Among his many jobs as 23andMe senior scientist in statistical genetics, Suyash Shringarpure, Ph.D. leads some of our rare disease discovery and prediction work.
But since first coming here in 2016, he’s been involved in a wide variety of projects all leaning on his extensive background in machine learning. Suyash came here after doing post-doctoral work in Carlos Bustamante’s Lab at Stanford University where he worked on genetic data privacy, ancestral inference, and next-generation genetic sequencing. He received his Ph.D. in Machine Learning from Carnegie Mellon University, and he received his undergraduate degree in Computer Science and Engineering from the Indian Institute of Technology in Bombay.
<div id="attachment_28941" style="width: 228px" class="wp-caption alignright"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-28941" src="https://blog-api.23andme.com/wp-content/uploads/2021/06/©PITER2017Suyash-Shringarpure2649-218x300.jpg" alt="" class="wp-image-28941 size-medium" width="218" height="300" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/06/©PITER2017Suyash-Shringarpure2649-218x300.jpg 218w, https://blogcms.23andme.com/wp-content/uploads/2021/06/©PITER2017Suyash-Shringarpure2649-768x1056.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2021/06/©PITER2017Suyash-Shringarpure2649-745x1024.jpg 745w, https://blogcms.23andme.com/wp-content/uploads/2021/06/©PITER2017Suyash-Shringarpure2649-640x880.jpg 640w, https://blogcms.23andme.com/wp-content/uploads/2021/06/©PITER2017Suyash-Shringarpure2649-858x1180.jpg 858w, https://blogcms.23andme.com/wp-content/uploads/2021/06/©PITER2017Suyash-Shringarpure2649-scaled.jpg 1862w" sizes="auto, (max-width: 218px) 100vw, 218px" />Suyash Shringapure, Ph.D., a 23andMe senior scientist, and statistical geneticist.</div>
There’s a lot we could talk about because his work touches so many parts of the company — from research and development for our health product team, to work in support of Therapeutics, to some of the backend technical efforts related to things like the phasing of genetic data. But we sat down, virtually, to talk to Suyash specifically about his work on rare diseases at 23andMe. This is one in an occasional series we’ve been doing over the last few months looking at rare diseases. Suyash recently spoke about his research at the National Press Foundation as part of <a href="https://hopin.com/events/rare-and-mystery-diseases">a session on rare diseases</a>. (We will post a recording of the session when it becomes available.) 
In the spring we published new research led by Suyash looking specifically at the unique way 23andMe can<a href="https://blog.23andme.com/23andme-research/new-way-to-study-rare-disease/"> study rare diseases.</a> It offered some unexpected insights into these hard-to-study conditions.
“This approach will enable us to discover new genetic associations across multiple populations much faster than could be done otherwise,” he said at the time.
Read on to find out more about what he had to say:
<h6>Even before you came to 23andMe, you were known for using machine learning and statistical methods for work on a broad range of different scientific problems. Why is machine learning such a powerful tool in genetics and biology and for the study of disease?</h6>
Genetics has become a data-rich field in the last couple of decades. There are now many large human genetic (and gene expression etc.) datasets available for researchers. Because the genetic risk for most common diseases is an aggregate of many different genetic variants — sometimes hundreds even thousands of variants — machine learning and statistical methods offer a powerful tool in calculating disease risk. In genetics and biology, these algorithms can infer the small contributions of many genetic variants and combine them appropriately to describe disease risk.
<h6>Why are you and other scientists at 23andMe so interested in rare diseases, and why are we studying<a href="https://www.23andme.com/systemic-sclerosis-study/"> systemic sclerosis</a>, and<a href="https://www.23andme.com/idiopathic-pulmonary-fibrosis/"> idiopathic pulmonary fibrosis (IPF)</a> in particular?</h6>
Though each rare disease only affects a small number of people, there are nearly 7000 known rare diseases, and the total number of people affected by rare diseases is quite large. It’s estimated that about 20-25 million Americans and 300 million people worldwide are living with a rare disease. In addition, about 70 percent of all rare diseases are genetic, while only 5 percent of all rare diseases have approved treatments. So there is a large unmet need for therapeutics for rare diseases, which is why we at 23andMe are so interested. Beyond the need, our large database is also well-suited for studying rare diseases. It’s often difficult to study rare diseases because it is a challenge to find enough individuals to participate in research. But 23andMe now has enough people who have consented to participate in research that we can more quickly gather enough individuals with a specific rare disease to find statistically robust genetic associations.
Idiopathic pulmonary fibrosis (IPF) is a life-threatening, progressive lung disease with a median survival of three to five years after diagnosis. The genetics of IPF is not well-understood, and at present, there are only two FDA-approved therapies, and unfortunately, neither is always well-tolerated by patients. We believe we can use our research model to find insights into the disease, and that’s why we started our <a href="https://www.23andme.com/idiopathic-pulmonary-fibrosis/">IPF Study</a>.
Similar to IPF, Systemic sclerosis is a rare disease for which there is an unmet need for treatments. Systemic sclerosis is an autoimmune disease that affects the skin and internal organs, and we don’t fully understand the genetics of the disease.  Much like with our IPF Study, we launched our <a href="https://www.23andme.com/systemic-sclerosis-study/">Systemic Sclerosis Study</a> to better understand the genetics of the condition and to improve our ability to discover new genetic associations for these diseases.   
<h6>You completed an <a href="https://blog.23andme.com/23andme-research/new-way-to-study-rare-disease/">interesting study</a> using 23andMe’s unique research model to study rare diseases. Were those findings a surprise when you made them?</h6>
Some of them were definitely a surprise. We have lots of experience in studying common diseases, where we need to have tens of thousands of affected individuals in our study to find statistically significant genetic associations. It was a surprise for us when we were able to find genetic associations in studies of rare diseases with only tens of affected individuals. Another surprise was finding that common genetic variants show association with rare disease risk. Previously, it has been found that rare genetic variants cause rare diseases, so this was unexpected. Unsurprisingly, we found that similar regions of the genome contribute to risk in different populations and that aggregating data across all populations enables us to make the most discoveries. 
<h6>What makes 23andMe’s research model unique for studying rare diseases?</h6>
The main bottleneck in studying rare diseases is finding enough people with the condition to participate in the research. 23andMe’s large research-consented cohort means that even for a disease that affects one-in-100,000 people, we can find nearly 100 affected individuals for our analysis. The self-reported data-collection model we have also allowed us to study thousands of diseases at once, rather than studying one disease at a time. So for example, in the study we just published on the preprint server <a href="https://www.medrxiv.org/content/10.1101/2021.06.09.21258643v1">MedRxiv</a>, we did genome-wide association studies (GWAS) on 33 different rare diseases. For three of those rare diseases, our GWAS was the first-ever done on those conditions. So the unique features of 23andMe’s research database allowed us to find the results included in our study. Another unique feature is that through additional surveys, we can also find associations of rare diseases with other traits/diseases. For example, <a href="https://blog.23andme.com/23andme-research/insights-from-ipf-study/">early insights</a> from our IPF study show that IPF patients are more likely to report having gastrointestinal reflux, shortness of breath, depression, and anxiety. 
<h6>What are you currently working on?</h6>
On the rare disease front, we are continuing to recruit IPF and Systemic sclerosis patients for our ongoing studies. We are also studying genetic associations for more diseases, as our cohort keeps growing. Outside of that, my team and I are working on trying to improve disease risk prediction, specifically on how to make genetic risk predictions accurate for all populations, and how to combine genetic and non-genetic data for risk prediction.
<h6>Have you learned anything interesting from your own 23andMe results?</h6>
I’ve never been a regular coffee drinker, even in graduate school, when many people are heavy coffee drinkers. Turns out I’m genetically less likely than average to drink caffeine, according to my 23andMe Caffeine  Consumption Wellness report! 
 
