*Source: https://www.years.co/en/medizinische-genetik-berlin* Berlin-Charlottenburg · Part of Ultimate # What your genes say and what follows from it. More than 170 risk genes via whole exome and whole genome sequencing, physician-ordered and with genetic counselling under German law. Not a percentage in a PDF, but a finding placed between your laboratory values, imaging and family history. - 170+ risk genes - Whole exome & whole genome - Genetic counselling required by law - Right not to know Book Ultimate Free intro call 170+ genes clinically curated, not chip-limited Physician-ordered counselling before and after Once, for life your genome does not change Overview ## Medical genetics at YEARS at a glance Medical genetics examines your germline, the hereditary information you were born with, which does not change across your life. At YEARS this is done using whole exome sequencing for the protein-coding regions and whole genome sequencing for the entire genome, evaluated across more than 170 clinically relevant risk genes. Unlike consumer tests, which use genotyping arrays to check a set of pre-selected positions, sequencing also makes rare variants visible. The analysis is part of the Ultimate program in Berlin-Charlottenburg and is interpreted by a physician alongside more than 230 biomarkers, whole-body MRI, liquid biopsy and epigenetic clocks. Predictive testing such as BRCA1/2 or ApoE follows the German Genetic Diagnostics Act: physician-ordered, with genetic counselling before and after the test, and with your right not to know applying to each individual category of findings. Key facts Method Whole exome sequencing and whole genome sequencing Scope More than 170 clinically relevant risk genes Sample Blood, drawn on your diagnostic day Legal framework German Genetic Diagnostics Act, counselling per §10 Included in YEARS Ultimate Location Joachimsthaler Straße 34, Berlin-Charlottenburg Medical genetics ## The findings that actually change something Not every genetic result changes a decision. These five do, which is why they sit at the centre. - BRCA1 · BRCA2 · PALB2 ### Hereditary breast and ovarian cancer risk Pathogenic variants raise cumulative breast cancer risk to roughly 60 to 70 percent by age 80. Concrete steps follow: intensified MRI surveillance from a considerably younger age, the option of risk-reducing surgery, and relevance for treatment selection in the event of disease. - MLH1 · MSH2 · MSH6 · PMS2 ### Lynch syndrome The most common hereditary cause of colorectal and endometrial cancer. The finding immediately changes the surveillance interval: colonoscopy every one to two years instead of every ten, starting well before the usual screening age. - LDLR · APOB · PCSK9 ### Familial hypercholesterolaemia Affects roughly one in 250 people and remains largely undiagnosed. Lifelong elevated LDL means advanced heart attack risk, but responds very well to statins and PCSK9 inhibitors. The earlier treatment starts, the greater the benefit. - APOE ### Alzheimer risk profile ApoE4 is the strongest known genetic risk factor for late-onset Alzheimer’s, but neither necessary nor sufficient, and no risk-lowering therapy exists. The status is clinically relevant above all before amyloid antibody treatment: homozygotes carry a markedly higher ARIA risk. - CYP2C19 · CYP2D6 · SLCO1B1 · DPYD · TPMT ### Pharmacogenetics The part with the most immediate benefit, because international dosing guidelines exist. Whether clopidogrel works for you, how high your risk of statin-associated muscle symptoms is, and which chemotherapies are safety-relevant for you. Obtained once, valid for life. Berlin · Near Kurfürstendamm A genotype is a probability, not a diagnosis. Interpretation is what makes the difference. Legal framework ## Why this is not a home test In Germany, predictive genetic testing is a medical service. That is not an obstacle, it is the difference. - ### Physician-ordered The Genetic Diagnostics Act permits predictive genetic testing only when ordered by a physician. No mail-order kit, no self-referral, but a clinical indication that checks whether the test answers anything at all in your situation. - ### Counselling before and after §10 of the Act requires genetic counselling both before the test and once the result is available. Beforehand we establish what a finding would mean for you; afterwards, what follows from it. - ### Right not to know You decide in writing and in advance which categories of findings you want to be told about. You can change that decision at any time, including after the blood draw and selectively for individual areas. An ApoE status you do not want to know is not disclosed to you. - ### Findings concern more than you A pathogenic germline variant is information about your family. Counselling therefore covers how you talk about it with siblings, children or parents, and what cascade testing would make sense for them. Method ## Array, exome or genome? The difference determines what can be found at all. An array only finds what the chip looks for. | Consumer array | YEARS: WES + WGS | Principle | Checks pre-selected positions | Sequences and reads the base sequence | Rare variants | Fundamentally not detectable | Detectable | Coverage | A few hundred thousand positions | All coding regions plus whole genome | Risk genes evaluated | Usually not disclosed | More than 170, clinically curated | Result | PDF with percentages | Medical report with counselling | Legal framework | Often outside the Act | Physician-ordered under the Act | Price | Around €100 to €300 | Part of Ultimate from €16,900 | If you want to clarify a single, already known family variant, a clinical genetics centre is the more appropriate and cheaper route, often with statutory insurance coverage where family history is documented. We will tell you that openly in the intro call. We have written up the methods and their limits in detail, one page per question: - → Genetic analysis — panel, array, exome and genome explained - → Whole genome sequencing: coverage, report structure, limits - → WGS or WES — the feature comparison with four decision cases - → Genetic risk factors: which findings carry a consequence - → Genetic health check: why a genetic finding needs measured values Lifestyle genetics ## Where we are deliberately cautious COMT, MTHFR and relatives are marketed as a basis for action. They are not. These variants come from association studies. The effect of any single variant is usually small and heavily context-dependent, and a genotype does not replace a measurement. We capture them as part of sequencing but treat them as context, not as a basis for recommendations. The more dependable route is the reverse: measure the metabolic state directly. Variant | What the market promises | What we do instead | MTHFR | Individual folate requirement, impaired detoxification | The ACMG explicitly recommends against testing. We measure homocysteine, folate and B12 directly. Abnormal values get treated, regardless of genotype. | COMT | Stress resilience, dopamine type, personality profile | Small effect, no clinical instruction for action. We measure the diurnal cortisol profile and HRV, because that reflects the actual state. | CYP1A2 | Optimal caffeine dose and timing | Plausible for metabolism, barely actionable in practice. Your sleep profile and blood pressure say more about your caffeine tolerance than the genotype. | ACTN3 · ACE | Power or endurance type, training recommendation | Not dependable for individual training prescription. Cardiopulmonary exercise testing with directly measured VO2max is far more informative. | If you are looking for a clinic that derives a nutrition plan from COMT and MTHFR, we are the wrong address. We consider that unproven, and we would rather write it here than explain it to you afterwards. FAQ ## Frequently asked questions about genetic testing How does medical genetics differ from a direct-to-consumer gene test? + The difference lies in method, scope and interpretation. Consumer tests usually rely on genotyping arrays: they check a few hundred thousand pre-selected positions and only find what the chip looks for. We sequence instead, using whole exome sequencing for the protein-coding regions and whole genome sequencing for the entire genome, and evaluate more than 170 clinically relevant risk genes. This makes rare variants visible that an array fundamentally cannot capture. The second difference is legal: in Germany, predictive genetic testing is a medical service governed by the Genetic Diagnostics Act. You receive findings and counselling from a physician, not a PDF full of percentages. Do I need medical counselling for a genetic test? + For predictive testing, yes, and it is mandatory. The German Genetic Diagnostics Act permits predictive genetic testing only when ordered by a physician, and §10 requires genetic counselling both before the test and once the result is available. This is not a formality: with BRCA1/2 or ApoE4, the counselling determines whether the result is usable for you at all. It also covers your right not to know, which you can exercise at any time, including after the blood draw and for individual categories of findings. Before sequencing we establish in writing which categories of results you want to be told about and which you do not. When does BRCA1/2 testing make sense? + Pathogenic variants in BRCA1 or BRCA2 substantially raise the risk of breast and ovarian cancer, for breast cancer to roughly 60 to 70 percent cumulatively by age 80. The decisive point is that concrete consequences follow: intensified surveillance with MRI from a considerably younger age, the option of risk-reducing surgery and, in the event of disease, relevance for treatment selection. Testing is particularly warranted with a family history, meaning breast or ovarian cancer in