“Bad things do happen; how I respond to them defines my character and the quality of my life. I can choose to sit in perpetual sadness, immobilized by the gravity of my pain, or I can choose to rise from the pain and treasure the most precious gift I have – life itself.”
– Walter Anderson
Genetic Testing:
Reward Deficiency Syndrome (RDS)
There are genetic aspects to Reward Deficiency Syndrome (RDS) which is why chemical and behavioral addictions, ADD/ADHD, and other RDS conditions tend to run in families. Genetic variations account for 40-70% of an individual’s vulnerability to RDS, while environmental factors like stress, diet, and toxicity also contribute to the chances of developing RDS.
Genetic predisposition to RDS can be assessed with DNA testing by obtaining a simple swab of saliva. While genetic testing is not yet a definitive assessment for who may develop RDS, it identifies an individual’s vulnerability to RDS. Understanding an individual’s specific vulnerabilities through genetic testing provides the abilitiy to both prevent and enhance recovery by actively modifying an individual’s environment, including the use of dietary supplements tailored to an individual’s vulnerabilities.
See:
Genetic Testing: Individual DNA Alleles
See also:
Complementary & Alternative Addiction Recovery
Definitions and Terms Related to Pain
Key to Links:
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Genetic Testing: Reward Deficiency Syndrome (RDS)
Drug addictions, behavioral addictions such as gambling and other conditions including PTSD, ADHD, Tics, Tourette Syndrome, autism, Asperger Syndrome, OCD, “compulsive” sexual practices, binge eating while appearing to be unrelated, they are not. Thes and other disorders are all manifestations of a condition called Reward Deficiency Syndrome (RDS). The relationships of these disorders becomes apparent with the understanding of the common genetic factors underlying them.
See: Reward Deficiency Syndrome (RDS)
Reward Deficiency Syndrome
Why do some people develop RDS conditions as described above, while others do not? Research shows 1/3 of the U.S. population carries genetic mutations that result in a predisposition to RDS. Having a predisposition to RDS does NOT mean a person will develop an addiction or other manifestation of RDS. But by learning an individual’s specific genetic vulnerabilies, it is possible understand their addictive or RDS predispositions so they can manage themselves better and minimize exposure to potentially “at risk” environments.
For the last few decades an enormous amount of research has been engaged to uncover the genes that contribute to addiction and RDS risk. This research has led to the identification of some core genetic variants that identify a number of conditions that predispose to the development of addiction and RDS. These variants result in difficulty in maintaining adequate amounts of certain neurotransmitters (chemical messengers) in areas of the brain involved in the experience of reward. It is the experience of reward that is one of the major drives in human behavior and a deficiency in the maintenance of these neurotransmitters is the basis of RDS and the vulnerability to addiction and other manifestations of RDS.
Genetic Addiction Risk Score (GARS®)</stron g>
Based largely on the research of Kenneth Blum PhD, including dozens of his publications over the last twenty years or more and supported by others, a panel of genetic tests has been compiled to test for addiction risk (actually RDS risk), the Genetic Addiction Risk Score (GARS®). Up until recently this panel of tests has been only available as a research tool but at the end of 2018 it became commercially available. The GARS® holds promise as the first useful tool in understanding an individual’s specific vulnerability to addiction and RDS that allows for personalized nutrition-based intervention for treatment.
The GARS Test is available through certifed health care providers (including Dr. Ehlenberger at Accurate Clinic). Performing the test requires just a simple cheek swap to collect the DNA. The $299 test is not covered by insurance, but results are available five to seven days after Geneus Health receives the sample. For a list of the individual genetic tests in the GARS panel and their implications, see:Genetic Testing: Individual DNA Alleles.
Why Perform Genetic Testing?
The GARS test can be performed only by clinicians certifed in its application. Dr. Ehlenberger at Accurate Clinic is certified and encourages those at risk for RDS to consider testing. There are 4 reasons to consider GARS® testing:
- Understanding Why For those individuals who have developed drug or behavioral addiction, it is important to understand the factors that contributed to this development. The understanding of the genetic drives underlying their addictive behaviors helps people overcome the profound sense of shame and guilt that often accompany addiction. At the same time, many patients in treatment programs deny that they have a biological problem underlying their condition and believe their addictions are simply the consequence of their failure of will power. Providing genetic evidence that predict risk for both substance and non-substance severity helps resolve both guilt and denial.