&nbsp;

23andMe Blog

23andMe Blog Team

Talking About Rare Disease with Senior Scientist Suyash Shringarpure

Editor&#8217;s Note: This post was updated 1/5/2022 with video comments from some of our customers. 
We’ve made some important updates to give customers greater control over tailoring their product experience so it more accurately reflects their gender.
23andMe now allows customers to distinguish between their sex assigned at birth and their gender. This allows all customers, but especially our transgender and/or non-binary customers, to have their gender accurately reflected in relevant product features, during their interactions with other customers they choose to make connections with, and if they choose to participate in DNA Relatives.
Current customers can take advantage of these updates by adding their gender and preferred relationship labels in their <a href="https://you.23andme.com/user/">Account Settings</a>.
<h6>Why have we made these changes?<img loading="lazy" decoding="async" class="alignright wp-image-29099 size-full" src="https://blog-api.23andme.com/wp-content/uploads/2021/08/account-gender-settin-page.png" alt="" width="236" height="512" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/08/account-gender-settin-page.png 236w, https://blogcms.23andme.com/wp-content/uploads/2021/08/account-gender-settin-page-138x300.png 138w" sizes="auto, (max-width: 236px) 100vw, 236px" /></h6>
As part of our commitment to <a href="https://www.23andme.com/diversity-equity-inclusion">diversity, equity, and inclusion</a>, we are continually improving our product to reflect the diversity of all of our customers. This particular update was in response to customers who want their 23andMe profiles to more accurately reflect their gender. Not only that, but it&#8217;s the right thing to do. Our trans and non-binary customers have every right to see themselves reflected accurately in their 23andMe experience. And we want them to be able to participate in all of the features 23andMe offers safely and as their full, authentic selves.
<h6>What has changed?</h6>
After consulting our 23andMe LGBTQ+ Employee Resource Group and a focus group of transgender customers, 23andMe has added the option for customers to provide their gender (including a non-binary option), in addition to their birth sex, during account registration and in their Account Settings. 
If a customer chooses to opt in to research, their gender may be included, but it is always de-identified from their genetic information. Additionally, if they indicate their gender is not the same as their birth sex, they will receive additional messaging about their health reports.
Customers can also now decide if they would like to have masculine, feminine, or gender-neutral relationship labels (e.g., brother, sister, or sibling) shown to their connections and DNA relatives (if they choose to opt into these features).
23andMe will continue to use a customer&#8217;s birth sex as a part of our laboratory quality control steps. This is because if someone’s self-reported sex doesn’t match what we’ve determined from our analysis of their DNA, we want to make sure there wasn’t an error in processing. We will also continue to use a customer&#8217;s birth sex to help us deliver or interpret results for certain health, wellness, and traits topics.
All of this information can be changed at any time in a user&#8217;s Account Settings.
We hope these changes will start to make our product more inclusive for our transgender and non-binary customers. As more research becomes available, for example on how hormone replacement therapy may affect risk estimates, we hope to keep improving our product so that it is more relevant for these customers. We also know we have more work to do (for example, for our intersex customers) to make sure everyone has the opportunity to access, understand, and benefit from the human genome.
More reading:
<ul>
<li aria-level="1"><a href="https://customercare.23andme.com/hc/en-us/articles/360010964373-How-23andMe-uses-your-self-reported-Sex">How 23andMe Uses Your Self-Reported Sex</a></li>
<li aria-level="1"><a href="https://blog.23andme.com/23andme-research/how-was-your-sex-determined-it-might-be-a-lot-more-complicated-than-you-think/">How was your sex determined? It might be a lot more complicated than you think</a></li>
<li aria-level="1"><a href="https://blog.23andme.com/articles/diversity-equity-inclusion">23andMe’s Commitment to Diversity, Equity &amp; Inclusion</a></li>
</ul>


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Making 23andMe More Inclusive for All Genders

By Daniella Coker, MPH, and Janie Shelton, Ph.D.*
Several studies show the three COVID-19 vaccines being used in the United States — from Johnson &amp; Johnson (J&amp;J), Moderna, and Pfizer — are safe<a href="https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/safety-of-vaccines.html">1,</a>2 and effective2,<a href="https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effectiveness/work.html">3</a>  and offer the best hope to beat the pandemic.2,4 And as so many of us have gotten vaccinated, it’s impossible not to notice that people react differently to the vaccines. Many people report having no reaction, while others feel sick enough to stay home in bed. 23andMe researchers wanted to know more about why. Is it due to the type of vaccine, our age, or something else?
To learn more about these differences we analyzed the data from more than 100,000 23andMe consented research participants and found that the second in the two-shot vaccine from Moderna produced the strongest reactions. We also learned that younger people and women tended to react more to the vaccine than others.
<h2>Get Vaccinated</h2>
But before going into what our researchers found, we should be clear: The side effects of vaccines are minimal, while the risks from the virus caused by COVID-19 are severe. This was further confirmed by new <a href="https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e4.htm?s_cid=mm7032e4_w">data from the CDC</a>.  More than 35 million people in the United States have contracted the virus caused by COVID-19, and 614,000 of them have died. Even with the emerging Delta variant cases, the most significant risk is remaining unvaccinated. We encourage people to take the advice of healthcare professionals, the <a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines/advice">World Health Organization</a>, state and local public health officials, and the CDC and get vaccinated. 
23andMe’s researchers wanted to examine differences in how sick people felt after receiving the vaccines. Now that more than half the U.S. population has been fully vaccinated and about 60 percent have had at least one shot,<a href="https://covid.cdc.gov/covid-data-tracker/#vaccinations">5</a> our scientists wanted to explore how people react differently to different vaccines and what factors may influence those differences. This study does not look at adverse reactions but categorizes how people felt after they were vaccinated and compares the degree of “feeling sick” between three different vaccines.
For 23andMe’s study, consented research participants were asked three questions: (1) What was their most recent COVID-19 vaccination? (2) What symptoms, if any, did they experience? and (3) How sick did they feel afterward.
Most research participants reported that their most recent vaccination was their second dose of either the Pfizer (44%) or Moderna (38%) vaccine.

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="260" height="167" src="https://blogcms.23andme.com/wp-content/uploads/2021/08/sample-size.png" alt="" class="wp-image-29110"/></figure>
 
Approximately half of respondents didn’t feel sick, 40% felt a little or somewhat ill, and 10% felt very or extremely sick. And to be clear, “feeling sick” as a reaction to the shot is not the same as being clinically sick from the virus and requiring hospitalization. 23andMe scientists sought to describe and characterize this wide range of reactions to the COVID-19 vaccines.
Here are some of the key findings:
<h2>The second Moderna shot seemed to produce the strongest reactions</h2>
Compared to the other vaccines, it was those people with a second dose Moderna vaccination who most often reported experiencing any symptoms (85%), and most often reported feeling either very or extremely sick (18%) after their vaccination. Again, these differences were not related to clinical outcomes. In other words, these are relatively modest reactions to the vaccines, but the vaccines still offered strong protection against the virus. In addition, these reactions were generally only for a couple of days after the vaccination. Whereas the severity of COVID-19 infections includes potential weeks or months of hospitalization or death. In addition, scientists still don’t fully know the timeline for so-called COVID-19 “longhaulers,” people dealing with lingering symptoms long after being infected.

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="512" height="314" src="https://blogcms.23andme.com/wp-content/uploads/2021/08/vaccine-reaction-by-type.png" alt="" class="wp-image-29111" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/08/vaccine-reaction-by-type.png 512w, https://blogcms.23andme.com/wp-content/uploads/2021/08/vaccine-reaction-by-type-300x184.png 300w" sizes="auto, (max-width: 512px) 100vw, 512px" /></figure>
 
Fatigue, pain at the injection site, and muscle/body aches were the most commonly reported symptoms for all vaccine types. Yet, for every symptom (except nausea), a larger portion of Moderna’s second-dose recipients reported experiencing that symptom compared to recipients of other vaccines.

