What Your Genes Can — and Can’t — Tell You: Genetic Testing in Functional Medicine

Many people first encounter genetic testing through direct-to-consumer DNA services. These tests may provide ancestry information, traits, or selected health-related reports, but understanding what a genetic result means for an individual’s health can be more complicated.

Clinical genetic testing can serve different purposes depending on the test being ordered and the medical question being evaluated. Some genetic findings have well-established clinical applications, while others have limited or uncertain significance.

At My Pure MD, genetic information may be considered as one part of a broader clinical evaluation when appropriate. It is not a standalone explanation for symptoms or a substitute for medical history, examination, appropriate diagnostic testing, or clinical judgment.

For patients interested in functional medicine in Houston, TX, understanding both the potential uses and limitations of genetic information is an important part of making informed healthcare decisions.

What Functional Medicine Genetic Testing Actually Looks At

Genetic testing examines DNA for specific changes or variants. Some panels evaluate single nucleotide polymorphisms, commonly called SNPs. These are variations at specific positions in DNA.

Some SNPs can influence biological functions, health-related traits, or disease susceptibility, while others have little or no established clinical significance. The meaning of a variant depends on the gene involved, the specific SNP, and the strength of the evidence linking it to a health outcome.

Depending on the purpose of testing, genetic information may involve areas such as:

• Folate and other metabolic pathways
• Drug metabolism and pharmacogenomics
• Certain inherited disease risks
• Nutrient-related biological pathways
• Immune or inflammatory pathways being investigated in genetic research

Importantly, accurately detecting a genetic variant does not automatically establish that the variant causes a patient’s symptoms or that acting on the result will improve health.

So How Is This Different From 23andMe?

Direct-to-consumer and clinician-ordered genetic tests can differ in their intended use, variants analyzed, laboratory methods, regulatory status, and interpretation.

Consumer testing may provide ancestry, trait, and selected health information. Clinician-ordered testing may instead be selected to address a particular medical question.

The distinction is not simply whether a test is consumer or clinician-ordered. The clinical value of a result depends on the validity of the test and the evidence supporting the relationship between a particular genetic finding and the health question being evaluated.

Results used in medical care should be interpreted alongside personal and family medical history, symptoms, medications, laboratory findings, and other relevant information.

For people considering holistic medicine in Houston, TX, this clinical context can help distinguish potentially useful genetic information from findings whose significance remains uncertain.

Gene Variants That May Come Up in Genetic Testing

Different genetic tests examine different variants, and their clinical usefulness varies.

MTHFR: MTHFR provides instructions for an enzyme involved in folate metabolism. Common variants can affect enzyme activity, but their presence does not automatically establish a folate deficiency, disease, or cause of nonspecific symptoms. The significance of a result depends on the reason for testing and the patient’s broader clinical circumstances.

COMT: COMT participates in the metabolism of catecholamines and other compounds. Genetic variants can affect enzyme activity, but a COMT result alone cannot reliably determine an individual’s mood, stress response, hormone status, or cause of symptoms.

Drug-metabolizing enzymes: Certain genetic variants can affect how specific medications are metabolized. For some gene-drug relationships, pharmacogenomic information can help clinicians assess medication response, dosing considerations, or adverse-effect risk. The usefulness of these findings depends on the specific medication and variant involved.

VDR (vitamin D receptor): VDR variants have been studied for their potential influence on vitamin D activity and their possible associations with different health outcomes. A genetic result alone, however, does not establish vitamin D status or determine an individual’s supplementation needs.

Immune and inflammatory pathways: Researchers have identified genetic variants associated with aspects of immune and inflammatory signaling. Many associations do not have established clinical utility, so these findings should not be used alone to explain the cause or severity of inflammatory symptoms.

How Genetic Data Gets Used in Practice

Genetic findings should not be reviewed in isolation. Depending on the clinical question, they may be considered alongside:

• Personal and family medical history
• Current symptoms and diagnoses
• Medications and supplements
• Relevant laboratory or diagnostic findings
• Nutrition and lifestyle factors
• Other clinically relevant information

In some situations, a clinically validated genetic finding can contribute useful information about inherited risk or medication response. In other situations, a variant may have uncertain significance and should not change treatment.

