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My approach to healing is rooted in genetics and the nutrients our bodies need. Genetic testing is the start of that process.

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Kristian Miley, functional medicine practitioner

Kristian Miley, Doctor of Pharmacy

Board Certified Pharmacotherapy Specialist

I have been in healthcare since 1999 as a clinical pharmacist. Most of my work has been in the community, problem solving with others to develop a path to health and longevity.

My experience in the hospital and community settings bring my knowledge base full circle for people looking to unlock their own health needs. My goal is to bring about an individual plan to take you another step closer to your daily health and wellness.

The one-carbon cycle. Amber nodes are where common variants slow things down.

24+ genesanalysed in the methylation panel

1 in 3people carry at least one MTHFR C677T variant

Cheek swabat home, no needles, no clinic visit

90-minuteresults consultation with your practitioner

ATP & energy production: why chronic fatigue is so widespread today

Every thought, heartbeat and immune response runs on one molecule: ATP. Your mitochondria make roughly your body weight in it every day. When that production line falters, the first thing you feel is tired.

ATP is made, not stored. Your cells hold only a few seconds' supply at any moment, so energy has to be regenerated continuously from the food you eat and the oxygen you breathe. That process happens inside mitochondria and depends on a long list of nutrient cofactors: B vitamins, magnesium, iron, CoQ10, carnitine and more. Run short on any of them and output drops.

Modern life raises demand and cuts supply at the same time. Chronic stress keeps the body in a high-cost alert state. Short sleep robs mitochondria of their repair window. Ultra-processed food delivers calories without the cofactors needed to burn them. Environmental toxins, sedentary days and lingering infections all add oxidative stress that damages the very machinery making energy. The result is a population that is over-fuelled and under-powered.

Genetics decides how much margin you have. Variants in mitochondrial and methylation genes change how efficiently you build ATP, recycle antioxidants and clear the by-products. The methylation cycle itself is an energy consumer: making SAMe costs ATP, and roughly 40 percent of your methyl groups go toward producing creatine, the molecule that buffers ATP in muscle and brain. A sluggish methylation pathway and a sluggish energy pathway tend to show up together.

This is why "normal labs" and exhaustion coexist. Standard blood work rarely measures cofactor status inside cells or how your genes shape demand. Genetic testing shows where your energy pathway is likely to be under strain, so support can be targeted instead of guessed.

~10 millionATP molecules used per second, per cell

~40%of methyl groups spent making creatine

≈ body weightin ATP recycled every day

What drains ATP production

Chronic stress and elevated cortisol
Sleep under 7 hours, or fragmented sleep
Nutrient-poor, ultra-processed diet
Toxin load: alcohol, mold, heavy metals, pesticides
Low-grade or post-viral infection
Sedentary days with no mitochondrial stimulus
Slow methylation or COMT variants raising the cost of clearance

What rebuilds it

B-complex in active forms (B1, B2, B3, B5, B6, folate, B12)
Magnesium, the cofactor ATP itself binds to
CoQ10 (ubiquinol) and PQQ for electron transport
Acetyl-L-carnitine to move fat into mitochondria
Creatine to spare methyl groups and buffer ATP
Iron and copper checked and corrected, not assumed
Zone-2 movement, sunlight and protected sleep

How your cells make energy

Food and oxygen go in one end; ATP comes out the other. Watch the flow, then note where the cofactors sit. Each one is a place where genetics or a nutrient gap can slow the line.

Simplified. Glycolysis happens in the cytosol; everything else inside the mitochondrion. Cofactors in grey are where deficiencies and gene variants show up.

Important considerations

Stress & energy production

Cortisol and adrenaline push cells to burn glucose fast and shut down repair. Sustained stress depletes B vitamins and magnesium, the exact cofactors the Krebs cycle and ATP synthase depend on.

Mold exposure & your mitochondria

Mycotoxins interfere with the electron transport chain and increase free-radical leakage. People with slower detox genetics (GST, HLA variants) tend to feel it first, often as fatigue and brain fog that improves away from the building.

Sleep & mitochondrial repair

Damaged mitochondria are recycled and rebuilt mainly during deep sleep. Short or fragmented sleep leaves the energy line running on ageing equipment.

Methylation & creatine

Creatine buffers ATP in muscle and brain, and making it consumes a large share of your methyl groups. Slow MTHFR or low B12 can mean less creatine and less energy reserve.

Cofactor gaps on "normal" labs

Standard panels rarely check B1, B2, CoQ10 or intracellular magnesium. A cell can be starved of cofactors while serum values look fine.

Toxins & oxidative stress

Alcohol, heavy metals, pesticides and some medications generate free radicals inside mitochondria. Variants in SOD2 and glutathione genes decide how well you neutralise them.

