By A. G. Moore
A White Teacup and Saucer
By Douglas P. Perkins
From Wikimedia Commons on Creative Commons Attribution
Just about everyone knows that before getting a blood transfusion, blood type has to be determined; receiving an incompatible blood type can lead to very grave consequences. What most people don’t know, and what most doctors don’t test for, is another factor, one which helps to determine how quickly your body processes chemicals. It’s important for doctors to have this information because, if your system processes medicines slowly, then it’s possible too much can accumulate; if your system processes medicines quickly, then it is possible that you may not receive the full benefit of a prescribed dose.
There are many factors which influence the rate at which your body breaks down and clears drugs from your system. One well-known factor is age. Another, not as widely acknowledged (by consumers, anyway) is the rate of acetylation. “Slow acetylators” tend to accumulate medications in their system; “fast acetylators” may process them so quickly that the full benefit of a dose may not be realized.
Rate of acetylation is recognized in medicine, and yet it seems that this is something most doctors don’t test for. The day will likely come when tests for acetylation rates are as routine as are blood panel profiles. It seems to me that day should be now. Often, when a doctor prescribes a drug, it’s a guessing game whether or not that drug will work for a particular patient. Knowing in advance whether someone is a slow or fast acetylator would give the doctor more information to go on, especially when multiple medications are being prescribed.
The British Journal of Pharmacology affirms that knowing a patient’s acetylation rate is “clinically important”. The journal describes a simple urine test which can determine whether someone is a fast or slow acetylator: the patient simply consumes caffeine (in the form of a commonly available beverage, such as coffee). Some six hours later the urine is sampled to see how much of certain chemicals from the caffeine have cleared the patient’s system.
Since acetylation rate bears so directly on the potential effectiveness of a medication, it seems logical that this information should be included in every patient’s chart.
Knowing whether you are a slow or fast acetylator can also be helpful in determining certain cancer risks: people who are slow acetylators have an increased risk of bladder cancer; fast acetylators have an increased risk of colon cancer. Slow acetylating, post-menopausal women with a history of smoking have an increased risk of breast cancer.
Lupus patients are often prescribed many medications, and they also tend to be sensitive to drugs (I know I am). Wouldn’t it make sense, especially with this group of highly sensitive patients, to find out acetylation rate before deciding on a drug regimen?
*A helpful article on this subject is: Personalized Medicine, by Amy Adams, MS, in the journal, Genetic Health