<div dir="ltr"><div class="gmail_extra"><div class="gmail_quote">On Wed, Nov 27, 2013 at 10:59 AM, BillK <span dir="ltr"><<a href="mailto:pharos@gmail.com" target="_blank">pharos@gmail.com</a>></span> wrote:<br><blockquote class="gmail_quote" style="margin:0px 0px 0px 0.8ex;border-left:1px solid rgb(204,204,204);padding-left:1ex">

<br>
It is the medical 'snake-oil' that the FDA doesn't like. And it has a<br>
lot of medical and scientific support.<br></blockquote><div><br></div><div>What medical snake-oil? Do you have a specific example? 23andMe seems to be very careful about explaining exactly what one's results mean.<br>

<br></div><div>For example:<br>
        





        
        
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    <h3 id="phenotype_title">Restless Legs Syndrome</h3>

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    <p>Imagine what it would be like to crawl into bed every night, 
ready to catch some much-needed Zs, only to be struck by an 
irrepressible urge to move your legs as soon as you began to relax. No 
matter how tired you were, instead of drifting off peacefully, you would
 be compelled to get up and move around. It may sound crazy, but this is
 exactly the situation people with restless legs syndrome (RLS) 
experience. Though the symptoms in many people are milder, it is 
estimated that about 4% of the U.S. population suffers from this 
puzzling disorder.</p>
    <p>The following results are based on
      
      <span class="">
        <a class="" href="https://www.23andme.com/you/journal/legend2/">
          <img class="" src="https://23andme.https.internapcdn.net/res/img/icons/journal/SXFvu0knArOA-3fuqp1Xzw_study_size4.gif">
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                <strong>Established Research</strong> for 1 reported marker,

            
        
        
        updated <a href="https://www.23andme.com/you/journal/restlesslegs/overview/#last_update" style="font-weight:normal" class="">July 16th, 2009.</a>
        
           
    </p>
    
                <p>
                        
                         <a href="https://www.23andme.com/you/journal/restlesslegs/howitworks/">Learn more about the biology of Restless Legs Syndrome...</a>
                        
                        
                                <br>
                                <a href="https://www.23andme.com/you/journal/restlesslegs/timeline/">Major discoveries in Restless Legs Syndrome...</a>
                        
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                       <span class="">1 of 3. Not getting enough sleep can 
cause decreased concentration, impaired memory, slowed reaction times, 
and a weakened immune system.</span>
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        <div class="" id="genetic_results">


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        <h3>Your Genetic Data</h3>
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    <div class="" style="margin-top:14px">
        <a href="https://www.23andme.com/user/invitations/invite/?phenotype_id=restlesslegs" class="">» Share your health results</a>
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                <form id="risk_assessment_form" action="/you/journal/restlesslegs/risk_assessment/" method="POST">
                    
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                <div class="">Show information for
                    

 assuming 
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                    <div>
                    


    
        
    

 ethnicity 
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                <div class="">and an age range of 


    
        
    
        
    
        
    
        
    
        
    
        
    
        
    
        
    

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                        <div class="" id="user_demography_title">David Sill</div>
                        <span class=""><span class="" id="numerator_user">1.5</span> out of 100</span>
                        <div class=""><span class="">men</span> of <span class="" id="ancestry_user">European</span> ethnicity
                        who share <span class="" id="genotype_user1">David Sill</span>'s genotype
                        will develop Restless Legs Syndrome
                        between the ages of <span class="" id="age_lo_user">0</span> and
                        <span class="" id="age_hi_user">79</span>.</div>
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                        <div class="">Average</div>
                        <span class=""><span class="" id="numerator_average">2.0</span> out of 100</span>
                        <div class=""><span class="">men</span> of <span class="" id="ancestry_average">European</span> ethnicity
                        will develop Restless Legs Syndrome
                        between the ages of <span class="" id="age_lo_average">0</span> and
                        <span class="" id="age_hi_average">79</span>.</div>
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            <div style id="odds_explanation" class="">
            <div class="">What does the Odds Calculator show me?</div>
            <div class="" style="color:rgb(51,51,51)">
            <p>Use the ethnicity and age range selectors above to see the estimated incidence of Restless Legs Syndrome due to genetics for <span class="">men</span> with <strong><span class="" id="genotype_user2">David Sill</span></strong>'s
 genotype.  The 23andMe Odds Calculator assumes that a person is free of
 the condition at the lower age in the range.  You can use the name 
selector above to see the estimated incidence of Restless Legs Syndrome 
for the genotypes of other people in your account.</p>
            <p>The 23andMe Odds Calculator only takes into account 
effects of markers with known associations that are also on our 
genotyping chip.  Keep in mind that aside from genetics, environment and
 lifestyle may also contribute to one's risk for Restless Legs Syndrome.</p>
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      <div class="">
        <h3 class="">Genes vs. Environment</h3>
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            <div class="" id="hlabel" style="text-align:center">
                    
