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Any else out there a "high metabolizer"? Any one have studies to prove it?

optimistooptimist Posts: 546
edited 06/11/2012 - 8:50 AM in Chronic Pain
I wonder if this comes up with anyone else - I seem to be a very high "metabolizer". We know meds are processed or destroyed by several different pathways, some involve the kidneys, esp. NSAIDs, but some involve the liver - lots of enzymes discovered and more & more drugs in other categories have been determined to be under or over-metabolized based on how much of an enzyme you make, which is a function of genetics, or other medications that can rev up or slow down those (i.e. cytochrome P450), or yes thins like grapefruit juice.
I'm not talking tolerance, where you adjust to affects of meds over time and need increasing doses, but where you doc starts you on a new med and says "this med should work for 12 hours" - and it helps for about 4, and "this med should work 4-6 hours" and works about 1-1.5 hours. Has anyone actually had pharmacologic testing to see if they actually do rapidly metabolize (destroy or process) meds more quickly? Any PM's suggest that to anyone?


  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    Have you had your thyroid function tested recently?

    It is somewhat related. (although rather simply)

    Just a thought,

    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • I am on thyroid medicine, and tested regularly.
  • I was told I am a high metabolizer. I am constantly tested for specific medication levels in my blood so that the doc can adjust my oral doses accordingly. I also have liver panels taken every 6 months. I do not know if I have had a specific enzyme test for this purpose, it is possible due to some extensive testing I've been through, but I can't say for certain.

    Just before I did the rapid detox I was taken off all ER meds and placed on 30mg of IR Oxycontin every hour. My body would chew it up so fast, I was constantly waiting for the next hour to pop up so I could take the next dose.

  • I am or not, but I remember that when I was first put on oxycodone, the prescription was for one every 4-6 hours. No way the relief lasted over 2.5-3 hours. Finally, my dosage was changed to 1-2 every 4 to six hours, so I just took one every three hours. It kept the pain at bay. You know how bad it gets when you let the pain build up on you. Takes a long time to get it back down. I surely do not miss the days of all that pain and all those meds. I hope you get it all worked out.
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • Hi there! I was so glad to see this post because I, too, am a "high metabolizer". I have taken the anti-depressant drug Paxil for 15 years and while my Psych. Dr. understands this...and is actually the one to point it out to me because I was talking to him about the fear of becoming - or already being - a narcotic addict (due to the way other Dr.'s were treating me) no other Dr. understands at all. They act like I am a "drug seeker"..."wanting" more. All I want is enough to relieve my pain. And one 7.5 mg. Percocet does NOT relieve my pain for 6 hours. Doesn't even come close. I actually got the tough stance from my Ortho the other day because, even though his prescription said I could take 1-2 (7.5 mg. Percs) every 4-6 hours (maximum amount would be 12 pills a day according to that script) when he asked how many I was taking (3 weeks post-op from c5/6 ACDF) I told him about 8 pills a day...and he freaked out. I was told I absolutely could NOT take that many any more and he cut me down to max. 4 pills per day. Also, after a fusion, you can't supplement with any kind of NSAID. So 4 percs (7.5 mg) is it for me. It is not doing much if anything for my pain but I don't know what else to do. Possibly get a note from the shrink (just kidding) that I am metabolizing the narcs quickly because of the anti-depressant...but that would only be a "theory" since I haven't had any blood tests to back it up. Are there blood tests to prove this??

    I would give anything to find one MD that understands all of my issues and actually listens to me instead of blowing me off! I have a strong genetic history of Psoriatic Arthritis and Ankylosing Spondylitis (my Mother and 2 of her sisters...so far) but my PCP's & Ortho's have completely disregarded my concerns and literally blown me off. I even had one PCP refuse to refer me to a rheumatologist (I fired her after that) but I still haven't been able to see a rheumatologist. I am kinda fed up with the entire medical profession!
    Sorry to vent about me so much. Just hoping you would understand.

    Take care!
  • Hi Jojo. I'm sorry that you have so much pain! You're likely to get more responses if you start a new thread.

    I have read that many surgeons do not like to prescribe pain medication for too long after surgery.

    It sounds like you have had bad luck with getting a good doctor.

    Can you try to get an appointment with a PM doctor (like a physiatrist or an anesthesiologist)? From my experience, physiatrists are great! Some people see PM doctors that are anesthesiologists too.

    Do you know anyone that could recommend a doctor to you? I would start by trying to find a PCP and go from there. Or, you could try to find both doctors at once. Do you need referrals? Some people can just make their own appts. for specialists.

    You don't deserve to suffer! There has to be help out there for you.


  • Hi Flower...yeah I kind of went off on a tangent on this thread w/out really meaning to.

    I do have the name of a good physiatrist in my area that I plan on calling today. I don't need a referral for my Insurance but I think the PM Doc requires one...as does the Rheumatologist I want to see.

    You are exactly right...and I am going to keep working on it until I get the care I deserve.

    My problem is that I let Dr.'s intimidate me. I am always too afraid to ask for the referral for fear that they will see me as a "drug seeker" or something. Probably silly on my part. I definitely need to stand up for myself when it comes to my health!

    Thank you and take care!

  • When I was taking oxycodone I "failed" two urine tests, it did not show up at all. They did a blood test which confirmed I had been taking it. My doctor said I must be burning it all up.
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