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="512" height="106" src="https://blogcms.23andme.com/wp-content/uploads/2021/08/vaccine-matrix.png" alt="" class="wp-image-29112" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/08/vaccine-matrix.png 512w, https://blogcms.23andme.com/wp-content/uploads/2021/08/vaccine-matrix-300x62.png 300w" sizes="auto, (max-width: 512px) 100vw, 512px" /></figure>
 
And in logistic regression models controlling for key demographics (age, sex, BMI, ethnicity, education, and history of COVID-19 infection), having received a second Moderna shot was significantly associated with 3x odds of experiencing any symptom and nearly 1.5x odds of feeling very or extremely sick (as compared to J&amp;J).
So, you are not imagining things &#8212; if you got the Moderna 2nd dose and felt “under the weather”, you are not alone. A lot of people did (nearly 1 in 5), but for <a href="https://www.cdc.gov/vaccines/covid-19/info-by-product/moderna/moderna-faqs.html#vaccine-safety-efficacy">94.1% effectiveness</a> against COVID-19, we are all applauding those of you who suffered through a few days of discomfort for your and the greater good.
<h2>A history of COVID-19 infection associated with feeling sicker </h2>
You may have heard the rumor that people who have had COVID-19 are more likely to feel sick after receiving a vaccine. According to 23andMe data, that seems to be true — a larger proportion of consented research participants previously infected with COVID-19 reported feeling sick for every degree of sickness (from “a little” to “extremely”) compared to those not previously infected with COVID-19. In fact, only a third of participants with a previous infection experienced no symptoms from their vaccine, compared to half of those without a COVID-19 history.

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="512" height="285" src="https://blogcms.23andme.com/wp-content/uploads/2021/08/How-Sick-do-you-feel.png" alt="" class="wp-image-29113" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/08/How-Sick-do-you-feel.png 512w, https://blogcms.23andme.com/wp-content/uploads/2021/08/How-Sick-do-you-feel-300x167.png 300w" sizes="auto, (max-width: 512px) 100vw, 512px" /></figure>
 
Even after controlling for the key demographic variables listed above, having a history of a COVID-19 infection increased your odds of experiencing any symptoms or feeling very/extremely sick after your vaccination, both by about 30%.
<h2>More and stronger reactions for women and younger individuals</h2>
Women were more likely to have any symptoms, have more whole body (systemic) symptoms, and generally feel sicker following their vaccination compared to men.  

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="512" height="314" src="https://blogcms.23andme.com/wp-content/uploads/2021/08/vaccin-reaction-by-sex.png" alt="" class="wp-image-29114" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/08/vaccin-reaction-by-sex.png 512w, https://blogcms.23andme.com/wp-content/uploads/2021/08/vaccin-reaction-by-sex-300x184.png 300w" sizes="auto, (max-width: 512px) 100vw, 512px" /></figure>
 
In fact, after controlling for potential confounders, women were almost twice as likely as men to have felt very or extremely ill.
Similar trends were observed for younger individuals when compared to older folks. Those 40 years of age and younger experienced between 2 and 3 whole-body symptoms on average, and nearly a quarter felt very or extremely sick. By contrast, those at least 75 years old experienced between 0 and 1 whole-body symptoms on average, and only 4% felt very ill.

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="512" height="315" src="https://blogcms.23andme.com/wp-content/uploads/2021/08/vaccine-reaction-by-age.png" alt="" class="wp-image-29109" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/08/vaccine-reaction-by-age.png 512w, https://blogcms.23andme.com/wp-content/uploads/2021/08/vaccine-reaction-by-age-300x185.png 300w" sizes="auto, (max-width: 512px) 100vw, 512px" /></figure>
 
These relationships between sex, age, and vaccine reaction held up, even after controlling for potential confounders.
<h2>How do the COVID-19 vaccines work?</h2>
The COVID vaccines teach your immune system to recognize and respond to the virus that causes COVID-19. The vaccines introduce genetic instructions to make a harmless protein that is unique to the virus. This triggers a two-step immune response: a first, more immediate and non-specific reaction (the innate immune response), followed by a more gradual, pathogen-specific reaction (the adaptive immune response).<a href="https://www.healio.com/hematology-oncology/learn-immuno-oncology/the-immune-system/the-innate-vs-adaptive-immune-response">6</a>
But why do some people feel very sick from their COVID-19 vaccine, and others don’t feel sick at all? Scientists aren’t quite sure why that is. However, data points to the immune system.
<h2>What does my vaccine reaction mean?</h2>
Trends identified in 23andMe data support what the vaccine clinical trials and other studies have observed — that certain groups of people are more likely to have felt sicker from their COVID-19 vaccination. These include:
<ul>
<li aria-level="1">Women<a href="https://www.cdc.gov/mmwr/volumes/70/wr/mm7008e3.htm">7</a></li>
<li aria-level="1">Younger people<a href="https://www.cdc.gov/mmwr/volumes/70/wr/mm7008e3.htm">7,</a> 8,9,<a href="https://www.cdc.gov/vaccines/covid-19/info-by-product/janssen/reactogenicity.html">10</a></li>
<li aria-level="1">Recipients of a second dose vaccine (compared to their first dose)8,9,<a href="https://jamanetwork.com/journals/jama/fullarticle/2778441">11</a></li>
</ul>
Women, for instance, seem to have stronger immune reactions than men. Research for other types of vaccinations, such as for influenza, yellow fever, and hepatitis, showed that women produce more infection-fighting antibodies than men following vaccination.<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7438701/">12</a> Hormonal and genetic differences between the sexes may also play a role in how the immune systems of men and women respond differently to vaccinations. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7438701/">12,</a><a href="https://www.sciencedirect.com/science/article/pii/S1028455920302175">13</a>
As we age, our immune systems tend to weaken.<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3901832/">14</a> This may explain why younger adults were generally more likely to report a larger number of and more severe symptoms following their vaccination compared to older adults, as seen in data from 23andMe consented research participants and elsewhere, including the vaccines’ clinical trials.<a href="https://www.cdc.gov/mmwr/volumes/70/wr/mm7008e3.htm">7,</a>8, 9, <a href="https://www.cdc.gov/vaccines/covid-19/info-by-product/janssen/reactogenicity.html">10</a>
By the time you receive a second dose, your body has already become primed to recognize and respond to the virus that causes COVID-19, and as a result your immune system responds faster and stronger. <a href="https://www.gavi.org/vaccineswork/why-vaccine-side-effects-might-be-more-common-people-whove-already-had-covid-19">15,</a><a href="https://www.nationalgeographic.com/science/article/why-vaccine-side-effects-really-happen-and-when-you-should-worry">16</a> This likely explains why people tend to have more severe reactions to their second dose compared to their first dose.
And it may also be why 23andMe researchers observe that people with a history of COVID-19 infection also feel more ill following their most recent vaccination, compared to those without a prior infection. The virus itself is an additional trigger for your immune responses to kick in. Several small studies have found that people with a history of COVID-19 infection experienced symptoms more frequently<a href="https://www.medrxiv.org/content/10.1101/2021.01.29.21250653v1">17,</a><a href="https://covid.joinzoe.com/post/vaccine-after-effects-more-common-in-those-who-already-had-covid">18 </a>and had higher levels of antibodies after a first dose,<a href="https://jamanetwork.com/journals/jama/fullarticle/2777171">19</a> compared to those without a history of infection.
This analysis on over 100,000 individuals builds upon these findings, showing that a previous COVID-19 infection might not just be related to the number of symptoms experienced following a COVID-19 vaccination, but also the severity of these symptoms.
<h2>The COVID-19 vaccines are still effective, regardless of your vaccine-related reaction</h2>
Although there is some uncertainty regarding why some people experience more mild or severe symptoms following their COVID-19 vaccination, what we do know is this: the COVID-19 vaccines are effective, whether or not you felt sick after the vaccination.
Data from the vaccine trials showed that not everyone reported vaccine-related reactions; 23% from Pfizer, 18% from Moderna (second dose), and between 39% (younger adults) and 55% (older adults) from J&amp;J didn’t experience any systemic reactions.8,9,<a href="https://www.cdc.gov/vaccines/covid-19/info-by-product/janssen/reactogenicity.html">10</a> And this is coming from the same data that demonstrated how safe and effective these vaccines are.
Put another way: “Even if you don’t have an unpleasant reaction, the vaccines are still doing their job, because the real work of the immune system &#8211; and of the vaccines &#8211; takes place during the second, or adaptive phase of the immune response.”<a href="https://www.nationalgeographic.com/science/article/why-vaccine-side-effects-really-happen-and-when-you-should-worry">16</a>
<h2>What’s next?</h2>
Research is ongoing to understand why reactions to the COVID-19 vaccines differ and what these differences mean.  This work is part of our ongoing broad research into COVID-19 that has included studying how genetics plays a role in both the <a href="https://www.nature.com/articles/s41588-021-00854-7">susceptibility and severity of COVID-19</a> and looking at other aspects of the pandemic like its impact on <a href="https://blog.23andme.com/23andme-research/covid-impact-on-sleep/">sleep</a>, <a href="https://blog.23andme.com/23andme-research/stepping-back-up-amid-covid-19/">physical activity</a> and how it has <a href="https://blog.23andme.com/23andme-research/impact-disparities-of-covid-19/">hit some communities harder than others</a>. As part of this work, our scientists are preparing to run genetic analyses to help answer why individuals react differently to the vaccine and what those differences might mean.
<hr />
*The 23andMe COVID-19 research team includes Adam Auton, Adrian Chubb, Alison Fitch, Alison Kung, Amanda Altman, Andy Kill, Anjali Shastri, Antony Symons, Catherine Weldon, Chelsea Ye, Jason Tan, Jeff Pollard, Jey McCreight, Jess Bielenberg, John Matthews, Johnny Lee, Lindsey Tran, Maya Lowe, Michelle Agee, Monica Royce, Nate Tang, Pooja Gandhi, Raffaello d’Amore, Ruth Tennen, Scott Dvorak, Scott Hadly, Stella Aslibekyan, Sungmin Park, Taylor Morrow, Teresa Filshtein Sonmez, Trung Le, and Yiwen Zheng.