- Understanding Nutrition/Nutriceutical Treatment Options Restoring “dopamine homeostasis (balance)” in the brain reward centers is the best, most fundamental way to treat addictive behaviors and reward deficiency syndromes. GARS® testing provides a definitive assessment of the brain’s neurotransmitter functions (including receptor numbers and neurotransmitter production). This can direct personalized nutrition-based nutriceutical supplementation to restore neurotransmitter regulation in different manifestations of RDS, including drug and behavioral addictions, ADD/ADHD, PTSD, impulsive and compulsive disorders. In addition, restoring dopamine homeostasis may play an important supportive role in managing chronic pain.
- Predicting Medication Assisted Treatment (MAT) Dosing Medication Assisted Treatment (MAT), the prescribing of buprenorphine (Suboxone or other brand) or methadone, is one of the fundamental components of treating opioid addiction. Certain genetic variations tested by GARS® help predict dosing requirements for these medications, especially when higher doses may be needed to prevent relapse.
- Understanding Family Genetics Identifying family history in the context of family tree genetics, called a “genogram,” offers the potential for prediction of family members and children’s risk for developing specific addictions or RDS syndromes.
Interpreting and Responding to GARS Results
The genetic test panel identifies genes that influence the body’s ability to manufacture and breakdown, or metabolize, a variety of neurotransmitters involved in establishing the balance of dopamine in the brain reward center. Also included in the test panel are tests evaluating the number and function of receptors in the brain associated with reward. As a result of assessing the findings of the GARS panel, it is possible to identify specific areas of vulnerability in the reward system and consequently identify the potential benefit of specific nutrition-based nutriceutical supplements to offset the vulnerabilities identified.
Neuro-nutrient Formulations
Dozens of published clinical studies have validated these neuro-nutrient formulations (research formulation KB220 including variants of KB220 such as KB220Z and KB220PAM). These formulations are designed to re-balance brain chemistry and optimize dopamine sensitivity and function to help with:
- Reducing substance and non-substance behaviors and cravings
- Optimizing brain health
- Increasing focus
- Enhancing energy levels
- Relieving stress
- Improving overall well-being
SynaptGenX
SynaptaGenX™ is a patented KB220z neuroadaptagen that provides greatly accelerated absorption by the body for optimal brain health, enhanced energy, reduced stress as well as helping nutritional maintenance of overall mood, health and a sense of well-being. This formulation is more of a broad spectrum supplement directed at the assumption of inadequate dopamine regulation in the reward centers and is not based directly on genetic testing.
Please note that Synaptamine, an earlier liquid manifestation of SynaptaGenX, now has been replaced by SynaptaGenX, which also uses the patented KB220z neuroadaptagen formula but it is a tablet instead of liquid.
For more information: synaptagenx.com
For purchase: nupathways.com/synaptagenx-3
RestoreGen®</s pan>
RestoreGen® is a patented line of neuro-nutrient formulations that work as pro-dopamine regulators, designed to provide maximum benefits based on GARS results. The different formulations are based on the individual’s genetic risk variants identified:
Endogen
This genetically based patented formula has been developed to provide real precision supplementation to help overcome ENDORPHIN deficit in the hypothalamus due to gene(s) impairments that influence the endorphinergic pathways to stimulate opioid receptors which subsequently regulate GABA activity at the substania nigra securing required glutaminergic drive thereby inducing normal dopamine function at pleasure sites in the brain.
Equigen
This genetically based patented formula has been developed to provide real precision supplementation to help overcome DOPAMINE deficit due to gene(s) influencing dopamine receptor activation and transport systems to balance dopamine function overcoming hypodopaminergia (low dopamine function) at the brain reward center and even pain sensitivity causing hypoanalgesia (reduced pain sensitivity).
Gabagen
This genetically based patented formula has been developed to provide precision supplementation to help overcome heightened GABA activity which unfortunately reduces the Ventral Tegmental Area (VTA) glutaminergic drive thereby preventing a GABA induced reduced dopamine release at the reward site of the brain enabling normal dopamine tonic tone.
Metagen
This genetically based patented formula has been developed to provide precision supplementation to help overcome SEROTONIN function deficits due overactive serotonin transporter and mitochondrial Monoamine oxidase (MAO-A ) and DOPAMINE deficits due to carrying certain overactive risk alleles including dopamine transporter and catecholamine-transferase (COMT) leading to reduced dopamine quanta neuronal release at the brain reward site leading to reward deficiency and overall perception of a lack of well-being.
Polygen
This genetically based patented formula has been developed to provide precision supplementation to help overcome SEROTONIN, ENDORPHIN, GABA and DOPAMINE deficits due to multiple systems and integrative polymorphic genes affecting the brain reward cascade (BRC) causing impairments across the BRC which lead to low dopamine function and subsequent reward deficiency and overall perception of a lack of well-being.
