Dr. Michael Ruscio, DC is a clinician, Naturopathic Practitioner, clinical researcher, author, and adjunct professor at the University of Bridgeport. His work has been published in peer-reviewed medical journals and he speaks at conferences around the globe.
Unfortunately, Genetic Testing is Expensive But Not Clinically Useful
Genetic testing can run you anywhere between $100 to $2000+, with most options between $100 to $300.
Unfortunately, most genetic testing, especially direct-to-consumer tests, aren’t worth paying for since they may be unreliable, difficult to interpret, and are not well supported by scientific research.
According to current research, genetic testing results often don’t have a clinically significant effect on treatment outcomes.
At the end of the day, our environment, lifestyle, and the daily choices we make for our health (or against it) have a much greater impact on our health outcomes than our genetics.
Curious to know if genetic testing fits in your health budget? Genetic testing, especially from direct-to-consumer companies not covered by health insurance, can be pricey. Unfortunately, that’s not the only reason to skip them: in most cases, they don’t provide helpful or accurate information that can be used to inform treatment or lifestyle health decisions. And I’m not just speaking from personal experience, we have multiple large-scale research studies that back this up.
In my clinical experience, it’s better to pursue tried and tested health strategies to improve your health rather than relying on genetic testing that may or may not be accurate. Not to mention you’ll save time, money, and energy that could be better spent on resources that will really help you feel better.
That said, there are times when genetic testing ordered by a medical professional can be useful and valid, so let’s break down what genetic testing is used for, the different types of testing, how much genetic testing costs, and the drawbacks and downsides of genetic testing.
What is Genetic Testing Used For?
Valid genetic testing is relevant and useful when screening for true genetic disorders, inherited diseases, determining a higher risk of developing a certain disease, or discovering a gene mutation you could pass along to your children. Genetic testing, aka DNA testing, uses a blood sample, skin, hair, saliva, or a pregnant person’s amniotic fluid, to look for any changes in genes, chromosomes, or proteins .
Especially when conducted by a qualified clinical geneticist or genetic counselor, DNA testing can be clinically relevant and useful. High-quality (medically validated) and well-interpreted genetic testing can help you identify genetic disorders and plan your life accordingly . Some of these diseases include:
You can think of genetic testing as falling into two main categories:
Health-related genetic testing labs for disease prevention, diagnosis, management, or prevention that are ordered and interpreted by a physician
Genetic tests for health and wellness optimization (often direct-to-consumer or DTC, but also sometimes ordered by functional or alternative health practitioners)
The first type, as we discussed above, can be clinically relevant and useful. The second type is the one we want to be wary of. DTC genetic tests are tempting and promise useful health information, but they often cause more distress and confusion than they help. We’ll dive deeper into the problems with DTC genetic tests in a little bit.
Genetic Testing Cost & Insurance Coverage
Since these screening tests (often prenatal testing) are usually meant for disease prevention or diagnosis, they are often covered by insurance plans when ordered by your medical care provider. But they can still run anywhere from $100 to $2,000+ in out-of-pocket costs for both medically validated tests and DTC tests [7, 8].
Some of these interpreters are free, and others charge a fee for specific interpretations around diet and nutrition, fitness, allergies, drug responses, and more. Many alternative health practitioners will also offer to interpret these (whether they’ve ordered them or not).
Genetic Testing Drawbacks and Downsides
Cost isn’t the only factor that keeps genetic testing from being useful. In reality, DTC genetic testing is difficult to interpret, possibly unreliable, and ultimately doesn’t seem to impact treatments and clinical outcomes. Here’s the full breakdown.
1. Up to Interpretation
Many companies offer direct-to-consumer genetic testing kits which typically don’t require a doctor or genetic specialist to interpret the results. These companies typically market their DNA tests as capable of supporting your everyday health and wellness. When you use them, they often make your raw data — the As, Cs, Ts, and Gs reflecting your genotype — available for downloading and third-party analysis .
The problem: Genetic data is remarkably difficult to interpret. When a healthcare provider orders genetic testing, they must provide detailed information about your medical history and symptoms to the lab conducting the test. This information is crucial for interpreting your genetic results accurately . DTC gene testing kits don’t always fulfill this requirement, which can degrade their ability to interpret your results accurately.
2. Low Clinical Significance
Beyond that, DTC genetic testing simply doesn’t seem to have clinical significance when it comes to lifestyle recommendations or treatment of specific conditions. Associative studies that link genetic variations to health conditions and outcomes can be confusing.
First, association does not equal causation, meaning that having a certain gene does not guarantee that you’ll have the condition observed to be related to that gene. Second, the effect sizes in these studies tend to be very small, meaning the actual increased risk or other effect is so small that it’s very unlikely to actually make a difference in someone’s life or health. In other words, their findings are not as meaningful as they may seem to be.