A logo for 23andMe's COVID-19 Research Study

COVID-19 Vaccine Reaction Data

For the uninitiated the mere idea of smearing a sticky blackish sludge of brewer&#8217;s yeast on a piece of toast and then eating it for breakfast might trigger a wee bit of nausea, and yet there are people in this world who love Marmite.
Why?
<h6>Taste Preference</h6>
Like many of the other <a href="https://www.bbc.co.uk/programmes/b007zpll">Big Questions</a> we face in this life, the answer is complicated. And then there&#8217;s the fact that Marmite is one of those polarizing foods you either love or hate. 
We&#8217;re into science, and we like to ask probing and even provocative questions here at 23andMe. So we wanted to know if we could learn a little about whether genetics might play a role in your choice of breakfast spreads. <img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2021/08/Marmite-300x220.png" alt="Pieces of toast with Marmite spread over them." class="alignright wp-image-29103 size-medium" width="300" height="220" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/08/Marmite-300x220.png 300w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Marmite-768x562.png 768w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Marmite-1024x750.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Marmite-880x644.png 880w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Marmite-1180x864.png 1180w" sizes="auto, (max-width: 300px) 100vw, 300px" />
Genetics, after all, factors into our taste preferences.  Whether it&#8217;s liking <a href="https://blog.23andme.com/health-traits/traits-never-looked-better/">Salty v. Sweet</a> snacks, or have an aversion to <a href="https://blog.23andme.com/health-traits/traits-never-looked-better/">Bitter Taste</a>, or a dislike of <a href="https://blog.23andme.com/health-traits/23andme-adds-four-new-trait-reports/">Cilantro</a>, your genes pay at least a small role. And don&#8217;t get us started on &#8220;<a href="https://blog.23andme.com/health-traits/tasty-genetics/">supertasters</a>.&#8221; These kinds of culinary inclinations are determined by a complex interaction between your environment, your lifestyle, and, yes, your DNA. 
So what about Marmite? (We&#8217;re going to leave Vegemite, Marmite&#8217;s even more robust Aussie cousin, in the pantry for now.)
<h6>What About the Genetics?</h6>
Genetics explains some of the appeal of Marmite, according to a new genome-wide association study by researchers at 23andMe. 
Looking at data from more than 100,000 23andMe customers of European descent who consented to participate in research — and who know what the heck Marmite is — Peter Chisnell, PhD., a 23andMe Health R&amp;D scientist found three genetic variants associated with &#8220;loving&#8221; Marmite. 
In follow-up analysis, Peter looked at the area in the genome where we saw the strongest genetic association. It is near a gene related to olfaction, a key to our sense of taste. The SNP is near the <a href="https://www.ncbi.nlm.nih.gov/gene/6496">SIX3 gene</a>, a &#8220;homeobox protein,&#8221; and acts like a master controller for the expression and regulation of a bunch of genes. 
“It&#8217;s a giant sledgehammer kind of gene that affects a lot of things,&#8221; said Peter. 
<h6>Smell and Taste</h6>
Large changes in its function have been shown to disrupt neurodevelopment in mice, including a part of their brain responsible for olfaction. We don&#8217;t really know exactly how these small genetic changes in people could explain differences in taste, but it’s plausible that changes in the sense of smell may make one more prone to like the salty savory flavor of Marmite. 
Along with the association found near the SIX3 homeobox gene, the study found an association near the gene OR12D1, an olfactory receptor. Finally, Peter’s analysis noted a significant single nucleotide polymorphism (SNP) associated with loving Marmite near the NRXN3 gene, which is involved in the nervous system, including behavioral traits like fear and empathy, but also tendencies toward addiction and obesity. 
What these all may or may not mean regarding a preference toward the salty-savory taste of Marmite is about as opaque as the dark syrupy spread itself. After all, our sense of taste is a complex process. 
Taste receptors on our tongue bind to a set of chemical compounds in food to recognize specific odorants or tastants and then sends that information to our brains. There are receptors for five types of tastes — sweet, sour, salty, bitter, and savory, also known as umami. Several different genes are essential for taste and smell. So, for example, the TAS1R and TAS2R gene group is involved in the perception of sweet, umami, and bitter perception. The hundreds of genes that are part of the olfactory receptor gene group also play a role. 
<h6>The Cultural Story </h6>
Beyond the biology involved in taste is a whole slew of cultural and environmental factors that go into what each of us likes and doesn&#8217;t like to eat. 
We see a little of that in 23andMe&#8217;s study because we also looked beyond genetics. The 23andMe researchers broke down individuals by sex and also by country, not just where they currently reside but where they were born. Men were more likely to love Marmite than women, for instance. The difference between men and women isn&#8217;t likely explained by the genetic associations we analyzed, Peter said. The data also gets interesting when you break it down geographically. 
This offers a great example of how culture also plays a role in taste preference. Genetics can&#8217;t really explain the differences in why some countries have more Marmite lovers than others. This is because countries have about the same proportion of people who are genetically predisposed to liking Marmite.
As you would expect, the researchers found that most people who knew about Marmite lived in Commonwealth countries with strong ties to the UK. And unsurprisingly, some of those same countries were where you found the most Marmite lovers — New Zealand, South Africa, Australia, and the UK. But also among the countries that ranked highest for loving it were Russia and Turkey.
Among those places that ranked highest for hating Marmite were the US, Canada, and Ireland.
&#8220;We don&#8217;t have a great biological mechanism to explain those differences,&#8221; said Peter. &#8220;The cultural story seems more plausible to me than a biological explanation.&#8221;
<h6>An Acquired Taste</h6>
Food preferences and acquired tastes are greatly influenced by the culture we live in. 
And why do you have more Marmite haters in Canada, Ireland, and the US? There are no discernable genetic differences to explain that. 
Interestingly, none of the genetic associations we found for loving Marmite were in the genes associated with bitter taste receptors. Nor did we replicate any of the associations in the only other genome-wide association study on Marmite. 
And yes, our GWAS is actually not the first one on Marmite. A few years back, the company that has made the spread since the first World War launched the <a href="https://www.marmite.co.uk/the-gene-project.html">Marmite Gene Project</a>. In collaboration with another company, they ran a <a href="https://www.dnafit.com/downloads/MarmiteGenetics_WhitePaper_Final.pdf">GWAS using just 261</a> people. That tiny study found 15 SNPs associated with Marmite preference. But the researchers acknowledged that the study lacked statistical power. None of the SNPs or genes identified in that study were replicated in our own.
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A black and white image of toast with Marmite spread on it

The Genetics of Loving or Hating Marmite

By Alexa Reynoso, 23andMe Associate Scientist, Genetic Epidemiology
The use of electronic cigarettes, or vaping, is associated with several unhealthy behaviors and traits particularly among young people, according to new data from 23andMe.
But the data merely notes an association between vaping and those behaviors and traits, it’s not an indication of causation. Unlike the long-established research that links smoking to cancer, disability, and death, there remains a dearth of data on the health effects of vaping. Some recent studies have linked vaping to deleterious effects on the lungs. And last year a Stanford study found an association between<a href="https://www.jahonline.org/article/S1054-139X(20)30399-2/fulltext#secsectitle0050"> risk for COVID-19 and vaping</a> among young people.
<h2>Health Impacts</h2>
Scientists are still at the beginning of understanding the long-term health implications of e-cigarettes. At 23andMe we’ve only been collecting data on vaping for about a year. In the summer of 2020, our researchers added new questions to our smoking survey to account for vaping and e-cigarette use.
By looking at data we’ve gathered from the more than 76,000 customers who consented to participate in research and responded to our smoking survey, we were able to explore demographic and other characteristics of e-cigarette users. We were then able to compare people who vape to those who smoke just cigarettes, or who both smoke and vape (dual users), and those who don’t smoke or vape at all. (Note: This is not a representative sample of the entire 23andMe population, nor is it representative of national numbers. The CDC estimates that 4.5 percent of adults in the United States vape.¹ Among 23andMe research participants, only about .2 percent, or 19,000 individuals, reported being regular e-cigarette users. The sample for this research is composed only of respondents to our Smoking survey.)

