DNA tests have gained in popularity over the last few years. They reveal a lot about us, but the data can be overwhelming. We tried one to find out how it all works
You’ve probably seen it somewhere. Personalised DNA tests are a big trend in medicine. Genetic tests are still a bit lowkey in South Africa, but globally, it’s a booming business.
These DNA tests can tell us a whole bunch of things.
From which diet is best, which exercise we might respond well to and, perhaps most crucially, help us understand how we process medication. It can also help us track our heritage, but for the purposes of this article, we’ll focus on the health aspects.
ARE WE DOOMED BY OUR GENES?
Most of the outcomes are theoretical, based on correlation, not causation.
And there is some debate around whether some of this information should even be shared with consumers. The reports have loads of info on them. Some scary, some less so. Some experts fear that without proper consultation, patients might freak out because they consulted Dr. Google on their results.
Fortunately, DNAlysis’ approach comes with an hour-long consultation to go through all the information. Some tests can only be requested through an accredited partner.
This is to help you understand what the tests mean, remind you that the results are just suggestions and just because you are at high-risk for disease X, does not mean you will develop it, provided you take the correct steps.
It is also not possible for the public to order some of the more nuanced tests, those that tell us about our risk for illness, for example.
These are some of the most popular “commercially available” tests offered.
This test helps identify:
- How your body responds to carbohydrates, saturated fats, mono-unsaturated fats and poly-unsaturated fats.
- Obesity Risk
- How your body responds to exercise and how much you need to maintain a healthy weight.
- Whether you have the sweet tooth gene.
- Whether your genes predispose you to snacking or overeating.
- Your circadian rhythm ie. Whether your body clock has a preference to morning or evening. An evening circadian rhythm may have a negative impact on weight as you may be prone to consuming more unhealthy options at night.
- What diet plan is best for you.
This test helps you understand:
- Lipid metabolization and how this may affect your heart health.
- Methylation – the process of DNA repair.
- Detoxification – the removal of harmful substances from your body.
- Oxidative stress and whether you may be prone to oxidative stress-driven disorders.
- Bone health specifically the gene associated with calcium absorption and bone loss..
- Insulin sensitivity looking at genes that either have a positive or negative impact on fasting insulin and insulin resistance.
- Food responsiveness – how your body responds to lactose, caffeine, poly- unsaturated fats, salt sensitivity, bitter tastes and alcohol metabolism
What my DNA tests revealed
Here’s the fun part. Well, fun for those reading, less fun for me. Because my genes are wonky.
The reports are easy to read and understand with keycodes that reveal what impact your genetic variants have. Like this.
SOME OF MY RESULTS
On the diet test, my genes are actually okay. For optimal performance, a Mediterranean diet is best. The bad news is that I cannot outrun a bad diet. For maintaining or losing weight, exercise won’t help me much. That doesn’t mean I should neglect it, but diet should take priority if I want to stay in shape.
Less pleasant, but not surprising, was finding out about issues relating to methylation, bone health and oxidative stress. These all came under the ‘high priority list’. The dietician who worked with me to explain these results, made recommendations and stressed that it’s about working with my genes to achieve optimal health.
DNA TESTS AND PERSONALISING MEDICINE
Most crucial for me, taking this test was to help my psychiatrist better understand how to tailor my medication to help me deal with my ADHD. I was only diagnosed as an adult. And, as anyone who has been through this process will tell you, finding the right dose of meds can be an (expensive) trial and error.
I’ve responded well to methylphenidate (often sold under the brand names Ritalin or Concerta), but seemingly processed the extended release far faster than expected.
It was hardly a surprise to find, then, that I have a genetic variant that suggests I could have an “unfavourable” or “less optimal” response to the medication.
What unfavourable or less optimal means will vary from patient to patient. In my case, it seems that it just means I process it differently. Those variations also mean that the inattentive symptoms of my ADHD probably won’t respond to medication (so, if you spot typos in this article, don’t write in).
“DNA testing cannot diagnose an ADHD disorder, however, the test can help your doctor prescribe medication that is best suited to your specific genes,” Dr Danny Meyersfeld, ounder and CEO of DNAlysis Biotechnology, explains “Our technology allows you to further understand your genes and how your body is going to metabolise certain medications.”
This test, known as the MygeneRx Report, can be ordered on the medcheck website, but it is advised that you do this in partnership with your doctor. It tests for responses to a variety of different medicines and will benefit anyone who has to take prescription drugs.
It’s also valuable to consider the bigger picture. When it comes to mental health and how our genomes can help us understand it, Dr. Meyersfeld explains:
I think there is extensive research in this area, but it takes time for the research to move to the area of clinical utility. There is still so much about the mind and mental health that is not fully understood, but our knowledge is
growing all the time.
And the good news is that research keeps progressing. While understanding around some gene variants might be limited, our understanding of their interaction with the environment is well established.
