After the Genetic Test... Then What? Why Your Genes May Explain Your Risk...But They Don't Have the Final Word

By Dustin Strong, CHN, ACN

A few days ago, I was hiking with one of my dearest friends.

As is often the case when we're together, I listened far more than I spoke. ;) (you know who you are)

She shared that several members of her family have a rare inherited condition called Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC)—also known as Reed syndrome.

It's caused by mutations in the FH (fumarate hydratase) gene and can increase the likelihood of developing multiple uterine fibroids, skin leiomyomas, and, in some families, kidney cancer.

She told me she wanted to pursue genetic testing.

As she spoke, my mind immediately began connecting dots. I wanted to share research. I wanted to draw diagrams. I wanted to reassure her that biology is wonderfully complex and that there are many aspects of health still within our influence.

But I didn't.

Not because I didn't care.

Because I did.

One of the greatest lessons I've learned is that help is most powerful when it is invited.

My friend Tony once taught me something I've never forgotten. When someone shares a struggle, don't immediately solve it. First say,

"That sounds hard."

Then ask,

"What do you think you should do about it?"

Those two simple sentences create something remarkable.

They communicate respect before advice.

They preserve dignity before direction.

In this conversation, we never even reached that second question. She had much more she wanted to share, and she had already decided that genetic testing was the next step.

I left that hike thinking about what comes afterward.

Because I believe that's the question so many people are asking.

After the Genetic Test... Then What?

Whether the report identifies a mutation in FH, MED12, or another gene associated with fibroids, many people are left wondering:

"Does this mean my future has already been written?"

I don't believe it does.

Genes matter.

They absolutely matter.

They help explain why one person may be more susceptible than another.

But genes are only one chapter of the story.

As our understanding of nutrition, metabolism, and molecular biology continues to grow, we're discovering that the environment surrounding our genes influences how they are expressed.

I often explain it this way:

Genes may load the gun. The environment often determines whether the trigger is pulled.

That doesn't mean nutrition can erase a genetic mutation.

It can't....to our current knowledge.

It doesn't mean we should ignore genetics.

We shouldn't.

It means that after we understand our genetic predisposition, our attention naturally turns toward the many biological systems we can influence.

That question inspired the checklist below.

Not because it promises a cure.

Not because every item applies equally to every person.

But because it shifts the conversation from fear toward possibility.

The Integrative Fibroid Support Checklist

Rather than asking only, "Which gene do I have?" I believe we should also ask:

Genetic Predisposition

• MED12 mutations

• HMGA2

• FH (when appropriate)

• Family history

Why? We can't change our genes, but understanding them helps us identify where we may need additional support.

Hormonal Environment

• Estrogen metabolism

• Progesterone signaling

• Thyroid function

• Iodine status

Why? Fibroids are highly responsive to hormones. Supporting healthy hormone metabolism may help reduce signals that encourage growth.

Cellular Communication

• Vitamin D

• Inositol

• Magnesium

Why? These nutrients help regulate how cells communicate, grow, and respond to hormonal and metabolic signals.

Metabolic Health

• Insulin resistance

• Omega-3 Index

• Body composition

Why? Healthy metabolism influences inflammation, hormone balance, and cellular growth pathways.

Tissue Remodeling

• Vitamin D

• Vitamin C

• Copper

• Silica

• Glycine

Why? Fibroids contain large amounts of collagen and connective tissue. These nutrients support healthy tissue maintenance and remodeling.

Detoxification & Elimination

• Liver function

• Gut microbiome

• Estrogen recycling (the estrobolome)

Why? Supporting normal hormone metabolism and elimination helps maintain hormonal balance.

Oxidative Stress & Inflammation

• Vitamin D

• Antioxidant status

• Polyphenol-rich diet

• Sleep

• Physical activity

Why? Chronic inflammation and oxidative stress create an environment that favors abnormal tissue growth. Reducing those influences supports the body's natural repair systems.

The Bigger Picture

This checklist isn't intended to replace medical care.

It isn't meant to suggest that every fibroid can be prevented or reversed through nutrition alone.

Instead, it reflects a philosophy that has shaped my work for many years.

Healing is rarely about finding one missing answer.

It's about improving the environment in which healing takes place.

Sometimes genetics explains why we are more vulnerable.

Nutrition helps determine how we respond.

Lifestyle influences what happens next.

That perspective has brought hope to countless people I've had the privilege of working with.

My hope is that it brings hope to my friend as well.

If she decides to pursue genetic testing, I genuinely hope it provides useful information.

But I also hope she remembers this:

A genetic result is not the end of the story.

It's often the beginning of a much more meaningful conversation.

One that asks not only,

"What genes did I inherit?"

but also,

"What can I do today to create the healthiest possible environment for those genes to exist within?"

I believe that question is where hope begins.