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PostPosted: Thu Nov 03, 2011 8:36 am 
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Joined: Sat Oct 08, 2011 3:49 pm
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Hi All,
A quick question; how can the doctor tell if you are metabolizing your subs quicker than usual?
My subs only last around the 6 hour mark and they discussed that they will have to look into if i am metabolizing too quickly, so how do they do that? blood work or just verbal assessment?


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PostPosted: Thu Nov 03, 2011 9:11 am 
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It's a difficult one. Most of the time, they listen to what you say, and make an assessment from there.

How can they prove you have a fast metabolism?

You can genetic tests (blood tests) to see if you have Polymorphisms for the Cytochrome P450 group of liver enzymes. These liver enzymes are responsible for the metabolism of many medications, especially psychiatric and narcotic medications. Basically, they look to see if you have certain genes. If these genes are active, there is a strong likelihood that you have more or less of certain CYP enzymes than other people. Buprenorphine is metabolised mainly by CYP3A4, I believe.

If you want to do some research yourself, have a look here: [urlhttp://en.wikipedia.org/wiki/CYP3A4[/url]

There is a list of all drugs / foods that involve CYP3A4 in some way. Substrate means the drugs are metabolised by CYP3A4. An inhibitor slows the metabolism of drugs metabolised by CYP3A4. An inducer speeds it up. You will notice that "grapefruit juice" is an inhibitor of CYP3A4. I have found that it does slow my metabolism of Suboxone a bit, so maybe ask your doctor about that.

When I went to get my liver enzyme test, the blood collector ticked the wrong box, and I got tested instead for a gene for Celiac Disease, and I tested positive! My doctor told me I had Celiac disease. Then next time I saw him he took it back, because you need another test for it as well. Thank God because.. gluten free sux! :lol: I never ended up getting the real test.


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Dr. Jeffrey Junig, M.D., Ph.D.

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