NOVEMBER 2015 ON HEALTH CONSUMER REPORTS 11 ConsumerReports.org/health KATIE EDWARDS/GETTY IMAGES A fewyearsago,a21-year-oldcollege student came to my office because of intermittent pain in his right ankle. He’d had a ski accident 10 months earlier, but the discomfort lingered, and after a Lyme disease test came back nega- tive, his primary care doctor referred him to me to investigate the possibility of nerve damage. He had also been expe- riencing increasingly frequent pain and numbness in his hands for several years— and the cause was unknown. I found no nerve damage. It was not until I asked about family health prob- lems that I determined the possible cause of his concerns. My patient’s mother and maternal grandmother had rheumatoid arthritis (RA), an autoimmune disorder that tends to attack the joints. Having a parent, sibling, or child with RA is one of the strongest risk factors for the disorder. His RA test came back positive, which also put him at higher risk for other auto­ immune diseases, as well as heart attack and stroke. So knowing a bit about the patient’s family’s health history allowed me to glean a great deal of information about his current health and future risks. In order to get a better picture of your own risks, put together a family history, a record of health data about several generations of relatives. A history will help you gain insight into your likelihood of developing specific conditions. It can also provide your doctors with clues they may need to reach a diagnosis. There is no better time to gather that information than at family get-togethers. So as the holiday season approaches, start the conversation. CHOOSE YOUR TOOL You can simply write down your family’s information, but some digital tools make it much easier to build, update, and share: àThe National Society of Genetic Coun- selors’ page (nsgc.org/p/cm/ld/fid=143) The Proactive Patient shows you how to draw a family tree. àThe March of Dimes’ form (marchof dimes.org/materials/family-health-history- form.pdf) considers lifestyle as well as family history. àThe Office of the Surgeon General’s My Family Health Portrait (familyhistory. hhs.gov) allows you to enter, print, and update your family health history. GET THE RIGHT INFORMATION Make a list of relatives to talk with. In- clude parents, siblings, children, aunts and uncles, cousins, nieces and nephews, and grandparents. Ask them about cur- rent and past medical and mental health conditions, and their ages at diagnosis. Pay special attention to conditions that developed much earlier than typical or affectedmultiplefamilymembers.Include pregnancy complications such as miscar- riage and stillbirth, and birth defects. Ask about deceased family members’ cause of death, other health problems, and age at death. Ethnicity is important, because some diseases are more common in certain groups. Sickle cell anemia, for example, is more likely to occur in those of African, African- American, or Mediterranean heritage. TALK WITH YOUR DOCTOR Share the history with relatives and your primary care doctor, who may use the information to assess your risk of cer- tain conditions and recommend lifestyle changes. If you have a strong family his- tory of heart disease, for example, he may suggest a healthy diet and exercise pro- gram or encourage you to stop smoking. Doctors may also use the history to identify other family members’ risks, choose diagnostic and genetic tests, put together a treatment plan, or change in- tervals for screening tests. The U.S. Pre- ventive Services Task Force, for instance, notes that women with a parent, sibling, or child with breast cancer may ben- efit more than average-risk women from starting screenings between 40 and 49, rather than at age 50. Without some background on your family’s health, your doctor really is at a disadvantage. In fact, I was startled to learn several years ago that my brother and his son had an autoimmune disease called ankylosing spondylitis. Each went undiagnosed for years by physicians who had not tied together their individual complaints of joint pain. A family history could have meant an earlier diagnosis. Orly Avitzur, M.D., M.B.A., is Consumer Reports’ medical director. Board certified in neurology, she is a fellow of the American Academy of Neurology, a clinical instructor at the Yale University School of Medicine, and a medical consultant to the New York Rangers hockey team. Orly Avitzur M.D., M.B.A. Why Family History Matters An open chat with relatives at the holiday dinner table can be a powerful way to improve your health To get a better picture of your risks, gather health information about several generations of relatives.