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Taking away the hurt

Robin Miller, Internist, MD, MHS
Oregon

I became interested in integrative medicine more than 25 years ago when I began my medical practice in Medford, Ore. The definition of integrative medicine is a healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence, and makes use of all appropriate therapies.

The pressures and financial limitations of traditional medicine often didn’t allow me to spend the time and resources I wanted to with my patients. I strongly believe that traditional medicine is important for good health, but I also believe in the benefits of complementary therapies.

So, in 2003, I received my fellowship in integrative medicine from the acclaimed University of Arizona and began the process of opening my practice, Triune Integrative Medicine, in 2006.

Patient Story: photo of Dr. Robin Miller

One of the tools we use at Triune is the GeneSight test. I’ve helped countless patients with the information it gives me and my colleagues.

Taking Away the Hurt

The trouble with trial-and-error prescribing – and there are many problems with it – is that it hurts. It hurts patients mentally, spiritually, and financially.

I don’t want my patients to hurt. I don’t want them to spend a lot of time and money trying to find a therapy that helps them.

So, I’m happy to turn to the GeneSight test for added information. For me, the thing that sets the GeneSight test apart from other genetic tests like it is the algorithm. A lot of medications go through more than one enzyme pathway – some go through as many as five different pathways. It’s not just a single gene or multigene issue – its more complex than that. I’ve seen how GeneSight has given me more accurate insight into a patient’s unique genetic composition.

In fact, I believe in the GeneSight test so much that I included it in my book, Healed: Health and Wellness for the 21st Century:

We are all born with a unique makeup of genes that code our DNA. They code for everything, our sex, our appearance and how our body works. Genes also code for the enzymes, the things that break down drugs in our liver. Many medications are metabolized there. There is an entire system of enzymes called Cytochrome P450 that do the work. The gene test that I do with a simple cheek swab, called GeneSight, determines the unique way the major enzymes of the liver metabolize the drugs that go through this system. It looks at the individual enzyme activity but also multiple enzymes’ activity that may all impact how we metabolize a certain drug.

This test has been literally a lifesaver for many. There is no way to look at someone and tell if a drug is going be harmful for them. By looking at how things are metabolized, I have a much better idea. …

It is amazing how many people were getting sick from the medications that were supposed to be helping them get better. I had one patient who was on so many medications she wasn’t metabolizing that when I stopped them all, she felt normal again. That is what was making her sick. …

I highly recommend you have this test done if you are on antidepressants or contemplating going on them.

Saving Your Patients Trouble

I believe that providers should consider giving their patients the GeneSight test. If you check the PDR (Physician Desk Reference), the metabolism rates and enzyme pathways of the drugs are there. The GeneSight test gives healthcare providers insight to your patient’s unique metabolism.

I tell my colleagues all the time that the GeneSight test will save your patients trouble. You will save yourself time by not seeing everyone over and over again trying to find a medication that helps your patients without horrible side effects.

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