What to Know Before You Buy a DNA Test

Thanks to at-home genetic testing kits, the future is now.

But it can be difficult to know which of these spit-and-send tests to trust and which ones are trying to make a buck off our saliva. Read ahead for an overview of three popular testing services and important factors to consider if you decide to buy.

Direct-to-consumer DNA tests do not require a doctor’s note, but the American Medical Association recommends using them under the guidance of a doctor, genetic counselor or licensed health care professionals who help patients, including couples planning to have a baby, discover genetic traits. A word of caution: Genetic testing neither guarantees the likelihood — or absence — of disease.

To find a reputable at-home kit, genetic counselor Scott Weissman of Chicago Genetics Consultants says you should verify that the company does confirmation testing, meaning it will run your test twice to confirm the result. He also says reputable companies should have a genetic counselor on hand to answer customer questions. “If the company can’t put them through [to] a genetic counselor and they talk to a sales rep or customer service rep instead, I’d be worried,” Weissman said.

DNA tests can be purchased through a company’s website directly or through a third-party vendor like Amazon. Weissman, however, strongly recommends buying through the company itself.

Insurance generally won’t cover direct-to-consumer DNA tests, Weissman says, only paying for genetic testing if your doctor recommends it and you meet the criteria designated by your insurance provider. Because every insurance company has its own policy, contact yours directly to find out if DNA testing will be covered.

Read the fine print on privacy. Patients worried about privacy have reason for concern, but Weissman says most test providers do not sell or share your information for malicious reasons. Instead, they’re likely to use it for further research. Be sure to read the fine print when you sign anything from the test provider — that’s where they’ll disclose how they plan to use your information.

DNA test

Cost

What information is included?

What can you do with the information?

How they use your data

Best for

23andMe

$99 for the ancestry option and $199 for health and ancestry information

The ancestry portion shows your DNA’s geographic history. The health option includes carrier information and diseases you’re more susceptible to, including Alzheimer’s and Parkinson’s

The ancestry information can be used to build your family tree. The health results can be shared with your doctor for further screening

23andMe shares your results for research

People who want a mix of ancestry and health information

AncestryDNA

$79

Ancestry information, including your ethnic makeup and when your ancestors arrived in America

If you have any potential relatives in the system, you may be able to contact them for more information about the family tree.

AncestryDNA doesn’t store data with names attached. You can request destruction of your sample and records.

People who are primarily concerned about documenting their family origins

Helix

Start at $80 and vary based on what you purchase Extra tests come from outside partners, which are reviewed by Helix.

Fitness and health information, such as what foods you’re sensitive to, if you have a rare form of diabetes or what kind of exercise your body responds to best

Tailor your diet and exercise to fit your genetic makeup

Helix only shares your data with the companies that service the extra tests that Helix provides. Helix doesn’t sell your data and you can revoke access any time

People who want to discover the intricacies of their body, including what foods are best for them and specific weight loss strategies

In this case, the scientist discovered a half-brother born from an extramarital affair, as the DNA Relative Finder option notifies users if their DNA is a match with someone else in the 23andMe database. The reveal was so damaging, the scientist’s parents divorced. If you don’t want to find any long lost relatives, skip that option.

Buyer beware. It’s also possible that test results could be used against you. Life insurance companies, for example, may deny coverage based on your health risks, including genetic information. The good news: The Genetic Information Nondiscrimination Act of 2008 (GINA) made it illegal for employers to discriminate or fire you because of your genetic makeup. GINA also prevents health insurers from denying coverage based on your genetic information.

If an at-home test reveals important information about your health, it’s time to contact your doctor. Most test companies will be happy to forward the results directly to your doctor or allow you to share them yourself.

Once you get your results, your primary care doctor may ask you to retake the genetic test, depending on the kind of DNA test you took. If you found out you’re at risk of high cholesterol, it may be as simple as watching what you eat or taking some medication.

The Angelina Jolie effect. However, if you find out you have a mutation for the BRCA1 or BRCA2 gene (which increases one’s risk of breast and ovarian cancers), it might be more complex. You’ll probably need to take more tests and meet with a clinical geneticist. In some instances, women may even have surgery to remove their ovaries and breasts (à la Angelina Jolie, who famously opted for a double mastectomy after discovering she carried a “faulty gene”). 23andMe recently became the first direct-to-consumer DNA test to start screening for BRCA gene mutations that increase the risk of breast cancer. However, the tests only screen for three mutations on the BRCA genes out of multiple possibilities. Some diseases, such as Alzheimer’s, have limited treatment options, so many question the value of knowing ahead of time.

Genetic testing is one piece of the health care pie. Many diseases, including cancer, can be traced to environmental conditions and personal choices.

“Genetics is amazing,” said Mayo Clinic researcher Matthew Ferber, “but for most healthy individuals, it only tells a part of the story. You still need to eat better, exercise, avoid smoking and alcohol, regardless of what your genetics tell you.”