Friday, October 4, 2013

Hacking Your Health

Recently "Hacking" has become a term that can been applied to just about any subject matter (see: Hacker Ethic).  For instance, "Hardware Hacking" is a largely accepted term by the InfoSec community and the idea of "Biohacking" is gaining ground.  This can range from medical implants to alternative diets (ex. Paleo) and the use of supplements.  You may already be doing it without even realizing it.  Have you ever increased your vitamin C intake to stave off a cold?  Drank ginger ale to calm an upset stomach?  These are simple examples of Biohacking.

Like any hack or professional penetration test you don't want to blindly attack a problem.  You need to gather intelligence first.  For Biohacking this can take the form of a DNA test.  In recent years genetic testing has become much more affordable.  At the forefront of personal testing for "Health, Disease & Ancestry" is 23andMe.

On August 17, 2013 I ordered two bio sample kits (one for me, one for my wife) and they arrived five days later.  The process is simple, you provide a saliva sample by spitting into a tube.  Initially, it looked like a large sample was required, however the tube is double walled and the inner tube is only about half the length of the outer tube (this separation is obscured by the label).  In reality, you only need about two milliliters to reach the fill line.  Once complete, you close the funnel which releases a "stabilization buffer" that mixes with your sample. You then remove the funnel, cap the tube, put it in a biohazard bag and mail it back in the included prepaid box.

The next part requires patience.  After 18 days I received a confirmation email that the sample had arrived at the lab and was being processed.  It took an additional 14 days to receive the initial results (health and limited genealogy).  The complete and final results arrived three days later.  Results are broken down into two sections, health and ancestry.

TL;DR Version: 23andMe provides a wealth of information for a relatively low cost.  I encourage you to get your own results.  If interested, please use this referral link: http://refer.23andme.com/v2/share/6224967130210323244



Health Results

I have to say I was surprised at the amount of detail that 23andMe provides and the number of levels you can drill down into each trait.  What I thought would take an hour or so ended up consuming my evening.  On the main page, 23andMe provides a health overview that lists your top 5 health risks, inherited conditions (genetic variations that have been strongly linked to particular diseases), likely physical traits and potential drug responses.  Each area can be expanded upon and risks/traits are rated on a scale from 1 to 4 stars:


Health Risks

23andMe covers a staggering 120 different types of health risks.  This ranges from various types of cancers and heart disease to skin conditions and restless leg syndrome.  Risks are divided into "Elevated Risks", "Decreased Risks" and "Typical Risks".  For those risks with a high level of confidence you are provided with your risk level (%) and the average risk (in my case, for "men of European ethnicity between the ages of 0 and 79").

Clicking on a disease opens up a plethora of information.  There are pages of information on your specific data along with numerous citations.  There are also tabs detailing the biology of the disease; resources, counseling and support services; a detailed technical report; and a community group.

23andMe considers some health risk information more sensitive than others.  These are defined as "serious diseases with no known cure for which a strong genetic factor has been established" (ex. Alzheimer's Disease).  You must accept an individual agreement specific to each sensitive risk before viewing the result.

Inherited Conditions 

This section displays 50 genetic variations that have been strongly linked to particular diseases.  All 50 traits have a high research confidence however, any result that is "Variant Absent" has a disclaimer which states: "This person does not possess this genetic variant.  It is possible he or she may have other variants linked to this condition that cannot be detected by 23andMe."  There is also a disclaimer stating that, "these reports cover only a subset of possible mutations that may be linked to a condition.  It is thus possible to have other mutations not covered by these reports."

Traits

23andMe states, "Some of our physical attributes are completely determined by genetics while others are influenced by many genetic as well as non-genetic factors.  This section includes easily detectable phenotypes like eye color, but also more subtle traits such as resistance to the Norwalk virus."

There are 60 different traits covered in this section of the report.  Each trait provides the same level of detail found under "Health Risks" and "Inherited Conditions".  Many of these are interesting curiosities such as, bitter taste perception, likely iris pattern and the estimated amount of caffeine consumed (high, low or average).  Others offer more useful information such as resistance to Malaria and HIV/AIDS or if you are likely to become lactose intolerant.

Drug Response

This section displays 24 genetic variations that have been linked to differences in how people respond to drugs.  This includes sensitivity and/or the likelihood of side effects.  These are more or less straight forward.  In my case it identified two drugs that would only require small doses for maximum effect, another drug that would require a significantly higher dose and a fourth that has a higher likelihood of side effects.

Interesting side note:  Two of the drug responses covered are, "Alcohol Consumption" (ability to break down acetaldehyde and associated cancer risks) and "Caffeine Metabolism" (whether drinking coffee increases a subject's heart attack risk).

Health Tools

Lastly, 23andMe offers some features that are still in development or require specialized knowledge.  There are currently three tools available:

ABO Blood Type:  This calculator factors the 25 different blood groups that determine a particular blood "type". (O, A, B, or AB, and positive or negative).  Additional technical details are provided along with a chart of applicable donor blood types you can accept and a break down of "Blood type frequencies (%) around the world".

Genetic Weight Calculator:  "Your genes influence your health and your appearance, so why not your weight as well? Two recent studies genotyped nearly 100,000 adults of European ancestry and confirmed six independent SNPs strongly associated with differences in body mass index (BMI)."  This calculator provides the supporting evidence we've become accustomed to with 23andMe.  In my case I can blame 4.47 pounds on my genetics.

Reynolds Risk Score:  This tool is used to calculate a 10-year risk for heart attack using your genetic data along with your current cholesterol and blood pressure.  The calculation provides you with the estimated current risk (%) as well as the estimated risk if you reduce your cholesterol by 40 points or your blood pressure by 20 points.

Risk Updates

Technology is constantly evolving and we are continually learning more about the human genome.  For no additional cost, 23andMe provides updates detailing new risks as they are discovered.  On any of the pages, you can click "See New and Recently Updated Reports" to display updated results along with the confidence level and date last updated.


This concludes my review of the health portion of my DNA analysis.  Personally, this report has given me a lot to think about and it may influence my medical care, especially later in life (while consulting with a doctor, of course).  If you are interested in obtaining your own results I encourage you to use this referral link: http://refer.23andme.com/v2/share/6224967130210323244



Continued in: Hacking Your Health Part II: Ancestry