxify their estrogen well, but want to be on estrogen for brain health and maybe are at risk for having memory loss and so forth. But other things on the list, soy. I’m not a big fan of soy unless it’s completely organic and not genetically modified. Caffeine, rosemary, exercise and even thyroxine. so that’s thyroid hormone. 

So if you’re hypothyroid, you’re not going to clear your estrogen. So making sure your thyroid function is optimized and you can do that in diet and lifestyle. And then if that doesn’t cut it and you have the discussion maybe even replacement depending on what your scenario is. The things that decrease that conversion of estrogen to the 2-hydroxyestrogen, think about all the bad things we do. So excess sugar and then excess omega-6 fatty acids. And that is typically found in vegetable oils or think of just processed foods.

So sugar, processed foods, and then the birth control pill of all things. And so I’m not knocking it and for many young women that might be the right choice, but you have to be mindful of that and support the nutrient depletions that it induces.

One of the other ones was a heartburn medication Cimetidine. So not to be confused with Ranitidine, which they recently found causes cancers in they’ll be yanked out the market. So you just want to know all these things. So what increases or decreases? We talked about what increases the conversion to the good estrogen. I always say, the way to remember is a healthy lifestyle. How about what increases or decreases the conversion to the 4-hydroxy which is considered the bad? The things that I would focus on are bioflavonoids or grapefruit. And then things that increase that conversion to bad is exposure to toxins. So PCVs and polycyclic aromatic hydrocarbons, so all the environmental exposures. Basically, if you support a healthy lifestyle, you should be able to detoxify these. And if you know you’re Gen X even better.

And the last thing I’ll say is, someone who has gone from estrogen and then broken down the estrogen into the hydroxy, then you need to excrete it further. And that’s done by a gene called COMT. COMT is a comp gene. It governs dopamine, but not only dopamine breakdown into norepinephrine and then epinephrine, but also estrogen. And one of the key things to support that is glutathione. So glutathione is not only important for your oxidative stress, but for estrogen clearance. So two ways it’s important, reducing our oxidative stress and metabolizing our estrogen. And you want to measure. So everyone gets measured. I do serum labs to start. You can look at saliva. Saliva’s better if you’re replacing with creams. And then I always look at the urinary metabolize. I’m measuring 2, 4 and 16, and everyone who’s on replacement at least one to two times a year until we know that they’re stable, then once a year.

There are companies that do this. Genova does it, their test is called Estronex. Another company Precision Analytical does the DUTCH test, which also does that. So that was a summary of the hormones. I’m hoping to have a time for the last case, BDNF. I just brought it up because BDNF is brain-derived neurotrophic factor because that is what is released and allows us to have brain elasticity, so elasticity for our nerve cells. And believe it or not, you have a gene that governance it’s a formation and then there are diet and lifestyle. So if someone has the highest expression, then they’re going to produce the most, if that gene is actually expressing and they’re living a healthy lifestyle. So what kinds of things in our lifestyle increase. So exercise and actually the sustained production was found in moderate intensity aerobic sustained production BDNF, over strength training. 

I always say anyone over 40 definitely needs the strength training to keep up the muscle tone. Dep sleep, meditation, exposure to sunlight, intermittent fasting, another vote for intermittent fasting and even the ketogenic diet. And I’m a big fan of an alkaline ketogenic diet just for clearance of toxins. And then there are a whole host of supplements and we’ll go over just the top three or four areas. Coffee fruit extract, there’s a lion’s mane. A lot of people supplement and DHA. I’d say, I’d even be a big fan because we know that stress can reduce BDNF. So one of my favorite herbs to make you resilient, to stresses rhodiola, so adaptogenic herbs. So we’re just going to touch upon that.

Ari: I like that you mentioned those three. I have a new brain formula that’s coming into the market in about three weeks and they’re three of the 19 ingredients. But I was going to say, they’re the three top ingredients, but that’s true of lion’s mane and rhodiola. And then NeuroFactor, which is a specific extract of a coffee fruit extract. It’s all in there plus a number of these other things like saffron. So nice to hear you verify that. 

Dr. Galbraith: Isn’t it great? I just keep telling people if you need to settlement, you do, but healthy diet and lifestyle. So what decreases it? Stress, being socially isolated and sugar. So the three S’s. And I know we only have a couple minutes, but I really want to wrap it up. So I had a case come in. A young lady in her late 40s came in with fatigue, Hashimoto’s and then went on to develop infertility, endometriosis, PMS, gallbladder disease, migraines that caused the loss of her speech, weight gain and then had a second mystery illness. Sever right upper quadrant pain, found to have liver enzymes that were more than 10 times normal, actually let me think about this, 20 times normal. Normal is like in the tens and so up at the 250 range and really felt unwell. Here is the snips that were wrong or missing.

For detox, SOD was homozygous, so two mutations. For PON1 homozygous. Zero copies of both of the two glutathione genes and then one copy was deleted in the third. Fortunately had optimal BDNF. What that tells me is that person’s extremely prone to stress and this person had poor conversation of estrogen to favorable estrogen and a fast conversation to the bad estrogen. So you’ve got to be really careful. That person was me. As I was sitting there in a celebratory vacation that me and my family almost took. I’m in liver failure thinking, so this is how it ends? I have two small kids that I’ve done everything to live a healthy life and finally overcome all these symptoms and now they think I’m having liver failure from autoimmune disease. It was strictly related to such terrible detoxification. 

Now I’ve achieved those dreams, not only being a doctor, a mother a wife, an international speaker, a mentor. I’m a small business owner and I speak in lots of summits, but that’s the caution. I’d say, if you have significant symptoms, you want to be looking at the whole picture. I hope everyone’s enjoyed my talk.

Ari: Yeah. That was beautiful. I like that. Thank you so much. This was absolutely awesome. This was just an amazing rundown on some of the top genes that influence energy levels, brain function, hormones and you did it masterfully in a very brief period of time a long with very clear practical recommendations on how to optimize the function of those genes.

Phenomenal. Thank so much. This was really a blast. It was brilliant stuff. For people interested in contacting you, working with you, what’s the best place to do that?

Dr. Galbraith: Probably head over to my website, D-R R-A-J-K-A .com. People can book a discovery call, see if it’s a good fit or find my high performance group called, High Performance Doctor for Busy Motivated Women on Facebook and join me there.

Ari: Beautiful. Thank you so much my friend. Really a pressure and it was really nice to connect with you again. I’m impressed as always with your amazing knowledge.

Dr. Galbraith: You’re very welcome. Enjoy the rest of the day.

Ari: Thank you.

Show Notes

What are genetics and epigenetics? (04:00)
The detox genes (07:27)
How hormone metabolism affects health (30:07)


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