Dr Dane Buxbaum ND Logo - Anxiety and OCD Specialist
Dr Dane Buxbaum ND Logo - Anxiety and OCD Specialist
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Genetic Guided Treatment for Anxiety and OCD

 

Individualization is absolutely key to the future of Medicine. While people are very similar in many ways, we differ drastically on some levels. Genetic or DNA testing allows for your care to be individualized more directly.

DNA is the blueprint to everything in your body, it is literally read and translated to make every cell and biochemical reaction. When your DNA has an error or “mis-spelling” it is called a SNP (Single Nucleotide Polymorphism). One of the most commonly known SNPs is MTHFR C677T, which plays a critical role in a reaction called Methylation. Testing allows us to look for these SNPs and understand areas that your DNA may not be making the best or correct product.

Genetics and Anxiety or OCD:

Genetic markers, such as those that impact how our adrenaline (catecholamines), serotonin, methylation, histamine, electrolytes, and detoxification, can have a tremendous impact on anxiety and OCD. When dealing with anxiety, the last thing you want is to just be guessing and unknowingly choosing treatments that only make things worse. Genetics are not a 'crystal ball', but they help guide treatment directions that make the most sense for you.

An example of a genetic marker that I have found critical in anxiety or OCD treatment is COMT (catechol-O-methyltransferase). It is an enzyme that breaks down catecholamines (dopamine, norepinephrine, and epinephrine aka adrenaline). Adrenaline is at the core of our fight-or-flight panic systems. The trick is that COMT has three presentations genetically, so it is not just as simple as seeing 'if you have it or not' but rather a matter of understanding which presentation you have along with the related methylation genetic markers. The COMT pathway is a common reason that some people find treatments that were supposed to calm anxiety actually made it worse. Tailoring treatment with COMT in mind can be a game-changer.

Genetic Testing:

The range of genetic testing available has exploded in recent years. I help my patients pick the testing that yields the most value and impact. Here are common options:

      • Curated Panels: Several companies offer panels with a selection of genetic markers suited for the goals of their product. Some of the tests have just a few markers, while others may have a few hundred. The value of these tests, both financially and in data, varies. It is important to select a test that matches your treatment goals.
      • 23andMe or Ancestry Testing: Consumer products, often focused on ancestry results, such as 23andMe or Ancestry can often be used. The validation of the testing varies, but for non-critical insight they can be a useful tool if you already have the results. Read more about using these tests.
      • Disease Specific Panels: Tests that are measuring specific, sometimes only one, disease markers. These are often done for rare conditions.
      • Whole Genome Sequencing: The entire DNA genome is sequenced. This testing has promise, but is currently limited in the resources available to actually apply the data. I use it with patients that want to take a deeper dive and need to evaluate for rare diseases.

Tailoring Treatment:

Understanding your genetic predisposition allows for your care to be highly individualized; selecting medications, supplements, dietary approaches, or lifestyle changes specifically for you. It helps take the guess work out of treatment and allows for better understanding of your condition.

Areas that I use this testing to evaluate:

 

Dr. Ben Lynch Training Completed SeekingHealth.org and listed as a provider on MTHFRSupport.com