Two people walk into a bar.

They’re of similar size and weight, have similar vital signs, similar health conditions.

They each have a glass of wine. Soon, one gets tipsy. The other shows no change in behavior.

Why the difference?

We might guess that it’s genetic. And now, thanks to some extraordinary new technology in the field called pharmacogenetics, we can prove it.

Introducing the Drug Metabolizing Enzyme Panel.

It’s not just about wine. It’s about your meds.

Every person on the planet has a unique genetic makeup. This determines, along with eye color and so on, how your body’s enzymes interact with medications. Some people absorb (metabolize) meds slowly, others quickly. It’s essential to your health to know where you sit on this spectrum.

If you’re a slow metabolizer, for example, your meds remain in your body longer than if you’re a fast metabolizer. In this case, the risk of an unhealthy drug buildup—you take your next dose before the previous one is fully metabolized—can tell your doc to reduce your dosage. A fast metabolizer might need a higher dose to ensure the medication is fully effective.

The Drug Metabolizing Enzyme Panel can help your doc customize your med dosages based on your genetic structure. The results are significant: I’ve reduced dosage for one slow-metabolizing patient, for example, from 80 mg to 40 mg. And done the opposite for a fast-metabolizing patient, increasing from 40 mg to 80 mg.

This wonderful technology is new in the field and not yet widely available. But I would suggest you seek out a practice that provides it. It’s a simple procedure—just a saliva swab.

If you can’t find one, I urge you to rigorously, routinely, and exhaustively review your meds with every visit to your doc(s). The old-fashioned way.

Why a thorough meds review is essential.

We doctors and our patients should always be up to date on what medications you’re taking, and why. Every visit should begin with a review: do you still need meds A, B or C? As you age and often take one med for one reason, and another to counter the first med’s side effects—up to a half-dozen or more similar scenarios—things get complicated. You and your doctor must always be hyper-vigilant as to possible adverse reactions or contra-indications as all of these medicationss interact with you and each other.

If you’re taking Med A to relieve symptom B, is there a lifestyle change—in diet, for example, or a supplement—that can achieve the same result? Is there a generic Med A that can save you a boatload of money? Do you really even still need Med A—or has it become just a habit that’s gone unquestioned?

Have you begun to experience anything new…dizziness, fatigue, sleeplessness, balance issues, headache, stomach upset? Any change like that can signal something potentially serious. Always tell your doc about it.

Do your homework.

You have to put in some work to keep from falling into a meds habit—”Time for another refill…”

Obviously, my first courses of action are always natural approaches and lifestyle changes. But I tell all of my patients to write or type out a complete list of every medication and supplement they take, how much of it, how often, and when, and to bring it with them every visit, and to update it to show every change. And I grill them with all the questions above and more to ensure I’m giving them the absolute optimum medication mix—the most effective, with the fewest moving parts, and least likelihood of side effects.

I do this even though my clinic can perform the Drug Metabolizing Enzyme Panel. No matter how brilliant the technology, nothing can replace “fact time” in the doctor-patient relationship.

As always, remember that you’re your own best health care provider. I’m just here to help you take the very best care.

Last Updated: August 16, 2018
Originally Published: April 13, 2015