close relatives, early age at onset or male breast cancer in the family. Without a family history the predictive value is lower, but a finding remains actionable. Counselling under the Genetic Diagnostics Act clarifies whether the test makes sense in your situation. Should I know my ApoE status? + That is a question to answer before the test, not after. ApoE4 is the strongest known genetic risk factor for late-onset Alzheimer’s disease: one copy raises risk roughly two to threefold, two copies considerably more. But ApoE4 is neither necessary nor sufficient: many carriers never develop the disease, and many patients carry no E4. There is no established therapy that lowers the risk. What has made the status clinically relevant is the new class of amyloid antibodies: ApoE4 homozygotes carry a markedly higher risk of ARIA, meaning treatment-associated brain oedema and microhaemorrhage. Anyone considering such a therapy needs the status. Anyone wanting it out of curiosity should honestly account for the psychological burden. Which genetic finding is most often missed? + Familial hypercholesterolaemia. Variants in LDLR, APOB or PCSK9 cause markedly elevated LDL cholesterol from birth and therefore substantially advanced cardiovascular risk. It affects roughly one in 250 people, making it more common than most inherited conditions, and it remains largely undiagnosed. That is precisely what makes it the most interesting finding from sequencing: it is common, it responds very well to statins and PCSK9 inhibitors, and the earlier treatment starts the greater the benefit gained. A high LDL in the lab is the first clue; genetic confirmation establishes whether this is a lifelong burden or an acquired shift. What does pharmacogenetics actually deliver? + Pharmacogenetics is the part of genetics with the clearest and most immediate benefit, because international dosing guidelines exist for the most important gene-drug pairs, for instance from CPIC. Practical examples: CYP2C19 determines whether clopidogrel works for you at all. SLCO1B1 says something about your risk of muscle symptoms on statins. DPYD and TPMT are safety-relevant before certain chemotherapies, because a variant can trigger severe toxicity. CYP2D6 affects numerous antidepressants and analgesics. The finding is obtained once and remains valid for life. It benefits you above all when you have it to hand at the point of treatment, which is why you receive it in a shareable format. How reliable is lifestyle genetics such as COMT or MTHFR? + Considerably less reliable than the market suggests, and we say so plainly. These variants are linked via association studies to traits such as stress reactivity, caffeine metabolism or homocysteine metabolism. The effect of any single variant is usually small and heavily context-dependent. With MTHFR the picture is especially clear: the American College of Medical Genetics explicitly recommends against testing, because no dependable clinical consequences can be derived from it. The more informative route is the reverse: we measure homocysteine, folate and B12 directly in blood. If those values are abnormal, we act, regardless of genotype. At YEARS, lifestyle genetics is interesting context, not a basis for recommendations. What does genetic analysis cost at YEARS? + It is part of YEARS Ultimate from 16,900 euros and is not sold as a standalone service. Ultimate includes more than 230 biomarkers, whole-body MRI, liquid biopsy, microbiome analysis, epigenetic clocks, neurological diagnostics and a dedicated health manager across the year. That is a deliberate decision: a genetic finding without laboratory work, imaging and longitudinal medical follow-up beside it is not, in our view, a service worth selling, because its consequences only emerge in context. If you want to answer one specific question, such as a known BRCA variant in your family, a clinical genetics centre is the more appropriate and cheaper route. With a documented family history, statutory insurance coverage is also possible there. Read more - → Lp(a) Lipoprotein(a): The Genetic Heart Risk Factor Nobody Tests For - → Biological Age Testing: Research-Grade Diagnostics vs. DTC Tests - → Liquid Biopsy for Cancer: Promise vs. Reality - → Silent Diseases: 5 Conditions With No Symptoms Medical Disclaimer This information is provided for general education and is not a substitute for professional medical advice, diagnosis or treatment. Please discuss findings and individual medical decisions with a qualified physician. Content is reviewed periodically against the current state of scientific evidence. Your next step ## Right in Berlin. All in one day. Schedule your free initial consultation — we advise you personally. Reserve your appointment Free Consultation 4,9 (71+ reviews) · 100+ customers per month Location ### YEARS – Preventive Medicine Joachimsthaler Straße 34 10719 Berlin Germany +49 3222 1094101 info@years.co