                    
                        54
                    %
                    
                    <div style="font-size:10px">Attributable to Genetics</div>
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        <div id="heritameter_text" class="">
        The heritability of restless legs syndrome is estimated to be 
54%.  This means that genetic and environmental factors contribute 
nearly equally to differences in risk for this condition.  Genetic 
factors that play a role in restless legs syndrome include both unknown 
factors and known factors such as the SNPs we describe here. 
Environmental factors include pregnancy.  Low iron levels, dialysis for 
end-stage renal disease, and damage to the nerves of the hands and feet 
tend to worsen the condition.
        (<span style="color:rgb(0,129,198)" id="show_hide_citations">sources</span>)
            
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        <br>
                <div class="">What You Can Do</div>
                <div class="">
                        <div class=""><p>Assuming the ethnicity setting above is correct, your test results indicate you are not at 
            increased risk for restless legs syndrome based on your genetics.  Family history and 
            non-genetic factors can also influence your risk, but note that this condition is fairly 
            rare. Below are some steps you can take to reduce your risk.</p></div>
                        
                        <p><strong>Keep chronic diseases under control</strong><br>
            Chronic diseases such as kidney failure, diabetes, Parkinson's, and peripheral neuropathy 
            can exacerbate symptoms of RLS, but managing them can reduce symptoms of RLS.</p>

            <p><strong>Watch iron levels, and your intake of caffeine, alcohol, and tobacco</strong><br>
            According to the <a href="http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm#154003237">
            National Institute of Neurological Disorders and Stroke</a>, caffeine, alcohol, and tobacco 
            may aggravate or trigger symptoms in patients who are predisposed to develop RLS, as can 
            low iron levels.</p>

            <p><strong>RLS can occur if you're pregnant or taking certain drugs</strong><br>
            If RLS symptoms appear, they usually disappear once the pregnancy is completed or the 
            drug regimen is stopped.</p>

            <p><strong>Learn your family medical history</strong><br>
            According to the <a href="http://www.mayoclinic.com/health/restless-legs-syndrome/DS00191/DSECTION=causes">
            Mayo Clinic</a>, RLS tends to run in families, especially when it occurs at an early age.  
            The U.S. Surgeon General's <a href="http://familyhistory.hhs.gov/fhh-web/home.action">
            My Family Health Portrait</a> tool can help you assemble your family medical history.</p>

            <p><strong>Connect with relevant groups</strong></p>
            <ul><li><a href="http://www.rls.org">Restless Legs Syndrome Foundation</a><br>
            877-INFO-RLS</li><li><a href="http://www.wemove.org/rls/">WE MOVE</a><br>
            800-437-MOV2</li></ul>

            <p><strong>Talk with a genetic counselor</strong><br>
            A genetic counselor specializes in helping people understand
 genetic disorders and genetic test results. Learn more about genetic 
counseling <a href="https://www.23andme.com/you/genetic_counseling">here</a>.</p>
                </div>
        
                <div class="">Marker Effects</div>
        <div class="">
            
            
            <div id="rt_marker_explanation" class="">
                <h5 class="">What does this chart show?</h5>
                <p>The chart shows the approximate effects of the selected
                person's genotype at the 1
                reported marker.
                Higher, <span style="color:rgb(240,0,64)">red bars</span> indicate
                <span style="color:rgb(240,0,64)">increased risk</span> from the
                average, while lower, <span style="color:rgb(56,208,11)">green
                    bars</span> indicate <span style="color:rgb(56,208,11)">decreased
                    risk</span> from the average. The light gray bars show the
                maximum possible effects for the possible genotypes at the
                marker.
                </p>

