Introduction:


As personalized medicine continues to grow in popularity, DNA testing has become an increasingly valuable tool for determining which medications will be most effective for an individual. By analyzing a patient's DNA, healthcare professionals can identify genetic variations that affect drug metabolism and determine the most appropriate medication and dosage for their patients.

However, with so many DNA testing options available, it can be challenging to determine which one is best suited for medication determination. In this article, we'll explore the various factors to consider when selecting a DNA test for medication determination and provide tips on how to find the best option for your needs.

What information can a DNA test tell me?

Your genetic information provides the blueprint for your body. With the right test you can tell how you are related to members of your family, what your heritage is, and help you create your family tree DNA. With another test you can tell whether your DNA carries the genes for multiple different diseases and whether your children will likely inherit them or not. Your test results also can be used to determine which medicines are most likely to work in your body and which ones are not.

Can I take a DNA test to find out what medicine works for me?

Yes. DNA testing can help determine which medications have the potential for working best and which medicines should likely be avoided. The DNA data will also tell whether you are at an increased risk for side effects or whether you should start a medication at a larger or smaller dose than is normal.

What blood test determines best medications?

Every year when we see our doctor for an annual exam, they want to test our blood. Why is this so important for knowing which are the best medicines?

  • Multiple medications may need to be avoided if your liver enzymes are elevated. A liver function test will help determine if certain medicines should be avoided.
  • Your kidney function can affect how well you are able to excrete medications. If your kidney function is poor, then there are several medicines that may need smaller doses or may need to be avoided completely.
  • Whether your red blood cells, white blood cells, or platelets are high or low can also determine if you need to avoid certain medicines.
  • Other blood tests may indicate that you might need certain medications. If your cholesterol is elevated, you may need to take a medicine called a statin. If your blood glucose level is high, you may need insulin or another medicine to help control your blood sugar levels.

Blood tests, however, are not required to determine whether your genetics will affect your medications. A simple cheek swab is used instead to collect DNA from the inside of your mouth. It is a painless test yet provides worlds of information. A pharmacogenomic test will look at the DNA that was collected to determine your genetic blueprint of how you are most likely to process multiple different medicines.

What kinds of results can you expect from genetic testing?

Certain diseases are caused by our genetics. There are blood tests that can help determine if you are a carrier. These are useful tests when there may be a history of a disease in your family. Genetic testing can be done to help determine your risk and whether you may pass that risk onto your children. Knowing whether you carry certain genetic differences can also help determine whether there are certain medications that should be avoided or if you may need to consider starting a medicine to help with your condition.

Depending on the reason for testing your genes, you may receive results that show your risk of having cancer, diabetes, heart disease, obesity, or other health related conditions. Or you may be testing your genes to determine whether your children may be at increased risk of a genetic disease such as Cystic Fibrosis or Sickle Cell Disease.

Pharmacogenomic testing, instead, concentrates on the genes that metabolize medications and do not typically look at genes that are related to other types of genetic tests. If you are concerned about knowing inheritance information, that will not be a part of pharmacogenomic testing. Contacting a genetic counselor would be more appropriate.

Genetic testing for medication effectiveness (pharmacogenomic testing) will give you information showing whether you are more likely to metabolize a medicine differently than expected.

Examples include:

  • You may have an enzyme that causes you to burn through omeprazole too fast for it to appropriately treat a H. pylori stomach infection that causes stomach ulcers.
  • You might have a less active enzyme, such as CYP2C19, making it difficult for your body to activate Plavix (clopidogrel) to protect your blood from clotting.
  • ADHD medications are affected by our genetics. Stimulants and non stimulants may perform differently than expected due to genetic variations.

Our genetics affect multiple different medications. Knowing how your genetics will process these medications will help determine which ones work best in your body and which ones may not work as well. How your body processes the medicines also helps you to avoid potential side effects.

It is important to choose the correct test for the best results because not all tests check the same parts of your DNA.

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Can genetic testing help me find the right mental health meds?

Yes, genetic testing provides a great deal of information on how you process medicines, including mental health medications. Your pharmacogenomic test will provide information on multiple mental illness medicines including psychiatric medications, antidepressants, and ADHD medications.

Is there a genetic test for antidepressants?

