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Brainy Moms
Brainy Moms is a parenting podcast with smart ideas to help moms and kids thrive! Hosted by cognitive psychologist Dr. Amy Moore along with rotating co-hosts Sandy Zamalis, Teri Miller, and Dr. Jody Jedlicka, this weekly show features conversations and guest experts in parenting, psychology, child development, education, and medicine with practical tips to help moms navigate the ups and downs of parenthood. We're smart moms helping make moms smarter...one episode at a time!
Brainy Moms
MTHFR and Epigenetics: Functional Medicine Insights for Parents | Dr. Randy James
Wondering what all the social media chatter about genes and genetic variants (like MTHFR) really have to do with your child's health? On this episode of the Brainy Moms podcast, Dr. Amy and Sandy talk to functional medicine physician Dr. Randy James about the connections between our genes, our environment, and our overall wellbeing.
Dr. James unpacks the philosophy of functional medicine, which seeks to understand the root causes of health issues rather than just masking symptoms. He explains why modern medicine often falls short when addressing chronic conditions or nebulous symptoms like fatigue, brain fog, or general unwellness. The key difference? Functional medicine recognizes that every human is "infinitely biochemically unique" and requires a personalized approach.
Dr. James breaks down how our genes and environment interact. He demystifies the often misunderstood MTHFR gene variant, which affects approximately 40% of the population to varying degrees. This genetic variation impacts methylation – a critical process involved in detoxification, neurotransmitter production, and cellular repair. Research has shown statistical associations between MTHFR variants and conditions like ADHD, autism, depression, and other mental health challenges.
But here's where hope enters the picture: Dr. James emphasizes that genetic predispositions are not deterministic. Just as someone with fair skin doesn't panic about their increased skin cancer risk but instead adapts with sunscreen and protective clothing, understanding your genetic variants allows you to make targeted lifestyle modifications that can dramatically improve outcomes. From prioritizing organic foods to eating plenty of green vegetables rich in natural B vitamins, these evidence-based strategies can help support optimal methylation pathways.
Parents will find particular value in Dr. James' practical advice for supporting children with genetic predispositions. He outlines developmental red flags to watch for, explains why "normal" symptoms might not be healthy, and offers guidance for navigating the complex world of nutrition and supplementation without becoming overwhelmed.
Ready to take control of your family's health journey? Join us for this empowering conversation that will change how you think about genes, environment, and your power to influence both.
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Hi, smart moms and dads. Welcome to another episode of the Brainy Moms podcast brought to you today by LearningRx Brain Training Centers. I'm Dr. Amy Moore here with Sandy Zamalis, and Sandy and I are excited to bring you a conversation with our guest, Dr. Randy James.
Dr. Amy Moore:Dr. James is a board certified family medicine physician and an Institute for Functional Medicine certified practitioner. His medical practice focuses on finding the root cause of illness, along with methods for prevention and healing, and he specializes in assessing each patient's unique biochemistry, their genetics and the social context of their health and wellness. And we're going to talk to him today a little bit about what functional medicine is, why we should care. But we also want to talk to him a little bit about the field of epigenetics and how our environment and lifestyles interact with our genes to cause risk and illness. Specifically, we do have questions about testing for genetic variances related to ADHD and autism and other mental health diagnoses and chronic illnesses. We are going to touch on MTHFR, which is one of those genes that we see all over social media these days and, fun fact, Dr. James is my physician, so I am super excited that we're going to have a conversation with someone who walks the chronic illness journey with me. So let's welcome Dr. Randy James.
Dr. Randy James:Thank you, Amy and Sandy Glad to be here.
Sandy Zamalis:All right, so let's start off with your story. How did you become a functional medicine physician?
Dr. Randy James:So my dad is a doc, he's an MD, he's an otolaryngologist, and I like to quote him. At one point in my teens he said you know well, he didn't say this, but this was the effect of I was his worst patient ever and I got all the stuff. I got the ear tubes and the tonsils and the allergy shots and everything, but I was still, and so I will quote him here. He said why is my son always so symptomatic but not really sick? And so I didn't have a diagnosis that I could do all of the, the, whatever I was doing, but there was always the head and neck symptoms. So that was the 80s and it was definitely not cool to do anything alternative back then. But that's where he started thinking and then experimenting on me, so to speak. So from 15 to 25, I got well-er, mostly through lifestyle changes, and by that point I'm already headed towards regular medical school, but with an eye towards a different approach. It wasn't called functional back then, right, like it was called integrative or holistic or whatever. It wasn't really called anything.
Dr. Randy James:So the 90s was kind of what I would say was the birth of functional medicine. That's where that term started to be coming in. I graduated medical school in 98. I was in the military. I got told very quickly, stop all that weirdo stuff and just color within the lines. So for 10 years in the military, and that was fine with me because we were overseas and newly married and traveling a lot Coming out of the military. Then in 2007,. And now I've started my family.
Dr. Randy James:So the second flavor of what was leading towards functional medicine was kid number one. And kid number three had some significant issues and I didn't want to start them off on medicines. You know, medicines first, questions later. So I remember coming home one day and I told my wife, well, we had done some extra labs, sort of outside the box labs, and I like holy cap, like we've got to figure this thing out. That was a Saturday and the next day was, I think, father's day and it was ice cream day at church.
Dr. Randy James:So here we go, day number one of declaring war on my son's metabolism and he can't have ice cream. And it's like, well, how do we do this? Well, you got to draw a line. And so you know, screaming kid in church can't have ice cream, screaming kid in church can't have ice cream. And that began. You know, those 10 years of helping my own kids, helping myself and trying to figure it out. And then that led to me saying, well gosh, how do I help patients? Because we had transitioned from the military into normal sort of insurance-based American medicine. And then several iterations later of how do you run a business trying to do that. And then here we are. So that's kind of my very high level 50,000 foot view of what led to what we're doing now with functional medicine.
Dr. Amy Moore:So talk a little bit for our listeners who don't necessarily know what functional medicine is. Talk a little bit about what that means and why we should listen.
Dr. Randy James:Oh yeah, Right Like, is it right or wrong? Is this true? And that's of course, and I would describe it as that's an infinite question, because, at the end of the day, no, you're not going to figure out a human being. There's always going to be mystery, there's always going to be pathology Nobody's perfect. But, in contrast to a typical American medical system, where the system is built very well if the problem is acute trauma or acute infection, well, if the problem is acute trauma or acute infection, so if you get in a car wreck, call 911, right, we got good stuff for that.
