Demystifying DNA

The Hidden Influence of our Genes on Stress and Anxiety

• Dr. Tiffany Montgomery (P23 Health) • Season 1 • Episode 3

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Wondering how your genetics might be shaping your stress response? Join us on this enlightening journey as we uncover the profound role our genes play in managing stress. Our esteemed co-host, Trena Weeks, offers a rich narrative of her personal experiences dealing with stress as a working mom. Together, we unravel the mysteries of how stress can physically manifest itself and how certain genetic variations can influence neurotransmitter release, thereby affecting our mood and anxiety levels.

Brace yourself as we dive deeper, exploring the interconnected world of pharmacogenetics in mental health treatment. You'll learn how genetic testing with P23 can reveal the secrets of how our genes interact with medication, food, and supplements and even influence our exercise regimen. Discover the exciting potential of personalized medicine - how, by understanding an individual's genetic makeup, we can predict their response to certain medications, anticipate potential side effects, and tweak dosages for optimal results. All this and more as we pledge to guide you to live your longest, healthiest, and happiest life possible. Tune in and grab this chance to unlock the secrets of your genes!

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Dr. Tiffany Montgomery:

Hello and welcome to another episode of P23 Tell-A-Lan Talks, where we delve into the fascinating world of genetics and its impact on our everyday lives. I'm your host, Dr. Tiffany Montgomery, and joining me today as my esteemed co-host is a true industry expert and the Chief Operating Officer of P23, Trena Weeks. With the wealth of expertise in the field of molecular testing, she brings a wide range of knowledge to our discussions. She is a mother, a wife, a sister, a niece, a cousin, a friend, a philanthropist. She is a mother, a wife, a daughter, a sister, a friend, a niece, a cousin, a philanthropist, an innovator and a true trailblazer. Trena, welcome to our discussions today.

Trena Weeks:

Thank you, Dr T, for such a warm welcome. Never really heard all those hats I wear out now, but you made them sound so great. Happy to be here tonight.

Dr. Tiffany Montgomery:

Absolutely. I couldn't think of anybody better to help us understand stress and how it affects our real life and all of the areas. So thank you for exposing yourself and allowing me to speak and let others know about you so that we all know that we can do it. Because one thing about you you're very down to earth and you put your shoes on one at a time, just like everybody else. So thank you for your time and joining us today. I think it's an important topic. Just to talk about stress. Stress is an inevitable part of life and we all experience it in different ways. But did you know our genetics play a significant role in how we respond to stress? Our DNA holds valuable clues about our stress response mechanisms and to shed light on this fascinating subject, I could think of no better co-host tonight to really get into the subject. So, as we delve into stress less and how our genetics impact our stress response, I was wondering if you could tell us a little bit about stress, Trena.

Trena Weeks:

Definitely know about stress. So, being a mother of a five-year-old and a seven-year-old, I actually deal with stress on a daily basis. Currently, my five-year-old is struggling in school with his behavior, so I'm having to balance teaching home techniques to cope with his behavior as well as maintaining my obligations for work in school, which is causing a lot of pressure and stress and a little bit of lack of sleep. So I have experienced stress recently in that area, as well as being able to work in some fitness activity and self-care. I think that self-care is an important thing for me and not being able to have those self-care activities causes me stress. So when you say, am I familiar with stress, I would say I am an expert on understanding what stress is. Now managing it, that's another story.

Dr. Tiffany Montgomery:

I can certainly relate to that and I think so many times we think about stress. When we look at the physical signs and we think about the physical manifestation of stress, like headaches, back and shoulder aches, or your gut is just a mess, right, you could also break out, so acne or eczema or psoriasis. These breakouts are often stress related. We sometimes notice it too when we start having our weight kind of creeping up weight gain because that nonstop stress can cause your glucose or your blood sugar levels to rise, which could lead to that weight gain, especially in your abdominal area. So these are things that we all have to be mindful of, especially when we have to balance work and life right. Work-life balance is a very serious thing. We use that term, but we just heard Trena describe how she has to balance that all the time. And with that, we've got to talk about some internal things that kind of happen when we have stress. Right, and these internal things you may or may not be aware of, but pay attention to those physical signs, because those physical signs are going to share so much light on what could be happening inside of your body.

