Why do bartenders have the most experience dealing with the differences in how women and men metabolize a drug?

Because alcohol.

A short thread on how medicine doesn't consider drug metabolism differences between the biological sexes.

1/5 Image
We used to think that differences in alcohol tolerance between M + F was only due to any differences in weight/fat.

But that's not the whole story.

Even when sexes are matched for weight, there is a marked discrepancy in which sex metabolizes alcohol faster, M>F.

2/5 Image
Women don't have the same level of activity of alcohol dehydrogenase, an enzyme which helps break down alcohol in the body.

And other enzymes that break down prescription drugs may also be less active in women, making them more likely to experience adverse side effects. Image
It's not just alcohol that males metabolize faster than women.

Many other drugs fall under this category. #Paracetamol/#Tylenol for example is metabolized (broken down) 22% faster by men.

3/5 Image
Then there's the gut.

Women on average have much longer colons, slower gastric motility and intestinal transit time.

This means that a woman needs to wait longer before taking a drug that needs to be taken on an empty stomach, such as the allergy medication Claritin.

4/5 Image
So why don't doctors adjust the dose of medications according to sex?

Because even if they wanted too, they can't.

Drug companies aren't required to provide sex specific dosing. This is likely why more women are overdosed unintentionally by doctors.

#TheBetterHalf

5/5 Image
*Clarityn Rapide/Claritin Rapid Dissolve

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More from @sharonmoalem

8 Jan
Turns out that getting chemo is like sending cancer to a relaxing spa getaway for the weekend, so that it comes back refreshed and ready to kill.

That's disturbing.

What else have we misunderstood?

Biological sex and cancer.

A short thread.

1/7
Almost every type of cancer affects men more than women. And overall, more women survive a cancer diagnosis. Men also develop about 150,000 extra cancers per year in the US, compared to women.

Why is that?

Because biology.

2/7
We used to think that the reason for female cancer 'resistance' was behaviorally based because: women see their doctor more often and drink less alcohol etc.

But that's not the whole story.

3/7
Read 7 tweets
1 Jan
Why are 95% of 'supercentenarians' (those who are 110 years of age and beyond) women?

Because biological sex.

And so, a short thread on sex and longevity.

1/7 Image
From the beginning of life more girls make it their first birthday almost everywhere around the world, according to the @WHO. Girls have lower rates of prematurity and fewer complications after birth.

Females don't wait long to begin to dominate when it comes to survival.

2/7 Image
Women are naturally resistant to cancer.

Throughout life, women not only develop less cancers in organs and tissues that they share with men, but even when they do, they're much more likely to survive them.

Note: this is the case even when we adjust for behavior.

3/7 Image
Read 8 tweets
21 Dec 20
The evolutionary arms race will never really end between microbes and humans. They (microbes) have as much to lose as we do if it does.
Microbes are responsible for some of the most profound differences between humans which we can still observe even today. This has been true since the first human.
Some humans are born able to naturally resist HIV. This is thanks to them inheriting a small but significant genetic change - CCR5 delta 32.

Most humans do not have CCR5 delta 32.

HIV takes advantage of this fact.
Read 6 tweets
12 Mar 20
It is an unwritten law of biology that human males are much more fragile and lack the stamina and resilience in the face of biological challenges such as cancer and infections.
Notwithstanding their greater muscle mass and physical strength, males are the XY heterogametic genetically weaker sex
The cost that XX females pay for their immunological vigor is a much higher preponderance towards developing autoimmunity.
Read 7 tweets

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