Serogen
This genetically based patented formula has been developed to provide precision supplementation to help overcome SEROTONIN deficit due to risk alleles of gene(s) essentially related to catabolism of circulating and mitochondrial serotonin as measured with GARS, including overactive serotonin transporter and mitochondrial monoamine oxidase (MAO-A) enabling required serotonin function in the hypothalamus to activate natural brain opioid peptides like endorphins leading to normalized dopamine release at the nucleus accumbens (reward site) with concomitant attenuation of drug seeking.
Resources:
RDS – Overview
- The Addictive Brain – All Roads Lead to Dopamine – 2012
- Hatching the behavioral addiction egg – Reward Deficiency Solution System – 2014
- Sex, Drugs, and Rock ‘N’ Roll – Hypothesizing Common Mesolimbic Activation as a Function of Reward Gene Polymorphisms – 2012
- “Dopamine homeostasis” requires balanced polypharmacy – Issue with destructive, powerful dopamine agents to combat America’s drug epidemic
- Neurodynamics of relapse prevention-neuronutrient approach to outpatient DUI offenders
- Genetic Addiction Risk Testing Coupled with Pro Dopamine Homeostasis
- Pro-dopamine regulator, KB220Z, attenuates hoarding and shopping behavior in a female, diagnosed with SUD and ADHD
- Neuro-Nutrient Effects on Weight Loss in Carbohydrate Bingers – an open clinical trial
- Enkephalinase Inhibition – Regulation of Ethanol Intake in Genetically Predisposed Mice
- The D2 dopamine receptor gene as a determinant of reward deficiency syndrome – 1996
- Dopamine D2 receptor gene variants: association and linkage studies in impulsive-addictive-compulsive behaviour. – PubMed – NCBI
- Activation instead of blocking mesolimbic dopaminergic reward circuitry is a preferred modality in the long term treatment of reward deficiency syndrome (RDS) – a commentary – 2008
- Reward deficiency syndrome: a biogenetic model for the diagnosis and treatment of impulsive, addictive, and compulsive behaviors. – PubMed – NCBI
- Association of polymorphisms of dopamine D2 receptor (DRD2), and dopamine transporter (DAT1) genes with schizoid:avoidant behaviors (SAB). – PubMed – NCBI
- Reward deficiency syndrome: genetic aspects of behavioral disorders. – PubMed – NCBI
- The D2 dopamine receptor gene as a predictor of compulsive disease: Bayes’ theorem. – PubMed – NCBI
- Delayed P300 latency correlates with abnormal Test of Variables of Attention (TOVA) in adults and predicts early cognitive decline in a clinical se… – PubMed – NCBI
RDS – ADD
- Attention-deficit-hyperactivity disorder and reward deficiency syndrome – 2008
- Reward Deficiency Syndrome – Attentional Arousal Subtypes, Limitations of Current Diagnostic Nosology, and Future Research – 2015
- Neurogenetic interactions and aberrant behavioral co-morbidity of attention deficit hyperactivity disorder (ADHD) -dispelling myths – 2005
- Epigenetics in Developmental Disorder – ADHD and Endophenotypes
- Low Dopamine Function in Attention Deficit:Hyperactivity Disorder – Should Genotyping Signify Early Diagnosis in Children? – 2014
- Enhancement of attention processing by Kantroll in healthy humans: a pilot study. – PubMed – NCBI
- Pro-dopamine regulator, KB220Z, attenuates hoarding and shopping behavior in a female, diagnosed with SUD and ADHD
RDS – Exercise
RDS – Gaming
RDS – Genetics
- Multilocus Genetic Composite Reflecting Dopamine Signaling Capacity Predicts Reward Circuitry Responsivity 2012
- Genetic Addiction Risk Score (GARS) – Testing For Polygenetic Predisposition and Risk to Reward Deficiency Syndrome (RDS) – 2011
- Neur
ogenetic Impairments of Brain Reward Circuitry Links to Reward Deficiency Syndrom
e (RDS) – Potential Nutrigenomic Induced Dopaminergic Activation
RDS – Obesity
- Reward Deficiency Syndrome Studies of KB220 Variants
- Mood, food, and obesity
- Dopamine and glucose, obesity, and reward deficiency syndrome – 2014
- Dopamine for “wanting” and opioids for “liking”: a comparison of obese adults with and without binge eating. – PubMed – NCBI
- “Liking” and “Wanting” Linked to Reward Deficiency Syndrome (RDS) – Hypothesizing Differential Responsivity in Brain Reward Circuitry – 2012
- Neuro-Genetics of Reward Deficiency Syndrome (RDS) as the Root Cause of “Addiction Transfer”- 2011
RDS – Chronic Pain
- Hypothesizing that brain reward circuitry genes are genetic antecedents of pain sensitivity and critical diagnostic and pharmacogenomic – 2009
