Is Your DNA Your Destiny? How Genetics Can Influence Your Risk for Disease

February 10, 2020

Thinking about the genetic traits that run in your family can be kind of fun. Maybe you can trace your red hair back to Irish ancestors or your athletic skills to a tennis-playing grandpa.

But genetic traits can also be a cause for concern, especially when it comes to your health. It’s natural to worry at least a little bit if your mom had breast cancer or a sibling had a heart attack at an early age.

Instead of worrying, why not take action? By talking to your primary care doctor about your family medical history, you can have a better understanding of what your inherited health risks may be. The next step is for your doctor to develop a personalized plan to help you prevent health problems in the future.

Managing all the risk factors

“Genetics is a good starting point, which is why we always ask patients about their family health history,” says Vernesha Montgomery, MD, a family physician with Kettering Health Network. “But we also have to look at ‘environmental’ risk factors, such as being overweight, smoking, and many others. These are all important pieces of the puzzle.”

Type 2 diabetes is a good example of a disease that can develop due to genetics and environmental factors. Your doctor will look at both when deciding how to help you prevent this disease.

“The goal is to lower your risk before symptoms appear—an ounce of prevention is worth a pound of cure,” Dr. Montgomery says. “If Type 2 diabetes runs in your family and you are overweight, I am going to recommend some lifestyle changes. These changes can include referring you to a dietitian and encouraging you to get 30 minutes of exercise five days a week. I will probably also test your blood glucose level regularly to make sure it is staying in a healthy range.”

Certain forms of heart disease can be hereditary as well. An example is familial hypercholesterolemia, which causes high cholesterol to develop at a young age and increases the risk of heart attack. In people who have familial hypercholesterolemia, lifestyle changes alone typically do not bring down their cholesterol levels.

“If I have a patient in her 30s who tells me about a strong family history of high cholesterol and early heart attacks, I am probably going to order fasting blood work and other comprehensive tests to help me learn more,” Dr. Montgomery says. “If her LDL, or ‘bad cholesterol’ is high, there’s a chance she has familial hypercholesterolemia. And if that’s the case, I know that even if she follows a heart-healthy diet and exercises regularly, she’s probably going to need medication to bring that LDL down. So I won’t wait to prescribe it.”

Like other primary care providers, Dr. Montgomery bases her recommendations on research studies and guidelines published by organizations such as the American Medical Association.

What about genetic testing?

Some people decide to have genetic testing to learn more about their risk for a specific disease or group of diseases. One good example of this is the genetic test for BRCA1 and BRCA2, which are genes associated with inherited forms of breast cancer. Other genetic tests can look for defects associated with other inherited forms of cancer and inflammatory bowel disease.

Keep in mind that genetic testing is not always conclusive, and the results don’t predict your future. Just because you have a certain genetic mutation doesn’t necessarily mean you will get that disease. On the other hand, a negative result doesn’t always guarantee that you won’t develop a particular disease. Your primary care doctor can help you decide whether genetic testing is right for you.

A personalized plan for prevention

Once your primary care doctor has a good understanding of your family history and other risk factors for disease, he or she can create a personalized plan for prevention and early detection. “Primary care doctors stay up to date on preventive medicine strategies, and use resources available from organizations such as American Cancer Society and American Heart Association to create a personalized prevention plan for each patient,” Dr. Montgomery says. “Genetics are not your destiny—there is so much people can do to improve their health and detect disease early, when it’s easiest to treat.”

Concerned about what your family health history means for you? A Kettering Health Network primary care physician can help. Find a physician near you.