Your family medical history matters. But what if it's a mystery?

You’ve probably heard this story of the twins separated at birth: identical twins – both adopted as babies and named Jim – were raised separately.

When they reconnected at age 39, they discovered some striking similarities. They smoked the same brand of cigarettes, drove the same type of car, and both prone to nail-biting and tension-headaches.

In the ongoing nature versus nurture debate, these similarities make a strong case for the power of genetics. Past studies on twins have looked at how genes influence everything from mannerisms to interests to IQ, but they’re perhaps most often used to quantify disease risk.

For better or worse, our genetic makeup has a significant influence on our health. Genetic mapping shows how health conditions can be passed down through families.

There are a variety of medical conditions thought to run in families, including Alzheimer’s, diabetes, anxiety and depression, colon cancer, and ovarian cancer.

But genes alone don’t determine how healthy you will be. The probability of developing a health condition – even one you’re predisposed to – may also depend on your environment.

For example, let’s say heart disease runs in your family. It’s likely that your genes put you at a higher risk than someone without a family history of the disease, but lifestyle changes can lower that risk. Even if you have a strong family history of the condition, studies show that people who exercise regularly are less likely to suffer a sudden heart attack or other life-threatening cardiac event.

In other words, having a family history of a particular illness doesn’t mean you’re destined to get it. Your DNA is just one piece of the puzzle, as there are other risk factors.

Still, knowing your family medical history can help you make informed health care choices. According to the American Medical Association, knowing if your close relatives have health problems can help health care providers look for early warning signs of disease and recommend treatments to reduce a patient’s risk.

A family health history can include:

• immediate relatives – this may include mother, father, brothers, sisters, and half-siblings
• extended relatives – maternal and paternal grandparents, great grandparents, aunts, uncles, nieces, and nephews
• known health conditions – includes mental and physical health conditions, age at diagnosis, and known risk factors

For some adoptees – and for people who don’t know or have access to their biological relatives – tracking down a family medical history can be a difficult task.

Donna, a Blue Cross and Blue Shield of North Carolina (Blue Cross NC) employee, has spent years trying to fill in the blanks of her own family health history. Her mother and father met in an orphanage as children, having both lost parents at a young age.

“It’s like putting together a puzzle with most of the pieces missing,” she said. “I only have bits of information about my grandparents. My dad’s mom died when he was five years old, and he always said that it was cancer. But he was only five. He wasn’t sure what kind of cancer.”

Donna tracked down additional information about her family – birth dates, death dates, death certificates – through genealogy websites. Then she searched for her grandmother’s death certificate, which revealed the cause of death as breast cancer.

On the other side of the family, Donna was able to ask relatives what they remembered about her maternal grandparents. From this she learned that her maternal grandmother struggled with mental illness.

It’s not a complete picture, but she has a few key pieces of information. Knowing that depression runs in her family, she’s gone to counseling and is more cognizant of her mental health. And because her dad’s mother died of breast cancer, she doesn’t miss a mammogram.

“It’s been helpful for my doctor to know that I don’t have my full family medical history,” she said. “We pay a lot more attention to the screening schedule and stay up to date on those. I just do what I can to be my healthy best.”

For people like Donna, resources for identifying family health information are limited. The CDC provides family history resources for adults looking to collect their family health history, but it assumes they have access to biological relatives.

If you are adopted, consider reaching out to the adoption agency⁠ or your state’s health and social services agency to learn about how to access medical records. If you know the names of your late relatives, you can also check state and county records, newspapers, and local libraries to search for obituaries.

Beyond that, few avenues exist to gather genetic health information.

Enter at-home DNA tests, which have exploded over the past decade. For some people, these at-home tests offer some of the first insights into their genetic disease risks.

In recent years, the FDA has approved some at-home genetic kits to assess genetic risks for a handful of conditions, including Celiac and Parkinson’s disease. But the FDA also says there are limitations to these direct-to-consumer tests:

• A positive test could cause unnecessary stress and alarm
• A negative test could encourage people to forgo regular screenings and checkups
• People may not understand their results without a doctor’s interpretation
• Not all tests provide useful health information for everyone
• These tests can’t definitively say whether you will develop a condition

The FDA encourages people to discuss their results with a doctor. A negative result doesn’t necessarily mean you won’t develop a certain condition, and a test showing increased risk also doesn’t mean that you will definitely develop that condition. So it’s important to put the results into context with the help of your primary care provider (PCP).

In some situations, your PCP might refer you to a specialist for genetic testing to look for mutations in your DNA.

If you have symptoms of a genetic condition or want to learn more about your risk, talk to your doctor about whether genetic testing is right for you.

Whether you have a complete family health portrait or are just beginning to uncover some information, preventive care can save lives. Preventive care includes screenings, services, and counseling to help prevent illness or disease¹. Everything from your annual flu shot to nutrition counseling falls under this category.

Most of this care will come from your PCP. Choosing a PCP who you trust is key to good overall health. 

Let your doctor know if you have a known family history of certain conditions. If you know you have a family history of certain cancers⁠, the American Cancer Society says your doctor might recommend you start screenings earlier or get them done more frequently.

If you don’t have a full medical history, that’s important information, too. Your doctor can help you identify healthy lifestyle habits to lower your risk of many hereditary diseases.

With Blue Cross NC, you will never be charged extra for preventive care with an in-network doctor. Talk to your health care provider about which preventive care services you should have based on your health and family history. 

Taking advantage of these services can help you stay healthy or identify disease sooner. If you have questions, you can always call the number on the back of your member ID card.