<h5 class="wp-block-heading" id="h-fda-now-recommends-genetic-testing-before-prescribing-specific-chemotherapy-medications">FDA Now Recommends Genetic Testing Before Prescribing Specific Chemotherapy Medications</h5>



For years, patient advocates have been calling for stronger safeguards against preventable toxicity from chemotherapy. Last week, the FDA took a major step forward, updating the label for a drug called <a href="https://medlineplus.gov/druginfo/meds/a699003.html" target="_blank" rel="noreferrer noopener">capecitabine</a> to explicitly recommend testing for variants in the DPYD gene before starting treatment. This is more than just a label change—it&#8217;s a long-awaited acknowledgment that genetics matter when it comes to patient safety.



<h2 class="wp-block-heading">What is DPYD?</h2>



The <a href="https://medlineplus.gov/genetics/gene/dpyd/" target="_blank" rel="noreferrer noopener">DPYD gene</a> provides instructions for making an enzyme called DPD (dihydropyrimidine dehydrogenase), which helps the body break down certain chemotherapy drugs like capecitabine and <a href="https://medlineplus.gov/druginfo/meds/a682708.html" target="_blank" rel="noreferrer noopener">5-fluorouracil</a>. These medications are commonly used to treat breast, colorectal, and other cancers. People with certain changes in this gene may not process these drugs properly, causing the drugs to build up in the body and, in some cases, leading to severe or even life-threatening <a href="https://medlineplus.gov/genetics/condition/dihydropyrimidine-dehydrogenase-deficiency/" target="_blank" rel="noreferrer noopener">reactions</a>.



<figure class="wp-block-image alignleft size-full is-resized"><img loading="lazy" decoding="async" width="508" height="531" src="http://35.88.189.111/wp-content/uploads/2025/10/drug-bottle.png" alt="" class="wp-image-34304" style="width:126px;height:auto" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/10/drug-bottle.png 508w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/10/drug-bottle-287x300.png 287w" sizes="auto, (max-width: 508px) 100vw, 508px" /></figure>



These reactions can include painful mouth sores, severe diarrhea, low white blood cell counts, and nerve problems. <a href="https://medlineplus.gov/genetics/condition/dihydropyrimidine-dehydrogenase-deficiency/#frequency" target="_blank" rel="noreferrer noopener">Up to 8%</a> of people have a variant in the DPYD gene that affects how well they process these medications. Sadly, some patients with DPYD variants have died after receiving these drugs. Such experiences have fueled years of advocacy calling for genetic testing before treatment, not after. 



<h2 class="wp-block-heading" id="h-a-change-in-the-recommendations">A change in the recommendations</h2>



Until now, the FDA advised doctors they could &#8220;consider testing&#8221; patients before giving capecitabine or similar drugs. The <a href="https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/020896s052lbl.pdf" target="_blank" rel="noreferrer noopener">new label</a> goes much further, adding a warning that says, &#8220;serious adverse reactions or death may occur in patients with complete DPD deficiency&#8221; and telling doctors to test for DPYD variants before prescribing the medication. (Experts predict a similar change to the 5-fluorouracil drug label soon.) It&#8217;s a major win for patient safety and for the <a href="https://test4dpd.org/" target="_blank" rel="noreferrer noopener">advocacy groups</a> who have pushed tirelessly for this change. Organizations that have long advocated for universal DPYD testing hope this update will encourage hospitals and cancer centers across the U.S. to make pretreatment genetic testing standard care.



<figure class="wp-block-image alignright size-large is-resized"><img loading="lazy" decoding="async" width="790" height="1024" src="http://35.88.189.111/wp-content/uploads/2020/09/PGt-Home-790x1024.png" alt="23andMe mobile pharmacogenomics" class="wp-image-28527" style="width:256px;height:auto" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2020/09/PGt-Home-790x1024.png 790w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2020/09/PGt-Home-231x300.png 231w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2020/09/PGt-Home-768x996.png 768w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2020/09/PGt-Home-679x880.png 679w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2020/09/PGt-Home-910x1180.png 910w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2020/09/PGt-Home.png 1583w" sizes="auto, (max-width: 790px) 100vw, 790px" /></figure>



We share the belief that genetic insights can empower individuals and help improve outcomes. The 23andMe® <a href="https://www.23andme.com/topics/pharmacogenetics/dpyd/" target="_blank" rel="noreferrer noopener">DPYD Drug Metabolism Pharmacogenetics report</a>*, available to <a href="https://www.23andme.com/membership/" target="_blank" rel="noreferrer noopener">23andMe+ Premium</a>™ members, provides information about two variants associated with reduced DPD enzyme activity. While this report isn&#8217;t a substitute for clinical testing, it can help people learn whether they carry certain DPYD variants and start a conversation with their healthcare provider. 



The FDA&#8217;s new label is an important step toward safer, more personalized cancer treatment and a long-awaited victory for the patients and advocates who made their voices heard.



<hr class="wp-block-separator has-alpha-channel-opacity"/>



 * 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 <a href="http://23andme.com/test-info/pharmacogenetics/" target="_blank" rel="noreferrer noopener">23andme.com/test-info/pharmacogenetics/</a>

A Big Step Forward for Patient Safety

Late in the first quarter in only his third game this season, one professional football team’s star edge-rusher limped off the field, gesturing to his trainers with his thumb down. Apparently, he already knew what he&#8217;d find out a short time later with an MRI: he&#8217;d again torn his ACL, the anterior cruciate ligament.



While a hard tackle or awkward fall can tear an ACL, some people may be more prone to an ACL tear than others, and their genetics may explain why.



A new 23andMe polygenic risk score (PRS) report sheds light on that genetic connection. The report examines how a person&#8217;s genetics may impact their likelihood of experiencing an ACL tear, an injury particularly common among those involved in high-impact sports.



<h2 class="wp-block-heading" id="h-how-genetics-may-influence-acl-tear-risk">How Genetics May Influence ACL Tear Risk</h2>



First, it&#8217;s important to note that your genetics is only one part of the story – many other factors can influence the risk of an ACL tear. 



<figure class="wp-block-image alignright size-full"><img loading="lazy" decoding="async" width="306" height="126" src="http://35.88.189.111/wp-content/uploads/2025/10/ACL-tear-PRS-Hero.png" alt="" class="wp-image-34316" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/10/ACL-tear-PRS-Hero.png 306w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/10/ACL-tear-PRS-Hero-300x124.png 300w" sizes="auto, (max-width: 306px) 100vw, 306px" /></figure>



Tears typically occur when the knee twists or extends beyond its normal range, often seen in sports that involve jumping and sudden stops, pivots, or changes in direction. That might be in sports such as football, soccer, basketball, or downhill skiing. The ACL is the most commonly injured ligament in the knee.&nbsp;&nbsp;



We also know that ACL tears are more common in female athletes. However, because more males participate in high-risk sports, the total number of ACL tears may actually be higher in males. They are also more likely in people with a family history of an ACL injury or a personal history of an ACL tear. Indeed, genetics plays an important role, with one 2020 sports medicine journal study estimating the <a href="https://bjsm.bmj.com/content/55/7/385" target="_blank" rel="noreferrer noopener">genetic contribution to an ACL tear at approximately 69 percent</a>. 