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="683" src="https://blogcms.23andme.com/wp-content/uploads/2021/08/GettyImages-975633438-1024x683.jpg" alt="" class="wp-image-29075" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/08/GettyImages-975633438-1024x683.jpg 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/08/GettyImages-975633438-300x200.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2021/08/GettyImages-975633438-768x512.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2021/08/GettyImages-975633438-880x587.jpg 880w, https://blogcms.23andme.com/wp-content/uploads/2021/08/GettyImages-975633438-1180x787.jpg 1180w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
<h2>What are E-Cigarettes?</h2>
Before we get into what the data showed, it’s worth understanding a bit more about how e-cigarettes work.
Introduced in 2004,² e-cigarettes were first touted as a less harmful way for smokers to kick their habit. Unlike with cigarettes, users of e-cigarettes are not inhaling smoke. They are inhaling a smoke-like aerosol, or vapor, produced when these devices heat a liquid that usually contains nicotine but also other potentially harmful substances.¹
While vaping may be helping some who are trying to kick their smoking habit, it may also be a gateway for others starting a nicotine addiction. This could be particularly relevant for young people. Juul Labs recently paid a $40 million settlement to the state of North Carolina for allegedly targeting youth in its marketing. According to a study on vaping trends published last year in the<a href="https://www.nejm.org/doi/full/10.1056/NEJMc1910739"> New England Journal of Medicine</a>, it was noted that an increase in vaping among young people between 2018 and 2019 was “the largest of any substance tracked” in the last four decades.
<h2>23andMe’s Data on Vaping Among Young People</h2>
In looking at our data, 23andMe researchers found that those between the ages of 18-30 were more likely to vape.

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="512" height="385" src="https://blogcms.23andme.com/wp-content/uploads/2021/08/Figure-1-E-cigs.png" alt="" class="wp-image-29097" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/08/Figure-1-E-cigs.png 512w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Figure-1-E-cigs-300x226.png 300w" sizes="auto, (max-width: 512px) 100vw, 512px" /></figure>
 
Not only were young people more likely to vape, but these younger users of e-cigarettes were also more likely to use them at a higher frequency. Essentially, they take more “puffs” each day than older people in the study who vape. These findings are in accordance with those of the CDC.¹
Beyond being younger, individuals who are dual users — they smoke and vape — come from locations with a slightly lower median household income when compared to cigarette-only users, e-cigarette only users, and those that used none. Lastly, when comparing the four use groups in regards to years of education, research participants that do not smoke or vape tend to have obtained the highest amount of education.
Our researchers also stratified by sex and ethnicity but did not find strong differences as they did with age.
<h2>23andMe Insights</h2>
While we did not look specifically at health outcomes, we did look at various associations with unhealthy behavior and traits.
We found associations between vaping and such things as being more likely to be stressed, depressed, and anxious compared to those who do not vape. People who vape also were more likely to be diagnosed with bi-polar disorder. We saw associations between people who vape being more likely to report poor overall health, low life satisfaction as well as being less likely to exercise and eat right. People who vape in our data also were more likely to eat less fruit, drink more caffeine, need higher doses of pain medication, and are less likely to be a morning person. (More associations found with e-cigarette use within the 23andMe database are summarized in Figure 1. )

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="512" height="418" src="https://blogcms.23andme.com/wp-content/uploads/2021/08/E-cig-associations.png" alt="" class="wp-image-29096" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/08/E-cig-associations.png 512w, https://blogcms.23andme.com/wp-content/uploads/2021/08/E-cig-associations-300x245.png 300w" sizes="auto, (max-width: 512px) 100vw, 512px" /></figure>
 

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="564" src="https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-1-E-Cigs-1024x564.png" alt="" class="wp-image-29095" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-1-E-Cigs-1024x564.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-1-E-Cigs-300x165.png 300w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-1-E-Cigs-768x423.png 768w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-1-E-Cigs-880x485.png 880w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-1-E-Cigs-1180x650.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-1-E-Cigs-271x149.png 271w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-1-E-Cigs-372x204.png 372w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-1-E-Cigs-574x315.png 574w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-1-E-Cigs-980x539.png 980w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-1-E-Cigs.png 1274w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 [/vc_column]
An environment-wide association study of cigarette smokers in our database was also conducted to determine if there are any fundamental differences between research participants that smoke e-cigarettes versus tobacco cigarettes.
<h2>Correlations</h2>
Our results indicated that the two groups are much more similar than they are different. Similar to the e-cigarette results, we saw that smokers were much more likely to experience depression and anxiety. Both cigarette and e-cigarette users also reported a lower general health score. Other interesting correlations (see Figure 2.) were that cigarette smokers tend to drink more alcohol  and tend to be more hot-headed.

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="512" height="414" src="https://blogcms.23andme.com/wp-content/uploads/2021/08/E-cigs-associations-2.png" alt="" class="wp-image-29094" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/08/E-cigs-associations-2.png 512w, https://blogcms.23andme.com/wp-content/uploads/2021/08/E-cigs-associations-2-300x243.png 300w" sizes="auto, (max-width: 512px) 100vw, 512px" /></figure>
 

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="395" src="https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-2-E-cigs-1024x395.png" alt="" class="wp-image-29093" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-2-E-cigs-1024x395.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-2-E-cigs-300x116.png 300w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-2-E-cigs-768x297.png 768w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-2-E-cigs-880x340.png 880w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-2-E-cigs-1180x456.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Table-2-E-cigs.png 1274w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
Although researchers uncovered correlations between smoking and certain demographic variables, it should be noted that correlation does not equal causation. Proving that certain behaviors or demographics cause another is quite difficult; meaning that we can’t say if someone isn&#8217;t a morning person they must be an e-cigarette user. In order to come to these conclusions, researchers must conduct years of extensive research consisting of numerous rigorous trials and studies.
That’s not to say what we uncovered so far is trivial, but rather we are on the right track. We are still just beginning to understand the long-term health implications of e-cigarettes. Over time, however, with the power of our large research cohort and scientific community, we could uncover more novel associations between e-cigarette use and long-term health effects.
23andMe customers who would like to contribute to our research efforts surrounding e-cigarette usage can take the survey <a href="https://you.23andme.com/research/surveys/tobacco/">here</a>. Not yet a customer? Find out more <a href="https://www.23andme.com/compare-dna-tests/?spt=spt">here</a>.
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<h2>References</h2>
<ol>
<li>“About Electronic Cigarettes (E-Cigarettes).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 28 Apr. 2021, www.cdc.gov/tobacco/basic_information/e-cigarettes/about-e-cigarettes.html.</li>
<li>Cobb, Nathan K., et al. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2978165/">“Novel Nicotine Delivery Systems and Public Health: The Rise of the ‘E-Cigarette.’</a>” American Journal of Public Health, vol. 100, no. 12, 2010, pp. 2340–2342., doi:10.2105/ajph.2010.199281.</li>
</ol>