Dr. Randy James:But when the problems or the puzzle becomes more, how do I feel? What is energy? And so then the question I would go to the patient and say well, you tell me how you want to function, what are your goals? Because functional medicine and this is where I would have a beef with most functional medicine doctors there is no such thing as optimal, there is no such thing as optimizing hormones, and there's no perfect human out there. So what does optimal even mean?
Dr. Randy James:So, through my lens, the word function is well, how did God design us to be? What does that even mean? So we quickly get into theology and philosophy and a person's own perception of their own, whatever they deem to be dysfunctional. So that's what I would say is the main essence of functional medicine. But then you get into well, it's a systems-based biological approach. You know, everything is related to everything. Every human is infinitely biochemically unique. So those are kind of the textbook answers. But I think it makes more sense for people. If they're asking the question or they're thinking I don't feel quite right, then I would ask okay, describe that. So that sounds like dysfunction. Well, what is function? Tell me about your fatigue without using the word energy. Even Einstein Einstein could not define energy, so don't use that word. And then we quickly get into somebody's life Like it. Whatever the thing is is impacting their, their marriage or their family or their, their, their effort or their perceived effort at work, or their success at work or grades or those things. So that's what I would call function.
Dr. Amy Moore:So talk a little bit about what that means for parents, right? So, like, at what point would a parent say, okay, this traditional approach to fixing what's broken is not fixing what's broken. Right, there's something else happening here, and so how would they know it's time to look towards functional medicine through a functional medicine lens instead?
Dr. Randy James:So when we approach it through that lens, my answer tends to be built around classically perceived pathologies Right, what's broken? So I'm going to answer that question. But I'm going to begin with. Gosh, in a perfect world, if there is a functional type of doc or, let's say, parents, that are thinking this way, then it begins, you know, pre-pregnancy, right, like. And it begins with gestation, like, how are you taking care of mom in order to take care of baby? And then, once that baby is born and you know, nowadays certainly the world has flopped back over to, yes, breastfeeding is the best way. Well, you know, when I I will ask people you know whether they're 10 or you know 50, were you breastfed? And the answer is always yes. And then I say how long? Oh, a month or two years, like. Well, like, if breastfeeding is only a month, then I wouldn't call that breastfed.
Dr. Randy James:And there's going to be a consequence, and maybe that consequence is now we're into that pathological kind of well, as a parent, what might we be seeing in young ones? And so you know, and I'll go back a step further, was this a C-section baby or was this a vaginal delivery? Because that makes a difference and C-section babies are at higher risk. That doesn't mean they're going to die when they're two, it just means they're at higher risk to maybe be for their physiology to respond in a dysfunctional way to normal challenges of life. So then in that infancy phase to the parents I'd say, well, are we, as an infant, meaning zero to one I would look for? Is there any kind of, you know, colic, being a famous one? Well, that's not normal. And the babies don't just grow out of it. Like that's a really terrible thing to say to a, you know, a mom that can't sleep. And now you've got a mad kid, 24, seven, something is going on there and I wouldn't just chalk it up to normal. Or that's this kid, or they're going to grow out of it in the infancy. So zero to one.
Dr. Randy James:I would also be very mindful of skin, like yes, we'll be tolerant of some cradle cap and some milia, but that you know that might be a little signal that something's going on. Another one, that when we're doing that, like the famous chappy rosy cheeks, you just look at a kid and they look cherubic or cherubic, whatever that was. They look like a cherub yeah, we don't say that word anymore, but that's not nice, right, like they should not look like that. That's an inflammatory response to something, and yet it. Just when I walk around, you know, I see people and I'm at a restaurant, I see those things. I learned a long time ago not to approach a mom and tell them that they don't want me to tell them that.
Dr. Amy Moore:Excuse me, I'm a doctor and I just want to let you know that your child's rosy cheeks are not normal.
Dr. Randy James:So moms have to have an ear to hear, right, like they got to be open to something like that. And then we go to the toddler phase. So two, three, four, you know it's not normal to have an ear infections. Children are built with a deficiency of the pink stuff. So how often what's going on? Are they in daycare? Those kinds of exposures? There's nothing right or wrong or good or bad, we just think through those things and toddler. If there's constipation, if the child's not sleeping, if there has been ear infections or multiple ear infections, those are kind of the clues that I'd say let's think more broadly about this. And then we go to the elementary years. So in the elementary years, now you know we've got, whatever it is these days, one out of 60 kids with autism or whatever. So we ask those questions and if we're seeing that early, we do want to ask. So we're not.
Dr. Randy James:Today is not a vaccine question, but we ask the question of well, are vaccines there and what was the timing and all of that? And has there been a personality change in the elementary years? Are they sleeping? Do they wake up rested, or is this kid hard to wake up? Are they mouth breathing? Do they snore. Snoring is never normal, mouth breathing is never. These are pathologies. All humans are on the spectrum. All humans are neurodiverse, so we give infinite mystery to the variability there. But if mom says no, no, this kid something different and now they're more this way, that's a big red flag Like let's be aggressive down that pathway looking for. And then it depends on what they're talking about, the kind of labs or procedures or a brain map or whatever that we want to do. But in the elementary years, that's when we really asked the brain questions ADD, adhd, ocd, how's the sleep? What's the sleep pattern? Mommy, my tummy hurts. Is that a theme? Congestion and irritability Maybe they have the allergic faces or the puffy eyes.
Dr. Randy James:Oral, if they're snaggletooth or if teeth don't have or if the dentist says there's not enough room on the oral side of things, that's where we start to really look aggressively at the oral window. What is the mouth helliness? If there's already caries or cavities in those early phases, it's not because they're on bubble yum or mom doesn't know how to brush their kids' teeth or whatever it's likely. What are they eating? And they're probably mouth breathing and then into the adolescent, pre-adolescent.
Dr. Randy James:And now we've got all these neuroendocrine disruptors out there. We've got women starting their menstrual cycles at nine Like. Those kinds of questions are are important to understand. What's the pathway of the function that this body is on and can we mitigate, can we nudge it one way or the other? So that's a biggie is asking young women, you know, when did the menstrual cycle start? And, of course, and I'll ask you guys, if I ask a teenager these days or a woman that's cycling, what's the percentage of women, teenage women these days or well, women these days, that have irregular cycles, cramping, pms or other sort of body symptoms, breast tenderness or acne or something related to their cycle? What percentage of women say yes?