Each human genome is vast and complex, containing about 4–5 million SNPs , and we don’t yet fully understand how genes and all their possible variations might interact with each other, with the complex reactions going on throughout the body, and with the numerous (and largely untracked) inputs and outputs related to a body.
The MTHFR gene (a gene variant suggested to affect the usability of vitamin B9, folate, in the body) is a good example of a gene with lots of associative studies suggesting the gene may be responsible for certain health outcomes. However, clinical trials have shown a lack of evidence to support these claims [12, 13, 14].
3. Not Well Supported by Clinical Trials
As for clinical trials testing how different interventions affect health outcomes in people with specific genotypes, many have come out with unsatisfying results [15, 16, 17, 18]. These studies haven’t found evidence that one’s genotype significantly determines their treatment success.
For example, a meta-analysis of 14 clinical trials found that people who had the AA or TA genotype of the FTO polymorphism (related to weight loss) only lost about a half-pound to a pound more than those who had the TT genotype for FTO after 3 months to 3 years of weight loss interventions .
Regarding MTHFR, another literature review concluded that, even though folate is important for cellular health and the MTHFR gene plays a significant role in the folate pathway, there is no statistically significant evidence that the 677C and 1298A polymorphisms have a clinically relevant effect on that pathway .
With multiple studies and literature reviews showing that genetic sequencing is not relevant diagnostic testing in terms of affecting clinical outcomes, it just doesn’t make sense to invest the time, money, and energy into ordering and interpreting them. If you’re the curious type and you have the funds to pursue genetic testing, you may find the results interesting as something to keep in mind in regards to your health and lifestyle. But they aren’t something to base your healthcare decisions on completely.
Environmental Factors > Genetic Destiny
The good news is that our environment and our lifestyle have a much greater impact on our health than our genetics, and these factors can even change how our genes are expressed. This is why someone with genes that might seem to predispose them to a certain disease could completely avoid that disease by making simple, healthy lifestyle choices that have been shown to improve health outcomes across the board, regardless of genetic expression.
According to the World Health Organization, the major risk factors for noncommunicable diseases — such as heart and lung diseases, cancers, and diabetes — are all environmental. They include tobacco use, lack of physical activity, unhealthy diet, and excess alcohol use . By making healthy choices that oppose these risk factors, you can have a huge impact on your health outcomes.
Don’t outsource the fate of your health to genetic testing — no matter what genes you have, your choices have the greatest influence over your own health and well-being.
Our Philosophy: Treat the Individual, Not the Test
At the Ruscio Institute for Functional Health, we prioritize practical, simple solutions to health challenges from your gut health to thyroid function to brain and mental health. Time and again, I’ve seen patients come in with these high-cost tests feeling so much anxiety about how to pursue treatment based on their genetics, and the research shows us it’s just not necessary to be so concerned.
If you’re interested in working with experienced clinicians who base treatment protocols on tried and tested research, thorough patient history, and true collaboration between doctor and patient, schedule a consultation with us here. Or learn more about my approach to gut and full body health in my book Healthy Gut, Healthy You.
The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.
Richards S, Aziz N, Bale S, Bick D, Das S, Gastier-Foster J, et al. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med. 2015 May;17(5):405–24. DOI: 10.1038/gim.2015.30. PMID: 25741868. PMCID: PMC4544753.
Aldubayan MA, Pigsborg K, Gormsen SMO, Serra F, Palou M, Galmés S, et al. A double-blinded, randomized, parallel intervention to evaluate biomarker-based nutrition plans for weight loss: The PREVENTOMICS study. Clin Nutr. 2022 Aug;41(8):1834–44. DOI: 10.1016/j.clnu.2022.06.032. PMID: 35839545.
Gardner CD, Trepanowski JF, Del Gobbo LC, Hauser ME, Rigdon J, Ioannidis JPA, et al. Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial. JAMA. 2018 Feb 20;319(7):667–79. DOI: 10.1001/jama.2018.0245. PMID: 29466592. PMCID: PMC5839290.
Fallaize R, Celis-Morales C, Macready AL, Marsaux CF, Forster H, O’Donovan C, et al. The effect of the apolipoprotein E genotype on response to personalized dietary advice intervention: findings from the Food4Me randomized controlled trial. Am J Clin Nutr. 2016 Sep;104(3):827–36. DOI: 10.3945/ajcn.116.135012. PMID: 27510539.
Bayer S, Winkler V, Hauner H, Holzapfel C. Associations between Genotype-Diet Interactions and Weight Loss-A Systematic Review. Nutrients. 2020 Sep 22;12(9). DOI: 10.3390/nu12092891. PMID: 32971836. PMCID: PMC7551578.
Xiang L, Wu H, Pan A, Patel B, Xiang G, Qi L, et al. FTO genotype and weight loss in diet and lifestyle interventions: a systematic review and meta-analysis. Am J Clin Nutr. 2016 Apr;103(4):1162–70. DOI: 10.3945/ajcn.115.123448. PMID: 26888713. PMCID: PMC4807705.
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