The distinction between detecting a variant and understanding its clinical significance is important. A laboratory may accurately identify a genetic change without that finding necessarily explaining a symptom, establishing a diagnosis, or indicating that a particular treatment is needed.

For people exploring alternative medicine in Houston, TX, genetic testing should therefore be considered according to the specific clinical question and the evidence supporting the test.

What Genetics Can’t Tell You

Genetic information can offer valuable health-related information, although its clinical usefulness has important limits.

For many common and complex health conditions, a genetic result cannot determine with certainty whether a disease will develop, when it might occur, or how severe it may become.

A genetic variant also does not automatically establish:

• The cause of a current symptom
• A nutrient deficiency
• The need for a particular supplement
• Whether a specific treatment will work
• Whether lifestyle or environmental factors will alter an individual’s risk

Genetic predisposition does not necessarily determine an individual’s health outcome. Genes interact with other genetic, environmental, behavioral, and biological factors.

Some genetic findings have well-established clinical implications. Others remain areas of ongoing research. Understanding that distinction is essential when deciding whether a result should influence medical care.

For patients searching for naturalistic medicine nearby, the value of genetic testing lies in careful interpretation of clinically relevant findings rather than treating every reported variant as an explanation for symptoms.

Who Is Most Likely to Benefit?

Whether genetic testing is appropriate depends on the clinical question being investigated.

Testing may be considered when:

• Personal or family medical history suggests that a genetic finding could provide clinically relevant information
• A healthcare professional suspects an inherited condition for which appropriate genetic testing is available
• A clinically supported pharmacogenomic test could help inform a specific medication decision
• A previous genetic finding requires further clinical interpretation

Testing simply because someone has persistent or unexplained symptoms does not guarantee that a meaningful genetic explanation will be identified.

Before testing, patients should understand what the test examines, why it is being considered, what its limitations are, and whether the results are likely to influence medical management.

FAQ: Genetic Testing and Functional Medicine

• Is functional medicine genetic testing the same as 23andMe?

  Not necessarily. Direct-to-consumer and clinician-ordered genetic tests can differ in purpose, variants analyzed, laboratory methods, regulatory status, and interpretation. Some consumer tests also provide health-related information. A healthcare professional can assess the clinical significance of a result and determine if further testing should be considered.

• Does having a variant mean I’ll develop a disease?

  No. The meaning of a genetic variant depends on the particular gene and condition. Some variants substantially influence the likelihood of specific inherited disorders, while others modestly affect risk or have uncertain significance. Medical history, family history, environmental factors, and other genetic factors may also influence health outcomes.

• What is MTHFR and why does it come up so often?

  The MTHFR gene contains the genetic instructions needed to produce an enzyme that plays a role in processing folate. Common MTHFR variants can alter enzyme activity, but a variant alone does not establish a nutrient deficiency, diagnose a disease, or explain nonspecific symptoms. Its clinical relevance depends on the reason for testing and the individual’s overall medical circumstances.

• Do I need genetic testing to work with the practice?

  No. Genetic testing is one potential source of clinical information and is not appropriate or necessary for every patient. Whether testing may be useful depends on the individual’s medical and family history, clinical circumstances, and the specific question the test is intended to address.

• How is genetic data protected?

  Genetic information maintained as part of a patient’s medical record is handled in accordance with applicable privacy requirements and the practice’s privacy policies. Patients who have questions about how their information may be used or disclosed should review the practice’s Notice of Privacy Practices or contact the practice directly.

  This information is provided for educational purposes and should not replace personalized medical advice, diagnosis, or treatment from a qualified healthcare professional. The clinical significance of genetic results varies by test and individual circumstances.

Dr. Kirmani, MD

Doctor of Medicine (MD)

Board Certified in Internal Medicine (ABIM)

Board Certified in Integrative Medicine (ABOIM)

Certified in Functional Medicine (IFMCP)

Bredesen Alzheimer’s Protocol Certified (RECODE)

International Society of Environmentally Acquired Illness (ISEAI) – Diplomat Member