Should you get Direct to Consumer Genetic Testing Through 23andme.com
Unless you have been living in the middle of the Everglades without a television or computer, you have no doubt heard of 23andme.com, the company offering direct-to-consumer (DTC) genetic testing. You don’t need a doctor’s visit or prescription. All you need is $99—a bargain considering that a visit to a walk-in medical center for a minor problem routinely costs $130 or more.
Before you decide to plunk down the money—and perhaps find out things you might be happier not knowing—you should be aware of what you will and will not be getting for your money.
First, consider what you will not be getting.
• You will not be tested for the CYP2D6 gene, which produces enzymes the liver uses to metabolize many drugs, including those used to treat depression. Understanding how your body handles these drugs is vital: if you metabolize them too quickly, the medications will not be effective. Metabolize them too slowly and even a “normal” dose could be toxic to you. The enzymes produced by this gene can also be inhibited (made less effective) by many commonly prescribed antipsychotic drugs. Therefore, someone who has below-average CYP2D6 activity and who is given an antidepressant that is metabolized by these enzymes and is also given an antipsychotic that inhibits those enzymes can have real problems. If you want this gene tested, you will have to pay nearly $700 to have it done by another company.
• You will not get a comprehensive report on BRCA genes that are linked to breast cancer. The test analyzes only 3 of hundreds of mutations that may be linked to breast cancer.
• You will not be tested for Huntington’s Chorea.
The 23andme website offers a list of all the drug responses, genetic traits, and disease susceptibilities and it is a long one. Many of these are of interest to younger people planning to have children. These tests can identify:
• An increased risk of pregnancy complications like gestational diabetes, preeclampsia, and placental abruption. preeclampsia, and placental abruption.
• The genes that will give breastfed children higher IQs.
• Genes that give you a higher risk of ADHD, bipolar disorder, schizophrenia, or drug addiction.
• Gluten intolerance
Older people may be interested in learning whether they are at an increased risk of developing the following conditions:
• Alzheimer’s disease
• Other forms of memory loss
• Parkinson’s disease
• Type II diabetes
• Colon cancer
• Pancreatic cancer
• ALS (Lou Gehrig’s disease)
For persons who were adopted, these tests can provide an incomplete but still useful substitute for family medical history. They can also tell you what your ancestry is. If you were adopted or lost touch with a parent at a young age, you will know whether you are Scottish, Jewish, or Danish. Thus, modern science can answer the questions that are important to most people about where they come from, both ethnically and medically.
The 23andme website also offers the opportunity to meet genetic relatives online, a prospect that should be approached with caution. This is a purely personal reaction, but the last way I would want to meet relatives is through a genetic testing website. We all pay lip-service to family values, but most of the long-lost relatives I had met have turned out to be colossal pains in the neck.
Of course, no one but you can decide whether you want to know the information these tests provide. Do you really want to know if you have an increased risk Lou Gehrig’s disease, an untreatable and always fatal condition? Would you be comfortable knowing that you had, for example, German ancestry?
Obviously, once you know this information, there is no way to “un-know” it. 23andme.com is very much a case of caveat emptor—let the buyer beware.