By Dr. Anthony Policastro

In the past I have written about the human genome. The genome is the name for the makeup of our chromosomes. One article was on using it to diagnose cancer. Another was on how evolution changed the genome over history.

A recent article has another use for the genome. Statin drugs are commonly used for high cholesterol. Unfortunately some people develop muscle aches on those medications. The muscle aches go away when the medication is stopped.

It would be useful to know ahead of time which people are going to develop muscle aches on the medication. For those patients an alternative medication can be chosen to prevent the aches from occurring in the first place.

The real problem is that there are no other drugs as good as the statins for lowering cholesterol. Therefore, you would like to have some certainty about things before starting a different medication.

We have found a gene that increases the risk for muscle pain with statins. The name of it is SLCO1B1. There is also a test for it. The test is called the StatinSmart genetic test. The test costs $99.

Each of us has two chromosomes with the gene for muscle pain on it. About 75 percent of the population has a normal gene on each chromosome. They will not get the muscle aches.

Another 23 percent of the population has one normal gene and one abnormal gene. Those individuals are four to five times more likely to get muscle aches than the average patient.

The remaining 2 percent of the population has two abnormal genes. They are about 17 times as likely to get muscle aches than the average patient. However, the chances are still low even in that population. About 2 people out of 100 in that group will get muscle aches.

So the current recommendation is not to do the test for everyone who begins taking a statin drug. The recommendation is to find out if any other family member has had muscle pain with a statin. If so, they are at high risk of having an abnormal gene. Your doctor (and it should be in consultation with your doctor) might want to do the test in that instance.

Otherwise, a statin can be prescribed. If muscle pain begins, it can be stopped until the pain goes away. It can then be started again one to two months later to see if the pain comes back.

Over time, we will see a lot more genes identified that involve the medications we take. We can expect to see more testing as well. We are well on our way to using genetics to decide which medication is best for each individual patient.