Genetics as a Starting Point, Not a Life Sentence

Life After Birth sat down with our founder, Natalie Samson, to talk genetic counseling, preconception planning, and what it really means to be proactive about your health. We loved the conversation so much, we wanted to share it here too.

Life After Birth:What led you to become a genetic counselor, and ultimately to founding Golden Genetics?

Natalie: I've always been fascinated by how the human body works on a micro level, and how we can use that information to optimize our health. That led me to study biology in undergrad, and when I took my first genetics course, I was endlessly fascinated. When I found out about genetic counseling as a profession, I was so excited because it brought together two things I loved: science and psychology, and working directly with people.

As I continued my education through my master's program, I loved seeing how genetics could help us find answers, understand risk, and be more proactive about our health. But I also found myself wanting to look at health from more of a whole-person perspective, not just genetics in isolation. That's ultimately why I started my practice.

Life After Birth: A lot of people don't encounter genetic counseling until something has already gone wrong, or they're referred by a doctor. What do you wish more people knew about when genetic counseling can be helpful, particularly concerning preconception and family planning?

Natalie: This is actually one of the reasons I wanted to start my practice. There's so much power in understanding your genes before something happens. I always talk about how genetics can help us optimize four P's: personalized, precise, proactive, and preventative care.

When it comes to preconception specifically, having information beforehand can help couples make informed decisions about family planning and understand whether there's genetic information they may want to consider before pregnancy. We can also look at genetics through a broader health lens and use that information alongside nutrition, lifestyle, medical history, and other factors to support the health of both partners as they prepare for pregnancy.

Life After Birth: Carrier screening can sound intimidating to someone who's never heard of it. Can you explain what carrier screening actually tells us, who might consider doing it, and why learning this information before pregnancy can be valuable?

Natalie: Carrier screening helps us assess whether either parent carries a genetic variant that's usually harmless to them, but that could increase the chance of having a child with a recessive genetic condition if both partners carry a variant in the same gene. There are also some conditions that are inherited differently, so part of our job is helping people understand what their specific results actually mean.

This information can be really helpful to know before trying to conceive, because it gives time and options. Depending on the results, it may affect family planning decisions, pregnancy management, or sometimes even provide relevant information about a person's own health or fertility. Most people who are planning a pregnancy can consider carrier screening. We always talk with our patients before ordering testing so they understand what the test can and cannot tell them, and can decide what feels right for them.

Life After Birth:Genetics can sometimes feel like a source of anxiety, especially when we're talking about fertility, pregnancy, or the health of a future child. How do you help patients process the emotional side of receiving genetic information?

Natalie: This is such an important part of genetic counseling. Our job isn't just to give someone genetic information it's also to help them process that information, however that looks emotionally for them.

At Golden Genetics, we spend a lot of time with our patients. Our appointments are typically an hour long, so there's time to talk through the information, ask questions, discuss concerns, and follow up afterward when needed. Genetic information can feel overwhelming, especially when it involves your health or the health of a future child, so our goal is for patients to leave their appointments feeling informed, supported, and more confident about what their next steps might look like.

Life After Birth:You often talk about genetics as a starting point rather than a life sentence. What does that philosophy mean to you, and how can genetic information help someone feel more informed and proactive about their health, rather than fearful about what might happen?

Natalie: Many patients come in worried that their genetic information is going to give them a diagnosis or tell them they're doomed, but that's usually not the case. Genetic testing can absolutely be used for diagnostic purposes, but depending on the type of testing, it can also help us understand the chance of developing disease, or how certain systems in the body may function, and give us direction for being more personalized.

For example, genetic testing may tell us that someone has an increased predisposition to certain cancers. That does not necessarily mean they have a 100% chance of developing cancer. Instead, that information may allow us to start screening earlier and more frequently, and consider other preventative tools like nutrition and lifestyle.

Other types of genetic testing can look at pathways involved in things like inflammation, nutrient metabolism, or histamine processing. That information isn't diagnostic on its own, but when we look at it alongside someone's symptoms, personal history, labs, and lifestyle, it can give us direction. Genetics is information, and the value is in understanding what that information actually means and what we can do with it.

Life After Birth:Golden Genetics takes an integrative approach that brings genetics together with nutrition, lifestyle, and prevention. How do you think about the relationship between our genetic makeup and the things we can actually influence in our everyday lives?

Natalie: Whenever anyone asks me the "is it nature or nurture?" question, I always say it's both, and how much each matters really depends on the gene in question.

Some genetic changes are extremely impactful and can directly cause a condition, which means environmental factors may play less of a role in whether that condition develops, Huntington disease is one example.

But many of the genes we look at fall on a different part of the spectrum. They may increase or decrease risk, or influence how certain systems in our body function, while factors like nutrition, exercise, sleep, stress, exposures, and other aspects of our environment can also play a role in the ultimate outcome. That interaction between our genes and our environment is one of the things I find so fascinating.

Life After Birth:There are so many genetic and DNA tests available now, from clinical testing to direct-to-consumer kits. How can someone know what kind of testing is actually useful for them, and what role does a genetic counselor play in making sure testing is appropriate and meaningful?

Natalie: There are so many tests, and they are definitely not all created equal. A huge part of our role is vetting the tests and laboratories that are out there, so we're recommending and interpreting testing that is appropriate and reputable.

There are a lot of things we look at: Who is behind the company, and do they have appropriate scientific and medical expertise? What is their privacy policy, and what happens to your genetic data? Is the laboratory appropriately certified? What genes and variants are actually being tested, and is there good evidence behind why they're included?

At the end of the day, we have more than 20,000 genes, so simply ordering "a genetic test" isn't necessarily helpful. Choosing the right test, the right genes, and the right laboratory based on the question you're trying to answer is an essential part of genetic testing — and that's one of the biggest roles a genetic counselor can play.

Life After Birth:Family medical history can sometimes feel overwhelming, particularly when someone is trying to understand what might be relevant for their own health or their future children. What family-history information should people pay attention to, and when is it worth bringing those questions to a genetic counselor?

Natalie: When it comes to preconception, family history of things like birth defects, developmental or intellectual disabilities, known genetic conditions, infant or childhood deaths, or multiple miscarriages can all be helpful to discuss with a genetic counselor.

More broadly, we also pay attention to patterns like cancer, heart disease, or dementia occurring at younger-than-expected ages, multiple relatives with the same or related conditions, or several diagnoses occurring on one side of the family.

But I also always remind people that you don't have to know everything about your family's health history before seeing us. We know it can be hard to remember or even have access to all of that information. We send our patients a family-history questionnaire before their appointment, review it together during the session, and work with whatever information they have.

Whether you're planning for pregnancy, trying to make sense of a complicated family history, or simply want a more personalized and proactive approach to your health, Natalie and the team at Golden Genetics are here to help you understand your genetics and what to do with it.

Ready to get started? Schedule a logistics call with our team today.