Dr. Amy Moore:Andre.
Dr. Randy James:Yeah, most.
Dr. Randy James:Right, it's the weirdos that don't have interesting metabolism. But it's the weirdos that don't have interesting metabolism. No, and so and so who is the first person that gives them their first medicine? Their mom, and they're highly educated, highly caring. Oh, I just want my kid to make it to school today. And you know, whatever we got to do something and I get it. But you're not born with a deficiency of Motrin. And then Motrin becomes Midol, and then Midol.
Dr. Randy James:These days, and I don't know what, the percentage is half close to women in high school on birth control. And my wife, who works at a pregnancy center, gets so frustrated because these women don't know why they're on birth control. They have not had that kind of a conversation with their doc. Moms don't even know why. It's just well take a pill and you'll be better. So, yes, there is going to be a woman should know she's on her cycle. There's going to be an awareness of those kinds of things. But it ought not be painful, it ought not be disruptive to life with you know it's so heavy you got to stay home or whatever. It ought not change your personality Like there. It's not normal to have PMS. That is abnormal.
Dr. Randy James:If we look at just a common sense evaluation of the data of women over the past recorded human history. Yes, there's menstrual cycles, but we in modern America we've normalized the pathology and I feel so badly for young women today and of course it's going to breed anxiety and of course it's going to have an impact on your brain and how you approach. You know the complexities of teenagerism is complex enough and then you throw this in there and it just becomes a problem. So you can tell we see a lot of people that are on that side of the hormone complexity and of course the younger and youngerness aspect of that is a little bit of a mystery.
Dr. Randy James:I mean, if you go back to 1850, what was the average age of starting your menstrual cycle? It was like 15. And now it's 11 or 12. So something is changing, you know, and it's multifactorial and we can debate forever about what's going on there, but something. And so I just want parents to have the awareness that what their culture tells them is normal is not wellness. It is normal like averagely people are overweight and depressed and anxious and all that stuff. But let's not normalize it. Let's give people the opportunity to know that you can think differently about that and it's not being a health nut or a weirdo, I would say it's.
Dr. Amy Moore:It's what medicine ought to be okay, so what I'm hearing you say, then, is that maybe one of the reasons why we hear so many doctors saying, well, let's wait and see, is because, as a culture and a society, we have normalized pathology, because it's so ubiquitous?
Dr. Randy James:Yes, and which makes sense. Right, like the fish doesn't see the water that it's swimming in. Right, the old joke of the man asking the fish how the water and the fish says what water, like they don't know anything otherwise. And I would say that's true of most especially, for, on the woman's side, most women who are adults and now grandmothers have also experienced this. It is normal, but it ought not be that way. My hope is that it ought not be that way. My hope is that it ought not be that way. There is a better way. Again, we can't moralize it and I don't want people to perceive shame or wrongness in that way, but more opportunity that it's not irrational to want to be abnormal, in that you're trying to be well, but the tide of our culture, or the flow of that river, is so strong. And to be quite honest with you, I would say the most difficult patient we have is female, 16 to 18. Because in order to change the physiology of her abnormal metabolism, the social coin is way too expensive.
Dr. Amy Moore:I'm sorry, I thought you were going to say the most difficult patient we have is 54 years old and her name is Dr Amy.
Dr. Randy James:Well, I should have asked you is there anything off limits?
Dr. Amy Moore:Right, no, there's nothing off limits, we're very honest about our struggles with our listeners, so they know all about our challenges. Okay, so one quick clarification, and then I want to move into something more specific. So what I'm hearing you say is that periods are not supposed to be painful.
Dr. Randy James:I don't think it's there are.
Dr. Randy James:So not all women have a painful menstrual cycle, and I would say my wife is one, and so here again, the fish doesn't see the water.
Dr. Randy James:So she didn't know that all the other women were having all of these things and at one point she was kind of surprised, not offended, but I can't tell when she was on or off or whatever. So she was like well, you should be able to tell, and I'm like well, it's a good thing. Then I can't tell when she was on or off or whatever. So she was like well, you should be able to tell, and I'm like well, it's a good thing that I can't, and right, like, because for most women would have the experience that they can tell and probably their family can tell, and I know, I don't think that that has been the norm for all women over all time, until the modern culture, modern society, our exposure to the amount of insulin, glucose, cortisol, the neuroendocrine disruptor question, et cetera, et cetera, et cetera, has had such an impact, a generational impact now, that in order to push that flow back the other way to where averagely, women would have not painful periods, I don't know that we can ever get there.
Dr. Randy James:Were you shocked by that.
Dr. Amy Moore:Sandy.
Sandy Zamalis:I'm one of those people that doesn't so for me, you know. I know other people struggle with this issue. I'm not one. I have my own other litany of things that I struggle with, but for that particular issue, no, I think what I keep thinking while I'm listening to you, dr James, is that it's so hard to find people that think like you, that really want to get down to the root of the issue. Because even if you know, these things come up like in my family we struggle with autoimmune issues, my daughter specifically juvenile rheumatoid arthritis, and that was a really hard challenge to find a physician who would help us get to the gut piece of that equation.
Sandy Zamalis:There was a lot of medications and things to try to calm things down and you know I love that. You're saying that it's a nuanced. It's a nuanced issue and you have to look at it from as many sides as possible and not just think about it from a, you know, put a bandaid on it or smack a medication on top of it, but really think about the sleep and you know what's happening and all these other pieces, but to not feel guilt about it, cause I've had people say that before. It's like oh, this is just another way to mom shame, right, like blame it all on the mom, that it happened in gestation or whatever, um, or they didn't breastfeed or all those things. But it's not about that. It's about just understanding how we're you know, how we're created and how things are naturally supposed to be, so that we can better manifest that.
Dr. Randy James:So I resonate with you so strongly because my third son is also on the autoimmune spectrum and so I can dad shame myself a whole lot. And in our family and the initial thing you said there is it's hard to find somebody, and that is the most. If I'm somewhere that's not my community, then the most common question is well, how do I find a doctor that thinks that way? And I know that that is the sort of the linchpin or the bottleneck, and and so we're trying to change it right, like can, we is, and there is more of a grassroots kind of awareness. You've got Google. Now there's, there's ways to spread that. But along with google in my awareness comes a lot of confusion, because now there's infinite things you can do and somebody always wants to sell you something.