23andMe Looks at Data on E-Cigarette Use

Ann, who formerly worked caring for the elderly, learned firsthand how chronic conditions could impact you as you age. So this year after looking at her 23andMe reports, she decided to carve out time to address her own health.
“I feel I have been given a chance to improve and enrich my health, all thanks to 23andMe,” Ann said.
When Ann used 23andMe, it was to help her son learn more about his heritage and background. But in looking at her own results, she saw she had an increased genetic likelihood of developing type 2 diabetes. She didn’t need her nursing training to know this was not something to take lightly. She decided to take action.
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 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="536" src="https://blogcms.23andme.com/wp-content/uploads/2021/08/anne-test-2-1024x536.png" alt="" class="wp-image-29082" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/08/anne-test-2-1024x536.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/08/anne-test-2-300x157.png 300w, https://blogcms.23andme.com/wp-content/uploads/2021/08/anne-test-2-768x402.png 768w, https://blogcms.23andme.com/wp-content/uploads/2021/08/anne-test-2-880x461.png 880w, https://blogcms.23andme.com/wp-content/uploads/2021/08/anne-test-2-1180x618.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2021/08/anne-test-2.png 1200w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
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<a href="https://www.cdc.gov/diabetes/basics/diabetes.html">Type 2 diabetes</a> is a condition where blood sugar is too high. It can develop when your body is unable to make enough insulin and/or respond properly to insulin. An estimated 34 million Americans — or about one in 10 adults in the United States — have type 2 diabetes, according to the <a href="https://www.cdc.gov/diabetes/basics/diabetes.html">Centers for Disease Control and Prevention</a>. Strikingly, one in five people don&#8217;t know they have it. Many others who are prediabetic, about 88 million adults in the United States, don’t even know they are at increased risk. Having type 2 diabetes increases your risk for life-threatening complications, such as heart disease and other organ damage. But, simple changes like eating healthy and getting more exercise can help prevent type 2 diabetes and the complications that can follow. 
23andMe’s Type 2 Diabetes report (Powered by 23andMe Research) estimates your chances of developing the condition by looking at more than 1,000 places in your DNA. It also equips you with information and tools to help you take action since healthy living can help lower your chance of developing it.
With this knowledge from her 23andMe report, Ann and her husband decided to take action to get healthier. After several surgeries, they had both become more sedentary and Ann’s DNA insights inspired them to adopt a healthier lifestyle. They didn’t make any big changes or join any gyms, but they did start walking their dog more, gardening and biking. Ann also bought a new health-focused cookbook and has been making recipes from it ever since. 
Ann and her husband are shocked at how much better food tastes without all the added sugars and fake flavor additives they had used in the past.
“It’s been like a wake-up call for my taste buds. They’ve come alive,” Ann said. They’ve also cut back significantly on sweets. What was once fondly known as their “Blues Drawer” (the vegetable drawer in their fridge filled with chocolate they would dive into when feeling “blue”) hasn’t been refilled since the day Ann opened her reports. While they still indulge from time to time, it’s more about satisfying a craving than overindulging. 
Since making all these changes, Ann and her husband have not only lost weight but generally, just feel better. They love the new recipes they are making and the projects they are working on together.
“This was something positive I could do,” Ann said.

Doing Something Positive For Your Health

23andMe’s internship program provides a diverse array of people with valuable experience and room to grow personally and professionally. The 2021 class of interns was the first to operate remotely, which allowed interns to contribute their talents and insights to the Gene Pool from every corner of the country. 
Read what some of our interns shared about what they accomplished, enjoyed, and experienced during their ten weeks with 23andMe. 
&nbsp;

