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Australian Institute for Functional Medicine
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Metabolic Subtyping

Human beings are faced with a continuous burden of reactive chemical entities that are formed during biotransformation of foreign compounds, as well as from endogenous molecules. The same complex biotransformational enzyme  systems, which protect us from these harmful substances have the potential to play a role in a wide array of serious illnesses, including cancer, fibromyalgia, immune dysfunction and female hormonal problems.

The study of biotransformational enzymes has strongly linked the functional capacity and activity of specific sub-groups or enzyme classes  to many common diseases, including heart disease and cancer.  Understanding the role of these enzymes play in disease states provides us with a powerful edge in disease management.

In the early nineteen seventies scientists discovered the first enzyme of the detoxification family Cytochrome  P450(CYP) . It was found that a  high level of this enzyme was present in the liver and researchers soon discovered that it was responsible for converting lipophilic (fat loving) toxins into intermediates that were more water soluble.

It was later revealed that these biotransformed intermediates underwent further biotransformation in the liver by a second series of enzymes called conjugases, which we now know as phase II detoxification.  The conjugases (fusing together) attach molecules to the biotransformed intermediates - these molecules include glucuronic acid, sulphate, glycine, taurine and methyl groups.

The study of biotransformational enzymes has strongly linked the functional capacity and activity of specific sub-groups of enzyme classes to many common diseases, hormonal problems, heart disease and cancer.

Since the initial discovery of the first CYPs and the phase II conjugases a tremendous number of these enzymes have been identified.  The various C. Y. P enzymes are now recognized as being members of an enzyme “super family. “.

Cytochrome P450s Support the oxidative, peroxidative  and reductive biotransformation of such endogenous and xenobiotic substrates as environmental pollutants agrochemicals, steroid hormones,  prostaglandin's and fatty acids. 

Researchers have also discovered that an incredible amount of individual variability exists in the structure and function of these enzymes in humans.  The genetic expression of specific CYP enzymes May be due to modifiable factor such as homeostatic control mechanisms – disease states that alter homeostasis, and up or down–regulation by environmental stimuli.

The diet and nutritional status of an individual is an important environmental determinate of functional biotransformation.   It has long been known that macronutrient ratios, micronutrient status and supplementation with botanical  medicines rich in phytochemicals, may effectively support and even regulate aspects of biotransformation.  For example sylimarin,  a phytochemical present in St Mary’s Thistle Has been shown to decrease the activity of the CYP3A4 enzyme. This particular CYP enzyme is responsible for the biotransformation of oestrogen to its undesirable 16-hydroxy metabolite . Part of the problem with Breast cancer and most if not all female hormone iregularities.

So, what we are talking about here is rather involved, deep seated biochemistry. 

Oversimplified The ingestion and/or inhalation of chemicals,  heavy metals and other toxic substances might interfere by down-regulation or up-regulation of, pharmaceutical drugs, nutrients and supplements, foods and any other substance.  In particular the reproductive cycle hormones may be adversely affected.

The Institute pays great attention to biotransformation as an integral part of our therapeutic and preventive medicine strategies. Thus, once again benchmarking Functional Medicine with the application of "Total Quality Control." This is our commitment to our patients.

If you are  female unresponsive or dissatisfied with your treatment take the test

Metabolic Subtyping Questionnaire.

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