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You’re feeling ill. You visit the doctor, pick up a script and head to the pharmacy to collect your meds. The person in front of you in the queue just came from the doctor too. And they have the same script. Once you’ve both taken your medication, you’ll feel an equal improvement, right?
Due to slight genetic variations in your DNA, you might metabolise and process the medication you’re taking differently to the person in front you. The ingredients in the pills you’re taking might stay in your body for three hours longer. They may have much more serious side effects. Or they may have no effect whatsoever. You’d probably never know – except you’d never feel quite right, and could have chronic side effects while taking the medication.
But you should learn to live with the side effects, right? Wrong again, fortunately. Most patients put up with frustrating side effects, simply because they think they have to. But with a little more knowledge of their DNA, they could be working with their doctor to find a tailored solution with far higher likelihood of working. And to a large extent, leaving ineffective meds and unwanted side effects behind.
Molecular biologist and founder of DNAlysis Biotechnology, Dr Daniel Meyersfeld, believes most South Africans simply aren’t aware of the various ways their unique DNA affects the metabolism of medication.
“Many patients don’t respond to the first drug they’re prescribed in the course of treatment. A trial and error approach is frustrating and expensive, so why not use genetic information to streamline the process?” says Meyersfeld. “By conducting a simple genetic test, patients and doctors can now work towards enhancing the safety and efficacy of their treatment and avoiding unpleasant side effects."
Meyersfeld speaks specifically of Warfarin as a stellar example of prescription that should be tailored to the individual. Warfarin is the anticoagulant of choice for cardiovascular disease, thromboembolism and post-surgery applications. It’s one of the most commonly prescribed drugs.
But the window for improper dosage is very narrow. Too little and you may form clots in the future, too much and it can cause haemorrhaging. Without knowledge of the patient’s DNA, dosing is largely informed by what the doctor has in front of them at that time – patient history, weight, condition.
With genetic information on their side, Meyersfeld says, doctors could be prescribing far more accurate and personalised doses of Warfarin – and saving time and money in the process. The same applies for medications such as codeine-based painkillers and SSRIs (Selective Serotonin Reuptake Inhibitors) used as anti-depressants.
“Medicine is such a specialised science; most patients are wary to even have a conversation with their doctor about the option of changing their treatment. They take what they’re given and hope for the best,” explains Meyersfeld.
“But by harnessing the power of their genetic information, they can work with their doctor to find a better solution. It’s about using all the modern tools at our disposable for the best possible result."
Meyersfeld also explains how most South Africans are unaware they have access to affordable genetic testing. “Genetic testing has always been viewed as invasive and astronomically expensive – out of reach for the average South African,” says Meyersfeld. “But the increasing demand for personalised medicine means these tests are no longer inaccessible. Pharmacogenomic testing can be done using a DNA sample taken from a cheek swab.”
Medcheck, offered through DNAlysis Biotechnology, is a test kit that screens for a variety of medications and can be done completely at the patient’s discretion, in the privacy of their home. Once analysed, the patient will review the report with their doctor, to find out how they could be tailoring their medication for more effective and safe treatment.
Parents can have their children tested for genetic variations, to ensure any medication they’re prescribed – painkillers after having tonsils removed, for example – is actually working. Older patients who are prescribed chronic medications would also benefit hugely from discovering how their DNA affects the metabolism of medication in their body. This type of testing can reduce unwanted side effects and lead to an overall improvement in the quality of life, something particularly pertinent in the elderly population.
“The truth is; no two human beings are exactly alike. Your DNA is unique – and it’s the roadmap for how your body functions. It makes sense to harness the power of your genetics to inform healthcare. This is the age of personalised medicine, and it’s just beginning."
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