<h6>Marcos Sandoval, IT Help Desk Intern &#8211; IT <img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2021/08/Marcos-S-1-150x150.jpg" alt="" class="alignright size-thumbnail wp-image-29086" width="150" height="150" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/08/Marcos-S-1-150x150.jpg 150w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Marcos-S-1-271x271.jpg 271w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Marcos-S-1-372x372.jpg 372w" sizes="auto, (max-width: 150px) 100vw, 150px" /></h6>
In this internship, I’ve learned how to use and provision various enterprise-level tools to help triage any and all IT-related issues. I have also been managing user permissions and troubleshooting problems! Something exciting I have been working on is helping prepare our Sunnyvale IT inventory for the move into a new location. Working at 23andMe has been an exciting opportunity so far, and I’ve learned much in the brief time I’ve spent here.
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<h6>Enyonam Odoom, Healthcare Operations Intern &#8211; Healthcare Operations <img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2021/06/Enyonam-O-150x150.png" alt="Photo of Enyonam Odoom" class="alignright size-thumbnail wp-image-28974" width="150" height="150" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/06/Enyonam-O-150x150.png 150w, https://blogcms.23andme.com/wp-content/uploads/2021/06/Enyonam-O-300x300.png 300w, https://blogcms.23andme.com/wp-content/uploads/2021/06/Enyonam-O-271x271.png 271w, https://blogcms.23andme.com/wp-content/uploads/2021/06/Enyonam-O-372x372.png 372w, https://blogcms.23andme.com/wp-content/uploads/2021/06/Enyonam-O.png 499w" sizes="auto, (max-width: 150px) 100vw, 150px" /></h6>
I&#8217;ve really enjoyed meeting with all the researchers at the company during my time here. Everyone, including researchers outside of my direct team, opened their calendars to me. It&#8217;s been a great opportunity to learn about what work is being done here, get career advice and mentorship, and just understand what working at 23andMe full time is like. I really appreciated that part of the internship. I&#8217;ve also loved learning more about how we can use genetics to help improve health, as that&#8217;s not something that was really emphasized while I was in school.
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<h6>Taylor Cavazos, Computational Biology Intern &#8211; Therapeutics<img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2021/06/Taylor-Cavazos_Headshot-150x150.jpg" alt="" class="alignright size-thumbnail wp-image-29009" width="150" height="150" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/06/Taylor-Cavazos_Headshot-150x150.jpg 150w, https://blogcms.23andme.com/wp-content/uploads/2021/06/Taylor-Cavazos_Headshot-271x271.jpg 271w, https://blogcms.23andme.com/wp-content/uploads/2021/06/Taylor-Cavazos_Headshot-372x372.jpg 372w, https://blogcms.23andme.com/wp-content/uploads/2021/06/Taylor-Cavazos_Headshot-574x574.jpg 574w, https://blogcms.23andme.com/wp-content/uploads/2021/06/Taylor-Cavazos_Headshot-980x980.jpg 980w" sizes="auto, (max-width: 150px) 100vw, 150px" /></h6>
As a computational biology intern with 23andMe’s Therapeutics team, I’m working on an exciting project that incorporates ancestry to identify variants in the human genome that alter our gene expression. It has been amazing to have the opportunity to conduct research at 23andMe that prioritizes the inclusion of diverse participants and has the potential to drive the development of new therapies. I not only enjoy working with the incredible researchers at 23andMe, but also the overall culture and environment that encourages creativity! 
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<h6>Mark McAdam, Secure Amazon Web Services Intern &#8211; Security <img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2021/08/Mark-McAdams-e1628805752795-150x150.jpg" alt="" class="alignright size-thumbnail wp-image-29087" width="150" height="150" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/08/Mark-McAdams-e1628805752795-150x150.jpg 150w, https://blogcms.23andme.com/wp-content/uploads/2021/08/Mark-McAdams-e1628805752795-271x271.jpg 271w" sizes="auto, (max-width: 150px) 100vw, 150px" /></h6>
If Terraform feels like a superpower when it comes to provisioning resources in AWS, running Terragrunt on top of Terraform feels like managing a team of superheroes. It&#8217;s literally that powerful. I am on a team that is building an application stack that allows people to provision resources to use in AWS without having to worry if they are building it securely, the safeguards are in place. 
Every day I come to work, I get to rub shoulders with a team of brilliant individuals as I try to match their skill and enthusiasm. I get to work on solving problems that have real-world implications. 
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<h6>Cailyn Schiltz, Internal Communications Intern &#8211; Communications<img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2021/06/Cailyn-S-150x150.png" alt="" class="alignright size-thumbnail wp-image-28969" width="150" height="150" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/06/Cailyn-S-150x150.png 150w, https://blogcms.23andme.com/wp-content/uploads/2021/06/Cailyn-S-300x300.png 300w, https://blogcms.23andme.com/wp-content/uploads/2021/06/Cailyn-S-271x271.png 271w, https://blogcms.23andme.com/wp-content/uploads/2021/06/Cailyn-S-372x372.png 372w, https://blogcms.23andme.com/wp-content/uploads/2021/06/Cailyn-S.png 499w" sizes="auto, (max-width: 150px) 100vw, 150px" /></h6>
Working in Internal Comms has taught me just how important every facet of a company is. I planned a Customer Panel for National Sisters&#8217; Day, and getting to see the real-world impacts of 23andMe was so powerful. People find families and can learn life-changing information from their genetic reports, and none of that would be possible without everyone at the company doing their part. Internal Comms is the glue holding the whole operation together. 
This internship has challenged not only my writing skills, but my creativity and leadership skills. I was responsible for weekly newsletters, DEI initiatives, and redesigning the company intranet. What made it truly special was the culture at 23andMe and the incredible team I got to work with. I felt like my thoughts were valued and had an impact, and I was comfortable stepping outside of my comfort zone. Interning with 23andMe gave me experience in a new field, a broader perspective on what it means to be a communicator, and the confidence to push myself to learn.
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<h6>Bhairavi Swaminathan, Statistical Genetics Intern &#8211; Research<img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2021/06/bhairavi-S-150x150.jpg" alt="" class="alignright size-thumbnail wp-image-29008" width="150" height="150" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/06/bhairavi-S-150x150.jpg 150w, https://blogcms.23andme.com/wp-content/uploads/2021/06/bhairavi-S-271x271.jpg 271w" sizes="auto, (max-width: 150px) 100vw, 150px" /></h6>
My internship goal was to replicate and test a publicly available fine-mapping tool with publicly available GWAS data. I definitely learned a lot both in aspects of science and skill sets &#8211; I got to process large datasets and code in a new language. Working at 23andMe has been an amazing experience: I learned a lot about different roles in different departments. People are approachable, friendly, and excited about what they do. I especially enjoyed working with my mentor, Karl, and the discussions with my colleague, Pierre. 
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<h6>April Orozco, Environmental Health &amp; Safety Specialist Intern &#8211; Workplace <img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2021/06/April-O-150x150.png" alt="A photo of April Orozco" class="alignright size-thumbnail wp-image-28968" width="150" height="150" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/06/April-O-150x150.png 150w, https://blogcms.23andme.com/wp-content/uploads/2021/06/April-O-271x271.png 271w, https://blogcms.23andme.com/wp-content/uploads/2021/06/April-O-372x372.png 372w" sizes="auto, (max-width: 150px) 100vw, 150px" /></h6>
I am most proud of seeing the South San Francisco lab flourish even amidst a global pandemic! With EH&amp;S programs being more thoroughly developed as 23andMe&#8217;s Therapeutics department grows, I feel like I truly have been granted a one-of-a-kind opportunity to identify, develop, and mature EH&amp;S programs that can have a lasting effect. Also, everyone I have met in the office and virtually  have been remarkably open to filling in any gaps in my knowledge. I’m so grateful for the opportunity to dive into the field with a company fueled by such an amazing mission.
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<h6>Alix Henderson, Archives Intern &#8211; Office of the CEO<img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2021/06/Alix-H-150x150.png" alt="A photo of Alix Henderson" class="alignright size-thumbnail wp-image-28976" width="150" height="150" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/06/Alix-H-150x150.png 150w, https://blogcms.23andme.com/wp-content/uploads/2021/06/Alix-H-271x271.png 271w, https://blogcms.23andme.com/wp-content/uploads/2021/06/Alix-H-372x372.png 372w" sizes="auto, (max-width: 150px) 100vw, 150px" /></h6>
Learning about the 15 year history of 23andMe through its internal archive has been a unique experience within itself. I am most proud of the improvements I have made in organizing and formatting our archived documents for more successful search and retrieval by the 23andMe team. Advancing the accessibility of these documents promotes the efficiency and education of the company&#8217;s growing success. In partnership with the other Archives Intern, Christina Li, we have developed a written account of the history of 23andMe for onboarding team members to potentially utilize in the future. 
Being able to express the milestones that 23andMe has achieved through the years testifies to the culture of the company itself and why I have enjoyed working here through the summer. I have been challenged in developing my archival knowledge and promoted to connect with multiple departments to continue my growth as a student and young professional.
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<h6>Ayanna Ajilore, Diversity, Equity, and Inclusion Intern- People Team <img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2021/06/Ayanna-A-150x150.png" alt="A photo of Ayanna Ajilore" class="alignright size-thumbnail wp-image-28964" width="150" height="150" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/06/Ayanna-A-150x150.png 150w, https://blogcms.23andme.com/wp-content/uploads/2021/06/Ayanna-A-271x271.png 271w, https://blogcms.23andme.com/wp-content/uploads/2021/06/Ayanna-A-372x372.png 372w" sizes="auto, (max-width: 150px) 100vw, 150px" /></h6>
This was my first time working full-time in DEI, so this summer, I really wanted to learn not just about 23andMe but also if this is the type of work I really want to do every day. Fortunately, not only did I affirm that I love this work, but I also found a place that welcomes me to do it to my heart&#8217;s content.
My work involves having a lot of fingers in a lot of different pots, which gave me the chance to see different sides of the job. I  spent the summer actively working on projects to improve our company and our product which was really refreshing. Some companies and people shy away from confronting their issues in DEI, but here, I spend so much time just helping people figure out how to get past a hurdle on a current project or get started on a new one.
While we still have a long way to go, I believe that 23andMe is really a company to watch in this field and I hope that I am able to continue to contribute to its journey.

Intern-al Perspectives

If you asked the average person to point to their gallbladder, the odds are pretty high they might make a vague indication toward somewhere south of their neck but miss the mark, that is unless they’ve had painful gallstones in the past.
Gallstones are actually quite common, affecting an estimated 25 million people in the US alone, according to the<a href="https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones/definition-facts"> National Institutes of Health.</a>
But most often people have no symptoms. Although most people have no symptoms, some are not so lucky and feel a mix of symptoms including pain in the upper abdomen and back, and nausea. Often, the only long-term way to remedy the problem is with surgical removal of the gallbladder. Women and people over the age of 40 are more likely to develop gallstones as are people with Indigenous American or Mexican ancestry. (See sidebar for more information about gallstones among people with Indigenous American ancestry.)
<h6>Higher and to the Right</h6>
<div style="float: right; text-align: justified; width: 300px; background-color: #eee; padding: 15px; margin-left: 10px;">
Gallstones and Indigenous Americans
A few studies have shown that the incidences of gallstones are much higher among those with Indigenous American ancestry — this includes people with Latino ancestry who typically have a mix of European, African, and Indigenous American ancestry.
But why would people with Indigenous American ancestry have a higher likelihood of developing gallstones?
While dietary factors play a role, so too does genetics. This may in part be due to variants in two genes — ABCG8 and TRAF3. A variant in ABCG8 is known to cause a release of excess cholesterol into bile, and a variant in TRAF3 is thought to contribute to increased inflammation in the gallbladder. Both variants were found to be more common among certain populations with Indigenous American ancestry and increase the likelihood of developing stones. It’s possible that the variants conferred an evolutionary advantage for Indigenous people living in the Americas, but modern diets that include more red meat, saturated fats, and sugars undercut that advantage.
Looking at our own data from customers who consented to participate in research, Samantha Ancona Esselmann, Ph.D., a 23andMe Product Scientist, found that Latino participants report higher incidence of gallstones at every age bracket. And again, Latinos typically have some Indigenous American ancestry.
As a side note, Samantha noticed something in the data related to statistics called the “Simpson’s Paradox.” Because 23andMe’s Latino research participants tend to be much younger than our participants with primarily European ancestry, and because gallstones tend to be heavily age-dependent, the first pass at the data seems to show a higher percentage of European participants reporting gallstones. But by controlling for age, Samantha confirmed a much higher incidence of gallstones among Latino 23andMe participants.
Beyond the implications this has for people with Indigenous American ancestry, it’s another important example of how understanding your genetic ancestry can help you better understand your health.
</div>
Before diving a little deeper it’s worth understanding a bit about this tiny organ that’s nestled up against your liver. (For those navigating their own body map, this is in the upper right portion of your abdomen.)
The gallbladder helps store bile, produced in the liver, that in turn assists the body in breaking down and digesting fat. In other words, it’s important for digestion. Things can get mucked up in the gallbladder when stones are formed. The formation of stones in and of itself may not result in symptoms but in some cases, these little masses that form, which can be as small as a grain of sand or as large as a golf ball, can block the outlet of the gallbladder causing severe pain. This often happens after a particularly fatty or large meal. In some cases, this sort of gallbladder attack lasts longer than a few hours and is accompanied by a fever and chills. This is often an indication of something more serious and may require surgery to remove the gallbladder.
<h6>Going Deeper</h6>
So, why do some people develop gallstones, and how do you prevent them? Well like a lot of conditions, your chances of developing gallstones is influenced by both genetic and non-genetic factors.
The good news is that simply maintaining a healthy lifestyle including keeping a healthy weight, exercising regularly, and eating a diet high in fiber, low in unhealthy fats, refined carbs, and sugars can go a long way toward lowering your risk. Your genetics also plays a role.
As part of<a href="https://blog.23andme.com/news/inside-23andme/23andmeplus/"> 23andMe+ Premium,</a> an annual membership with 10+ exclusive reports and features delivered to you throughout the calendar year, we now offer a report that estimates the likelihood of developing gallstones. This report is based on a statistical model that considers 6,950 genetic markers. The model also includes ethnicity and sex to calculate an estimate. The data used in the model comes from 23andMe customers who consented to participate in research.
<h6>Taking Action</h6>
Understanding more about your genetics can be a good next step in learning about your chances of developing gallstones. Remember to talk with your healthcare provider before making any major lifestyle changes. That said, maintaining a healthy weight, eating a diet that is low in saturated fat, refined carbs, sugars, and getting plenty of exercise can go a long way toward reducing your likelihood of developing gallstones.
To learn more about 23andMe+ Premium membership, go<a href="https://www.23andme.com/membership?fdpt=true"> here</a>.
***23andMe 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. 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. For important information and limitations regarding each genetic health risk report, visit 23andme.com/test-info/.