“I think, for me, this in itself is the exciting part. The very notion that our genes are not our destiny, but that we have the power to control and modulate gene expression through our choice of environment. This allows us to be more proactive and take more responsibility for our health,” Dr. Meyersfeld adds.
As with the other tests, the DNA Mind test looks at elements related to mental health. Specifically, we are looking at genes that are linked with the risk for mood disorders, cognitive decline and elements of addictive behaviour. These risk factors can be an important clinical tool for the healthcare practitioner, giving them insight on both the diagnostic side, as well as with intervention strategies.
THE RISK OF DNA INFORMATION OVERLOAD
The results revealed that I carry a number of genetic variants (mutations if you want to make the scientists angry or sound like you belong in X-Men, or polymorphisms if you want to right) that are associated with a number of risk factors. Note the use of the word ‘risk factor’.
If these markers show up (like they did for me) as something that requires action or that is a “high priority”, you risk going down a potentially terrifying rabbit hole if you frantically start Googling stuff.
This why DNAnalysis does things in a very specific way and why you can’t just go around ordering all of the available tests. As Dr. Meyersfeld explains:
“These genes by themselves are not causing the disorders. They are risk factors that can predispose an individual to a disease/disorder, but this may or may not manifest depending on environmental exposure.
“The reports can be overwhelming but working through them with a trained healthcare practitioner definitely makes it easier to manage. It is important to bear in mind that the tests focus on modifiable risk factors; meaning we are empowering the patient to make the necessary changes to diet, nutrition and lifestyle that can help to overcome many of the identified risk factors.
But even if all these steps are followed, there is always the risk that patients will still go around Googling stuff because they are curious.
One of the leaders in these “to consumer” tests caused a big uproar in the United States over the last few years. An important distinction here is that DNAlysis is linked to healthcare offering – which is very different.
Direct consumer tests, though, have had their share of problems. As reported by AFP earlier in the year:
US regulators granted biotech firm 23andMe permission to become the first company to market reports showing customers’ health risks based on their genetics.
The private company had been focusing on providing ancestry information after the FDA reined in efforts to offer genetics-based health information about four years ago.
The FDA said it granted permission for 23andMe to market “personal genome service genetic health risk” tests for ten diseases or conditions in a first-of-its-kind service direct to consumers.
IS YOUR DNA SAFE?
This is another worry for many. Because some sites (not all) that offer these tests, store data online, there is a risk. Sometimes, it can actually help catch bad guys. But even that isn’t so simple. Also from an AFP report earlier this year:
Detectives in California used DNA left at crime scenes, combined with genetic information from a relative who joined an online genealogy service, to catch an alleged rapist and murderer who eluded authorities for four decades.
The arrest of 72-year-old Joseph James DeAngelo – believed to be the “Golden State Killer” responsible for 12 murders and more than 50 rapes in the 1970s and 1980s – was hailed as a victory for cutting-edge science and old-fashioned detective work.
“The answer was, and always was going to be, in the DNA,” said Sacramento County District Attorney Anne Marie Schubert.
While that sounds pretty nifty, it raised some concerns around privacy and ethics.
“What if you become uninsurable because of a genetic test?” said Joseph Turow, a professor at the Annenberg School for Communication at the University of Pennsylvania.
The FBI maintains a database containing the DNA of millions of convicted criminals, but DeAngelo did not have a felony conviction and his DNA was not on file – forcing the police to turn to public genealogy sites to find a match.
The collection of intimate personal data is by no means restricted to genealogy services such as Ancestry.com, 23andMe or GEDmatch, the one used to track down DeAngelo.
Yep, things are complicated. But in the greater scheme of things, knowing as much as you can about how your body works is becoming increasingly accessible.
HOW DOES A DNA TEST WORK AND WHAT DOES IT COST?
DNAlysis offers the following tests – DNA diet, DNA health, DNA oestrogen, DNA sport, DNA skin, DNA Coeliac Disease Risk tests and My Gene Rx.
The tests can be ordered through the website and will be couriered to you in a pretty little box. Although, please note that not all of these are available to be ordered online. In some cases, you might need to go through an accredited practitioner – remember what we said about these things needing to be explained by professionals?
Inside, you’ll find the swab and a plastic tube. Read the instructions carefully – it’s advised you avoid food, drink and smoking/vaping some time before taking the sample.
Taking the sample is simple and painless: wipe around your cheek for a while and pop the swab into the tube. Label it carefully with the labels provided and send it back. The tests can be sent or collected via courier and the whole process is simple.
Processing can take anything from two to six weeks. You’ll receive an e-mail from your appointed DNA Explainer as soon as it’s ready to set up an hour-long session to go through all your results. These consultations can be done over the phone or on Skype.
You should also receive a prepared summary explaining the most important results and what you can do to make diet/lifestyle improvements based on your genetics.
The cost varies depending on which test you take, but you’re looking at a couple of thousands of rands, between R2500 and R4300 depending on the DNA test option selected.
In the long run, though, this might be a price worth paying for the benefit of your well being.