23andMe and Us (September 25, 2018)

If I hadn’t been watching way too much television lately, I wouldn’t have seen a somewhat disturbing commercial for 23andMe. Well, I found it disturbing, anyway. Disturbing enough that it compelled me to GET UP OFF THE COUCH to look some stuff up. That is dedication, friends.

Said commercial featured an ordinary-looking lady of pleasant but serious manner who confided to us viewers that because of her dedication to her health, she had used 23andMe’s genetic testing service in order to – what? Well, she didn’t say exactly. But the impression she left me with was that after dishing out $199 and allowing 23andMe to pick her chromosomes apart, she had a much better idea of what she needed to do in order to stay healthy.

Here’s the thing. The lifestyle you follow to stay healthy is the same lifestyle that EVERYONE follows to stay healthy. It doesn’t matter if you’re 3% Neanderthal (which your friends could have told you anyway) or that that legendary great-great-grandma wasn’t actually Cherokee after all. If you do the stuff that the government recommends you do (that IS what “federal guidelines” means), your chances of dying prematurely from a nasty disease will be reduced by 80%. 

Eighty percent is a LOT. If you can quit smoking, (mostly) quit drinking, and eat and exercise as suggested, you’ve given yourself as big an advantage in the longevity sweepstakes as anyone can. Plus you’ll feel good the entire time, which is even better than living longer.

Now, it's possible that you might be more motivated to be good about following the government’s recommendations if you know you have a ticking genetic time bomb waiting to go off. But I think that although that's what people will tell you about why they got themselves tested for genetic disease issues, what's really going on is kind of the opposite. I think that they are actually secretly thinking that if they get a genetic clean slate from 23andMe, they won’t have to be so serious about vegetables and getting all their steps in.

I suspect that the latter crew is the true target audience for Ordinary Lady’s spiel. And I am ashamed of her for trying to appeal to people’s baser motives that way. There is quite enough of THAT around already.

So eat your vegetables, no matter what your test results say. Because they won’t tell you anything particularly useful even if you shell out that extra $100, and here’s why.

The genetic testing done by 23andMe is very limited. It will tell you whether or not you have a variant of a particular gene (called an “allele”) that might POSSIBLY result in one of a few specific diseases, fewer than half of which I was familiar with before. But let’s pick a juicy one – the apoE allele, the proud possessors of which have an increased chance of late-onset Alzheimer's disease. 

• There are a whole bunch of genes involved in Alzheimer’s disease, and although the apoE allele will increase an individual’s risk of late-onset Alzheimer’s if they DO have it, its presence is very, very far from determining that they WILL get Alzheimer’s. There are a lot of other factors involved in that happening -- many of which we still don't know.
• If you DON’T have this variant, you still could get Alzheimer’s disease. Knowing it’s not present doesn’t lower your risk of getting the disease by all that much. And on top of all that,
• There is no special lifestyle or treatment information out there that being privy to this piece of information will open up to you if it turns out that you DO have the apoE gene. There’s little to nothing known about what’s helpful to prevent Alzheimer’s and what is actually known applies equally to everyone, whether they have apoE or not. 

See what I mean? For all practical purposes, a waste of money. Possibly even harmful, if knowing that they have a scary gene gets people all unnecessarily panicked. There’s quite enough of THAT around already, too.

If some particularly unpleasant disease runs in your family, talk to a reputable MD about being specifically tested for it. If not, don't go looking for trouble.

Now if you want to find some long-lost relatives, overriding the opinions of your ancestors who probably lost touch with them for good reason, then 23andMe is certainly for you. Or if you have what I consider to be an unhealthy interest in the precise nature of your ancestors, knock yourself out. There is all kinds of human drama around and each of us is entitled to our special bit of it.

This commercial didn't fall into that category. It was a pitch to anxious people who want a little extra insight into their biological programming to help them better take care of themselves. And it’s really not going to do that, and dishonest to suggest otherwise. Pooh on you, 23andMe.

But if you’re just wondering why it is you look so much more like one of your dad's golfing partners than you look like your dad - well, then, hey. Go for it.

--dr. diane holmes
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