While the exact biological mechanism involved is not yet known, the genetic associations do offer some hints. Among the many genetic variants associated with ACL tears are variants in or near genes involved in the formation of collagen, a building block for ligaments. Scientists have discovered other variants linked to tears, but most of those associations are inconclusive, and more research is needed.&nbsp;



<h2 class="wp-block-heading" id="h-23andme-s-new-acl-tear-prs-report">23andMe&#8217;s New ACL Tear PRS Report</h2>



Knowing how genetics influences the risk for an ACL tear can empower athletes, who are at the highest risk, train smarter and work toward preventing them.&nbsp;



To create the new ACL Tear PRS Report* 23andMe scientists analyzed data from people who consented to participate in research to identify thousands of variants associated with ACL tears. The 23andMe scientists then created a genetic model that incorporated those variants to calculate the genetic likelihood of an ACL tear.



This PRS report, like other 23andMe PRS reports, is research-based and not validated for medical diagnostic use; it may have limitations for people with mixed or less-studied ancestries and does not account for every possible factor influencing ACL health. In addition, polygenic risk scores integrate many common variants, but they do not account for rare genetic variants or lifestyle factors that can heavily impact risk.&nbsp;



For individuals with an elevated genetic or family risk, creating a personalized prevention plan and scheduling regular check-ins with sports medicine professionals are great ways to keep knees healthy.&nbsp;



<h2 class="wp-block-heading" id="h-mitigating-the-risk-of-acl-tears">Mitigating the Risk of ACL Tears</h2>



Whether you’re a pro athlete or not, and especially if you’ve already had an ACL tear before, proper training and technique&nbsp; are simple ways to help lower the likelihood of injury.



Here are a few things you can do to help lower the risk of an ACL tear:



<ul class="wp-block-list">
<li>Build muscle strength in the hamstrings, and core to stabilize the knee.</li>



<li>Maintain proper technique for movements such as jumping, pivoting, and squatting — like landing on the balls of your feet with knees bent and keeping knees aligned over your toes.</li>



<li>Warm up and cool down before and after physical activity to increase flexibility.</li>



<li>Wear supportive, activity-appropriate footwear for correct alignment.</li>



<li>Consulting with physical therapists or trainers for form and strength assessments can further reduce the risk, regardless of one&#8217;s genetic background.</li>
</ul>



We continue to learn about the role genetics plays in sports-related injuries, including ACL tears, but genetics is just one factor.&nbsp;



<h2 class="wp-block-heading" id="h-learn-more">Learn More</h2>



<a href="https://www.23andme.com/membership/" target="_blank" rel="noreferrer noopener">23andMe+ Premium</a>™ members can view this report with their other Wellness reports.



<a href="https://you.23andme.com/" target="_blank" rel="noreferrer noopener">Sign in</a> to learn more about what 23andMe&#8217;s ACL Tear PRS can tell you. 



* The 23andMe ACL Tear PRS report is based on a genetic model that includes data and insights from 23andMe consented research participants and incorporates more than 6,000 genetic variants to provide information on the likelihood of experiencing an ACL tear. The report does not describe a person’s overall likelihood, does not account for lifestyle or family history and has not been reviewed by the US Food and Drug Administration. The ACL Tear PRS report is not intended to tell you anything about your current state of health, or to be used to make medical decisions or determine any treatment.

Genetics May Explain Why Some Athletes Are More Prone to ACL Tears

As many as one in 10 women have endometriosis, but diagnosing it can take up to a decade or more. Dive into the science, and learn a bit about a new 23andMe Endometriosis report that looks at the genetic likelihood of developing this painful condition.



<figure class="wp-block-image size-full"><img loading="lazy" decoding="async" width="612" height="252" src="http://35.88.189.111/wp-content/uploads/2025/09/endometriosis_hero-1.jpg" alt="" class="wp-image-34227" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/09/endometriosis_hero-1.jpg 612w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/09/endometriosis_hero-1-300x124.jpg 300w" sizes="auto, (max-width: 612px) 100vw, 612px" /></figure>



Have you ever been told your debilitating period pain is &#8220;normal&#8221;? Do you find yourself planning your life around your cycle, canceling plans, or missing work or school due to pain, heavy bleeding, or exhaustion? If so, you&#8217;re not alone; these symptoms could point to endometriosis, a common, yet often misunderstood, condition.



For those with endometriosis, tissue similar to the lining of the uterus grows in other places, like the ovaries, fallopian tubes, or even the bowel and bladder. This can lead to severe pain, heavy periods, and in some cases, may make it harder to become pregnant (between 30–50% of women with endometriosis experience infertility).



If this sounds familiar, it’s important to know that your pain is real and more common than many people think. Endometriosis affects as many as 10% of women in the U.S. Despite this, the journey to a diagnosis can be frustratingly long, sometimes <a href="https://pubmed.ncbi.nlm.nih.gov/39373298/" target="_blank" rel="noreferrer noopener">taking up to 12 years</a>. This delay often happens because symptoms are dismissed as &#8220;just a bad period.&#8221;



To support awareness and help people understand their genetic predisposition to endometriosis, we’ve launched the new Endometriosis* report for female <a href="https://www.23andme.com/membership/" target="_blank" rel="noreferrer noopener">23andMe+ Premium</a>™ and <a href="https://www.23andme.com/total-health/" target="_blank" rel="noreferrer noopener">Total Health</a>™ members.



<h2 class="wp-block-heading" id="h-what-causes-endometriosis">What causes endometriosis?</h2>



While the exact cause isn&#8217;t known, several factors can increase your likelihood of developing endometriosis:



<figure class="wp-block-image alignright size-full is-resized"><img loading="lazy" decoding="async" width="612" height="720" src="http://35.88.189.111/wp-content/uploads/2025/09/Group-125628.png" alt="" class="wp-image-34211" style="width:259px;height:auto" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/09/Group-125628.png 612w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/09/Group-125628-255x300.png 255w" sizes="auto, (max-width: 612px) 100vw, 612px" /></figure>



<ul class="wp-block-list">
<li>Age: It most often affects menstruating people and is frequently diagnosed in the 30s and 40s.</li>



<li>Family history: Having a family member with endometriosis increases risk.</li>



<li>Reproductive history: Starting menstruation at a young age, experiencing menopause later in life, and having frequent or heavy periods (short cycles or bleeding lasting more than 7 days) can all increase chances of developing the condition.</li>
</ul>



These factors are associated with a higher risk. On the other hand, having been pregnant or breastfeeding may reduce risk.



<h3 class="wp-block-heading" id="h-the-genetic-connection">The genetic connection</h3>



Endometriosis is what’s known as a <a href="https://www.genome.gov/genetics-glossary/Polygenic-Trait" target="_blank" rel="noreferrer noopener">polygenic</a> condition — meaning that many different genetic variants in many different genes can influence a person’s chances of developing it. In fact, <a href="https://pubmed.ncbi.nlm.nih.gov/26209831/" target="_blank" rel="noreferrer noopener">research suggests</a> that genetics may explain nearly half of the differences in who develops endometriosis across a population.