Yes. There are dozens of different antidepressants. One of the most frustrating things about having depression is finding a medicine that works for you. Genetic testing helps reduce the number of choices allowing you a greater chance of finding the best medication first. Your test results will help determine whether an SSRI, selective serotonin reuptake inhibitor, an SNRI, serotonin and norepinephrine reuptake inhibitor, or an alternative would work best in your body.

Can genetic testing help me find medication for other diseases?

Yes. Pharmacogenomic testing tests how your body will react to more than 200 different medications. Medicines that are used for psychiatry, cardiovascular disease, diabetes, pain, and multiple other conditions are frequently affected by your genetics. Regardless of your disease, your genetics may affect the medicines that are chosen to treat it. Knowing ahead of time what to expect from different medicines can help your doctor treat your disease optimally.

What diseases can be detected through genetic testing?

Genetic testing can detect multiple different diseases. Cystic Fibrosis, Down syndrome, Huntington’s disease, Phenylketonuria, Sickle cell disease, Tay-Sachs disease and many others. Most of the time genetic diseases are detected in childhood. Huntington’s, however, manifests later in life although the mutations would already be present at birth.

If there are genetic diseases in your family history, it may be appropriate to speak with a genetic counselor to discuss whether there is an increased risk for yourself or your children. Not all genetic tests will be able to tell if there is a specific disease.

Will genetic testing help me and my doctor choose the best treatment?

The results you receive from pharmacogenomic testing will help your doctor and you decide which medication may work best in your situation. Pharmacogenomic testing does not state whether you have the disease or not, but only looks at how your body is expected to process the medicines.

What genetic tests are available for people with epilepsy?

If you have epilepsy and are concerned if your disease has genetic causes, speaking with a genetic counselor and looking at your genes with their specialized tests may be appropriate. Your physician would look for multiple different causes for your epilepsy.

Examples of genetic tests used to detect potential for epilepsy:

  • Epilepsy Gene Panel – a direct look at the most common genes associated with epilepsy
  • Chromosome Microarray – a look at whether there is an imbalance in your chromosomes that may lead to your epilepsy
  • Whole Exome Sequencing – a look at your entire DNA code to look for changes in your genes that are associated with epilepsy
  • Targeted testing – looking in one person’s genes for a gene known to affect another family member to see if there is an increased risk of epilepsy.

If you are more concerned with which anti seizure medicines will work best in your body, then doing a pharmacogenomic test would be extremely useful. Multiple antiepileptic medications are affected by our genes. How your body processes phenytoin, fosphenytoin, lorazepam, lamotrigine, and many more can be predicted with pharmacogenetic testing. Whether these medicines may require smaller starting doses, cause severe side effects, or even be available for the body to use can all be determined with a genetic test.

Why is genetic testing important in finding cancer risk?

Certain diseases occur after multiple mutations have happened. Specifically, cancer occurs because of a sequence of multiple mutations over time. This is why cancer often does not appear until later in life or not at all. Mutations that occur can often be prevented with a healthy lifestyle.

Having a family member who has had cancer may increase your own risk for developing cancer. Knowing ahead of time can help you to make better choices. There are multiple genes in our body that increase our risk of having cancer. These genes are often the ones responsible for repairing damaged DNA and therefore preventing multiple mutations from accumulating. The BRCA genetic variants that are linked with an increase in breast cancer are an example.

Conclusion

Genetic testing comes in many forms depending on why you need the test. When testing for how your genes affect your medicines, ClarityX provides pharmacogenomic testing through a simple cheek swab you can do in the privacy of your own home. If your concern is regarding mental health medications, then the Mindwell test would be most appropriate. If, however, you are interested in broader knowledge regarding multiple types of medications the Max Rx test will provide an additional 21 therapeutic areas including greater than 265 medicines. Let ClarityX help you feel better sooner.

References:

  1. https://my.clevelandclinic.org/health/diagnostics/24508-blood-tests
  2. https://my.clevelandclinic.org/health/diseases/21751-genetic-disorders
  3. https://www.cancer.org/healthy/cancer-causes/genetics/genes-and-cancer/oncogenes-tumor-suppressor-genes.html
  4. https://www.cdc.gov/genomics/gtesting/genetic_testing.htm
  5. https://www.epilepsy.com/causes/genetic/testing#What-Are-The-Most-Common-Genetic-Tests-For-Epilepsy?
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388157/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5942154/
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