Dr. Randy James:So we have felt that too. Uh, with a kid that's got pathology and and then I'll wake up one day and I'll feel the feeling of, okay, I gotta, I gotta fix this. Well, now that kid is 14 and he has his own opinions on anything that I can suggest, and they're usually opinions that are opposite of mine. So so now we're in that the navigation of not only my sense of maybe failure at not helping him as much as I and you know I could have, should have, would have, and his own sense of so. My son has alopecia, so totalis like everything, alopecia so totalis like everything.
Dr. Randy James:And well, can you know for us to think about going to middle school in the 80s with alopecia like I? I think it was more traumatic then and probably more traumatic for a girl. These days, though, he's kind of a cool kid and different and unique and so near as I can tell he's not perceiving devastation. But still, how do we help our kids without shaming ourselves, without you know, with without shaming our kids, especially in those middle teen years? There's no pill for that and there's no right diet for that. There is no magic sleep powder for that. It is what you're saying hopefully finding a partner in the medical community that can walk with you down that pathway, and they are just very hard to find.
Sandy Zamalis:Figure out what works for you, right, you're saying too, is you know, we're all biologically diverse, right? Like we're all you know, what works for one person may not work for another, because it depends on what's causing, like the inflammation or what your genetic markers are, what your blood type is.
Dr. Randy James:So many factors factors, it's just infinite. You know All right.
Dr. Amy Moore:I love that you said that, because I think that's a great segue, sandy, into really what we want to talk about today. I want you to talk about MTHFR as a genetic variation on a theme and what that means for us and should we care.
Dr. Randy James:Yeah, I do enjoy talking about genetics and I hate it talking about genetics, and I hate it because it it. Well, let's start at the 50 000 foot view, like what you know, the genome and what it is and all of that. And so here, a good analogy is that you know, we cracked the code, so to speak, of the human genome, and in 2001, whatever it was. So we are 25 years later. That's, in the science world, that's an eternity. How many genetic drugs are out there? How many major breakthroughs have there been? Barely any. Why is that so?
Dr. Randy James:It's like one day when my son, at you know, age four or five, said, hey, dad, I know how a car works. I'm like, oh, how's it work? And he's like you push that pedal down there with your foot and it goes. And he's totally true. And I'm like, oh, let me show you something. And I take him around, I pop the head and I show him the engine. He's like, yeah, whatever you push this pedal, that's what makes the car go. And he's completely correct. So we pop the hood on the human genome and we said, whoa, no idea how this stuff works Like this. You know, they thought they were going to see the code for diabetes, the code for cancer, the code for whatever, but the reality is that all humans can get diabetes, all humans can get cancer. So all it did was create more, not confusion, but complexity. So here we are, 25 years later, and then you've got guys like Ben whatever his name was that did the.
Dr. Randy James:MTHFR stuff, and so then we kind of have flopped over to maybe an over-reading of oh, I'm MTHFR, so therefore my depression or my whatever symptom is is, well, I'm MTHFR. I'm like, wow, okay, that's not totally true. And so, to help people think about it, I am going to use a genetic reality that we're all familiar with, called what is the tone of your skin.
Dr. Amy Moore:I don't want to offend you guys, but as far as I can tell, you are Caucasian females.
Sandy Zamalis:That would be correct. Okay, I thought I was going to get a rosy cheek analysis.
Dr. Randy James:We look terrific today I'm going to ask you what you've been eating. So the tone of your skin is a genetic predestination. You know, it doesn't matter what you eat, it doesn't matter whatever. But as a Caucasian person, by definition you have an increased risk of skin cancer. So there's a medical true statement based on averages compared to average brown, you are at more risk, right, fair? But have you ever walked around saying, oh, I am pre-skin cancer, I'm going to get cancer, I am Caucasian.
Dr. Randy James:Therefore, I have to think about skin cancer every day, all the time, and what most people will do is they'll say you know what? I'm going to wear a hat, I'm going to put on some sunscreen, I'm going to wear some clothes, I'm going to create a habit, a lifestyle that is appropriate to the genes that I now understand, have an impact on my future well-being in my life, and we would call that wisdom. Okay, what about MTHFR? And this is a? Or what about epigenetics? So epi means above, so it's kind of like what is surrounding the genome and technically it's about well, how does the twisted up ladder of the gene you know, how does it fold in on itself and unfold and all of that. But people don't want to walk around thinking about that. They can think about well, what am I bathing my genes in? What kind of food, what kind of sleep, what kind of environment? Do I love my job or hate my job? All of those things. That is the epi. And then these days, we now have these subsets because we do have enough knowledge to say well, this MTHFR thing and how people methylate and what methylation is, seems to be related to some of the things that we care about. So we check everybody. I think that ought to be a version of primary care, and the two that I think we have enough data on would be NTHFR and the APOE, and then there's probably another 20 that we could argue. You know, maybe we should know the COM, the comp or the, you know whatever.
Dr. Randy James:And then you've got the genetic hobbyist, and I would call it a high. They want to know everything. And but at at the end of a discussion of genome, my frustration. So in 2019, before COVID, so in 2019, before COVID, we did everybody's almost full genome. So that's a cost, and the problem is you can't interpret. Or if you try to interpret, you're going to wind up with a lot of bottles of supplements, and that's it that drove me insane. It just became this conduit to buy these supplements, to buy these supplements, and they called it precision.
Dr. Randy James:The day you know, you go through one of those things and it says, oh, you need more quercetin or PQQ or these weird whatevers. But people don't take their PQQ and say, wow, I'm more kind and gentle. I think my wife thinks I'm a better husband. The things that you care about are so distantly related that it did not seem like it was functional to do a practice that way, at least through my lens. So these two with methylation and APOE, I think they are related enough to the things that you do every day that we can kind of say, okay, here's, you know, if you're this kind of genetic variant or that variant, it's not. We don't say the word mutation anymore, it's a variance, and we don't say good or bad, any more than Caucasian skin is good or bad or whatever. Caucasian skin would be a deep challenge if you're born in the Sahara. But if you're born in Norway, you probably don't think twice about it, like you don't even wear sunscreen. So the same thing if you are MTHFR, whatever variant, and you are going to live like an average American, you're probably inviting some complications down the road. The epi part of that if you don't. Well, so to be simplistic about it, what we tend to say is well, let's go one step.