In 2023, 23andMe collaborated with researchers at Oxford in what was at the time the largest study on <a href="https://blog.23andme.com/articles/largest-genetic-study-to-date-links-endometriosis-with-chronic-pain" target="_blank" rel="noreferrer noopener">endometriosis and its association with chronic pain</a>. Now, to further understand the genetics of this condition, researchers at 23andMe looked at genetic and self-reported data from more than 1.5 million consented research participants. Using this information, they created a Polygenic Risk Score (PRS) — a model that considers thousands of genetic variants to estimate a person’s likelihood of developing endometriosis.



However, this model did not perform as accurately for 23andMe customers with Black or African American ancestry. Due to this limitation, we cannot provide a result for the Endometriosis report to those customers at this time. This is an important reminder that genetics research has historically underrepresented many communities. With continued research and broader participation, we hope to improve this work and reduce these disparities in the future.



<h2 class="wp-block-heading" id="h-what-you-can-do-about-it">What you can do about it</h2>



While the road to getting a diagnosis and managing endometriosis can be long and frustrating, there are proactive steps you can take on your journey to getting answers and feeling better.



<h3 class="wp-block-heading" id="h-advocate-for-yourself">Advocate for yourself</h3>



Track Your Symptoms. Before you see a doctor, consider starting a symptom diary. Being specific can make a big difference. Every day, note:



<ul class="wp-block-list">
<li>Pain: On a scale of 1–10, where is the pain, and what does it feel like (sharp, dull, cramping)?</li>



<li>Timing: When during your cycle do you feel symptoms? (During your period, during ovulation, all month long?)</li>



<li>Bleeding: How heavy is your flow? Are you passing clots?</li>



<li>Other Symptoms: Note any bloating, painful bowel movements, pain with sex, or fatigue.</li>



<li>Impact: How do these symptoms affect your daily life? (e.g., &#8220;Missed two days of work,&#8221; &#8220;Couldn&#8217;t exercise,&#8221; &#8220;Had to leave the party early.&#8221;)</li>
</ul>



Connect with a Doctor. Armed with your symptom diary, make an appointment with a healthcare provider.



<ul class="wp-block-list">
<li>Be clear and confident. Say, &#8220;I am concerned I might have endometriosis because of these specific symptoms.&#8221;</li>



<li>Don&#8217;t be afraid to ask questions. &#8220;What are the next steps for diagnosis?&#8221; or &#8220;Could we explore treatment options for my pain now?&#8221;</li>



<li>If you feel dismissed, get a second opinion. Look for a gynecologist who specializes in endometriosis or pelvic pain.</li>
</ul>



<h3 class="wp-block-heading" id="h-manage-symptoms">Manage symptoms</h3>



There’s no one-size-fits-all approach, but experts agree that certain lifestyle habits can make a difference:



<ul class="wp-block-list">
<li>Exercise: Activities like yoga can improve blood flow, relax muscles, and reduce pain.</li>



<li>Relaxation and self-care: Rest, warmth on the lower stomach (like a heating pad, warm water bottle, or bath), and gentle movement can help ease discomfort.</li>
</ul>



Medical options may include medications to manage pain and hormone levels, pelvic floor physical therapy, and in some cases, surgery. Because endometriosis tissue can respond to estrogen, symptoms may improve after menopause, when estrogen levels remain consistently low.



<h2 class="wp-block-heading" id="h-take-the-next-steps">Take the next steps</h2>



Endometriosis pain is not an exaggeration, and it deserves to be taken seriously. Seeking answers is the first and most powerful step toward managing your health and reclaiming your quality of life.



Ready to learn more about your health and genetics and take the next step in your journey? Learn more about <a href="https://www.23andme.com/membership/" target="_blank" rel="noreferrer noopener">23andMe+ Premium</a> or <a href="https://www.23andme.com/total-health/" target="_blank" rel="noreferrer noopener">Total Health</a> memberships.



Already part of 23andMe? <a href="https://you.23andme.com/" target="_blank" rel="noreferrer noopener">Sign in</a> to view this report with your other Health Predisposition reports or upgrade 23andMe+ Premium or Total Health memberships.



* The 23andMe Endometriosis PRS report is based on a genetic model that includes data and insights from 23andMe consented research participants and incorporates more than 13,000 genetic variants to provide information on the likelihood of developing endometriosis. The report does not describe a person’s overall likelihood, does not account for lifestyle or family history, and has not been reviewed by the US Food and Drug Administration. The Endometriosis PRS report is not intended to tell you anything about your current state of health, or to be used to make medical decisions or determine any treatment. 



NOTE: Within this blog post, we use the words &#8220;women&#8221; and &#8220;female&#8221; to refer to people whose sex assigned at birth is female. However, we recognize that not everyone who experiences endometriosis will identify as female, and being categorized by birth sex may be an uncomfortable experience for some people. We do not mean to delegitimize anyone’s gender identity. Learn more about why we made this decision in this <a href="https://customercare.23andme.com/hc/en-us/articles/360010964373-How-23andMe-Uses-Your-Genetic-Sex-Birth-Sex-and-Gender" target="_blank" rel="noreferrer noopener">help article</a>.

Could Your Painful Periods Be Endometriosis? Here’s What You Should Know

This week, 23andMe added a new genetic report to help us all be more aware of an often overlooked contributor to health disparities.



<figure class="wp-block-image alignright size-large is-resized"><img loading="lazy" decoding="async" width="1024" height="763" src="http://35.88.189.111/wp-content/uploads/2025/08/duffy-statistic-1024x763.png" alt="" class="wp-image-34101" style="width:309px;height:auto" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/08/duffy-statistic-1024x763.png 1024w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/08/duffy-statistic-300x224.png 300w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/08/duffy-statistic-768x572.png 768w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/08/duffy-statistic-880x656.png 880w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/08/duffy-statistic-1180x879.png 1180w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/08/duffy-statistic.png 1224w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>



<a href="https://pubmed.ncbi.nlm.nih.gov/35994632/" target="_blank" rel="noreferrer noopener">Nearly 70%</a> of Black and African Americans have two copies of a variant in the Duffy antigen gene that can cause them to have white blood cell (WBC) counts that are lower than most standard reference ranges.&nbsp;



People who have this genotype — called Duffy null status — do not have an increased risk for <a href="https://pubmed.ncbi.nlm.nih.gov/32959868/" target="_blank" rel="noreferrer noopener">infection</a> or <a href="https://pubmed.ncbi.nlm.nih.gov/39825822/" target="_blank" rel="noreferrer noopener">other health problems</a>. But they may be flagged incorrectly as having abnormally low WBC counts, which can negatively impact the healthcare they receive.&nbsp;



&#8220;I&#8217;ve seen patients that are told that they might have cancer, go through painful bone marrow biopsies, miss out on joining clinical trials, or have critical medications like chemotherapy discontinued simply because their white blood cell counts were interpreted without understanding their Duffy status,&#8221; says Dr. Lauren Merz, Assistant Professor of Medicine, Division of Hematology/Oncology at the University of Michigan, who is leading efforts to raise awareness about Duffy null status and develop Duffy null-specific reference ranges and who provided expert feedback on 23andMe&#8217;s new report.