Dr. Tiffany Montgomery:

There are certain genes involved in regulating the production and the activity of stress-related hormones such as cortisol. Genetic variations in these genes can impact how efficiently our bodies manage and recover from stressful situations. Some individuals may have genetic variations that make them more resilient to stress, while others may be more susceptible to its effects. Our genetic predisposition can influence the way we perceive and react to stressors. For example, certain genetic variations can affect the release of neurotransmitters, which can impact our mood and anxiety levels. Additionally, variations in genes related to stress response pathway can affect the duration and intensity of our stress response.

Dr. Tiffany Montgomery:

Just like different people have different genetic makeups, different people are going to respond differently to that stress. You may hear one person's situation and say, oh my goodness, I don't even know how I would manage if that happened to me. Or you may hear somebody's situation and say that's lightweight compared to what I'm dealing with. Either way, your body and your DNA are going to react to those stressors and it's important that we understand how our DNA can help us personalize our stress management strategies. By knowing our genetic makeup, we can identify specific areas of vulnerability and develop targeted interventions. What am I talking about? For instance, individuals with certain genetic variations may benefit from stress-producing activities such as mindfulness practices exercise or specific dietary modifications. This personalized approach can optimize our stress management efforts and enhance our overall well-being. Trena, do you have any stress management techniques or strategies that you currently use?

Trena Weeks:

Yes, there are a few of those techniques that I've tried before, but one thing that I know really works for me just resting and relaxation.

Dr. Tiffany Montgomery:

I think those are key. So, thank you. I think that those are pivotal and sometimes we forget, right, those little things. There's also a study of how an individual's genetic makeup affects their response to medication. That's called pharmacogenetics, and pharmacogenetics, also known as PGX, can be used in the context of mental health treatment. It involves analyzing specific genes to influence how our bodies metabolize and respond to psychiatric medications, among many others, but it's really really effective for psychiatric medication management.

Dr. Tiffany Montgomery:

And psychiatric medicine includes things from anxiety and depression all the way to schizophrenia, bipolar, multiple personality disorders. It's a wide range, right? So you can't say, ooh, psychiatric medications. I mean, think about it, how many of us deal with stress, anxiety, depression on a regular basis? By understanding an individual's genetic profile, we can predict their likelihood of responding to certain medications, potential side effects and optimal dosage adjustments. Pharmacogenetic testing has been particularly useful in the treatment of depression, anxiety disorders, bipolar disorders and schizophrenia.

Dr. Tiffany Montgomery:

These conditions often require a combination of medication and dosages, making it challenge to find the right balance, the right medication or to take it in the right amounts. These are all things that I think we have to be mindful of, because no two persons are alike. This is our DNA is different. We also experience differences with how we're going to respond or what we need to manage those particular conditions, elements, whether they're temporary or long term. Sometimes you can take a medicine just to temporarily build up your reserves and your fortitude, and associated with other practices, so that after a period of time determined by your doctor three months, six months, a year, two years you're transitioning away from those medications and you're transitioning to what we would call the balance, using other natural pathways. So you're transitioning to the balance of using other natural mechanisms or more holistic mechanisms, such as you know, the things Trena talked about yoga, mindfulness, exercise, et cetera. But we have to remember all of these things work together and nothing happens in a silo or all by itself. Right, and that's the overwhelming part, just understanding that just like there are many pieces and parts to you, there are gonna be many parts and ways that we can manage stress and use our genetics as a tool to do so.

Dr. Tiffany Montgomery:

Trena, with that, I wanna open it up to some questions. Maybe we received in the chat, the email or in the DMs. Hopefully we have time for two or three questions. Could you give me the first one?

Trena Weeks:

Sure, and also Dr T, I wanted to say I'm glad that you explained those medications because I know for myself I've always wanted to have a better understanding of taking medications, because it's something that's found upon when I talk about it to like my social circle. So thank you for doing that. The first question is how can we use the genetic data to develop our personalized stress management strategy specific to our own individual needs?

Dr. Tiffany Montgomery:

That's a great question. There are tests available, like those at P23, where we're using the research already established in a clinical setting, looking at particular variants on different genes, such as the serotonin transporter gene, known as the short allele, and we're looking at the susceptibility to developing stress-related disorders, such as the anxiety or depression. We can look at other alleles that lower serotonin availability in the brain, increase cortisol response, and we look at those variations in the genes that are involved in stress response, such as those related to the hypothalamic pituitary adrenal axis, called HPA axis, and those all contribute to an individual's differences and stress susceptibility. So when we delve in and really look at those genes, we're able to get guidance and while we can't change our genetic makeup, we can certainly take steps to manage stress and improve our overall well-being With those healthy coping mechanisms that we talked about, like regular exercise, mindfulness practices, in addition to maintaining strong support systems, can all help an individual regulate their stress response. Additionally, seeking professional help, such as therapy or counseling, can be beneficial in managing stress-related disorders. So I'm glad you bring that up because sometimes, depending on where people are coming from, they might say move on or you need to get over that, and sometimes we all need a little help.

