When you were a child, you might have noticed that your parent or grandparent took a medication, but do you know what it was for? You may be aware that your parents see several specialists for their health now, but could you name all the reasons why?
If not, you may want to pick up the phone or pay a visit to start collecting your family health history.
“A lot of health conditions are genetic and can run in families, like diabetes, high blood pressure and cholesterol, and some cancers,” says UNC Health family medicine doctor Rana Alkhaldi, MD. “Knowing the health issues your family members have can help with understanding your own risk factors for certain diseases.”
Dr. Alkhaldi shares tips for starting the conversation and shares what you need to know.
The Basics of Family Health History
Don’t feel as if you have to know a family member’s entire health history at once; it’s OK to start with some basics.
“Any form of cardiovascular disease, including heart attack or stroke, diabetes and cancer, particularly breast, ovarian and colon, are the conditions that make us most concerned about increased risk,” Dr. Alkhaldi says.
Your immediate family is the most relevant because they are closest to you genetically—that’s biological parents, siblings and children, called first-degree relatives.
When you have a first-degree relative with breast cancer, for example, it may change the age at which you have your first mammogram.
You may have some family members eager to tell you every ailment they’ve ever had, while others may be more private.
“It can be helpful to say, ‘I want to be as open with my doctor as I can, and knowing what kinds of issues you’ve had or currently have can help my doctor understand my own health better,’” Dr. Alkhaldi says. “You can explain that it will help your doctor take better care of you.”
The U.S. Surgeon General provides a tool called My Family Health Portrait, where you can input and print a family health history, but you can also just write down what you learn on a piece of paper or note it in your phone. You could make a shareable document so others in the family could benefit, including your own children (once your health concerns are included).
More Questions to Ask About Your Family Health History
Once you’ve gathered the basics from your immediate family members, ask for additional details.
“Knowing at what age someone was diagnosed and how they were treated for something is really helpful,” Dr. Alkhaldi says. “You don’t have to know the names of specific medications, but just knowing that a parent has been on a medication for high cholesterol for many years is useful.”
If your parent was diagnosed with cancer or heart disease in their 70s, that’s important to know, but it’s even more important to know if they were diagnosed at a younger age, such as in their 30s or 40s. That means you could be at higher risk for an early diagnosis yourself.
If your family member is open to a conversation, it can be helpful to ask about factors such as smoking or alcohol use before a diagnosis. While you may still have some genetic risk, you can take steps to reduce those known lifestyle risks.
Then, you can ask about other medical conditions or health experiences. A variety of conditions—from autoimmune disorders to gastrointestinal issues to mental health concerns—have a genetic component.
Ask your mother about gynecologic and obstetric concerns, such as whether she dealt with infertility, recurrent miscarriages or fibroids. Your experience with perimenopause and menopause will likely be similar to your mother’s.
Once you’ve identified issues with first-degree relatives, consider asking about aunts, uncles and grandparents. You generally don’t need to go beyond that—a cousin or niece’s health issue will be less useful to your provider.
As you investigate your grandparents or relatives who are no longer living, you may find family members are less certain of exact diagnoses; you may hear, “He always had stomach problems,” or, “She died suddenly, and they think it was her heart.”
“It never hurts to share that, and some detail is better than none,” Dr. Alkhaldi says. “Your doctor still might be able to glean something from the story.”
Talking to Your Provider About Your Family Health History
The first time you visit a new provider, you’ll be asked about your family history. On visits that follow, be sure to tell your provider about any new developments.
“Family histories are living, breathing things, like your own medical history,” Dr. Alkhaldi says. “If your parent has been diagnosed with colon cancer since the last time I’ve seen you, communicate that—it might change at what age we should start screening you for colon cancer.”
Your provider can help you understand any steps to take if there are gaps you can’t fill in your family medical history, whether that’s due to adoption, lack of contact or death of family members before you could acquire the information.
“We still have standardized screening guidelines for everyone, so if you can’t access your biological family’s information, there’s no reason to stress too much about it,” Dr. Alkhaldi says.
There are private companies that offer genetic testing as a shortcut to understanding hereditary risk for disease, but Dr. Alkhaldi recommends that you talk to your provider before pursuing it on your own.
“Some of those companies give you a lot of information but no way to understand the results,” she says. “A geneticist will be able to do a more thorough assessment, order the appropriate tests and have the tools to interpret your results. If you’re interested, your doctor can refer you to a genetics clinic.”
You might feel some anxiety to learn about conditions that you’re at increased risk for, but remember that family history is just one part of the equation. Your provider can help you understand other steps you can take to prevent disease, such as changing your diet or exercising, and screenings that will help catch disease at its earliest and most treatable stage.
“Hopefully, this information can be empowering rather than stressful,” Dr. Alkhaldi says. “Developing a condition that needs medical care at some point is a natural part of life for all of us, but when your doctor knows about genetic patterns, they can help you stay healthy for as long as possible.”
If you have questions about your risk for medical conditions, talk to your doctor. If you need a doctor, find one near you.