The FDA just approved the first direct-to-consumer genetic tests that promise to give people a peek into their future. Bypassing the doctor completely, these tests let people find out whether their genetic makeup predisposes them for 10 different diseases, 1ncluding Alzheimer’s, Parkinson’s, celiac, and more.
Sounds like a good idea, right? I mean, if the science is available, why not find out what your individual risks are? I’ve had plenty of patients ask me about genetic testing over the years, and that’s their reasoning. And it appears to be the reasoning of these testing companies too.
But the truth is there are plenty of reasons this isn’t a good idea. In fact, I’m generally against genetic testing without a specific goal. If you are testing for something that would change your treatment plans or goals, then sure. I’m all for it. But if it’s just to satisfy your curiosity, I think it’s a Pandora’s box. Let me explain a few reasons why …
First, having the genes that predispose you to a disease does not necessarily mean you will get the disease. In my new book, The A-List Diet, I write about the role epigenetics play in weight management and what you can do to help that.
As a reminder, epigenetics affects how the cells in our bodies react to our genes. And the main point here is that the genes you carry are one thing. But your epigenetic makeup — or how your body responds to those genes — is something else entirely. Our epigenetic makeup determines which genes get turned on and off. And unlike our gene pool, our epigenetic makeup can be altered by outside influences. Like diet, exercise, and exposure to toxins.
To explain genetics and epigenetics, I often use the analogy of the seed falling onto fertile soil. You may have the seed (in this case the gene that predisposes you for a disease). But if the soil doesn’t nurture it, it won’t grow. Your epigenetic makeup is that soil. You can make sure you’re not creating soil that lets that seed grow.
When it comes to genes that lead to disease, the “soil” that nurtures them and helps them grow is the stuff I warn you against every day. It’s the poor diet, the toxins, the stress, the obesity. All factors that are in your control.
So in the end, does it really matter if you have the gene — which is something you can’t change anyway? Instead, control the soil. Lead a healthy lifestyle. Eat the right foods. Get enough exercise and sleep. Avoid toxins. If you do that, you starve the genetic seeds of what they need to grow into disease.
The second reason I don’t think these tests make sense without a specific goal in mind might sound like a conspiracy theory. But hear me out.
If you do a genetic test and find that you’re at increased risk for certain diseases, who has access to that information? Conceivably, insurance companies could look at that data and decide that you’re too high risk to cover. Or that you’ll have to pay astronomical rates for coverage. And in today’s healthcare environment, with the hotly debated issue of pre-existing conditions and high-risk pools, my concerns don’t seem that far out there.
My third objection has to do with the fact that these tests are marketed directly to the consumer.
Why is the FDA suddenly allowing this? I think it’s just another attempt to remove the physician from patient care and to marginalize the relationship between you and your doctor. This is a slippery slope and one I hope you do not fall down.
Now, please don’t misinterpret these objections to mean that I don’t believe in genetic testing at all. I absolutely do. In fact, I think it will eventually revolutionize the way we practice medicine. But we’re not there yet. We don’t know enough about what to do with the information. Other than to scare people into doing things they probably don’t need to be doing.
And that’s not something I can support.