<h2 class="wp-block-heading" id="h-when-a-one-size-fits-all-blood-test-falls-short">When a one-size-fits-all blood test falls short</h2>



When we have our blood drawn, testing labs use reference ranges to determine whether our results fall in the range considered &#8220;normal&#8221; or are too high or too low, which can flag the need for clinical follow-up. One common blood test measures neutrophils, which are a type of white blood cell that helps the body fight infections.



Most neutrophil reference ranges are defined based on populations where Duffy null status is rare, such as people with European or Asian genetic ancestry. And blood testing labs don&#8217;t usually take into account Duffy status. As a result, <a href="https://pubmed.ncbi.nlm.nih.gov/35994632/" target="_blank" rel="noreferrer noopener">nearly 25%</a> of healthy Black and African Americans with Duffy null status — and more than 15% of all Black and African Americans — have neutrophil counts below the standard reference range.



These individuals may be misdiagnosed with neutropenia (low neutrophil counts), which can lead to a number of downstream harms, including <a href="https://pubmed.ncbi.nlm.nih.gov/34180972/" target="_blank" rel="noreferrer noopener">unnecessary specialty referrals and follow-up tests</a> like bone marrow biopsies; <a href="https://pubmed.ncbi.nlm.nih.gov/39259539/" target="_blank" rel="noreferrer noopener">exclusion from clinical trials</a> (because many trials require a minimum number of neutrophils that is higher than the normal range for people with the Duffy null genotype); and delayed or reduced access to medications for <a href="https://pubmed.ncbi.nlm.nih.gov/39259539/" target="_blank" rel="noreferrer noopener">cancer</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/34645395/" target="_blank" rel="noreferrer noopener">mental health conditions</a>, and <a href="https://pubmed.ncbi.nlm.nih.gov/35724382/" target="_blank" rel="noreferrer noopener">autoimmune disorders</a>. (See the sidebar at the bottom for more details.)



<h2 class="wp-block-heading" id="h-what-is-the-duffy-antigen-and-how-does-it-impact-white-blood-cells">What is the Duffy antigen, and how does it impact white blood cells?</h2>



<figure class="wp-block-image alignleft size-large is-resized"><img loading="lazy" decoding="async" width="87" height="138" src="http://35.88.189.111/wp-content/uploads/2021/11/research.b57972a5e8fa.svg" alt="an icon representing research" class="wp-image-29284" style="width:117px;height:auto"/></figure>



The Duffy antigen is a protein found on the surface of red blood cells and certain other cells in the body. People with two copies of a specific <a href="https://www.cincinnatichildrens.org/health/d/duffy-null-associated-neutrophil-count" target="_blank" rel="noreferrer noopener">genetic variant in the ACKR1 (Duffy antigen) gene</a> don&#8217;t express this protein on their red blood cells — giving rise to the name &#8220;Duffy null.&#8221;



Being Duffy null can also impact infection-fighting white blood cells called neutrophils. People who are Duffy null tend to have naturally lower levels of circulating neutrophils in the peripheral blood — <a href="https://pubmed.ncbi.nlm.nih.gov/37338884/" target="_blank" rel="noreferrer noopener">about 40% lower, on average</a>. But they don&#8217;t have an increased risk for infection, because the total number of neutrophils in their bodies remains the same. (Their neutrophils just move from the blood into other tissues like the spleen more easily.)



In the past, healthy people with low neutrophil counts were said to have &#8220;benign ethnic neutropenia,&#8221; because the Duffy null variant is more common in certain populations. But the preferred name is now <a href="https://www.cincinnatichildrens.org/health/d/duffy-null-associated-neutrophil-count" target="_blank" rel="noreferrer noopener">Duffy null-associated neutrophil count (DANC)</a>, as this refers to the biological driver of Duffy status rather than the social construct of race or ethnicity — and highlights that lower neutrophil counts are normal for people who are Duffy null.



<h2 class="wp-block-heading" id="h-is-duffy-null-status-associated-with-any-health-conditions">Is Duffy null status associated with any health conditions?</h2>



To date, there is no robust evidence that people with Duffy null status are at increased risk for any health conditions. In fact, a <a href="https://pubmed.ncbi.nlm.nih.gov/39825822/" target="_blank" rel="noreferrer noopener">recent, large phenome-wide association study (PheWAS)</a> — which looked for potential associations between the Duffy null variant and 1,400 possible health conditions using the National Institutes of Health&#8217;s All of Us initiative and other cohorts — did not report any associations with disease. However, this is an active area of research.



<h2 class="wp-block-heading" id="h-why-is-duffy-null-status-most-common-in-certain-populations">Why is Duffy null status most common in certain populations?</h2>



Although anyone can have Duffy null status, it is most common among people with African or Middle Eastern ancestry. In the U.S., two-thirds of people who identify as Black or African American have the Duffy null genotype, which means they do not express the Duffy antigen on their red blood cells.&nbsp;



Scientists believe this variant became common in certain populations because it <a href="https://pubmed.ncbi.nlm.nih.gov/21468018/" target="_blank" rel="noreferrer noopener">helps protect against Plasmodium vivax</a>, a malaria parasite that relies on the Duffy antigen to infect red blood cells. (The variant does not protect against other types of malaria.) Over generations, people in regions where this malaria parasite was widespread were more likely to inherit this protective variant, and it remains common today in people with ancestry from some malaria-endemic regions.



<figure class="wp-block-image size-full"><img loading="lazy" decoding="async" width="934" height="597" src="http://35.88.189.111/wp-content/uploads/2025/08/af_rs2814778_C.png" alt="" class="wp-image-34139" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/08/af_rs2814778_C.png 934w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/08/af_rs2814778_C-300x192.png 300w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/08/af_rs2814778_C-768x491.png 768w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2025/08/af_rs2814778_C-880x562.png 880w" sizes="auto, (max-width: 934px) 100vw, 934px" /><figcaption class="wp-element-caption">23andMe data also show that the Duffy null genetic variant is most common in people with ancestry from parts of the world where Plasmodium vivax malaria is common.</figcaption></figure>



<h2 class="wp-block-heading" id="h-the-importance-of-raising-awareness">The importance of raising awareness</h2>



Last year, the American Society of Hematology (ASH) launched the <a href="https://www.hematology.org/education/danc/danc-project" target="_blank" rel="noreferrer noopener">Absolute Neutrophil Count (ANC) by Duffy Status Project</a>, aimed at creating specific neutrophil reference ranges for people with the Duffy null genotype and advocating for broader awareness and testing.



&#8220;The Duffy null genotype is a perfect example of how well-meaning systems can fall short when they don&#8217;t reflect the full diversity of the people they serve,&#8221; says Dr. Merz. &#8220;Raising awareness — among both clinicians and patients — is essential to prevent misdiagnosis and ensure more equitable and personalized care.&#8221;



You can become your own advocate by learning about your Duffy status and sharing that information with your doctor.&nbsp;



The White Blood Cell Count (Duffy Antigen-Related) report is available to <a href="https://www.23andme.com/membership/" target="_blank" rel="noreferrer noopener">23andMe+ Premium™ members</a> with their other Wellness reports.