Dr. Randy James:So methylation is a subset of the biochemistry of detoxification, so that big, we could say, which is a subset of this thing called metabolism. And metabolism is what your body does to just not die Every day. You gotta breathe, you gotta drink some water, you got to eat some food, you got to sleep. This is all metabolism. Underneath metabolism would be the biochemistry of detoxification, which I hate that word because it really doesn't mean anything. Every breath you take is toxins and you got to breathe out and if you stop that you'll be dead at about three, four minutes. But in between breath in and breath out is a few billion molecules of detoxifying and oxygenation and all that. And so a subset of that is methylation. And there's hydroxylation and sulfation and all that. Nobody talks about those because we don't have a real nice neat, you know genetic whatever, because there's lots of genes. Even with mthfr it's you know 30 genes. It's not just the main two that people talk about. So so there's that complexity to remember.
Dr. Randy James:So we're in the relative detox and then underneath detox is methylation and and we have under-methylators and over-methylators and you are genetically predisposed not predestined, but predisposed to do detoxification a little bit more efficiently or a little bit less efficiently. Well, you can imagine, if somebody is less efficient, problems tend to happen. I am one of those variants, not quite as unique as Amy, but still I'm on the spectrum of more variable, and I didn't learn this until 50. Right, like we didn't learn this until 50, right, like we didn't know these things. And so then I see the red flags on and in me there was the hyperhobocystinemia. So that's a consequence of that inefficiency. But you don't feel it? Well, some of me when I was 10 and my frustrations that my dad was saying well, why is this kid symptomatic by definition, had to be related to that. Because I was born with a need to be epi, or environmented, not in the typical American way, but in a different way. My mama loved me, but she fed me Froot Loops and then we got healthy and it was Cheerios and for 30 more years.
Dr. Randy James:The missing piece for most people down that methylation pathway is this crazy supplement.
Dr. Randy James:Everybody hates taking it.
Dr. Randy James:I'm so sorry, but it's called green vegetable, so we don't live in a culture that I like that, in even families that do pretty good, I say, well, what if we compared you to the little boy in okinawa or somewhere else and we don't know, like if I had been exposed to more spinach when I was two, would I have less of a consequence at 50?
Dr. Randy James:That's where the science ends. So methylation, it's about 40% of people to a varying degree, of whatever the variants are. And then if you're way over there, then we'd say, well then, yeah, learn how to eat the kind to create the environment, eat the kind of things that enhance methylation as opposed to unenhance. And we have supplements that we can use and we have markers that we can look at to help. You know, are you on a better track or are you off track? And so that's the idea of increasing the chances of better function according to the person, infusing that with the science that we know and infusing that also with the genetics that you now know about yourself, using that also with the genetics that you now know about yourself.
Dr. Amy Moore:So is that a good overview? Yeah, absolutely so. Let's talk about the association between MTHFR variants and some mental health diagnoses, and do you believe that that information is power? Do we want to know? Does it help you explain to a parent? Well, first of all, let me back up. So if you read recent meta-analyses, so collections of multiple studies that have been done, there is a statistically significant association between MTHFR 677 and ADHD, autism, schizophrenia, bipolar disorder and major depression. Did I say major depression? Anyway, that's one of them. Okay, so let's say that you have one of those diagnoses. Is it helpful to know that that could be a possible contributor? Or we care and would you do anything differently?
Dr. Randy James:well, no, I agree that it is very helpful to know very well, very enough to spend the money to buy the data and to have the data. Yes, and of course you know, do you go through 23? Well, whatever other genetic thing is out there, buy it on your own and that kind of thing. If you run it through Quest and LabCorp, your cost is about 85 bucks per and of course you can spend thousands on that. For MTHFR, I like what you just said.
Dr. Randy James:There is evidence that suggests that if you have these variants you are at more risk for these things and especially the manifestation of what I just said about methylation and detox as it now impacts your brain and that brain-body connection. Yes, I agree that that is a piece of the puzzle of why we see more of those things today in younger people. Not that I mean that the genetics haven't changed, but our environment has changed. And so back again to and I know I'm being oversimplistic by saying vegetables or whatever but the well, infinite complexity of B-complex vitamins and methylation and all of the interplay of whatever that is. And that's where I'd go to a mom or go to myself and, in the nicest, non-shamingest way possible, say you can't expect that the infinite complexity of a four-year-old brain is going to be helped by Doritos or by whatever right Like. And nor are we out to become Pharisees about. You know, Nazis and you have to eat this kind of food. But you're you right, we don't have to go to a mom these days and say, oh, you should really think about SPF 30 on that fair-skinned child. I mean, it makes common sense. I think it should make common sense that Doritos and Froot Loops and Cheerios ought not be on the table. But we live in a culture where the water, the flow of that, is so strong and we live in a culture where the awareness of the spectrum disorders is so well, it feels so medical and it feels so out of my control and it feels so bad luck and it feels so all of these kinds of things.
Dr. Randy James:And we need that. We need the government to come in and make it free and we need to. You know, we need to get resources in there. And yes, OK, we can debate about that forever too. But I would say, well, what you can do is be aware of methylation genetics and those kind of things. And if you're a, if you're a 677 homozygous, then that parent then knows well, yeah, this kid, the doritos are bad, but in this kid is really, really bad, and just knowing that I do think it helps. Like some people say, oh, I don't want to know that because then it, you know it freaks me out and I'm going to that bad things are going to happen. And I'd say, well, does it freak you out that you know you're a Caucasian, Like it's just, or you know that it's just data that you can respond to, to give yourself a better chance to be as well or as functional as you want to be.
Dr. Amy Moore:OK, so I love that and I'll even share that. So one of one of our kids is homozygous 677. And so we may. I am too. But you know, we made the conscious decision that we were going to only eat organic foods because we did not want to have to worry about whether or not those pesticides were going to hang around in our bodies, because we had that decreased ability to methylate or detox those right, and so it was a decision that I was able to make. That I would not have made because it is a little bit more expensive not a lot, a little bit more expensive to eat all organic, but I probably wouldn't have even thought of that 15 years ago.
