Genetic Testing
Comprehensive genetic analysis for disease risk, pharmacogenomics, and personalized health optimization.
Evidence Summary
Pharmacogenomics is now RCT-proven: in the PREPARE trial (Swen et al., Lancet 2023; 6,944 patients across 7 European countries, 12-gene panel), genotype-guided prescribing reduced clinically relevant adverse drug reactions by ~30% — from 28% to 21% of patients (odds ratio 0.70, 95% CI 0.54-0.91). Polygenic risk scores are maturing for prevention: a 2025 multi-ancestry score (npj Cardiovascular Health) reclassified 7-11% of borderline/intermediate-risk adults into a high-risk group carrying 3.2-3.8x the 10-year coronary-artery-disease risk, validated in more than 150,000 people. APOE genotyping informs Alzheimer's-prevention planning: APOE4 homozygotes show near-complete biological penetrance for AD pathology, with biomarker changes from roughly age 55 and 75% amyloid-positive scans by 65 (Fortea et al., Nature Medicine 2024). BRCA, APOE, and pharmacogenomic variants remain well-validated for risk and drug selection; polygenic scores are evolving rapidly. Educational information, not medical advice. Sources: https://pubmed.ncbi.nlm.nih.gov/36739136/ ; https://www.nature.com/articles/s44325-025-00049-7 ; https://www.nature.com/articles/s41591-024-02931-w
Evidence Scale
Mechanism of Action
DNA analysis identifies variants affecting disease risk, drug metabolism, nutrient needs, and health optimization opportunities.
Who Is This For?
Personalized prevention, pharmacogenomics, family planning, curiosity. Consider psychological readiness.
Protocol & Dosing
Dose
Single test providing lifetime information. Various depths of analysis available.
Frequency
Once (lifetime)
Duration
Results permanent
Protocol Summary
Saliva or blood sample. Various test depths from consumer to medical-grade. Genetic counseling recommended for significant findings.
Interactions & Precautions
Contraindications
- None for testing
- Psychological readiness considerations
Potential Risks
- •Psychological impact
- •Uncertainty in interpretation
- •Privacy concerns
Potential Side Effects
Practitioner Notes
Clinical annotations from Dr. Goel
Pharmacogenomics immediately actionable. APOE useful for Alzheimer prevention strategies. Consider genetic counseling for significant findings. PREPARE (Lancet 2023) now provides randomized evidence that pre-emptive pharmacogenomic panel testing reduces clinically relevant adverse drug reactions — consider pre-emptive PGx for patients starting higher-risk drugs such as clopidogrel, codeine/opioids, SSRIs, statins, and fluoropyrimidines.
Dr. Sanjeev Goel
Chief Medical Officer, Peak Human
Latest Evidence
2023-2025: genetic testing moves from information to intervention
The strongest new signal is in pharmacogenomics. The randomized PREPARE trial (6,944 patients across seven European countries) tested a pre-emptive 12-gene pharmacogenomic panel against standard prescribing. Genotype-guided prescribing cut clinically relevant adverse drug reactions by about 30% — from 28% of patients to 21% (odds ratio 0.70, 95% CI 0.54-0.91) — across common medicines including clopidogrel, codeine, SSRIs, and statins. This is the first large randomized evidence that knowing a patient's drug-metabolism genotype before prescribing measurably reduces harm.
Risk prediction is maturing too. A 2025 multi-ancestry polygenic risk score (npj Cardiovascular Health, validated in more than 150,000 people) reclassified 7-11% of adults at borderline or intermediate clinical risk into a high-risk group whose 10-year coronary-artery-disease risk was 3.2-3.8 times higher than their peers'. And for cognitive-aging planning, Fortea and colleagues (Nature Medicine 2024) showed that APOE4 homozygotes have near-complete biological penetrance for Alzheimer's pathology, with biomarker changes emerging around age 55 and 75% showing amyloid-positive scans by 65 — reframing this genotype as a distinct, highly predictable form of the disease and strengthening the case for early, personalized prevention.
These are summaries of published research, not treatment claims or guarantees. Genetic and genomic testing carries psychological, interpretive, and privacy considerations; polygenic scores are still evolving and perform differently across ancestries. Educational information, not medical advice — discuss testing and results with a qualified clinician, ideally with genetic counseling for significant findings.
PREPARE Randomized Trial
Pharmacogenomic testing cut adverse drug reactions ~30%
Clinically relevant adverse drug reactions (% of patients)
PREPARE trial — Swen et al., Lancet 2023 (n=6,944; odds ratio 0.70, 95% CI 0.54-0.91).
Related on Peak Human
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Optimization at Peak Human
Turn test results into a biomarker-tracked prevention plan.
Apolipoprotein Testing
Pairs with APOE genotype for cardiovascular risk.
Plasma p-Tau217 Testing
A blood marker that complements APOE for Alzheimer's risk.
Comprehensive Blood Panel
The broader baseline most testing plans start from.
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An evidence review of biological-age testing in two randomized trials.
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Key references: A 12-gene pharmacogenetic panel to prevent adverse drug reactions (PREPARE trial) — The Lancet (2023) · Polygenic risk scores improve CAD risk prediction in borderline and intermediate clinical risk — npj Cardiovascular Health (2025) · APOE4 homozygosity represents a distinct genetic form of Alzheimer's disease — Nature Medicine (2024)
Cost & Access
Cost Range
$$
Accessibility
Availability varies by location
Sample member
Longevity Operator
One number for your longevity journey.
FICO for credit. PHS for longevity. Eight biological domains collapsed into one provable score — intuitive at a glance, rigorous underneath.
- Metabolic
- Hormonal
- Cardiovascular
- Brain / Cognitive
- Sleep
- Musculoskeletal
- Gut
- Immunity / Inflammation