Go Beyond the Basics with Biannual Blood Tests

A woman in a pool with the words

By Tomi Oyedeji-Olaniyan, 23andMe Medical Communications Associate

Editor’s note: This is the second blog in a series about 23andMe+ Total Health™ and how it can aid healthcare providers in providing patient care.

While genetics offer insight into the future, blood testing gives insight into the now. 

23andMe+ Total Health includes both, providing patients with biannual blood labs* that examines over 55 biomarkers. These include measuring important blood tests like glucose and lipids, as well as kidney, liver and thyroid function.With ~70 percent of clinical decisions relying on blood tests and lab data1, according to the Centers for Disease Control Division of Laboratory Systems, it’s important to get it right. Furthermore, Total Health members can expect to receive a comprehensive risk assessment that considers all these factors, including blood testing, family history, exome sequencingΔ, and lifestyle choices. It is clear that blood testing is a crucial piece of puzzle in helping patients to work toward total health. Here’s how Total Health goes beyond routine care to paint a fuller picture of a patient’s health through regular blood labs and analysis.  

How We Do It Differently 

Total Health includes labs ordered as part of routine checkups. But how do we go beyond standard care? What sets our blood tests apart from a typical clinical checkup? Read on to learn more:

Markers that Matter  

Total Health blood tests cover over 55 biomarkers, including:

  • A comprehensive blood count panel (CBC)
  • A comprehensive metabolic panel (CMP)
  • Hemoglobin A1c (HbA1c)
  • Thyroid Stimulating Hormone (TSH)
  • Advanced lipid panel including Lipoprotein(a) (Lp(A)) and Apolipoprotein B (ApoB)

The test goes beyond routine blood panels by measuring lesser-known yet highly informative biomarkers, such as Lp(a) and ApoB. Lp(a) is a specific type of low-density lipoprotein that carries cholesterol through the bloodstream and is an independent and causal risk factor for cardiovascular conditions. Elevated levels indicate a higher risk of heart disease, stroke, and heart attack and research also links Lp(a) to processes like atherogenesis, chronic inflammation, and thrombosis. 2, 3 Lp(a) levels are largely driven by genetic factors.ApoB is another vital biomarker, as it serves as a proxy for all atherogenic particles in the blood. Elevated ApoB levels have been associated with an increased risk for cardiovascular disease and type II diabetes mellitus (DM).  Some healthcare providers believe ApoB is a better measure of cardiovascular risk than a traditional lipid panel.4 Ultimately, abnormal values of both Lp(a) and ApoB can indicate an increased risk for cardiovascular disease. By checking both of these metrics, we gain insights that go beyond traditional blood testing, identifying risks that might otherwise be missed.

In addition to this, our blood testing evaluates a broad range of organ function, including liver, renal, and blood health, providing a holistic view of the patient’s health. It is important to note that this is not a one-time service. Similarly to a regular checkup, we encourage patients to stay on top of their health through biannual blood testing. Patients can have their results shared with their PCP or other members of their care team providing information that can better inform PCPs in developing a personalized care and prevention plan.

Sample report for biological age

Biological Age

Your patients may be older than you think. Total Health calculates your patient’s biological age based on how

 their body systems function as measured through a carefully chosen selection of 13 blood-based biomarkers and powerful AI modeling. Biological age is useful because it is a better predictor of several age-related health conditions including type 2 diabetes and heart attack. Instead of just

 considering calendar age, using biological age offers patients an accessible way of visualizing their overall health. It also provides an opportunity for patient engagement as patients are encouraged to track their biology over time and may be more motivated to take healthy steps to reduce their biological age. To learn more about biological age, read our whitepaper on the model. 

 

 

What does this mean for my practice?

While blood tests are not new to clinical practice, 23andMe is seeking to provide more comprehensive information within a clinician-guided setting and empower patients to be active participants in their care. Patients can play an active role in keeping up with their blood testing and creating an action plan to achieve their health goals. You might soon see a patient come to their appointment whose blood biomarker results from 23andMe indicate they need to be followed up with and treated for high cholesterol for example. Such a situation presents an opportunity to discuss how lifestyle and dietary choices can impact one’s risk of high cholesterol. The goal of 23andMe+ Total Health regular blood tests is for the resulting information to be both accessible and actionable. 

Learn more about blood testing at 23andMe+ Total Health and stay tuned for the release of our 23andMe+ Total Health blood testing sample reports. For more information on how to discuss and interpret 23andMe reports, you can watch our genetic education videos. 

*Blood testing services are available to eligible customers over 18 years of age after completion of an intake questionnaire that must be reviewed, approved and ordered by a third-party clinician. Lab services are not available in NY, NJ, RI, HI, PR. Find a lab service location near you. 