Dr. Randy James:That's a great example. And even there, where the complexity of here we are 15 years later and your son is what they are, they're not perfect, they could be better, they could be worse, and you actually don't get to know how much of a positive impact was 15 years of organic versus not. You will never know. And that here is not that right word. Be because people always say, well, how do I know if if it's going to make a difference or not? I'm like you don't know if you're going to die in a car wreck tomorrow, like you don't get to know what the future holds. But does that mean you should only eat doritos because you might die in a firework tomorrow? Like, of course, not Right. So down that pathway. That's a great example.
Dr. Randy James:And even if somebody is financially challenged, I'd say, well, there's the clean 15 and the dirty dozen. Like there are things that you can do that increase your sense of captaincy and agency in your own life and in the life of your kids, in your own life and in the life of your kids. If you don't do them or think about them, then by definition you're placing your hope in an insurance company, in big pharma, in the government or somebody else that's going to take care of, whatever the issue is. And again, if you get in a car wreck, the system works really well, but it does not work well when it comes to the spectrum disorders and all of these things that are becoming the major problem. Well, there already are major issues in our culture.
Dr. Amy Moore:Yeah, and I think that right, we don't know if we're going to get in a car accident or not, but every time we get in a car we take that risk, and so we mitigate that risk by wearing a seatbelt. Right. And so if we've identified a risk like being homozygous MTHFR, why would we not want to mitigate that risk, even though we don't necessarily we don't have a pre-post metric, you know, for everything that we do to mitigate risks, why would we not, as parents, want that for our children and for ourselves?
Dr. Randy James:And that's right. So our age group, like you, remember when you were going off to college you didn't wear a seatbelt. I did Right, like and somehow we did change the flow of society and now you feel absolutely naked if you don't have the seatbelt on. Like and our kids they actually obey right Like teenagers they put their seatbelt on. I remember back to the 80s saying I'm never going to wear a seatbelt and whatever.
Dr. Randy James:Like, how does that happen? So I have a a sense of hope. You know, in our society that in smoking is another example of well, you know it went from super common to not. And it's these kinds of things and the work that you guys are doing to increase the awareness and, uh and I'd love that word the captaincy, the agency that you are the one that's most in control of your own wellness destiny. And again, without shaming, without blaming, without all of that, but if you don't take responsibility, you are giving it away to the government or to somebody and hoping for the best.
Dr. Randy James:And I always joke and I say, look, medicare doesn't care. All right, like yeah, at least they don't care about what you care. You care about your function and your child's function, according to your scale of what success and function is not what Blue Cross says it ought to be, or your boss or your mom, or you know culture. That shift and I think we're I, I really think we're coming into it that there is more grassroots awareness of these things and and using mthfr as kind of one point of departure for it, here's a way to think broadly about those things, in a way that it increased mom Amy's sense of confidence in the future well-being of her son, and that's a good thing, sure.
Dr. Amy Moore:So can you talk just briefly about some of those things like pesticides that we might want to minimize exposure to if we have a child with an MTHFR variant that is a higher risk? Yeah, like smoking and pesticides.
Dr. Randy James:Well.
Dr. Amy Moore:Lead and.
Dr. Randy James:All of them and I'm one of them, and so, again, this has been a thinking process. I also have a family, and they're not me, and you have to navigate all of these things and nobody has infinite money and infinite resources and infinite time. So for me, the threading of that needle, and so our family, and the general recommendation right Like if we don't go to specifics for specific people with specific things, and we say generally, like and that's where I stumble like I think all people over all times should minimize their smoking and their Doritos and glyphosate and everything. Right Like that. Now we're into politics and why can Germany outlaw this stuff and why are we doing it? And I don't know. So now we're talking to unique individuals who are making their own shopping choices and and so, um, yes to the best.
Dr. Randy James:Well, first I would say each vegetables, and when it comes to vegetables, I would say, on that, clean 15 and dirty dozen or whatever, but lean as organic as you possibly can. And that then becomes like we have and you and I have talked about this, but half of my plate is always green Like that was a thing that I could do to say, yep, yes, organic, get the glyphosate off. Thankfully I didn't have to worry about smoking and some of the other biggies. I live in Colorado. I live at 8,000 feet, we don't have a lot of pollution, so there's that In my world I don't have to trouble myself with. I don't buy an air filter Like some people, like if you live in a city I'd have an air filter and those kind of things. I filter the water. Which one? We'll debate forever about all of that stuff, but we finally landed on one. We do lean organic and glyphosate, I think is a big deal and it's a big problem, and you can test for it and your Cheerios right.
Dr. Randy James:And we don't eat Cheerios. And I challenged a person the other day I said because they were not aware of this. I was like you need to walk down that middle aisle of the grocery store on the bright, colorful, interesting, aimed at children aisle, and look at what is the front of the box of Cheerios brag about. It is emblazoned yes, with the American Heart Association stamp of approval. That's criminal, that's just criminal. And it's Cheerios and that's one of the healthy ones, right? So we live in this confusing world, in somebody that's listening to this is overwhelmed, like oh my gosh, the overwhelming feeling of I've got to change everything and whatever. And I'd say, well, maybe Start with step number one. It might be for me it was Cheerios, you remember Denver. Might be, for me it was Cheerios, you remember Denver. So Denver was an old partner and smoking, drinking, hard charging, you know, military guy, heart attack at 36, alright, and he told the story and the first healthiest thing he did was he switched from a 12 pack of Pepsi a day to a 12 pack of Gatorade. Not a great move. That was step number one and it took, you know, decades of refinement and engagement and all of that.
Dr. Randy James:So your standard can be perfection, the heavy metal question, land mercury, those kind of things. And so that's where, down the meat pathway, I would say our mantra is eat happy animals. A happy cow is a cow that only eats grass. Leave it alone, let it be a cow. Happy chickens only eat whatever chickens eat, mostly bugs, but not soy and gluten products or molasses, sugar and corn, which is what we finish those things with, and we live in this industrialized world. So, to simplify it, if you eat happy animals and so wild caught, grass fed, grass finished, all those kinds of things, cost goes up a little bit. Sure, manage that the best you can. That, I think, is the best way, because you know the organic question when it comes to meats is a little bit more complex. I think there's probably more value on the grass fedto-edgrass finish, because the cow's system actually, you know, pulls off some of that glyphosate if it's not completely organic. So there's a purification or a processing there.