<div style="float: left; text-align: justified; width: 700px; background-color: #eee; padding: 15px; margin-left: 5px;">
 
<h3>A deeper dive: How lack of awareness of Duffy null status can lead to downstream harm</h3>


Although Duffy null status does not usually cause health problems, harms can arise when Duffy null individuals are misdiagnosed with abnormally low neutrophil counts. These harms can include:
<ul>
<li>
Unnecessary follow-up testing. In general, low neutrophil counts can prompt concern from doctors, because they can be caused by blood cancers like leukemia. Follow-up testing involves a bone marrow biopsy, which is an invasive and sometimes painful test. 
 Because their neutrophil counts may be naturally lower than standard reference ranges, people with Duffy null status are much more likely to receive <a href="https://pubmed.ncbi.nlm.nih.gov/34180972/" target="_blank" rel="noreferrer noopener">unnecessary bone marrow biopsies</a>. And one study reported that Duffy null status was the <a href="https://pubmed.ncbi.nlm.nih.gov/37419240/" target="_blank" rel="noreferrer noopener">most common reason</a> for children to be referred to a children&#8217;s hospital for low neutrophil counts.
</li>
 
<li>
Exclusion from clinical trials. Many chemotherapy drugs reduce WBC production, which can make patients more susceptible to infections. As a result, most cancer clinical trials require patients to have a minimum neutrophil count before starting the trial, to help keep patients safe. 
 But a recent study found that more than 75% of cancer clinical trials have neutrophil thresholds that <a href="https://pubmed.ncbi.nlm.nih.gov/39259539/" target="_blank" rel="noreferrer noopener">exclude some people with Duffy null status</a>. Researchers have suggested these exclusion criteria may be one reason that Black Americans are <a href="https://pubmed.ncbi.nlm.nih.gov/37477920/" target="_blank" rel="noreferrer noopener">less likely to be included in cancer clinical trials</a>.
</li>
 
<li>
Delayed or reduced access to medications. Because some medications reduce WBC production, patients often have their neutrophils counted before and during treatment, so that their clinicians can adjust the dose, delay the start of treatment, or discontinue medications if counts become too low. 
 Because people with Duffy null status tend to have lower starting neutrophil counts, they may experience reduced or delayed access to important medications for <a href="https://pubmed.ncbi.nlm.nih.gov/39259539/" target="_blank" rel="noreferrer noopener">cancer</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/34645395/" target="_blank" rel="noreferrer noopener">mental health conditions</a>, and <a href="https://pubmed.ncbi.nlm.nih.gov/35724382/" target="_blank" rel="noreferrer noopener">autoimmune disorders</a>, or inappropriate dose adjustments. Because chemotherapy dose often increases the chance of survival, some scientists think that inappropriate chemotherapy dosing related to Duffy null status could help explain, in part, why <a href="https://www.cancer.org/about-us/what-we-do/health-equity/cancer-disparities-in-the-black-community.html" target="_blank" rel="noreferrer noopener">breast cancer mortality is higher in Black than white Americans</a>.
</li>
</ul>

</div>

The Duffy Antigen Gene: A Clue Behind White Blood Cell Differences

When it comes to calculating 23andMe customers’ Ancestry Composition results, details are invariably what matter most: more specificity, more interactivity, more <img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2019/01/Ancestry-Overview-Square-300x297.png" alt="" class="alignright size-medium wp-image-26832" width="300" height="297" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/Ancestry-Overview-Square-300x297.png 300w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/Ancestry-Overview-Square-150x150.png 150w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/Ancestry-Overview-Square-768x759.png 768w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/Ancestry-Overview-Square-1024x1012.png 1024w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/Ancestry-Overview-Square-880x870.png 880w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/Ancestry-Overview-Square-1180x1166.png 1180w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/Ancestry-Overview-Square.png 1212w" sizes="auto, (max-width: 300px) 100vw, 300px" />opportunities to draw meaning about how we are all genetically connected to people around the globe. 
In service to this idea, 23andMe has added a trove of content-rich new pages called Ancestry Detail Reports, which offer a more granular view of your ancestry, snapshots of the places and people to which your DNA connects you, and more. This update comes in tandem with an array of improvements and new features to the <a href="https://www.23andme.com/dna-ancestry">Ancestry experience</a>, including a new interactive map of your <a href="https://www.23andme.com/dna-ancestry/">DNA Relatives</a> and enhanced look and feel on mobile and desktop.
We are now offering more than 30 new population-specific pages called Ancestry Detail Reports, as well as evaluating each customer’s ancestry based on more than 1,000 specific regions. 
Ancestry Detail Reports provide a closer look at each of the global populations currently included in our Ancestry Composition feature, enabling customers to explore their own genetic heritage while also learning about other populations included in Ancestry Composition. The creation of this additional layer of detail comes in direct response to requests from our customers for more granularity and additional content in Ancestry Composition.
<img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2019/01/ac_pop@3x-992x1024.png" alt="" class="aligncenter wp-image-26813 size-large" title="Ancestry Composition and Ancestry in Detail Pages" width="992" height="1024" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/ac_pop@3x-992x1024.png 992w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/ac_pop@3x-291x300.png 291w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/ac_pop@3x-768x793.png 768w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/ac_pop@3x-852x880.png 852w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/ac_pop@3x-1143x1180.png 1143w" sizes="auto, (max-width: 992px) 100vw, 992px" />

<div style="float: right; text-align: justified; width: 350px; background-color: #eee; padding: 15px; margin-left: 10px;">
<h6 style="text-align: center;"> Improvements to 23andMe’s Ancestry Experience</h6>
<ul>
<li>30+ new Ancestry Detail Reports with regional maps for our most refined view of your ancestry.</li>
</ul>
<ul>
<li>1000+ regions now included in Ancestry Composition.</li>
</ul>
<ul>
<li><a href="https://you.23andme.com/tools/relatives/map/">Interactive map</a> of where your DNA Relatives call home.</li>
</ul>
<ul>
<li><a href="https://you.23andme.com/ancestry/">Ancestry Overview</a> on desktop and mobile functions like a homepage for all your Ancestry reports, enabling exploration and discovery. </li>
</ul>
<ul></ul>

