cytochrome P450 testing?

[momslove]

I'm wondering if anyone here has had cytochrome P450 testing and how the results helped you/your child.

 

As I've been reading about CBD oil, checking for potential problems, I've read that it uses these particular enzymes from or in the liver (CYP450 or P450). Seems there could be drug interactions with other drugs or supplements that use these same enzymes. The effectiveness of the drugs/supplements could be altered.

 

When I check for general drug interactions and look at the professional information, I also see mention of CYP450--for many of the meds my DD is taking or has taken.

 

Then I remembered an article I read and saved when we sat in the Mayo Clinic for CBT a year ago. I pulled it out and sure enough... A man was found to be a poor metabolizer of medications so they built up and became toxic. This was found by testing his CYP450. His history was 16 years of struggle with OCD, depression, anxiety, fatigue, tremors, abnormal thyroid function...all following a simple strep infection.

 

When I read more about CYP450 testing, it seems it is used when people respond poorly to SSRIs. Hmmm. DD has been on 3 different ones now.

 

Any thoughts on this?

Edited October 17, 2014 by momslove

[PowPow]

My daughter had this issue and also did very poorly in prozac and luvox.

She has had relief from clomipramine for ocd.

Have you considered that drug?

[momslove]

Our mental health practitioner replied to my question about checking DD's CYP450. Said it was not established or something like that for children/adolescents and that there was limited evidence for the clinical usefulness of this information for adults. She did not say no, but initial written reply was not supportive. Have not been able to connect yet with our lyme or PANS practitioners.

 

Any of you who have checked this, have you done it as a separate test with a provider or have you done it through something like 23 and Me?

[LNN]

We used 23andMe - best $99 I ever spent.

[momofadult]

You bring up a very good point. Its a reminder that it is worthwhile to check how the meds and supplements we give our children are metabolized. When I looked further into CBD oil, I found that it is a potent inhibitor of CYP 450 enzymes, in particular, CYP3A4 and CYP3A5. If your child is already taking meds that affect these particular cytochromes, dosages of the medication or CBD may need to be adjusted or avoided to prevent toxicity or poor effectiveness of either. For example, my son takes Nuedexta for glutamate/gaba modulation. Nuedexta is a CYP3A4 inhibitor. Since CBD oil is also a potent inhibitor of CYP34A, taking recommended doses of CBD oil can decrease the activity of this enzyme and increase the levels of Nuedexta in his body to toxic levels. Conversely, the combination could cause side effects from usual doses of CBD. In addition, 23andMe testing shows my son has a polymorphism in one of his CYP3A4 genes that gives me added caution.

[momslove]

So if I understand this...

 

My DD takes Fluvoxamine which is also an inhibitor of the enzyme CYP3A4 and rifampin which is an inducer of CYP3A4. I can't predict how they will interact, but I know that they will, right? Do the inhibitors slow down metabolism of the meds so they may possibly build up in her system to undesirable or toxic levels? Do inducers speed up metabolism of meds so more could be needed for therapeutic levels?

 

I did not find the information about the enzymes for CBD. I'm using the information from momofadult, above.

 

Momofadult, did you try it?

[rowingmom]

I just posted a new topic on the disruption of Vitamin D activation and sulfate production by Glyphosate (RoundUp). I forgot to add the tag: cytochrome p450 to the title - can't change it now.

 

http://articles.mercola.com/sites/articles/archive/2014/10/19/cholesterol-sulfate.aspx

 

"Glyphosate disrupts cytochrome p450 enzymes. There are lots of them in the liver [where they] activate vitamin D. We have a vitamin D deficiency epidemic right now. I think a lot of it might be due to the fact that it's not getting activated in the liver because of the disruption from the glyphosate."

[momofadult]

Momslove I tried the CBD oil at very low dosages on my son and myself. (I put 4 drops in a capsule. He is 195 pounds.) Unfortunately, it made me feel awful and caused undesirable side effects in him. I was disappointed but curious so I looked up its pharmokinetics and figured out that his current meds and genetics made him more sensitive to CDB's effects. Now I am checking everything!

 

I would expect (hope?) that your doctor took into account the inducing/inhibiting effects of the drugs when they prescribed their dosages. If you are concerned because you are not seeing the effects you hoped for it would be worthwhile to discuss it with your doc. Here's some info that might be useful. The subsequent links are helpful too.

http://www.ebi.ac.uk/interpro/potm/2006_10/Page3.htm