Throughout my clinical practice years, I have always said to my patients that I don’t believe in cookie-cutter medicine. Every person and body is different and hence treatment regimens should be individually tailored to every patient. A recent study has made it easier for me to further ingrain that idea into the minds of my patients when they come into my clinic with the idea that if their friend is taking something, then that’s the only thing that would work for them.
In a recent study at Duke University, scientists recently found that how we respond to certain medications, such as the cholesterol-lowering medication called simvastatin, may be determined by our gut bacteria. The results were published in PLos ONE on October 13, 2011 and it demonstrated that gut bacteria can cause differences in how people digest and metabolize different drugs and substances; hence drug effectiveness can differ from person to person based on that.
Within this study, they identified three bile acids produced by gut bacteria that altered medication response such that the effectiveness of the drug differs. What is ground-breaking about this study is the idea that drug effects differ from person to person and is personalized because we are all physiologically somewhat different and a medication effect on any given patient is in fact not going to be cookie-cutter or identical amongst various patients.
This concept is called ‘metabolomics.’ It’s the science of examining the multitude of biochemical components involved in cellular metabolism and its effect on health. It is essentially an examination of personalized medicine and how every person may respond differently to various treatments due to the uniqueness of each of our individual physiological factors. The reason we may respond differently to any given treatment or medicine may be more than our genetics; it may also be due to other physiological factors such as our microflora.
What is interesting about this finding is that we may be looking forward to an era where drugs will target specific sub-populations instead of assuming all of our physiology is cookie-cutter.
We may be seeing a growth in the industry of diagnostic studies that help us to fine-tune our medication regimens toward more personalized physiological factors; as well as pharmaceuticals that derive optimal results from our body’s individualized micro-environments instead of medications that are presumed to function the same in every body.
It’s comforting to finally see medicine take on the obvious assumption that we all know when we interact with other people in our life; that every person we meet is slightly different and hence our relationships are different from person to person.
So, if inherent differences in people are easily recognized in social interactions, isn’t it about time that these obvious inherent differences seen in people are taken into consideration when we choose medications and treatment regimens? I think it’s a long time in waiting to finally see medicine catch up to the concept that our bodies just like our personalities are not cookie-cutter; thus medications and treatments shouldn’t be either.