<ul>
<li>
More African and East Asian populations now available for all customers (first released in September 2018).</li>
</ul>
</div>
<h6></h6>
If you are a 23andMe customer, you can find your specific Ancestry Detail Reports (and explore all possible Ancestry Detail Reports) in a few ways. 
<ul>
<li>The easiest path is navigating to your <a href="https://you.23andme.com/ancestry/">Ancestry Overview</a> and clicking on each featured population under your Ancestry Composition summary. </li>
<li>You can also find these pages by clicking on the <a href="https://you.23andme.com/ancestry/all-reports/">All Reports</a> tab in your Ancestry Overview and looking under Ancestry Composition. There, you can easily view all of the more than 30 new reports and learn more about the diverse populations included in Ancestry Composition. </li>
</ul>
On the 23andMe Mobile Apps, you should see a list of featured populations under your Ancestry Composition results in the Ancestry tab. 
&nbsp;
<h6>A Deeper Dive</h6>
Let’s take a deeper dive into the Ancestry Detail Reports, and learn more about what you’ll discover when you view them. 
&nbsp;
If you’ve been assigned one or more “Recent Ancestor Locations” — these are indicated by the country and territory names you may see listed in your Ancestry Composition summary — you will also likely receive a more detailed map of your results on the associated Ancestry Detail Report. These maps may include the specific states or even counties where we have found evidence of your family’s recent ancestry. The stronger the evidence of a given ancestry, the  higher ranking on the adjacent list and darker the shading is for that region. This new “live” map with specific regional breakdowns will continuously update over time to reflect the growing number of individuals from around the world in 23andMe’s database. 
<img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2019/01/maps@3x-1024x473.png" alt="" class="aligncenter wp-image-26822 size-large" title="Ancestry in Detail, India and China" width="1024" height="473" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/maps@3x-1024x473.png 1024w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/maps@3x-300x139.png 300w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/maps@3x-768x355.png 768w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/maps@3x-880x407.png 880w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/maps@3x-1180x545.png 1180w" sizes="auto, (max-width: 1024px) 100vw, 1024px" />
&nbsp;
A number of the Ancestry Detail Reports contain immersive educational materials that provide further context around each population’s genetics, demographics, history, and more. Curated and written by 23andMe’s scientists, these materials aim to help customers learn important information about their genetic ancestry. These reports can also be used to learn about diverse populations with which you are not genetically connected, but may be curious about.
<h6><img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2019/01/genetics@3x-1024x630.png" alt="" class="aligncenter wp-image-26817 size-large" title="Hunter Gathers and Ashkenazi" width="1024" height="630" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/genetics@3x-1024x630.png 1024w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/genetics@3x-300x184.png 300w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/genetics@3x-768x472.png 768w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/genetics@3x-880x541.png 880w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/genetics@3x-1180x726.png 1180w" sizes="auto, (max-width: 1024px) 100vw, 1024px" />Snapshots</h6>
Another layer to the Ancestry Detail Reports are Snapshots — a handful of researched and reported stories that provide glimpses into the many nuances that make each ancestral population unique. Snapshot topics include: Talk the Talk (words and phrases unique to one of the languages spoken by each population), Ancestry Eats (traditional foods and beverages), Sights to See (off-the-beaten-path travel tips and important landmarks), Natural Wonders, Celebrations, Crafts &amp; Traditions, and more. We encourage customers to contribute ideas for future Snapshots by clicking on the Customer Feedback bar located at the bottom of each Ancestry Detail Report. 
<img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2019/01/snapshots@3x-1014x1024.png" alt="" class="aligncenter wp-image-26830 size-large" title="Snapshots, Sudan and Southeast Asia" width="1014" height="1024" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/snapshots@3x-1014x1024.png 1014w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/snapshots@3x-150x150.png 150w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/snapshots@3x-297x300.png 297w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/snapshots@3x-768x775.png 768w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/snapshots@3x-872x880.png 872w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2019/01/snapshots@3x-1169x1180.png 1169w" sizes="auto, (max-width: 1014px) 100vw, 1014px" />Lastly, at the bottom of each Ancestry Detail Report, customers who have chosen to participate in the DNA Relatives tool can view their relatives who share ancestry from that particular population. For example, a customer with 20 percent Italian ancestry or 55 percent Vietnamese ancestry would see the profile names and profile images of some of their relatives connected to those populations. The content on each Ancestry Detail Report may provide inspiration for starting a conversation with those relatives about your genetic heritage. 
&nbsp;
This new paradigm for exploring Ancestry results on a deeper, more actionable level will set the standard for future updates to the Ancestry Composition experience. Since Ancestry Composition is truly a “living analysis” of your DNA that reflects our growing database, 23andMe will continue to update the  Ancestry Detail Reports at a county and state-level to provide an ever-closer view of your ancestry. Though country and territory maps may not yet be available for every customer, our intent is that this will change as our database continues to expand and diversify.
&nbsp;
23andMe customers can go to their <a href="https://you.23andme.com/ancestry/">Ancestry Overview</a> to start exploring. Not yet a customer? Find out more about 23andMe’s Ancestry service <a href="https://www.23andme.com/dna-ancestry/">here</a>.

More Regions for Most Refined View of Ancestry To-Date

This week 23andMe added a new Carrier Status report on familial Mediterranean fever, a genetic disorder that can include periodic fevers and inflammation in the abdomen, chest or joints.
The Familial Mediterranean Fever (FMF) Carrier Status* report provides information on whether a customer has at least one of seven variants in the MEFV gene. These are not the only variants associated with the condition. However, these are common variants associated with this disorder in people of Arab, Armenian, Sephardic Jewish, and Turkish descent.
<h6>More on Familial Mediterranean Fever</h6>
People with familial Mediterranean fever often have two variants in the MEFV gene, and the disorder often shows up in childhood. Beyond periodic fevers and inflammation, typical symptoms may also include skin rashes. In some cases, FMF can lead to an abnormal buildup of protein in the kidneys.
Among the treatments for FMF are anti-inflammatory drugs that can be used to manage episodes of fever. On some occasions, doctors prescribe drugs to prevent fever attacks and kidney damage, especially for people with the M694V variant. 
<img loading="lazy" decoding="async" class="aligncenter size-large wp-image-26776" src="https://blog-api.23andme.com/wp-content/uploads/2018/12/Scientific-Detail-FMF-1024x870.jpg" alt="" width="1024" height="870" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2018/12/Scientific-Detail-FMF-1024x870.jpg 1024w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2018/12/Scientific-Detail-FMF-300x255.jpg 300w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2018/12/Scientific-Detail-FMF-768x653.jpg 768w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2018/12/Scientific-Detail-FMF-880x748.jpg 880w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2018/12/Scientific-Detail-FMF.jpg 1172w" sizes="auto, (max-width: 1024px) 100vw, 1024px" />This new Carrier Status report doesn’t diagnose familial Mediterranean fever. Instead, it reports on whether a customer is a carrier for at least one of seven variants in the MEFV gene associated with a risk for FMF.
<h6>Carrier Detection Rate</h6>
<div style="float: right; text-align: justified; width: 300px; background-color: #eee; padding: 15px; margin-left: 10px;">
<h6>What’s a Carrier Status* Report?</h6>
Carrier status tests are a type of genetic test used to find out if you carry a genetic change – or variant. For the types of conditions included in a carrier status test, having one genetic change – being a carrier – typically means you do not have that condition, but you could pass the variant on to your each of your children.Carrier status tests are typically offered for autosomal recessive conditions [or disorders]. For these conditions, a child needs to inherit a variant from both parents in order to have the condition. If both parents are carriers, each child has a one in four, or 25 percent, chance of being affected with the condition. 
(It’s important to note that this also means that each child has a 75 percent chance of not being affected.)Autosomal recessive conditions for which carrier testing is commonly offered by healthcare providers include cystic fibrosis, Tay-Sachs disease, and <a href="https://www.23andme.com/topics/carrier/sickle-cell-anemia">sickle cell anemia</a>, among many others.
</div>
The &#8220;carrier detection rate&#8221; for this report — which is the percentage of carriers of FMF who are expected to be identified by this test — is from 70 percent to more than 90 percent for people of Arab, Armenian, Sephardic Jewish, and Turkish descent.
The FMF report is the latest in a regular cadence of new health-related reports 23andMe offers <a href="https://www.23andme.com/dna-health-ancestry/">Health+Ancestry</a> Service customers, all of which meet FDA requirements. This brings the total number of <a href="https://www.23andme.com/dna-health-ancestry/#toc-carrierstatus">Carrier Status</a>* reports to 44.
23andMe also offers nine <a href="https://www.23andme.com/dna-health-ancestry/#toc-ghr">Genetic Health Risk</a>* reports, eight Wellness reports on such things as Genetic Weight and Sleep Movement, and more than two dozen different trait reports.
As with other health-related reports, 23andMe has a tutorial that customers can go through before viewing their Familial Mediterranean Fever Carrier Status report. In addition to the tutorial, the report itself offers details on the condition, the specific variants tested for and the scientific information supporting the report. There are also links to information about genetic counseling and support group resources.
<h6>Note </h6>
*The 23andMe PGS 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&#8217;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. The Familial Mediterranean Fever Carrier Status Report is indicated for the detection of seven (7) variants in the MEFV gene and is most relevant for people of Arab, Armenian, Sephardic, Jewish, and Turkish descent. For important information and limitations regarding other genetic health risk reports and carrier status reports, visit <a href="https://www.23andme.com/test-info/">https://www.23andme.com/test-info/</a>.