Movement as a signal

Regular zone-2 activity tells cells to build new mitochondria. Without that signal, mitochondrial density falls with age regardless of diet.

Iron: too little or too much

The electron transport chain needs iron, but excess iron accelerates oxidative damage. Ferritin and transferrin saturation should be measured, not guessed.

From swab to plan in four steps

No guessing, no supplement roulette. Every recommendation traces back to a pathway in your own report.

What arrives at your door: collection tube, swab and prepaid return mailer.

Discovery call

Twenty minutes to hear your story, your symptoms and what you've already tried. We decide together whether testing makes sense.

At-home DNA kit

A saliva or cheek-swab kit arrives at your door. Register it, swab, mail it back. Results typically take 3–5 weeks.

Results session

A 90-minute walkthrough of your reports, your relevant variants and what they may mean for how you feel.

Your protocol

A written food, lifestyle and supplement plan, phased so you can start low and slow. Follow-up coaching keeps it on track.

See Tests & Pricing

Ten reports. One picture of you.

We run genetic reports through SelfDecode's platform and interpret them in the context of your symptoms and history. Each report below shows what it measures, the kinds of symptoms it can help explain, and the support options we commonly discuss. Open any report to read more.

Methylation pathway

The core report. Folate and B-vitamin metabolism, homocysteine recycling, methyl-group supply.

What it shows

How efficiently you convert folate and B12 into their active forms and how well you recycle homocysteine. This is the engine behind DNA repair, neurotransmitter production and detoxification.

Genes include MTHFR, MTR, MTRR, COMT, CBS, PEMT, SHMT1, BHMT.

Symptoms it may explain

Persistent fatigue, brain fog, low mood or anxiety, elevated homocysteine on blood work, poor response to standard folic acid, recurrent pregnancy loss history, migraines.

Support we may discuss

Methylfolate (5-MTHF) in place of folic acid, methyl- or hydroxo-B12, riboflavin (B2) as the MTHFR cofactor, B6, trimethylglycine (TMG), choline-rich foods.

Detox pathway

Phase I and Phase II liver detoxification and antioxidant defence.

What it shows

How quickly you activate toxins (Phase I) versus how well you neutralise and clear them (Phase II), plus your capacity to mop up the oxidative stress produced along the way.

Genes include CYP1A2, CYP2D6, GSTM1, GSTP1, NAT2, SOD2, NQO1.

Symptoms it may explain

Headaches from wine, perfume or cleaning products; feeling wired after one coffee; chemical sensitivity; sluggish recovery after alcohol or medications; frequent sinus or skin flare-ups.

Support we may discuss

N-acetylcysteine (NAC) or liposomal glutathione, sulforaphane from broccoli sprouts, milk thistle, cruciferous vegetables, reducing exposure load before adding supplements.

Gut health

Digestive enzymes, microbiome tendencies, food-related immune triggers.

What it shows

Genetic tendencies toward lactose and gluten sensitivity, how your gut lining and microbiome are likely to behave, and whether you carry the immune markers associated with coeliac-type reactions.

Genes include FUT2, MCM6 (lactase), HLA-DQ2/DQ8, IL-10, NOD2.

Symptoms it may explain

Bloating, irregular bowel habits, reflux, food reactions that shift week to week, low B12 despite a good diet, skin issues that track with what you eat.

Support we may discuss

Targeted probiotics and prebiotic fibres, digestive enzymes with meals, L-glutamine or zinc carnosine for the gut lining, a structured elimination trial where appropriate.

Inflammation

Your baseline inflammatory "volume knob" and how fast it turns down.

What it shows

Variants that tune the production and clearance of inflammatory messengers, and how strongly your body responds to everyday triggers like poor sleep, processed fats or infection.

Genes include IL-6, TNF, CRP, IL-1B, IL-10.

Symptoms it may explain

Joint stiffness, slow recovery after exercise, puffiness, mildly elevated CRP, eczema or asthma flares, aches that move around.

Support we may discuss

Omega-3 fish oil (EPA/DHA), curcumin with piperine, quercetin, a Mediterranean-style pattern of eating, vitamin D if levels are low.

Mood & stress resilience

Neurotransmitter production and breakdown, stress hormone sensitivity.

What it shows

How quickly you clear dopamine, adrenaline and serotonin, how your brain supports new connections, and how reactive your stress response tends to be.

Genes include COMT, MAOA, BDNF, SLC6A4, TPH2, FKBP5.

Symptoms it may explain

Anxiety that ramps up under pressure, irritability, low motivation, feeling flat, poor tolerance to caffeine or stimulants, sleep that suffers with stress.

