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Atypical drug metabolism factors.

Drug Metabolism (When You’re Not Average!)

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When Your Medications Run Out… Of You

Everybody knows that alcohol can affect medications’ effects, but what of smoking, and what of obesity? And how does the alcohol thing work anyway?

It’s all about the enzymes

Medicines that are processed by the liver (which is: most medicines) are metabolized there by specialist enzymes, and the things we do can increase or decrease the quantity of those enzymes—and/or how active they are.

Dr. Kata Wolff Pederson and her team of researchers at Aarhus University in Denmark examined the livers of recently deceased donors in ways that can’t (ethically) be done with live patients, and were able to find the associations between various lifestyle factors and different levels of enzymes responsible for drug metabolism.

And it’s not always how you might think!

Some key things they found:

  • Smokers have twice as high levels of enzyme CYP1A2 than non-smokers, which results in the faster metabolism of a lot of drugs.
  • Drinkers have 30% higher levels of enzyme CYP2E1, which also results in a faster metabolism of a lot of drugs.
  • Patients with obesity have 50% lower levels of enzyme CYP3A4, resulting in slower metabolism of many drugs

This gets particularly relevant when we take into account the next fact:

  • Of the individuals in the study, 40% died from poisoning from a mixture of drugs (usually: prescription and otherwise)

Read in full: Sex- and Lifestyle-Related Factors are Associated with Altered Hepatic CYP Protein Levels

Read a pop-sci article about it: Your lifestyle can determine how well your medicine will work

How much does the metabolism speed matter?

It can matter a lot! If you’re taking drugs and carefully abiding by the dosage instructions, those instructions were assuming they know your speed of metabolism, and this is based on an average.

  • If your metabolism is faster, you can get too much of a drug too quickly, and it can harm you
  • If your metabolism is faster, it also means that while yes it’ll start working sooner, it’ll also stop working sooner
    • If it’s a painkiller, that’s inconvenient. If it’s a drug that keeps you alive, then well, that’s especially unfortunate.
  • If your metabolism is slower, it can mean your body is still processing the previous dose(s) when you take the next one, and you can overdose (and potentially die)

We touched on this previously when we talked about obesity in health care settings, and how people can end up getting worse care:

Let’s Shed Some Obesity Myths

As for alcohol and drugs? Obviously we do not recommend, but here’s some of the science of it with many examples:

Why it’s a bad idea to mix alcohol with some medications

Take care!

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