                <p>Mouse over individual bars to view additional
                information about each marker. Click on a bar to view detailed
                information about that marker below. You can read more about
                all markers in the <a href="https://www.23andme.com/you/journal/restlesslegs/techreport/">technical report</a>.
                </p>
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            <div id="gene_desc_wrapper">
              
              <div id="gene_description">
                  

        <div class="">
            <div id="gene_name" class="">
                <div class="">BTBD9</div>
                        
                    <div class="">Marker:<a class="" href="https://www.23andme.com/you/explorer/snp/?snp_name=rs3923809">rs3923809</a></div>
                        
                
            </div>
            <div class="">
            <p>The function of this gene is not yet known. Scientists do know 
that it belongs to a large family of genes that encode proteins that can
 influence activity levels of other genes. The SNP in this gene doesn’t 
actually cause a change in the protein sequence of BTBD9. Instead, it 
lies in a non-coding part of the gene where it may affect how BTBD9 is 
turned on or off.</p>
                        
                        <p>One group found that the A version of this SNP is 
specifically associated with PLMS. Because such a large percentage of 
people with RLS also have PLMS, this SNP is also a good predictor of RLS
 risk. There was, however, no association of the riskier version of the 
SNP in people with RLS who did not also have periodic limb movements in 
sleep (PLMS).</p>
                        
                        <p>The protein encoded by BTBD9 is found in many 
different parts of the brain (in addition to other organs) and is 
therefore a good candidate for a gene involvement in other neurological 
disorders similar to RLS and PLMS. In addition, even though there is no 
previously known link between BTBD9 and iron levels, the riskier version
 of this SNP was has been associated with decreased iron stores in the 
body.</p>
                        
                        <p>The studies whose data we report as applicable to 
those of "European" ancestry confirmed the association between this SNP 
and RLS in samples from Germany and Canada.</p>
                        
                        <p>This association has not been investigated in samples of Asian or African ancestry.</p>
            </div>
        </div>
        
        
                <div class="">
                    <div class="">Citations</div>
                    <div class="">
                                
                                        <div class="">
                                            

    <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Search&db=PubMed&term=17634447">Stefansson et al. (2007)</a>




. “A genetic risk factor for periodic limb movements in sleep.” <em>N Engl J Med</em> 357(7):639-47.

                                        </div>
                                
                                        <div class="">
                                            

    <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Search&db=PubMed&term=17637780">Winkelmann et al. (2007)</a>




. “Genome-wide association study of restless legs syndrome identifies common variants in three genomic regions.” <em>Nat Genet</em> 39(8):1000-1006.

                                        </div>
                                
                                        <div class="">
                                            

    <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Search&db=PubMed&term=11340155">Collins et al. (2001)</a>




. “All in the family: the BTB/POZ, KRAB, and SCAN domains.” <em>Mol Cell Biol</em> 21(11):3609-15.

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    The genotyping services of 23andMe are performed in LabCorp's
    CLIA-certified laboratory. The tests have not been cleared or
    approved by the FDA but have been analytically validated
    according to CLIA standards. The information on this page is 
    intended for research and educational purposes only, and is not 
    for diagnostic use.
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<br></div><blockquote class="gmail_quote" style="margin:0px 0px 0px 0.8ex;border-left:1px solid rgb(204,204,204);padding-left:1ex">
I think it is too early to be making health recommendations. We don't<br>
know enough about how our DNA affects us and how genes interact with<br>
each other. More research is required.<br></blockquote><div><br></div><div>And 23andMe is contributing to that research. <br></div><div> </div><blockquote class="gmail_quote" style="margin:0px 0px 0px 0.8ex;border-left:1px solid rgb(204,204,204);padding-left:1ex">


Maybe if 23andMe enhanced the genealogy side and toned down the<br>
medical side to vague 'worth asking your doctor about' hints, they<br>
might keep the FDA happy.</blockquote><div><br></div><div>I wouldn't bet on it.<br><br></div><div>-Dave<br></div></div></div></div>