CYP2C19 is an important detox enzyme responsible for clearing approximately 10% of commonly used clinical drugs, including antidepressants (citalopram), proton pump inhibitors (omeprazole), and antiplatelet drugs (Plavix/clopidogrel). High enzyme activity has been associated with depression. Read on to find our more about CYP2C19 function, gene variants, and supplements that decrease enzyme activity.
CYP2C19 is one of the cytochrome P450 monooxygenases (CYPs). These are enzymes that eliminate most of the drugs and toxins from the human body (R).
This enzyme is responsible for processing more than 25 clinically important drug groups. It clears about 10% of commonly used clinical drugs that undergo Phase I detoxification (R).
This enzyme metabolizes:
- Antidepressants: citalopram, escitalopram (R, R), amitriptyline (R), and sertraline (R).
- Proton pump inhibitors: omeprazole (R).
- Anticonvulsants: mephenytoin (R).
- Diazepam (R).
- Methadone (R).
- Antimalarial proguanil (R).
- Anticoagulant warfarin (R).
- Antiplatelet clopidogrel (Plavix) (R).
- Antifungal voriconazole (R).
- MDMA (ecstasy) (R).
This enzyme is found in the liver. However, it is also active in the fetal brain, with a possible role in brain development (R).
CYP2C19 The Good
This enzyme participates in converting arachidonic acid to epoxyeicosatrienoic acids (EETs). EETs have beneficial effects on the heart and blood vessels.
CYP2C19 The Bad
High CYP2C19 activity is associated with depression and smaller hippocampus volume in humans (1418 subjects) (R).
A study in Sweden shows that people with high enzyme activity (CYP2C191 carriers) are more prone to depression than those with defective enzyme function (CYP2C192 carriers) (1472 subjects) (R).
Depressed suicide attempters with high enzyme activity show higher suicidality (209 subjects) (R).
CYP2C19 Gene Polymorphism
Based on the the variants they carry, individuals can be categorized as:
- ultrarapid metabolizers (*1 /*17 or *17 /*17)
- extensive metabolizers (*1/*1)
- intermediate metabolizers (*1 /*2, *1 /*3, or *2 /*17)
- poor metabolizers (*2 /*2 or *2 /*3) (R).
On the other hand, ultrarapid metabolizers have an increased risk of being refractory (resistant) to proton pump inhibitor (PPI) therapy (meta-analysis, 19 studies) (R).
rs424485 is also known as CYP2C19*2. This variant (A) reduces enzyme function (R).
Also known as the CYP2C19*3, this variant (A) reduces enzyme function (R).
rs12248560 is also known as the CYP2C19*17 variant. The T in this position increases enzyme function (R).
This variant protects against recurrent heart damage. People with this variant have greater therapeutic responsiveness to Plavix (clopidogrel) but they have an increased risk of developing bleeding (meta-analysis, 11 studies) (R).
These decrease CYP2C19:
- Propolis (R).
- Caffeic acid (R).
- Quercetin (R).
- Ginger extract (R).
- Kale (R).
- African lettuce (L. taraxacifolia) (R).
- Licochalcone A, a major compound in traditional Chinese herbal licorice (R).
- Apomorphine, berberine, noscapine, and papaverine (R).
- Bulbocapnine, canadine, and protopine (R).
- Capsaicin (R).
Health Tools I Wish I Had When I Was Sick
At SelfHacked, it’s our goal to offer our readers all the tools possible to get optimally healthy. When I was struggling with chronic health issues I felt stuck because I didn’t have any tools to help me get better. I had to spend literally thousands of hours trying to read through studies on pubmed to figure out how the body worked and how to fix it.
That’s why I decided to create tools that will help others cut down the guesswork:
- Lab Test Analyzer – a software tool that will analyze your labs and tell you what the optimal values are for each marker — as well as provide you with actionable tips and personalized health and lifestyle recommendations to help you get there.
- SelfDecode – a software tool that will help you analyze your genetic data from companies such as 23andme and ancestry. You will learn how your health is being impacted by your genes, and how to use this knowledge to your advantage.
- SelfHacked Secrets – an ebook where we examine and explain the biggest overlooked environmental factors that cause disease. This ebook is a great place to start your journey if you want to learn the essential steps to optimizing your health.
- SelfHacked Elimination Diet course – a video course that will help you figure out which diet works best for you
- Selfhacked Inflammation course – a video course on inflammation and how to bring it down
- Biohacking insomnia – an ebook on how to get great sleep
- Lectin Avoidance Cookbook – an e-cookbook for people with food sensitivities
- BrainGauge – a device that detects subtle brain changes and allows you to test what’s working for you
- SelfHacked VIP – an area where you can ask me (Joe) questions about health topics
The information on this website has not been evaluated by the Food & Drug Administration or any other medical body. We do not aim to diagnose, treat, cure or prevent any illness or disease. Information is shared for educational purposes only. You must consult your doctor before acting on any content on this website, especially if you are pregnant, nursing, taking medication, or have a medical condition.
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