Dr. Tiffany Montgomery:

I was talking to my sister last week and we were processing just stress and I think our mom said something like come on, you're stronger than that, get going. And I was trying to explain to her that you have moments now where everything is so rapid, emails are so right away, bills are emailing you now to pay them. Problems, coworkers, client services All of these work relationships are coming at you 24 hours a day and there's no off button, there's no do not disturb. In my mom's day you were able to or she was able to, put a letter in the mail, deal with that stress. Later Somebody mail her a bill. You say I didn't get the mail yet. 17, 20 days sometimes it takes for the mail. You get the mail and then you respond and your response takes 10, 20 days and there was a cooling off period that allowed people time to separate from a problem, to think it through, to get help, to get guidance.

Dr. Tiffany Montgomery:

There is something to be said about the technology age that we live in. With so many factors making instantaneous gratification, fulfillment, everyday part of life, it doesn't allow you those moments to separate. So, whereas they were able to have coping mechanisms and time to balance those stressors. We miss a lot of that in the technology age. So my sister and I have to form a support group for each other to say, hey, stop breathe. Let's think about this. Do we want to talk to a therapist? Are we gonna provide therapy for each other or whatever that looks like, just to get through those moments. So I wanna encourage you and all of our listeners to develop that support system and don't be afraid to do whatever it is that you need to do to tackle those health issues. But let's not worry about what people have to say about our stress or our mental health. It's gonna be up to us to understand our genetics and to proactively deal with those things. And do you have one more question?

Trena Weeks:

I do, I do. Could you explain how or if knowing your genetic makeup in DNA can help with creating that exercise routine?

Dr. Tiffany Montgomery:

Absolutely At P23, we have a test called P23 Optimum, where we actually look at genetic markers that will help you decide the most effective fitness mechanism or routine for you.

Dr. Tiffany Montgomery:

Are you better at strength exercises? Are you better suited for, and do you see the most result out of, cardiovascular exercises? Is your genetic makeup one where you need to be equally balanced, where, instead of alternating days, you probably need to focus every day on 30 minutes cardio, 30 minutes strength training? We're able to look genetically and help you come up with the best type of workouts that will work for you, so that you could work with your fitness trainers or our health coaches and really define a workout routine with the correct physiology, exercises and guidance that work for you. So our testing will give you the class and then you will work with the trainer to tell the type of exercises within that class that would be most effective for you, and biomarkers is a phenomenal way to do that, which is based strictly on your genetic composition. So thank you for those great questions and I will turn it over to you for any wrap up or final points that you'd like to throw in.

Trena Weeks:

After our discussion, our final advice would be to have open and honest conversations with your health care provider about pharmacogenomic testing. Ask questions there's always ways to find solutions and talk about the limitations and make informed decisions that are best for you to gather with your health care provider. Remember that everyone's journey is different. It's unique, and what works for one person may not work for another.

Dr. Tiffany Montgomery:

Thank you, Trena.

Dr. Tiffany Montgomery:

That is a phenomenal piece of advice and I think you summed that up perfectly for both of us.

Dr. Tiffany Montgomery:

In this episode of P23 TeleLabs Talks, we were able to really get into the topic of stress and how it holds valuable information within our DNA on how to manage and respond to stress.

Dr. Tiffany Montgomery:

We were able to shed light on this fascinating topic and really get into the genes, understand our DNA to personalize stress management strategies, and then we were also able to talk about how those genetics not only help with stress management but also affect medications and pharmacogenetics. More importantly, we were able to give you the solution, and one of the strongest solutions we can offer is testing with P23, whether you choose to test for pharmacogenomics or nutrigenomics or the combination of what we call P23 optimum, where we look at your medication metabolism, your food metabolism, your supplement metabolism the best exercises for you and really hone in on those stress management genes. I think it is definitely well worth joining our membership program and talking to our healthcare providers and specialists today. I would also like to take a moment just to thank our phenomenal co-hosts and our listeners. Thank you so much for tuning into this episode of Tell a Lab Talks here at P23 Health, we're passionate about helping you live your longest, healthiest and happiest life possible. It is all backed by science.

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