Three telomere testing myths to watch out for

Signposts for myths and facts, in this case relating to telomere length testing

As a relatively new and constantly advancing science, telomere biology is not yet fully understood. This is an exciting time for research in the field, with many opportunities for new discoveries. Although, in the meantime, with the lack of knowledge comes the risk of misunderstandings and myths around telomere length testing.

Myth #1. Telomere length measurements can tell you how long you’ll live…

The relatively new field of telomere length testing has been constantly evolving, resulting in increasingly accurate and sensitive testing procedures. While these advances have enabled reliable measurements of telomere length, the interpretation of these results in the context of aging and longevity is under-developed.

Scientific discoveries in this field are helping to increase knowledge about the aging process and population-based studies are revealing associations with some health risk factors. However, it is not as simple as boosting telomerase to halt aging!

Despite this, there is a crowded market offering longevity information based on telomere length measurements. Some solutions are being specifically marketed to improve individual results. There is a lack of robust scientific evidence in this area, so results in the context of aging should be approached with caution.

What telomere testing can tell you:

With Flow FISH telomere length analysis, an individual’s median telomere length (across six cell subtypes) is matched to others of the same age. This result can then be categorized on a scale from very low (<1st percentile) to very high (≥99th percentile) for that specific age group.

These results are used by physicians to support the diagnosis of Telomere Biology Disorders, for example dyskeratosis congenita and idiopathic pulmonary fibrosis. There are established clinical guidelines (as well as ongoing research) that enable the accurate interpretation of telomere length results in this context.

To note, RepeatDx does not offer direct-to-consumer testing and requires a physician’s signature in order to perform telomere length analysis. You can find out more about the Flow FISH process in a separate blog.

Myth #2: Telomere length testing is too expensive…

Many medical diagnostic tests can be considered expensive. Especially when you think of particularly challenging cases (such as rare genetic diseases), that may require a number of highly specialized tests.

Physicians need access to accurate test information regarding the patient’s condition, in order to make a conclusive diagnosis. An accurate diagnosis for an individual (and their family), is an essential step in order to guide treatment decisions. In addition, it can provide the psychological benefit of identifying their condition for better understanding, improved self-care, and enabling valuable connections with peer and support groups.

While cost is undeniably an important factor in medical care, whether on the part of an individual, hospital or government health service, it cannot be considered in a vacuum. When considering options for diagnostic testing, context is very important.

For example:

When considering the cost of telomere length testing it should be weighed against the cost (and turn around time) of genetic testing – as a comparable technology used for diagnosis. The cost of a Flow FISH telomere test, for example, is less than genetic testing and it has a faster turn around time.

Another factor to consider is that telomere testing (and similarly genetic testing) typically only need to be performed once, whereas other tests may be required to be conducted at regular intervals. Therefore, you may be comparing a one-off cost to a repeated expense.

Other considerations could also include the technical requirements and accuracy of different tests and the invasiveness of different options.

Myth #3: Longer telomeres and more telomerase must be better for you…

It may seem logical to think that having longer telomeres would be beneficial, as our cells would be able to live longer and wouldn’t be at risk of premature cellular aging (senescence).

Increasing telomerase, the enzyme involved in telomere maintenance, has been investigated as a potential option for improving longevity. However, it is not that simple.

While having short telomeres can have negative implications in the form of Telomere Biology Disorders, the opposite is not necessarily a healthier alternative.

The built-in mechanism prompting cells to stop dividing is designed to be protective. Excessive and uncontrollable cell proliferation is one of the mechanisms by which cancer can develop.

Studies have found links between mutations that cause long telomeres and malignant tumor development – in particular with melanoma and glioma.

So, the best case scenario?

Telomeres can be too short, or too long, and you can have too much or too little telomerase. It is an example of the Goldilocks principle – the middle ground is the optimum for health.

You can find out more about telomere testing and how it can be an important diagnostic and treatment guidance tool here.

Sources
Gutierrez-Rodrigues, F. et al. (2014). Direct Comparison of Flow-FISH and qPCR as Diagnostic Tests for Telomere Length Measurement in Humans. PLoS ONE. 9(11): e113747. doi:10.1371/journal.pone.0113747.
Kuo, C‐L. et al. (2019). Telomere length and aging‐related outcomes in humans: A Mendelian randomization study in 261,000 older participants. Aging Cell. 00:e13017. https://doi.org/10.1111/acel.13017.
Savage, S. & Cook, E. Dyskeratosis Congenita and Telomere Biology Disorders: Diagnosis and Management Guidelines. (First ed.) 2015. Accessed at: https://teamtelomere.org/wp-content/uploads/2018/07/DC-TBD-Diagnosis-And-Management-Guidelines.pdf
Stanley, S. E., & Armanios, M. (2015). The short and long telomere syndromes: paired paradigms for molecular medicine. Current Opinion in Genetics & Development. 33, 1–9. doi:10.1016/j.gde.2015.06.004.