Support we may discuss

Magnesium glycinate, L-theanine, B6 (P5P), adaptogens such as rhodiola or ashwagandha, careful pacing of methyl donors in "slow COMT" profiles.

Sleep

Circadian rhythm, melatonin production, caffeine sensitivity.

What it shows

Whether you lean early-bird or night-owl, how your body makes and clears melatonin, and how long caffeine stays active in your system.

Genes include CLOCK, PER2, ADORA2A, CYP1A2, MTNR1B.

Symptoms it may explain

Trouble falling or staying asleep, waking unrefreshed, afternoon crashes, sensitivity to late-day coffee, difficulty adjusting to schedule changes.

Support we may discuss

Magnesium, glycine before bed, timed light exposure, caffeine cut-off tailored to your metaboliser status, low-dose melatonin only when the pattern warrants it.

Energy & mitochondria

Cellular energy production and antioxidant recycling.

What it shows

How efficiently your mitochondria turn fuel into ATP, how well you make and recycle CoQ10 and carnitine, and how much oxidative stress your cells generate doing it.

Genes include PPARGC1A, NDUFS, COQ2, SLC22A5, SOD2, UCP2.

Symptoms it may explain

Fatigue that doesn't match your sleep, exercise intolerance, muscle soreness that lingers, post-viral tiredness, "hitting a wall" mid-afternoon.

Support we may discuss

Coenzyme Q10 (ubiquinol), acetyl-L-carnitine, B-complex, magnesium, creatine, graded movement rather than push-and-crash.

Hormone balance

Oestrogen metabolism and clearance, testosterone and thyroid tendencies.

What it shows

Which routes your body uses to break down oestrogen, how quickly those metabolites are cleared (this overlaps with methylation), and genetic tendencies in androgen and thyroid signalling.

Genes include CYP1B1, CYP19A1, COMT, SULT1A1, SHBG, DIO2.

Symptoms it may explain

Heavy or painful cycles, PMS, perimenopausal symptoms out of proportion to age, oestrogen-dominant patterns, low libido, stubborn weight around the middle.

Support we may discuss

Cruciferous vegetables and DIM or indole-3-carbinol, calcium-D-glucarate, magnesium, adequate fibre for clearance, methylation support where COMT is slow.

Vitamin & nutrient needs

Which nutrients you absorb, convert and use less efficiently.

What it shows

Whether you convert beta-carotene to vitamin A well, how your vitamin D receptor behaves, how efficiently you make omega-3s from plant sources, and your choline and B12 handling.

Genes include VDR, BCMO1, FADS1/FADS2, PEMT, FUT2, TCN2.

Symptoms it may explain

Low vitamin D despite sun and supplements, dry eyes and skin on a plant-based diet, fatty liver tendencies, deficiencies that keep coming back on labs.

Support we may discuss

Vitamin D3 with K2, preformed vitamin A, EPA/DHA rather than flax alone, choline or phosphatidylcholine, dosing guided by follow-up blood work.

Heart & metabolic health

Cholesterol handling, blood sugar regulation and cardiovascular tendencies.

What it shows

Genetic tendencies in how you process fats and carbohydrates, your lipoprotein profile, and whether elevated homocysteine is likely to be part of your cardiovascular picture.

Genes include APOE, LPA, TCF7L2, PPARG, MTHFR, ACE.

Symptoms it may explain

Cholesterol that stays high on a "clean" diet, blood sugar swings and cravings, energy dips after carbohydrate-heavy meals, family history of early heart disease.

Support we may discuss

Omega-3s, soluble fibre, B-vitamin support for homocysteine, magnesium, chromium or berberine only in coordination with your prescribing doctor, movement after meals.

Reports describe genetic tendencies, not diagnoses. Supplement suggestions are starting points for a conversation, not a prescription; doses, forms and timing are set individually and reviewed against your blood work and any medications you take. Always tell your prescribing doctor what you are adding.

The MTHFR variants, explained plainly

MTHFR is the enzyme that turns folate into its active form, 5-MTHF. Two common variants slow it down. Neither is a disease, but both change what your body needs from food and supplements. Roughly 60 percent of people carry at least one.

C677T, one copy heterozygous · ~35–40% of people

Enzyme activity is reduced by roughly a third. Most people notice nothing unless folate, B12 or B2 intake is low, at which point homocysteine can creep up and energy and mood can suffer.

Approximate enzyme activity: ~65% of typical

C677T, two copies homozygous · ~10% of people

Activity can drop to around 30 percent of normal. This is the variant most consistently linked to elevated homocysteine, and the one where the choice of folate form matters most.

Approximate enzyme activity: ~30% of typical

A1298C one or two copies · ~30% of people

A milder variant that affects a different part of the enzyme. On its own it rarely raises homocysteine, but it is often discussed in relation to BH4, a cofactor for making serotonin and dopamine.

