Hacking hemochromatosis: how to get your HFE gene status via 23andMe (C282Y, H63D, and S65C)

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UPDATE! August, 2017: The 23andMe service has resumed provision of HFE status as part of its normal service, which makes the following "hack" unnecessary. For more details, see this 23andMe article.) 

If you already know about hereditary hemochromatosis and you want to find your genetic HFE status, you can skip to section 2 for the link to download our document that shows how to use raw 23andMe DNA data to check your HFE for C282Y, H36D, and S65C. If you are new to hemochromatosis, start with section 1.

1. About hereditary hemochromatosis

Sometimes referred to as HHC or simply HH, hereditary hemochromatosis is a genetic condition in which your body accumulates iron in joints and organs (also called genetic haemochromatosis in some countries and nicknamed bronze diabetes and Celtic Curse).

If untreated, HH can lead to iron overload which causes cirrhosis of the liver, diabetes, heart disease, endocrine problems, depression, impotence, and joint pain and eventual replacement. However, if detected early enough, which sometimes happens due to above normal readings on a set of tests called an iron panel, the effects of hemochromatosis can be kept at bay through supervised blood donation referred to as phlebotomy.

HH is caused by a mutation of the HFE gene that regulates the body's iron absorption and it is the most common genetic killer in America. Roughly 1 in 10 Americans with carries at least one copy of an HFE gene mutation that may be passed on to their children. About 1 in 200 Americans have two copies of the mutation, putting them at risk of developing iron overload. Knowing your HFE status can help prevent damage from iron overload.

2. Using 23andMe to determine HFE status

I have produced a PDF document titled Using 23andMe to determine HFE status in which I describe how to use the $99 genetic testing service called 23andMe to determine your HFE status, in other words, whether or not you are at risk, or a carrier, or completely clear. You can do this despite the restrictions placed on the 23andMe service by the FDA in November of 2013.

Thankfully, 23andMe is still entirely legal* and it only costs $99 to get the genetic data you need to assess your HFE status plus a lot of other information. Of course, 23andMe is not the only way to get the genetic test for HH. You can order an HFE test here, but it is $195 and only tests HFE. With 23andMe you get access to a lot more data, including deep ancestry links.

You may  be able to persuade your doctor to order the test for you, but ironically, some doctors seem loathe to approve this test. This is particularly problematic when it comes to testing family members who might be at risk. Fortunately, if you know where to look, 23andMe reports data for three of the most common HH-causing mutations in the HFE gene, for only $99. Download the PDF document Using 23andMe to determine HFE status to learn how to find this data.

Disclaimer: This document is not an official publication of 23andMe and 23andMe had no part in preparation or dissemination of this document. This document was prepared by Stephen Cobb who is a customer of 23andMe but otherwise unrelated to 23andMe. This document is for informational use only and should not be used as a basis for medical diagnosis or treatment. Stephen Cobb is not a medical doctor. Consult your doctor for more information about hemochromatosis (and switch to a different doctor if you don’t get a satisfactory response).

* The only legal obstacle to 23andMe that I am aware of is the state of New York's ban on mailing a DNA sample in that state. (Until the good folk of New York state vote out the politicians whose views on this topic have been overly influenced by campaign contributions from the medical community, I suggest simply driving across state lines to mail your sample...that's what I did when I got the 23andMe test kit while living in New York, and I would welcome a chance to defend my actions in court...I know of no cases in which the law has been enforced...but it would be fun to demonstrate how absurd and protectionist it is.)

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