I just took a DNA test: Turns out, my NQO1 gene is 100% inactive. My results don't exactly roll off the tongue à la Lizzo's lyrics — but they are, at least, actionable. The stat is one of 52 genetic markers that supplement company Rootine takes into account each time it formulates my personalized pack of daily multivitamins.
The brand belongs to a handful of next-gen nutrition start-ups bringing custom supplements on (metaphorical) steroids to market. Instead of "Complete an online quiz and get a personalized pill pack with your name on it!," in the vein of influencer favorite Care/Of and Persona Nutrition, Rootine and its contemporaries have customers go well beyond that by completing an online quiz, and a DNA test and, sometimes, a blood test. The resulting vitamins also have your name on them, of course, if only because a rendering of your unique, 23-chromosome genome sequence isn't as Instagrammable.
The field is known as nutrigenomics — "nutri" for nutrition, "genomics" for the study of genes — and it posits that the secret to total wellness may be hidden in your genetic code. "The hope is that once you understand someone's underlying predispositions, you can then create a personalized program that incorporates a variety of vitamins and addresses potential deficiencies," Dr. Richard Firshein, a leading expert in integrative and precision-based medicine and founder of the Firshein Center, tells Fashionista.
It's true that all humans, to some extent, have the same basic nutritional needs — recommended Daily Values are a thing for a reason — but there are a surprising number of mutations and markers that render generic DVs useless. Rootine checks for "52 genetic variations that have a proven impact on nutrient needs" when analyzing saliva samples from customers' at-home DNA testing kits, says co-founder Rachel Sanders.
Orthomolecular medicine company AOR recently released MyBlueprint, a DNA-informed health report that provides users with "84 SNPs, 65 genes, 41 clinical endpoints and eight key health categories" to inform their independent supplement purchases, or to review with a specialist — like "Epigenetic Human Potential Coach" and certified holistic nutritionist Lindsay Lekhraj. Lekhraj offers clients access to her preferred private clinical tests, too. "We currently test over 120,000 more gene variants than mainstream direct-to-consumer tests," she says.
In my case, one non-functioning NQO1 gene means my body can't efficiently convert enzyme Q10 into an antioxidant, so Rootine loads my multivitamin with other antioxidants, like vitamin C. But not too much vitamin C. "Excess vitamin C might lead to kidney stones, and excess B vitamins have been linked to a slightly increased risk of cancer," explains Dr. Firshein (two reasons he doesn't love when patients self-prescribe supplements).
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Luckily, Rootine and AOR screen for potential overdose situations, too. "For instance, for certain individuals with a genetic variation on the HFE gene, taking extra iron supplements can be similar to poisoning your body over time and may even lead to death," Dr. Daniel Wallerstorfer, a genetic scientist and co-founder of Rootine, says. "If we see the genetic variation on the HFE gene, we will remove iron from the vitamin packs."
This evidence-based approach seems straightforward and infallible (what's more trustworthy than hard-and-fast DNA data?), but — as with so many wellness innovations — it is not. "It's very difficult to determine how much vitamins or nutrients an individual needs strictly based on DNA," says Dr. Firshein. That's why Baze, a new startup backed by old-school vitamin company Nature's Way — to the tune of $6 million in Series A funding — creates custom vitamins based on at-home blood tests. "The problem with DNA is that it's static, and what you really want to know is what nutrients you need right here, right now," Phillip Schulte, the CEO and co-founder of Baze, tells Fashionista.
In Lizzo terms: Your DNA may say you're 100% that bitch — but other things can get in the way of you embodying that bitch, including lifestyle factors (are you sleeping enough?) and dietary factors (are you eating your vegetables?). "What we do at Baze is what basically any doctor would do. We look at your blood," Schulte says. "A blood test is by far the best, it's the gold standard."
Of course, in this case "best" is subjective, but blood tests do hold one distinct advantage over DNA tests: They measure change over time. "If you don't get the nutrients that you need [from our vitamins], you will see it in the lab test," Schulte explains. Baze sends customers a three-month supply of supplements based on the initial findings, and encourages them to re-test with every reorder; at which point, their personalized vitamins will be reformulated to accommodate changes.
