I've seen some references to TSM and genetics and have read that for some people NAL won't work because of their genetic make-up. I just happen to have done one of those spit tests a couple or three years ago so I have my genetic data, but I have no idea how to interpret it beyond what the testing company provided. I got the results from 23 and Me before they had to stop giving health data. Can anyone tell me what to look for? Is there a geneticist in the house?

I'm not sure you would be even be able to pull that info from your test. From what I read they didn't even know for sure why it didn't work for some, but their theory is that for a percentage of people they think the alcohol is affecting a different type of endorphin receptor or some other type of reward system that they can't identify yet. If they don't know why it doesn't work on some, I don't think you could test for it.

This may not be a popular comment but I think there could also be a chance that there could be other factors in play too - perhaps some have additional challenges that could include past trauma, mental health issues, maybe even being addicted to multiple substances - that may interfere with either the motivation or clarity to take the medication properly. Although the percentages are 80% in the studies, I wonder if it isn't lower than 20% of the people who truly don't have any success with the Nal itself although I wouldn't know how to guess what the true percentage is. There is also some indication that Baclofen is another option for some people - it appears to affect a different reward system so some people have had some success with very high doses of that drug, or a combination of Baclofen and Nal - although it sounds like the problems with the high dose Baclofen and the side effects can be very debilitating so I would certainly consider Nal first.

I was able to see a difference during my 'honeymoon period' so I knew it effected something. If it affects you in any way, it is unlikely you are part of that small percentage who it doesn't work for. Just keep taking it an hour before you drink and eventually it will work. It is rarely as quick as we would like, but it works eventually.

Good luck!

Jephiner

Not popular maybe, but it does bear repeating.

My understanding is that the research suggests that there are people born with a genetically favorable condition for alcoholism. The model is that those with this disposition have more sites on the receptors than normal people. So IOW (totally arbitrary here) you have 1000 endorphin sites on a receptor where a normal person has 100. When you take a sip the alcohol reaches the nervous system and thousands of endorphins are released. As they go through your circulatory system and hit the receptors in the brain you absorb 1000 of them into the little key holes and wow, oh man, your brain really lights up, while a normal person only absorbs 100 and you know it's nice and all but not that big of a deal.

So in a way your genetic predisposition to alcoholism makes you a much smarter learner then a normal person. Aren't you a lucky one!

So, I don't think that they have identified the genes responsible for making some super learners vs regular learners. But since genetics is indeed hereditary then the research shows that if you have a lineage of alcoholism in the family then there is a good chance that you have the genetic predisposition to become a super learner and quickly learn how to become an alcoholic. This is actually good news because it demonstrates for you that you probably have closer to a 100% chance of recovery just like Sinclare's rats did.

I understand it in the same manor that Jephiner stated. We are not rats and hence have many more problems that can interfere with TSM. Out of that 20% certainly there are some who fail because they just don't take the meds properly, another portion could be from people who drink to much but have no lineage of alcoholism in the family and hence are really not genetically predisposed super learners and drink for reasons other then the reflexive action of a well schooled addict.