23andMe’s Report on Familial Mediterranean Fever

Over the last decade, more and more people have embraced a gluten-free diet, but their motivations often differ.

Some of these people might have wheat allergies or gluten intolerance. But a small percentage of people have a condition called <a href="https://www.23andme.com/topics/health-predispositions/celiac-disease">celiac disease.</a> For someone with celiac disease gluten triggers an immune response that damages the small intestine. This can affect the absorption of nutrients and lead to painful digestive problems.

<img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2017/10/Celiac_1-1024x535.png" alt="" class="aligncenter size-large wp-image-25801" width="1024" height="535" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2017/10/Celiac_1-1024x535.png 1024w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2017/10/Celiac_1-300x157.png 300w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2017/10/Celiac_1-768x401.png 768w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2017/10/Celiac_1-880x460.png 880w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2017/10/Celiac_1-1180x617.png 1180w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2017/10/Celiac_1.png 1200w" sizes="auto, (max-width: 1024px) 100vw, 1024px" />
&nbsp;
<h6>New 23andMe Report on Celiac Disease</h6>
This week 23andMe released a new genetic health risk report on celiac disease.*  The new report looks at two genetic variants — rs2187668 and rs7454108 — that are linked to the HLA-DQ2.5 and HLA-DQ8 haplotypes associated with higher risk for celiac. 
A haplotype is a group of genes inherited together from a single parent. People with one or both of these two haplotypes account for about 95 percent of all of celiac disease cases. So if you have celiac disease, it’s likely you have one of these variants. 
But it’s important to note that having one of these variants doesn’t mean you will develop celiac disease. Although 15 to 30 percent of all people have one of these risk variants, only about 3 percent of people with one of these variants develop celiac disease. If you don’t have one of these haplotypes it is very unlikely that you will develop celiac disease.
<h6>A Gluten-Free Diet</h6>
But knowing you have one of these variants can be important especially for those who believe they have symptoms or additional risk factors. If they learn they have at least one of the risk variants, the report could help them follow-up with a doctor. A doctor  may recommend more rigorous screening. For most people with celiac disease, the most effective treatment is adhering to a completely gluten-free diet. This can help alleviate symptoms and allow the small intestine to heal.

It’s possible to have gluten sensitivity and not have celiac disease. This report does not cover non-celiac disease gluten sensitivity. 23andMe doesn’t currently have reports on food allergies or other sensitivities to gluten.

23andMe&#8217;s Celiac Disease report adds to a growing list of valuable and actionable <a href="https://www.23andme.com/dna-health-ancestry">genetic health risk reports</a> we offer customers. 

*The Celiac Disease genetic health risk report (i) is indicated for reporting of the rs2187668 variant in the HLA-DQA1 gene, which tags the HLA-DQ2.5 haplotype; and the rs7454108 variant near the HLA-DQB1 gene, which tags the HLA-DQ8 haplotype, (ii) describes if a person has variants associated with an increased risk of developing celiac disease, and (iii) is most relevant for people of European descent.