Dr. Amy Moore:So Unless the cow has MTHFR 6, 7, and W, that's right, that's double variant right.
Dr. Randy James:Now I think that's an interesting question If we go to Colorado State up here and say, hey, what's the impact on cows over the last 50 years? But I just don't think that you know, their big money source is still big government, big pharma, big whatever. So they're not asking those questions. So it's left to brainy moms to help other brainy moms who ask those brainy questions, not with an eye towards perfection, but with we always say improve. But we always say improve.
Dr. Randy James:You can become a little bit better on your own standards of function. Yes, we have science, we have doctors, we have whatever that's going to help us to think through those things. And yes, if I need surgery, I don't want to be awake, I want to trust the system to do those things. But after that surgery or in order to prevent that surgery, it is metabolism. There's just no way to get around. It is your diet, it is the epi, it is your sleep, it's your relationship with your spouse, it's your relationship with your work. It's all of those things is what is going into either better function or dysfunction. And you or we people, we get to be the main influencers in our own well-being.
Dr. Randy James:Can't change your skin tone. You don't get to become, you know, a different color of skin. You don't get to change your NTHFR, but you get to determine how you nurture those genes.
Dr. Amy Moore:Love it. So, dr James, we know you have a super busy practice that you need to get back to, but we would love it if you would come back, have a part two to this conversation, or even a part three Once you go. We're going to talk about you and then commentate on this.
Dr. Randy James:Really, interesting information. Thank you, and I'm happy to. I think this is important and we should be talking more about it. So thank you, guys, for the work that you're doing out there and for the people that listen to you and are impacted by that. There is hope for we Americans there is hope you're doing out there and for the people that listen to you and are impacted by that. There is hope. For we Americans, there is hope, all right, so I'm just going to exit myself here.
Dr. Amy Moore:Thank you guys for having me on.
Dr. Randy James:Thanks for being with us, dr James.
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Dr. Amy Moore:Yeah, I think I was doing the same thing. Of course, these are conversations that you know he and I have had previously too, because I am homozygous 677 on the MTHFR SNP. So these are things that I have been working on and concerned about, you know, since about 2000, I don't know 13, 14, when we had our genome run. We did the entire one for the whole family and it's funny, I was looking at some email traffic that I had with Dr James from 2017, after he had taken my genome and run it through like an external interpretation program and sent me the big 37-page report and I typed back oh my gosh, I'm going to die a slow, painful death. You know you're at risk for this and this and this and this.
Dr. Amy Moore:And you know he quickly wrote back and said number one, you're being dramatic. And number two, you have to interpret this more broadly than that. Right, like, yes, here are where your genetic variations land, but that isn't a prescription for death. Right, that isn't a prescription for death, right, that's? Hey, let's identify where you can mitigate certain risks and know that just because you have that genetic predisposition doesn't mean that switch is going to get flipped, right.
Dr. Amy Moore:So I think that's the important thing to say is like once we've identified okay, you know, you have a double variant in the NTHFR gene, that does not mean that you don't have any ability to detox right. It means that that whole epigenetic component that he was talking about means the more burden you put on your body, the harder it is then for that gene to function right. So if you don't put the burden on your body, then it isn't necessarily going to carry the same risk that if you overburden it with pesticides, lead-based paint, unfiltered water, air pollution, drugs and alcohol abuse, like all of the things and so what you know. I guess I could back up just a little bit, because we didn't even identify what MTHFR stood for.
Sandy Zamalis:No, I was going to say for those, for someone who's listening, who has never heard of that particular gene marker. You know, we probably need to just say what it is.
Dr. Amy Moore:Yeah, so MTHFR stands for methylene tetrahydrofolate enzyme, so it is the enzyme that's responsible for the production of, or the processing of, l-methylfolate. So you've heard of folic acid, right, which is a synthetic version of folate. So L-methylfolate is a methylated version, right, an already broken down version, I think is the easiest way to say. But that is responsible for this entire system of being able to help your DNA function properly, and so methylation is responsible for detox. It's responsible for production and metabolism of a few of our neurotransmitters, including serotonin and dopamine, which is probably why MTHFR is associated with some of those mental health diagnoses, right, because we know that serotonin and dopamine are important and implicated in ADHD and autism depression.
Sandy Zamalis:We'll have to ask Dr James, but the only thing I had ever really heard about MTHFR is that if you have that genetic variance then it's actually more difficult for your body to like methylate. I think is it the folate Like. So all those enriched, everything we enrich our wheat with right, the folic acid right.
Dr. Amy Moore:It actually stops the process. It blocks the pathway.
Dr. Amy Moore:Yeah, but that's why it's a kicker, because you know you walk down those middle aisles of the grocery store and everything is enriched Enriched bread, enriched cereals all of that, and so if you do have, so, first let me say that something like 60% of the population has at least one MTHL variant, and so that having one variant is not the issue. You get one from each parent, right? And so if you have a, he says we don't use the word mutation anymore, but let's just use that to make it easier to understand, right? So if you have one mutation out of two options, then there's not much to worry about, right? Like? You lose about 10% function is what they think. 10% function is what they think. But if you have a double variant or a double mutation for lack of a better word, you know then that can reduce its function, you know, down to 30% or 20%. So then that's when it becomes a risk, that's when it becomes a problem, and so it's so interesting.
Dr. Amy Moore:When the research on this first came out, you know around 2014, 2015, like I heard people say well, I have MTHFR. Well, yeah, we all do, but we all have the MTHFR gene, right? So you need to take a step back and not be panicked at the moment. Right, it's okay. Do you have the variant that puts you at higher risk for being able to detox pesticides and toxins and all of the things that we were talking about with him. So it is a conversation worth having with your physician, yeah.
Sandy Zamalis:It's interesting for you guys to have put it in that kind of space of thinking of it as giving a parent or yourself the ability to have agency. Because that's the problem, right, when you've been dealing with autoimmune issues for your whole life, like you don't know what it would be like to not have dysfunction, right, you don't know what that looks like. So it is just a part of who you are. So you know, if you think about the agency piece of it, like if I have this piece of knowledge, then I can make a different choice and then over time it might impact me for the better, right, versus it just being this overwhelming, like you can eat nothing but grass, no, don't eat grass. But, yeah, you know, because we tend to want to find the easy path and that's the problem with, I think, a lot of this health conversation is it's really overwhelming. The cooking and the buying and the. You know it's a little bit of a trial and error. You know of what works, you know what you can eat and what you can't eat.
