DNA in Retrograde
This article in , a collaboration among , , and .
When uBiome was founded in 2012, the world was a different place. Silicon Valley was regarded with more reverence than suspicion, and DNA testing company had just dropped its $299 price tag down to $99 to attract less wealthy customers interested in learning more about their genetics. UBiome promised people the same kind of insight into their bodies, but through their poop. Plus, it was for a good cause: uBiome billed itself as a citizen science project, where all samples would go toward gut microbiome research. 鈥淏y joining uBiome, you can explore your own microbiome as well as take part in the process of scientific discovery,鈥 the company鈥檚 website .
Personal microbiome explorers were initially uBiome鈥檚 target audience, but as investors poured money into the company, its business model evolved. In , Business Insider reports that according to internal emails, uBiome 鈥渟witched gears鈥 in 2016 to marketing its tests as medical tools. Realizing that it had overpromised investors the number of billable tests run, the company approached previous customers and asked them if they wanted to 鈥渦pgrade鈥 to a medical-grade test called SmartGut. The upgrade was free for customers, but billed insurance companies thousands of dollars. Fast forward three years: After an FBI raid in April, the company has now and is under investigation for .
The company鈥檚 claims that its tests could be medically diagnostic were always somewhat dubious. The gut microbiome is a constantly changing environment, and a single sample can鈥檛 tell you about its overall health. One former uBiome employee who had used the company鈥檚 tests told Business Insider鈥檚 Erin Brodwin that some of the results 鈥渞emind me of astrology.鈥 He went on: 鈥淵ou get one SmartGut report and you might say, 鈥極h, well that totally explains why I鈥檝e been having such-and-such problem.鈥 Then you do it the next day, and you get completely different results.鈥
Science and astrology are often seen as opposite poles, and this former employee鈥檚 words seem carefully chosen to draw on that contrast. The implication is that anything making a scientific claim, like a medical test, should not be as squishy as astrology. Yet the same thing that drives some people toward astrology drives others toward mail-in test kits: People want to learn more about themselves and make sense of why they are the way they are. Your life might be fine, but perhaps it could be better if you understand yourself on a deeper level.
After all, that鈥檚 where 23andMe started. There was novelty in a test that told you where your ancestors came from, and the company鈥檚 website in 2008 reflects that, using words like discovery, fun, and empowerment. The company still offers many tests that seem born of idle curiosity more than anything else, like what genes you have for . This type of result invites armchair self-diagnosis: Ah, so maybe my genes explain why I can鈥檛 handle more than a cup of coffee without getting super jittery! In a review of the 23andMe user experience, Sofia Sokolove writes in that her report turns up a high caffeine metabolism, which 鈥渇eels like a solid piece of information to wield over friends that judge me for a 5 p.m. coffee. And I brag to everyone who will listen about my muscle composition, which apparently is, ahem, 鈥榗ommon in elite athletes.鈥 鈥 She鈥檚 eager to know more about her genetic traits: 鈥淭here鈥檚 just something inherently compelling about learning why I am the way that I am.鈥
One might turn to astrology for the same type of meaning-making. You have about as much control over the cosmos as you do your genetics, but perhaps returning to core elements of your identity can reveal new insights. A horoscope might not be based in science, but if you take the time to read it and believe it鈥檚 speaking to you, it might spur you on to examine why a friendship feels off or why you鈥檙e feeling uninspired at work. It鈥檚 not a coincidence that astrology, too, is having a cultural moment: Horoscope app Co-Star just raised to expand from iOS to Android, and astrology social media accounts like have amassed hundreds of thousands of followers. In the Atlantic, Julie Beck explores right now:
It does give one a pleasing orderly sort of feeling, not unlike alphabetizing a library, to take life鈥檚 random events and emotions and slot them into helpfully labeled shelves. This guy isn鈥檛 texting me back because Mercury retrograde probably kept him from getting the message. I take such a long time to make decisions because my Mars is in Taurus. My boss will finally recognize all my hard work when Jupiter enters my tenth house. A combination of stress and uncertainty about the future is an ailment for which astrology can seem like the perfect balm.
But the don鈥檛 believe astrology is scientific; many of the people Beck interviews see it as a tool for contemplation, not an empirically rigorous practice. Mail-order test companies, however, give off that air of scientific authority. People might be more apt to believe that a test using your spit, blood, or poop will yield scientifically rigorous information about your health and physiology.
Take, for instance, the claim that a genetic analysis can help . On its face, this seems plausible, but there isn鈥檛 yet strong evidence linking genetics and any kind of personalized health plan. Certainly, it can鈥檛 hurt to know what genes you have, but will knowing actually yield actionable results? When the Verge鈥檚 Angela Chen , she concluded that it was 鈥渦nlikely to do major harm, but it鈥檚 unlikely to help either.鈥 She, too, found a parallel between her results and astrology, calling our DNA 鈥渢he original birth charts.鈥 A have also reported being unimpressed with their mail-in test results.
Disappointment is one thing, but the darker side of these tests is when a company overpromises their tests鈥 diagnostic abilities, providing an avenue for people to seek astrology-style answers to questions that really should be addressed by live medical experts. A single, easy-to-take test may seem authoritative, but there could be important missing context that a trained professional could provide, or they may suggest a different diagnostic tool entirely. In the case of uBiome, gastroenterologists say the company鈥檚 diagnostic test can鈥檛 hurt, but is of the gut. That would require longer-term monitoring and multiple tests over time.
But just taking a test can lead people to mistakenly believe they know more about their health than they actually do. For instance, food sensitivity tests, like one offered by health test company EverlyWell, use a customer鈥檚 tiny pinprick of a blood sample to determine their immune responses to dozens of foods.* The test measures the blood鈥檚 reactivity to an immune protein called Immunoglobulin G; high IgG levels are interpreted as a show of food sensitivity. But say IgG tests are not a reliable way of measuring allergies or sensitivities, even if some people report feeling better after cutting out certain foods at the recommendation of their IgG tests. Rather, , this 鈥渉uxterist testing is keying off of the placebo effect鈥: You might feel better just because you took a step toward understanding what鈥檚 鈥渨rong鈥 with you. But in the long run, , at-home food sensitivity tests are 鈥渁 confusing distraction 鈥 in the pursuit of actually helpful and actionable answers.鈥
Tests can also be used to 鈥渃onfirm鈥 existing beliefs about health and wellness. One recent example of this is how some people are using 23andMe tests to seek medical exemptions for vaccinating their children. They use the test to , a move that鈥檚 based on an overinterpretation of a 2008 paper that found people with certain genetic mutations are at greater risk of developing adverse reaction to smallpox vaccines. That this finding is being used to justify medical exemptions on the basis of linking vaccines with autism is an outcome the paper鈥檚 authors did not expect, and that one author of the paper called 鈥渋llogical and inappropriate.鈥
That鈥檚 not to mention the risk that these tests are sometimes just straight-up , or the serious privacy concerns with sending companies your biological data. But if there鈥檚 one thing we can learn from uBiome鈥檚 failure, it鈥檚 that when companies rebrand services once marketed as 鈥済enetic explorations for the curious鈥 as diagnostic tools, consumers should be wary of their claims.
Personalized genetic readings can still be fun, even if they don鈥檛 promise the sun, moon, and stars; genomics company sells, alongside some dubious-sounding tests, personalized DNA clothing, tote bags, couch throws, and artwork. But if you鈥檙e really concerned about your fertility, your gut health, or your cancer risk? If you wouldn鈥檛 consult your horoscope, you might not want to consult a mail-in test either.