Thursday, March 31, 2011

Coming Home to Die of Drug Interactions

The wars in Iraq and Afghanistan have returned 40,000 wounded soldiers to the US, the highest number, compared to combat deaths, of any war in history. Another 300,000 or more troops have returned with traumatic brain injury, P.T.S.D. (post traumatic stress disorder), depression, or chronic pain; difficult to treat conditions our troops will likely suffer from for many years. As a result, psychiatric drugs, central nervous system depressants, and narcotic painkillers have been used by military doctors more than in any previous war. But those medications are being increasingly linked to a rising tide of other problems, among them drug dependency, suicide, and fatal accidents—sometimes from the interaction of the drugs themselves. An Army report on suicide released last year noted that medications were involved in one-third of the record 162 suicides by active-duty soldiers in 2009. An additional 101 soldiers died accidentally from the toxic mixing of prescription drugs from 2006 to 2009. DNA testing can help improve this situation because almost all of the drugs contributing to the drug interactions afflicting our troops are affected by DNA status. When prescribers know the DNA status of their patients, they’re in a better position know when drugs or combinations of drugs will work or when they might be unsafe. Adapted from “For Some Troops, Powerful Drug Cocktails Have Deadly Results,” The New York Times, Feb. 12, 2011

Tuesday, March 29, 2011

Dangerous Drug-Gene Interactions at a Glance, and Other Report Improvements

Although an estimated 6-10% of physicians have ordered genetic tests to personalize prescribing or treatment for patients, the technology is not as widely adopted as many industry experts predicted it would be. Kristine Ashcraft, Genelex’s Director of Sales and Marketing, notes, “one of the key barriers to widespread adoption of personalized prescribing is the interpretation gap—the gap that exists between the information provided and a clinician’s ability to use it.”

As a leader in the field since 2000, Genelex has encouraged input from the patients and healthcare providers we serve so we can continue to improve the tools and reports we provide so the positive healthcare impact of this technology can be fully realized. These are some improvements recently implemented, based on client feedback that we believe will further close the interpretation gap.

No Easy Way for Patient to Share Results with Other Providers – The graphic below shows cards that are now provided for patients. The information on the cards allows any healthcare provider secure web access to GeneMedRx where they can reduce drug and gene interaction risk when making medication decisions.

Specific Drug-Gene Interaction Requires GeneMedRx Login – We now provide drug-gene tables for all phenotypes. A graphic depicting a sample for CYP2D6 poor metabolizers (10% of patients) is to the right.

Reports Too Long – We have shortened our reports to one page for the three main cytochromes – 2D6, 2C9, and 2C19 as well as VKOR. A sample can be viewed at

If you are one of our referring physicians or previously tested patients and would like drug-gene tables or updated reports and patient cards, call 800 TEST-DNA or email

A Family Battle to Overcome Bad Genes for Drug Metabolism

This is an abridged version of an article Tom Carlson, owner of HostasDirect and IdealGardenMarkers, is sending to all of his subscribers because he is a staunch advocate for personalized medicine based upon almost tragic personal experiences.

It has been known for years that people react differently to medications. There is more than a 50% chance that you have an easily diagnosed drug metabolizing enzyme problem, a genetic mutation that causes 100,000 deaths and 2,200,000 serious drug reactions in the U.S. every year. If you know and understand your enzyme situation, you can learn which prescription drugs are best and worst for you. A simple genetic test can mean the difference between a drug that makes you well and one that gives you a toxic reaction or has no effect at all. Despite these tests being around for the last few years, a recent study found that only "1 in 4 physicians had any education in the use of genetic testing to guide medical decisions,” and many people are unaware of how far personalized medicine has come.

My family and I have experienced first-hand how pivotal this information is. We have all been tested, and it has been very influential in improving our health care. Members of my family have suffered and almost died from being prescribed medications that did not match their unique and genetically determined drug metabolizing enzymes. I am not in any way affiliated with the genetic testing industry; this is simply something I am passionate about and I feel that it is my responsibility to share this knowledge with you.

My dad almost died from a bad drug-gene interaction in 2008 caused by a common prescription pain killer. Even though he explained to his outstanding health care providers that, like 10% of the population, he is a poor metabolizer of the CYP2D6 enzyme, he was still prescribed the wrong pain medication after surgery. His caregivers did not understand the drug-metabolizing enzyme information he provided and he was prescribed a medication that is solely metabolized by CYP2D6. He rapidly became very sick, and experienced no pain relief. I thought he was going to die in front of me. As he was suffering, I went on the web and learned that thousands have died from the combination of drugs and being a CYP2D6 poor metabolizer.

My mother also had a problem with Coumadin, a common blood thinner, which could have been very serious. Like 35% of the population, she is an intermediate metabolizer of the CYP2C9 enzyme, which metabolizes the blood thinner. She told her caregivers about her enzyme deficiency, but they did not know of the tests or what my mom’s meant. Worse yet, they did not tell her they did not understand what she told them. These caring, smart, hardworking people proceeded to give her way too much blood thinner for her enzyme situation. When she returned to get her blood checked, they discovered that her blood had become dangerously thin, and there was a risk that she could bleed to death.

These incidences–and others I can’t name here–could have, and should have, been prevented!

Please realize I am not a physician and take no liability for your decisions. Talk to your doctors, pharmacists, and nurses and find out if they are familiar with this testing. I have talked to many highly regarded physicians that were not familiar with these tests. They greatly appreciated the information I shared, and some even changed how they prescribed medications to members of my family. One physician told me, “Of course we have seen different results in patients given the same medications, but we have never understood why–this makes total sense. Thanks for letting me know.”

Please pass this information along–knowledge and understanding of these tests needs to get to the public and medical community. You might save or improve a life!

Genelex has created a new web page at called Real People, Real Stories to help raise awareness.

Do you have a story to share? Email

DNA in the News

The Innocence Project is currently working to free a man in Virginia who has served over 27 years for three rapes he did not commit; DNA and other evidence prove a known offender actually committed the crimes. Unfortunately, the man was convicted based on witness identification that has proven time and time again to be unreliable. More than 250 people have been exonerated in the last 20 years based on post-conviction DNA testing. Learn more at

DNA Debates Continue, Strangely Paternity Overlooked

Direct-to-consumer (D2C) DNA paternity testing has been missing from the controversy about D2C genetic testing hitting the news lately. The FDA has held multiple public comment sessions on consumer genetics. A task force report commissioned by the American Society for Human Genetics has called for better oversight of ancestry DNA tests. Yet paternity, with arguably the most important impact, has not even garnered a mention.

Many Americans do not realize that accreditation for parentage testing is voluntary and that no accreditation process exists for home paternity tests. Although most AABB accredited labs such as Genelex voluntarily apply the same scientific rigor to self-collection tests as they do the legally collected samples, no guidance exists. As America argues over whether people understand the shortfalls of tracing ancient genealogy, or whether they should be allowed to know that a genetic variation may increase their chance of heart disease, no one has stepped forward to make certain that tests that determine your parentage are passing muster. Yet, most physicians would agree family history is a key predictor of health. DNA paternity testing has been around for 20 years so maybe it is not as sexy as the new tests on the scene, but it impacts hundreds of thousands of Americans every year, and the impact of lack of quality is much further reaching.