ΔExome Sequencing and blood testing services are available to eligible customers upon completion of the intake questionnaire that must be reviewed, approved and ordered by a third-party clinician. Exome Sequencing is analyzed by a CLIA- and CAP-accredited laboratory. Blood testing is completed by Quest Diagnostics. All telehealth services are provided in accordance with the Telehealth Terms and Consent to Telehealth.

References:

  1. Sikaris KA. Enhancing the Clinical Value of Medical Laboratory Testing. Clin Biochem Rev. 2017 Nov;38(3):107-114; Source: National Library of Medicine
  2. Nurmohamed, N. S., Gaillard, E. L., Malkasian, S., de Groot, R. J., Ibrahim, S., Bom, M. J., … Knaapen, P. (2024). Lipoprotein(a) and long-term plaque progression, low-density plaque, and pericoronary inflammation. JAMA Cardiology, 9(9), 826. 
  3. Di Fusco, S. A., Maggioni, A. P., Scicchitano, P., Zuin, M., D’Elia, E., & Colivicchi, F. (2023). Lipoprotein (a), inflammation, and atherosclerosis. Journal of Clinical Medicine, 12(7), 2529. 
  4. Cleveland Clinic (2024). What’s an apo B test? Retrieved from https://my.clevelandclinic.org/health/diagnostics/24992-apolipoprotein-b-test 

 

* The 23andMe PGS test includes health predisposition and carrier status reports. Health predisposition reports include both reports that meet FDA requirements for genetic health risks and reports which are based on 23andMe research and have not been reviewed by the FDA. The test uses qualitative genotyping to detect select clinically relevant variants in the genomic DNA of adults from saliva for the purpose of reporting and interpreting genetic health risks and reporting carrier status. It is not intended to diagnose any disease. Your ethnicity may affect the relevance of each report and how your genetic health risk results are interpreted. Each genetic health risk report describes if a person has variants associated with a higher risk of developing a disease, but does not describe a person's overall risk of developing the disease. The test is not intended to tell you anything about your current state of health, or to be used to make medical decisions, including whether or not you should take a medication, how much of a medication you should take, or determine any treatment. Our carrier status reports can be used to determine carrier status, but cannot determine if you have two copies of any genetic variant. These carrier reports are not intended to tell you anything about your risk for developing a disease in the future, the health of your fetus, or your newborn child's risk of developing a particular disease later in life. For certain conditions, we provide a single report that includes information on both carrier status and genetic health risk. Warnings & Limitations: The 23andMe PGS Genetic Health Risk Report for BRCA1/BRCA2 (Selected Variants) is indicated for reporting of 44 variants in the BRCA1 and BRCA2 genes. The report describes if a person's genetic result is associated with an increased risk of developing breast cancer and ovarian cancer and may be associated with an increased risk for prostate cancer, pancreatic cancer, and potentially other cancers. The variants included in this report do not represent the majority of the BRCA1/BRCA2 variants in people of most ethnicities. This report does not include variants in other genes linked to hereditary cancers and the absence of variants included in this report does not rule out the presence of other genetic variants that may impact cancer risk. This report is for over-the-counter use by adults over the age of 18, and provides genetic information to inform discussions with a healthcare professional. The PGS test is not a substitute for visits to a healthcare professional for recommended screenings or appropriate follow-up. Results should be confirmed in a clinical setting before taking any medical action. For important information and limitations regarding each genetic health risk and carrier status report, visit 23andme.com/test-info/

**23andMe PGS Pharmacogenetics reports: The 23andMe test uses qualitative genotyping to detect 3 variants in the CYP2C19 gene, 2 variants in the DPYD gene and 1 variant in the SLCO1B1 gene in the genomic DNA of adults from saliva for the purpose of reporting and interpreting information about the processing of certain therapeutics to inform discussions with a healthcare professional. It does not describe if a person will or will not respond to a particular therapeutic. Our CYP2C19 Pharmacogenetics report provides certain information about variants associated with metabolism of some therapeutics and provides interpretive drug information regarding the potential effect of citalopram and clopidogrel therapy. Our SLCO1B1 Pharmacogenetics report provides certain information about variants associated with the processing of some therapeutics and provides interpretive drug information regarding the potential effect of simvastatin therapy. Our DPYD Pharmacogenetics report does not describe the association between detected variants and any specific therapeutic. Results for DPYD and certain CYP2C19 results should be confirmed by an independent genetic test prescribed by your own healthcare provider before taking any medical action. Warning: Test information should not be used to start, stop, or change any course of treatment and does not test for all possible variants that may affect metabolism or protein function. The PGS test is not a substitute for visits to a healthcare professional. Making changes to your current regimen can lead to harmful side effects or reduced intended benefits of your medication, therefore consult with your healthcare professional before taking any medical action. For important information and limitations regarding Pharmacogenetic reports, visit 23andme.com/test-info/pharmacogenetics/