Dr. Firshein is a fan of combining both technologies, saying, "I use DNA testing along with blood testing routinely in my practice, and I do feel it has added a critical dimension to how I treat my patients." (It's worth noting that although Rootine only offers at-home DNA kits, customers can also upload independent blood panels to their profile for more well-rounded results.) Lekhraj assesses her clients' nutritional needs by considering a host of indicators: DNA, blood, diet, current lifestyle, personal history and preferences and "other factors including methylation and metabolism." They agree that both DNA and blood tests can provide invaluable information about an individual’s nutrient needs — they're just not sold on the vitamin part.
"Ultimately, I'd rather teach a client how to optimize their nutrition with real food sources, which are more bioavailable," Lekhraj says. It's a valid concern: The supplement industry is famously under-regulated by the Food and Drug Administration, and there's no guarantee that a powder-filled plastic capsule will have any sort of bearing on a person's overall health. "In fact, on average, if you take 20 different nutrients, one will be harmful, two will have no effect and the rest will be incorrectly dosed,"Sanders says.
Baze and Rootine believe they've cracked the bioavailability code, though. Schulte claims Baze uses "high-potency supplements" sourced from Europe (the EU has stricter regulations than the U.S.) and promises results will be reflected in customers' periodic blood tests. Rootine, on the other hand, has engineered "innovative slow-release microbeads" to "deliver a customized dosage of vitamins into your bloodstream throughout the day, which is how your body naturally likes to absorb nutrients — in the same way it would from food," explains Sanders. Bonus: The microbeads are easier to swallow than traditional capsules, and can even be incorporated into smoothies, acai bowls and yogurt, like very healthy sprinkles.
As lovely as that sounds, I have to address double-helix-shaped elephant in the room: data. Services like Ancestry.com and 23andMe have shone a light on the potential dangers of sharing your DNA with genetic testing companies: Since the field is relatively new, there aren't many laws around genetic privacy. There are concerns your DNA may be sold to third parties, including marketers (who use it to fine-tune targeted ads) and "Big Pharma" (who use it to develop and profit off of new drugs). The online nature of these start-ups makes DNA data vulnerable to hacking, as was the case last year when 92 million accounts from MyHeritage "were found on a private server," according to CNBC. Genetic testing companies might give your DNA to law enforcement if asked; it's how the Golden State Killer was caught in 2018.
There's also the very rare but very real chance results will be inaccurate. (DNA testing, after all, is a hard science administered and processed by error-prone humans.) In one case, as reported by the Huffington Post, a woman opted to have a double mastectomy after discovering she was positive for the BRCA1 gene mutation. She wasn't.
Rootine, Baze, AOR and Lekhraj all address these concerns with a version of the same: None of their data is shared with third parties, ever. Samples are always "anonymized" through the use of a barcode system or a similar process. (Although, as Gizmodo reports: "It's debatable how anonymous that data really is. Researchers were able to find out a man's last name using only the short repeats on his Y chromosome and access to a genealogy database.") Rootine destroys DNA samples immediately after testing, AOR destroys them after six months and the lab Lekhraj uses only stores DNA data for 90 days. Tests have 99.97% accuracy.
Depending on your personal feelings about digital privacy, or whether you or a family member is a yet-uncaptured serial killer, handing over your DNA just might be worth the risk. "DNA testing was my last frontier in finding answers to my own ‘unsolvable’ health mysteries," Lekhraj reveals. "After living for years with undiagnosed food intolerances and autoimmune symptoms, I have connected all the missing dots through learning how to read and interpret genetic coding."
Her enthusiasm was so encouraging that I decided to re-up on Rootine vitamins; this time, adding the results from my latest blood test to the mix. My hope is that the dual power of DNA and a blood panel will help deflate my perma-bloat and fix my chronic fatigue. "Technology has come a long way in leading us in the right direction to streamline optimization, but it's not quite this simple yet," Lekhraj tells me in a mini-epigenetic coaching session. "The truth is, if someone isn't eating properly for their unique body, then taking a 'magic pill' isn't going to solve anything." In other words: I should probably cut back on the White Claw before placing my order. Truth hurts.