Gene Variants can affect meds, pain, supplements, neuro, etc

I have chronic pain and have been very sensitive to medications. I had the opportunity to do pharmacogenomics testing at Mayo Jacksonville (though they send it out to an outside lab), and while the research is still emerging, I found it to be very validating.

They were able to tell me that I have generic variants that may affect two common receptors for medications—I think the pharmacist told me more than one third of prescription medications are somehow involved with those two receptors. So it actually makes sense that I’ve had so many issues in the past. There were a handful of medications they have more research on so they could advise dosage adjustments at least to start with, since the test isn’t absolute. I’m glad I did it.

On reviewing this product it shows it’s not a covered service by Medicare and the company says if the fee is greater than $330.00 they contact you first before processing. And the site shows the test was developed for use with psychotropic medication, the type most prescribed by psychiatrist. It appears this test is not for all medications. In addition this test has not been approved by the FDA so the efficacy of the results should be suspect.

Hello @madvzebra. Genetic testing can be helpful in revealing markers, sensitivities and other health triggers. However, there are still some limitations. Here is a helpful breakdown from Mayo Clinic on some of the benefits and limitations of genetic testing, https://www.mayoclinic.org/tests-procedures/genetic-testing/about/pac-20384827. This articles does talk about Pharmacogenetics which can help determine how you handle medications and proper dosages.

There are plenty of mixed reviews out there on genetic testing as far as your overall diet goes. Patients should use caution when selecting a company for their testing and should also keep their providers in the loop. They may support this testing and have some suggestions on the most reliable source to go through in their opinion.

@madvzebra - it sounds like you are feeling better overall, which is great to hear. Have you been able to share this information with your provider as well?

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.