New 23andMe Report on Celiac Disease

A Personalized Guide to the Incredible You
By Scott Andress, Director of Product Design at 23andMe
Your 23andMe results have arrived. The day you’ve been waiting for is here. It’s the culmination of curiosity, mystery — even trepidation. What will you find out about yourself and your family? The answers are just one click away.<img loading="lazy" decoding="async" class="alignright wp-image-24050 size-medium" src="https://blog-api.23andme.com/wp-content/uploads/2016/06/Homepage4-300x202.jpg" alt="Homepage4" width="300" height="202" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/Homepage4-300x202.jpg 300w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/Homepage4-768x518.jpg 768w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/Homepage4-1024x690.jpg 1024w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/Homepage4-880x593.jpg 880w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/Homepage4-1180x796.jpg 1180w" sizes="auto, (max-width: 300px) 100vw, 300px" />
This is a pivotal moment for our customers – and this is where we first placed ourselves as product designers. How can we help people navigate through a rich forest of hundreds of thousands of genetic markers and show them the ways their genes make them truly unique?
<h2>The opportunity</h2>
Designing a consumer product powered by complex genetic information is challenging. 23andMe provides customers with deeply personal insights into themselves and their families. Access to this knowledge is useful, interesting, and fun, but it can also be sensitive. As product designers, we strive to create a customer experience that presents a wide range of information with a clear, approachable, and human tone.
<img loading="lazy" decoding="async" class="alignright wp-image-24049 size-medium" src="http://35.88.189.111/wp-content/uploads/2016/06/group_sprint-300x114.jpg" alt="" width="300" height="114" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/group_sprint-300x114.jpg 300w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/group_sprint-768x291.jpg 768w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/group_sprint-1024x388.jpg 1024w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/group_sprint-880x333.jpg 880w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/group_sprint-1180x447.jpg 1180w" sizes="auto, (max-width: 300px) 100vw, 300px" />Late last year, we launched the new 23andMe experience, making us the first and only direct-to-consumer company to offer reports that meet FDA standards for scientific and clinical validity. Building on what we learned from earlier versions of our product, our objective was to design a more streamlined interface that would clearly present personalized information on carrier status, traits, and ancestry.
The new website design improved our product in many ways. Overall, streamlining the experience paid off by making genetic information easier to access and comprehend. But our homepage — the first thing our customers see when they log in to our service and the crossroad for our experience — was overly simplified and lacked key functionality. We knew we could do better.
Early this year, we took a fresh look at our homepage. Our goal was to create something that would guide customers through our services by providing meaningful and personalized information, while surfacing interesting activities to engage with. Here’s how we approached this project.
<h2>Our process</h2>
To kick off our project, we conducted a design sprint. For inspiration, we looked to the great foundations provided by the <img loading="lazy" decoding="async" class="alignright size-medium wp-image-24046" src="https://blog-api.23andme.com/wp-content/uploads/2016/06/sketch_wall-300x137.jpg" alt="sketch_wall" width="300" height="137" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/sketch_wall-300x137.jpg 300w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/sketch_wall-768x351.jpg 768w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/sketch_wall-1024x468.jpg 1024w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/sketch_wall-880x402.jpg 880w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/sketch_wall-1180x539.jpg 1180w" sizes="auto, (max-width: 300px) 100vw, 300px" />
Day one of our sprints started with an intensive cross-functional collaborative session that included not just designers, but product managers, engineers, and scientists. Each team member brought their own experience, perspective, and data to the table so that we could paint a holistic picture of the possibilities and challenges at hand. After setting the stage and outlining the customer journey, we separated to individually create a broad range of potential solutions through rapid, low-fidelity sketches. Our goal was to generate and collect as many different concepts as possible. When we reconvened as a group, we critiqued, questioned, and ranked each concept. From there we decided which ideas were the top contenders to inform a design prototype that we would test with customers. Clear themes were beginning to emerge:
<ul>
<li>Personalization is essential. Everyone is unique and their results should illustrate that. If we could create ways to personalize the experience, we would make our services feel more friendly, human and approachable.</li>
<li>Easy navigation will enhance value. Some of our customers know exactly what they are looking for and just want a quick way to find it. Other customers aren’t sure what features are available to them. We should create a system that allows all customers to find what they are looking for, while also offering a way to discover new things they were previously unaware of. As customers go on their own individual journeys, they would benefit from recommendations for what to do next.</li>
<li>Summarize and provide context. Ultimately our goal is to help customers better understand themselves through genetics. We should find ways to inform and educate our customers about how genetics influences their lives. Our job is to connect the dots and provide easy to understand take-aways.</li>
</ul>
Days two and three of our sprint focused on bringing these ideas together into a cohesive design for us to test. As the design team started to work through the concept sketches and notes from the previous day, organizing them according to themes and emerging principles, we started to see some patterns that indicated two possible directions.
<img loading="lazy" decoding="async" class="alignright size-medium wp-image-24048" src="https://blog-api.23andme.com/wp-content/uploads/2016/06/homepage-laydown-9-300x164.jpg" alt="homepage laydown 9" width="300" height="164" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-9-300x164.jpg 300w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-9-768x420.jpg 768w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-9-1024x560.jpg 1024w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-9-880x481.jpg 880w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-9-1180x645.jpg 1180w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-9-271x149.jpg 271w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-9-372x204.jpg 372w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-9-574x315.jpg 574w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-9-980x539.jpg 980w" sizes="auto, (max-width: 300px) 100vw, 300px" />The first direction centered around a comprehensive overview that encouraged free-range exploration. In this model we would reveal almost everything available for the customer to explore, all on one dashboard. The other direction provided a more focused and guided experience, where we would provide some high-level information and focus on a personalized activity feed that would recommend what the customer could do next. After debating the merits of both ideas, we came to the conclusion that each direction had promise. We decided to rapidly design and prototype both models. Essentially, we kicked-off a UX bake-off, putting both designs up against each other to find the ultimate customer experience.
On days four and five we tested our design prototypes with current customers and with people who were not familiar with 23andMe. We learned a lot from these interviews. First, we found that both directions were perceived as an improvement over the current version. Good news —  we were on to something! But instead of a singular winning direction, we learned that customers wanted the best parts of each design. Customers want clear and easy navigation, interesting take-aways and guidance on what to do next. We also relearned something that we had, admittedly, heard in previous studies – personalization doesn’t necessarily mean a prominently featured profile photo. “I already know what I look like! I don’t need to see my face at the top of the page,” is something we heard from more than one participant. Okay, no big profile photos — got it!
<h2>The outcome</h2>
Having a robust, clear, and well-grounded point of view is essential for meaningful product experiences. As designers and as a cross-functional product team, we should strive to be the experts of our product and formulate a vision for how it should evolve over time. A crucial part of this expertise is gained by becoming ardent advocates for our customers and understanding their points of view. Being open and receptive to their candid feedback is essential. A highly effective product team knows how to gauge and absorb feedback while thoughtfully incorporating it into the directional vision.
When done successfully, the result fulfills the customer’s desires and the overall goals for the product experience. This approach is especially important when designing for new and emerging experiences like personal genetics and consumer health products. These capabilities are so new to most people that it is our responsibility to show our customers what is possible, to educate them about the science and to guide them through the best ways to take advantage of what they learn.
<img loading="lazy" decoding="async" class="alignright size-medium wp-image-24047" src="https://blog-api.23andme.com/wp-content/uploads/2016/06/homepage-laydown-10-300x164.jpg" alt="homepage laydown 10" width="300" height="164" srcset="https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-10-300x164.jpg 300w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-10-768x420.jpg 768w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-10-1024x560.jpg 1024w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-10-880x481.jpg 880w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-10-1180x645.jpg 1180w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-10-271x149.jpg 271w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-10-372x204.jpg 372w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-10-574x315.jpg 574w, https://blog.pub.us-west-2.prd.23andme.us/wp-content/uploads/2016/06/homepage-laydown-10-980x539.jpg 980w" sizes="auto, (max-width: 300px) 100vw, 300px" />As our design sprint approached conclusion, we used our study findings to help us blend the best components from both directions into a single compelling design.
The final homepage design provides our customers with just three main elements: an interactive header that educates by providing context for results, quick navigation fortified with some basic summary information and a dynamic activity feed that recommends items to see and do. In other words, this page answers these questions for our customers; How do my genes make me unique? Where is my most important information? What can I do next?
Next, we started the hard work to bring the vision to life. For several weeks our product management and engineering teammates collaborated to build the functionality required to power the personalization and other new capabilities of the homepage. One key element was the new interactive header module. This was a big opportunity to provide valuable, personalized context and education to our customers. It was also a chance to incorporate our vibrant and friendly brand. Tuning this interaction to make it work well responsively — across desktop, tablet and phone browsers — was a big challenge. But the result is a great example of how a delightful interactive element can enhance the presentation of substantive information.
Before we made the new homepage available to all of our customers, we conducted a final series of tests with live traffic on our website to compare how well it would perform relative to the version it would replace. Overall, the results of this test showed us that customers spent more time on the new homepage and on the entire website each time they logged in. They also engaged with more reports and other key features compared to our original homepage. These findings demonstrated that our goal had been achieved. Our new homepage was a valuable guide for customers, helping them gain most from our services.
<h3>What’s next?</h3>
Our new personalized homepage advances our goal to provide customers with easy and straightforward access to their most important personal information — their own genetics. Customers can easily gain insights into how their genes make them unique. And the new homepage guides them with personalized recommendations to get the most from our service. But this is just the beginning of a continuously improving and expanding experience. The page will evolve as we learn more from our customers over time.
So what lies ahead for product design at 23andMe? After the success of our design sprint for the new homepage, we started to ask how we might take this thinking and apply it to other key features across our customer experience. Stay tuned — we’re working hard on some awesome new capabilities for the 23andMe service over the next few months.
Special thanks to Crystal Shei, Diane Wei, Caitlyn McCarthy, Gloria Lin,   and Susan Furest on our product design team, as well as Sooyun Choi and our brand and marketing team, for bringing their talents and insights to this project.   And a shout out to our cross-functional team across product management, science, consumer insights, analytics and engineering for enthusiastically embracing the design sprint process and for collaboratively driving this project from concept to reality.

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