Which Genetic Test Is Best for Your Health? Understanding ApoE, MTHFR, BRCA, and Beyond
Genetic testing is everywhere right now. From at-home kits to single-gene tests, it can feel like unlocking your DNA will suddenly give you all the answers about your health.
But here’s the truth: genetics are powerful only when they’re interpreted in context. A single gene rarely tells the full story. What matters most is how your genes interact with each other, your lifestyle, and your current health.
That’s where genetic testing shifts from interesting information to actionable insight.
Let’s break it down. Below are some of the most common stand-alone genetic tests, followed by how we take a more personalized, integrative approach.
ApoE (Apolipoprotein E)
There are 3 main versions of ApoE:
ApoE2 - decreased Alzheimers risk but increased early cardiovascular risk, in particular hyperlipoproteinemia III
ApoE3 - most common
ApoE4 - increased Alzheimers and cardiovascular risk, including hyperlipidemia
You have two copies of the ApoE gene (you inherit one copy of each gene from each parent). If both of your ApoE genes are ApoE4, your risk of developing Alzheimers is significantly higher.
BRCA1 and BRCA2 (Breast Cancer genes 1 and 2)
If you inherit a genetic variant (a nicer term for mutation) in the BRCA genes, it can increase your risk of developing cancer, especially breast and ovarian and, to a lesser extent, pancreatic and prostate.
Certain populations can have an increased prevalence of BRCA variants, making timely testing potentially more relevant.
COMT (catechol-O-methyltransferase)
Variations in the COMT gene impact your body’s ability to break down catecholamines. This means that neurotransmitters like epinephrine, norepinephrine and dopamine can be elevated and stay in circulation for extended amounts of time, which can impact your behavior, your mood, energy and your physiological stress response.
CYP450 (cytochrome P450)
This is a group of enzymes that metabolize substances like fats, medications and other chemicals, and is an important aspect of your liver’s Phase I detox pathway.
Variants in the CYP genes can affect how your body processes and breaks down medications, which can sometimes help your healthcare team understand what medications and dosages may work better for your body.
MTHFR (methylenetetrahydrofolate reductase)
The MTHFR gene is involved in how your body processes folate, which is essential for important things like methylation and your DNA. Methylation affects how your genes are expressed.
Your folate status affects mood, energy, and other physiological functions, and it’s often highlighted during pregnancy as it’s important for fetal development. (Btw, did you know? Folate is vitamin B9.)
One of the most common MTHFR variants is C677T, which can increase cardiovascular risk.
The results of these genetic tests give us information - and information can be empowering.
While test results can give you an idea of your genetic risk, stand-alone tests don’t tell the whole story.
The ultimate way to understand more about your genetic makeup as it relates to your actual health? More in-depth testing interpreted in the context of your individual health picture.
Why does this matter?
For starters, your genes may be fixed but their expression is not. For example, just because you have the ApoE4 gene does not necessarily mean you will experience dementia. (But knowing that risk is increased, we can take proactive steps to reduce it.)
With most genes, having a genetic variant alone does not tell you if or how it will be expressed.
This makes it imperative to understand how your genetic information applies to your health - what are your other risk factors, test results, concerns and diagnoses?
Also, there are many thousands more of your genes than this handful of the most-talked-about tests. Genes form a complex network, and we can use our understanding of other genetic variants and influences to modulate how that network impacts gene expression.
For example, there are many genes involved in the methylation cycle - it’s not only MTHFR. We also have MTRR, MTHFD1L, SMHT and others.
When we look at a gene in isolation, we miss the opportunity to understand how the whole system - the network really - works together to create our health.
Looking at the network of your genes in the context of your health allows us to understand what levers to adjust so that the whole works more optimally. This is the expertise we bring to our genomics consults at Wellness Insights.
Learn more about genomics consults here.
