Biochemical Individuality and Its Importance In Patient Care

​Functional medicine focuses on global health by emphasizing the personalized and systems-oriented approach found in the functional medicine matrix. At the heart of this is the consideration of everyone as a “biochemically individual” patient. Just what does this mean?

Definition of “Biochemical Individuality”

This term represents the concept that the human body is a composite of each individual's physiological structure, nutritional, and chemical makeup as influenced by their environment, lifestyle, and genes. Some geneticists say we control 80% – 97% of our genetic expressions. Genes are turned on and off by nutrition and the environment. The term was coined in 1956 by Dr. Roger Williams, so it is not a new concept, just a newly used concept.

It is a familiar concept in integrative medicine, but not so much in allopathic approaches such as obtained with traditional medical doctors who have had no osteopathic or integrative experience.

Functions of Biochemical Individuality in Functional Medicine

This term explains how the body individually reacts to stimuli such as:

• Detoxification rates of drugs and chemicals
• Whether the harmful chemical homocysteine will cause heart damage or not
• How cancer genes respond
• Why some people are drug addicted or get certain diseases like diabetes
• Why low-fat diets cause some people to gain weight
• One person needs a higher level of a nutrient than another person to remain healthy

Determining the Biochemical Individuality often Require Specific Tests

The most accurate test to determine the nutritional status of the blood is not always a blood test. A “challenge” test or other more specific tests are often needed to determine individuality.

 For example, a simple blood test of B12 levels may show values in a normal range, but testing for antibodies to vitamin B12 may uncover a problem that otherwise would not be seen. Antibodies against B12 mean you may have adequate B12 levels in the blood, but you also have substances causing the B12 not to work.

In addition, folate and B12 should be measured at the same time because deficiencies of both can cause similar symptoms. The Schillings test tells the practitioner if you are absorbing that average level of B12 properly. The methylmalonic test detects early B12 deficiency that a regular blood test would not pick up. These are tests that an MD is unfamiliar with, but that shed light on the intricacies of precise deficiencies and how to fix them.

Gene-Nutrient Interactions

Each of us may have a unique “barcode” that separates us as individuals buried in our genes. The mind, emotions, behavior, and physiological functioning are all determined to a great extent by the interaction of this “barcode” with nutrition. For example, metabolic syndrome progression largely depends on gene/nutrition/environment interactions. The importance of nutrition cannot be overstated. Studies have shown that personalized dietary instruction improves insulin sensitivity in those with metabolic syndrome, a disease for which no one treatment is entirely adequate.

This raises questions about the adequacy of the Recommended Dietary Intake (RDI) levels established by the government and based on “normal” people. The RDI levels did not consider biochemical individuality.

Genetotrophic Disease

These diseases result from genetically determined metabolic needs not being met through diet and supplements. Medications, the environment, or other nutritional factors may have altered the genes. Nevertheless, the disease will develop if the nutrient in question is not provided.

Remember, your doctor does not usually test the vitamin status of your blood, yet these tests are available and are often ordered by dietitians or integrative medicine practitioners. Insurance may cover these tests if properly coded and ordered by a licensed professional such as a Physician's Assistant or Doctor of Osteopathic Medicine. Companies such as Labcorp, or Ulta Labs perform micronutrient tests.

​*Note: RDs may be able to order reimbursable labs once our licensure is in place next year in 2025. We can already order clinical diets in hospitals and long-term care.

Application
Consideration of each person's biochemical individuality is integral to a comprehensive functional medicine assessment. Implementing patient-specific treatment plans based on biochemical individuality is essential to the success of patient outcomes.