- A Multi-Locus Approach to Treating Fibromyalgia by Boosting Dopaminergic Activity in the Meso-Limbic System of the Brain – 2014
- Love as a Modulator of Pain – 2017
- Comorbidity of alcohol use disorder and chronic pain – Genetic influences on brain reward and stress systems – 2017
- Reward Circuitry Plasticity in Pain Perception and Modulation – 2017
- Modulation of pain, nociception, and analgesia by the brain reward center – 2016
- Pharmacology of enkephalinase inhibitors: animal and human studies. – PubMed – NCBI 198
- Analgesic properties of enkephalinase inhibitors: animal and human studies. – PubMed – NCBI 1985
- DL-phenylalanine markedly potentiates opiate analgesia – an example of nutrient:pharmaceutical up-regulation of the endogenous analgesia system. – PubMed – NCBI – 2000
- Iatrogenic opioid dependence is endemic and legal – Genetic addiction risk score (GARS) with electrotherapy a paradigm shift in pain treatment programs – 2013
- Mesolimbic dopamine signaling in acute and chronic pain – implications for motivation, analgesia, and addiction – 2016
- Microglia Disrupt Mesolimbic Reward Circuitry in Chronic Pain Positive emotions and brain reward circuits in chronic pain – 2016
- The indirect pathway of the nucleus accumbens shell amplifies neuropathic pain – 2016
- Dopamine and Pain Sensitivity – Neither Sulpiride nor Acute Phenylalanine and Tyrosine Depletion Have Effects on Thermal Pain Sensations in Healthy Volunteers – 2013
- Dopamine Precursor Depletion Influences Pain Affect Rather than Pain Sensation – 2014
- Insurance Companies Fighting the Peer Review Empire without any Validity – 2018
RDS – PTSD
- Neuro-psychopharmacogenetics and Neurological Antecedents of Posttraumatic Stress Disorder – Unlocking the Mysteries of Resilience and Vulnerability – 2010
- Diagnosis and Healing In Veterans Suspected of Suffering from Post-Traumatic Stress Disorder (PTSD) Using Reward Gene Testing and RewardCircuitry Natural Dopaminergic Activation-2012</l i>
- Putative dopamine agonist (KB220Z) attenuates lucid nightmares in PTSD patients – Role of enhanced brain reward functional connectivity and homeostasis redeeming joy – 2015
RDS – Sleep
RDS – Treatment
RDS Treatment – Overview
- Clinically Combating Reward Deficiency Syndrome (RDS) with Dopamine Agonist Therapy as a Paradigm Shift – Dopamine for Dinner? 2015
- Neurogenetics and Nutrigenomics of Neuro-Nutrient Therapy for Reward Deficiency Syndrome (RDS)
RDS Treatment – Meditation
RDS Treatment – Music Therapy
RDS Treatment – SynaptaGenX
SynaptaGenX – Overviews
SynaptaGenX – Buptrenorphine
SynaptaGenX – Fibromyalgia
SynaptaGenX – Lucid Nightmares
- Putative dopamine agonist (KB220Z) attenuates lucid nightmares in PTSD patients – Role of enhanced brain reward functional connectivity and homeostasis redeeming joy – 2015
- Using the Neuroadaptagen KB200zTM to Ameliorate Terrifying, Lucid Nightmares in RDS Patients – the Role of Enhanced, Brain- Reward, Functional Connectivity and Dopaminergic Homeostasis – 2015
SynaptaGenX – PTSD
- Putative dopamine agonist (KB220Z) attenuates lucid nightmares in PTSD patients – Role of enhanced brain reward functional connectivity and homeostasis redeeming joy – 2015
- Diagnosis and Healing In Veterans Suspected of Suffering from Post-Traumatic Stress Disorder (PTSD) Using Reward Gene Testing and RewardCircuitry Natural Dopaminergic Activation-2012
SynaptaGenX – Sleep
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Emphasis on Education
Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.
For medical-legal reasons, access to these links is limited to patients enrolled in an Accurate Clinic medical program.
Should you wish more information regarding any of the subjects listed – or not listed – here, please contact Dr. Ehlenberger. He has literally thousands of published articles to share on hundreds of topics associated with pain management, weight loss, nutrition, addiction recovery and emergency medicine. It would take years for you to read them, as it did him.
For more information, please contact Accurate Clinic.
Supplements recommended by Dr. Ehlenberger may be purchased commercially online or at Accurate Clinic.
Please read about our statement regarding the sale of products recommended by Dr. Ehlenberger.
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