Approximate enzyme activity: ~80% of typical

Compound heterozygous one C677T + one A1298C · ~15–20%

One copy of each. The combined effect can approach that of two C677T copies, so we treat it with the same care and the same emphasis on active nutrient forms.

Approximate enzyme activity: ~40–50% of typical

How we address an MTHFR variant

Confirm with blood work. A gene is a tendency; homocysteine, serum folate, B12 and RBC folate tell us whether the tendency is actually showing up.
Swap folic acid for folate. Synthetic folic acid needs MTHFR to become useful. Leafy greens, lentils, liver and methylfolate (5-MTHF) skip that step.
Feed the cofactors. Riboflavin (B2) stabilises the enzyme. B6 and B12 keep the rest of the cycle turning.
Start low, go slow. Some people feel jittery, irritable or headachey when methyl donors are introduced too fast. Small doses, one change at a time.
Reduce what drains the pathway. Alcohol, smoking, some medications and chronic stress all consume methyl groups.
Retest in 8–12 weeks. Homocysteine should move. If it doesn't, we look elsewhere in the cycle.

If you are pregnant, planning pregnancy, or take medications such as methotrexate, anticonvulsants or antidepressants, folate and B12 changes should be made with your physician involved.

Pharmacogenomics

Your genes shape how your body handles medications — how fast you clear them, how much reaches its target, and how likely you are to benefit or react. Kristian Miley, a board certified pharmacotherapy specialist and clinical pharmacist since 1999, reads those genetic tendencies and helps you and your doctor make sense of them.

PGx

Pharmacogenomics · 4 min read

What pharmacogenomics actually is

Most medications are prescribed by averages, but there is no typical person. The liver enzymes that process most drugs are encoded by genes, and common variants change how fast or slowly you clear a medication — the difference between a drug that "doesn't work" and one that causes a serious reaction.

CYP2D6 and CYP2C19 decide blood levels of many antidepressants
SLCO1B1 and VKORC1 shape statin and warfarin response
Codeine and tramadol activation depend on CYP2D6

Read the full note

How Kristian works · 5 min read

How Kristian helps you use your genetics

A genetic report on its own is a list of variants. Kristian turns that list into context — connecting what your genes say about drug handling to the medications you actually take, the symptoms you feel, and the labs your doctor has already ordered.

Your report reviewed against your current medication list
Plain-language explanation of each relevant variant
A phased summary you can share with your doctor

Read the full note

PharmD

Why experience matters · 4 min read

Why a pharmacotherapy specialist reads genetics differently

Anyone can hand you a report. What is harder is reading it against polypharmacy, drug interactions, and kidney and liver function — judgment that comes from decades of clinical problem solving, not a single test.

Genetics set the tendencies; your medication list sets the stakes
Your doctor holds the decision; Kristian translates between them
An educational resource, used alongside your prescriber

Read the full note

Care from a practitioner, not a prescription pad

Kristian Miley is a certified functional medicine practitioner and health coach who specialises in nutrigenomics and methylation. That means long conversations, careful reading of your reports, and a plan built around food and lifestyle first.

This is not a medical practice. We don't diagnose, treat or cure any condition, and we don't replace your doctor. What we do is take the time the medical system rarely has: to connect your genetics, your labs and your lived experience into something you can act on. Many clients work with us alongside their GP, OB-GYN or specialist, and we're happy to share your plan with them.

Certified Functional Medicine Practitioner Nutrigenomics trained Board-certified health coach Virtual consultations worldwide

Questions people ask before they book

Is this the same as a medical genetic test?

No. Medical genetic tests look for disease-causing mutations and are ordered by physicians. The reports we use look at common variants (SNPs) that influence nutrient needs and metabolic tendencies. They are wellness tools, not diagnostic tests.

Can I use raw data I already have from 23andMe or Ancestry?

Often, yes. Existing raw data can usually be uploaded and analysed, which saves the cost of a new kit. Some older files miss key methylation SNPs, so we check coverage first.

Will you tell me which supplements to take?

We'll suggest nutrients, forms and a phased approach based on your reports and blood work, and explain the reasoning behind each. Final decisions are yours, ideally made with your prescribing doctor aware of any additions.

Do I need a doctor's referral?

No referral is needed. If we spot something in your results or history that warrants medical attention, we'll say so clearly and point you to the right kind of clinician.

How is my genetic data protected?

Testing is processed through third-party laboratories and platforms with their own privacy controls. We don't sell or share your data, and we can walk you through how to delete it when you're done.

Start with a conversation

A free 20-minute discovery call. We'll hear what's going on, tell you honestly whether genetic testing is likely to help, and outline what working together would look like.