That’s right; the Mayo pharmacists were very clear with me that pharmacogenomics can identify gene variants/markers that may impact how someone’s body responds to medication, but it’s not an absolute—it’s more like likelihoods based on the research that exists. They were also clear that research is ongoing and there’s more information on some types of drugs than others. All of the genetic variants tested for in my Mayo test were related to the liver, so it’s completely unhelpful for drugs that get cleared by the kidneys, for example, or topical medications.

It was my understanding there’s more data on some neuromodulators (aka antidepressants), notably for me, amitryptiline and nortryptiline, which are often prescribed for chronic pain. There was also a clotting medication and a sedative used sometimes in surgery.

So my testing was more useful for understanding where I have variants that may impact certain types of drugs—it allows me to make a dosage adjustment if I know it’s something that may be more likely to cause side effects. And just in general it was validating to me because I spent a lot of time explaining to physicians that I’m cautious with medication because of previous bad experiences which would sometimes be met with skepticism. It is nice for me to be able to point to the report I have from Mayo, and say, “This is why we’re cautious.” I wish I didn’t feel the need to lean on it, but that’s the medical system for you.

And you’re right—any kind of genetic testing is very iffy with insurance.