Should I get genetic tests?

I believe that genetic testing should be chosen on a very individual basis with an emphasis on those tests for which there is a treatment decision that can change the gene expression.  Doing a large expensive battery of genetic testing in low risk individuals with no plan to use them to change lifestyle or treatment can get expensive and confusing.

Let’s discuss some examples.

9p21 is the Heart Attack Gene, the one to Beat as the title of Dr. Bale and Dr. Doneen’s book suggests.  But there is no specific treatment for it.  Its presence could motivate someone sitting on the fence about some treatments, but for the most part I rarely order it.

KIF-6 genotype determines whether atorvastatin and pravastatin are effective or ineffective at reducing heart attack and stroke frequency.  But if we use lovastatin and rosuvastatin as our preferred statins, it doesn’t matter.  Again, useful in a limited set of circumstances.

ApoE genotype 4 increases the risk of Alzheimer’s Disease and arterial disease.  It can predict better outcomes with a very low fat diet and no alcohol.  If you are willing to modify these choices based on the result, let’s get it.  But if other dietary priorities, like reducing carbs due to insulin resistance, are a priority, maybe it won’t matter.

One genetic test is worth the money in patients with Type 2 Diabetes and insulin resistance or prediabetes.  Haptoglobin genotype 1-1 is the lowest risk, 1-2 increases your risk by 200%.  Both experience more events if given vitamin E! 

Haptoglobin 2-2 increases risk by 500%!  But guess what!  Vitamin E reduces much of that risk!  Now that is cool to know!

But if we don’t know your genotype, we can guess and be wrong about 50% of the time.  Isn’t $350 (a dollar a day for an extra year, less if you live even longer) invested one time worth saving your life?  I thought so.    

It’s easy to procure these tests.  The results are based on saliva, and the results are available in about a week.