Genes R US —Personalized medicine for a ‘special’ brain

Posted: Tuesday, March 27, 2012 5:00 pm

Ten days ago, I was watching a PBS program on the brain. When the program turned to the impact of hormones on overall brain health, I was surprised to see images of my own brain scans from 2007, right there on national TV. One image showed my brain prior to hormone replacement therapy (HRT) and the second image showed my brain after HRT.  
The difference in the images was (and still is) astonishing and ever so … “special.” Those images are included in the 2010 book, “Change Your Brain, Change Your Body,” by Dr. Daniel Amen. Of course, those images are not annotated as “Nancy’s scans,” but they are the exact images for which I signed the medical research release forms. (On amazon.com, you can query for this book, my brain images are on the bottom of page 142.)
There is another scan that was done too late for inclusion this book. The corresponding image shows what my brain looked like after three more years on HRT with added proper tweaking of neurotransmitters.
Honestly, this is the brain to die for.  This last image could win the Ms. America contest for beautiful brain images. At the time we reviewed this scan, my brain-imaging-specialist doctor exclaimed, “This is even better than the ideal on our website.”
OK, now that you know that my brain is famous for its transformation from an ugly duckling to a gorgeous swan brain, let me assure you that having such a “special” brain was not so fun. It is much easier, quicker and cheaper to get a proper diagnosis and treatment plan if one has a common problem, like high cholesterol and triglycerides — which I do not.
Personalized medicine typically means medical care based on your genetic make-up. But to me it also means that I am the person who is responsible for my own health — yes, me, not my primary care physician.
The internet and publically available databases, such as PubMed, have made it possible to access the latest in medical research. With cheap access to direct to consumer (DTC) genetic testing, you and I can understand our genetic vulnerabilities at a level of detail never before possible.
But what are the consequences of truly taking ownership for your own health?  Well, selecting your primary care physician becomes more … challenging. 
You will need a doctor who will embrace the new “I-want-to-understand” you. You will need a doctor who is open to consideration of the latest findings in research journals, perhaps years before they trickle down into clinical practice.   
It is possible to find primary care doctors like this? Yes. My mid-south primary care doctor looks forward to my annual visits. And lucky for me, he has observed first-hand the amazing work done by the Amen Clinics in a two of his patients long before I walked through his doors. 
The Amen Clinic uses a special kind of imaging, called SPECT scans, to reveal the overall health of the brain. The images, also, highlight underactive or overactive internal structures within the brain that are associated with a multitude of brain problems. 
Certain neurotransmitters and hormones stimulate or calm down specific structures within the brain. Proper interpretation brain images can significantly reduce the trial and error of diagnosing brain problems and prescribing the correct therapies.  Moreover, they provide an objective way to monitor progress.
It took a long time to figure out what my medical problems were. But thankfully, once I went to the Amen Clinic, I was able to receive an accurate diagnosis and treatment plan quickly. Furthermore, over time “we” were able to document the response of my brain as it was “fed” the proper hormones and neurotransmitters. The HRT stopped all episodes of cardiac arterial spasms and the insomnia. The neurotransmitters adjustments further brought the 24-7 headaches under control and restored my quality of life.
Researchers from University of North Carolina at Chapel Hill, N.C., published an article last year in the Depression and Anxiety Journal, entitled, “Hormones, heart disease and health: individualized medicine versus throwing the baby out with the bathwater.”
They state: “This convergence of depression and altered physiology is particularly dramatic during midlife — a time during which reproductive failure presages dramatic increases in prevalence of both heart disease and depression.
“The potentially meaningful and illuminating links between estrogen (E2) deficiency, cardiovascular disease (CVD) and depression have largely been obscured, first by assertions, subsequently repudiated that the perimenopause was not a time of increased risk of depression, and more recently by the denegration[sic] of hormone replacement therapy by initial reports of the Women’s Health Initiative.
“Increasingly, however, research has led to unavoidable conclusions that CVD and depression share common and mediating pathogenic processes and that these same processes are dramatically altered by the presence or absence of E2.”
My DTC genetic testing results are quite interesting given my mid-life medical crisis. I have a higher than average risk of coronary heart disease and a lower than average risk for breast and ovarian cancer.
Nothing strikes angst into the hearts of perimenopausal and menopausal women like the perceived risks of HRT. I can, with confidence and peace, know I have done my personalized medical homework. Give me hormones or give me death.
Editor’s note: Nancy Miller Latimer has worked in scientific research and development for 27 years. She blogs at NeuronalBeauty.BlogSpot.com. Published in The Messenger 3.28.12