New 23andMe+ Premium Report on Gallstones

When Melissa Tarantino talks about facing challenges every day to her special needs students at a middle school near Sacramento, they listen. They all are aware that she knows what she&#8217;s talking about.
A former gymnast, Melissa learned at 19 that the pain and numbness in her hands was a symptom of scleroderma, a rare disease that she&#8217;d never heard of before. The diagnosis came after more than a year of being treated, including two surgeries for what doctors thought was carpal tunnel syndrome brought on by her years in gymnastics. It was a heavy diagnosis for someone who was just starting college.
When the doctor gave her the diagnosis, she asked:
&#8220;Will I ever be able to do a cartwheel again?&#8221;
<h6>Cartwheels and Research</h6>
That was eight years ago now. Melissa was able to do cartwheels again, but it hasn&#8217;t been easy.
She recently chatted with 23andMe about how she&#8217;s approached living with scleroderma, a progressively debilitating autoimmune disease that often results in tightening and hardening of the skin, muscle weakness, and pain. The condition affects an estimated <a href="https://worldsclerofound.org/what-is-ss/">2.5 million people</a> globally. Most of those with systemic sclerosis — about 80 percent — are women like Melissa between 16 and 45.
Although there are some treatments for this progressively debilitating autoimmune disease, there currently is no cure. But there is promising research like that being done by 23andMe.
Our conversation with Melissa is one in an occasional series on the blog about rare diseases like scleroderma. You can read some of the other posts about new insights into the <a href="https://blog.23andme.com/23andme-research/new-way-to-study-rare-disease/">study of rare diseases</a>, living with another rare disease idiopathic pulmonary fibrosis, and a discussion with a community engagement director for the <a href="https://blog.23andme.com/23andme-research/scleroderma-research/">Scleroderma Research Foundation</a>. The posts detail studies into rare diseases, as well as two specific studies 23andMe is currently recruiting for — <a href="https://www.23andme.com/idiopathic-pulmonary-fibrosis/">idiopathic pulmonary fibrosis</a>, a chronic progressive lung disease, and <a href="https://www.23andme.com/systemic-sclerosis-study/">systemic sclerosis</a>, a form of scleroderma.
Melissa, who is participating in <a href="https://www.23andme.com/systemic-sclerosis-study/">23andMe&#8217;s Systemic Sclerosis Study</a>, said it&#8217;s important to contribute to the effort.
&#8220;Of course, I&#8217;m participating,&#8221; she said. &#8220;I just want to be able to help in whatever way I possibly can.&#8221;
Here&#8217;s more of what Melissa had to say.
<h6>Many people with a rare disease talk about how difficult it was to simply find the right diagnosis. Was that your experience?</h6>
The backstory is that I’d been a gymnast all my life, from like second grade to senior year of high school. I decided I wanted to stop and be a kid again, you know, go to the prom and not have to train 30 hours a week.
After I stopped, I started noticing pain and numbness in my hands. The doctors thought it was carpal tunnel from all that training, so I had surgery first on one hand and then the other.
My freshman year in college I still had pain, the knuckles in my hands were super swollen and I started to gain weight, then lose it, and I had this bloating in my face. The pain in my hands was really bad. At one point during a history final, it hurt so bad that I was crying. At that point, I went back to the doctor and they still thought the pain was from my time as a gymnast. The doctor told me to take acetaminophen. It was super frustrating.
<h6>What changed?</h6>
I knew something was wrong and my mom knew it too. We switched doctors and got blood work done. Even before the appointment my mom and I looked at the results from the lab work and then sort of self-diagnosed things. We looked up lupus and scleroderma while we sat on the couch. We weren’t 100 percent sure but we kind of pieced things together. We didn’t know anyone who had (scleroderma). We never heard of it before.
But we lucked out and got connected to a good rheumatologist with connections to Stanford who’d actually studied the disease. So, after the first diagnosis, I’ve had good care.
<h6>What were some of the hardest things for you during that time?</h6>
I was in college, and as I said, I wanted to live a college life. I wanted to live my life as a young person. So, at first, I didn’t take all the heavy medications that were prescribed. I let my doctor know. (Among the medication she waited to take was an immunosuppressant methotrexate. She waited to take it because of some of its side effects.)
Like I said I didn’t know anything about scleroderma until we’d Googled it, and everything we read online basically said you die right away. I didn’t have high hopes, but it turns out I won the scleroderma lottery. The kind of scleroderma I have isn’t affecting my internal organs now. Once I had my years in college, I started using the immunosuppressant methotrexate. Maybe I wouldn’t have lost some of the bone that I lost if I’d started taking it during college, but I’m glad I had that time in college to lead a somewhat normal student life.
<h6>What are some of the things you find that help you day-to-day?</h6>
Five years is a big marker for this condition, and I’m now seven or eight years in, and I’m at my healthiest. I now do powerlifting and being active really helps me feel better. You know before I started powerlifting I did tell myself I wanted to prove my doctor wrong.
So, while I was at Sacramento State I joined a gymnastics club and ended up competing in Nationals when they were in Sacramento. I proved that I could do cartwheels. I might have done them a little differently than I did before, but I did them. I did four events. Once I did that, I knew that having a physical outlet was important for me but I needed to shift to something else so that’s when I started powerlifting. 
Powerlifting really helps me release stress. I usually try and go at about 3:30 in the morning before I start my day. When I don’t work out my kids (who she teaches at a middle school in Sacramento) know it, and usually say something.
<h6>How has being involved with different groups such as the Scleroderma Research Foundation helped you?</h6>
Going to their fundraisers or conferences helped me meet more people with the disease who were actually my age. That’s been very helpful for my mental health. I don’t feel alone and I can talk to someone who I can ask about, you know, things like dating or how to deal with changes in your appearance. That kind of stuff has really helped.
<h6>Why are you participating in 23andMe’s Systemic Sclerosis Study?</h6>
Of course, I&#8217;m participating. I&#8217;ve actually tried to participate in other (scleroderma) studies but this is the first I qualified for.
I’m participating in the 23andMe study because I just want to be able to help in whatever way I possibly can. This disease isn&#8217;t going to just go away. I have it for life, so this is something I can do now in my lifetime to help others. It might not make a difference for me but it might for someone in the future.

Latest Posts — Page 46