Sandy Zamalis:There's the whole glyphosate piece and the organic piece, but there's a. Is it the phytotoxin? I mean there's a whole phytotoxin, I think. Argument on the on the vegetable side of things, like which vegetables are better to eat. You know, you might have somebody who really can't handle any of the cabbages or things that have like a like a high. I think that phytotoxin that's probably the wrong word but response where you get gassy and bloated and miserable when you eat it.
Sandy Zamalis:But that's the nuanced part that we're all uniquely different and so we almost need to journal it out. We just need to pick one thing and think, okay, I'm going to try you know, just doing this for a while and see if I feel better. And then try another thing, knowing that it's beneficial in the long run, like if you're choosing to eat organic, that's beneficial in the long run. Even if it doesn't help you feel better. You don't just give up on organic Right.
Dr. Amy Moore:Right and he said that right Like you're not necessarily going to know right Is this helping.
Sandy Zamalis:You just know you're walking a better path and then you try something else, because I know the supplement conversation that gets overwhelming too like well, and there were lots of supplement companies that jumped on that mthfr bandwagon, right.
Dr. Amy Moore:They were like, oh, you've got this double mutation, then you need to take these supplements, right?
Sandy Zamalis:and so then you end up getting supplemented, you know, to death and the cost is astronomical, and so Right, and you have to be careful, because if you have sensitivities, like some of them have gluten in them and you know all sorts of other wonky things, it just it becomes this you get stuck in paralysis, analysis, paralysis of all the possible options, and you have to actually live your life every day. And I think that's where moms get stuck, honestly, unless it's life or death, like you know. If it wasn't that like we were having to make like really hard decisions about my daughter's health, like we were having to make a decision to put her on a really expensive drug that was going to shut her liver and kidneys down, that's what made me be like OK, we're going to change everything. You know, because we just kind of stayed on that train of you know medication and you know doctors and just trying to calm it down that way. And it wasn't until we were kind of at this crossroads where we had to make a huge, you know, from a parent perspective, the guilt of that decision.
Sandy Zamalis:Like I just remember sitting in my kitchen, both my husband and I in tears, trying to figure out, like what are we going to do? I don't feel comfortable going this direction, and my husband was like well, I don't feel comfortable going this direction. I was like, well, we got to figure it, can we try it? You know we had to come to like a compromise of what to do and so for those kinds of situations it's a little bit easier. It's way harder when it's something like ADHD. You know, unless it's extreme, unless you're really having to you know, have you're in mental health crisis with your child, you know ADHD can be something that is just part of you and who you are and you know we're going to manage it with medication and we don't necessarily think about all these other things.
Sandy Zamalis:Same can go with other mental health diagnoses. Just depends on where they are on that spectrum, how much they're affecting your life, which is what Dr James was saying.
Dr. Amy Moore:Sure, but we also know that all of those diagnoses wax and wane in severity, right? Just like every time we get in a car, we don't know how high the risk is that day for getting in an accident. We just know the risk is there. And so I'm just a firm believer that once we've identified the risk, then we need to do everything that we can, to you know, reduce the risk, to mitigate the risk, to lower the temperature on the risk, and so making half of your plate green seems like a pretty no-brainer kind of choice, because they're full of B vitamins, by the way. So that's the issue.
Dr. Amy Moore:So when you have a double variant, you do need B vitamins and methylated folate in order to reduce some of the risks that having that variant can cause, for example, high homocysteine, right, so it gets in the middle of being able to break down homocysteine, that amino acid that can build up in the blood and damage the vessels, increase cardiovascular risk, increase blood clotting risk, and so, oh, okay, well, there's a risk. How can I mitigate it? Oh, b vitamins can help mitigate that risk. I ought to eat food with B vitamins, right? Like those seem like choices that are low risk for big reward.
Sandy Zamalis:I hear you in theory. I just know someone's out there going, but it's disgusting or I just can't do it.
Dr. Amy Moore:And then. So then you could look at supplements. Right, exactly Right, you could take the items.
Sandy Zamalis:I can't handle the texture of spinach cooked. Then you could look at supplements. Right, exactly, you could take the items I can't handle the texture of spinach cooked Well.
Dr. Amy Moore:can you handle other green vegetables?
Sandy Zamalis:I can. I'm speaking for others.
Dr. Amy Moore:Yeah, can you do spinach salad? I like spinach salad, yes.
Sandy Zamalis:I like, yeah, I like, I like most greens. Some of them don't like me, which is why I said you know, you know, it really depends. There are things I don't choose because they I don't feel good when I eat them. So I have to not eat them. Yeah, so you have to kind of, like I said, journal your way through it a little bit because, yes, in theory all of those things are good and you should try them and you should try them. But also, you know, you also have to pay attention to how it makes you feel when you eat it.
Sandy Zamalis:You know, at this point you know, my daughter and I are very much like a. You know, nope, that's out, we can't eat. That it's just because the reaction is almost immediate. We can feel it, but for some people it's not like that, it's slower. So then you can't always correlate it either, you know, if you don't feel any effects. You know my daughter can eat corn. When she was younger it was fine. I mean, we avoid it anyway now for other reasons, but when she was younger it was fine and she would get sick at night. But as it got worse and worse and worse, now she can't eat it at all, she gets immediately violently ill immediately. So you know, I think some of that stuff just changes over time. You just have to be watchful.
Dr. Amy Moore:Yeah, all right. Well, this has been a super interesting conversation, don't you think?
Sandy Zamalis:Oh, I guess I think that could have. We could have talked about for a long time. There's so many questions. Yeah, well, I think we. Just I guess I think that could have. We could have talked about that for a long time. There's so many questions.
Dr. Amy Moore:Yeah, well, I think we just need to have Dr James back, but we are out of time for this episode, so we're going to wrap it up. We're super excited that Dr. James joined us, and so if you want to know more about him, you can visit his website at truelifemedicine. com. That's Dr. Randy James. All right, moms. Thank you so much for listening today. If you liked our show, we would love it if you would follow us on Instagram and Facebook at the Brainy Moms. You can find our website at thebrainymomscom. If you'd rather watch us, you can go to our YouTube channel at the Brainy Moms. Well, that is all the smart stuff that we have for you today. We hope you feel a little smarter and we're going to catch you next time.
